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Toto® Lateral Turning System, with Toto® Touch Control Unit
User Guide
www.frontier-group.co.uk
Page 2
This user guide contains important information on correct usage, handling, cleaning and
decontamination. Please read carefully prior to use.
! IMPORTANT - This indicates a hazardous situation that could result in damage to property if
it is not avoided.
Kit Contents
Before you start please ensure that you have all the necessary components. If any are
absent, or in case of doubt, please contact Frontier Therapeutics Ltd Customer Services on
+44 (0) 1495 235800.
Toto® Touch Lateral Turning System Labelling
65ºc for 10 minutes or
73ºc for 3 minutes
allowed
Do not ironLine dry Refer to user manual
Max user weightBleaching agent
Keep dry
Do not pierce
or cut
Toto Touch Control Unit
• 1x Toto Touch Control Unit.
• 1x Control Unit power lead.
• 1x User guide.
Toto Lateral Turning System Platform
• 1x Platform.
• 1x Platform cover.
• 1x CPR deflation valve and tubing set.
• 1x Pair of air cells with quick
connectors.
CE Compliant Type BF applied part
Disposal: do not dispose of this
product as unsorted domestic
waste. It must be sent to a separate
collection facility for recovery
and recycling.
Toto Touch Control Unit Labelling
Class II equipment
2 3
Caution symbol
1. Starts, stops and pauses the Control Unit.
2. Air Cell side selection.
3. Air Cell inflation time.
4. Air Cell rest time.
5. Alarm mute and interface
lock mode.
6. Service indicator.
7. Interface lock indicator.
1 2 3 4 5 6 7
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Contents Product Specifications
Page 5 Product specifications
Page 6 Intended use
Page 7 Safety
Page 8 Instructions for use
Page 15 Alarms and Alerts
Page 18 Care
Page 20 Cleaning
Toto Lateral Turning System - Standard: Fully customisable
control unit with a 30° degree tilt.
Toto Lateral Turning System - 45: Fully customisable control
unit with a 45° degree tilt.
Toto Lateral Turning System - XL: Fully customisable control
unit, with an extra wide platform suitable for bariatric patients
with 30° degree tilt.
Toto Platform
Product
Standard 18 (40) 190 (419) 745 (29) 1850 (73)
45 18 (40) 190 (419) 745 (29) 1850 (73)
XL
Product
Standard 35 (1.4) 185 (7.3) Quick Release Pull Tag 30
Weight - kg (lbs)
23 (51) 190 (419) 1067 (42) 1850 (73)
Depth (flat position - air cells
empty) mm (Inches)
Maximum User Weight - kg (lbs) Width - mm (Inches) Length - mm (Inches)
Depth (raised position - air cells
inflated) mm (Inches)
CPR Deflation Valve Angle of Tilt (°)
Page 22 Warranty
Page 23 Technical Specification
45 35 (1.4) 223 (9) Quick Release Pull Tag 45
XL
35 (1.4) 271 (11) Quick Release Pull Tag 30
Toto Touch Control Unit
Specifications
Dimensions - Width / Depth / Height - mm (Inches)
Weight - kg (Ibs)
Rated voltage - EU
Rated voltage - USA
Rated input power (VAC)
Protection class
Power cord length - Meters (Feet)
Air output (LPM)
4 5
240 (9.5) x 100 (4) x 200 (8)
2.2 (4.8)
220 - 240VAC, 50/60Hz, 0.3A
110 - 120VAC, 60Hz, 0.3A
20
Class II
5 (16.4)
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Intended Use
Safety
Product Description
Toto is an automated lateral turning system which consists of a Toto Touch Control Unit and a
turning platform with cover.
Designed to assist with patient turning and pressure ulcer prevention plans, the system is based
on inflating alternating air cells within the platform. These turn patients laterally via the mattress
surface to a maximum of either 30 or 45 degrees depending on which version is used.
The digital Control Unit provides customised care with a user determined side selection feature
and accurately timed digital inflation and rest durations. Sophisticated blockage and air leak alarms
help ensure patient safety, as well as an interface lock to avoid unwanted setting changes.
A convenient therapy pause mode enables patient interaction without having to stop therapy and
a service indicator to maintain performance also comes as standard.
The system is compatible with profiling beds and both standard and alternating pressure relieving
equipment. It is also compatible with domestic mattresses, except pocket sprung.
Toto lateral turning system does not replace pressure relieving and redistribution surfaces and is
supplementary to their use.
Indications
Toto lateral turning system is suitable for the prevention of pressure ulcers for the following
patients:
! Warnings and Precautions
Individual patient assessments should be made prior to use and appropriate pressure relieving
devices put in place. Please note the following:
• Caution is advised when using with patients with underlying neurological disorders which may
lead to increased anxiety.
• Unusual body shapes and body postures.
• Other medical devices should be assessed for suitability.
• The Toto lateral turning system should be fully deflated when attempting to leave the bed.
• Ensure that the Toto lateral turning system is discontinued or therapy pause mode is engaged
for feeding times to avoid the risk of spillages.
• During hygiene procedures, please use therapy pause mode.
• When elevating a profiling bed back rest, raise the knee break first.
• Ensure that the surface of the bed frame is clear from debris before placing the Toto lateral
turning system platform, as this can damage the coating of the cover.
• The system should not be used without a mattress.
• Do not strap the mattress to the bed frame as this will prevent Toto lateral turning system from
operating.
• Those identified as being at moderate to high risk of developing pressure ulcers as defined by
commonly used assessment tools.
• Weighing up to 190kg (419lbs).
• Who are unable to change their position without assistance.
• Identified as requiring regular turning and who are non-compliant with manual turning schedules.
Contraindications
• Do not use without a suitable pressure redistribution surface & package of care.
• Do not use with patients with unstable spinal cord injuries or who are undergoing traction.
• Do not use with patients with equilibrium disturbances.
• Not to be used where patients must be supported by wedges or pillows etc.
Intended Care Setting
Toto Lateral turning system is intended to be used in the following care settings:
• Long term or extended care, such as nursing homes and care homes.
• Home care.
• If mattress overlays are being used, these must be securely fastened to the mattress, not the
Toto lateral turning system platform.
• The Toto lateral turning system can be used with positioning systems, bed levers and linen
cradles, if their support frame fits horizontally across the bed. These must be positioned under
the Toto lateral turning system platform.
• Evacuation hammocks must be placed between the Toto lateral turning system platform and
the mattress.
• If using bed sides, check for clearance from the top of the mattress to the bottom of the bed
side (minimum of 185mm) and assess for risk of entrapment.
• If using foot board protectors, assess for compatibility.
• Do not place the Control Unit directly underneath the bed frame if placing on the floor to avoid
lowering the bed onto the Control Unit.
• Do not use if mains power lead or plug is damaged.
• Hospitals.
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Instructions for Use
Platform Installation and Operating Guide
To ensure the system is correctly installed and functions smoothly, please follow this step-by-step
guide.
1. Remove all items from the packaging and inspect for damage.
2. The platform should be placed directly onto the bed frame and underneath the existing mattress.
DO NOT strap or fasten the mattress to the bed frame. (A)
G. Connect the Control Unit to the mains
power via the cable supplied.
Patient Positioning
3. Inspect the platform and cover for any visible signs of damage. (B)
4. Ensure the air cells within the platform are secured in position via the Velcro®.
5. Fit the cover and close zip, ensuring the air cell hoses are fed through the apertures at the foot
end of the cover.
Note: The platform cover should be free to move, allowing each side of the platform unrestricted
room to inflate.
6. Using the quick connectors, connect the air inflation hoses to the air cell hoses - 'Red to Red' ensuring the hoses are not twisted or kinked. (C)
7. Check the CPR deflation valves are securely in place to ensure no air leaks. (D)
8. Using the bed hooks, hang the Control Unit on footboard of the bed. (E)
9. Using the quick connectors, connect the air inflation hoses to the Control Unit - 'Black to Control
Unit' - ensuring the hoses are not twisted or kinked. (F)
10. Connect the Control Unit to the mains power via the cable supplied. (G)
Patients should be positioned along the centre line of the mattress by aligning the patients nose
with the centre point of the head board. Ensure head and shoulders are supported to prevent neck
roll and pivoting at the hips during use.
For patients lying on their side, if they can self-support and they are in the middle of the bed, Toto
lateral turning system can be used.
If patients cannot control their limbs and bed sides are being used, padding or net infills are
recommended.
A. The platform should be placed directly
onto the bed frame and underneath the
existing mattress.
D. Check the CPR deflation valves are
securely in place to ensure no air leaks.
B. Inspect the platform for visible signs of
damage.
E. Using the bed hooks, hang the Control
Unit on footboard of the bed.
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Centre Line
C. Using the quick connectors, connect
the air inflation hoses to the air cell hoses
- 'Red to Red' - ensuring the hoses are
not twisted or kinked.
F. Using the quick connectors, connect
the air inflation hoses to the Control Unit
'Black to Control Unit' - ensuring the
hoses are not twisted or kinked.
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Instructions for Use
Toto Touch Control Unit Operating Guide
Air Cell Inflation Selection
• Press the Air Cell side selection button to scroll through the three available options:
o Left and Right air cell
1. Starts, stops and pauses the Control Unit.
2. Air Cell side selection - Left only, Right only or Both.
3. Air Cell inflation time - Length of time the air cell is inflated; minimum 30 minutes, maximum 240
minutes.
4. Air cell rest time - Length of time the air cells are deflated and the platform is supine; minimum
30 minutes, maximum 240 minutes.
5. Mute and interface lock mode activation.
1
2
3
4
5
o Left air cell only
o Right air cell only
• Note: Refers to patient’s side, as stood at the foot end of the bed.
• A single beep and a lit green LED identifies the selected option.
Turning the Toto Touch Control Unit On
• Press and hold the start / stop button for 3 seconds.
• A single beep will confirm activation and the start / stop green LED will be lit.
• Note the system default setting will automatically be selected.
o Air cell inflation - Both sides
o Air cell inflation time - 120 minutes
o Air cell rest time - 120 minutes
• The pump will engage and the patients left air cell will start to inflate.
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Changing the Air Cell Inflation Time
Therapy Pause Mode
• Press the inflate time button to scroll through the five available options:
o 30 minutes
o 60 minutes
o 120 minutes
o 180 minutes
o 240 minutes
• A single beep and a lit green LED identifies the selected option.
• Note: 120 minutes is the default setting.
The Therapy pause mode temporarily deactivates all Control Unit functions, returning the platform
to a flat position allowing for patient interactions such as feeding and hygiene requirements.
• Press the start / stop button a single beep will confirm activation.
• The start / stop LED will flash when active and all other LED’s will turn o.
• After 10 minutes in Therapy Pause Mode the alarm will sound. To continue in this mode, press
the Alarm mute button to silence.
• The Control Unit will remain in Therapy pause mode for a further 10 mins. The process may be
repeated until no longer required.
• To deactivate, press the start / stop button. A single beep confirms deactivation and the Control
Unit returns to its previously selected settings.
Start / Stop LED will be flashing light shows
control unit is in ‘Therapy Mode’
Changing the Air Cell Rest Time
• Press the Rest Time button to scroll through the five available options:
o 30 minutes
o 60 minutes
o 120 minutes
o 180 minutes
o 240 minutes
• A single beep and a lit green LED identifies the selected option.
• Note: 120 minutes is the default setting.
Interface Lock
The interface lock prevents any unwanted changes to the Control Unit settings.
• Press and hold the Alarm Mute button for four seconds.
• The padlock LED will light amber and a double beep heard, confirming activation.
• When locked, only the Alarm Mute button will remain operational.
• To deactivate, press and hold the Alarm MUTE button for four seconds.
• The padlock LED will turn o and a double beep heard.
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Mute Control Button
Alarms and Alerts
The alarm can be muted for up to 10 minutes while trouble shooting is conducted. After 10 minutes,
if the fault has not been rectified, the alarm will reactivate.
• To mute the alarm, press the Alarm Mute Button this is confirmed with a single Beep.
The Toto Touch Control Unit has five integrated system error indicators
System Error Indicators Indicated by an audible beep and:
Low system pressure
Pressure in the system has fallen below the minimum
operational requirements.
High system pressure
Air flow between the Control Unit and platform is
prevented.
Service interval
Service required default at one-year use.
Power Failure
Power to the Control Unit has been interrupted.
Initialisation Failure
Control unit fails to start.
Five ‘Rest time LEDs’ flashing (when activated).
Five ‘Inflate time LEDs’ flashing (when activated).
Service LED permanently lit amber
(No audible alarm).
Audible beep, no LED lit.
Five ‘Inflate time LEDs’ and Five ‘Rest time LEDs’
flashing (when activated).
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System Error Trouble Shooting Guide
System Error
Indicator
No LEDs lit and no
audible beeps can be
heard.
All five Rest Time
LEDs are flashing, an
audible beep can be
heard. (J - N)
Cause Initial Checks / Trouble Shooting
• Control Unit may not
be attached to a power
source.
• Fuse may need replacing.
1. Check the Control Unit is connected to a mains
power outlet and is switched on.
2. Check the Control Unit is switched on.
3. Switch o, unplug the Control Unit:
- Check the mains plug fuse (3 AMP).
- Check Control Unit fuse (1 AMP).
4. Restart Control Unit.
! If the problem persists, contact Frontier
Therapeutics Ltd Tel. +44 (0) 1495 235800 for
assistance.
! Do open the Control Unit. Opening the unit could
cause personal injury or equipment damage.
• Pressure has fallen below
the minimum operational
requirements.
1. Press the Alarm Mute button.
2. Check the CPR valve is properly closed, ensuring all
sealing connectors are fully pressed in.
3. Check each air cell is securely attached to the
connecting air cell hose.
4. Check all air cells, and hoses for any air leakage.
! If the problem persists, contact Frontier
Therapeutics Ltd Tel. +44 (0) 1495 235800 for
assistance.
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
! If the problem persists, contact Frontier Therapeutics Ltd Tel. +44 (0) 1495 235800 for
assistance. Do not open the Control Unit. Opening the unit could cause personal injury or
equipment damage.
All five Inflate Time
LEDs are flashing, an
audible beep can be
heard. (E - I)
Service LED
permanently lit
Amber. (O)
Interface panel is lit
but unresponsive.
Audible beep, no
LEDs lit.
• Air Flow between the
Control Unit and platform
is obstructed.
1. Press the Alarm Mute button.
2. Check for twists or kinks in the air hoses between
the platform and Control Unit.
3. Resolve and wait for the alarm to reset.
! If the problem persists, contact Frontier
Therapeutics Ltd Tel. +44 (0) 1495 235800 for
assistance.
• Service required. • Indicates the need of periodic maintenance.
Please contact Frontier Therapeutics Customer
Services for support Tel. +44 (0) 1495 235800
! The Control Unit will continue to function even
though the service LED remains lit.
• Interface panel is locked. • Press and hold ALARM MUTE button for 4 seconds.
• Accidental removal of
power cord.
• Reconnect mains power lead cable to Control Unit.
• Check mains power wall switch is turned on.
• Accidental mains wall
power turned o.
• Mains power failure.
CPR Emergency Deflation System
CPR Deflation Valve Open
The Toto lateral turning system features a quick release CPR deflation valve which allows for rapid
deflation for emergency procedures.
The CPR deflation valve can be found on the air hoses between the Toto Touch Control Unit and
the platform, clearly marked with a yellow tab.
In the event of an emergency, firmly pull and release the yellow tab.
To re-inflate the system after the CPR tag has been removed, replace the CPR tag ensuring both
sealing connectors are firmly attached, and restart the Toto Touch Control Unit.
CPR Deflation Valve Closed CPR Deflation Valve Open
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Care
Disposal
Inspection and care of the platform and cover
Inspect the inner and outer surfaces of the cover and zip fasteners regularly for signs of damage.
Damaged covers should be reported to the ward or department manager or relevant healthcare
professional.
Torn covers should be withdrawn from service, and replacements sought.
Regularly inspect the interior and exterior of the platform, ensuring that the hinges and air cells
remain intact.
The labels on the Toto lateral turning system cover, platform and Control Unit have a unique batch
number which should be retained and used in the event of a warranty claim. NEVER remove the
labels.
Regularly check that the platform has not drifted out of position and the hoses are not blocked,
kinked or twisted.
Fitting / Replacing Damaged Air Cells
In the event of puncture or leak, it is possible to replace either or both air cells. Please contact
Frontier Therapeutics Customer Services for replacement parts Tel: +44 (0) 1495 235800.
1. Switch o the Control Unit and disconnect from mains.
2. Disconnect the air hoses to the platform using the quick connectors.
3. Unzip and pull back the cover revealing the platform.
4. Determine the faulty air cell and remove by unfastening the Velcro® straps.
5. Inspect the platform for other signs of damage, including what could have caused air cells to
have become damaged.
6. Using the Velcro® straps, fit the new air cell ensuring it is in-line with the correct section.
! IMPORTANT In order to minimise hazards to health and the environment and ensure that
materials can be recycled, this product should be disposed of at a separate collection facility for
waste electronic equipment. The Wheelie Bin symbol marked on the product is there to remind
you.
Storage Guidance
When not in use, the Toto lateral turning system should be stored in a secure location away from
the public.
It is recommended that the Toto platform is handled by a minimum of two people.
• Do not drag.
• Never store other items on top of the Toto platform.
• Place a protective covering over the platform and do not store directly on the floor.
• Do not store next to radiators or other heating devices.
• Do not allow sharp objects to penetrate the cover.
• Do not store in damp conditions.
• Remove the cover during transportation and storage.
Inspection and Care of the Toto Touch Control Unit
The Toto Touch Control Unit is designed to be reliable and long lasting, with few parts requiring
maintenance.
Air filters should be cleaned at least every 24 months and inspections should be undertaken noting
any visible signs of damage.
In the event of product failure, please contact Frontier Therapeutics for advice and recommendations
on service and repair.
7. Replace the cover ensuring correct orientation and feed air cell hoses through apertures at the
bottom of the cover.
8. Reattach the hoses using the quick connectors - 'Red to Red' - ensuring they are not twisted or
kinked.
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Although there are no requirements for PAT testing, guideline recommendations indicate:
• Class II moveable equipment such as extension leads and portable electrical equipment should
be tested every six months. This is the responsibility of the operator alone.
Please refer to local guidance.
Page 11
Cleaning
Cleaning Air Filters
Toto Lateral Turning System Platform Cover
Keeping a cleaning record is recommended as the product is suitable for re-use.
Light Soiling
! IMPORTANT In the absence of gross contamination or unusual risk, the removal of dirt and
spillages with a neutral detergent and warm water should be sucient. A 0.1% hypochlorite solution
(1,000ppm) may also be used. Ensure that the cover is rinsed with clean water using a single use,
non-abrasive cloth and thoroughly dried. Ensure adequate ventilation.
Heavy Soiling
! IMPORTANT In cases of gross contamination, the Toto lateral turning system platform cover
should be cleaned first with detergent and water and then with a 0.1% hypochlorite solution
(1,000ppm). Rinse well with clean water and wipe down with a single use, non-abrasive cloth and
thoroughly dry. Ensure adequate ventilation.
! IMPORTANT If required, a 1% hypochlorite solution (10,000ppm) and cold water may be applied
for no more than two minutes.
Machine Washing Instructions
1. Switch o the power supply to the Control Unit.
2. Disconnect the power lead and air hoses.
3. Place the Control Unit on a flat surface with its back panel uppermost (place a soft cloth under
the unit to prevent scratches).
4. Carefully remove the air filter cover located on the back panel of the Control Unit (x1).
5. Remove and clean the filter with clean water and allow to fully dry.
6. Refit the air filter cover to the Control Unit.
7. The Control Unit is now ready for re-use.
! IMPORTANT Disinfection may be achieved by laundering at temperatures not exceeding 65ºC
for 10 minutes or 73ºC for three minutes.
1
Protect, Rinse and Dry - BHTA guidance on the care, cleaning and inspection of healthcare
mattresses. (January 2012 - BHTA HM 0112)
1
Drying
To avoid shrinkage, line dry in a clean, indoor environment. Covers must be thoroughly dried
before re-fitting to the Toto platform.
Do not mangle or iron.
Platform, Cabling, Control Unit and Air Hoses
Before cleaning, disconnect from mains power supply.
The platform, cabling, Control Unit and air hoses can be wiped clean with alcohol wipes and/or a
chlorine derivative. Care should be taken when wiping the Control Unit not to allow liquids to enter
through any apertures.
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Warranty
The Toto lateral turning system warranty is valid for one year from time of shipping. If a
defect or fault is discovered, please contact Frontier Therapeutics Ltd Customer Services on
Tel: +44 (0) 1495 235800 or email: info@frontier-group.co.uk immediately.
Frontier Therapeutics Ltd guarantees the equipment is free from defects in material and
workmanship, under normal use and service.
During the warranty period, any product that has become defective due to faulty workmanship or
material will be replaced as deemed appropriate by Frontier Therapeutics Ltd, without charge for
parts or labour. During this time, a loaned Control Unit will be made available if required.
If the product is damaged due to an accident, negligence or misuse, the product warranty will be
forfeited. No unauthorised alterations are permitted. Both warranty and fire retardancy certification
will be null and void if non-Frontier Therapeutics Ltd spares or replacement parts are used.
Technical Specification
Toto Touch Technical Specifications
Power input - Europe AC 220 - 240VAC 50Hz, 0.2A
Power input - USA AC 100 - 120VAC 60Hz, 0.3A
Fuse rating T1AL250V
Compressor SAA-1
Frontier Therapeutics Ltd will not accept responsibility for damage caused by misuse, negligence,
accidental damage nor non-observance of the instruction set out within this document. This
warranty does not aect your statutory rights.
Fire Testing
The Toto lateral turning system platform meets the requirements of ‘The Furniture & Furnishings
(Fire) (Safety) Regulations 1988’. Meeting the requirements of BS 7175: 2008 for medium hazards.
Standards and Regulation
This Active Class II Device complies with the requirements of the MDD 93/42/EEC (as amended).
The Control Unit is tested to EC Directive 2004/108/EEC and EN 55011.
Other Standards
ISO 9001:2015 Quality Management Systems
ISO 13485:2016 Medical Devices - Quality Management Systems
No modification of this equipment is allowed.
Air distributor Timing motor working as rotary valve
Control system Digital control system
Power consumption 14 Watt (typical) / 20 Watt (maximum)
Operation mode Non-continuous
Cycle control Distributor valve supplying air to the inflatable cells
Cycle time Adjustable 30 > 240 minutes
Pressure setting 120mmHg ± 10mmHg
Piping output 2
Max. load on platform 190Kg
Operating environment Air humidity 30% to 70%
Storage/Transportation Environment air humidity 10% to 70%
Classification Class II equipment
22 23
Ambient temperature 10ºC to 40ºC Altitude ≤ 2000m
Ambient temperature -10°C to 60°C Altitude ≤ 2000m
Type B applied part
IP44
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Toto lateral turning system is covered by UK patent no. GB 2449318
Toto lateral turning system is a registered trade mark of Frontier Therapeutics Ltd
© November 2017 Frontier Therapeutics Limited. All rights reserved. GP0133_A50_01
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Frontier Therapeutics Limited
Newbridge Road Industrial Estate,
Blackwood, Caerphilly
NP12 2YN United Kingdom
Tel:
Email:
+44 (0) 1495 235800
info@frontier-group.co.uk
www.frontier-group.co.uk
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