ZOLL CoolGard 3000 Operation Manual

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Operation Manual
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Copyright © 2009 ZOLL Circulation, Inc.. All rights reserved. Printed in U.S.A.
Alsius, CoolGard, CoolGard 3000, Thermogard XP, Cool Line, Fortius, and Icy are trademarks of ZOLL Circulation, Inc.
Mallinckrodt is a registered trademark of Mallinckrodt Inc. Windows is a registered trademark of Microsoft Corporation.
Other products and names listed in this document may be trademarked by their owners and no representation is made by ZOLL Circulation, Inc. as to rights thereto.
U.S. Patents Pending
This product is covered by or for use under one or more of the following U.S. patents. Other U.S. and foreign patents pending:
4,290,428 4,648,384 4,689,041 4,850,969 4,865,581 4,917,667 4,927,412 5,011,468 5,033,998 5,059,167 5,908,407 6,019,783 6,126,684 6,149,670 6,165,207 6,287,326 6,290,717 6,299,599 6,338,727 6,368,304 6,393,320 6,405,080 6,409,747 6,416,533 6,419,643 6,432,124 6,436,130 6,447,474 6,450,990 6,451,045 6,454,792 6,454,793 6,458,150 6,460,544 6,494,903 6,516,224 6,520,933 6,529,775 6,530,945 6,530,946 6,554,797 6,572,640 6,581,403 6,582,398 6,585,692 6,589,271 6,602,243 6,620,131 6,641,602 6,641,603 6,645,233 6,645,234 6,652,565 6,682,551 6,699,268 6,706,060 6,709,448 6,716,188 6,716,236 6,719,724 6,726,653 6,726,710 6,733,517 6,749,585 6,749,625 6,755,851 6,786,916 6,796,995 6,872,222 6,878,156 6,893,419 6,893,454 6,942,644 7,001,418 7,014,651 7,070,612 7,090,792 7,097,657 7,101,388 7,144,407
ZOLL Circulation, Inc. 650 Almanor Avenue Sunnyvale, California 94085 U.S.A.
Telephone: +1-408-541-2140 Facsimile: +1-408-541-1030
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Contents
1. Safety Information
2. Introduction
3. Receiving, Inspection, and Assembly
4. Operation
Overview Alarms & Alerts Your First Case Setup - Variations Ending Treatment Temperature Trend Data Mechanical Components Accessory: HMIA
5. TempTrend CSV Program User’s Guide
6. Alarms and Corrective Actions
7. Troubleshooting
8. Maintenance
9. Warranty and Service
10. Specification
Safety Information
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Safety Information
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Contents
Safety Information 3
Overview 3 Warnings, Cautions, and Notes 3 Definitions of Symbols and Labels Used on the Product and in the Manual 4 General Safety Precautions 5 Shipping and Storage Conditions 6 Ignition of Flammable Anesthetic Mixtures 6 Electrical Hazards 6 Primary Patient Temperature Probe (T1) Failure 7 Configuration Changes 7 Priming the Saline Circuit 7 Air Entry Into the Tubing Circuit 8
Check the Integrity of the Catheter 8
Check the Integrity of the Start-up Kit Tubing 8 Interference 9 Product Label 9
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Safety Information
Overview
Safety is of primary concern to ZOLL Circulation, Inc.. This chapter provides
information on safely using the System. You must read and understand the
information in this chapter before operating the System. Always follow the
warnings, cautions, and notes throughout this document.
If you have questions about the safe or effective use of the System, please
contact the manufacturer.
Warnings, Cautions, and Notes
This document uses the following conventions to indicate important information.
WARNING!
Warnings are accompanied by symbols surrounded by a triangle and are printed in the text in bold italics. Warnings indicate events or conditions that can result in serious injury or death or severe damage to the equipment.
CAUTION!
Cautions are accompanied by symbols surrounded by a triangle and are printed in the text in bold italics. Cautions indicate information for safe operation, proper performance, or avoiding actions that may result in damage to the equipment.
NOTE:
Notes are accompanied by a symbol of the letter “i” surrounded by a circle and are printed in the text in italics. Notes clarify understanding, aid in the proper operation of the product, and prevent problems or errors from occurring.
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Definitions of Symbols and Labels Used on the Product and in the Manual
Symbol Definition Symbol Definition
Attention. Consult accompanying documents.
Electrical warning or electrical caution.
Alternating current.
Protective earth (ground).
Type B applied part. Defibrillator protected.
Type BF applied part. Defibrillator protected.
Fuse.
This symbol designates the connector for the data acquisition cable.
Indicates notes intended to clarify understanding.
Temperature and pressure range.
Do not allow liquids to spill on the product or package.
Humidity range.
Fragile contents.
Top facing up.
Ground equipment.
On.
Off.
Lo
Hi
The low patient
temperature alarm limit.
The high patient
temperature alarm limit.
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General Safety Precautions
WARNING! SYSTEMIC HYPOTHERMIA RISKS.
Systemic hypothermia may cause cardiac arrhythmia, patient shivering, or other system or organ complications. Systemic hypothermia should only be utilized under the supervision of a qualified physician.
When treating a patient with the System, appropriately qualified medical staff
must routinely and closely monitor the patient and must comply with the following
procedures:
Audible and visual alarms generated by the System require the
authorized individual to remain in close proximity to the patient throughout the procedure.
Always verify the function of the System prior to insertion of an Alsius
catheter. In the event of a malfunction, have other means of cooling available.
When combining the use of the System and other adjunctive means
of cooling, ensure that close observation of the patient is maintained.
Do not use the ZOLL System in conjunction with other temperature
maintenance devices that have an automatic temperature controller. Temperature oscillations may occur that are dangerous to the patient.
Performance of installation, operation, or maintenance procedures
other than those described in this manual may create hazards and may cause the manufacturer’s warranty to become void.
Sterile components are designed for a single use only. If
unauthorized disposable components are used, proper operation cannot be guaranteed and harm to the patient may result.
Proper aseptic technique must be used while making all sterile
connections to the System.
Never operate damaged or leaking equipment.  Never operate the equipment without coolant fluid in the coolant well.  Never use pure water, pure propylene glycol, or alcohol as a coolant
fluid.
Never operate the equipment while smoking or in the presence of
open flame.
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Shipping and Storage Conditions
When shipping or storing the System, follow these recommendations:
Temperature range: -20ºC (-4ºF) to 60ºC (140ºF).  Atmospheric pressure range: 50 kPa to 106 kPa.  Do not allow liquids to spill on the System or its packaging.  Humidity range: 10% to 90% noncondensing.  Fragile contents, handle with care.  Always handle and store with the top facing up.
Ignition of Flammable Anesthetic Mixtures
The System is not category AP or APG equipment and must not be used in
environments where flammable anesthetic gas mixtures are present.
Electrical Hazards
This equipment has been tested and found to comply with the EMC limits of the
international standard EN 60601-1-2. These limits are designed to provide
reasonable protection against interference in a typical medical installation. The
equipment can radiate radio frequency energy if not installed in accordance with
the instructions, and may cause harmful interference to other devices in the
vicinity. There is no guarantee that interference will not occur in a particular
installation. Always comply with the following:
To avoid the risk of electrical shock, do not remove any panels of the
product.
Refer servicing to qualified personnel.  Never operate equipment with damaged power line cords.  Refer service and repairs to a qualified technician.
CAUTION! ELECTRIC SHOCK HAZARD.
Electric shock hazard. Always turn off the System and disconnect the power line cord from the source before performing any service or maintenance procedures, or before moving the System.
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Primary Patient Temperature Probe (T1) Failure
The System relies upon the patient temperature reading from a YSI-400 type
thermistor connected to the Primary Patient Temperature Probe (T1). There are
rare failures of this type of thermistor that cannot be detected by the System with
100% reliability. Failure of the T1 can result in either patient hypo- or hyper-
thermia. Death or serious injury to the patient may result. A secondary patient
temperature probe (T2) connection is therefore built into the system. For patient
safety, either use both the T1 and T2 connections or employ the T1 probe with
an independent frequent check of patient core temperature.
WARNING! NEVER CLINICALLY USE A RESISTOR IN PLACE OF THE T1 TEMPERATURE PROBE
ZOLL supplies fixed value resistors and variable resistor test boxes (e.g the TP-400 FOGG Box) for testing, training and demonstration purposes. These can be plugged into the Primary Patient Temperature Probe T1 connection on the front of the System to represent a patient. Never use this device, or other method, to circumvent the normal patient temperature feedback control when the system is connected to the patient. Doing so exposes the patient to the hazards associated with hypo- or hyper- thermia. Death or serious injury may result.
Configuration Changes
CAUTION! CONFIGURATION CHANGES MUST BE CERTIFIED.
Equipment connected to the analog and digital interfaces must be certified to the respective IEC standards (i.e., IEC 950 for data processing equipment and IEC 60601-1 for medical equipment). Furthermore, all configurations shall comply with the system standard IEC 60601-1. Any person who connects additional equipment to the signal input part or the signal output part con­figures a medical system and is therefore responsible that the system com­plies with the requirements of the system standard IEC 60601-1.
Priming the Saline Circuit
WARNING! DO NOT PRIME THE SALINE CIRCUIT WHILE CONNECTED TO A PATIENT
During the priming operation, the air-trap alarm will be disabled. Air present in the saline line may be circulated through the indwelling catheter.
Before priming the circuit or during troubleshooting for possible leak, disconnect the heat exchange catheter, then connect the inflow and outflow luer fittings of the saline circuit together.
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Air Entry Into the Tubing Circuit
Air entry may occur with the failure of any part of the start-up kit, between the
saline bag and the outflow of the pump. In such cases, the integrity of the
catheter prevents air entry into the patient. In the rare event of a second,
simultaneous failure of the catheter, air entry into the patient is possible.
Air entry into the tubing circuit will usually, but not always, be associated with an
air trap alarm that will stop the System. Always investigate air trap alarms. The
cooling circuit is a closed loop–usually air trap alarms indicate a breach
somewhere in this closed loop (occasionally an air trap alarm can be caused by
condensation forming on the air trap exterior). With any air trap alarm, check both
the integrity of the catheter and the start-up kit (see below).
Periodically check the start-up kit for significant air bubbles and re place the kit if
necessary.
WARNING! NEVER CLINICALLY CIRCUMVENT THE AIR TRAP ALARM
ZOLL supplies air trap “dummies” for testing, training and demonstration purposes. These are fluid filled air trap assemblies that are separate from a standard Start-up Kit assembly. Never use this device, or other method, to circumvent the air trap alarm when the system is connected to the patient. Doing so exposes the patient to the hazards associated with air embolism should the catheter fail. Death or serious injury may result.
Check the Integrity of the Catheter
To check the integrity of the catheter, perform these steps in the indicated order:
1. Stop the System.
2. Using aseptic technique, disconnect the tubing from the catheter and properly cap both the catheter and the tubing set.
3. Fill a sterile 10 ml syringe with sterile saline.
4. Connect the syringe to the INFLOW lumen of the catheter and disconnect the outflow cap.
5. Infuse the 10 ml of saline – it should flow out the outflow lumen.
6. Cap the OUTFLOW lumen and pull and hold 5 ml of vacuum for at least 10 seconds. Approximately 4 ml of saline, but not blood, should enter the syringe and you should be able to maintain the vacuum.
7. Ease the vacuum, disconnect the syringe, and recap the INFLOW lumen.
Check the Integrity of the Start-up Kit Tubing
To check the integrity of the start-up kit tubing, perform these steps in the indicated order:
1. Stop the System.
2. Look for obvious leakage.
3. Remove the tubing from the pump and check it for damage. Replace it in the pump if it is undamaged.
4. Inspect the tubing from the pump to the patient for sources of fluid loss:
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Look for damage to the tubing and/or the presence of air inside the
tubing.
Inspect, and tighten if necessary, each Luer fitting (do not use
instruments to tighten the fittings).
5. Inspect the tubing that returns to the pump from the patient.
6. Examine the saline bag to ensure that it has not been accidentally compromised (for example, the spike may have damaged the bag wall).
7. Inspect the tubing from the saline bag to the saline reservoir and the pump.
Interference
If this equipment does cause interference with other devices, which can be determined by turning the equipment off and on, the user is encouraged to try to correct the interference by one or more of the following measures:
Reorient or relocate the receiving device.  Increase the separation between the equipment.  Connect the equipment into an outlet on a circuit different from that
to which the other device(s) is connected.
Product Label
An identifying label is attached to the outside of the System console near the power cord inlet. The label is illustrated in Figure 1-1.
The label provides safety information and identifies the manufacturer, model number, serial number, power requirements, fuse capacity, and m anufacturing date for the System.
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Figure 1-1. Product Label .
Introduction
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Introduction
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Introduction
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Contents
Introduction 3
Use of the System 3
Operating Life 3
Functional Description 3 System Components 4
Controls and Display 4
Display 4 Power Indicators 5 Alarm Indicators 5 Control Buttons 5 Control Knob 6 Serial Interface Connector 6
Recirculating Chiller 6 Temperature Controller 7
Temperature Probe Connectors 7
Pump 7
Prime Switch 8
Start-up Kit 9 Data Memory 10
Saline Circuit Diagram 10
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Introduction
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Introduction
Use of the System
WARNING! PATIENTS MUST BE CONTINUOUSLY MONITORED.
Patients being treated with the System must be checked frequently (hourly) when the System is operating. It is possible for malfunctions or misuse of the System to result in patient injury or death.
The ZOLL Thermal Regulating System is comprised of an external heat exchange system (CoolGard 3000 or Thermogard) and an Alsius endovascular heat-exchange catheter connected via a sterile heat exchanger and tubing circuit (the Alsius Start-up Kit). These components together comprise a patient temperature-regulation apparatus employing feedback control. The catheter and the Start-up Kit (its heat exchange coil, air trap, and tubing) are single-use disposable devices.
This manual provides operating instructions for the System and the start-up kit. Catheter components are referenced where it is necessary to assure proper use with the system components. Always refer to the catheter’s Instructions for Use for additional specific information.
Operating Life
The operating life of the catheters may vary according to design as indicated by the model designation. Always refer to the catheter’s Instructions for Use for information about the catheter’s operating life.
The disposable components of the Alsius start-up kit are designed for continuous use for a period not to exceed seven (7) days. After seven days of use, all start­up kit components must be removed and replaced with component s from a new start-up kit.
CAUTION! START-UP KIT LIFETIME IS SEVEN (7) DAYS.
The designed operating lifetime for start-up kit components is seven (7) days of continuous operation. If a patient must be treated for a longer period, a new start-up kit must be installed in the System. Failure to adhere to this time limit may cause injury to the patient.
Functional Description
The System can be described in terms of three major components: a recirculating chiller, a sterile fluid roller pump, and a temperature control system. The System is connected to the temperature-controlled catheter by two small­bore plastic tubes. One tube supplies temperature-controlled sterile saline solution to the catheter, and the other tube returns the saline solution to the System. The sterile saline is pumped through a continuous recirculating loop by a peristaltic pump inside the console. The saline solution acts as an intermediate heat-transfer medium between the patient and the System. Sterile saline is used because it is biologically compatible with the patient and in the unlikely event of a leak in the catheter, the possibility of harming the patient is reduced to a practical minimum.
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Introduction
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Patient temperature feedback is used to control the system. The patient’s temperature is measured by an indwelling YSI 400 thermistor temperature sensor. In response to the patient’s measured temperature, the System employs both cooling and heating. Cooling occurs when the patient’s temperature is above the set point target temperature. Heating occurs when the patient’s temperature is below the set point target temperature. The amount of heating or cooling power is proportional to the difference in temperature between the set point target temperature and the patient’s measured temperature.
A basic diagram of the System is illustrated in the following figure.
1. Saline bag.
2. Peristaltic pump
3. Air trap
4. Heat exchange coil
5. Coldwell
6. Coolant pump
7. Chiller & Heater
8. Catheter
9. Patient
10. Pin wheel flow indicator
Figure 2-1. Simplified Flow Diagram.
System Components
Controls and Display
The operator’s display panel contains four buttons and one knob used to access functions and adjust settings with the aid of the menus and messages displayed on the screen. The controls and display are illustrated in figure 2-2 and explained in the following text.
Display
The display is a backlit color LCD panel that can be easily read in all ambient lighting conditions. It is used to display status, menus, messages, alarms, and patient temperature trend graphs.
The display head is attached to the mast by an adjustable swivel/tilt mounting clamp. The user can adjust the tilt and rotation of the display head and lock it into position by using this clamp.
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Introduction
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1. Display Screen
2. Alarm Indicator LED.
3. Mute Button
4. Power On Indicator LED.
5. Target Temp Button.
6. Standby / Run Button.
7. Rate Deg / HR Button.
8. Press for Menu / Enter Knob
Figure 2-2. Controls and Display.
Power Indicators
An indicator lamp on the control panel is illuminated when power is switched on. A second power-on indicator is mounted directly above the power swit ch on the rear of the console.
Alarm Indicators
The System typically notifies users of alarm conditions in two ways. When an alarm occurs, the screen displays an alarm message, and an alarm annunciator produces an audible alarm tone (beep). The alarm tone can be temporarily muted by the user, but it cannot be turned off.
If the nature of the failure prevents the System from displaying an alarm message, the alarm indicator on the control panel will be illuminated.
Control Buttons
The display head features four pushbuttons that are used to control System functions. To provide confirmation, each time a button is pressed, a “key click” sound is produced by the annunciator.
Target Temp
Press the “Target Temp” button to display a screen that allows you to set the patient’s target temperature. You may set a target temperature between 31º C and 38º C (87.8º F and 100.4º F).
Rate Deg/Hr
Press the “Rate Deg/Hr” button to display a screen that allows you to set the cooling/warming rate (expressed in degrees per hour). You may set a cooling/ warming rate between 0.10º C/hr and 0.65º C/hr (0.18º F/hr and 1.17º F/hr).
Standby/Run
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Introduction
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Press the “Standby/Run” button to toggle the operation of the System between standby mode (the pump is stopped) or run mode.
An alarm or fault can place the System into standby mode automatically. After remedying the condition that caused the alarm, press this button to return to run mode.
Silence Alarm
Press the silence alarm button to silence the audible alarm tone for two minutes (120 seconds). If the alarm condition has not been cleared during this two -minu te period, the audible alarm will sound again.
Control Knob
The “Press for Menu/Enter” control is a dual-function control knob and pushbutton.
Press the knob to display a menu screen or to indicate the completion of a selection.
Turn the knob to scroll between selections or to scroll temperature trend graphs.
Serial Interface Connector
A female 9-pin subminiature D connector is mounted on the lower left corner of the rear of the display head. Use this connector to attach a serial interface cable between the System and a laptop computer. Once connected, the computer can download patient temperature trend data stored by the System.
Recirculating Chiller
The chiller consists of an air-cooled refrigeration system, reservoi r heater, circulation pump, stainless steel reservoir, reservoir cover, and a temperature controller.
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Figure 2-3. Serial Interface Connector.
Introduction
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Temperature Controller
The temperature controller uses input from the patient’s temperature probe and the operator-selected patient temperature setpoint to regulate the coolant temperature of the recirculating chiller. The temperature controller constantly adjusts the coolant temperature by means of a closed-loop control system. The operator enters a setpoint that represents the patient’s target temperature. The controller cools or heats the coolant, in a range between 0º and 42º C (32º and
107.6º F) to optimally achieve and maintain the target temperature. The controller
constantly displays the measured patient temperature and the target temperature.
An optional mode can command the controller to approach the target temperature at a user-selected rate.
Temperature Probe Connectors
The front of the System console features two connectors, labeled “T1” and “T2” which are used for connection to patient temperature probes. The primary patient temperature probe is plugged into connector T1. The secondary probe is plugged into connector T2.
Pump
Sterile saline solution is circulated through the heat exchanger coil and the catheter by a high-performance, compact roller pump. It pumps by peristaltic action on the tubing installed in the pump head. The pump rotation speed is accurately controlled by an electronic speed control system. The pump flow rate can be selected by the user.
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Figure 2-4. Temperature Probe Connectors.
Introduction
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WARNING! FINGER INJURIES
Be careful when inserting the pump tubing that you do not catch your fingers with the roller.
When the System is operating DO NOT attempt to circumvent the safety interlocks on the peristaltic pump lid. DO NOT place fingers or foreign objects into the pump raceway when the pump is turning. The peristaltic pump has sufficient torque to severely damage a finger.
If a tubing leak or failure occurs in the pump raceway, the saline solution will cause corrosion in the moving parts of the rotor.
1. Remove the pump rotor (refer to Pump Rotor removal instructions in System Service Manual).
2. Rinse the rotor in clean water and thoroughly dry the rotor.
3. Apply a few drops of light machine oil to the moving parts of the rotor.
4. Reinstall the rotor (refer to pump rotor installation instructions in System Service Manual).
Prime Switch
The prime switch is located next to the pump under the top cover. The switch is used to operate the pump to prime the tubing with sterile saline solution from the saline source. When the switch is held down, the pump runs; when the switch is released, the pump stops.
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Figure 2-5. Pump.
Introduction
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Start-up Kit
The Alsius start-up kit contains the sterile disposable components for this system. Each kit contains a heat exchanger coil, air trap, saline coolant delivery lines, saline container connectors, catheter connectors, and the roller pump tubing. These components are described in detail in later chapters of this document. The components in the start-up kit are designed to operate continuously for seven days, after which they must be replaced.
Figure 2-6. Prime Switch
.
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Figure 2-7. Start-up Kit.
Introduction
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CAUTION! START-UP KIT LIFETIME IS SEVEN (7) DAYS.
The designed operating lifetime for start-up kit components is seven (7) days of continuous operation. If a patient must be treated for a longer period, a new start-up kit must be installed in the System. Failure to adhere to this time limit may cause injury to the patient.
Data Memory
The System is capable of continuously recording patient temperature and system activity for up to 21 days. This stored data can be downloaded to an attached computer over a serial interface using optional software furnished by ZOLL.
Saline Circuit Diagram
A flow diagram is printed on the inside of the top cover. Use this diagram to assure that the start-up kit has been installed correctly.
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Figure 2-8. Flow Diagram.
Introduction
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Indications for Use - USA
The Indications for Use listed below have clearance within the USA for the following models of ZOLL Thermal Regulation System:
The CoolGard 3000  The Thermogard XP
These systems can be used with any of the Alsius Catheters. The indications for use are specific to the catheter. Please refer to the Indications for Use statement in the catheter specific Instructions for Use.
Indications for Use – Cool Line Catheters
The ZOLL Thermal Regulation System using the Alsius Cool Line™ Catheter is indicated for use in fever reduction, as an adjunct to other antipyretic therapy, in patients with cerebral infarction and intracerebral hemorrhage who require access to the central venous circulation and who are intubated and sedated.
Warning – Fever Reduction
The safety of this device has not been demonstrated for fever reduction in patients presenting with subarachnoid hemorrhage or primary trau m atic brain injury. The safety and effectiveness of this device was examined in a random­ized controlled trial of 296 patients. The mortality results reported in this trial, for the four patient cohorts enrolled, are presented in the table below (CI – cerebral infarction, ICH – intracerebral hemorrhage, PTBI – primary traumatic brain injury, SAH – subarachnoid hemorrhage).
Table 1-1. Mortality by Diagnosis (ITT).
Cool Line Control n N % n N % p-value*
CI 3 16 18.8 3 14 21.4 0.74
ICH 8 33 24.2 7 27 25.9 1.00
PTBI 10 44 22.7 4 38 10.5 0.24
SAH 13 61 21.3 7 63 11.1 0.15
*Fischer’s exact test For more details on the results of this study please refer to Physician’s Manual –
“Normothermia for the Neuro-critically Ill Stroke Patient” #101416-001.
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Indications for Use – All Other Catheters
The ZOLL Thermal Regulation System, using one of the Icy ®, Quattro ™ or Fortius
®
model catheter, is indicated for use: in cardiac surgery patients to achieve and or maintain normothermia
during surgery and recovery/intensive care, and
to induce, maintain and reverse mild hypothermia in neurosurgery
patients in surgery and recovery/intensive care.
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Receiving, Inspection & Assembly
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Receiving, Inspection
& Assembly
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Receiving, Inspection & Assembly
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Contents
Receiving, Inspection, and Assembly 3
Overview 3 Inspection for Damage 3 Required Tools 3 Unpacking 3 Assembly 4
Hook 4 Handle 5 Control Head 5 Control Cable 6 Power Cord 7 Condensate Pan 7 Saline Container Insulating Jacket 7
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Receiving, Inspection, and Assembly
Overview
This chapter provides information on how to receive, unpack, and assemble the System. If your System was delivered and set up by an ZOLL representative, you may skip this chapter and turn to Chapter 4.
Inspection for Damage
Each System is carefully inspected before it is shipped. When the carrier delivers your System, ensure that the shipping containers are not damaged. Visually inspect the outside of the shipping container for any damage. If damage is detected, please notify ZOLL’s customer service department and file a damage claim with the carrier.
Required Tools
To safely unpack, inspect, and assemble the System, you will need the following tools:
Phillips screwdriver (included in shipping container).  3/16-inch Allen wrench (included in shipping container).  5/32-inch Allen wrench (included in shipping container).  7/64-inch Allen wrench (included in shipping container).  Scissors or box knife.
Unpacking
CAUTION! AVOID LIFTING INJURY.
The System weighs 115 lb (52 kg). Never attempt to lift the equipment without assistance. Use safe lifting practice when handling the equipment.
To unpack the System, follow these steps in the indicated order.
1. Remove the straps from the carton and pallet.
2. Open the top flaps of the carton and remove the inner carton containing
3. Remove the protective inserts and lift the outer carton up and off.
4. Use scissors or a box knife to carefully cut away the moisture barrier bag
5. With the help of an assistant, grasp the base of the console just above
the control head. This carton also contains the handle, attachment hardware, spare fuses, the condensate pan, the saline container insulating jacket, and other miscellaneous parts.
surrounding the console. Use care to avoid scratching the console.
the casters, carefully lift the console off the platform, and set it on the floor.
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Figure 3-1. System Unpacked and Ready for Assembly.
Assembly
To assemble the unpacked System, follow these steps in the indicated order.
Hook
1. Attach the gray hook to the front of the mast using the short bolt provided. Use a 7/64-inch Allen wrench to tighten the bolt securely (see figure 3-2).
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Figure 3-2. System With Hook Attached.
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Handle
2. Attach the handle to the mast using the long bolt and the short screw provided. Use a 3/16-inch Allen wrench to tighten the bolt securely. Use a 5/32-inch Allen wrench to tighten the screw (see figure 3-3). Do not lift the System by the handle.
Figure 3-3. Use the Long Bolt and Center Screw to Attach the Handle.
Control Head
3. Carefully remove the control head from its packaging.
4. Attach the control head to the mast. Hold the pivot assembly perfectly
vertical and slide it into the mast opening by applying even, gradual pressure. The pivot assembly fits into the mast only in one direction.
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Figure 3-4. Attach the Control Head to the Mast.
5. Secure the control head to the mast by installing four screws in the holes provided at the top of the mast. Use a Phillips screwdriver to tighten the screws securely.
Control Cable
6. Connect the control cable to the socket on the lower right rear corner of the control head. Align the plug with the socket and gently push the plug into the socket until it is seated. Turn the retaining collar approximately two full turns clockwise to lock the plug in the socket.
6
Figure 3-5. Plug the Control Cable Into the Socket.
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