Nihon Kohden ZM-531PA WMTS TRANSMITTER User Manual
Nihon Kohden Corporation WMTS TRANSMITTER
User Manual
ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmitter ZM-520PA/ZM-521PA ZM-530PA/ZM-531PA If you have any comments or suggestions on this manual, please contact us at: www.nihonkohden.com 0614-904743 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Copyright Notice The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No part of this document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical, photocopied, recorded, or otherwise) without the prior written permission of Nihon Kohden. ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Contents GENERAL HANDLING PRECAUTIONS ...................................................................... i WARRANTY POLICY ..................................................................................................iii Equipment Authorization Requirement ........................................................................iv EMC RELATED CAUTION ........................................................................................... v Conventions Used in this Manual and Instrument ......................................................vii Warnings, Cautions and Notes..............................................................................vii Explanations of the Symbols in this Manual and Instrument................................ viii Intended Use ..................................................................................................................... 1 General ........................................................................................................................ 1 Receiving Monitor ........................................................................................................ 3 Panel Description .............................................................................................................. 4 Top Panel ..................................................................................................................... 4 Front Panel................................................................................................................... 5 Rear Panel ................................................................................................................... 7 Important Safety Information ............................................................................................. 8 General ........................................................................................................................ 8 Output Signal ............................................................................................................. 12 Battery ....................................................................................................................... 12 Transmitter Channel Management ............................................................................. 13 For Patients Using Implantable Pacemaker ............................................................... 13 ECG Monitoring ......................................................................................................... 14 SpO2 Monitoring......................................................................................................... 15 Maintenance .............................................................................................................. 17 Preparation on Transmitter .............................................................................................. 19 Batteries..................................................................................................................... 19 Handling Batteries ................................................................................................ 19 Battery Lifetime .................................................................................................... 19 Installing (Replacing) Batteries ............................................................................ 20 Situations Requiring Battery Replacement .......................................................... 21 Battery Level Indication ........................................................................................ 21 Attaching a Strap to the Transmitter ........................................................................... 22 Turning On the Transmitter ......................................................................................... 23 Check Items Before Use ...................................................................................... 23 Check Items After Power On ................................................................................ 24 Check Items After Use ......................................................................................... 24 Turning Off the Transmitter ......................................................................................... 25 Changing the Transmitter Channel............................................................................. 25 Changing Parameter and System Setup Settings ........................................................... 26 Changing PARAMETER SETUP Settings.................................................................. 26 Operator’s Manual ZM-520PA/521PA/530PA/531PA C.1 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Parameter Setup Setting List ............................................................................... 26 Displaying the PARAMETER SETUP Screen ...................................................... 27 Changing Parameter Setup Settings .................................................................... 28 Changing SYSTEM SETUP Settings ......................................................................... 31 System Setup Setting List .................................................................................... 31 Displaying the SYSTEM SETUP Screen.............................................................. 32 Changing System Setup Settings ........................................................................ 33 Initializing Settings ..................................................................................................... 36 Attaching Electrodes and SpO2 Probe to the Patient....................................................... 37 Attaching Electrodes .................................................................................................. 37 Selecting Electrode Lead ..................................................................................... 37 Connecting the Electrode Lead to the Transmitter ............................................... 38 Electrode Position ................................................................................................ 39 Attaching Electrodes to the Patient and Connecting the Electrode Leads to Disposable Electrodes ......................................................................................... 43 Checking ECG on the Transmitter Screen............................................................ 44 Attaching the SpO2 Probe .......................................................................................... 44 Selecting the SpO2 Probe .................................................................................... 44 Connecting the SpO2 Probe to the Transmitter .................................................... 47 Attaching the Probe to the Patient........................................................................ 48 Locking the Keys on the Transmitter ................................................................................ 50 Monitoring ........................................................................................................................ 51 Screen Descriptions................................................................................................... 51 Check Electrodes Screen ..................................................................................... 53 Numeric and Waveform Screen ........................................................................... 54 Waveform Review Screen .................................................................................... 55 Numeric Review Screen ....................................................................................... 56 Display Off ............................................................................................................ 56 Basic Monitoring Operation ....................................................................................... 57 Using the Function Key ........................................................................................ 57 Suspending Alarms on the Receiving Monitor ..................................................... 58 Pause Monitoring ................................................................................................. 59 Resume Monitoring after Pause ........................................................................... 61 Confirming Patient ................................................................................................ 61 Turning the Display Off ......................................................................................... 62 Turning the Display On after It was Turned Off ..................................................... 62 ECG and Respiration Monitoring ............................................................................... 63 Turning ECG Measurement On/Off ...................................................................... 66 Turning Respiration Measurement On/Off............................................................ 66 Electrode Detachment.......................................................................................... 66 SpO2 Monitoring......................................................................................................... 67 Indications and Messages ............................................................................................... 71 C.2 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Indication ................................................................................................................... 71 Messages .................................................................................................................. 71 Message Display Priority...................................................................................... 74 Troubleshooting ............................................................................................................... 75 Transmitter ................................................................................................................. 75 ECG/Respiration ........................................................................................................ 76 SpO2 ......................................................................................................................... 77 Maintenance .................................................................................................................... 78 1. External Check ................................................................................................. 78 2. Transmitter Channel ......................................................................................... 78 3. Transmitting/Receiving Signal .......................................................................... 79 4. Display .............................................................................................................. 79 5. Key Operation ................................................................................................... 81 6. ECG Check....................................................................................................... 82 7. Respiration Check ............................................................................................ 83 8. SpO2 Check ...................................................................................................... 83 Maintenance Check Sheet ................................................................................... 85 Lifetime and Disposal ...................................................................................................... 86 Disposing of Used Batteries ...................................................................................... 86 Battery Lifetime .................................................................................................... 86 Disposal ............................................................................................................... 86 Disposing of Electrodes and SpO2 Probes ................................................................ 86 Disposing of Transmitter............................................................................................. 86 Cleaning, Disinfection and Sterilization ........................................................................... 87 Transmitter and Electrode Leads ............................................................................... 87 Cleaning ............................................................................................................... 87 Disinfection ........................................................................................................... 87 SpO2 Probe ................................................................................................................ 88 Periodic Replacement Schedule ..................................................................................... 88 Repair Parts Availability Policy ........................................................................................ 88 Specifications .................................................................................................................. 89 ZM-520PA/530PA ....................................................................................................... 89 Measuring Parameters ......................................................................................... 89 Transmitting Data ................................................................................................. 89 Display.................................................................................................................. 89 Displayed Data ..................................................................................................... 89 ECG ..................................................................................................................... 89 Respiration Measurement .................................................................................... 91 SpO2 Measurement (ISO 9919: 2005 compliance) .............................................. 91 Transmitter ........................................................................................................... 93 Power Requirements ............................................................................................ 93 Dimension and Weight ......................................................................................... 94 Operator’s Manual ZM-520PA/521PA/530PA/531PA C.3 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Environment ......................................................................................................... 94 Safety Standards .................................................................................................. 94 Electromagnetic Compatibility .............................................................................. 95 Electromagnetic Emissions .................................................................................. 95 Electromagnetic Immunity .................................................................................... 96 Recommended Separation Distances between Portable and Mobile RF Communications Equipment ................................................................................ 98 Recovery Time after Defibrillation ........................................................................ 98 System Composition for EMC Test ....................................................................... 98 ZM-521PA/531PA ....................................................................................................... 99 Measuring Parameters ......................................................................................... 99 Transmitting Data ................................................................................................. 99 Display.................................................................................................................. 99 Displayed Data ..................................................................................................... 99 ECG ..................................................................................................................... 99 Respiration Measurement .................................................................................. 101 SpO2 Measurement (ISO 9919: 2005 compliance) ............................................ 101 Transmitter ......................................................................................................... 103 Power Requirements .......................................................................................... 103 Dimension and Weight ....................................................................................... 104 Environment ....................................................................................................... 104 Safety Standards ................................................................................................ 104 Electromagnetic Compatibility ............................................................................ 105 Electromagnetic Emissions ................................................................................ 105 Electromagnetic Immunity .................................................................................. 106 Recommended Separation Distances between Portable and Mobile RF Communications Equipment .............................................................................. 108 Recovery Time after Defibrillation ...................................................................... 108 System Composition for EMC Test ..................................................................... 108 Standard Accessories.................................................................................................... 109 Options .......................................................................................................................... 110 Transmitter ......................................................................................................... 110 ECG/RESP......................................................................................................... 110 SpO2 .................................................................................................................. 111 Transmission Frequencies ............................................................................................. 112 C.4 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ GENERAL HANDLING PRECAUTIONS This device is intended for use only by qualified medical personnel. Use only Nihon Kohden approved products with this device. Use of nonapproved products or in a non-approved manner may affect the performance specifications of the device. This includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode leads, input boxes and AC power. Please read these precautions thoroughly before attempting to operate the instrument. 1. To safely and effectively use the instrument, its operation must be fully understood. 2. When installing or storing the instrument, take the following precautions: (1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive humidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air. (2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport. (3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage. (4) The power line source to be applied to the instrument must correspond in frequency and voltage to product specifications, and have sufficient current capacity. (5) Choose a room where a proper grounding facility is available. 3. Before Operation (1) Check that the instrument is in perfect operating order. (2) Check that the instrument is grounded properly. (3) Check that all cords are connected properly. (4) Pay extra attention when the instrument is in combination with other instruments to avoid misdiagnosis or other problems. (5) All circuitry used for direct patient connection must be doubly checked. (6) Check that battery level is acceptable and battery condition is good when using batteryoperated models. 4. During Operation (1) Both the instrument and the patient must receive continual, careful attention. (2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety. (3) Avoid direct contact between the instrument housing and the patient. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ 5. To Shutdown After Use (1) Turn power off with all controls returned to their original positions. (2) Remove the cords gently; do not use force to remove them. (3) Clean the instrument together with all accessories for their next use. 6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is not functioning properly, it should be clearly marked to avoid operation while it is out of order. 7. The instrument must not be altered or modified in any way. 8. Maintenance and Inspection: (1) The instrument and parts must undergo regular maintenance inspection at least every 6 months. (2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect operating condition. (3) Technical information such as parts list, descriptions, calibration instructions or other information is available for qualified user technical personnel upon request from your Nihon Kohden representative. 9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or location of electrodes and/or transducers to avoid possible burn to the patient. 10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage. ii Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ WARRANTY POLICY Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded from the warranty. NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period, provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals. No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any other warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding this warranty. Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure. Shipping costs must be pre-paid. This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation or application, or on which the original identification marks have been removed. In the USA and Canada other warranty policies may apply. CAUTION United States law restricts this product to sale by or on the order of a physician. Operator’s Manual ZM-520PA/521PA/530PA/531PA iii ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Equipment Authorization Requirement This device complies with Part 15 of the FCC (Federal Communications Commission) Rules. Operation is subject to the following two conditions: (1) this device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation. This device complies with Part 95 Subpart H of the FCC Rules to be used in wireless medical telemetry service. Operation of this equipment requires the prior coordination with a frequency coordinator designated by FCC for the Wireless Medical Telemetry Service. CAUTION To comply with the FCC radio frequency (RF) exposure compliance requirements, no change to the antenna or the device is permitted. Any change to the antenna or the device could result in the device, exceeding the RF exposure requirements and void user’s authority to operate this device. NOTE • Use this device only indoors. • This device has been tested and complies with FCC radiation exposure limits set forth for an uncontrolled environment. The RF transmission power from the antenna conforms to the general public FCC RF Exposure Guidelines in Supplement C to OET65 limit of Specific Absorption Rate (SAR) 1.6 W/kg. The maximum SAR value measured from this device was extremely smaller than 1.6 W/kg. This device must not be located together with or operated in conjunction with any other unspecified antenna or transmitter. • The devices require registration and deployment by an authorized frequency coordinator. The ASHE (American Society for Healthcare Engineering) has been designated by the FCC to manage the WMTS frequencies. This device has frequency bands which may not be used in some areas. For details, contact your Nihon Kohden representative. For details on the guidelines, refer to the ASHE home page. iv Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ EMC RELATED CAUTION This equipment and/or system complies with the International Standard IEC 606011-2 for electromagnetic compatibility for medical electrical equipment and/or system. However, an electromagnetic environment that exceeds the limits or levels stipulated in the IEC 60601-1-2, can cause harmful interference to the equipment and/or system or cause the equipment and/or system to fail to perform its intended function or degrade its intended performance. Therefore, during the operation of the equipment and/or system, if there is any undesired deviation from its intended operational performance, you must avoid, identify and resolve the adverse electromagnetic effect before continuing to use the equipment and/or system. The following describes some common interference sources and remedial actions: 1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station or cellular phone: Install the equipment and/or system at another location if it is interfered with by an emitter source such as an authorized radio station. Keep the emitter source such as cellular phone away from the equipment and/or system. 2. Effect of direct or indirect electrostatic discharge: Make sure all users and patients in contact with the equipment and/or system are free from direct or indirect electrostatic energy before using it. 3. Electromagnetic interference with any radio wave receiver such as radio or television: If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or system as far as possible from the radio wave receiver. 4. Electromagnetic interference with any radio wave receiver such as radio or television: If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or system as far as possible from the radio wave receiver. 5. Interference of lightning: When lightning occurs near the location where the equipment and/or system is installed, it may induce an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord from the equipment and/or system and operate the equipment and/or system by battery power, or use an uninterruptible power supply. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ 6. Use with other equipment: When the equipment and/or system is adjacent to or stacked with other equipment, the equipment and/or system may affect the other equipment. Before use, check that the equipment and/or system operates normally with the other equipment. 7. Use of unspecified accessory, transducer and/or cable: When an unspecified accessory, transducer and/or cable is connected to this equipment and/or system, it may cause increased electromagnetic emission or decreased electromagnetic immunity. The specified configuration of this equipment and/or system complies with the electromagnetic requirements with the specified configuration. Only use this equipment and/or system with the specified configuration. 8. Use of unspecified configuration: When the equipment and/or system is used with the unspecified system configuration different than the configuration of EMC testing, it may cause increased electromagnetic emission or decreased electromagnetic immunity. Only use this equipment and/or system with the specified configuration. 9. Measurement with excessive sensitivity: The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the surrounding electromagnetic conditions and remove this artifact source. If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden representative for additional suggestions. vi Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Conventions Used in this Manual and Instrument Warnings, Cautions and Notes Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information. WARNING A warning alerts the user to the possible injury or death associated with the use or misuse of the instrument. CAUTION A caution alerts the user to possible injury or problems with the instrument associated with its use or misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other property. NOTE A note provides specific information, in the form of recommendations, prerequirements, alternative methods or supplemental information. Operator’s Manual ZM-520PA/521PA/530PA/531PA vii ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Explanations of the Symbols in this Manual and Instrument The following symbols found in this manual/instrument bear the respective descriptions as given. On Panel Symbol Description Symbol Description Change screen Defibrillation proof type BF applied part Attention, consult operator’s manual Defibrillation proof type CF applied part Moves cursor, scrolls data Serial number Direction for attaching battery cover Date of manufacture Direction for inserting battery RF transmitter Non-ionizing radiation Direct current cCSAus mark Call key On LCD Symbol viii Description Symbol Description Batteries are fully charged Batteries are almost empty Replace battery Batteries are getting low Alarm suspended Batteries are low QRS/pulse sync mark Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Intended Use General The ZM-520PA and ZM-521PA transmitter transmits ECG and respiration from a patient to a Nihon Kohden monitor for continuous monitoring. The front LCD displays ECG, numeric values of monitoring parameters, messages and battery condition.* It also displays the compressed waveform and numeric data of the latest 10 minutes. The ZM-530PA and ZM-531PA transmitter transmits ECG, respiration and pulse waveforms and SpO2 from a patient to a Nihon Kohden monitor for continuous monitoring. The front LCD displays ECG (or pulse wave), numeric values of monitoring parameters, messages and battery condition.* It also displays the compressed waveform and numeric data of the latest 10 minutes. * Essential performance of this transmitter. The difference between the ZM-520PA/530PA and ZM-521PA/531PA is the transmission frequency range. ZM-520PA/530PA: 608.0250 MHz (channel number 9002) to 613.9750 MHz (channel number 9478) ZM-521PA/531PA: 1395.0250 MHz (channel number E002) to 1399.9750 MHz (channel number E398) 1427.0250 MHz (channel number E502) to 1431.9750 MHz (channel number E898) The transmitter channel can be changed with a QI-901PK channel writer. Read the operator’s manual for the receiving monitor together with this manual before use. WARNING Do not diagnose a patient based only on data acquired by the transmitter. Overall judgement must be performed by a physician who understands the features, limitations and characteristics of the transmitter and by reading the biomedical signals acquired by other instruments. WARNING Do not use the same transmitter for more than one patient at the same time. Do not connect different sensors from different patients to the same transmitter. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION • Do not use the same channel for different patients. If the same channel is used for two patients, the two patients’ data will be lost due to mutual modulation interference, or another patient’s data may appear on the receiving monitor screen. • Do not use two transmitters with adjacent channels in the same hospital. If transmitters with adjacent channels are used, their radio waves interfere with each other. CAUTION Signal loss and artifact may occur because of the multipath cancellation* when using a transmitter. * Multipath Cancellation (Standing Wave Interference): When a radio wave reflects off a surface, there may be some points in the room where the reflected and direct waves are exactly out of phase. At these points in the room, the reflected and direct waves cancel each other out so that the signal strength is decreased. Locations where signal loss occurs are called “null spots”. If the transmitter is moving or nearby people or objects are moving, null spots can occur anytime and anywhere. NOTE • To prevent interference between channels, assign a channel administrator in the hospital and only he or she should manage channel assignment. • Use Nihon Kohden parts and accessories to assure maximum performance from your instrument. • For stable signal reception, it is recommended to use a diversity antenna system on the receiving monitor. Otherwise, spike noise from transient fading of electric field strength (for example, people moving) may interfere with the transmitter signal and may be mistaken as an arrhythmia on the receiving monitor. • For details on antennas and antenna construction, contact your Nihon Kohden representative. You can also refer to the Telemetry System Installation Guide. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Receiving Monitor Any Nihon Kohden receiving monitor (central monitor with multiple patient receiver) can receive signals from this transmitter as long as the protocol version and channel setting are the same on the receiving monitor and transmitter. NOTE • For details on the receiving monitor and upgrade information, contact your Nihon Kohden representative. • The transmitter does not give any alarm other than a “no battery” alarm. Alarms must be managed on the receiving monitor. • To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. For the protocol setting, refer to the “Changing SYSTEM SETUP Settings” section. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Panel Description Top Panel ZM-530PA/531PA only For attaching a strap. SpO2 socket Connects the SpO2 probe. ECG/RESP socket Connects the electrode lead for measuring ECG and/or respiration by the impedance method. WARNING WARNING Before defibrillation, all persons must keep clear of the bed and must not touch the patient or any equipment or cord connected to the patient. Failure to follow this warning may cause electrical shock or injury. WARNING CAUTION When the transmitter is used with an electrosurgical unit (ESU), firmly attach the entire area of the ESU return plate. Otherwise, the current from the ESU flows into the electrodes of the transmitter, causing electrical burn where the electrodes are attached. For details, refer to the ESU manual. When performing defibrillation, discharge as far as possible from electrodes, patches and any gel, cream or medicine on the chest of the patient. If there is a possibility that the defibrillator paddle could touch these materials, remove them from the patient. If the defibrillator paddle directly contacts these materials, the discharged energy may cause skin burn to the patient. Do not shake or swing the transmitter while holding the leads or cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Front Panel No. Name Description CALL key LCD Screen key When this key is pressed, a “peep” sounds at the transmitter, and “CALL” message appears at the monitor. Depending on the settings on the monitor, an ECG waveform is recorded when this key is pressed. Displays numeric values, ECG or pulse wave, messages and battery status. For details, refer to the “Screen Descriptions” section. Toggles the screen in the following order. After power on: Start up → Check electrodes → Numeric and waveform → Waveform review → Numeric review → Display off → Check electrodes … After auto display off: Numeric and waveform → Waveform review → Numeric review → Display off → Check electrodes → Numeric and waveform … On a SETUP or CHECK screen, this key cancels changing setting or exits the screen. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ No. Name Description Infrared receiver Used for upgrading the transmitter software. Channel number label Indicates the channel number of the transmitter. Lead/Scroll keys On the numeric and waveform screen, these keys change the ECG lead. On the waveform review screen, these keys scroll data. On a SETUP screen, these keys move the cursor. Function key Depending on the setting on the transmitter, this key suspends alarms, pauses monitoring on the receiving monitor or transmits “Patient confirmed” message. On a SETUP screen, this key registers the selected setting and moves the cursor to the next setting item. On a CHECK screen, this key starts or stops the maintenance test. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Rear Panel ZM-530PA/531PA only Refer to the “Explanations of the Symbols in this Manual and Instrument” section. Refer to the WARNING below. Refer to the WARNING below. Refer to the “Explanations of the Symbols in this Manual and Instrument” section. Battery case: Contains two alkaline dry cell batteries (AA TYPE). WARNING Close the battery case cover during operation. If the transmitter is used with the battery case cover open, anyone who touches the opened battery case may receive an electrical shock when defibrillation is performed. Touching the opened battery case may cause electrostatic discharge and intermittently interfere with the waveform or data. WARNING This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop using it and contact your Nihon Kohden representative. If a wet transmitter is used, the patient or operator may receive an electrical shock or injury. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Important Safety Information General WARNING WARNING Never use the transmitter in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. Never use the transmitter in a hyperbaric oxygen chamber. Failure to follow this warning may cause explosion or fire. WARNING WARNING Do not take this transmitter into the MRI test room. This transmitter is not designed to be used during MRI tests. When performing MRI test, remove all electrodes and probe from the patient which are connected to this transmitter. Failure to follow this warning may cause skin burn on the patient. For details, refer to the MRI manual. WARNING WARNING Before defibrillation, all persons must keep clear of the bed and must not touch the patient or any equipment or cord connected to the patient. Failure to follow this warning may cause electrical shock or injury. When performing defibrillation, discharge as far as possible from electrodes, patches and any gel, cream or medicine on the chest of the patient. If there is a possibility that the defibrillator paddle could touch these materials, remove them from the patient. If the defibrillator paddle directly contacts these materials, the discharged energy may cause skin burn to the patient. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ WARNING WARNING When the transmitter is used with an electrosurgical unit (ESU), firmly attach the entire area of the ESU return plate. Otherwise, the current from the ESU flows into the electrodes of the transmitter, causing electrical burn where the electrodes are attached. For details, refer to the ESU manual. This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop using it and contact your Nihon Kohden representative. If a wet transmitter is used, the patient or operator may receive an electrical shock or injury. WARNING WARNING Close the battery case cover during operation. If the transmitter is used with the battery case cover open, anyone who touches the opened battery case may receive an electrical shock when defibrillation is performed. Touching the opened battery case may cause electrostatic discharge and intermittently interfere with the waveform or data. Do not use the same transmitter for more than one patient at the same time. Do not connect different sensors from different patients to the same transmitter. WARNING When the signal is unstable, keep the patient under close observation. When the signal is unstable, the monitoring and alarm are not reliable and the receiving monitor cannot detect a sudden change of the patient’s condition. This may cause critical changes in the patient condition to be overlooked. Install an appropriate antenna system to ensure stable signal condition. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ WARNING Do not diagnose a patient based only on data acquired by the transmitter. Overall judgement must be performed by a physician who understands the features, limitations and characteristics of the transmitter and by reading the biomedical signals acquired by other instruments. CAUTION CAUTION Only use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed. CAUTION CAUTION The measurement values and displayed waveforms on the transmitter and receiving monitor may be different due to timing delay of the display or difference in detection settings. 10 Do not reuse disposable parts and accessories. Do not shake or swing the transmitter while holding the leads or cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION CAUTION Signal loss and artifact may occur because of the multipath cancellation* when using a transmitter. Turn off the power of mobile phones, small wireless devices and other devices which produce strong electromagnetic interference around a patient (except for devices allowed by the hospital administrator). Radio waves from devices such as mobile phones or small wireless devices may be mistaken as pulse waves or respiration waves and the displayed data may be incorrect. * Multipath Cancellation (Standing Wave Interference): When a radio wave reflects off a surface, there may be some points in the room where the reflected and direct waves are exactly out of phase. At these points in the room, the reflected and direct waves cancel each other out so that the signal strength is decreased. Locations where signal loss occurs are called “null spots”. If the transmitter is moving or nearby people or objects are moving, null spots can occur anytime and anywhere. CAUTION • Do not use the same channel for different patients. If the same channel is used for two patients, the two patients’ data will be lost due to mutual modulation interference, or another patient’s data may appear on the receiving monitor screen. • Do not use two transmitters with adjacent channels in the same hospital. If transmitters with adjacent channels are used, their radio waves interfere with each other. Operator’s Manual ZM-520PA/521PA/530PA/531PA 11 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Output Signal WARNING Do not use the output signal from the receiving monitor as the synchronization signal for other equipment such as IABP, MRI, echocardiography or defibrillator. There may be time delay between the monitor and the other equipment caused by waveform transmission delay and spike noise may interfere on the output signal and be mistaken as a trigger. Battery WARNING Do not use NiMH batteries for this transmitter. Some operating environments may cause NiMH batteries to produce gas and explode. CAUTION CAUTION Battery replacement must be performed by the operator. When replacing the batteries of a transmitter that is currently used for a patient, disconnect the electrode leads from the transmitter before replacing batteries or do not touch the patient during replacement. When the transmitter is not in use, remove the batteries. When the batteries are installed, battery power is consumed even when measurement is not performed. CAUTION CAUTION Do not handle the batteries with wet hands. 12 Refer to the battery manual for details on handling the batteries. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmitter Channel Management WARNING The following actions must be taken to properly receive the transmitter signal of the correct patient on the receiving instrument. Otherwise, there may be signal loss or signals may mix causing a serious accident, such as monitoring a different patient. • Assign a channel administrator in the hospital and only he or she should manage channel assignment. • The channel administrator must manage the channels in the facility so that there is no signal interference. • When the transmitter channel is changed, the channel administrator must check that the channel on the receiving monitor is also changed and the signal is properly received. • The channel administrator must replace the channel number label on the transmitter with the new one after changing the channel. For Patients Using Implantable Pacemaker WARNING Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac Monitoring and Diagnostic Equipment* The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker may be affected by transmitter which is connected to the same patient. If this occurs, the pacemaker may pace at its maximum rate and the transmitter may give incorrect data to the monitor. If this occurs, disconnect the electrode leads from the patient or change the setting on the pacemaker by referring to the pacemaker’s manual. For more details, contact your pacemaker representative or Nihon Kohden representative. * Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric impedance measurement (BIM). Many medical devices in addition to pacemakers use this technology. When one of these devices is used on a patient with an active, minute ventilation rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals created in the patient, resulting in an elevated pacing rate. For more information, see the FDA web site. http://www.fda.gov/cdrh/safety.html Operator’s Manual ZM-520PA/521PA/530PA/531PA 13 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ ECG Monitoring WARNING WARNING After attaching the electrode to the patient and connecting the electrode lead to the transmitter, check that electrodes are attached to the patient and check that the electrode lead is connected to the transmitter properly. When the electrodes are removed from the patient, do not touch the metal part of the electrode with bare hands or let the metal part of the electrode contact the metal part of the bed or any other conductive parts. Failure to follow this warning may cause electrical shock or injury to the patient by discharged energy. The transmitter detects the pacemaker pulse and rejects the pacemaker pulse from the heart rate count. However, all of the pacemaker pulse might not be rejected. If the pacemaker pulse is not rejected, the pacemaker pulse is detected as QRS and false heart rate may be indicated. Keep pacemaker patients under close observation. * For the pacemaker pulse rejection capability of ZM-520PA/521PA/530PA/531PA transmitter refer to the “Specifications ECG” section. WARNING The pacemaker pulse can be overlooked or detected as QRS. You cannot confirm the pacemaker operation only from the detected pacemaker pulse. CAUTION CAUTION Only use Nihon Kohden specified electrodes and electrode leads. When other type of electrodes or electrode leads are used, the “CHECK ELECTRODES” message may be displayed and ECG monitoring may stop. When the “ELECTRODE OFF” or “CHECK ELECTRODES” message is displayed on the receiving monitor, ECG is not monitored properly and the ECG alarm does not function. Check the electrode, electrode leads, and if necessary, replace with new ones. CAUTION Hold the connector of the electrode lead when connecting/disconnecting the electrode lead. If you disconnect the electrode lead by pulling the lead, it damages the electrode lead. 14 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 Monitoring WARNING SpO2 measurement may be incorrect in the following cases. • When the patient’s carboxyhemoglobin or methemoglobin increases abnormally. • When dye is injected in the blood. • When using an electrosurgical unit. • During CPR. • When measuring at a site with venous pulse. • When there is body movement. • When the pulse wave is small (insufficient peripheral circulation). WARNING When monitoring SpO2 of a patient who is receiving photodynamic therapy, the light from the finger probe sensor may cause a burn. Photodynamic therapy uses a photosensitizing agent that has a side effect of photosensitivity. The SpO2 probe manufactured by Nihon Kohden have two wavelengths with peaks in the range of 650 and 950 nm. The maximum light intensity is less than 5.5 mW. WARNING WARNING • When using the TL-201T finger probe, do not fasten the probe and cable to the finger by wrapping with tape. This may cause burn, congestion or pressure necrosis from poor blood circulation. • When using probes other than the TL-201T finger probe, to avoid poor circulation, do not wrap the tape too tight. Check the blood circulation condition by observing the skin color and congestion at the skin peripheral to the probe attachment site. Even for short-term monitoring, there may be burn or pressure necrosis from poor blood circulation, especially on neonates or low birth weight infants whose skin is delicate. Accurate measurement cannot be performed on a site with poor peripheral circulation. Check the circulation condition by observing the skin color at the measurement site and pulse waveform. Change the measurement site every 8 hours for disposable probes and every 4 hours for reusable probes (every 8 hours for TL-631T series probe). The skin temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and cause a burn or pressure necrosis. When using the probe on the following patients, take extreme care and change the measurement site more frequently according to symptoms and degree. • Patient with a fever • Patient with insufficient peripheral circulation • Neonate or low birth weight infant with delicate skin Operator’s Manual ZM-520PA/521PA/530PA/531PA 15 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ WARNING When not monitoring SpO2, disconnect the SpO2 cable from the transmitter. Otherwise, noise from the probe sensor may interfere and incorrect data is displayed on the screen. CAUTION CAUTION Refer to the probe instruction manual for details. CAUTION CAUTION Do not attach the probe to the same limb that is used for NIBP measurement or an IBP catheter. The SpO2 measurement may be incorrect. CAUTION While a patient is on medication which causes vasodilation, the pulse waveform may change and in rare cases the SpO2 value might not be displayed. CAUTION Normal external light does not affect monitoring but strong light such as a surgical light or sunlight may affect monitoring. If affected, cover the measuring site with a blanket. CAUTION When a message indicates a faulty probe, stop monitoring and replace the probe with a new one. CAUTION Do not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient. 16 The disposable probe is not sterilized. Use the disposable probe only for a single patient. Never reuse the disposable probe for another patient because it causes cross infection. Do not use a probe which is deteriorated by aging. Accurate measurement cannot be performed. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION CAUTION If the attachment site is dirty with blood or bodily fluids, clean the attachment site before attaching the probe. If there is nail polish on the attachment site, remove the polish. Otherwise, the amount of transmitted light decreases, and measured value may be incorrect or measurement cannot be performed. If the skin gets irritated or redness appears on the skin from the probe, change the attachment site or stop using the probe. Take extreme care for the patients with delicate skin. CAUTION CAUTION Failure to follow these instructions may cause cable discontinuity, short circuit, skin burn on the patient from the probe temperature increase due to the short circuit of the probe cable, and incorrect measurement data. If the probe is broken, replace it with a new one. • Do not immerse any part of the probe cable other than the disposable probe in chemical solutions or water. • Do not pull or bend the probe cable. • Do not let caster feet run over the probe cable. When the probe is attached on an appropriate site with sufficient circulation and the error message confirming the probe attachment repeatedly appears, the probe may be deteriorated. Replace it with a new one. Maintenance CAUTION This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop cleaning or disinfecting it and contact your Nihon Kohden representative. The transmitter needs to be checked for safety and function before use. CAUTION Do not immerse the electrode lead connector in liquid. Operator’s Manual ZM-520PA/521PA/530PA/531PA 17 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION CAUTION Never disassemble or repair the transmitter. If there is any problem with the transmitter, contact your Nihon Kohden representative. Dispose of Nihon Kohden products according to your local laws and your facility’s guidelines for waste disposal. Otherwise, it may affect the environment. If there is a possibility that the product may have been contaminated with infection, dispose of it as medical waste according to your local laws and your facility’s guidelines for medical waste. Otherwise, it may cause infection. 18 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Preparation on Transmitter Batteries Handling Batteries WARNING Do not use NiMH batteries for this transmitter. Some operating environments may cause NiMH batteries to produce gas and explode. CAUTION CAUTION Refer to the battery manual for details on handling the batteries. CAUTION Do not handle the batteries with wet hands. When the transmitter is not in use, remove the batteries. When the batteries are installed, battery power is consumed even when measurement is not performed. NOTE Remove the batteries from the transmitter before disposing of it. Battery Lifetime Use two AA(LR6) type alkaline dry cell batteries. With new Nihon Kohden recommended alkaline batteries, the transmitter can continuously measure for the following number of days at room temperature. Operation time depends on the thickness of the SpO2 probe attachment site. Transmitter ZM-520PA/530PA ZM-521PA/531PA Operating time (Measuring parameters) ECG, Resp ECG, Resp, SpO2 2.5 days 3.5 days 2.0 days 2.5 days Recommended Batteries Alkaline primary: Nihon Kohden Medipower (equivalent to Panasonic LR6 (G)) Operator’s Manual ZM-520PA/521PA/530PA/531PA 19 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ NOTE • Use Nihon Kohden Medipower to ensure specified performance. Outdated, mismatched or poor-quality batteries can give unacceptable performance (e.g., insufficient low battery indication). The use of fresh high-quality alkaline batteries is strongly recommended. • When the display is turned on, it reduces the battery power. Instruct the patient not to turn on the display during monitoring. Installing (Replacing) Batteries CAUTION Battery replacement must be performed by the operator. When replacing the batteries of a transmitter that is currently used for a patient, disconnect the electrode leads from the transmitter before replacing batteries or do not touch the patient during replacement. If electrode leads are attached to the patient and the person replacing batteries touches the patient during battery replacement, excess patient leakage current may flow into the patient. NOTE • Replace all batteries at the same time. • Do not use different types of batteries together. • Insert the batteries with the correct polarity (+ and –). 1. Open the battery case cover. 2. Insert two new batteries into the battery case observing the correct polarity. ii The transmitter is automatically turned on when the batteries are installed. 20 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ NOTE Insert the (–) end of the battery first and press it against the spring. If you try to force the (+) end of the battery in first, it will deform the spring and damage the battery and transmitter. 3. Close the cover. ii Situations Requiring Battery Replacement Replace the batteries when any of the following occurs: • The transmitter displays the “BATTERY WEAK” message or “ ” icon. • The transmitter generates a constant alarm (continuous “peep” sound). • The transmitter LCD does not display anything when the power is turned on. • The receiving monitor displays a battery replacement message. Battery Level Indication The following icons on the LCD indicate the battery level. When “PROTOCOL” on the SYSTEM SETUP screen is set to 51, the battery level indication is transmitted to the receiving monitor. To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. Indication Battery level Message on the receiving monitor Batteries are fully charged. Batteries are getting low. There is no message on the monitor. Batteries are low. Batteries are almost empty. Replace batteries. No indication Dead batteries Message requiring battery replacement is displayed. No signal can be transmitted to the monitor. There is no indication on the monitor. Operator’s Manual ZM-520PA/521PA/530PA/531PA 21 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Attaching a Strap to the Transmitter NOTE Do not attach the clip to hard objects such as thick cloth or a zipper. It will break the clip. Attach a strap to the transmitter and fasten the clip to the patient’s clothes or bed sheets. If the transmitter falls off, the transmitter may be damaged and the batteries may come out. If the patient touches the battery terminal when putting the batteries back in the transmitter, excess patient leakage current may flow into the patient. If the transmitter falls into water or a toilet, stop using the transmitter and contact your Nihon Kohden representative. 22 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Turning On the Transmitter When the batteries are installed correctly, the power is turned on. A one second “peep” sounds and the startup screen appears, then the check electrodes screen appears. (There is no “peep” sound when there is no battery power.) After checking that the ECG is stable on the check electrodes screen, press the Screen key to display the numeric and waveform screen. For details on the screen, refer to the “Screen Descriptions” section. Check Items Before Use Before turning on the transmitter power, check the following to confirm that the transmitter can be used in normal and safe condition. Appearance • There are no damaged or dirty parts on the outside of the transmitter (LCD, keys, sockets, battery case cover, battery case, etc.). • The transmitter is completely dry. • The electrodes, electrode lead and SpO2 probe are not broken. Operator’s Manual ZM-520PA/521PA/530PA/531PA 23 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Batteries • The battery polarity is correct. • The battery case spring is firmly attached and the battery is not loose. • The battery case cover is firmly closed. Channel Setting • The transmitter channel matches the receiving monitor channel. • There is no nearby transmitter with the same channel. Other • When performing defibrillation, set the hum filter to ON on the receiving monitor. The waveform recovery may become slow due to electrode polarization when the hum filter is set to OFF. Check Items After Power On After turning on the power, check the following. Power On • The transmitter generates a one second “peep” sound and the startup screen appears. • The transmitter displays the check electrodes screen. • The transmitter is not too hot. • The transmitter does not display the “BATTERY WEAK” message. • The transmitter does not interfere with the operation of other medical instruments. Daily Check • The “signal loss” message is not displayed on the receiving monitor when the transmitter is inside the receiving range of the monitor. • The battery replacement message is not displayed on the monitor. • The keys on the transmitter function properly. • The LCD brightness is appropriate. To adjust brightness, refer to the “Changing SYSTEM SETUP Settings” section. Check Items After Use To use the transmitter in safe and optimum condition for next time, check the following. Before Turning Power Off • Temporarily changed settings are changed back to the previous settings. • There was no malfunction on the transmitter. Storage • ECG electrode leads and SpO2 probe are cleaned and disinfected. • If the transmitter got wet, liquid is wiped off and the transmitter is thoroughly dried. • There are enough consumables, such as disposable electrodes. • The transmitter power is turned off by removing batteries from the transmitter. • Dead batteries are disposed of properly. 24 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Turning Off the Transmitter To turn off the power, remove batteries. When the power is turned off, the saved waveform and numeric data are deleted. Changing the Transmitter Channel The channel of the transmitter can be changed with an optional QI-901PK channel writer. WARNING The following actions must be taken to properly receive the transmitter signal of the correct patient on the receiving instrument. Otherwise, there may be signal loss or signals may mix causing a serious accident, such as monitoring a different patient. • Assign a channel administrator in the hospital and only he or she should manage channel assignment. • The channel administrator must manage the channels in the facility so that there is no signal interference. • When the transmitter channel is changed, the channel administrator must check that the channel on the receiving monitor is also changed and the signal is properly received. • The channel administrator must replace the channel number label on the transmitter with the new one after changing the channel. NOTE • The software version of the QI-901PK channel writer must be 02-01 or later to change the channel on the transmitter. • The channel writer must be used outside the patient environment. The channel is displayed in the upper left corner of the screen. Channel Operator’s Manual ZM-520PA/521PA/530PA/531PA 25 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Changing Parameter and System Setup Settings The initial settings on the PARAMETER SETUP and SYSTEM SETUP screens can only be changed before monitoring. Changing these settings during monitoring interrupts monitoring. NOTE Changing Parameter and System Setup settings must be done by qualified personnel. Changing PARAMETER SETUP Settings Parameter Setup Setting List The factory default settings are underlined. Setting item Description ECG ELECTRODES Select the electrode lead type. LEAD TYPE Select the type of ECG leads. Turn ECG monitoring on or off. When electrodes are attached to the patient and ECG leads are connected, ECG monitoring starts even when this setting is set to OFF. If this setting is set to OFF, the same setting on the receiving monitor must also be set to OFF. Settings IEC, AHA AUTO, 6 LEADS NOTE ECG MEASUREMENT RESP MEASUREMENT 26 When “PROTOCOL” on the transmitter is set to 51 and the receiving monitor is able to receive protocol 51, ECG measurement on the receiving monitor is automatically set to OFF when this setting is set to OFF on the transmitter. To use protocol 51, the ORG-9100A/ORG9110A multiple patient receiver software version 03-03 or later is required. Turn respiration monitoring on or off. When this setting is set to OFF, the same setting on the receiving monitor is automatically set to OFF. ON, OFF ON, OFF Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Setting item ᛚ ⌀ᨩ⌬ޓ Description Settings Select the SpO2 response mode. FAST: Select this for special applications that require a fast response. FAST is FAST, NORMAL, suitable for detecting short apnea. SLOW NORMAL: For normal monitoring. SLOW: Select this when you need to suppress a rapid change in SpO2. SpO2 RESPONSE Displaying the PARAMETER SETUP Screen Turn off the transmitter by removing one battery. 2. While pressing the Function key, turn on the transmitter (install the battery). The MENU screen appears. 3. Press the key to move the cursor to “PARAMETER SETUP”. 4. Press the Function key to enter PARAMETER SETUP. The current settings are highlighted. 5. Change settings: • To move the cursor and select the setting item, press the or key then press the Function key. • To select and register the setting, press the or key then press the Function key. • To cancel changing the setting of the selected item, press the Screen key. 6. When changing settings on the PARAMETER SETUP screen is complete, press the Screen key to return to the MENU screen. MENU screen Cursor Setting item Setting ▼ ▼ ▼ ▼ ▼ PARAMETER SETUP screen - page 1 7. Press the 8. Press the Function key. The numeric and waveform screen appears. or ▼ Cursor ▼ 1. key to move the cursor to “EXIT”. Operator’s Manual ZM-520PA/521PA/530PA/531PA 27 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Changing Parameter Setup Settings ECG ELECTRODES Select the electrode lead type. On the PARAMETER SETUP screen, press the key to move the cursor to “ECG ELECTRODES”. 2. Press the Function key. The cursor moves to the selection item. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “ECG ELECTRODES”. Selected setting ▼ Cursor 1. ▼ Cursor Setting item key to select “IEC” or “AHA”. ▼ LEAD TYPE Select the type of ECG leads. In normal use, select “AUTO”. When using DIN type lead with 6 electrodes, select “6 LEADS”. 1. On the PARAMETER SETUP screen, press the 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “LEAD TYPE”. 28 ▼ key to move the cursor to “LEAD TYPE”. key to select “AUTO” or “6 LEADS”. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ ECG MEASUREMENT Turn ECG monitoring on or off. When electrodes are attached to the patient and ECG leads are connected, ECG monitoring starts even when this setting is set to OFF. If this setting is set to OFF, the same setting on the receiving monitor must also be set to OFF. NOTE ▼ When “PROTOCOL” on the transmitter is set to 51 and the receiving monitor is able to receive protocol 51, ECG measurement on the receiving monitor is automatically set to OFF when this setting is set to OFF on the transmitter. To use protocol 51, the ORG9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. 1. On the PARAMETER SETUP screen, press the MEASUREMENT”. 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “ECG MEASUREMENT”. ▼ key to move the cursor to “ECG key to select “ON” or “OFF”. ▼ RESP MEASUREMENT Turn respiration monitoring on or off. When this setting is set to OFF, the same setting on the receiving monitor is automatically set to OFF. key to move the cursor to “RESP On the PARAMETER SETUP screen, press the MEASUREMENT”. 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “RESP MEASUREMENT”. ▼ 1. key to select “ON” or “OFF”. Operator’s Manual ZM-520PA/521PA/530PA/531PA 29 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 RESPONSE Select the SpO2 response mode. FAST: Select this for special applications that require a fast response. FAST is suitable for detecting short apnea. NORMAL: For normal monitoring. SLOW: Select this when you need to suppress a rapid change in SpO2. On the PARAMETER SETUP screen, press the key to move the cursor to “SpO2 RESPONSE”. “SpO2 RESPONSE” is on the second page of the PARAMETER SETUP screen. 2. Press the Function key. 3. Press the key to select “FAST”, “NORMAL” or “SLOW”. 4. Press the Function key to register the selected setting. The cursor returns to “SpO2 RESPONSE”. PARAMETER SETUP screen - page 2 30 ▼ ▼ 1. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Changing SYSTEM SETUP Settings System Setup Setting List The factory default settings are underlined. Setting Item PROTOCOL Description Select the transmitting protocol. 51: New protocol. A central monitor with ORG9100A/9110A multiple patient receiver whose software version 03-03 or later can receive this protocol. 41: Old protocol. A central monitor with ORG9100A/9110A/9700A multiple patient receiver can receive this protocol. Settings 51, 41 NOTE When 51 is set, the receiving monitor must be able to receive protocol 51. Otherwise, signals from the transmitter cannot be received. To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. BRIGHTNESS FUNCTION KEY Select the screen brightness. Select the function of the Function key. SUSPEND ALARM & PAUSE: Suspends alarm on the receiving monitor for 2 minutes. Pauses monitoring on the transmitter and receiving monitor. SUSPEND ALARM: Suspends alarm on the receiving monitor for 2 minutes. CONFIRM: Displays the “PATIENT CONFIRMED” message on the transmitter screen and transmits the message to the receiving monitor. OFF: No function. DARK, BRIGHT SUSPEND ALARM & PAUSE, SUSPEND ALARM, CONFIRM, OFF NOTE “SUSPEND ALARM & PAUSE” and “CONFIRM” can only be set when PROTOCOL is set to 51. To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. Operator’s Manual ZM-520PA/521PA/530PA/531PA 31 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Setting Item AUTO RESUME AFTER PAUSE Description Select the interval to resume monitoring after PAUSE. Settings 10 s, 30 s, 1 min, 2 min, 3 min, OFF Displaying the SYSTEM SETUP Screen Turn off the transmitter by removing one battery. 2. While pressing the Function key, turn on the transmitter (insert the battery). The MENU screen appears. 3. Press the key to move the cursor to “SYSTEM SETUP”. 4. Press the Function key to enter SYSTEM SETUP. The current settings are highlighted. 5. Change settings. • To move the cursor and select the setting item, press the or key then press the Function key. • To select and register the setting, press the or key then press the Function key. • To cancel changing the setting of the selected item, press the Screen key. Setting ▼ ▼ ▼ Setting item ▼ MENU screen ▼ Cursor 1. ▼ The SYSTEM SETUP screen has two pages. To display the second page, press the key when the cursor is at “BRIGHTNESS”. 7. Press the “EXIT”. 8. Press the Function key. The numeric and waveform screen appears. SYSTEM SETUP screen - page 1 32 or ▼ When changing settings on the SYSTEM SETUP screen is complete, press the Screen key to return to the MENU screen. ▼ 6. key to move the cursor to Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Changing System Setup Settings PROTOCOL Select the transmitting protocol. For differences between protocols, refer to the table below. 51: New protocol. A central monitor with ORG-9100A/9110A multiple patient receiver whose software version 03-03 or later can receive this protocol. 41: Old protocol. A central monitor with ORG-9100A/9110A/9700A multiple patient receiver can receive this protocol. NOTE When 51 is set, the receiving monitor must be able to receive protocol 51. Otherwise, signals from the transmitter cannot be received. Differences Between Protocols Transmit RESP message Cursor Setting Protocol 51 No (ECG measurement must be turned off on Yes the receiving monitor) No Yes No Yes No Yes Some messages (refer to the “Indication and All messages Message List” section) No Yes ▼ Transmit SpO2 messages Protocol 41 1. Press the key to move the cursor to “PROTOCOL”. 2. Press the Function key. 3. Press the Operator’s Manual ZM-520PA/521PA/530PA/531PA ▼ Function Setting ECG MEASUREMENT to OFF on the transmitter automatically turns off the ECG measurement setting on the receiving monitor Pause monitoring on the receiving monitor from the transmitter Transmit “PATIENT CONFIRMED” message Display battery level of the transmitter on the receiving monitor key to select “51” or “41”. 33 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ NOTE FUNCTION KEY (on the second page of the SYSTEM SETUP screen) can be set to “SUSPEND ALARM & PAUSE” or “CONFIRM” only when PROTOCOL is “51”. If PROTOCOL is changed to “41”, FUNCTION KEY is automatically changed to “OFF”. 4. Press the Function key to register the selected setting. The cursor returns to “PROTOCOL”. ▼ BRIGHTNESS Select the screen brightness. 1. Press the 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “BRIGHTNESS”. ▼ key to move the cursor to “BRIGHTNESS”. key to select “DARK” or “BRIGHT”. FUNCTION KEY Select the function of the Function key. For details on using these functions, refer to “Basic Monitoring Operation” in the “Monitoring” section. SUSPEND ALARM & PAUSE: Suspends alarm on the receiving monitor for 2 minutes. Pauses monitoring on the transmitter and receiving monitor. SUSPEND ALARM: Suspends alarm on the receiving monitor for 2 minutes. CONFIRM: Displays the “PATIENT CONFIRMED” message on the transmitter screen and transmits the message to the receiving monitor. OFF: No function. NOTE “SUSPEND ALARM & PAUSE” and “CONFIRM” can only be set when PROTOCOL is set to 51. 34 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᛚ ⌀ᨩ⌬ޓ 1. On the SYSTEM SETUP screen, press the key to move the cursor to “FUNCTION KEY”. “FUNCTION KEY” is on the second page of the SYSTEM SETUP screen. 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns “FUNCTION KEY”. SYSTEM SETUP screen - page 2 ▼ ▼ ᚑ 㒙ጊޓᖘᏆ key to select the function. ▼ AUTO RESUME AFTER PAUSE Select the interval to resume monitoring after PAUSE. When one of the following conditions is met, monitoring resumes on the receiving monitor. When OFF is selected, monitoring does not automatically resume. • Heart rate is properly monitored for the selected interval • SpO2 is properly monitored for the selected interval Press the key to move the cursor to “AUTO RESUME AFTER PAUSE”. “AUTO RESUME AFTER PAUSE” is on the second page of the SYSTEM SETUP screen. 2. Press the Function key. 3. Press the 4. Press the Function key to register the selected setting. The cursor returns to “AUTO RESUME AFTER PAUSE”. ▼ 1. key to select interval. Operator’s Manual ZM-520PA/521PA/530PA/531PA 35 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Initializing Settings Do the following procedure to initialize all settings, except for channel, to the factory default settings. 1. Turn off the transmitter by removing a battery. 2. While pressing the Function key, turn on the transmitter (put back the battery). The MENU screen appears. 3. Press the key to move the cursor to “SYSTEM INITIALIZE”. 4. Press the Function key to enter SYSTEM INITIALIZE screen. 5. Press the Function key to initialize settings. The confirmation message appears. ▼ Cursor To return to the MENU screen without initializing, press the Screen key. Press the Function key to initialize settings. ▼ 6. To cancel initializing, press the key. The screen returns to the MENU screen. 36 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Attaching Electrodes and SpO2 Probe to the Patient Attaching Electrodes Selecting Electrode Lead CAUTION Only use Nihon Kohden specified electrodes and electrode leads. When other type of electrodes or electrode leads are used, the “CHECK ELECTRODES” message may be displayed and ECG monitoring may stop. The following electrodes and leads can be used on the transmitter (option). No. of Electrodes Disposable Electrodes Vitrode F-150M, F-150S, L-150, L-150X Electrode Lead BR-903PA (AHA, clip type) (I, II, III) Disposable Electrode with DIN type lead, Vitrode V-090M3, V-09IO3, V-120S3, N-03IS3 Vitrode F-150M, F-150S, L-150, BR-906PA (AHA, clip type) L-150X (I, II, III, aVR, aVL, aVF, 2 from V1 to V6) Disposable Electrode with DIN type lead, Vitrode V-040M4, V-04IO4, V-060M6, V-06IO6 Operator’s Manual ZM-520PA/521PA/530PA/531PA 37 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Connecting the Electrode Lead to the Transmitter Connect the electrode lead to the ECG/RESP socket on the transmitter. WARNING After attaching the electrode to the patient and connecting the electrode lead to the transmitter, check that electrodes are attached to the patient and check that the electrode lead is connected to the transmitter properly. When the electrodes are removed from the patient, do not touch the metal part of the electrode with bare hands or let the metal part of the electrode contact the metal part of the bed or any other conductive parts. Failure to follow this warning may cause electrical shock or injury to the patient by discharged energy. CAUTION Do not shake or swing the transmitter while holding the leads or cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. CAUTION Hold the connector of the electrode lead when connecting/disconnecting the electrode lead. If you disconnect the electrode lead by pulling the lead, it damages the electrode lead. 38 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Electrode Position Follow the physician’s instructions for electrode placement when available. For ECG monitoring, electrodes are attached only on the chest to allow patient movement and obtain continuous stable ECG. The following leads are examples. When also monitoring respiration, refer to the “Electrode Position for Respiration Monitoring” section. NOTE The optimum electrode positions for ECG measurement are not always optimum for respiration measurement. Select positions that are suitable for both ECG and respiration measurement or positions which give priority to either ECG or respiration measurement. Electrode Positions for ECG Monitoring Six Electrodes The 6-electrode method with lead II and lead V5 is effective for monitoring myocardial ischemia. You can improve monitoring accuracy considerably by adding lead V4 to this combination. Va and Vb can be at any position of the standard 12 leads V1 to V6, but V4 and V5 are most appropriate for myocardial ischemic monitoring. LA/L RA/R Va/Ca Vb/Cb RL/RF Electrode Position LL/F Symbol AHA IEC Lead Color AHA IEC Left infraclavicular fossa LA Black Yellow Right infraclavicular fossa RA White Red Below lowest rib on the left anterior axillary line LL Red Green RL RF Green Black Va Ca Brown-blue White-brown Vb Cb Right anterior axillary line at the same level as LL/F Fifth intercostal space on the left midclavicular line (V4 position of standard 12 leads) Left anterior axillary line at the same level as Va (V5 position of standard 12 leads) Operator’s Manual ZM-520PA/521PA/530PA/531PA Brown-orange White-black 39 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Lead Position Standard limb leads Lead II Lead RA Lead II LA Lead III RA LL N (RL) Monopolar limb leads aVR lead N (RL) aVL lead aVF lead RA LA RA LA N (RL) N (RL) LA LL LL LL LA LL LL N (RL) RA RA LA N (RL) Monopolar chest leads V1 to V6 leads to RA LA LL N (RL) 40 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Three Electrodes • Lead MII, which is similar to standard lead II, used when ECG measurement has priority R/RA (−) L/LA (N) F/LL (+) Electrode Position Left infraclavicular fossa Right infraclavicular fossa Below lowest rib on the left anterior axillary line • Lead MI, which is similar to standard lead I Change F/LL and L/LA of lead MII. R/RA (−) Symbol AHA IEC Lead Color AHA IEC LA Black Yellow RA White Red LL Red Green • Lead MIII, which is similar to standard lead III Change R/RA and L/LA of lead MII. F/LL (+) L/LA (N) L/LA (N) R/RA (−) F/LL (+) If the electrode positions above are not available due to chest surgery, attach the electrodes to the root of the limbs or below the clavicles for stable ECG monitoring. Operator’s Manual ZM-520PA/521PA/530PA/531PA 41 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Electrode Positions for Respiration Monitoring Place the R/RA and F/LL electrodes so that the lungs are between the electrodes. Position 1 In this position, respiration measurement is available; however, there is a difference in amplitude between different patients. R or RA R/RA (−) Right infraclavicular fossa F or LL Fifth intercostal space on the left midclavicular line, V4 F/LL (+) Position 2 In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead MII. This position can be generally recommended. R or RA R/RA (−) Right infraclavicular fossa F or LL Fifth intercostal space on the left midaxillary line, V6 F/LL (+) Position 3 In this position, the respiration waveform is optimum, but the ECG lead is unusual. R/RA (−) 42 R or RA Right midaxillary at the horizontal level of V6 F or LL Fifth intercostal space on the left midaxillary line, V6 F/LL (+) Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Position 4 In this position, the respiration measurement is influenced by the impedance variation of the abdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that the waveform is inverted in phase compared with the chest movement (the waveform goes down during inspiration). It is difficult to measure the ECG at the same time. R/RA (−) R or RA Lowest rib on the right anterior axillary line F or LL Lowest rib on the left anterior axillary line F/LL (+) Attaching Electrodes to the Patient and Connecting the Electrode Leads to Disposable Electrodes Prepare the Patient Skin Shave off excessive body hair. To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistened with alcohol. Thoroughly dry the skin with a clean cotton pad. NOTE • For a patient with frequent body movement, rub the sites with skinPure skin preparation gel. However, do not use skinPure skin preparation gel on sensitive skin. • Do not place electrodes on a wound or on an inflamed, wrinkled or uneven skin surface. Attaching Electrodes to the Patient CAUTION Do not reuse disposable parts and accessories. NOTE • To maintain good contact between the electrode and skin, check that the paste of the disposable electrode is not dry. • When contact between the disposable electrode and skin becomes poor, replace electrodes with new ones immediately. Otherwise, contact impedance between the skin and the electrode increases and accurate ECG and respiration waveforms cannot be obtained. Operator’s Manual ZM-520PA/521PA/530PA/531PA 43 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Refer to the electrode operator’s manual for details. 1. Carefully remove the backing paper from the electrode. Avoid touching the adhesive surface. 2. Place the electrode on the previously cleaned skin. Pay attention to the electrode lead color and symbol. 3. Clip the electrode lead to the electrode. 4. Fasten the electrode lead wire with surgical tape with an extra length of wire between the tape and the electrode. This lessens the movement of electrode leads by body movement and helps stable monitoring. Checking ECG on the Transmitter Screen After attaching electrodes and connecting ECG leads, check that the electrodes are properly attached to the patient and the ECG waveform is acquired on the check electrodes screen. For details on the screen, refer to the “Screen Descriptions” section. Attaching the SpO2 Probe Selecting the SpO2 Probe Select an appropriate probe for the patient. CAUTION CAUTION Only use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed. 44 Do not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Reusable Probes When using a TL-201T finger probe, choose the appropriate cable length for attachment. Probe Finger probe TL-201T Cable Length 0.6 m Patient Adult or child 20 kg or more Attachment Site Finger Adult or infant 3 kg or more Finger or toe Neonate 3 kg or less Instep and sole Adult or child 20 kg or more Finger or toe 1.6 m Multi-site probe TL-220T Attachment tape Finger probe TL-631T1, TL-631T3 Attachment tape TL-631T1: 0.6 m TL-631T3: 1.6 m Disposable Probes CAUTION The disposable probe is not sterilized. Use the disposable probe only for a single patient. Never reuse the disposable probe for another patient because it causes cross infection. Operator’s Manual ZM-520PA/521PA/530PA/531PA 45 ᚑ 㒙ጊޓᖘᏆ Probe TL-051S, TL-052S ᛚ ⌀ᨩ⌬ޓ Patient Attachment Site Adult 50 kg or more Finger Neonate 3 kg or less Instep and sole Adult or child 15 to 50 kg Finger Infant 3 to 15 kg Toe Adult 30 kg or more Finger or toe 40 mm Cable length TL-051S: 0.8 m TL-052S: 1.6 m TL-061S, TL-062S 35 mm Cable length TL-061S: 0.8 m TL-062S: 1.6 m TL-271T, TL-271T3 Cable length TL-271T: 0.8 m TL-271T3: 1.6 m TL-272T, TL-272T3 Child 10 to 50 kg Cable length TL-272T: 0.8 m TL-272T3: 1.6 m 46 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Probe TL-273T, TL-273T3 ᛚ ⌀ᨩ⌬ޓ Patient Neonate 3 kg or less Attachment Site Instep and sole Adult 40 kg or more Finger or toe Infant 3 to 20 kg Finger or toe Cable length TL-273T: 0.8 m TL-273T3: 1.6 m TL-274T, TL-274T3 Cable length TL-274T: 0.8 m TL-274T3: 1.6 m Connecting the SpO2 Probe to the Transmitter Connect the probe to the SpO2 socket on the transmitter. CAUTION Do not shake or swing the transmitter while holding the leads or cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. CAUTION Do not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient. Operator’s Manual ZM-520PA/521PA/530PA/531PA 47 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Attaching the Probe to the Patient Attach the probe to the patient by referring to the probe’s manual. Make sure that the light emitter and photo detector of the probe face each other at the attachment site. WARNING WARNING • When using the TL-201T finger probe, do not fasten the probe and cable to the finger by wrapping with tape. This may cause burn, congestion or pressure necrosis from poor blood circulation. • When using probes other than the TL-201T finger probe, to avoid poor circulation, do not wrap the tape too tight. Check the blood circulation condition by observing the skin color and congestion at the skin peripheral to the probe attachment site. Even for short-term monitoring, there may be burn or pressure necrosis from poor blood circulation, especially on neonates or low birth weight infants whose skin is delicate. Accurate measurement cannot be performed on a site with poor peripheral circulation. Check the circulation condition by observing the skin color at the measurement site and pulse waveform. Change the measurement site every 8 hours for disposable probes and every 4 hours for reusable probes (every 8 hours for TL-631T series probe). The skin temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and cause a burn or pressure necrosis. When using the probe on the following patients, take extreme care and change the measurement site more frequently according to symptoms and degree. • Patient with a fever • Patient with insufficient peripheral circulation • Neonate or low birth weight infant with delicate skin WARNING When monitoring SpO2 of a patient who is receiving photodynamic therapy, the light from the finger probe sensor may cause a burn. Photodynamic therapy uses a photosensitizing agent that has a side effect of photosensitivity. The SpO2 probe manufactured by Nihon Kohden have two wavelengths with peaks in the range of 650 and 950 nm. The maximum light intensity is less than 5.5 mW. 48 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION CAUTION If the attachment site is dirty with blood or bodily fluids, clean the attachment site before attaching the probe. If there is nail polish on the attachment site, remove the polish. Otherwise, the amount of transmitted light decreases, and measured value may be incorrect or measurement cannot be performed. When the probe is attached on an appropriate site with sufficient circulation and the error message confirming the probe attachment repeatedly appears, the probe may be deteriorated. Replace it with a new one. CAUTION CAUTION If the skin gets irritated or redness appears on the skin from the probe, change the attachment site or stop using the probe. Take extreme care for the patients with delicate skin. Do not use a probe which is deteriorated by aging. Accurate measurement cannot be performed. CAUTION Refer to the probe instruction manual for details. CAUTION The disposable probe is not sterilized. Use the disposable probe only for a single patient. Never reuse the disposable probe for another patient because it causes cross infection. Operator’s Manual ZM-520PA/521PA/530PA/531PA 49 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Locking the Keys on the Transmitter ▼ Press the appears. and ▼ To prevent the patient from pressing the keys on the transmitter during monitoring, you can lock the keys. keys at the same time and hold for more than 3 seconds. The key lock screen When there is no key operation for one minute after locking the keys, the display turns off. 50 ▼ ▼ To unlock the keys: Press the and keys at the same time and hold for more than 3 seconds. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Monitoring CAUTION The measurement values and displayed waveforms on the transmitter and receiving monitor may be different due to timing delay of the display or difference in detection settings. NOTE Do not let the transmitter continuously contact the patient’s skin directly. The transmitter heats up by 2 or 3°C (4 or 5°F) during operation and it may cause low temperature burn to the patient. Screen Descriptions When the transmitter is turned on, the startup screen appears, then the check electrodes screen to check the electrode attachment appears. The screen changes in the following order each time the Screen key is pressed. Check electrodes → numeric and waveform → waveform review → numeric review → display off → check electrodes . . . Screen key Operator’s Manual ZM-520PA/521PA/530PA/531PA 51 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ The screen automatically turns off when there is no key operation for 2 minutes on the check electrodes screen or 1 minute on other screens. When the display is off and the Screen key is pressed, the numeric and waveform screen appears. NOTE When the screen before the display off is check electrodes screen and the Screen key is pressed within 5 minutes after the display off, the check electrodes screen appears. 52 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Check Electrodes Screen You can check whether the electrodes are properly attached to the patient and the ECG waveform is acquired. When 6 leads are used, I, II, Va and Vb lead waveforms are displayed. When 3 leads are used, only II lead waveform is displayed. Battery level Channel number Lead ECG waveform Filter: off Sweep speed: 12.5 mm/s Waveform sensitivity: 0.5 cm/1 mV Message Detached electrode position When electrodes are detached, the “CHECK ELECTRODES” message and detached electrode position appear on the screen. NOTE When ECG measurement is set to OFF on the PARAMETER SETUP screen, the check electrodes screen does not appear. Operator’s Manual ZM-520PA/521PA/530PA/531PA 53 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Numeric and Waveform Screen ▼ ▼ Numeric values and waveforms of the monitoring parameters are displayed. You can change the ECG lead with the and keys. SpO2 Pulse bar graph QRS sync mark Heart rate ECG lead ECG waveform Filter: on Sweep speed: 12.5 mm/s Waveform sensitivity: auto Waveform sensitivity When ECG and respiration measurement is turned off Pulse rate SpO2 Pulse sync mark Pulse wave sensitivity Pulse waveform Sweep speed: 12.5 mm/s Waveform sensitivity: auto 54 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ NOTE The pulse wave amplitude varies according to the ratio of the pulsation component to the entire transmitted IR signal. When the pulsation component ratio is 1%, the pulse wave amplitude is about 5 mm at ×1 sensitivity on the screen. Waveform Review Screen ECG full disclosure for up to 10 minutes can be saved and reviewed. When ECG measurement is turned off and SpO2 is monitored, the pulse waveform is saved. When ECG lead is changed on the numeric and waveform screen, the ECG full disclosure of the changed lead is saved. The saved data is deleted when the transmitter is turned off. Time range of the displayed waveform (time before the waveform review screen is displayed) Displayed page Older data Newer data ECG lead ▼ To scroll the waveform, press the or ▼ Compressed ECG waveform Waveform sensitivity 7.5 s × 4 traces per page, total of 20 pages key. The waveform is scrolled by 30 seconds. Operator’s Manual ZM-520PA/521PA/530PA/531PA 55 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Numeric Review Screen Numeric data of heart rate (or pulse rate when ECG is turned off), SpO2 and respiration rate for up to 10 minutes are saved at 1 minute intervals. The saved data is deleted when the transmitter is turned off. Older data Time before the numeric review screen is displayed Newer data Display Off The display can be turned off any time. To turn off the display, press the Screen key several times until the following screen appears then wait 5 seconds. 56 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Basic Monitoring Operation Using the Function Key Function key One of the following functions can be assigned to the Function key on the SYSTEM SETUP screen. Refer to the “Changing SYSTEM SETUP Settings” section. SUSPEND ALARM: Suspends alarms on the receiving monitor before they occur for 2 minutes. PAUSE: Pauses monitoring on the transmitter and receiving monitor. CONFIRM: Transmits the signal that the patient is confirmed and displays the “PATIENT CONFIRMED” message on the transmitter. NOTE To use the Function key for PAUSE or CONFIRM, you must set “PROTOCOL” on the SYSTEM SETUP screen of the transmitter to 51 and the receiving monitor must be able to receive protocol 51. To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. Operator’s Manual ZM-520PA/521PA/530PA/531PA 57 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Suspending Alarms on the Receiving Monitor When the FUNCTION KEY is set to “SUSPEND ALARM” or “SUSPEND ALARM & PAUSE” on the SYSTEM SETUP screen, alarms can be suspended for 2 minutes on the receiving monitor before they occur. 2. ▼ To suspend alarms: 1. Press the Function key. The “Suspend alarms” confirmation screen appears. Press the key to suspend alarms. To cancel suspending alarms and return to the previous screen, press the Screen key. When the alarms are suspended, the “ALARMS SUSPENDED” message and alarm suspended icon with the remaining minutes in alarm suspension appear on the transmitter screen. Message 58 Icon Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ 2. ▼ To cancel suspending alarms during 2 minute alarm suspension: 1. Press the Function key while the “ALARMS SUSPENDED” message is displayed. The confirmation screen appears. Press the key to cancel alarm suspension. Press the Screen key to not cancel alarm suspension. Pause Monitoring When the FUNCTION KEY is set to “SUSPEND ALARM & PAUSE” on the SYSTEM SETUP screen, you can pause monitoring on the receiving monitor from the transmitter when the patient cannot be monitored, such as during X-ray examination. NOTE To use the Function key for PAUSE, you must set “PROTOCOL” on the SYSTEM SETUP screen of the transmitter to 51 and the receiving monitor must be able to receive protocol 51. To use protocol 51, the ORG-9100A/ORG-9110A multiple patient receiver software version 03-03 or later is required. Monitoring on the receiving monitor resumes when one of the following conditions is met. When OFF is selected for “AUTO RESUME AFTER PAUSE” on the SYSTEM SETUP screen, monitoring does not automatically resume. • Heart rate is properly monitored on the transmitter for the interval selected for “AUTO RESUME AFTER PAUSE”. • SpO2 is properly monitored on the transmitter for the interval selected for “AUTO RESUME AFTER PAUSE”. Operator’s Manual ZM-520PA/521PA/530PA/531PA 59 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ To pause monitoring: 1. Press the Function key. The “Suspend alarms” confirmation screen appears. Press the Function key for 3 seconds to display the “Pause monitoring” confirmation screen. 3. Press the key to pause monitoring. To cancel pause monitoring, press the Screen key. 4. Wait about 5 seconds until the “Turn power off” screen appears. 60 ▼ 2. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ 5. ᛚ ⌀ᨩ⌬ޓ Turn off the transmitter. If the transmitter is not turned off and monitoring continues for the interval set for “AUTO RESUME AFTER PAUSE” on the SYSTEM SETUP screen, pause monitoring is cancelled and monitoring continues. Resume Monitoring after Pause To resume monitoring after pause, check that the electrodes, electrode leads and probe are attached to the patient then turn on the transmitter. Confirming Patient When the FUNCTION KEY is set to “CONFIRM” on the SYSTEM SETUP screen, pressing the Function key sends a signal to the receiving monitor to indicate that the patient or patient condition is confirmed by medical staff. Message Operator’s Manual ZM-520PA/521PA/530PA/531PA 61 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Turning the Display Off The display can be turned off any time. To turn off the display, press the Screen key several times until the following screen appears then wait 5 seconds. 5 second time bar until the display turns off Turning the Display On after It was Turned Off Press the Screen key. The numeric and waveform screen appears. If the screen is turned off on the “Keys locked” screen, the “Keys locked” screen appears. When the Screen key is pressed within 5 minutes after the display was turned off, the previous screen appears. 62 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ ECG and Respiration Monitoring When the electrodes are attached and the ECG leads are connected, the heart rate, ECG waveform, respiration rate and respiration waveform appear on the receiving monitor. Refer to the operator’s manual of the receiving monitor for details. When 6 leads are used on this transmitter, up to 8 leads (I, II, III, aVR, aVL, aVF, Va and Vb) of ECG waveforms can be displayed on the receiving monitor. The heart rate is also measured. When 3 leads are used, one channel ECG waveform of lead II can be displayed on the receiving monitor. Refer to the operator’s manual of the monitor for details. QRS sync mark Heart rate Respiration rate Pacing marks White pacing marks are displayed at the points where a pacing spike is detected. ▼ Filter: on Sweep speed: 12.5 mm/s Waveform sensitivity: auto ▼ ECG waveform ECG lead You can change the ECG lead with the and keys. CAUTION Turn off the power of mobile phones, small wireless devices and other devices which produce strong electromagnetic interference around a patient (except for devices allowed by the hospital administrator). Radio waves from devices such as mobile phones or small wireless devices may be mistaken as pulse waves or respiration waves and the displayed data may be incorrect. NOTE • ECG cannot be monitored on a neonate using this transmitter. • When performing defibrillation, set the hum filter to ON on the receiving monitor. The waveform recovery may become slow due to electrode polarization when the hum filter is set to OFF. Operator’s Manual ZM-520PA/521PA/530PA/531PA 63 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Use with a Pacemaker When monitoring a pacemaker patient, the transmitter detects pacemaker pulse and rejects the pacemaker pulse from the heart rate count. WARNING Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac Monitoring and Diagnostic Equipment* The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker may be affected by transmitter which is connected to the same patient. If this occurs, the pacemaker may pace at its maximum rate and the transmitter may give incorrect data to the monitor. If this occurs, disconnect the electrode leads from the patient or change the setting on the pacemaker by referring to the pacemaker’s manual. For more details, contact your pacemaker representative or Nihon Kohden representative. * Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric impedance measurement (BIM). Many medical devices in addition to pacemakers use this technology. When one of these devices is used on a patient with an active, minute ventilation rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals created in the patient, resulting in an elevated pacing rate. For more information, see the FDA web site. http://www.fda.gov/cdrh/safety.html WARNING The transmitter detects the pacemaker pulse and rejects the pacemaker pulse from the heart rate count. However, all of the pacemaker pulse might not be rejected. If the pacemaker pulse is not rejected, the pacemaker pulse is detected as QRS and false heart rate may be indicated. Keep pacemaker patients under close observation. * For the pacemaker pulse rejection capability of ZM-520PA/521PA/530PA/531PA transmitter refer to the “Specifications - ECG” section. WARNING The pacemaker pulse can be overlooked or detected as QRS. You cannot confirm the pacemaker operation only from the detected pacemaker pulse. NOTE • If an electric blanket is used and incorrect heart rate is displayed on the monitor, turn off the pacing spike detection on the monitor. 64 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ • Turn the pacing spike detection to ON on the receiving monitor when monitoring a pacemaker patient. Pacing pulse is detected by the transmitter and transmitted to the monitor. If the pacing spike detection is turned OFF, QRS and pacemaker spike might not be distinguished and pacemaker failure might not be recognized. Use with an Electrosurgical Unit For use with an electrosurgical unit (ESU), this transmitter has a circuit to protect the patient from skin burn and to reduce ESU interference on the ECG waveform. However, the effectiveness of this circuit depends on electrode position and transmitter setup. With an ESU, pay attention to the following points. WARNING When the transmitter is used with an electrosurgical unit (ESU), firmly attach the entire area of the ESU return plate. Otherwise, the current from the ESU flows into the electrodes of the transmitter, causing electrical burn where the electrodes are attached. For details, refer to the ESU manual. NOTE Noise generated from an electrosurgical unit may interfere on an ECG waveform, but will not damage it. • Measure with 3-electrode lead Use the minimum number of electrodes. Use new electrodes. • Minimize noise 1. Select an ECG lead where the active ECG electrodes are located as far from the incision as possible. 2. Position the + and – electrodes as close as possible. 3. Select the leads where the angle (θ) between the active electrodes and the incision is as small as possible. 4. Set the electrosurgical return plate as close to the incision as possible. As far as possible from electrode and as near as possible to incision. Return plate Incision Make Operator’s Manual ZM-520PA/521PA/530PA/531PA small 65 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Turning ECG Measurement On/Off ECG measurement can be turned on or off on the PARAMETER SETUP screen. When electrodes are attached to the patient and ECG leads are connected, ECG monitoring starts even when ECG is turned off. When PROTOCOL on the SYSTEM SETUP screen is set to 51: ECG measurement on the receiving monitor is automatically set to off. NOTE ECG measurement on the transmitter cannot be turned on or off from the receiving monitor. When PROTOCOL on the SYSTEM SETUP screen is set to 41: If ECG measurement is turned off on the transmitter, ECG measurement on the receiving monitor must also be turned off. Turning Respiration Measurement On/Off Respiration measurement can be turned on or off on the PARAMETER SETUP screen. If respiration measurement is turned off, respiration measurement on the receiving monitor is also turned off. Electrode Detachment In the following conditions, the “CHECK ELECTRODES” message is displayed on the transmitter and receiving monitor. • Electrode is detached from skin. • Electrode lead is disconnected from the electrode. • Polarization voltage between the electrode and skin is excessively high. In these cases, check the cause and if necessary, replace electrodes with new ones. CAUTION When the “ELECTRODE OFF” or “CHECK ELECTRODES” message is displayed on the receiving monitor, ECG is not monitored properly and the ECG alarm does not function. Check the electrode, electrode leads, and if necessary, replace with new ones. 66 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 Monitoring The SpO2 monitoring is only available on the ZM-530PA/531PA transmitter. When monitoring starts, SpO2 and the pulse waveform are sent to the receiving monitor and SpO2 and the pulse level bar graph are displayed on the transmitter screen. When ECG is not measured, the pulse waveform and pulse rate are also displayed. SpO2 Pulse bar graph NOTE During SpO2 monitoring, the transmitter constantly checks the light intensity of the probe and adjusts the light intensity to maintain optimum measurement condition. During adjustment, the pulse wave becomes flat for about 0.5 seconds. Operator’s Manual ZM-520PA/521PA/530PA/531PA 67 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ WARNING WARNING SpO2 measurement may be incorrect in the following cases. • When the patient’s carboxyhemoglobin or methemoglobin increases abnormally. • When dye is injected in the blood. • When using an electrosurgical unit. • During CPR. • When measuring at a site with venous pulse. • When there is body movement. • When the pulse wave is small (insufficient peripheral circulation). Check the circulation condition by observing the skin color at the measurement site and pulse waveform. Change the measurement site every 8 hours for disposable probes and every 4 hours for reusable probes (every 8 hours for TL-631T series probe). The skin temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and cause a burn or pressure necrosis. When using the probe on the following patients, take extreme care and change the measurement site more frequently according to symptoms and degree. • Patient with a fever • Patient with insufficient peripheral circulation • Neonate or low birth weight infant with delicate skin WARNING WARNING When monitoring SpO2 of a patient who is receiving photodynamic therapy, the light from the finger probe sensor may cause a burn. Photodynamic therapy uses a photosensitizing agent that has a side effect of photosensitivity. When not monitoring SpO2, disconnect the SpO2 cable from the transmitter. Otherwise, noise from the probe sensor may interfere and incorrect data is displayed on the screen. The SpO2 probe manufactured by Nihon Kohden have two wavelengths with peaks in the range of 650 and 950 nm. The maximum light intensity is less than 5.5 mW. 68 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ CAUTION CAUTION Turn off the power of mobile phones, small wireless devices and other devices which produce strong electromagnetic interference around a patient (except for devices allowed by the hospital administrator). Radio waves from devices such as mobile phones or small wireless devices may be mistaken as pulse waves or respiration waves and the displayed data may be incorrect. Failure to follow these instructions may cause cable discontinuity, short circuit, skin burn on the patient from the probe temperature increase due to the short circuit of the probe cable, and incorrect measurement data. If the probe is broken, replace it with a new one. • Do not immerse any part of the probe cable other than the disposable probe in chemical solutions or water. • Do not pull or bend the probe cable. • Do not let caster feet run over the probe cable. CAUTION CAUTION Normal external light does not affect monitoring but strong light such as a surgical light or sunlight may affect monitoring. If affected, cover the measuring site with a blanket. When the probe is attached on an appropriate site with sufficient circulation and the error message confirming the probe attachment repeatedly appears, the probe may be deteriorated. Replace it with a new one. CAUTION CAUTION When a message indicates a faulty probe, stop monitoring and replace the probe with a new one. While a patient is on medication which causes vasodilation, the pulse waveform may change and in rare cases the SpO2 value might not be displayed. CAUTION Do not attach the probe to the same limb that is used for NIBP measurement or an IBP catheter. The SpO2 measurement may be incorrect. Operator’s Manual ZM-520PA/521PA/530PA/531PA 69 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ NOTE • In order to maintain sufficient blood circulation, keep the measurement site warm by covering it with a blanket or something similar. Warming the site is effective, especially for a patient with a small pulse amplitude. • When monitoring a patient who has an IABP and SpO2 cannot be measured, monitor the patient on a wired monitor. If the monitor has a sensitivity mode, set the mode to “MAX”. 70 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Indications and Messages Indication Indication Cause Countermeasure Batteries are fully charged. — Batteries are getting low. Batteries are low. Batteries are almost empty. Replace batteries. Alarms on the receiving monitor were suspended by pressing the Function key on the transmitter. Alarms resume when the suspend interval elapses. To cancel alarm suspension, press the Function key again. Messages When PROTOCOL on the SYSTEM SETUP screen is set to 51, all messages are transmitted. When PROTOCOL is set to 41, the messages marked with * are not transmitted. Message Cause Countermeasure Alarms resume when the 2 minute suspend interval elapses. To cancel alarm suspension, press the Function key again. ALARMS SUSPENDED Alarms on the receiving monitor is suspended by pressing the Function key on the transmitter. BATTERY WEAK Dead batteries. CANNOT DETECT PULSE* Check the patient condition, probe Poor blood circulation for measuring attachment or change the attachment the SpO2 value. site. The probe is attached too tightly and Reattach the probe. is obstructing the blood circulation. The probe is not attached to the Attach the probe to the patient patient properly. properly. Refer to the cause and “LIGHT INTERFERENCE”, countermeasure for each message in “CHECK PROBE SITE” or “DETECTING PULSE” message is this Messages table and remove the displayed for more than 30 seconds. cause. Operator’s Manual ZM-520PA/521PA/530PA/531PA Replace batteries. 71 ᚑ 㒙ጊޓᖘᏆ Message CANNOT MEASURE* CHECK ELECTRODES CHECK PROBE ᛚ ⌀ᨩ⌬ޓ Cause Contact between the disposable electrode and skin becomes poor. Electrode lead is disconnected from the electrode. Electrode lead is disconnected from the transmitter. Electrode lead discontinuity. Electrode is not firmly attached to the skin. Polarization voltage is abnormally high. The probe is not attached to the patient properly. The probe is not attached at the appropriate site. The probe is disconnected from the transmitter. Countermeasure Replace electrodes with new ones immediately. Firmly connect the electrode lead to the electrode. Firmly connect the electrode lead to the transmitter. Replace the electrode lead with a new one. Replace the electrode with a new one. Attach the probe to the patient properly. Attach the probe to an appropriate site indicated in the probe manual. Connect the probe cable to the transmitter. The probe is past its expiration date. Replace the probe with a new one. CHECK PROBE SITE* The probe is not attached at the appropriate site. The probe is deteriorated. The probe is past its expiration date. Searching for the correct pulse wave for SpO2 monitoring. DETECTING The SpO2 value cannot be obtained PULSE because the waveform is unstable. The probe is not attached to the patient properly. The SpO2 measurement site is under LIGHT fluorescent light, surgical light, INTERFERENCE sunlight, or other strong light. Considerable body movement. The probe is not attached to the patient properly. 72 Attach the probe to an appropriate site indicated in the probe manual. Replace the probe with a new one. Wait until the pulse wave is detected. Attach the probe to the patient properly. Cover the measurement site with a blanket or cloth. When the message is displayed frequently, check the patient condition and, if necessary, change the attachment site. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Message PATIENT CONFIRMED* ᛚ ⌀ᨩ⌬ޓ Cause Function key is pressed and the “PATIENT CONFIRMED” signal is transmitted to the receiving monitor. (When “PATIENT” is assigned as the function for the Function key on the SYSTEM SETUP screen.) The probe is past its expiration date. PROBE FAILURE* Probe is damaged or short-circuited. Transmitter failure. SpO2 MODULE ERROR* SYS OUT OF RANGE WEAK PULSE* RESP OFF Transmitter failure. Countermeasure — Replace the probe with a new one. Contact your Nihon Kohden representative. Contact your Nihon Kohden representative. The maximum blood pressure cannot be measured even when the Measure by palpation or auscultation. cuff inflation pressure exceeded 280 mmHg when using adult cuff. Check the patient condition and Poor peripheral circulation. change the probe attachment site. Check the probe attachment The probe is attached too tightly and condition and if necessary, reattach is obstructing the blood circulation. the probe. “RESP MEASUREMENT” on the PARAMETER SETUP screen is set to OFF. Operator’s Manual ZM-520PA/521PA/530PA/531PA If respiration monitoring is necessary, set “RESP MEASUREMENT” to ON. 73 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Message Display Priority When more than one message condition occurs on the transmitter, only the message with the highest priority is displayed. Priority Highest Message PATIENT CONFIRMED PROBE FAILURE CHECK ELECTRODES SpO2 MODULE ERROR CHECK PROBE CHECK PROBE SITE CANNOT DETECT PULSE LIGHT INTERFERENCE CANNOT MEASURE DETECTING PULSE WEAK PULSE ALARMS SUSPENDED Lowest 74 BATTERY WEAK Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Troubleshooting If a problem occurs, use the following to find and fix it. If the problem still remains after checking the following, contact your Nihon Kohden representative. Transmitter Problem Cause Nothing is displayed Batteries are not installed correctly. The battery polarity is on the LCD after turning the power on. wrong. Batteries are completely discharged. LCD brightness is not LCD is difficult to appropriate. see (too dark or too light). Nothing is displayed on the receiving monitor after turning the transmitter power on. The channel of the transmitter and monitor does not match. The software version of the multiple patient receiver or central monitor is old. Protocol on the transmitter and monitor does not match. Protocol on the transmitter is set to 51 but the monitor cannot receive protocol 51. Operator’s Manual ZM-520PA/521PA/530PA/531PA Countermeasure Install the batteries correctly. Replace the batteries with new ones. Change the LCD brightness on the SYSTEM SETUP screen. Refer to the “Changing SYSTEM SETUP Settings” section. Set the correct channel on the monitor. Upgrade the multiple patient receiver or central monitor software to receive signal from the transmitter. Contact your Nihon Kohden representative. Set the same protocol on the transmitter and monitor. Set the protocol on the transmitter to 41. Refer to the “System Setup Setting List” section. 75 ᚑ 㒙ጊޓᖘᏆ Problem Signal receiving condition is poor. ᛚ ⌀ᨩ⌬ޓ Cause Another transmitter with the same channel is used nearby. Signals of another patient are mixing. The transmitter is damaged. Countermeasure Turn the transmitter power off. If the monitor still receives a signal, there is a high probability that another transmitter of the same channel is used nearby. Follow the instruction of your channel administrator and use another transmitter with a different channel. Follow the instructions of your channel administrator and use another transmitter of a different channel. Contact your Nihon Kohden representative. ECG/Respiration Problem Cause The heart rate is unstable. Pacing detection setting on the monitor is not correct. The “CHECK ELECTRODES” message appears on the receiving monitor. Electrode lead is disconnected from the electrode. Electrode lead discontinuity. ECG baseline is thick (AC hum). 76 Electrode is not firmly attached to the skin. Polarization voltage is abnormally high. The gel on the electrode is dried out. The gel on the electrode is coming off. An electric blanket is used. The hum filter is set to OFF on the monitor. Countermeasure Turn off the pacing detection setting on the receiving monitor. When monitoring a pacemaker patient, turn on pacing detection. Firmly connect the electrode lead to the electrode. Replace the electrode lead with a new one. Replace the electrode with a new one. Use Nihon Kohden specified electrodes. Replace the electrode with a new one. Cover the blanket with a shield cover. Set the filter to ON. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Problem The heart rate of a patient who is using an electric blanket is unstable on the receiving monitor. No heart rate or ECG is displayed. Respiration waveform measurement is unstable. ᛚ ⌀ᨩ⌬ޓ Cause Countermeasure Pacing pulse detection is turned ON on the receiving monitor. Turn OFF the pacing pulse detection on the receiving monitor. “ECG MEASUREMENT” on the PARAMETER SETUP screen is set to OFF. The gel on the electrode is dried out. The gel on the electrode is coming off. If ECG monitoring is necessary, set “ECG MEASUREMENT” to ON. Replace the electrode with a new one. If respiration monitoring is necessary, No respiration rate is “RESP MEASUREMENT” on displayed. the PARAMETER SETUP screen set “RESP MEASUREMENT” to ON. is set to OFF. SpO2 Problem Cause SpO2 data is unstable The probe size is not appropriate and not reliable. for the patient. Probe attachment condition is poor. The probe is partly detached from the skin. External light is entering the probe. Measurement site is dirty. Patient is wearing nail polish. The probe is attached to the same limb that is used for NIBP measurement. Operator’s Manual ZM-520PA/521PA/530PA/531PA Countermeasure Use the appropriate probe for the patient. Firmly attach the probe according to the procedure in the probe operator’s manual. Remove dirt and nail polish. Attach the probe to the opposite limb. Avoid a site where blood circulation condition changes greatly. 77 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Maintenance To use the transmitter in safe and optimum condition, perform maintenance check every six months. The following units are necessary for some checking items. • AX-400G Vital Sign Simulator • AX-300T SpO2 Checker • Receiving monitor CAUTION Never disassemble or repair the transmitter. If there is any problem with the transmitter, contact your Nihon Kohden representative. NOTE • The measurement accuracy of the above units must be managed to perform accurate maintenance check. • For details on the operation of the above units, refer to the manuals provided with these units. A maintenance check sheet is provided at the end of this section. Make a copy of this check sheet before performing maintenance check. 1. External Check • There is no damage or dirt on the outside of the transmitter. • The battery case cover is not damaged, the spring is firmly attached and the battery case cover can be closed firmly. • No keys are damaged. • No electrode leads are damaged. • There are no blood or chemicals on the transmitter. • The springs in the battery compartment are not damaged or detached. • Terminals in the battery case are not corroded. 2. Transmitter Channel • The channel number label on the transmitter is not torn or removed. • The channel of the transmitter matches the label. The transmitter channel is displayed in the upper left corner of the screen. The channel number also appears on the startup screen. 78 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Channel numbers Startup screen Numeric and waveform screen 3. Transmitting/Receiving Signal Use the AX-400G vital sign simulator and receiving monitor. 1. Connect the vital sign simulator to the transmitter. AX-400G 2. Place the transmitter 2 to 3 m from the receiving monitor. 3. Set the channel on the receiving monitor to the channel of the transmitter. 4. Turn on the transmitter and vital sign simulator. 5. Check that the ECG of the transmitter appears on the receiving monitor. 6. Turn off the transmitter. 7. Check that the ECG disappears from the receiving monitor. 4. Display Check that there are no dots missing on the screen. 1. Turn off the transmitter. Operator’s Manual ZM-520PA/521PA/530PA/531PA 79 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ While pressing the Function key, turn on the transmitter. The MENU screen appears. 3. Press the ▼ 2. key to move the cursor to “MANUAL CHECK” and press the Function key. Press the or 5. Each time the key to move the cursor to “LCD TEST” and press the Function key. ▼ ▼ 4. ▼ Cursor key is pressed, the screen changes as below. Check that no dots are missing. → → blue 80 → → red → → green → →. . . Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ 6. Press the Screen key to return to the MANUAL CHECK screen. 7. Press the Screen key again to return to the MENU screen. 5. Key Operation Turn off the transmitter. 2. While pressing the Function key, turn on the transmitter. The MENU screen appears. 3. Press the ▼ 1. key to move the cursor to “MANUAL CHECK” and press the Function key. ▼ 4. Press the or ▼ Cursor key to move the cursor to “KEY CHECK” and press the Function key. Operator’s Manual ZM-520PA/521PA/530PA/531PA 81 ᚑ 㒙ጊޓᖘᏆ 5. ᛚ ⌀ᨩ⌬ޓ Press each key one at a time and check that the pressed key is highlighted on the screen. When the CALL key is pressed, the key name is highlighted. 6. After checking, press and hold the Screen key to return to the MANUAL CHECK screen. 6. ECG Check 1. Connect the vital sign simulator to the transmitter. AX-400G 2. Place the transmitter 1 m from the receiving monitor. 3. Turn on the transmitter and vital sign simulator. 4. Check that the ECG of the transmitter appears on the receiving monitor. 82 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ 7. Respiration Check 1. Connect the vital sign simulator to the transmitter. AX-400G 2. Place the transmitter 1 m from the receiving monitor. 3. Turn on the transmitter and vital sign simulator. 4. Check that the respiration waveform of the transmitter appears on the receiving monitor. 8. SpO2 Check 1. Connect the SpO2 checker to the transmitter. AX-300T 2. Place the transmitter 1 m from the receiving monitor. 3. Turn on the transmitter and SpO2 checker. 4. Check that the pulse bar graph appears on the transmitter screen. Operator’s Manual ZM-520PA/521PA/530PA/531PA 83 ᚑ 㒙ጊޓᖘᏆ 5. ᛚ ⌀ᨩ⌬ޓ Check that SpO2 and pulse rate on the transmitter is within the following range. SpO2 on the SpO2 Checker SpO2 Pulse rate 97% 80% 70% 60 beats/min 120 beats/min Range 95 to 99%SpO2 (±2 digit) 78 to 82%SpO2 (±2 digit) 67 to 73%SpO2 (±3 digit) 57 to 62 beats/min (±3%/±1 beat/min) 115 to 124 beats/min (±3%/±1 beat/min) NOTE The above range includes the error margin of the SpO2 checker. Therefore, the range is ±1 digit outside the SpO2 measuring accuracy of the transmitter in the “Specifications” section. 6. 84 Check that the SpO2 and pulse waveform of the transmitter appear on the receiving monitor. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Maintenance Check Sheet Hospital/Organization: Service Personnel: Instrument Name: Transmitter Instrument Model: ZM-520PA/ZM-521PA/ZM-530PA/ZM-531PA Instrument Serial Number: Hardware Revision Number: Software Revision Number: 1. External Check OK No 2. Transmitter Channel OK No 3. Transmitting/Receiving Signal OK No 4. Display OK No 5. Key Operation OK No 6. ECG Check OK No 7. Respiration Check OK No 8. SpO2 Check OK No Overall Judgement □ OK □ Can be used but needs maintenance. □ Maintenance required. Cannot be used. Operator’s Manual ZM-520PA/521PA/530PA/531PA 85 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Lifetime and Disposal CAUTION Dispose of Nihon Kohden products according to your local laws and your facility’s guidelines for waste disposal. Otherwise, it may affect the environment. If there is a possibility that the product may have been contaminated with infection, dispose of it as medical waste according to your local laws and your facility’s guidelines for medical waste. Otherwise, it may cause infection. Disposing of Used Batteries Battery Lifetime Replace the batteries when the battery replacement indication appears on the transmitter. When using rechargeable batteries, recharge them. Disposal NOTE Remove the batteries before disposing of the transmitter. Before disposing of the batteries, check with your local solid waste officials for details in your area for proper disposal. It may be illegal to dispose of these batteries in the municipal waste stream. Disposing of Electrodes and SpO2 Probes Refer to the manual for each item. Disposing of Transmitter Remove the batteries from the transmitter and dispose of the transmitter following your local laws for disposal. 86 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Cleaning, Disinfection and Sterilization Transmitter and Electrode Leads CAUTION This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop cleaning or disinfecting it and contact your Nihon Kohden representative. The transmitter needs to be checked for safety and function before use. NOTE The transmitter cannot be sterilized. Sterilizing the transmitter may damage it. Before cleaning or disinfecting, remove the batteries from the transmitter. Be careful not to let any liquid get inside the transmitter. Cleaning Wipe the transmitter and electrode leads with a soft cloth moistened with ethanol for disinfection (76.9 to 81.4% by vol) or neutral detergent diluted with water. After cleaning, dry them completely. Use cotton swab moistened with neutral detergent diluted with water to clean inside the battery compartment. Disinfection CAUTION Do not immerse the electrode lead connector in liquid. Wipe the outside surface of the transmitter and electrode lead with a non-abrasive cloth moistened with any of the disinfectants listed below. For details on the disinfectants, refer to the instruction provided with the disinfectants. Use the recommended concentration. Disinfectant Glutaraldehyde solution Alkyldiaminoethylglycine hydrochloride Benzalkonium chloride Benzethonium chloride solution Chlorhexidine gluconate solution Phtharal Phenol Concentration (%) 2.0 0.5 0.2 0.2 0.5 0.55 1.56 Operator’s Manual ZM-520PA/521PA/530PA/531PA 87 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 Probe Refer to the probe manual. Periodic Replacement Schedule To maintain the performance of the instrument, the following part must be periodically replaced. Name Silicon seal (for battery case cover) Code no. 6114-918705 Expected life span 1 year Repair Parts Availability Policy Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain the performance of the instrument) for a period of 8 years from the date of delivery. In that period NKC or its authorized agents will repair the instrument. This period may be shorter than 8 years if a board or part necessary for the faulty section is not available. 88 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Specifications ZM-520PA/530PA Measuring Parameters Measuring waveforms: Measuring numeric data: ECG, respiration in impedance method, pulse Heart rate, respiration rate, SpO2, pulse rate Transmitting Data Waveform data: Numeric data: Status information: ECG, respiration, pulse wave SpO2, pulse rate Battery replacement, battery level*, alarm suspended, pause monitoring*, patient confirmed*, ECG lead, pacing detection, electrode detachment, electrode impedance*, ECG off*, respiration method (impedance)*, SpO2 status, respiration status*, channel ID, time constant (3.2 s), type of transmitter, transmitter code number*, transmitter serial number* * The items marked with * are transmitted only when the protocol is “51”. Display Display size: Viewing area: Resolution: 2.2 inch TFT color LCD 44.16 (H) × 33.12 (V) mm 320 (H) × 240 (V) dots Displayed Data Numeric and waveform screen: Waveform review screen: Numeric review screen: Check electrodes screen: ECG (one waveform from lead I, II, III, Va or Vb), heart rate, pulse rate, respiration rate, SpO2, message, battery level, QRS/pulse sync mark, pulse bar graph, ECG lead ECG or pulse wave of past 10 minutes Heart rate or pulse rate, respiration rate and SpO2 at 1 minute interval for past 10 minutes ECG for checking electrode attachment ECG ECG measurement Channels: Input dynamic range: Electrode offset potential tolerance: Input impedance: ±10 mV or more ±500 mV or more 5 MΩ or more Operator’s Manual ZM-520PA/521PA/530PA/531PA 89 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Common mode rejection ratio: 95 dB or more IEC 60601-2-27: 2005 50.102.10 complied Pacing pulse detection: amplitude ±2 to 700 mV, duration 0.1 to 2 ms IEC 60601-2-27: 2005 complied Based upon pacemaker pulse rejection capability Defibrillation-proof: ECG input protected against 400 Ws/DC 5 kV IEC 60601-2-27 17.101 complied ECG recovery time after defibrillation: within 10 s Electrode condition: Displays CHECK ELECTRODES message Tall T-wave rejection capability: Complies with the heights of T-waves from 0 to 1.2 mV IEC 60601-2-27: 2005 50.102.17 complied Heart rate averaging: Calculated by using the most recent 8 beats. Heart rate meter accuracy and response to irregular rhythm: Ventricular bigeminy (Test waveform name: aami3a*): 80 bpm Slow alternating ventricular bigeminy (Test waveform name: aami3b*): 60 bpm Rapid alternating ventricular bigeminy (Test waveform name: aami3c*): 108 bpm Bidirectional systoles (Test waveform name: aami3d*): 88 bpm * The test waveforms can be download at http://www. physionet.org Response time of heart rate meter to change in heart rate: HR change from 80 to 120 bpm: 4 to 8 seconds HR change from 80 to 40 bpm: 11 to 15 seconds Pacemaker pulse rejection capability, without overshoot: Complies with the amplitudes of pacemaker pulses ±2 to ±700 mV and widths 0.1 to 2 ms (specified in IEC 60601-227: 2005 50.102.13) Pacemaker pulse rejection capability, with overshoot: Overshoot amplitudes and time constants of ±0.12 mV/100 ms to ±2 mV/4 ms (As defined by method B of IEC 606012-27: 2005 50.102.13, this corresponds to the pacemaker pulses amplitudes and widths of ±4 mV/2 ms to amplitudes ±80 mV/0.1 ms.) ECG display and heart rate count Frequency characteristic: filter on: 1 to 18 Hz, filter off: 0.05 to 60 Hz Heart rate detection method: Average QRS detection: 70 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 200 beats/min 40 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 250 beats/min 90 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Heart rate counting range: 0, 15 to 300 beats/min Heart rate counting accuracy*: ±2 beats/min, (0, 15 to 300 beats/min) * Essential performance of this transmitter Respiration Measurement Measuring method: Impedance method Measuring lead: Between R and F Impedance range: 220 to 2000 Ω Excitor current: 54 to 93 μAp-p, 48 kHz Respiration rate measuring accuracy*: ±2 counts/min (at 0 to 150 counts/min) Respiration rate counting range: 0 to 150 counts/min * Essential performance of this transmitter SpO2 Measurement (ISO 9919: 2005 compliance) Measuring range: Declared range: Minimum display range: Display update cycle: Measuring accuracy (rms)*: Total accuracy including probe: 0 to 100%SpO2 70 to 100%SpO2 1%SpO2 Every 3 seconds Accuracy assurance temperature: 18 to 40ºC 80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±2%SpO2 70%SpO2 ≤ %SpO2 < 80%SpO2: ±3%SpO2 under 70%SpO2: not specified Accuracy of the transmitter: 80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±1%SpO2 50%SpO2 ≤ %SpO2 < 80%SpO2: ±2%SpO2 under 50%SpO2: not specified Pulse rate declared range: 30 to 300 bpm Pulse rate display range: 30 to 300 bpm Pulse rate accuracy (rms)*: ±3% ±1 bpm * Essential performance of this transmitter NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T, TL-271T and TL-631T SpO2 probes. The testing was performed during induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2 Africans, 1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age: 21 to 34), (5 women and 11 men) under the condition of no motion. Arterial blood was sampled and measured by a CO-oximeter. The difference between SpO2 measured by the SpO2 probe and functional SaO2 measured by a CO-oximeter was calculated using the root-mean-square (rms) method according to ISO 9919: 2005. This measurement accuracy figure represents 2/3 of all test measurements. • A pulse oximeter tester that generates simulated signals can be used to check the difference from the design specification, but it cannot be used as a replacement for human signals for testing accuracy. Operator’s Manual ZM-520PA/521PA/530PA/531PA 91 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Response time: Selectable from “Slow”, “Normal” and “Fast”. The following graphs show the response time example when SpO2 changes 0.6%/s. Pulse Rate = 70 bpm SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow 100 95 SpO2 (%) 90 85 80 75 70 65 60 10 20 30 40 50 60 70 80 90 100 110 120 130 140 Time (seconds) Pulse Rate = 140 bpm SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow 100 95 SpO2 (%) 90 85 80 75 70 65 60 10 20 30 40 50 60 70 80 90 100 110 120 130 140 Time (seconds) The following graph shows the response time example when pulse rate changes 10 bpm/s. 92 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 = 97 PR Reference PR 150 140 PR (bpm) 130 120 110 100 90 80 70 60 10 20 30 40 50 60 70 80 90 100 110 120 Time (seconds) Transmitter FCC regulation: Field strength limits: Undesired emissions: Antenna: Transmission channel: Transmission frequency range: Channel spacing: Modulation: Type of emission: Occupied bandwidth: Effective radiated power: FCC part 95 Subpart H Wireless Medical Telemetry Service (WMTS) ≤ 200 mV/m (at 3 m) ≤ 960 MHz: ≤ 200 μV/m (at 3 m) ≥ 960 MHz: ≤ 500 μV/m (at 3 m) Internal Indicated on the transmitter 608.0250 to 613.9750 MHz 50 kHz or 37.5 kHz (12.5 kHz when interleaved) FSK (frequency shift keying) F1D 12 to 18 kHz 1.0 mW Power Requirements Rated voltage: 3.0 V Shutdown voltage: 1.4 to 1.75 V Operating voltage: Shutdown voltage to 3.2 V Battery type: Two AA (LR6) type alkaline dry cell primary batteries Battery lifetime (with alkaline batteries, at room temperature): ZM-520PA: approximately 3.5 day ZM-530PA: approximately 2.5 day (measuring ECG, respiration and SpO2) approximately 3.5 day (measuring ECG and respiration) Operator’s Manual ZM-520PA/521PA/530PA/531PA 93 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Dimension and Weight Dimension: Weight: 78 W × 137 H × 36 D (mm) about 230 g (excluding batteries and other accessories) about 280 g (including batteries, excluding other accessories) Environment Operating environment Temperature: Humidity: Atmospheric pressure: 5 to 40°C (41 to 104°F) 30 to 85% (noncondensing) 700 to 1060 hPa Storage and transport environment Temperature: −20 to +65°C (−4 to +149°F) Humidity: 10 to 95% Atmospheric pressure: 700 to 1060 hPa Water resistance Water does not get inside the transmitter when immersed in water up to 30 cm deep for 3 minutes. Safety Standards Safety standard: CAN/CSA-C22.2 No. 601-1 M90 CAN/CSA-C22.2 No. 601-1. 1S1-94 CAN/CSA-C22.2 No. 601-1. 1B-90 CAN/CSA-C22.2 No. 60601-2-49-04 CAN/CSA-C22.2 No. 60601-2-27-06 IEC 60601-1: 1988 IEC 60601-1 Amendment 1: 1991 IEC 60601-1 Amendment 2: 1995 IEC 60601-2-27: 2005 IEC 60601-2-49: 2001 ISO 9919: 2005 UL 60601-1: 2003 Type of protection against electrical shock: INTERNALLY POWERED EQUIPMENT Degree of protection against electrical shock: ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED PART SpO2: DEFIBRILLATION-PROOF TYPE BF APPLIED PART Degree of protection against harmful ingress of water: IPX0 (non-protected) 94 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Degree of safety of application in the presence of a FLAMMABLE ANAESTHETIC MIXTURE WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence of FLAMMABLE ANAESTHETIC MIXTURE WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE Mode of operation: CONTINUOUS OPERATION ME EQUIPMENT type: HAND-HELD and PORTABLE Electromagnetic Compatibility IEC 60601-1-2: 2001 IEC 60601-1-2 Amendment 1: 2004 Electromagnetic Emissions This Model ZM-520PA/530PA is intended for use in the electromagnetic environment specified below. The customer or the user of the ZM-520PA/530PA should assure that it is used in such an environment. Emissions test RF emissions CISPR 11 RF emissions CISPR 11 Harmonic emissions IEC 61000-3-2 Voltage fluctuations/ flicker emissions IEC 61000-3-3 Compliance Electromagnetic environment - guidance Group 1 The ZM-520PA/530PA uses RF energy only for its internal function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment. Class B The ZM-520PA/530PA is suitable for use in all establishments, including domestic establishments. Not applicable Not applicable Operator’s Manual ZM-520PA/521PA/530PA/531PA 95 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Electromagnetic Immunity This Model ZM-520PA/530PA is intended for use in the electromagnetic environment specified below. The customer or the user of the ZM-520PA/530PA should assure that it is used in such an environment. Immunity test IEC 60601 test level Compliance level Electrostatic discharge (ESD) IEC 61000-4-2 ±6 kV contact ±8 kV air ±6 kV contact ±8 kV air Electrical fast transient/burst IEC 61000-4-4 ±2 kV for power supply lines ±1 kV for input/ output lines Not applicable Electromagnetic environment - guidance Floors should be wood, concrete or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%. — Not applicable ±1 kV differential mode ±2 kV common mode Voltage dips, short <5% UT (>95% dip in Not applicable interruptions and UT) for 0.5 cycles voltage variations on power supply 40% UT (60% dip in input lines UT) for 5 cycles IEC 61000-4-11 70% UT (30% dip in UT) for 25 cycles Surge IEC 61000-4-5 — — <5% UT (>95% dip in UT) for 5 s 3 A/m 3 A/m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment. NOTE: UT is the AC mains voltage prior to application of the test level. Power frequency (50/60 Hz) magnetic field IEC 61000-4-8 Avoiding Electromagnetic Interference (Impedance Respiration) Impedance respiration measurement is very sensitive and affected by electromagnetic interference. Technological limitations do not allow immunity levels higher than 1 V/m for radiated RF electromagnetic fields. Electromagnetic fields with field strengths above 1 V/m may cause measurement error. Do not use electrically radiating equipment near the impedance respiration measurements. 96 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Immunity test IEC 60601 test level ᛚ ⌀ᨩ⌬ޓ Compliance level Electromagnetic environment - guidance Portable and mobile RF communications equipment should be used no closer to any part of the ZM-520PA/530PA, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter. Recommended separation distance Conducted RF IEC 61000-4-6 3 Vrms 3 Vrms 150 kHz to 80 MHz d = 1.2 P Radiated RF IEC 61000-4-3 3 V/m 3 V/m 80 MHz to 80 MHz to 2.5 GHz 2.5 GHz d = 1.2 P 80 MHz to 800 MHz d = 2.3 P 800 MHz to 2.5 GHz (1 V/m 80 MHz to 2.5 GHz for respiration) (d = 3.5 P 80 MHz to 800 MHz for respiration d = 7.0 P 800 MHz to 2.5 GHz for respiration) where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m). Field strengths from fixed RF transmitters, as deter mined by an electromagnetic site survey*1, should be less than the compliance level in each frequency range*2. Interference may occur in the vicinity of equipment marked with the following symbol: NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies. NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. *1 Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the ZM-520PA/530PA is used exceeds the applicable RF compliance level above, the ZM-520PA/530PA should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the ZM-520PA/530PA. * Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 1 V/m for respiration and 3 V/m for all other functions. Operator’s Manual ZM-520PA/521PA/530PA/531PA 97 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Recommended Separation Distances between Portable and Mobile RF Communications Equipment The ZM-520PA/530PA is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the ZM-520PA/530PA can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the ZM-520PA/530PA as recommended below, according to the maximum output power of the communications equipment. Separation distance according to frequency of transmitter (m) Rated maximum output power of transmitter (W) 150 kHz to 80 MHz d = 1.2 P 80 MHz to 800 MHz d = 1.2 P 800 MHz to 2.5 GHz d = 2.3 P (For respiration: d = 3.5 P) (For respiration: d = 7.0 P) 0.01 0.12 0.12 (0.35*) 0.23 (0.7*) 0.1 0.38 0.38 (1.1*) 0.73 (2.2*) 1.2 1.2 (3.5*) 2.3 (7.0*) 10 3.8 3.8 (11*) 7.3 (22*) 100 12 12 (35*) 23 (70*) For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer. (* For respiration) NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies. NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. Recovery Time after Defibrillation The transmitter returns to the normal operating mode within 10 seconds after defibrillation. The stored settings are not affected. System Composition for EMC Test The ZM-520PA/530PA bedside monitor is tested to comply with IEC 60601-1-2: 2001 with the following composition. Units ZM-520PA/530PA transmitter BR-906P ECG electrode lead TL-201T finger probe 98 Cable Length — 0.8 m 1.6 m Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ ZM-521PA/531PA Measuring Parameters Measuring waveforms: Measuring numeric data: ECG, respiration in impedance method, pulse Heart rate, respiration rate, SpO2, pulse rate Transmitting Data Waveform data: Numeric data: Status information: ECG, respiration, pulse wave SpO2, pulse rate Battery replacement, battery level*, alarm suspended, pause monitoring*, patient confirmed*, ECG lead, pacing detection, electrode detachment, electrode impedance*, ECG off*, respiration method (impedance)*, SpO2 status, respiration status*, channel ID, time constant (3.2 s), type of transmitter, transmitter code number*, transmitter serial number* * The items marked with * are transmitted only when the protocol is “51”. Display Display size: Viewing area: Resolution: 2.2 inch TFT color LCD 44.16 (H) × 33.12 (V) mm 320 (H) × 240 (V) dots Displayed Data Numeric and waveform screen: Waveform review screen: Numeric review screen: Check electrodes screen: ECG (one waveform from lead I, II, III, Va or Vb), heart rate, pulse rate, respiration rate, SpO2, message, battery level, QRS/pulse sync mark, pulse bar graph, ECG lead ECG or pulse wave of past 10 minutes Heart rate or pulse rate, respiration rate and SpO2 at 1 minute interval for past 10 minutes ECG for checking electrode attachment ECG ECG measurement Channels: Input dynamic range: Electrode offset potential tolerance: Input impedance: Common mode rejection ratio: Pacing pulse detection: ±10 mV or more ±500 mV or more 5 MΩ or more 95 dB or more IEC 60601-2-27: 2005 50.102.10 complied amplitude ±2 to 700 mV, duration 0.1 to 2 ms IEC 60601-2-27: 2005 complied Based upon pacemaker pulse rejection capability Operator’s Manual ZM-520PA/521PA/530PA/531PA 99 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Defibrillation-proof: ECG input protected against 400 Ws/DC 5 kV IEC 60601-2-27 17.101 complied ECG recovery time after defibrillation: within 10 s Electrode condition: Displays CHECK ELECTRODES message Tall T-wave rejection capability: Complies with the heights of T-waves from 0 to 1.2 mV IEC 60601-2-27: 2005 50.102.17 complied Heart rate averaging: Calculated by using the most recent 8 beats. Heart rate meter accuracy and response to irregular rhythm: Ventricular bigeminy (Test waveform name: aami3a*): 80 bpm Slow alternating ventricular bigeminy (Test waveform name: aami3b*): 60 bpm Rapid alternating ventricular bigeminy (Test waveform name: aami3c*): 108 bpm Bidirectional systoles (Test waveform name: aami3d*): 88 bpm * The test waveforms can be download at http://www. physionet.org Response time of heart rate meter to change in heart rate: HR change from 80 to 120 bpm: 4 to 8 seconds HR change from 80 to 40 bpm: 11 to 15 seconds Pacemaker pulse rejection capability, without overshoot: Complies with the amplitudes of pacemaker pulses ±2 to ±700 mV and widths 0.1 to 2 ms (specified in IEC 60601-227: 2005 50.102.13) Pacemaker pulse rejection capability, with overshoot: Overshoot amplitudes and time constants of ±0.12 mV/100 ms to ±2 mV/4 ms (As defined by method B of IEC 606012-27: 2005 50.102.13, this corresponds to the pacemaker pulses amplitudes and widths of ±4 mV/2 ms to amplitudes ±80 mV/0.1 ms.) ECG display and heart rate count Frequency characteristic: filter on: 1 to 18 Hz, filter off: 0.05 to 60 Hz Heart rate detection method: Average QRS detection: 70 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 200 beats/min 40 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 250 beats/min Heart rate counting range: 0, 15 to 300 beats/min Heart rate counting accuracy*: ±2 beats/min, (0, 15 to 300 beats/min) * Essential performance of this transmitter 100 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Respiration Measurement Measuring method: Impedance method Measuring lead: Between R and F Impedance range: 220 to 2000 Ω Excitor current: 54 to 93 μAp-p, 48 kHz Respiration rate measuring accuracy*: ±2 counts/min (at 0 to 150 counts/min) Respiration rate counting range: 0 to 150 counts/min * Essential performance of this transmitter SpO2 Measurement (ISO 9919: 2005 compliance) Measuring range: Declared range: Minimum display range: Display update cycle: Measuring accuracy (rms)*: Total accuracy including probe: 0 to 100%SpO2 70 to 100%SpO2 1%SpO2 Every 3 seconds Accuracy assurance temperature: 18 to 40ºC 80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±2%SpO2 70%SpO2 ≤ %SpO2 < 80%SpO2: ±3%SpO2 under 70%SpO2: not specified Accuracy of the transmitter: 80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±1%SpO2 50%SpO2 ≤ %SpO2 < 80%SpO2: ±2%SpO2 under 50%SpO2: not specified Pulse rate measuring range: 30 to 300 bpm Pulse rate display range: 30 to 300 bpm Pulse rate accuracy (rms)*: ±3% ±1 bpm * Essential performance of this transmitter NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T, TL-271T and TL-631T SpO2 probes. The testing was performed during induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2 Africans, 1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age: 21 to 34), (5 women and 11 men) under the condition of no motion. Arterial blood was sampled and measured by a CO-oximeter. The difference between SpO2 measured by the SpO2 probe and functional SaO2 measured by a CO-oximeter was calculated using the root-mean-square (rms) method according to ISO 9919: 2005. This measurement accuracy figure represents 2/3 of all test measurements. • A pulse oximeter tester that generates simulated signals can be used to check the difference from the design specification, but it cannot be used as a replacement for human signals for testing accuracy. Operator’s Manual ZM-520PA/521PA/530PA/531PA 101 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Response time: Selectable from “Slow”, “Normal” and “Fast”. The following graphs show the response time example when SpO2 changes 0.6%/s. Pulse Rate = 70 bpm SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow 100 95 SpO2 (%) 90 85 80 75 70 65 60 10 20 30 40 50 60 70 80 90 100 110 120 130 140 Time (seconds) Pulse Rate = 140 bpm SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow 100 95 SpO2 (%) 90 85 80 75 70 65 60 10 20 30 40 50 60 70 80 90 100 110 120 130 140 Time (seconds) The following graph shows the response time example when pulse rate changes 10 bpm/s. 102 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 = 97 PR Reference PR 150 140 PR (bpm) 130 120 110 100 90 80 70 60 10 20 30 40 50 60 70 80 90 100 110 120 Time (seconds) Transmitter FCC regulation: Field strength limits: Undesired emissions: Antenna: Transmission channel: Transmission frequency range: Channel spacing: Modulation: Type of emission: Occupied bandwidth: Effective radiated power: FCC part 95 Subpart H Wireless Medical Telemetry Service (WMTS) ≤ 740 mV/m (at 3 m) ≤ 960 MHz: ≤ 200 μV/m (at 3 m) ≥ 960 MHz: ≤ 500 μV/m (at 3 m) Internal Indicated on the transmitter 1395.0250 to 1399.9750 MHz 1427.0250 to 1431.9750 MHz 50 kHz or 37.5 kHz (12.5 kHz when interleaved) FSK (frequency shift keying) F1D 12 to 18 kHz 5.0 mW Can be changed to 1.0 mW if required Power Requirements Rated voltage: 3.0 V Shutdown voltage: 1.4 to 1.75 V Operating voltage: Shutdown voltage to 3.2 V Battery type: Two AA (LR6) type alkaline dry cell primary batteries Battery lifetime (with alkaline batteries, at room temperature): ZM-521PA: approximately 2.5 day ZM-531PA: approximately 2 day (measuring ECG, respiration and SpO2) approximately 2.5 day (measuring ECG and respiration) Operator’s Manual ZM-520PA/521PA/530PA/531PA 103 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Dimension and Weight Dimension: Weight: 78 W × 137 H × 36 D (mm) about 230 g (excluding batteries and other accessories) about 280 g (including batteries, excluding other accessories) Environment Operating environment Temperature: Humidity: Atmospheric pressure: 5 to 40°C (41 to 104°F) 30 to 85% (noncondensing) 700 to 1060 hPa Storage and transport environment Temperature: −20 to +65°C (−4 to +149°F) Humidity: 10 to 95% Atmospheric pressure: 700 to 1060 hPa Water resistance Water does not get inside the transmitter when immersed in water up to 30 cm deep for 3 minutes. Safety Standards Safety standard: CAN/CSA-C22.2 No. 601-1 M90 CAN/CSA-C22.2 No. 601-1. 1S1-94 CAN/CSA-C22.2 No. 601-1. 1B-90 CAN/CSA-C22.2 No. 60601-2-49-04 CAN/CSA-C22.2 No. 60601-2-27-06 IEC 60601-1: 1988 IEC 60601-1 Amendment 1: 1991 IEC 60601-1 Amendment 2: 1995 IEC 60601-2-27: 2005 IEC 60601-2-49: 2001 ISO 9919: 2005 UL 60601-1: 2003 Type of protection against electrical shock: INTERNALLY POWERED EQUIPMENT Degree of protection against electrical shock: ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED PART SpO2: DEFIBRILLATION-PROOF TYPE BF APPLIED PART Degree of protection against harmful ingress of water: IPX0 (non-protected) 104 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Degree of safety of application in the presence of a FLAMMABLE ANAESTHETIC MIXTURE WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence of FLAMMABLE ANAESTHETIC MIXTURE WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE Mode of operation: CONTINUOUS OPERATION ME EQUIPMENT type: HAND-HELD and PORTABLE Electromagnetic Compatibility IEC 60601-1-2: 2001 IEC 60601-1-2 Amendment 1: 2004 Electromagnetic Emissions This Model ZM-521PA/531PA is intended for use in the electromagnetic environment specified below. The customer or the user of the ZM-521PA/531PA should assure that it is used in such an environment. Emissions test RF emissions CISPR 11 RF emissions CISPR 11 Harmonic emissions IEC 61000-3-2 Voltage fluctuations/ flicker emissions IEC 61000-3-3 Compliance Electromagnetic environment - guidance Group 1 The ZM-521PA/531PA uses RF energy only for its internal function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment. Class B The ZM-521PA/531PA is suitable for use in all establishments, including domestic establishments. Not applicable Not applicable Operator’s Manual ZM-520PA/521PA/530PA/531PA 105 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Electromagnetic Immunity This Model ZM-521PA/531PA is intended for use in the electromagnetic environment specified below. The customer or the user of the ZM-521PA/531PA should assure that it is used in such an environment. Immunity test IEC 60601 test level Compliance level Electrostatic discharge (ESD) IEC 61000-4-2 ±6 kV contact ±8 kV air ±6 kV contact ±8 kV air Electrical fast transient/burst IEC 61000-4-4 ±2 kV for power supply lines ±1 kV for input/ output lines Not applicable Electromagnetic environment - guidance Floors should be wood, concrete or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%. — Not applicable ±1 kV differential mode ±2 kV common mode Voltage dips, short <5% UT (>95% dip in Not applicable interruptions and UT) for 0.5 cycles voltage variations on power supply 40% UT (60% dip in input lines UT) for 5 cycles IEC 61000-4-11 70% UT (30% dip in UT) for 25 cycles Surge IEC 61000-4-5 — — <5% UT (>95% dip in UT) for 5 s 3 A/m 3 A/m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment. NOTE: UT is the AC mains voltage prior to application of the test level. Power frequency (50/60 Hz) magnetic field IEC 61000-4-8 Avoiding Electromagnetic Interference (Impedance Respiration) Impedance respiration measurement is very sensitive and affected by electromagnetic interference. Technological limitations do not allow immunity levels higher than 1 V/m for radiated RF electromagnetic fields. Electromagnetic fields with field strengths above 1 V/m may cause measurement error. Do not use electrically radiating equipment near the impedance respiration measurements. 106 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Immunity test IEC 60601 test level ᛚ ⌀ᨩ⌬ޓ Compliance level Electromagnetic environment - guidance Portable and mobile RF communications equipment should be used no closer to any part of the ZM-521PA/531PA, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter. Recommended separation distance Conducted RF IEC 61000-4-6 3 Vrms 3 Vrms 150 kHz to 80 MHz d = 1.2 P Radiated RF IEC 61000-4-3 3 V/m 3 V/m 80 MHz to 80 MHz to 2.5 GHz 2.5 GHz d = 1.2 P 80 MHz to 800 MHz d = 2.3 P 800 MHz to 2.5 GHz (1 V/m 80 MHz to 2.5 GHz for respiration) (d = 3.5 P 80 MHz to 800 MHz for respiration d = 7.0 P 800 MHz to 2.5 GHz for respiration) where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m). Field strengths from fixed RF transmitters, as deter mined by an electromagnetic site survey*1, should be less than the compliance level in each frequency range*2. Interference may occur in the vicinity of equipment marked with the following symbol: NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies. NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. *1 Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the ZM-521PA/531PA is used exceeds the applicable RF compliance level above, the ZM-521PA/531PA should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the ZM-521PA/531PA. * Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 1 V/m for respiration and 3 V/m for all other functions. Operator’s Manual ZM-520PA/521PA/530PA/531PA 107 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Recommended Separation Distances between Portable and Mobile RF Communications Equipment The ZM-521PA/531PA is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the ZM-521PA/531PA can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the ZM-521PA/531PA as recommended below, according to the maximum output power of the communications equipment. Separation distance according to frequency of transmitter (m) Rated maximum output power of transmitter (W) 150 kHz to 80 MHz d = 1.2 P 80 MHz to 800 MHz d = 1.2 P 800 MHz to 2.5 GHz d = 2.3 P (For respiration: d = 3.5 P) (For respiration: d = 7.0 P) 0.01 0.12 0.12 (0.35*) 0.23 (0.7*) 0.1 0.38 0.38 (1.1*) 0.73 (2.2*) 1.2 1.2 (3.5*) 2.3 (7.0*) 10 3.8 3.8 (11*) 7.3 (22*) 100 12 12 (35*) 23 (70*) For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer. (* For respiration) NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies. NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. Recovery Time after Defibrillation The transmitter returns to the normal operating mode within 10 seconds after defibrillation. The stored settings are not affected. System Composition for EMC Test The ZM-521PA/531PA bedside monitor is tested to comply with IEC 60601-1-2: 2001 with the following composition. Units ZM-521PA/531PA transmitter BR-906P ECG electrode lead TL-201T finger probe 108 Cable Length — 0.8 m 1.6 m Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Standard Accessories Name Strap Model — Operator’s Manual ZM-520PA/521PA/530PA/531PA Q’ty Supply Code No. Y233 109 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Options CAUTION Only use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed. Transmitter Channel writer, QI-901PK ECG/RESP Name Purpose 3 electrodes AHA, 6 electrodes clip type Length (m) Code No. BR-903PA Electrode 0.8 lead BR-906PA L-150 General – L-150X F-150M 1.0 V-090M3 1.5 V-09IO3 1.0 V-040M4 General with DIN type lead 1.5 V-04IO4 Disposable 1.0 V-060M6 electrodes, 1.5 V-06IO6 Vitrode For neonates and premature infants – F-150S For NICU For neonates and premature infants For NICU with DIN type lead 110 Q’ty 30 × 5 3 × 50 3 × 30 4 × 10 6 × 10 Supply Code No. K911A K912A G203 G207 G210D G272A G278A G272B G273A G272C G274A 3 × 50 G210C V-120S3 3 × 40 G271A N-03IS3 3 × 10 G300A 60 cm Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ SpO2 Name Finger probe (reusable) Multi-site probe (reusable) Finger probe (reusable) SpO2 probe (for adult, disposable) SpO2 probe (for child, disposable) SpO2 probe (for neonate/adult, disposable) SpO2 probe (for child/infant, disposable) SpO2 probe (for adult/neonate, disposable) SpO2 probe (for child/infant, disposable) COTTONY tape Foam tape for TL-051S/052S/ 061S/062S Attachment tape for TL220T/631T Probe fastener Cable Length 0.6 m 1.6 m 1.6 m 0.6 m 1.6 m 0.8 m 1.6 m 0.8 m 1.6 m 0.8 m 1.6 m 0.8 m 1.6 m 0.8 m 1.6 m 0.8 m 1.6 m — Model/ Code No. 20 Supply Code No. P225H P225F P225G P311A P311C P203A P203E P203B P203F P203C P203G P203D P203H P228A P228B P229A P229B P259 4 × 25 packages P260 3 × 30 packages P263 30 P267 Q’ty TL-201T TL-220T TL-631T1 TL-631T3 TL-271T TL-271T3 TL-272T TL-272T3 TL-273T TL-273T3 TL-274T TL-274T3 TL-051S TL-052S TL-061S TL-062S 340703 24 — YS-093P2 Operator’s Manual ZM-520PA/521PA/530PA/531PA 111 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Frequencies Channel: 9002 to 9478 Transmission Transmission Transmission Frequency Channel No. Frequency Channel No. Frequency Channel No. (MHz) (MHz) (MHz) 608.0250 608.0375 608.0500 608.0625 608.0750 608.0875 608.1000 608.1125 608.1250 608.1375 608.1500 608.1625 608.1750 608.1875 608.2000 608.2125 608.2250 608.2375 608.2500 608.2625 608.2750 608.2875 608.3000 608.3125 608.3250 608.3375 608.3500 608.3625 608.3750 608.3875 608.4000 112 9002 9003 9004 9005 9006 9007 9008 9009 9010 9011 9012 9013 9014 9015 9016 9017 9018 9019 9020 9021 9022 9023 9024 9025 9026 9027 9028 9029 9030 9031 9032 608.4375 608.4500 608.4625 608.4750 608.4875 608.5000 608.5125 608.5250 608.5375 608.5500 608.5625 608.5750 608.5875 608.6000 608.6125 608.6250 608.6375 608.6500 608.6625 608.6750 608.6875 608.7000 608.7125 608.7250 608.7375 608.7500 608.7625 608.7750 608.7875 608.8000 608.8125 9035 9036 9037 9038 9039 9040 9041 9042 9043 9044 9045 9046 9047 9048 9049 9050 9051 9052 9053 9054 9055 9056 9057 9058 9059 9060 9061 9062 9063 9064 9065 608.8500 608.8625 608.8750 608.8875 608.9000 608.9125 608.9250 608.9375 608.9500 608.9625 608.9750 608.9875 609.0000 609.0125 609.0250 609.0375 609.0500 609.0625 609.0750 609.0875 609.1000 609.1125 609.1250 609.1375 609.1500 609.1625 609.1750 609.1875 609.2000 609.2125 609.2250 9068 9069 9070 9071 9072 9073 9074 9075 9076 9077 9078 9079 9080 9081 9082 9083 9084 9085 9086 9087 9088 9089 9090 9091 9092 9093 9094 9095 9096 9097 9098 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Transmission Transmission Frequency Channel No. Frequency Channel No. Frequency Channel No. (MHz) (MHz) (MHz) 608.4125 608.4250 9033 9034 608.8250 608.8375 9066 9067 609.2375 609.2500 9099 9100 609.2625 609.2750 609.2875 609.3000 609.3125 609.3250 609.3375 609.3500 609.3625 609.3750 609.3875 609.4000 609.4125 609.4250 609.4375 609.4500 609.4625 609.4750 609.4875 609.5000 609.5125 609.5250 609.5375 609.5500 609.5625 609.5750 609.5875 609.6000 609.6125 609.6250 9101 9102 9103 9104 9105 9106 9107 9108 9109 9110 9111 9112 9113 9114 9115 9116 9117 9118 9119 9120 9121 9122 9123 9124 9125 9126 9127 9128 9129 9130 609.7125 609.7250 609.7375 609.7500 609.7625 609.7750 609.7875 609.8000 609.8125 609.8250 609.8375 609.8500 609.8625 609.8750 609.8875 609.9000 609.9125 609.9250 609.9375 609.9500 609.9625 609.9750 609.9875 610.0000 610.0125 610.0250 610.0375 610.0500 610.0625 610.0750 9137 9138 9139 9140 9141 9142 9143 9144 9145 9146 9147 9148 9149 9150 9151 9152 9153 9154 9155 9156 9157 9158 9159 9160 9161 9162 9163 9164 9165 9166 610.1625 610.1750 610.1875 610.2000 610.2125 610.2250 610.2375 610.2500 610.2625 610.2750 610.2875 610.3000 610.3125 610.3250 610.3375 610.3500 610.3625 610.3750 610.3875 610.4000 610.4125 610.4250 610.4375 610.4500 610.4625 610.4750 610.4875 610.5000 610.5125 610.5250 9173 9174 9175 9176 9177 9178 9179 9180 9181 9182 9183 9184 9185 9186 9187 9188 9189 9190 9191 9192 9193 9194 9195 9196 9197 9198 9199 9200 9201 9202 609.6375 9131 610.0875 9167 610.5375 9203 609.6500 9132 610.1000 9168 610.5500 9204 609.6625 9133 610.1125 9169 610.5625 9205 Operator’s Manual ZM-520PA/521PA/530PA/531PA 113 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Transmission Transmission Frequency Channel No. Frequency Channel No. Frequency Channel No. (MHz) (MHz) (MHz) 114 609.6750 9134 610.1250 9170 610.5750 9206 609.6875 9135 610.1375 9171 610.5875 9207 609.7000 9136 610.1500 9172 610.6000 9208 610.6125 9209 611.0625 9245 611.5125 9281 610.6250 9210 611.0750 9246 611.5250 9282 610.6375 610.6500 610.6625 610.6750 610.6875 610.7000 610.7125 610.7250 610.7375 610.7500 610.7625 610.7750 610.7875 610.8000 610.8125 610.8250 610.8375 610.8500 610.8625 610.8750 610.8875 610.9000 610.9125 610.9250 610.9375 610.9500 610.9625 610.9750 610.9875 611.0000 9211 9212 9213 9214 9215 9216 9217 9218 9219 9220 9221 9222 9223 9224 9225 9226 9227 9228 9229 9230 9231 9232 9233 9234 9235 9236 9237 9238 9239 9240 611.0875 611.1000 611.1125 611.1250 611.1375 611.1500 611.1625 611.1750 611.1875 611.2000 611.2125 611.2250 611.2375 611.2500 611.2625 611.2750 611.2875 611.3000 611.3125 611.3250 611.3375 611.3500 611.3625 611.3750 611.3875 611.4000 611.4125 611.4250 611.4375 611.4500 9247 9248 9249 9250 9251 9252 9253 9254 9255 9256 9257 9258 9259 9260 9261 9262 9263 9264 9265 9266 9267 9268 9269 9270 9271 9272 9273 9274 9275 9276 611.5375 611.5500 611.5625 611.5750 611.5875 611.6000 611.6125 611.6250 611.6375 611.6500 611.6625 611.6750 611.6875 611.7000 611.7125 611.7250 611.7375 611.7500 611.7625 611.7750 611.7875 611.8000 611.8125 611.8250 611.8375 611.8500 611.8625 611.8750 611.8875 611.9000 9283 9284 9285 9286 9287 9288 9289 9290 9291 9292 9293 9294 9295 9296 9297 9298 9299 9300 9301 9302 9303 9304 9305 9306 9307 9308 9309 9310 9311 9312 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Transmission Transmission Frequency Channel No. Frequency Channel No. Frequency Channel No. (MHz) (MHz) (MHz) 611.0125 611.0250 611.0375 611.0500 9241 9242 9243 9244 611.4625 611.4750 611.4875 611.5000 9277 9278 9279 9280 611.9125 611.9250 611.9375 611.9500 9313 9314 9315 9316 611.9625 611.9750 611.9875 612.0000 612.0125 612.0250 612.0375 612.0500 612.0625 612.0750 612.0875 612.1000 612.1125 612.1250 612.1375 612.1500 612.1625 612.1750 612.1875 612.2000 612.2125 612.2250 612.2375 612.2500 612.2625 612.2750 612.2875 612.3000 612.3125 612.3250 612.3375 612.3500 9317 9318 9319 9320 9321 9322 9323 9324 9325 9326 9327 9328 9329 9330 9331 9332 9333 9334 9335 9336 9337 9338 9339 9340 9341 9342 9343 9344 9345 9346 9347 9348 612.4125 612.4250 612.4375 612.4500 612.4625 612.4750 612.4875 612.5000 612.5125 612.5250 612.5375 612.5500 612.5625 612.5750 612.5875 612.6000 612.6125 612.6250 612.6375 612.6500 612.6625 612.6750 612.6875 612.7000 612.7125 612.7250 612.7375 612.7500 612.7625 612.7750 612.7875 612.8000 9353 9354 9355 9356 9357 9358 9359 9360 9361 9362 9363 9364 9365 9366 9367 9368 9369 9370 9371 9372 9373 9374 9375 9376 9377 9378 9379 9380 9381 9382 9383 9384 612.8625 612.8750 612.8875 612.9000 612.9125 612.9250 612.9375 612.9500 612.9625 612.9750 612.9875 613.0000 613.0125 613.0250 613.0375 613.0500 613.0625 613.0750 613.0875 613.1000 613.1125 613.1250 613.1375 613.1500 613.1625 613.1750 613.1875 613.2000 613.2125 613.2250 613.2375 613.2500 9389 9390 9391 9392 9393 9394 9395 9396 9397 9398 9399 9400 9401 9402 9403 9404 9405 9406 9407 9408 9409 9410 9411 9412 9413 9414 9415 9416 9417 9418 9419 9420 Operator’s Manual ZM-520PA/521PA/530PA/531PA 115 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Transmission Transmission Frequency Channel No. Frequency Channel No. Frequency Channel No. (MHz) (MHz) (MHz) 612.3625 612.3750 612.3875 612.4000 9349 9350 9351 9352 612.8125 612.8250 612.8375 612.8500 9385 9386 9387 9388 613.2625 613.2750 613.2875 613.3000 9421 9422 9423 9424 613.3125 9425 613.5375 9443 613.7625 9461 613.3250 9426 613.5500 9444 613.7750 9462 613.3375 9427 613.5625 9445 613.7875 9463 613.3500 9428 613.5750 9446 613.8000 9464 613.3625 9429 613.5875 9447 613.8125 9465 613.3750 9430 613.6000 9448 613.8250 9466 613.3875 9431 613.6125 9449 613.8375 9467 613.4000 9432 613.6250 9450 613.8500 9468 613.4125 9433 613.6375 9451 613.8625 9469 613.4250 9434 613.6500 9452 613.8750 9470 613.4375 9435 613.6625 9453 613.8875 9471 613.4500 9436 613.6750 9454 613.9000 9472 613.4625 9437 613.6875 9455 613.9125 9473 613.4750 9438 613.7000 9456 613.9250 9474 613.4875 9439 613.7125 9457 613.9375 9475 613.5000 9440 613.7250 9458 613.9500 9476 613.5125 9441 613.7375 9459 613.9625 9477 613.5250 9442 613.7500 9460 613.9750 9478 Channel: E002 to E398 116 Channel No. Transmission Frequency (MHz) Channel No. E037 1395.9000 E072 1395.9125 E073 E074 E075 E076 E077 E078 E002 Transmission Frequency (MHz) 1395.4625 1395.0375 1395.0500 E003 E004 1395.4750 1395.4875 E038 E039 1395.0625 1395.0750 E005 E006 1395.5000 1395.5125 E040 E041 1395.9250 1395.9375 1395.9500 1395.0875 1395.1000 E007 E008 1395.5250 1395.5375 E042 E043 1395.9625 1395.9750 Transmission Frequency (MHz) 1395.0250 Channel No. Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Transmission Frequency (MHz) 1395.1125 1395.1250 1395.1375 1395.1500 Channel No. E009 E010 E011 E012 ᛚ ⌀ᨩ⌬ޓ Channel No. Transmission Frequency (MHz) Channel No. E044 1395.9875 E079 1395.5625 1395.5750 1395.5875 E045 E046 E047 1396.0000 1396.0125 1396.0250 E080 E081 E082 Transmission Frequency (MHz) 1395.5500 1395.1625 E013 1395.6000 E048 1396.0375 E083 1395.1750 1395.1875 1395.2000 E014 E015 E016 1395.6125 1395.6250 1395.6375 E049 E050 E051 1396.0500 1396.0625 1396.0750 E084 E085 E086 1395.2125 1395.2250 E017 E018 1395.6500 1395.6625 E052 E053 1396.0875 1396.1000 E087 E088 1395.2375 1395.2500 1395.2625 1395.2750 1395.2875 1395.3000 1395.3125 1395.3250 1395.3375 E019 E020 E021 E022 E023 E024 E025 E026 E027 1395.3500 1395.3625 1395.3750 1395.3875 E028 E029 E030 E031 1395.6750 1395.6875 1395.7000 1395.7125 1395.7250 1395.7375 1395.7500 1395.7625 1395.7750 1395.7875 1395.8000 1395.8125 E054 E055 E056 E057 E058 E059 E060 E061 E062 E063 E064 E065 1396.1125 1396.1250 1396.1375 1396.1500 1396.1625 1396.1750 1396.1875 1396.2000 1396.2125 1396.2250 1396.2375 1396.2500 E089 E090 E091 E092 E093 E094 E095 E096 E097 E098 E099 E100 1395.4000 1395.4125 E032 E033 1395.8250 1395.8375 1395.8500 E066 E067 E068 1396.2625 1396.2750 1396.2875 E101 E102 E103 1395.4250 1395.4375 1395.4500 E034 E035 E036 1395.8625 1395.8750 E069 E070 E107 E108 E071 E143 E144 E104 E105 E106 1396.3375 1396.3500 1395.8875 1396.7875 1396.8000 1396.3000 1396.3125 1396.3250 1397.2375 1397.2500 E179 E180 1396.3625 1396.3750 E109 E110 1396.8125 1396.8250 E145 E146 1397.2625 1397.2750 E181 E182 1396.3875 1396.4000 1396.4125 E111 E112 E113 1396.8375 1396.8500 1396.8625 E147 E148 E149 1397.2875 1397.3000 1397.3125 E183 E184 E185 Operator’s Manual ZM-520PA/521PA/530PA/531PA 117 ᚑ 㒙ጊޓᖘᏆ E150 E151 E152 Transmission Frequency (MHz) 1397.3250 1397.3375 1397.3500 1396.9125 E153 1397.3625 E189 E118 E119 E120 1396.9250 1396.9375 1396.9500 E154 E155 E156 1397.3750 1397.3875 1397.4000 E190 E191 E192 1396.5125 1396.5250 E121 E122 1396.9625 1396.9750 E157 E158 1397.4125 1397.4250 E193 E194 1396.5375 1396.5500 1396.5625 1396.5750 1396.5875 1396.6000 1396.6125 1396.6250 1396.6375 1396.6500 1396.6625 1396.6750 1396.6875 E123 E124 E125 E126 E127 E128 E129 E130 E131 E132 E133 E134 E135 1396.9875 1397.0000 1397.0125 1397.0250 1397.0375 1397.0500 1397.0625 1397.0750 1397.0875 1397.1000 1397.1125 1397.1250 1397.1375 E159 E160 E161 E162 E163 E164 E165 E166 E167 E168 E169 E170 E171 1397.4375 1397.4500 1397.4625 1397.4750 1397.4875 1397.5000 1397.5125 1397.5250 1397.5375 1397.5500 1397.5625 1397.5750 1397.5875 E195 E196 E197 E198 E199 E200 E201 E202 E203 E204 E205 E206 E207 1396.7000 1396.7125 1396.7250 E136 E137 E138 1397.1500 1397.1625 1397.1750 E172 E173 E174 1397.6000 E208 1397.6125 1397.6250 E209 E210 1396.7375 1396.7500 E139 E140 1397.1875 1397.2000 E175 E176 1397.6375 1397.6500 E211 E212 1396.7625 1396.7750 E141 E142 1397.2125 1397.2250 E177 E178 1397.6625 1397.6750 E213 E214 1397.6875 1397.7000 E215 E216 1398.1375 1398.1500 E251 E252 1398.5875 1398.6000 E287 E288 1397.7125 1397.7250 1397.7375 E217 E218 E219 1398.1625 1398.1750 1398.1875 E253 E254 E255 1398.6125 1398.6250 1398.6375 E289 E290 E291 1397.7500 E220 1398.2000 E256 1398.6500 E292 E114 E115 E116 Transmission Frequency (MHz) 1396.8750 1396.8875 1396.9000 1396.4625 E117 1396.4750 1396.4875 1396.5000 Transmission Frequency (MHz) 1396.4250 1396.4375 1396.4500 118 ᛚ ⌀ᨩ⌬ޓ Channel No. Channel No. Channel No. E186 E187 E188 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Transmission Frequency (MHz) Channel No. Transmission Frequency (MHz) Channel No. Transmission Frequency (MHz) Channel No. 1397.7625 1397.7750 E221 E222 1398.2125 1398.2250 E257 E258 1398.6625 1398.6750 E293 E294 1397.7875 1397.8000 E223 E224 1398.2375 1398.2500 E259 E260 1398.6875 1398.7000 E295 E296 1397.8125 1397.8250 1397.8375 E225 E226 E227 1398.2625 1398.2750 1398.2875 E261 E262 E263 1398.7125 1398.7250 1398.7375 E297 E298 E299 1397.8500 E228 1398.3000 E264 1398.7500 E300 1397.8625 1397.8750 1397.8875 E229 E230 E231 1398.3125 1398.3250 1398.3375 E265 E266 E267 1398.7625 1398.7750 1398.7875 E301 E302 E303 1397.9000 1397.9125 1397.9250 1397.9375 1397.9500 1397.9625 1397.9750 1397.9875 1398.0000 1398.0125 1398.0250 E232 E233 E234 E235 E236 E237 E238 E239 E240 E241 E242 1398.3500 1398.3625 1398.3750 1398.3875 1398.4000 1398.4125 1398.4250 1398.4375 1398.4500 1398.4625 1398.4750 E268 E269 E270 E271 E272 E273 E274 E275 E276 E277 E278 1398.8000 1398.8125 1398.8250 1398.8375 1398.8500 1398.8625 1398.8750 1398.8875 1398.9000 1398.9125 1398.9250 E304 E305 E306 E307 E308 E309 E310 E311 E312 E313 E314 1398.0375 1398.0500 1398.0625 E243 E244 E245 1398.4875 1398.5000 1398.5125 E279 E280 E281 1398.9375 1398.9500 1398.9625 E315 E316 E317 1398.0750 1398.0875 E246 E247 1398.5250 1398.5375 E282 E283 1398.9750 1398.9875 E318 E319 1398.1000 1398.1125 E248 E249 1398.5500 1398.5625 E284 E285 1398.1250 1399.0375 1399.0500 E250 E323 E324 1398.5750 1399.4625 1399.4750 E286 E357 E358 1399.0000 1399.0125 1399.0250 E320 E321 E322 1399.8875 1399.9000 E391 E392 1399.0625 1399.0750 E325 E326 1399.4875 1399.5000 E359 E360 1399.9125 1399.9250 E393 E394 1399.0875 E327 1399.5125 E361 1399.9375 E395 Operator’s Manual ZM-520PA/521PA/530PA/531PA 119 ᚑ 㒙ጊޓᖘᏆ E328 E329 Transmission Frequency (MHz) 1399.5250 1399.5375 1399.1250 1399.1375 1399.1500 E330 E331 E332 1399.5500 1399.5625 1399.5750 E364 E365 E366 1399.1625 E333 1399.5875 E367 1399.1750 1399.1875 1399.2000 E334 E335 E336 1399.6000 1399.6125 1399.6250 E368 E369 E370 1399.2125 1399.2250 1399.2375 1399.2500 1399.2625 1399.2750 1399.2875 1399.3000 1399.3125 1399.3250 1399.3375 1399.3500 1399.3625 1399.3750 E337 E338 E339 E340 E341 E342 E343 E344 E345 E346 E347 E348 E349 E350 1399.6375 1399.6500 1399.6625 1399.6750 1399.6875 1399.7000 1399.7125 1399.7250 1399.7375 1399.7500 1399.7625 1399.7750 1399.7875 1399.8000 E371 E372 E373 E374 E375 E376 E377 E378 E379 E380 E381 E382 E383 E384 1399.3875 E351 1399.8125 E385 1399.4000 1399.4125 1399.4250 E352 E353 E354 1399.8250 1399.8375 1399.8500 E386 E387 E388 1399.4375 1399.4500 E355 E356 1399.8625 1399.8750 E389 E390 Transmission Frequency (MHz) 1399.1000 1399.1125 120 ᛚ ⌀ᨩ⌬ޓ Channel No. Channel No. E362 E363 Transmission Frequency (MHz) 1399.9500 1399.9625 1399.9750 Channel No. E396 E397 E398 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ Channel: E502 to E898 E536 Transmission Frequency (MHz) 1427.8750 1427.4625 E537 1427.8875 E571 E504 E505 E506 1427.4750 1427.4875 1427.5000 E538 E539 E540 1427.9000 1427.9125 1427.9250 E572 E573 E574 1427.0875 E507 1427.5125 E541 1427.9375 E575 1427.1000 1427.1125 1427.1250 E508 E509 E510 1427.5250 1427.5375 1427.5500 E542 E543 E544 1427.9500 1427.9625 1427.9750 E576 E577 E578 1427.1375 1427.1500 E511 E512 1427.5625 1427.5750 E545 E546 1427.9875 1428.0000 E579 E580 1427.1625 1427.1750 E513 E514 1427.5875 1427.6000 E547 E548 1428.0125 1428.0250 E581 E582 1427.1875 1427.2000 1427.2125 E515 E516 E517 1427.6125 1427.6250 1427.6375 E549 E550 E551 1428.0375 1428.0500 1428.0625 E583 E584 E585 1427.2250 1427.2375 1427.2500 E518 E519 E520 1427.6500 1427.6625 1427.6750 E552 E553 E554 1428.0750 1428.0875 1428.1000 E586 E587 E588 1427.2625 1427.2750 E521 E522 1427.6875 1427.7000 E555 E556 1428.1125 1428.1250 E589 E590 1427.2875 1427.3000 E523 E524 1427.7125 1427.7250 E557 E558 1428.1375 1428.1500 E591 E592 1427.3125 1427.3250 E525 E526 1427.7375 1427.7500 E559 E560 1428.1625 1428.1750 E593 E594 1427.3375 1427.3500 1427.3625 E527 E528 E529 1427.7625 1427.7750 1427.7875 E561 E562 E563 1428.1875 1428.2000 1428.2125 E595 E596 E597 1427.3750 1427.3875 E530 E531 1427.8000 1427.8125 E564 E565 1428.2250 1428.2375 E598 E599 1427.4000 1427.4125 1427.4250 E532 E533 E534 1427.8250 1427.8375 1427.8500 E566 E567 E568 1428.2500 1428.2625 1428.2750 E600 E601 E602 E502 Transmission Frequency (MHz) 1427.4500 1427.0375 E503 1427.0500 1427.0625 1427.0750 Transmission Frequency (MHz) 1427.0250 Channel No. Channel No. Operator’s Manual ZM-520PA/521PA/530PA/531PA Channel No. E570 121 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ E569 Transmission Frequency (MHz) 1428.2875 1428.7500 1428.7625 E640 E641 1429.2000 1429.2125 E676 E677 E606 E607 E608 1428.7750 1428.7875 1428.8000 E642 E643 E644 1429.2250 1429.2375 1429.2500 E678 E679 E680 1428.3625 1428.3750 1428.3875 E609 E610 E611 1428.8125 1428.8250 1428.8375 E645 E646 E647 1429.2625 1429.2750 1429.2875 E681 E682 E683 1428.4000 E612 1428.8500 E648 1429.3000 E684 1428.4125 1428.4250 1428.4375 E613 E614 E615 1428.8625 1428.8750 1428.8875 E649 E650 E651 1429.3125 1429.3250 1429.3375 E685 E686 E687 1428.4500 1428.4625 E616 E617 1428.9000 1428.9125 E652 E653 1429.3500 1429.3625 E688 E689 1428.4750 1428.4875 1428.5000 E618 E619 E620 1428.9250 1428.9375 1428.9500 E654 E655 E656 1429.3750 1429.3875 1429.4000 E690 E691 E692 1428.5125 1428.5250 E621 E622 1428.9625 1428.9750 E657 E658 1429.4125 1429.4250 E693 E694 1428.5375 1428.5500 E623 E624 1428.9875 1429.0000 E659 E660 1429.4375 1429.4500 E695 E696 1428.5625 1428.5750 1428.5875 E625 E626 E627 1429.0125 1429.0250 1429.0375 E661 E662 E663 1429.4625 1429.4750 1429.4875 E697 E698 E699 1428.6000 1428.6125 E628 E629 1429.0500 1429.0625 E664 E665 1429.5000 1429.5125 E700 E701 1428.6250 1428.6375 1428.6500 E630 E631 E632 1429.0750 1429.0875 1429.1000 E666 E667 E668 1429.5250 1429.5375 1429.5500 E702 E703 E704 1428.6625 E633 1429.1125 E669 1429.5625 E705 1428.6750 1428.6875 1428.7000 1428.7125 E634 E635 E636 E637 1429.1250 1429.1375 1429.1500 1429.1625 E670 E671 E672 E673 1429.5750 1429.5875 1429.6000 1429.6125 E706 E707 E708 E709 E535 Transmission Frequency (MHz) 1427.8625 1428.3000 1428.3125 E604 E605 1428.3250 1428.3375 1428.3500 Transmission Frequency (MHz) 1427.4375 122 Channel No. Channel No. Channel No. E603 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ E674 E675 E748 E749 Transmission Frequency (MHz) 1429.6250 1429.6375 1430.5500 1430.5625 1430.1250 1430.1375 1430.1500 E750 E751 E752 1430.5750 1430.5875 1430.6000 E786 E787 E788 E717 1430.1625 E753 1430.6125 E789 1429.7250 1429.7375 1429.7500 E718 E719 E720 1430.1750 1430.1875 1430.2000 E754 E755 E756 1430.6250 1430.6375 1430.6500 E790 E791 E792 1429.7625 1429.7750 E721 E722 1430.2125 1430.2250 E757 E758 1430.6625 1430.6750 E793 E794 1429.7875 1429.8000 E723 E724 1430.2375 1430.2500 E759 E760 1430.6875 1430.7000 E795 E796 1429.8125 1429.8250 1429.8375 E725 E726 E727 1430.2625 1430.2750 1430.2875 E761 E762 E763 1430.7125 1430.7250 1430.7375 E797 E798 E799 1429.8500 1429.8625 1429.8750 E728 E729 E730 1430.3000 1430.3125 1430.3250 E764 E765 E766 1430.7500 1430.7625 1430.7750 E800 E801 E802 1429.8875 E731 1430.3375 E767 1430.7875 E803 1429.9000 1429.9125 1429.9250 1429.9375 E732 E733 E734 E735 1430.3500 1430.3625 1430.3750 1430.3875 E768 E769 E770 E771 1430.8000 1430.8125 1430.8250 1430.8375 E804 E805 E806 E807 1429.9500 E736 1430.4000 E772 1430.8500 E808 1429.9625 1429.9750 1429.9875 E737 E738 E739 1430.4125 1430.4250 1430.4375 E773 E774 E775 1430.8625 1430.8750 1430.8875 E809 E810 E811 1430.0000 1430.0125 1430.0250 1430.0375 E740 E741 E742 E743 1430.4500 1430.4625 1430.4750 1430.4875 E776 E777 E778 E779 1430.9000 1430.9125 1430.9250 1430.9375 E812 E813 E814 E815 1430.0500 E744 1430.5000 E780 1430.9500 E816 E638 E639 E712 E713 Transmission Frequency (MHz) 1429.1750 1429.1875 1430.1000 1430.1125 1429.6750 1429.6875 1429.7000 E714 E715 E716 1429.7125 Transmission Frequency (MHz) 1428.7250 1428.7375 1429.6500 1429.6625 Channel No. Channel No. Operator’s Manual ZM-520PA/521PA/530PA/531PA Channel No. E710 E711 E784 E785 123 ᚑ 㒙ጊޓᖘᏆ ᛚ ⌀ᨩ⌬ޓ E781 E782 E783 Transmission Frequency (MHz) 1430.9625 1430.9750 1430.9875 1431.4375 1431.4500 E855 E856 1431.8750 1431.8875 E890 E891 E822 E823 E824 1431.4625 1431.4750 1431.4875 E857 E858 E859 1431.9000 1431.9125 1431.9250 E892 E893 E894 1431.0625 1431.0750 1431.0875 E825 E826 E827 1431.5000 1431.5125 1431.5250 E860 E861 E862 1431.9375 1431.9500 1431.9625 E895 E896 E897 1431.1000 1431.1125 E828 E829 1431.5375 1431.5500 E863 E864 1431.9750 E898 1431.1250 1431.1375 1431.1500 E830 E831 E832 1431.5625 1431.5750 1431.5875 E865 E866 E867 1431.1625 1431.1750 E833 E834 1431.6000 1431.6125 E868 E869 1431.1875 1431.2000 1431.2125 E835 E836 E837 1431.6250 1431.6375 1431.6500 E870 E871 E872 1431.2250 E838 1431.6625 E873 1431.2375 1431.2500 1431.2625 E839 E840 E841 1431.6750 1431.6875 1431.7000 E874 E875 E876 1431.2750 1431.2875 E842 E843 1431.7125 1431.7250 E877 E878 1431.3000 1431.3125 1431.3250 E844 E845 E846 1431.7375 1431.7500 1431.7625 E879 E880 E881 1431.3375 1431.3500 E847 E848 1431.7750 1431.7875 E882 E883 1431.3625 1431.3750 1431.3875 E849 E850 E851 1431.8000 1431.8125 1431.8250 E884 E885 E886 E745 E746 E747 Transmission Frequency (MHz) 1430.5125 1430.5250 1430.5375 1431.0000 1431.0125 E820 E821 1431.0250 1431.0375 1431.0500 Transmission Frequency (MHz) 1430.0625 1430.0750 1430.0875 124 Channel No. Channel No. Channel No. E817 E818 E819 Operator’s Manual ZM-520PA/521PA/530PA/531PA ᚑ 㒙ጊޓᖘᏆ Transmission Frequency (MHz) 1431.4000 1431.4125 1431.4250 Channel No. E852 E853 E854 ᛚ ⌀ᨩ⌬ޓ Transmission Frequency (MHz) 1431.8375 1431.8500 1431.8625 Channel No. Transmission Frequency (MHz) Channel No. E887 E888 E889 Operator’s Manual ZM-520PA/521PA/530PA/531PA 125
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