Nihon Kohden ZM-531PAA TRANSMITTER User Manual

Nihon Kohden Corporation TRANSMITTER

(Short-Term Confidential) User Manual

If you have any comments or suggestions on this manual, please contact us at:www.nihonkohden.comTransmitterZM-520PA/ZM-521PAZM-530PA/ZM-531PA0614-904743D
In order to use this product safely and fully understand all its functions, read this manual before using the product.Keep this manual near the instrument or in the reach of the operator and refer to it whenever the operation is unclear.This product stores personal patient information. Manage the information appropriately.3DWLHQWQDPHVRQWKHVFUHHQVKRWVDQGUHFRUGLQJH[DPSOHVLQWKLVPDQXDODUH¿FWLRQDODQGDQ\resemblance to any person living or dead is purely coincidental.The contents of this manual are subject to change without notice.Copyright NoticeThe 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA C.1ContentsGENERAL HANDLING PRECAUTIONS ...................................................................... iWARRANTY POLICY ..................................................................................................iiiEquipment Authorization Requirement ........................................................................ivCompliance with FCC Requirements .....................................................................ivEMC RELATED CAUTION ........................................................................................... vConventions Used in this Manual and Instrument ......................................................viiWarnings, Cautions and Notes..............................................................................viiExplanations of the Symbols in this Manual and Instrument ................................viiiIntended Use ..................................................................................................................... 1General ........................................................................................................................1Receiving Monitor ........................................................................................................ 3Panel Description ..............................................................................................................4Top Panel ..................................................................................................................... 4Front Panel ................................................................................................................... 5Rear Panel ................................................................................................................... 7Important Safety Information ............................................................................................. 8General ........................................................................................................................8Output Signal ............................................................................................................. 11Battery ....................................................................................................................... 12Transmitter Channel Management ............................................................................. 12For Patients Using Implantable Pacemaker ............................................................... 13ECG Monitoring ......................................................................................................... 13SpO2 Monitoring ......................................................................................................... 15Maintenance .............................................................................................................. 17Preparation on Transmitter .............................................................................................. 18Batteries ..................................................................................................................... 18Handling Batteries ................................................................................................ 18Battery Lifetime .................................................................................................... 18Installing (Replacing) Batteries ............................................................................ 19Situations Requiring Battery Replacement .......................................................... 20Battery Level Indication ........................................................................................ 20Attaching a Strap to the Transmitter ........................................................................... 21Turning On the Transmitter ......................................................................................... 22Check Items Before Use ...................................................................................... 22Check Items After Power On ................................................................................ 23Check Items After Use ......................................................................................... 23Turning Off the Transmitter ......................................................................................... 24Changing the Transmitter Channel ............................................................................. 24
C.2 Operator’s Manual ZM-520PA/521PA/530PA/531PAChanging Parameter and System Setup Settings ........................................................... 25Changing PARAMETER SETUP Settings.................................................................. 25Parameter Setup Setting List ............................................................................... 25Displaying the PARAMETER SETUP Screen ...................................................... 26Changing Parameter Setup Settings .................................................................... 27Changing SYSTEM SETUP Settings ......................................................................... 30System Setup Setting List .................................................................................... 30Displaying the SYSTEM SETUP Screen .............................................................. 31Changing System Setup Settings ........................................................................ 32Initializing Settings ..................................................................................................... 35Attaching Electrodes and SpO2 Probe to the Patient....................................................... 36Attaching Electrodes .................................................................................................. 36Selecting Electrode Lead ..................................................................................... 36Connecting the Electrode Lead to the Transmitter ............................................... 36Electrode Position ................................................................................................ 37Attaching Electrodes to the Patient and Connecting the Electrode Leads to Disposable Electrodes ......................................................................................... 41Checking ECG on the Transmitter Screen ............................................................ 42Attaching the SpO2 Probe .......................................................................................... 42Selecting the SpO2 Probe .................................................................................... 42Connecting the SpO2 Probe to the Transmitter .................................................... 45Attaching the Probe to the Patient ........................................................................ 46Locking the Keys on the Transmitter ................................................................................ 48Monitoring ........................................................................................................................ 49Screen Descriptions ................................................................................................... 49Check Electrodes Screen ..................................................................................... 50Numeric and Waveform Screen ........................................................................... 51Waveform Review Screen .................................................................................... 52Numeric Review Screen ....................................................................................... 53Display Off ............................................................................................................ 53Basic Monitoring Operation ....................................................................................... 54Using the Function Key ........................................................................................ 54Suspending Alarms on the Receiving Monitor ..................................................... 55Pausing Monitoring............................................................................................... 56Resuming Monitoring after Pause ........................................................................ 58Confirming the Patient .......................................................................................... 58Turning the Display Off ......................................................................................... 59Turning the Display On after It was Turned Off ..................................................... 60ECG and Respiration Monitoring ............................................................................... 61Turning ECG Measurement On/Off ...................................................................... 64Turning Respiration Measurement On/Off ............................................................ 64Electrode Detachment .......................................................................................... 64
Operator’s Manual ZM-520PA/521PA/530PA/531PA C.3SpO2 Monitoring ......................................................................................................... 65Indications and Messages ............................................................................................... 69Indication ................................................................................................................... 69Messages .................................................................................................................. 69Message Display Priority ...................................................................................... 72Troubleshooting ............................................................................................................... 73Transmitter ................................................................................................................. 73ECG/Respiration ........................................................................................................ 74SpO2 ......................................................................................................................... 75Maintenance ....................................................................................................................761. External Check ................................................................................................. 762. Transmitter Channel ......................................................................................... 763. Transmitting/Receiving Signal .......................................................................... 774. Display .............................................................................................................. 775. Key Operation ................................................................................................... 796. ECG Check....................................................................................................... 807. Respiration Check ............................................................................................ 818. SpO2 Check (with SpO2 Checker) .................................................................... 819. SpO2 Check (with Vital Sign Simulator) ............................................................ 82Maintenance Check Sheet ................................................................................... 84Lifetime and Disposal ...................................................................................................... 85Disposing of Used Batteries ...................................................................................... 85Battery Lifetime .................................................................................................... 85Disposal ............................................................................................................... 85Disposing of Electrodes and SpO2 Probes ................................................................ 85Disposing of Transmitter ............................................................................................. 85Cleaning, Disinfection and Sterilization ........................................................................... 86Transmitter and Electrode Leads ............................................................................... 86Cleaning ............................................................................................................... 86Disinfection ........................................................................................................... 86SpO2 Probe ................................................................................................................ 87Periodic Replacement Schedule ..................................................................................... 87Repair Parts Availability Policy ........................................................................................ 87Specifications ..................................................................................................................88ZM-520PA/ZM-530PA ................................................................................................ 88Measured Parameters .......................................................................................... 88Transmitted Data .................................................................................................. 88Display.................................................................................................................. 88Displayed Data ..................................................................................................... 88ECG ..................................................................................................................... 88Respiration Measurement .................................................................................... 90SpO2 Measurement (ISO 9919: 2005 compliance) .............................................. 90
C.4 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmitter ........................................................................................................... 92Power Requirements ............................................................................................ 93Dimension and Weight ......................................................................................... 93Environment ......................................................................................................... 93Safety Standards .................................................................................................. 93Electromagnetic Compatibility .............................................................................. 94Electromagnetic Emissions .................................................................................. 94Electromagnetic Immunity .................................................................................... 95Recommended Separation Distances between Portable and Mobile RF Communications Equipment ................................................................................ 97Recovery Time after Defibrillation ........................................................................ 97System Composition for EMC Test ....................................................................... 97ZM-521PA/ZM-531PA ................................................................................................ 98Measured Parameters .......................................................................................... 98Transmitted Data .................................................................................................. 98Display.................................................................................................................. 98Displayed Data ..................................................................................................... 98ECG ..................................................................................................................... 98Respiration Measurement .................................................................................. 100SpO2 Measurement (ISO 9919: 2005 compliance) ............................................ 100Transmitter ......................................................................................................... 102Power Requirements .......................................................................................... 103Dimension and Weight ....................................................................................... 103Environment ....................................................................................................... 103Safety Standards ................................................................................................ 103Electromagnetic Compatibility ............................................................................ 104Electromagnetic Emissions ................................................................................ 104Electromagnetic Immunity .................................................................................. 105Recommended Separation Distances between Portable and Mobile RF Communications Equipment .............................................................................. 107Recovery Time after Defibrillation ...................................................................... 107System Composition for EMC Test ..................................................................... 108Standard Accessories.................................................................................................... 109Options .......................................................................................................................... 110Transmitter ............................................................................................................... 110ECG/RESP .............................................................................................................. 110SpO2 ....................................................................................................................... 111Transmission Frequencies ............................................................................................. 112
Operator’s Manual ZM-520PA/521PA/530PA/531PA iGENERAL HANDLING PRECAUTIONSThis device is intended for use only by qualified medical personnel.Use only Nihon Kohden approved products with this device. Use of non-approved 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. 3ODFHWKHLQVWUXPHQWRQDQHYHQOHYHOÀRRU$YRLGYLEUDWLRQDQGPHFKDQLFDOVKRFNHYHQduring transport.(3) Avoid placing in an area where chemicals are stored or where there is danger of gas OHDNDJH(4) The power line source to be applied to the instrument must correspond in frequency and YROWDJHWRSURGXFWVSHFL¿FDWLRQVDQGKDYHVXI¿FLHQWFXUUHQWFDSDFLW\(5) Choose a room where a proper grounding facility is available.3. Before Operation &KHFNWKDWWKHLQVWUXPHQWLVLQSHUIHFWRSHUDWLQJRUGHU &KHFNWKDWWKHLQVWUXPHQWLVJURXQGHGSURSHUO\&KHFNWKDWDOOFRUGVDUHFRQQHFWHGSURSHUO\(4) Pay extra attention when the instrument is in combination with other instruments to avoid misdiagnosis or other problems. $OOFLUFXLWU\XVHGIRUGLUHFWSDWLHQWFRQQHFWLRQPXVWEHGRXEO\FKHFNHG &KHFNWKDWEDWWHU\OHYHOLVDFFHSWDEOHDQGEDWWHU\FRQGLWLRQLVJRRGZKHQXVLQJEDWWHU\operated 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.
ii Operator’s Manual ZM-520PA/521PA/530PA/531PA5. 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. 7KHLQVWUXPHQWPXVWQRWEHDOWHUHGRUPRGL¿HGLQDQ\ZD\8. Maintenance and Inspection(1) The instrument and parts must undergo regular maintenance inspection at least every 6 months. ,IVWRUHGIRUH[WHQGHGSHULRGVZLWKRXWEHLQJXVHGPDNHVXUHSULRUWRRSHUDWLRQWKDWWKHinstrument is in perfect operating condition.(3) Technical information such as parts list, descriptions, calibration instructions or other LQIRUPDWLRQLVDYDLODEOHIRUTXDOL¿HGXVHUWHFKQLFDOSHUVRQQHOXSRQUHTXHVWIURP\RXU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.:KHQWKHLQVWUXPHQWLVXVHGZLWKDGH¿EULOODWRUPDNHVXUHWKDWWKHLQVWUXPHQWLVSURWHFWHGDJDLQVWGH¿EULOODWRUGLVFKDUJH,IQRWUHPRYHSDWLHQWFDEOHVDQGRUtransducers from the instrument to avoid possible damage.
Operator’s Manual ZM-520PA/521PA/530PA/531PA iiiWARRANTY POLICYNihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and ZRUNPDQVKLSIRURQH\HDUIURPWKHGDWHRIGHOLYHU\+RZHYHUFRQVXPDEOHPDWHULDOVVXFKDVUHFRUGLQJSDSHULQNVW\OXVDQGEDWWHU\DUHH[FOXGHGIURPWKHZDUUDQW\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.1RRWKHUSDUW\LVDXWKRUL]HGWRPDNHDQ\ZDUUDQW\RUDVVXPHOLDELOLW\IRU1.&¶VSURGXFWVNKC will not recognize any other warranty, either implied or in writing. In addition, service, WHFKQLFDOPRGL¿FDWLRQRUDQ\RWKHUSURGXFWFKDQJHSHUIRUPHGE\VRPHRQHRWKHUWKDQ1.&RULWV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 H[SODQDWLRQRIWKHIDLOXUH6KLSSLQJFRVWVPXVWEHSUHSDLG7KLVZDUUDQW\GRHVQRWDSSO\WRSURGXFWVWKDWKDYHEHHQPRGL¿HGGLVDVVHPEOHGUHLQVWDOOHGRUrepaired without Nihon Kohden approval or which have been subjected to neglect or accident, GDPDJHGXHWRDFFLGHQW¿UHOLJKWQLQJYDQGDOLVPZDWHURURWKHUFDVXDOW\LPSURSHULQVWDOODWLRQRUDSSOLFDWLRQRURQZKLFKWKHRULJLQDOLGHQWL¿FDWLRQPDUNVKDYHEHHQUHPRYHGIn the USA and Canada other warranty policies may apply.CAUTIONUnited States law restricts this product to sale by or on the order of a physician.
iv Operator’s Manual ZM-520PA/521PA/530PA/531PAEquipment Authorization RequirementCompliance with FCC RequirementsThis 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.7KLVGHYLFHFRPSOLHVZLWK3DUW6XESDUW+RIWKH)&&5XOHVWREHXVHGLQZLUHOHVVPHGLFDO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 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA vEMC RELATED CAUTIONThis equipment and/or system complies with the International Standard IEC 60601-1-2 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.
vi Operator’s Manual ZM-520PA/521PA/530PA/531PA6. 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA viiConventions Used in this Manual and InstrumentWarnings, Cautions and Notes:DUQLQJVFDXWLRQVDQGQRWHVDUHXVHGLQWKLVPDQXDOWRDOHUWRUVLJQDOWKHUHDGHUWRVSHFL¿Finformation.WARNINGA warning alerts the user to the possible injury or death associated with the use or misuse of the instrument.CAUTIONA 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.NOTEA note provides specific information, in the form of recommendations, prerequirements, alternative methods or supplemental information.
viii Operator’s Manual ZM-520PA/521PA/530PA/531PAExplanations of the Symbols in this Manual and InstrumentThe following symbols found in this manual/instrument bear the respective descriptions as given.On PanelSymbol Description Symbol DescriptionChange screen 'H¿EULOODWLRQSURRIW\SH%)applied partAttention, consult operator’s manual'H¿EULOODWLRQSURRIW\SH&)applied partMoves cursor, scrolls data Serial numberDirection for attaching battery cover Date of manufactureDirection for inserting battery RF transmitter1RQLRQL]LQJUDGLDWLRQDirect current F&6$XVPDUN&DOONH\On LCDSymbol Description Symbol DescriptionBatteries are fully charged Batteries are almost emptyReplace batteryBatteries are getting low Alarm suspendedBatteries are low 456SXOVHV\QFPDUN
Operator’s Manual ZM-520PA/521PA/530PA/531PA 1Intended UseGeneral7KH=03$DQG=03$WUDQVPLWWHUVWUDQVPLW(&*DQGUHVSLUDWLRQIURPDSDWLHQWWRD1LKRQ.RKGHQPRQLWRUIRUFRQWLQXRXVPRQLWRULQJ7KHIURQW/&'GLVSOD\V(&*QXPHULFYDOXHVof monitoring parameters, messages and battery condition.* They also display the compressed ZDYHIRUPDQGQXPHULFGDWDRIWKHODWHVWPLQXWHV7KH=03$DQG=03$WUDQVPLWWHUVWUDQVPLW(&*UHVSLUDWLRQDQGSXOVHZDYHIRUPVand SpO2 from a patient to a Nihon Kohden monitor for continuous monitoring. The front LCD GLVSOD\V(&*RUSXOVHZDYHQXPHULFYDOXHVRIPRQLWRULQJSDUDPHWHUVPHVVDJHVDQGEDWWHU\condition.7KH\DOVRGLVSOD\WKHFRPSUHVVHGZDYHIRUPDQGQXPHULFGDWDRIWKHODWHVWPLQXWHV (VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHU7KHGLIIHUHQFHEHWZHHQ=03$3$DQG=03$3$LVWKHWUDQVPLVVLRQIUHTXHQF\range.=03$3$  WR0+]FKDQQHOQXPEHUWR=03$3$  WR0+]FKDQQHOQXPEHU(WR( WR0+]FKDQQHOQXPEHU(WR(NOTE• 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.WARNINGDo 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.WARNINGDo 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.
2 Operator’s Manual ZM-520PA/521PA/530PA/531PACAUTION• 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.CAUTIONSignal loss and artifact may occur because of the multipath cancellation* when using a transmitter.* Multipath Cancellation (Standing Wave Interference): :KHQDUDGLRZDYHUHÀHFWVRIIDVXUIDFHWKHUHPD\EHVRPHSRLQWVLQWKHURRPZKHUHWKHUHÀHFWHGDQGGLUHFWZDYHVDUHH[DFWO\RXWRISKDVH$WWKHVHSRLQWVLQWKHURRPWKHUHÀHFWHG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 3Receiving MonitorAny 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 “low battery” alarm. Alarms must be managed on the receiving monitor.• To use protocol 51, an ORG-9100A or 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.
4 Operator’s Manual ZM-520PA/521PA/530PA/531PAPanel DescriptionTop PanelFor attaching a strap.ECG/RESP socketConnects the electrode lead for PHDVXULQJ(&*DQGRUUHVSLUDWLRQE\the impedance method.ZM-530PA/531PA onlySpO2 socketConnects the SpO2 probe.WARNINGBefore 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.WARNINGWhen 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.WARNINGWhen 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.CAUTIONDo 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 5Front Panel1346752No. Name Description  &$//NH\ :KHQWKLVNH\LVSUHVVHGD³SHHS´VRXQGVDWWKHWUDQVPLWWHU and “CALL” message appears at the monitor. Depending on    WKHVHWWLQJVRQWKHPRQLWRUDQ(&*ZDYHIRUPLVUHFRUGHGZKHQ   WKLVNH\LVSUHVVHG  /&' 'LVSOD\VQXPHULFYDOXHV(&*RUSXOVHZDYHPHVVDJHVDQG battery status. For details, refer to the “Screen Descriptions” section.  6FUHHQNH\ 7RJJOHVWKHVFUHHQLQWKHIROORZLQJRUGHU   $IWHUSRZHURQ6WDUWXSĺ&KHFNHOHFWURGHVĺ1XPHULFDQG   ZDYHIRUPĺ:DYHIRUPUHYLHZĺ1XPHULFUHYLHZĺ'LVSOD\   RIIĺ&KHFNHOHFWURGHV«   $IWHUDXWRGLVSOD\RII1XPHULFDQGZDYHIRUPĺ:DYHIRUP   UHYLHZĺ1XPHULFUHYLHZĺ'LVSOD\RIIĺ&KHFNHOHFWURGHV   ĺ1XPHULFDQGZDYHIRUP«   2QD6(783RU&+(&.VFUHHQWKLVNH\FDQFHOVFKDQJLQJ setting or exits the screen.
6 Operator’s Manual ZM-520PA/521PA/530PA/531PA1346752No. Name Description 4 Infrared receiver Used for upgrading the transmitter software. 5 Channel number label Indicates the channel number of the transmitter.  /HDG6FUROONH\V 2QWKHQXPHULFDQGZDYHIRUPVFUHHQWKHVHNH\VFKDQJHWKH   (&*OHDG   2QWKHZDYHIRUPUHYLHZVFUHHQWKHVHNH\VVFUROOGDWD   2QD6(783VFUHHQWKHVHNH\VPRYHWKHFXUVRU  )XQFWLRQNH\ 'HSHQGLQJRQWKHVHWWLQJRQWKHWUDQVPLWWHUWKLVNH\VXVSHQGV alarms, pauses monitoring on the receiving monitor or transmits    WKH³3DWLHQWFRQ¿UPHG´PHVVDJH   2QD6(783VFUHHQWKLVNH\UHJLVWHUVWKHVHOHFWHGVHWWLQJDQG moves the cursor to the next setting item.   2QD&+(&.VFUHHQWKLVNH\VWDUWVRUVWRSVWKHPDLQWHQDQFH test.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 7Rear Panel5HIHUWRWKH³([SODQDWLRQVof the Symbols in this Manual and Instrument” section.5HIHUWRWKH:$51,1*below.5HIHUWRWKH:$51,1*below.5HIHUWRWKH³([SODQDWLRQVof the Symbols in this Manual and Instrument” section.ZM-530PA/531PA onlyBattery case&RQWDLQVWZRDONDOLQHGU\FHOOEDWWHULHV$$7<3(WARNINGClose 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.WARNINGThis 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.
8 Operator’s Manual ZM-520PA/521PA/530PA/531PAImportant Safety InformationGeneralWARNINGNever 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.WARNINGNever use the transmitter in a hyperbaric oxygen chamber. Failure to follow this warning may cause explosion or fire.WARNINGDo not take this transmitter into the MRI test room. This transmitter is not designed to be used during MRI tests.WARNINGWhen 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.WARNINGBefore 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.WARNINGWhen 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.WARNINGWhen 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 9WARNINGDo 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.WARNINGThis 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.WARNINGClose 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.WARNINGDo 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.WARNINGWhen 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.WARNINGWhile the “ALARMS SUSPENDED” message is displayed on the transmitter, all alarms on the receiving monitor are suspended so keep the patient under close observation.WARNINGWhen the patient returns to the bed, turn on the transmitter and check that the monitoring is resumed on the receiving monitor.WARNINGIf the transmitter is not turned off and monitoring continues for the selected interval, pause monitoring is canceled and monitoring continues. Check that the monitoring is resumed on the receiving monitor.
10 Operator’s Manual ZM-520PA/521PA/530PA/531PACAUTIONOnly use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed.CAUTIONThe 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.CAUTIONTurn 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.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.CAUTIONSignal loss and artifact may occur because of the multipath cancellation* when using a transmitter.* Multipath Cancellation (Standing Wave Interference): :KHQDUDGLRZDYHUHÀHFWVRIIDVXUIDFHthere may be some points in the room where WKHUHÀHFWHGDQGGLUHFWZDYHVDUHH[DFWO\out of phase. At these points in the room, the UHÀHFWHGDQGGLUHFWZDYHVFDQFHOHDFKRWKHU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.CAUTIONDo 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.CAUTIONDo not reuse disposable parts and accessories.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 11CAUTIONWhen monitoring respiration is needed, measure respiration with an instrument. The transmitter calculates SpO2 of arterial blood based on the principle of pulse oximeter and does not measure respiration.CAUTIONWhen monitoring SpO2 only, detection of arrhythmia and asystole is not available and arrhythmia alarms such as ASYSTOLE, VF or VT are not available. If the patient requires ECG monitoring, monitor the ECG.CAUTIONWhen monitoring SpO2 only (without ECG monitoring), turn on both the upper and lower limit alarms for PR and SpO2 on the receiving monitor. If the patient’s pulse is not detected during asystole or other condition, a “CANNOT DETECT PULSE” or “CHECK PROBE” alarm occurs instead of an SpO2 limit alarm. Furthermore, if the patient has no pulse, noise from probe movement could be misjudged as a pulse and cause an incorrect PR or SpO2 value to be displayed.Output SignalWARNINGDo 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.
12 Operator’s Manual ZM-520PA/521PA/530PA/531PABatteryWARNINGDo not use NiMH batteries for this transmitter. Some operating environments may cause NiMH batteries to produce gas and explode.CAUTIONDo not handle the batteries with wet hands.CAUTIONRefer to the battery manual for details on handling the batteries.CAUTIONBattery 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.CAUTIONWhen the transmitter is not in use, remove the batteries. When the batteries are installed, battery power is consumed even when measurement is not performed.Transmitter Channel ManagementWARNINGThe 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 13For Patients Using Implantable PacemakerWARNINGThe 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.ECG MonitoringWARNINGAfter 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.WARNINGThe 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.* )RUWKHSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\of the =03$3$3$3$WUDQVPLWWHUUHIHUWRWKH³6SHFL¿FDWLRQV(&*´VHFWLRQWARNINGThe pacemaker pulse can be overlooked or detected as QRS. You cannot confirm the pacemaker operation only from the detected pacemaker pulse.
14 Operator’s Manual ZM-520PA/521PA/530PA/531PACAUTIONOnly 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.CAUTIONWhen the “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.CAUTIONHold 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 15SpO2 MonitoringWARNINGSpO2 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).WARNINGWhen 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 probes manufactured by Nihon .RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKHUDQJHRIDQGQP7KHPD[LPXPOLJKWintensity is less than 5.5 mW.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.WARNINGCheck 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
16 Operator’s Manual ZM-520PA/521PA/530PA/531PAWARNINGWhen 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.CAUTIONThe 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.CAUTIONWhile a patient is on medication which causes vasodilation, the pulse waveform may change and in rare cases the SpO2 value might not be displayed.CAUTIONDo not attach the probe to the same limb that is used for NIBP measurement or an IBP catheter. The SpO2 measurement may be incorrect.CAUTIONNormal 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.CAUTIONWhen a message indicates a faulty probe, stop monitoring and replace the probe with a new one.CAUTIONDo not use a probe which is deteriorated by aging. Accurate measurement cannot be performed.CAUTIONDo not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient.CAUTIONRefer to the probe instruction manual for details.CAUTIONWhen 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 17CAUTIONFailure 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.CAUTIONIf 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.CAUTIONIf 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.MaintenanceCAUTIONThis 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.CAUTIONDo not immerse the electrode lead connector in liquid.CAUTIONDispose 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.CAUTIONNever disassemble or repair the transmitter. If there is any problem with the transmitter, contact your Nihon Kohden representative.
18 Operator’s Manual ZM-520PA/521PA/530PA/531PAPreparation on TransmitterBatteriesHandling BatteriesWARNINGDo not use NiMH batteries for this transmitter. Some operating environments may cause NiMH batteries to produce gas and explode.CAUTIONRefer to the battery manual for details on handling the batteries.CAUTIONWhen the transmitter is not in use, remove the batteries. When the batteries are installed, battery power is consumed even when measurement is not performed.CAUTIONDo not handle the batteries with wet hands.NOTERemove the batteries from the transmitter before disposing of it.Battery Lifetime8VHWZR$$/5W\SHDONDOLQHGU\FHOOEDWWHULHV:LWKQHZ1LKRQ.RKGHQUHFRPPHQGHGDONDOLQHEDWWHULHVWKHWUDQVPLWWHUFDQFRQWLQXRXVO\PHDVXUHIRUWKHIROORZLQJQXPEHURIGD\VDWURRPWHPSHUDWXUH2SHUDWLRQWLPHGHSHQGVRQWKHWKLFNQHVVRIWKH6S22 probe attachment site.Transmitter Operating Time (Measuring parameters)ECG, Resp, SpO2ECG, Resp=03$=03$ 2.5 days 3.5 days=03$=03$ GD\V 2.5 daysRecommended Batteries$ONDOLQHSULPDU\1LKRQ.RKGHQ0HGLSRZHUHTXLYDOHQWWR3DQDVRQLF/5*
Operator’s Manual ZM-520PA/521PA/530PA/531PA 19NOTE• 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 on, it consumes battery power. Instruct the patient not to turn on the display during monitoring.Installing (Replacing) BatteriesCAUTIONBattery 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 GXULQJEDWWHU\UHSODFHPHQWH[FHVVSDWLHQWOHDNDJHFXUUHQWPD\ÀRZLQWRWKHSDWLHQW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. The transmitter is automatically turned on when the batteries are installed.iii
20 Operator’s Manual ZM-520PA/521PA/530PA/531PANOTEInsert 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.Situations Requiring Battery ReplacementReplace the batteries when any of the following occurs. 7KHWUDQVPLWWHUGLVSOD\VWKH³%$77(5<:($.´PHVVDJHRU 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 Indication7KHIROORZLQJLFRQVRQWKH/&'LQGLFDWHWKHEDWWHU\OHYHO:KHQ³35272&2/´RQWKH6<67(06(783VFUHHQLVVHWWRWKHEDWWHU\OHYHOLQGLFDWLRQLVWUDQVPLWWHGWRWKHUHFHLYLQJPRQLWRU7RXVHSURWRFROWKH25*$RU25*$PXOWLSOHSDWLHQWUHFHLYHUVRIWZDUHYHUVLRQor later is required.Indication Battery Level Message on the Receiving MonitorBatteries are fully charged.There is no message on the monitor.Batteries are getting low.Batteries are low.Batteries are almost empty. Replace batteries.Message requiring battery replacement is displayed.No indication Dead batteries No signal can be transmitted to the monitor.There is no indication on the monitor.iii
Operator’s Manual ZM-520PA/521PA/530PA/531PA 21Attaching a Strap to the TransmitterNOTEDo 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 WKHSDWLHQWWRXFKHVWKHEDWWHU\WHUPLQDOZKHQSXWWLQJWKHEDWWHULHVEDFNLQWKHWUDQVPLWWHUH[FHVVSDWLHQWOHDNDJHFXUUHQWPD\ÀRZLQWRWKHSDWLHQW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/531PATurning On the TransmitterWhen the batteries are installed correctly, the power is turned on. A “peep” sounds for one second, WKHVWDUWXSVFUHHQDSSHDUVWKHQWKHFKHFNHOHFWURGHVVFUHHQDSSHDUV7KHUHLVQR³SHHS´VRXQGwhen there is no battery power.) $IWHUFKHFNLQJWKDWWKH(&*LVVWDEOHRQWKHFKHFNHOHFWURGHVVFUHHQSUHVVWKH6FUHHQNH\WRdisplay the numeric and waveform screen.For details on the screen, refer to the “Screen Descriptions” section.Check Items Before Use%HIRUHWXUQLQJRQWKHWUDQVPLWWHUSRZHUFKHFNWKHIROORZLQJWRFRQ¿UPWKDWWKHWUDQVPLWWHUFDQEHused in normal and safe condition.Appearance 7KHUHDUHQRGDPDJHGRUGLUW\SDUWVRQWKHRXWVLGHRIWKHWUDQVPLWWHU/&'NH\VVRFNHWVbattery case cover, battery case, etc.).• The transmitter is completely dry.• The electrodes, electrode lead and SpO2SUREHDUHQRWEURNHQ
Operator’s Manual ZM-520PA/521PA/530PA/531PA 23Batteries• The battery polarity is correct. 7KHEDWWHU\FDVHVSULQJLV¿UPO\DWWDFKHGDQGWKHEDWWHU\LVQRWORRVH 7KHEDWWHU\FDVHFRYHULV¿UPO\FORVHGChannel Setting• The transmitter channel matches the receiving monitor channel.• There is no nearby transmitter with the same channel.Other :KHQSHUIRUPLQJGH¿EULOODWLRQVHWWKHKXP¿OWHUWR21RQWKHUHFHLYLQJPRQLWRU7KHZDYHIRUPUHFRYHU\PD\EHFRPHVORZGXHWRHOHFWURGHSRODUL]DWLRQZKHQWKHKXP¿OWHULVVHWWROFF.Check Items After Power On$IWHUWXUQLQJRQWKHSRZHUFKHFNWKHIROORZLQJPower On• The transmitter generates a one second “peep” sound and the startup screen appears. 7KHWUDQVPLWWHUGLVSOD\VWKHFKHFNHOHFWURGHVVFUHHQ• The transmitter is not too hot. 7KHWUDQVPLWWHUGRHVQRWGLVSOD\WKH³%$77(5<:($.´PHVVDJH• 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. 7KHNH\VRQWKHWUDQVPLWWHUIXQFWLRQSURSHUO\ 7KH/&'EULJKWQHVVLVDSSURSULDWH7RDGMXVWEULJKWQHVVUHIHUWRWKH³&KDQJLQJ6<67(06(7836HWWLQJV´VHFWLRQCheck Items After Use7RXVHWKHWUDQVPLWWHULQVDIHDQGRSWLPXPFRQGLWLRQIRUQH[WWLPHFKHFNWKHIROORZLQJBefore Turning Power Off 7HPSRUDULO\FKDQJHGVHWWLQJVDUHFKDQJHGEDFNWRWKHSUHYLRXVVHWWLQJV• There was no malfunction on the transmitter.Storage (&*HOHFWURGHOHDGVDQG6S22 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/531PATurning Off the TransmitterTo turn off the power, remove the batteries. When the power is turned off, the saved waveform and numeric data are deleted.Changing the Transmitter Channel7KHFKDQQHORIWKHWUDQVPLWWHUFDQEHFKDQJHGZLWKWKHRSWLRQDO4,3.FKDQQHOZULWHUWARNINGThe 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 25Changing Parameter and System Setup Settings7KHLQLWLDOVHWWLQJVRQWKH3$5$0(7(56(783DQG6<67(06(783VFUHHQVFDQRQO\EHchanged before monitoring. Changing these settings during monitoring interrupts monitoring.NOTEChanging Parameter and System Setup settings must be done by qualified personnel.Changing PARAMETER SETUP SettingsParameter Setup Setting ListThe factory default settings are underlined.Setting Item Description Settings(&*(/(&752'(6 Select the electrode lead type. ,(&$+$/($'7<3( 6HOHFWWKHW\SHRI(&*OHDGV AUTO/($'6(&*0($685(0(177XUQ(&*PRQLWRULQJRQRURII:KHQHOHFWURGHVDUHDWWDFKHGWRWKHSDWLHQWDQG(&*OHDGVDUHFRQQHFWHG(&*PRQLWRULQJVWDUWVHYHQZKHQWKLVVHWWLQJLVVHWto OFF. If this setting is set to OFF, the same setting on the receiving monitor must also be set to OFF.NOTEWhen “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 or ORG-9110A multiple patient receiver software version 03-03 or later is required.ON, OFF5(630($685(0(17Turn 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, OFFSpO25(63216( Select the SpO2 response mode. FAST, NORMAL, SLOW
26 Operator’s Manual ZM-520PA/521PA/530PA/531PADisplaying the PARAMETER SETUP Screen1. Turn off the transmitter by removing one battery. :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHULQVHUWWKHEDWWHU\7KH0(18screen appears. 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³3$5$0(7(56(783´ 3UHVVWKH)XQFWLRQNH\WRHQWHU3$5$0(7(56(7837KHFXUUHQWVHWWLQJVDUHKLJKOLJKWHG5. Change the settings:• To move the cursor and select the setting LWHPSUHVVWKHŻRUŹNH\WKHQSUHVVWKH)XQFWLRQNH\• To select and register the setting, press the ŻRUŹNH\WKHQSUHVVWKH)XQFWLRQNH\• To cancel changing the setting of the VHOHFWHGLWHPSUHVVWKH6FUHHQNH\ :KHQFKDQJLQJVHWWLQJVRQWKH3$5$0(7(56(783VFUHHQLVFRPSOHWHSUHVVWKH6FUHHQNH\WRUHWXUQWRWKH0(18VFUHHQ 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR³(;,7´ 3UHVVWKH)XQFWLRQNH\7KHQXPHULFDQGZDYHIRUPVFUHHQDSSHDUVCursorMENU screenSetting itemPARAMETER SETUP screen - page 1SettingCursor
Operator’s Manual ZM-520PA/521PA/530PA/531PA 27Changing Parameter Setup SettingsECG ELECTRODESSelect the electrode lead type. 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³(&*(/(&752'(6´ 3UHVVWKH)XQFWLRQNH\7KHFXUVRUPRYHVWRthe selection item. 3UHVVWKHŹNH\WRVHOHFW³,(&´RU³$+$´ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³(&*(/(&752'(6´LEAD TYPE6HOHFWWKHW\SHRI(&*OHDGV,QQRUPDOXVHVHOHFW³$872´:KHQXVLQJ',1W\SHOHDGZLWKHOHFWURGHVVHOHFW³/($'6´ 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³/($'7<3(´ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³$872´RU³/($'6´ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³/($'7<3(´Setting itemCursorSelected settingCursor
28 Operator’s Manual ZM-520PA/521PA/530PA/531PAECG MEASUREMENT7XUQ(&*PRQLWRULQJRQRURII:KHQHOHFWURGHVDUHDWWDFKHGWRWKHSDWLHQWDQG(&*OHDGVDUHFRQQHFWHG(&*PRQLWRULQJVWDUWVHYHQZKHQWKLVVHWWLQJLVVHWWR2))If this setting is set to OFF, the same setting on the receiving monitor must also be set to OFF.NOTEWhen “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/ORG-9110A multiple patient receiver software version 03-03 or later is required. 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³(&*0($685(0(17´ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³21´RU³2))´ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³(&*0($685(0(17´RESP MEASUREMENTTurn respiration monitoring on or off. When this setting is set to OFF, the same setting on the receiving monitor is automatically set to OFF. 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³5(630($685(0(17´ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³21´RU³2))´ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³5(630($685(0(17´
Operator’s Manual ZM-520PA/521PA/530PA/531PA 29SpO2 RESPONSESelect the response mode from FAST, NORMAL or SLOW. For details on the response time, refer WRWKH³6SHFL¿FDWLRQV6S220HDVXUHPHQW,62FRPSOLDQFH´VHFWLRQLQWKLVPDQXDONOTEWhen measurement condition is unstable due to strenuous movement of the patient, etc., response may become slower in all modes. 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³6S25(63216(´³6S25(63216(´LVRQWKHVHFRQGSDJHRIWKH3$5$0(7(56(783screen. 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³)$67´“NORMAL” or “SLOW”. 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHselected setting. The cursor returns to “SpO2 5(63216(´PARAMETER SETUP screen - page 2
30 Operator’s Manual ZM-520PA/521PA/530PA/531PAChanging SYSTEM SETUP SettingsSystem Setup Setting ListThe factory default settings are underlined.Setting Item Description SettingsPROTOCOLSelect the transmitting protocol.51: New protocol. A central monitor with an 25*$RU25*$PXOWLSOHSDWLHQWUHFHLYHUZKRVHVRIWZDUHYHUVLRQRUODWHUFDQUHFHLYHWKLVprotocol.41: Old protocol. A central monitor with an 25*$25*$RU25*$PXOWLSOHpatient receiver can receive this protocol.NOTEWhen 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, an ORG-9100A or ORG-9110A multiple patient receiver software version 03-03 or later is required.51, 41%5,*+71(66 Select the screen brightness. DARK, %5,*+7)81&7,21.(<6HOHFWWKHIXQFWLRQRIWKH)XQFWLRQNH\6863(1'$/$503$86( Suspends alarm on the receiving monitor for 2 minutes. Pauses monitoring on the transmitter and receiving monitor.6863(1'$/$50 Suspends alarm on the receiving monitor for 2 minutes.CONFIRM: 'LVSOD\VWKH³3$7,(17&21),50('´PHVVDJH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. To use protocol 51, the ORG-9100A or ORG-9110A multiple patient receiver software version 03-03 or later is required.6863(1'ALARM 3$86(, 6863(1'ALARM, CONFIRM, OFF
Operator’s Manual ZM-520PA/521PA/530PA/531PA 31Setting Item Description Settings$8725(680($)7(53$86( 6HOHFWWKHLQWHUYDOWRUHVXPHPRQLWRULQJDIWHU3$86(VV, 1 min, 2 min, 3 min6(/(&7$%/(6&5((17,0(2873(5,2'PLQ6HOHFWWKHGLVSOD\WLPHRXWSHULRG , Displaying the SYSTEM SETUP Screen1. Turn off the transmitter by removing one battery. :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQthe transmitter by inserting the battery. The 0(18VFUHHQDSSHDUV 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³6<67(06(783´ 3UHVVWKH)XQFWLRQNH\WRHQWHU6<67(06(7837KHFXUUHQWVHWWLQJVDUHKLJKOLJKWHG5. Change the settings.• To move the cursor and select the setting LWHPSUHVVWKHŻRUŹNH\WKHQSUHVVWKH)XQFWLRQNH\• To select and register the setting, press the ŻRUŹNH\WKHQSUHVVWKH)XQFWLRQNH\• To cancel changing the setting of the VHOHFWHGLWHPSUHVVWKH6FUHHQNH\ 7KH6<67(06(783VFUHHQKDVWZRSDJHV7RGLVSOD\WKHVHFRQGSDJHSUHVVWKHŹNH\ZKHQWKHFXUVRULVDW³%5,*+71(66´ :KHQFKDQJLQJVHWWLQJVRQWKH6<67(06(783VFUHHQLVFRPSOHWHSUHVVWKH6FUHHQNH\WRUHWXUQWRWKH0(18VFUHHQ 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR³(;,7´ 3UHVVWKH)XQFWLRQNH\7KHQXPHULFDQGZDYHIRUPVFUHHQDSSHDUVCursorMENU screenSetting itemSYSTEM SETUP screen - page 1Setting
32 Operator’s Manual ZM-520PA/521PA/530PA/531PAChanging System Setup SettingsPROTOCOLSelect the transmitting protocol. For differences between protocols, refer to the table below. 1HZSURWRFRO$FHQWUDOPRQLWRUZLWKDQ25*$RU25*$PXOWLSOHSDWLHQWUHFHLYHUZKRVHVRIWZDUHYHUVLRQRUODWHUFDQUHFHLYHWKLVSURWRFRO 2OGSURWRFRO$FHQWUDOPRQLWRUZLWKDQ25*$25*$RU25*$PXOWLSOHpatient receiver can receive this protocol.NOTEWhen 51 is set, the receiving monitor must be able to receive protocol 51. Otherwise, signals from the transmitter cannot be received.Differences Between ProtocolsFunction Protocol 41 Protocol 516HWWLQJ(&*0($685(0(17WR2))RQthe transmitter automatically turns off the (&*PHDVXUHPHQWVHWWLQJRQWKHUHFHLYLQJmonitor 1R(&*PHDVXUHPHQWmust be turned off on the receiving monitor)YesPause monitoring on the receiving monitor from the transmitter No Yes7UDQVPLW³3$7,(17&21),50('´PHVVDJH No YesDisplay battery level of the transmitter on the receiving monitor No YesTransmit SpO2 messages Some messages (refer to the “Indication and Message List” section)All messages7UDQVPLW5(63PHVVDJH No Yes 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR“PROTOCOL”. 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³´RU³´SettingCursor
Operator’s Manual ZM-520PA/521PA/530PA/531PA 33NOTEFUNCTION 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”. 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGsetting. The cursor returns to “PROTOCOL”.BRIGHTNESSSelect the screen brightness. 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³%5,*+71(66´ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFW³'$5.´RU³%5,*+7´ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³%5,*+71(66´FUNCTION KEY6HOHFWWKHIXQFWLRQRIWKH)XQFWLRQNH\)RUGHWDLOVRQXVLQJWKHVHIXQFWLRQVUHIHUWR³%DVLFMonitoring Operation” in the “Monitoring” section.6863(1'$/$503$86( 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV3DXVHV monitoring on the transmitter and receiving monitor.6863(1'$/$50 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV&21),50 'LVSOD\VWKH³3$7,(17&21),50('´PHVVDJHRQWKH 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 2QWKH6<67(06(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³)81&7,21.(<´,WLVRQWKHVHFRQGSDJHRIWKH6<67(06(783VFUHHQ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFWWKHIXQFWLRQ 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGsetting. The cursor returns to “FUNCTION .(<´AUTO RESUME AFTER PAUSE6HOHFWWKHLQWHUYDOWRUHVXPHPRQLWRULQJDIWHU3$86(:KHQHLWKHURIWKHIROORZLQJFRQGLWLRQVLVmet, monitoring resumes on the receiving monitor. +HDUWUDWHLVSURSHUO\PRQLWRUHGIRUWKHVHOHFWHGLQWHUYDO• SpO2 is properly monitored for the selected interval 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³$8725(680($)7(53$86(´,WLVRQWKHVHFRQGSDJHRIWKH6<67(06(783VFUHHQ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŹNH\WRVHOHFWWKHLQWHUYDO 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³$8725(680($)7(53$86(´SELECTABLE SCREEN TIME OUT PERIOD (min)6HOHFWWKHGLVSOD\WLPHRXWSHULRG,IQRNH\LVSUHVVHGIRUWKHVHOHFWHGWLPHWKHGLVSOD\LVautomatically turned off. The selected time is shown on the Select Screen Time Out Period screen. Refer to the “Turning the Display Off” section for details. 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³6(/(&7$%/(6&5((17,0(2873(5,2'PLQ´,WLVRQWKHWKLUGSDJHRIWKH6<67(06(783VFUHHQ 3UHVVWKH)XQFWLRQNH\ 3UHVVWKHŻRUŹNH\WRVHOHFWWLPHRXWperiod.SYSTEM SETUP screen - page 2SYSTEM SETUP screen - page 3
Operator’s Manual ZM-520PA/521PA/530PA/531PA 35 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³6(/(&7$%/(6&5((17,0(2873(5,2'PLQ´Initializing SettingsDo the following procedure to initialize all settings, except for channel, to the factory default settings.1. Turn off the transmitter by removing a battery. :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQthe transmitter by inserting the battery. The 0(18VFUHHQDSSHDUV 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³6<67(0,1,7,$/,=(´ 3UHVVWKH)XQFWLRQNH\WRHQWHUWKH6<67(0,1,7,$/,=(VFUHHQ 3UHVVWKH)XQFWLRQNH\$FRQ¿UPDWLRQmessage appears. 7RUHWXUQWRWKH0(18VFUHHQSUHVVWKH6FUHHQNH\ 3UHVVWKH)XQFWLRQNH\WRLQLWLDOL]HVHWWLQJV 7RFDQFHOLQLWLDOL]LQJSUHVVWKHŹNH\7KHVFUHHQUHWXUQVWRWKH0(18VFUHHQCursor
36 Operator’s Manual ZM-520PA/521PA/530PA/531PAAttaching Electrodes and SpO2 Probe to the PatientAttaching ElectrodesSelecting Electrode LeadCAUTIONOnly 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 optional electrode leads can be used with the transmitter.%53$HOHFWURGHV$+$FOLSW\SH %53$HOHFWURGHV$+$FOLSW\SHConnecting the Electrode Lead to the Transmitter&RQQHFWWKHHOHFWURGHOHDGWRWKH(&*5(63VRFNHWRQthe transmitter.WARNINGAfter 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 37CAUTIONDo 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.CAUTIONHold 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.Electrode PositionFollow the physician’s instructions for electrode placement when available.)RU(&*PRQLWRULQJHOHFWURGHVDUHDWWDFKHGRQO\RQWKHFKHVWWRDOORZSDWLHQWPRYHPHQWDQGREWDLQFRQWLQXRXVVWDEOH(&*7KHIROORZLQJOHDGVDUHH[DPSOHV:KHQDOVRPRQLWRULQJUHVSLUDWLRQUHIHUWRWKH³(OHFWURGH3RVLWLRQIRU5HVSLUDWLRQ0RQLWRULQJ´VHFWLRQNOTEThe 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 MonitoringSix Electrodes7KHHOHFWURGHPHWKRGZLWKOHDG,,DQGOHDG9LVHIIHFWLYHIRUPRQLWRULQJP\RFDUGLDOLVFKHPLD<RXFDQLPSURYHPRQLWRULQJDFFXUDF\FRQVLGHUDEO\E\DGGLQJOHDG9WRWKLVFRPELQDWLRQ9DDQG9EFDQEHDWDQ\SRVLWLRQRIWKHVWDQGDUGOHDGV9WR9EXW9DQG9DUHPRVWDSSURSULDWHfor myocardial ischemic monitoring.RA/R LA/LRL/RF LL/FVa/CaVb/Cb
38 Operator’s Manual ZM-520PA/521PA/530PA/531PAElectrode Position Symbol Lead ColorAHA IEC AHA IECLeft infraclavicular fossa LA L %ODFN YellowRight infraclavicular fossa RA R White RedBelow lowest rib on the left anterior axillary line LL F Red *UHHQRight anterior axillary line at the same level as LL/F RL RF *UHHQ %ODFNFifth intercostal space on the left midclavicular OLQH9SRVLWLRQRIVWDQGDUGOHDGV 9D Ca %URZQEOXH :KLWHEURZQ/HIWDQWHULRUD[LOODU\OLQHDWWKHVDPHOHYHODV9D9SRVLWLRQRIVWDQGDUGOHDGV 9E Cb %URZQRUDQJH :KLWHEODFNLead PositionStandard limb leadsMonopolar limb leadsMonopolar chest leadsLead ILead I Lead II Lead IIIaVR lead aVL lead aVF leadtoV1 to V6 leadsRARARA RA RARARALALALALALALALALLLLLLLL LLLLLLN (RL)N (RL)N (RL) N (RL) N (RL)N (RL)N (RL)
Operator’s Manual ZM-520PA/521PA/530PA/531PA 39Three Electrodes /HDG0,,ZKLFKLVVLPLODUWRVWDQGDUGOHDG,,XVHGZKHQ(&*PHDVXUHPHQWKDVSULRULW\Electrode Position Symbol Lead ColorAHA IEC AHA IECLeft infraclavicular fossa LA L %ODFN YellowRight infraclavicular fossa RA R White RedBelow lowest rib on the left anterior axillary lineLL F Red *UHHQ• Lead MI, which is similar to standard lead I Change F/LL and L/LA of lead MII.R/RA (−)L/LA (N)F/LL (+)• Lead MIII, which is similar to standard lead III Change R/RA and L/LA of lead MII.L/LA (N)R/RA (−)F/LL (+)If the electrode positions above are not available due to chest surgery, attach the electrodes to the URRWRIWKHOLPEVRUEHORZWKHFODYLFOHVIRUVWDEOH(&*PRQLWRULQJL/LA (N)R/RA (−)F/LL (+)
40 Operator’s Manual ZM-520PA/521PA/530PA/531PAElectrode Positions for Respiration MonitoringPlace the R/RA and F/LL electrodes so that the lungs are between the electrodes.Position 1In this position, respiration measurement is available; however, there is a difference in amplitude between different patients.R or RA F or LLRight infraclavicular fossa Fifth intercostal space on the OHIWPLGFODYLFXODUOLQH9Position 2,QWKLVSRVLWLRQWKHZDYHIRUPDPSOLWXGHLVXVXDOO\ODUJHDQGWKH(&*OHDGLVVLPLODUWR/HDG0,,This position can be generally recommended.R or RA F or LLRight infraclavicular fossa Fifth intercostal space on the OHIWPLGD[LOODU\OLQH9Position 3,QWKLVSRVLWLRQWKHUHVSLUDWLRQZDYHIRUPLVRSWLPXPEXWWKH(&*OHDGLVXQXVXDOR or RA F or LLRight midaxillary at the KRUL]RQWDOOHYHORI9Fifth intercostal space on the OHIWPLGD[LOODU\OLQH9R/RA (−)F/LL (+)NR/RA (−)F/LL (+)NNR/RA (−)F/LL (+)
Operator’s Manual ZM-520PA/521PA/530PA/531PA 41Position 4,QWKLVSRVLWLRQWKHUHVSLUDWLRQPHDVXUHPHQWLVLQÀXHQFHGE\WKHLPSHGDQFHYDULDWLRQRIWKH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 GXULQJLQVSLUDWLRQ,WLVGLI¿FXOWWRPHDVXUHWKH(&*DWWKHVDPHWLPHR or RA F or LLLowest rib on the right anterior axillary lineLowest rib on the left anterior axillary lineAttaching Electrodes to the Patient and Connecting the Electrode Leads to Disposable ElectrodesPrepare the Patient SkinShave off excessive body hair.7RUHGXFHVNLQLPSHGDQFHFOHDQWKHHOHFWURGHVLWHZLWKFUHDPRUZLWKDFRWWRQSDGPRLVWHQHGZLWKDOFRKRO7KRURXJKO\GU\WKHVNLQZLWKDFOHDQFRWWRQSDG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 PatientCAUTIONDo 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.NR/RA (−)F/LL (+)
42 Operator’s Manual ZM-520PA/521PA/530PA/531PARefer to the electrode operator’s manual for details. &DUHIXOO\UHPRYHWKHEDFNLQJSDSHUIURPWKHHOHFWURGHAvoid touching the adhesive surface. 3ODFHWKHHOHFWURGHRQWKHSUHYLRXVO\FOHDQHGVNLQ3D\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$IWHUDWWDFKLQJHOHFWURGHVDQGFRQQHFWLQJ(&*OHDGVFKHFNWKDWWKHHOHFWURGHVDUHSURSHUO\DWWDFKHGWRWKHSDWLHQWDQGWKH(&*ZDYHIRUPLVDFTXLUHGRQWKHFKHFNHOHFWURGHVVFUHHQ)RUdetails on the screen, refer to the “Screen Descriptions” section.Attaching the SpO2 ProbeSelecting the SpO2 ProbeSelect an appropriate probe for the patient.CAUTIONOnly use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed.CAUTIONDo not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 43Reusable Probes:KHQXVLQJD7/7¿QJHUSUREHFKRRVHWKHDSSURSULDWHFDEOHOHQJWKIRUDWWDFKPHQWProbe Cable Length Patient Attachment Site)LQJHUSUREH7/7PAdult or childNJRUPRUHFinger1.6 m0XOWLVLWHSUREH7/7Attachment tapeAdult or infantNJRUPRUHFinger or toeNeonateNJRUOHVVInstep and soleFinger probe7/77/7Attachment tape7/7PAdult or childNJRUPRUHFinger or toe7/71.6 mDisposable ProbesCAUTIONThe 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.
44 Operator’s Manual ZM-520PA/521PA/530PA/531PAProbe Patient Attachment Site7/67/640 mm&DEOHOHQJWK 7/6P 7/6PAdultNJRUPRUHFingerNeonateNJRUOHVVInstep and sole7/67/635 mm&DEOHOHQJWK 7/6P 7/6PAdult or childWRNJFingerChiled or infantWRNJToe7/77/7&DEOHOHQJWK 7/7 P 7/7PAdultNJRUPRUHFinger or toe7/77/7&DEOHOHQJWK 7/7 P 7/7PChildWRNJ
Operator’s Manual ZM-520PA/521PA/530PA/531PA 45Probe Patient Attachment Site7/77/7&DEOHOHQJWK 7/7 P 7/7PAdultNJRUPRUHFinger or toeNeonateNJRUOHVVInstep and sole7/77/7&DEOHOHQJWK 7/7 P 7/7PInfantWRNJFinger or toeConnecting the SpO2 Probe to the TransmitterConnect the probe to the SpO2VRFNHWRQWKHWUDQVPLWWHUCAUTIONDo 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.CAUTIONDo not use a damaged or disassembled probe. It causes incorrect measurement and may injure the patient.
46 Operator’s Manual ZM-520PA/521PA/530PA/531PAAttaching the Probe to the Patient$WWDFKWKHSUREHWRWKHSDWLHQWE\UHIHUULQJWRWKHSUREH¶VPDQXDO0DNHVXUHWKDWWKHOLJKWHPLWWHUand photo detector of the probe face each other at the attachment site.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.WARNINGCheck 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 skinWARNINGWhen 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 probes manufactured by Nihon .RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKHUDQJHRIDQGQP7KHPD[LPXPOLJKWintensity is less than 5.5 mW.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 47CAUTIONIf 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.CAUTIONWhen 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.CAUTIONIf 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.CAUTIONDo not use a probe which is deteriorated by aging. Accurate measurement cannot be performed.CAUTIONRefer to the probe instruction manual for details.CAUTIONThe 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.
48 Operator’s Manual ZM-520PA/521PA/530PA/531PALocking the Keys on the Transmitter7RSUHYHQWWKHSDWLHQWIURPSUHVVLQJWKHNH\VRQWKHWUDQVPLWWHUGXULQJPRQLWRULQJ\RXFDQORFNWKHNH\V7RORFNWKHNH\V3UHVVWKHŻDQGŹNH\VDWWKHVDPHWLPHDQGKROGIRUPRUHWKDQVHFRQGV7KH³.H\ORFNHG´screen appears.:KHQWKHVFUHHQWLPHRXWSHULRGLVVHWWR³PLQ´IDFWRU\GHIDXOWWKH³.H\ORFNHG´VFUHHQLVGLVSOD\HGIRUVHFRQGVWKHQWKHGLVSOD\WXUQVRIILIWKHUHLVQRNH\RSHUDWLRQ:KHQWKHVFUHHQWLPHRXWSHULRGLVVHWWRDFHUWDLQQXPEHURIPLQXWHVWKH³.H\ORFNHG´VFUHHQLVGLVSOD\HGIRUVHFRQGVWKHQLWFKDQJHVWRWKHQXPHULFDQGZDYHIRUPVFUHHQ,IWKHUHLVQRNH\operation, the display turns off when the remaining time elapses. Refer to the “Turning the Display Off” section for details.7RXQORFNWKHNH\V3UHVVWKHŻDQGŹNH\VDWWKHVDPHWLPHDQGKROGIRUPRUHWKDQVHFRQGV
Operator’s Manual ZM-520PA/521PA/530PA/531PA 49MonitoringCAUTIONThe 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.NOTEDo 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:KHQWKHWUDQVPLWWHULVWXUQHGRQWKHVWDUWXSVFUHHQDSSHDUVWKHQWKHFKHFNHOHFWURGHVVFUHHQWRFKHFNWKHHOHFWURGHDWWDFKPHQWDSSHDUV7KHVFUHHQFKDQJHVLQWKHIROORZLQJRUGHUZKHQWKH6FUHHQNH\LVSUHVVHG&KHFNHOHFWURGHVĺQXPHULFDQGZDYHIRUPĺZDYHIRUPUHYLHZĺQXPHULFUHYLHZĺGLVSOD\RIIĺFKHFNHOHFWURGHVScreen key
50 Operator’s Manual ZM-520PA/521PA/530PA/531PACheck Electrodes Screen<RXFDQFKHFNZKHWKHUWKHHOHFWURGHVDUHSURSHUO\DWWDFKHGWRWKHSDWLHQWDQGWKH(&*ZDYHIRUPis acquired.:KHQOHDGVDUHXVHGWKH,,,9DDQG9EOHDGZDYHIRUPVDUHGLVSOD\HGWhen 3 leads are used, only the lead II waveform is displayed.Filter: offSweep speed: 12.5 mm/sWaveform sensitivity: 0.5 cm/1 mVECG waveformBattery levelLeadChannel numberDetached electrode positionMessage When electrodes are GHWDFKHGWKH³&+(&.(/(&752'(6´message and detached electrode position appear on the screen.NOTEWhen 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 51Numeric and Waveform ScreenNumeric values and waveforms of the monitoring parameters are displayed. You can change the (&*OHDGZLWKWKHŻDQGŹNH\VHeart rateQRS sync markPulse bar graphSpO2ECG waveformFilter: onSweep speed: 12.5 mm/sWaveform sensitivity: autoWaveform sensitivityECG lead:KHQ(&*DQGUHVSLUDWLRQPHDVXUHPHQWLVWXUQHGRIIPulse ratePulse sync markSpO2Pulse wave sensitivityPulse waveformSweep speed: 12.5 mm/sWaveform sensitivity: auto
52 Operator’s Manual ZM-520PA/521PA/530PA/531PANOTEThe 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(&*IXOOGLVFORVXUHIRUXSWRPLQXWHVFDQEHVDYHGDQGUHYLHZHG:KHQ(&*PHDVXUHPHQWLVturned off and SpO2 is monitored, the pulse waveform is saved.:KHQ(&*OHDGLVFKDQJHGRQWKHQXPHULFDQGZDYHIRUPVFUHHQWKH(&*IXOOGLVFORVXUHRIWKHchanged lead is saved.The saved data is deleted when the transmitter is turned off.ECG leadDisplayed pageCompressed ECG waveform7.5 s × 4 traces per page, total 20 pagesOlder dataNewer dataTime range of the displayed waveform (time before the waveform review screen is displayed)Waveform sensitivity7RVFUROOWKHZDYHIRUPSUHVVWKHŻRUŹNH\7KHZDYHIRUPLVVFUROOHGE\VHFRQGV
Operator’s Manual ZM-520PA/521PA/530PA/531PA 53Numeric Review Screen1XPHULFGDWDRIKHDUWUDWHRUSXOVHUDWHZKHQ(&*LVWXUQHGRII6S22 and respiration rate for up WRPLQXWHVDUHVDYHGDWPLQXWHLQWHUYDOVThe saved data is deleted when the transmitter is turned off.Time before the numeric review screen is displayed.Older dataNewer dataDisplay OffThe display can be turned off any time. Refer to the “Turning the Display Off” section for details.10-second time bar
54 Operator’s Manual ZM-520PA/521PA/530PA/531PABasic Monitoring OperationUsing the Function KeyFunction key2QHRIWKHIROORZLQJIXQFWLRQVFDQEHDVVLJQHGWRWKH)XQFWLRQNH\RQWKH6<67(06(783VFUHHQ5HIHUWRWKH³&KDQJLQJ6<67(06(7836HWWLQJV´VHFWLRQ6863(1'$/$50 6XVSHQGVDODUPVRQWKHUHFHLYLQJPRQLWRUEHIRUHWKH\RFFXUIRUPLQXWHV3$86( 3DXVHVPRQLWRULQJRQWKHWUDQVPLWWHUDQGUHFHLYLQJPRQLWRU&21),50 7UDQVPLWVWKHVLJQDOWKDWWKHSDWLHQWLVFRQ¿UPHGDQGGLVSOD\VWKH  ³3$7,(17&21),50('´PHVVDJHRQWKHWUDQVPLWWHUNOTETo use the Function key for PAUSE or CONFIRM, you must set “PROTOCOL” on the SYSTEM SETUP screen of the transmitter to 51 and the receiving monitor must be able to receive protocol 51. To use protocol 51, an ORG-9100A or ORG-9110A multiple patient receiver software version 03-03 or later is required.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 55Suspending Alarms on the Receiving MonitorWARNINGWhile the “ALARMS SUSPENDED” message is displayed on the transmitter, all alarms on the receiving monitor are suspended so keep the patient under close observation.:KHQWKH)81&7,21.(<LVVHWWR³6863(1'$/$50´RU³6863(1'$/$503$86(´RQWKH6<67(06(783VFUHHQDODUPVFDQEHVXVSHQGHGIRUPLQXWHVRQWKHUHFHLYLQJPRQLWRUbefore they occur.To suspend alarms: 3UHVVWKH)XQFWLRQNH\7KH³6XVSHQGDODUPV´FRQ¿UPDWLRQVFUHHQDSSHDUV 3UHVVWKHŹNH\WRVXVSHQGDODUPV 7RFDQFHOVXVSHQGLQJDODUPVDQGUHWXUQWRWKHSUHYLRXVVFUHHQSUHVVWKH6FUHHQNH\:KHQWKHDODUPVDUHVXVSHQGHGWKH³$/$5066863(1'('´PHVVDJHDQGDODUPVXVSHQGHGicon with the remaining minutes in alarm suspension appear on the transmitter screen.Message Icon
56 Operator’s Manual ZM-520PA/521PA/530PA/531PATo cancel suspending alarms during 2 minute alarm suspension: 3UHVVWKH)XQFWLRQNH\ZKLOHWKH³$/$5066863(1'('´PHVVDJHLVGLVSOD\HG7KHFRQ¿UPDWLRQVFUHHQDSSHDUV 3UHVVWKHŹNH\WRFDQFHODODUPVXVSHQVLRQ 3UHVVWKH6FUHHQNH\WRQRWFDQFHODODUPVXVSHQVLRQPausing Monitoring:KHQ)81&7,21.(<LVVHWWR³6863(1'$/$503$86(´RQWKH6<67(06(783screen, you can pause monitoring on the receiving monitor from the transmitter when the patient FDQQRWEHPRQLWRUHGVXFKDVGXULQJ;UD\H[DPLQDWLRQNOTETo 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, an ORG-9100A or 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. :KHQ2))LVVHOHFWHGIRU³$8725(680($)7(53$86(´RQWKH6<67(06(783VFUHHQmonitoring does not automatically resume. +HDUWUDWHLVSURSHUO\PRQLWRUHGRQWKHWUDQVPLWWHUIRUWKHLQWHUYDOVHOHFWHGIRU³$8725(680($)7(53$86(´• SpO2LVSURSHUO\PRQLWRUHGRQWKHWUDQVPLWWHUIRUWKHLQWHUYDOVHOHFWHGIRU³$8725(680($)7(53$86(´
Operator’s Manual ZM-520PA/521PA/530PA/531PA 57To pause monitoring: 3UHVVWKH)XQFWLRQNH\7KH³6XVSHQGDODUPV´FRQ¿UPDWLRQVFUHHQDSSHDUV 3UHVVWKH)XQFWLRQNH\IRUVHFRQGVWRGLVSOD\WKH³3DXVHPRQLWRULQJ´FRQ¿UPDWLRQVFUHHQ 3UHVVWKHŹNH\WRSDXVHPRQLWRULQJ 7RFDQFHOSDXVHPRQLWRULQJSUHVVWKH6FUHHQNH\4. Wait about 5 seconds until the “Turn power off” screen appears.
58 Operator’s Manual ZM-520PA/521PA/530PA/531PA5. Turn off the transmitter. If the transmitter is not turned off and monitoring continues for the interval set for “AUTO 5(680($)7(53$86(´RQWKH6<67(06(783VFUHHQSDXVHPRQLWRULQJLVFDQFHOOHGand monitoring continues.Resuming Monitoring after Pause7RUHVXPHPRQLWRULQJDIWHUSDXVHFKHFNWKDWWKHHOHFWURGHVHOHFWURGHOHDGVDQGSUREHDUHDWWDFKHGto the patient then turn on the transmitter.WARNINGWhen the patient returns to the bed, turn on the transmitter and check that the monitoring is resumed on the receiving monitor.WARNINGIf the transmitter is not turned off and monitoring continues for the selected interval, pause monitoring is canceled and monitoring continues. Check that the monitoring is resumed on the receiving monitor.Confirming the Patient:KHQWKH)81&7,21.(<LVVHWWR³&21),50´RQWKH6<67(06(783VFUHHQSUHVVLQJWKH)XQFWLRQNH\VHQGVDVLJQDOWRWKHUHFHLYLQJPRQLWRUWRLQGLFDWHWKDWWKHSDWLHQWRUSDWLHQWFRQGLWLRQLVFRQ¿UPHGE\PHGLFDOVWDIIMessage
Operator’s Manual ZM-520PA/521PA/530PA/531PA 59Turning the Display OffThe display can be turned off any time. To turn off the display:  3UHVVWKH6FUHHQNH\VHYHUDOWLPHVXQWLOWKHIROORZLQJVFUHHQDSSHDUV10-second time bar 6HOHFWWKHWLPLQJIRUWXUQLQJRIIWKHGLVSOD\ZLWKWKHŻRUŹNH\7KHVHOHFWHGLWHPLVKLJKOLJKWHGLQEOXH$VHFRQGFRXQWGRZQVWDUWV<RXFDQVHOHFWDGLIIHUHQWWLPHZLWKLQWKHVHFRQGFRXQWGRZQ 1 min (factory default): Turns the display off 1 minute later. RUPLQ 7XUQVWKHGLVSOD\RIIZKHQWKHVHOHFWHGWLPHHODSVHV  7RVHWWKHWLPHUHIHUWR³6(/(&7$%/(6&5((17,0( 2873(5,2'PLQ´LQWKH³&KDQJLQJ6\VWHP6HWXS Settings” section. &217,18( .HHSWKHGLVSOD\WXUQHGRQNOTEIf longer than “1 min” is selected, it reduces the battery lifetime. :DLWVHFRQGVXQWLOWKHFRXQWGRZQHQGV:KHQWKHFRXQWGRZQHQGVWKHQXPHULFDQGwaveform screen appears. 2USUHVVWKH6FUHHQNH\EHIRUHWKHFRXQWGRZQHQGV7KHFKHFNHOHFWURGHVVFUHHQDSSHDUV :KHQWKHVHOHFWHGWLPHHODSVHVZLWKRXWDQ\NH\RSHUDWLRQWKHGLVSOD\WXUQVRIIDXWRPDWLFDOO\,IDNH\LVSUHVVHGWKHFRXQWGRZQUHVHWV :KHQGLVSOD\LQJWKHFKHFNHOHFWURGHVVFUHHQDIWHUVHOHFWLQJWKHWLPHRXWSHULRGWKHVFUHHQDXWRPDWLFDOO\FKDQJHVWRWKHQXPHULFDQGZDYHIRUPVFUHHQPLQXWHVODWHULIWKHUHLVQRNH\operation, then the display turns off when the remaining time elapses. :KHQGLVSOD\LQJDQRWKHUVFUHHQDIWHUVHOHFWLQJWKHWLPHRXWSHULRGWKHVFUHHQFKDQJHVWRWKHQXPHULFDQGZDYHIRUPVFUHHQPLQXWHODWHULIWKHUHLVQRNH\RSHUDWLRQWKHQWKHGLVSOD\WXUQVoff when the remaining time elapses.• When “1 min” is selected, the display turns off without changing to the numeric and waveform screen.
60 Operator’s Manual ZM-520PA/521PA/530PA/531PAWhen the display is turned off automatically or the power is turned off, the setting returns to “1 min” (factory default).Turning the Display On after It was Turned Off3UHVVWKH6FUHHQNH\2QHRIWKHIROORZLQJVFUHHQDSSHDUV 7KHSUHYLRXVVFUHHQ 7KH6FUHHQNH\LVSUHVVHGZLWKLQPLQXWHVDIWHUWKHGLVSOD\ turned off. 1XPHULFDQGZDYHIRUPVFUHHQ 7KH6FUHHQNH\LVSUHVVHGPRUHWKDQPLQXWHVDIWHUWKH display turned off.  ³.H\ORFNHG´VFUHHQ 7KH6FUHHQNH\LVSUHVVHGDIWHUWKHGLVSOD\WXUQHGRIIDQGWKH ³.H\ORFNHG´VFUHHQZDVWKHODVWVFUHHQEHIRUHWKHGLVSOD\ turned off.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 61ECG and Respiration Monitoring:KHQWKHHOHFWURGHVDUHDWWDFKHGDQGWKH(&*OHDGVDUHFRQQHFWHGWKHKHDUWUDWH(&*ZDYHIRUPrespiration rate and respiration waveform appear on the receiving monitor. Refer to the operator’s manual of the receiving monitor for details.:KHQOHDGVDUHXVHGRQWKLVWUDQVPLWWHUXSWROHDGV,,,,,,D95D9/D9)9DDQG9ERI(&*ZDYHIRUPVFDQEHGLVSOD\HGRQWKHUHFHLYLQJPRQLWRU7KHKHDUWUDWHLVDOVRPHDVXUHG:KHQOHDGVDUHXVHGRQHFKDQQHO(&*ZDYHIRUPRIOHDG,,FDQEHGLVSOD\HGRQWKHUHFHLYLQJmonitor. Refer to the operator’s manual of the monitor for details.Pacing marks:KLWHSDFLQJPDUNVare displayed at the points where DSDFLQJVSLNHLVdetected.Heart rateQRS sync mark Respiration rateECG leadYou can change the (&*OHDGZLWKWKHŻDQGŹNH\NH\VECG waveform Filter: onSweep speed: 12.5 mm/sWaveform sensitivity: autoCAUTIONTurn 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.
62 Operator’s Manual ZM-520PA/521PA/530PA/531PAUse with a Pacemaker:KHQPRQLWRULQJDSDFHPDNHUSDWLHQWWKHWUDQVPLWWHUGHWHFWVSDFHPDNHUSXOVHDQGUHMHFWVWKHSDFHPDNHUSXOVHIURPWKHKHDUWUDWHFRXQWWARNINGThe 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.WARNINGThe 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.* )RUWKHSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\RIWKH=03$3$3$3$WUDQVPLWWHUUHIHUWRWKH³6SHFL¿FDWLRQV(&*´VHFWLRQWARNINGThe 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.• 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 63Use with an Electrosurgical Unit)RUXVHZLWKDQHOHFWURVXUJLFDOXQLW(68WKLVWUDQVPLWWHUKDVDFLUFXLWWRSURWHFWWKHSDWLHQWIURPVNLQEXUQDQGWRUHGXFH(68LQWHUIHUHQFHRQWKH(&*ZDYHIRUP+RZHYHUWKHHIIHFWLYHQHVVRIWKLVFLUFXLWGHSHQGVRQHOHFWURGHSRVLWLRQDQGWUDQVPLWWHUVHWXS:LWKDQ(68SD\DWWHQWLRQWRWKHfollowing points.WARNINGWhen 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.NOTENoise generated from an electrosurgical unit may interfere on an ECG waveform, but will not damage it. 0HDVXUHZLWKHOHFWURGHOHDG Use the minimum number of electrodes. Use new electrodes.• Minimize noise 6HOHFWDQ(&*OHDGZKHUHWKHDFWLYH(&*HOHFWURGHVDUHORFDWHGDVIDUIURPWKHLQFLVLRQDVpossible.2. Position the + and – electrodes as close as possible. 6HOHFWWKHOHDGVZKHUHWKHDQJOHșEHWZHHQWKHDFWLYHHOHFWURGHVDQGWKHLQFLVLRQLVDVVPDOOas possible.4. Set the electrosurgical return plate as close to the incision as possible.Make smallIncisionReturn plateAs far as possible from electrode andas near as possible to incision
64 Operator’s Manual ZM-520PA/521PA/530PA/531PATurning ECG Measurement On/Off(&*PHDVXUHPHQWFDQEHWXUQHGRQRURIIRQWKH3$5$0(7(56(783VFUHHQ:KHQHOHFWURGHVDUHDWWDFKHGWRWKHSDWLHQWDQG(&*OHDGVDUHFRQQHFWHG(&*PRQLWRULQJVWDUWVHYHQZKHQ(&*LVturned off.When PROTOCOL on the SYSTEM SETUP screen is set to 51:(&*PHDVXUHPHQWRQWKHUHFHLYLQJPRQLWRULVDXWRPDWLFDOO\VHWWRRIINOTEECG 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:,I(&*PHDVXUHPHQWLVWXUQHGRIIRQWKHWUDQVPLWWHU(&*PHDVXUHPHQWRQWKHUHFHLYLQJPRQLWRUmust also be turned off.Turning Respiration Measurement On/Off5HVSLUDWLRQPHDVXUHPHQWFDQEHWXUQHGRQRURIIRQWKH3$5$0(7(56(783VFUHHQ,Irespiration measurement is turned off, respiration measurement on the receiving monitor is also turned off.Electrode Detachment,QWKHIROORZLQJFRQGLWLRQVWKH³&+(&.(/(&752'(6´PHVVDJHLVGLVSOD\HGRQWKHWUDQVPLWWHUand receiving monitor. (OHFWURGHLVGHWDFKHGIURPVNLQ (OHFWURGHOHDGLVGLVFRQQHFWHGIURPWKHHOHFWURGH 3RODUL]DWLRQYROWDJHEHWZHHQWKHHOHFWURGHDQGVNLQLVH[FHVVLYHO\KLJK,QWKHVHFDVHVFKHFNWKHFDXVHDQGLIQHFHVVDU\UHSODFHHOHFWURGHVZLWKQHZRQHVCAUTIONWhen the “CHECK ELECTRODES” message is displayed on the receiving monitor, ECG is not monitored properly and the ECG alarm does not function. Check the electrode, electrode leads, and if necessary, replace with new ones.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 65SpO2 MonitoringThe SpO2PRQLWRULQJLVRQO\DYDLODEOHRQWKH=03$DQG=03$WUDQVPLWWHUWhen monitoring starts, SpO2 and the pulse waveform are sent to the receiving monitor and SpO2 DQGWKHSXOVHOHYHOEDUJUDSKDUHGLVSOD\HGRQWKHWUDQVPLWWHUVFUHHQ:KHQ(&*LVQRWPHDVXUHGthe pulse waveform and pulse rate are also displayed.Pulse bar graphSpO2NOTEDuring 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.
66 Operator’s Manual ZM-520PA/521PA/530PA/531PAWARNINGSpO2 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).WARNINGCheck 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 skinWARNINGWhen 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 probes manufactured by Nihon .RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKHUDQJHRIDQGQP7KHPD[LPXPOLJKWintensity is less than 5.5 mW.WARNINGWhen 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 67CAUTIONTurn 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.CAUTIONFailure 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.CAUTIONNormal 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.CAUTIONWhen 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.CAUTIONWhen a message indicates a faulty probe, stop monitoring and replace the probe with a new one.CAUTIONWhile a patient is on medication which causes vasodilation, the pulse waveform may change and in rare cases the SpO2 value might not be displayed.CAUTIONDo not attach the probe to the same limb that is used for NIBP measurement or an IBP catheter. The SpO2 measurement may be incorrect.
68 Operator’s Manual ZM-520PA/521PA/530PA/531PANOTE• 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”.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 69Indications and MessagesIndicationIndication Cause CountermeasureBatteries are fully charged.—Batteries are getting low. Batteries are low.Batteries are almost empty. Replace the batteries.Alarms on the receiving monitor were suspended by pressing the )XQFWLRQNH\RQWKHWUDQVPLWWHUAlarms resume when the suspend interval elapses. To cancel alarm suspension, press WKH)XQFWLRQNH\DJDLQMessages:KHQ35272&2/RQWKH6<67(06(783VFUHHQLVVHWWRDOOPHVVDJHVDUHWUDQVPLWWHG:KHQ35272&2/LVVHWWRWKHPHVVDJHVPDUNHGZLWKDUHQRWWUDQVPLWWHGMessage Cause CountermeasureALARMS 6863(1'('Alarms on the receiving monitor are suspended by pressing the Function NH\RQWKHWUDQVPLWWHU$ODUPVUHVXPHZKHQWKHPLQXWHsuspend interval elapses. To cancel alarm suspension, press the Function NH\DJDLQ%$77(5<:($. Dead batteries Replace the batteries.CANNOT '(7(&738/6(Poor blood circulation for measuring the SpO2 value&KHFNWKHSDWLHQWFRQGLWLRQSUREHattachment or change the attachment site.The probe is attached too tightly and is obstructing the blood circulation Reattach the probe.The probe is not attached to the patient properlyAttach the probe to the patient properly.³/,*+7,17(5)(5(1&(´³&+(&.352%(6,7(´RU³'(7(&7,1*38/6(´PHVVDJHLVGLVSOD\HGIRUPRUHWKDQVHFRQGVRefer to the cause and countermeasure for each message in this Messages table and remove the cause.
70 Operator’s Manual ZM-520PA/521PA/530PA/531PAMessage Cause CountermeasureCANNOT 0($685(Poor contact between the disposable HOHFWURGHDQGVNLQReplace electrodes with new ones immediately.&+(&.(/(&752'(6(OHFWURGHOHDGLVGLVFRQQHFWHGIURPthe electrodeFirmly connect the electrode lead to the electrode.(OHFWURGHOHDGLVGLVFRQQHFWHGIURPthe transmitterFirmly connect the electrode lead to the transmitter.(OHFWURGHOHDGGLVFRQWLQXLW\ Replace the electrode lead with a new one.(OHFWURGHLVQRW¿UPO\DWWDFKHGWRWKHVNLQ Replace the electrode with a new one.Polarization voltage is abnormally high&+(&.352%(The probe is not attached to the patient properlyAttach the probe to the patient properly.The probe is not attached at the appropriate siteAttach the probe to an appropriate site indicated in the probe manual.The probe is disconnected from the transmitterConnect the probe cable to the transmitter.The probe is past its expiration date Replace the probe with a new one.&+(&.352%(6,7(The probe is not attached at the appropriate siteAttach the probe to an appropriate site indicated in the probe manual.The probe is deteriorated Replace the probe with a new one.The probe is past its expiration date'(7(&7,1*38/6(Searching for the correct pulse wave for SpO2 monitoring Wait until the pulse wave is detected.The SpO2 value cannot be obtained because the waveform is unstable Attach the probe to the patient properly.The probe is not attached to the patient properly/,*+7,17(5)(5(1&(The SpO2 measurement site is under ÀXRUHVFHQWOLJKWVXUJLFDOOLJKWsunlight, or other strong lightCover the measurement site with a EODQNHWRUFORWKConsiderable body movementWhen the message is displayed IUHTXHQWO\FKHFNWKHSDWLHQWFRQGLWLRQand, if necessary, change the attachment site.The probe is not attached to the patient properly
Operator’s Manual ZM-520PA/521PA/530PA/531PA 71Message Cause Countermeasure3$7,(17&21),50(')XQFWLRQNH\LVSUHVVHGDQGWKH³3$7,(17&21),50('´VLJQDOLVtransmitted to the receiving monitor ZKHQ³3$7,(17´LVDVVLJQHGDVWKHIXQFWLRQIRUWKH)XQFWLRQNH\RQWKH6<67(06(783VFUHHQ—352%()$,/85(The probe is past its expiration date Replace the probe with a new one.3UREHLVGDPDJHGRUVKRUWFLUFXLWHGTransmitter failure Contact your Nihon Kohden representative.SpO202'8/((5525 Transmitter failure Contact your Nihon Kohden representative.:($.38/6(Poor peripheral circulation &KHFNWKHSDWLHQWFRQGLWLRQDQGchange the probe attachment site.The probe is attached too tightly and is obstructing the blood circulation&KHFNWKHSUREHDWWDFKPHQWcondition and if necessary, reattach the probe.5(632))³5(630($685(0(17´RQWKH3$5$0(7(56(783VFUHHQLVVHWto OFFIf respiration monitoring is necessary, VHW³5(630($685(0(17´WRON.
72 Operator’s Manual ZM-520PA/521PA/530PA/531PAMessage Display PriorityWhen more than one message condition occurs on the transmitter, only the message with the highest priority is displayed.Priority Message+LJK 3$7,(17&21),50('352%()$,/85(&+(&.(/(&752'(6SpO202'8/((5525&+(&.352%(&+(&.352%(6,7(&$1127'(7(&738/6(/,*+7,17(5)(5(1&(&$11270($685('(7(&7,1*38/6(:($.38/6($/$5066863(1'('Low %$77(5<:($.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 73Troubleshooting,IDSUREOHPRFFXUVXVHWKHIROORZLQJWDEOHVWR¿QGDQG¿[LW,IWKHSUREOHPVWLOOUHPDLQVDIWHUtroubleshooting according to these tables, contact your Nihon Kohden representative.TransmitterProblem Possible Cause ActionNothing is displayed on the LCD after turning the power on.Batteries are not installed correctly. The battery polarity is wrong.Install the batteries correctly.Batteries are completely discharged.Replace the batteries with new ones./&'LVGLI¿FXOWWRVHHWRRGDUNRUWRRlight).LCD brightness is not appropriate.Change the LCD brightness on the 6<67(06(783VFUHHQ5HIHUWRWKH³&KDQJLQJ6<67(06(783Settings” section.Nothing is displayed on the receiving monitor after turning the transmitter power on.The channel of the transmitter and monitor does not match.Set the correct channel on the monitor.The software version of the multiple patient receiver or central monitor is old.Upgrade the multiple patient receiver or central monitor software to receive signal from the transmitter. Contact your Nihon Kohden representative.Protocol on the transmitter and monitor does not match.Set the same protocol on the transmitter and monitor.Protocol on the transmitter is set to 51 but the monitor cannot receive protocol 51.Set the protocol on the transmitter to 41. Refer to the “System Setup Setting List” section.
74 Operator’s Manual ZM-520PA/521PA/530PA/531PAProblem Possible Cause ActionSignal receiving condition is poor.Another transmitter with the same channel is used nearby.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.Signals of another patient are mixing.Follow the instructions of your channel administrator and use another transmitter of a different channel.The transmitter is damaged. Contact your Nihon Kohden representative.ECG/RespirationProblem Possible Cause ActionThe heart rate is unstable.Pacing detection setting on the monitor is not correct.Turn off the pacing detection setting on the receiving monitor. When PRQLWRULQJDSDFHPDNHUSDWLHQWWXUQon pacing detection.7KH³&+(&.(/(&752'(6´message appears on the receiving monitor.(OHFWURGHOHDGLVGLVFRQQHFWHGfrom the electrode.Firmly connect the electrode lead to the electrode.(OHFWURGHOHDGGLVFRQWLQXLW\ Replace the electrode lead with a new one.(OHFWURGHLVQRW¿UPO\DWWDFKHGWRWKHVNLQReplace the electrode with a new one.Polarization voltage is abnormally high.8VH1LKRQ.RKGHQVSHFL¿HGelectrodes.(&*EDVHOLQHLVWKLFN$&KXPThe gel on the electrode is dried out.Replace the electrode with a new one.The gel on the electrode is coming off.$QHOHFWULFEODQNHWLVXVHG &RYHUWKHEODQNHWZLWKDVKLHOGFRYHU7KHKXP¿OWHULVVHWWR2))RQthe monitor.6HWWKH¿OWHUWR21
Operator’s Manual ZM-520PA/521PA/530PA/531PA 75Problem Possible Cause ActionThe heart rate of a patient who is using DQHOHFWULFEODQNHWis unstable on the receiving monitor.Pacing pulse detection is turned ON on the receiving monitor.Turn OFF the pacing pulse detection on the receiving monitor.1RKHDUWUDWHRU(&*is displayed.³(&*0($685(0(17´RQWKH3$5$0(7(56(783VFUHHQLVset to OFF.,I(&*PRQLWRULQJLVQHFHVVDU\VHW³(&*0($685(0(17´WR21Respiration waveform measurement is unstable.The gel on the electrode is dried out.Replace the electrode with a new one.The gel on the electrode is coming off.No respiration rate is displayed.³5(630($685(0(17´RQWKH3$5$0(7(56(783VFUHHQis set to OFF.If respiration monitoring is necessary, VHW³5(630($685(0(17´WR21SpO2 Problem Possible Cause ActionSpO2 data is unstable and not reliable.The probe size is not appropriate for the patient.Use the appropriate probe for the patient.Probe attachment condition is poor. The probe is partly GHWDFKHGIURPWKHVNLQ([WHUQDOlight is entering the probe.Firmly attach the probe according to the procedure in the probe operator’s manual.Measurement site is dirty. Patient is wearing nail polish.Remove dirt and nail polish.The probe is attached to the same limb that is used for NIBP measurement.Attach the probe to the opposite limb. Avoid a site where blood circulation condition changes greatly.
76 Operator’s Manual ZM-520PA/521PA/530PA/531PAMaintenance7RXVHWKHWUDQVPLWWHULQVDIHDQGRSWLPXPFRQGLWLRQSHUIRUPPDLQWHQDQFHFKHFNHYHU\VL[months.7KHIROORZLQJXQLWVDUHQHFHVVDU\IRUVRPHFKHFNLQJLWHPV $;*YLWDOVLJQVLPXODWRU $;76S22FKHFNHU• Receiving monitorCAUTIONNever disassemble or repair the transmitter. If there is any problem with the transmitter, contact your Nihon Kohden representative.NOTE• The measurement accuracy of the above units must be managed to perform accurate maintenance check.• For details on the operation of the above units, refer to the manuals provided with these units.$PDLQWHQDQFHFKHFNVKHHWLVSURYLGHGDWWKHHQGRIWKLVVHFWLRQ0DNHDFRS\RIWKLVFKHFNVKHHWEHIRUHSHUIRUPLQJPDLQWHQDQFHFKHFN1. External Check• There is no damage or dirt on the outside of the transmitter. 7KHEDWWHU\FDVHFRYHULVQRWGDPDJHGWKHVSULQJLV¿UPO\DWWDFKHGDQGWKHEDWWHU\FDVHFRYHUFDQEHFORVHG¿UPO\ 1RNH\VDUHGDPDJHG• 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.
Operator’s Manual ZM-520PA/521PA/530PA/531PA 77Channel numbersStartup screen Numeric and waveform screen3. Transmitting/Receiving Signal8VHWKH$;*YLWDOVLJQVLPXODWRUDQGUHFHLYLQJPRQLWRU1. Connect the vital sign simulator to the transmitter only with the electrode leads.AX-400G2. 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. &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU6. Turn off the transmitter. &KHFNWKDWWKH(&*GLVDSSHDUVIURPWKHUHFHLYLQJPRQLWRU4. Display&KHFNWKDWWKHUHDUHQRGRWVPLVVLQJRQWKHVFUHHQ1. Turn off the transmitter.
78 Operator’s Manual ZM-520PA/521PA/530PA/531PA :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHU7KH0(18VFUHHQDSSHDUV 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\Cursor 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR³/&'7(67´DQGSUHVVWKH)XQFWLRQNH\ (DFKWLPHWKHŹNH\LVSUHVVHGWKHVFUHHQFKDQJHVDVEHORZ&KHFNWKDWQRGRWVDUHPLVVLQJ ĺ ĺ ĺ ĺ red ĺ green ĺ blue ĺ ĺ. . .
Operator’s Manual ZM-520PA/521PA/530PA/531PA 79 3UHVVWKH6FUHHQNH\WRUHWXUQWRWKH0$18$/&+(&.VFUHHQ 3UHVVWKH6FUHHQNH\DJDLQWRUHWXUQWRWKH0(18VFUHHQ5. Key Operation1. Turn off the transmitter. :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHU7KH0(18VFUHHQDSSHDUV 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\Cursor 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR³.(<&+(&.´DQGSUHVVWKH)XQFWLRQNH\
80 Operator’s Manual ZM-520PA/521PA/530PA/531PA 3UHVVHDFKNH\RQHDWDWLPHDQGFKHFNWKDWWKHSUHVVHGNH\LVKLJKOLJKWHGRQWKHVFUHHQ:KHQWKH&$//NH\LVSUHVVHGWKHNH\QDPHLVhighlighted. $IWHUFKHFNLQJSUHVVDQGKROGWKH6FUHHQNH\WRUHWXUQWRWKH0$18$/&+(&.VFUHHQ6. ECG Check1. Connect the vital sign simulator to the transmitter only with the electrode leads.AX-400G2. Place the transmitter 1 m from the receiving monitor.3. Turn on the transmitter and vital sign simulator. &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU
Operator’s Manual ZM-520PA/521PA/530PA/531PA 817. Respiration Check1. Connect the vital sign simulator to the transmitter only with the electrode leads.AX-400G2. Place the transmitter 1 m from the receiving monitor.3. Turn on the transmitter and vital sign simulator. &KHFNWKDWWKHUHVSLUDWLRQZDYHIRUPRIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU8. SpO2 Check (with SpO2 Checker)1. Connect the SpO2FKHFNHUWRWKHWUDQVPLWWHURQO\ZLWKWKH6S22 connection cable.AX-300T2. Place the transmitter 1 m from the receiving monitor.3. Turn on the transmitter and SpO2 FKHFNHU &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ
82 Operator’s Manual ZM-520PA/521PA/530PA/531PA &KHFNWKDW6S22 and pulse rate on the transmitter is within the following range.SpO2 on the SpO2 Checker RangeSpO2* WR6S22 (±2 digits) WR6S22 (±2 digits) WR6S22 (±4 digits)Pulse rate EHDWVPLQ WREHDWVPLQEHDWPLQEHDWVPLQ WREHDWVPLQEHDWPLQ* The SpO2FKHFNE\WKH6S22FKHFNHULVDIIHFWHGE\WKHFKHFNHU¶VWROHUDQFHWRWKH6S22 measuring accuracy of the transmitter. (The measurement accuracy is described in the ³6SHFL¿FDWLRQV´VHFWLRQ)RUGHWDLOVUHIHUWRWKH6S22FKHFNHUPDQXDO &KHFNWKDWWKH6S22 and pulse waveform of the transmitter appear on the receiving monitor.9. SpO2 Check (with Vital Sign Simulator)1. Connect the vital sign simulator to the transmitter only with the SpO2 connection cable.AX-400G2. Place the transmitter 1 m from the receiving monitor.3. Turn on the transmitter and vital sign simulator. &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ &KHFNWKDW6S22DQG(&*RQWKHWUDQVPLWWHULVZLWKLQWKHIROORZLQJUDQJHVital Sign Simulator RangeSpO2* WR6S22 (±2 digits) WR6S22 (±2 digits) WR6S22 (±4 digits)(&* 1250$/ WREHDWVPLQEHDWVPLQ
Operator’s Manual ZM-520PA/521PA/530PA/531PA 83* The SpO2FKHFNE\WKHYLWDOVLJQVLPXODWRULVDIIHFWHGE\WKHVLPXODWRU¶VWROHUDQFHWRWKHSpO2 measuring accuracy of the transmitter. (The measurement accuracy is described in WKH³6SHFL¿FDWLRQV´VHFWLRQ)RUGHWDLOVUHIHUWRWKHYLWDOVLJQVLPXODWRUPDQXDO &KHFNWKDWWKH6S22DQG(&*RIWKHWUDQVPLWWHUDSSHDURQWKHUHFHLYLQJPRQLWRU
84 Operator’s Manual ZM-520PA/521PA/530PA/531PAMaintenance Check Sheet+RVSLWDO2UJDQL]DWLRQ Service Personnel: Instrument Name: TransmitterInstrument Model: =03$=03$=03$=03$Instrument Serial Number: +DUGZDUH5HYLVLRQ1XPEHU Software Revision Number:  ([WHUQDO&KHFN 3DVV )DLO2. Transmitter Channel Pass Fail3. Transmitting/Receiving Signal Pass Fail4. Display Pass Fail5. Key Operation Pass Fail (&*&KHFN 3DVV )DLO 5HVSLUDWLRQ&KHFN 3DVV )DLO 6S22&KHFN 3DVV )DLOOverall JudgementƑ2.Ƒ&DQEHXVHGEXWQHHGVPDLQWHQDQFHƑ0DLQWHQDQFHUHTXLUHG&DQQRWEHXVHG
Operator’s Manual ZM-520PA/521PA/530PA/531PA 85Lifetime and DisposalCAUTIONDispose 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 BatteriesBattery LifetimeReplace the batteries when the battery replacement indication appears on the transmitter.DisposalNOTERemove the batteries before disposing of the transmitter.%HIRUHGLVSRVLQJRIWKHEDWWHULHVFKHFNZLWK\RXUORFDOVROLGZDVWHRI¿FLDOVIRUGHWDLOVLQ\RXUDUHDfor proper disposal. It may be illegal to dispose of these batteries in the municipal waste stream.Disposing of Electrodes and SpO2 ProbesRefer to the manual for each item.Disposing of TransmitterRemove the batteries from the transmitter and dispose of the transmitter following your local laws for disposal.
86 Operator’s Manual ZM-520PA/521PA/530PA/531PACleaning, Disinfection and SterilizationTransmitter and Electrode LeadsCAUTIONThis 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.NOTEThe 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.CleaningWipe the transmitter and electrode leads with a soft cloth moistened with ethanol for disinfection WRE\YRORUQHXWUDOGHWHUJHQWGLOXWHGZLWKZDWHU$IWHUFOHDQLQJGU\WKHPcompletely.Use cotton swab moistened with neutral detergent diluted with water to clean inside the battery compartment. DisinfectionCAUTIONDo not immerse the electrode lead connector in liquid.:LSHWKHRXWVLGHVXUIDFHRIWKHWUDQVPLWWHUDQGHOHFWURGHOHDGZLWKDQRQDEUDVLYHFORWKPRLVWHQHG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 &RQFHQWUDWLRQ*OXWDUDOGHK\GHVROXWLRQ $ON\OGLDPLQRHWK\OJO\FLQHK\GURFKORULGH %HQ]DONRQLXPFKORULGH %HQ]HWKRQLXPFKORULGHVROXWLRQ &KORUKH[LGLQHJOXFRQDWHVROXWLRQ 3KWKDUDO Phenol 1.56
Operator’s Manual ZM-520PA/521PA/530PA/531PA 87SpO2 ProbeRefer to the probe manual.Periodic Replacement ScheduleTo maintain the performance of the instrument, the following part must be periodically replaced.Name Code No. Expected Life SpanSilicon seal (for battery case cover)  1 yearRepair Parts Availability Policy1LKRQ.RKGHQ&RUSRUDWLRQ1.&VKDOOVWRFNUHSDLUSDUWVSDUWVQHFHVVDU\WRPDLQWDLQWKHSHUIRUPDQFHRIWKHLQVWUXPHQWIRUDSHULRGRI\HDUVIURPWKHGDWHRIGHOLYHU\,QWKDWSHULRG1.&RULWVDXWKRUL]HGDJHQWVZLOOUHSDLUWKHLQVWUXPHQW7KLVSHULRGPD\EHVKRUWHUWKDQ\HDUVLIa board or part necessary for the faulty section is not available.
88 Operator’s Manual ZM-520PA/521PA/530PA/531PASpecificationsZM-520PA/ZM-530PAMeasured Parameters:DYHIRUPV (&*LPSHGDQFHPHWKRGUHVSLUDWLRQSXOVH1XPHULFGDWD +HDUWUDWHUHVSLUDWLRQUDWH6S22, pulse rateTransmitted Data:DYHIRUPV (&*UHVSLUDWLRQSXOVHZDYHNumeric data: SpO2, pulse rateStatus information: Battery replacement, battery level*, alarm suspended, SDXVHPRQLWRULQJSDWLHQWFRQ¿UPHG(&*OHDGSDFLQJdetection, electrode detachment, electrode impedance*, (&*RIIUHVSLUDWLRQPHWKRGLPSHGDQFH6S22 status, respiration status*, channel ID, time constant (3.2 s), type of transmitter, transmitter code number*, transmitter serial number** Transmitted only when the protocol is “51”.DisplayDisplay size: 2.2 inch TFT color LCD9LHZLQJDUHD +î9PP5HVROXWLRQ +î9GRWVDisplayed Data1XPHULFDQGZDYHIRUPVFUHHQ (&*RQHZDYHIRUPIURPOHDG,,,,,,9DRU9EKHDUWrate, pulse rate, respiration rate, SpO2, message, battery level, 456SXOVHV\QFPDUNSXOVHEDUJUDSK(&*OHDG:DYHIRUPUHYLHZVFUHHQ (&*RUSXOVHZDYHRISDVWPLQXWHV1XPHULFUHYLHZVFUHHQ +HDUWUDWHRUSXOVHUDWHUHVSLUDWLRQUDWHDQG6S22 at 1 minute LQWHUYDOIRUSDVWPLQXWHV&KHFNHOHFWURGHVVFUHHQ (&*IRUFKHFNLQJHOHFWURGHDWWDFKPHQWECGECG MeasurementChannels: 4,QSXWG\QDPLFUDQJH P9RUPRUH(OHFWURGHRIIVHWSRWHQWLDOWROHUDQFH P9RUPRUH,QSXWLPSHGDQFH 0ȍRUPRUH
Operator’s Manual ZM-520PA/521PA/530PA/531PA 89Common mode rejection ratio: 95 dB or more ,(&FRPSOLHG3DFLQJSXOVHGHWHFWLRQ DPSOLWXGHWRP9GXUDWLRQWRPV ,(&FRPSOLHG %DVHGXSRQSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\'H¿EULOODWLRQSURRI (&*LQSXWSURWHFWHGDJDLQVW:V'&N9 ,(&FRPSOLHG(&*UHFRYHU\WLPHDIWHUGH¿EULOODWLRQ ZLWKLQV(OHFWURGHFRQGLWLRQ 'LVSOD\V&+(&.(/(&752'(6PHVVDJH7DOO7ZDYHUHMHFWLRQFDSDELOLW\ &RPSOLHVZLWKWKHKHLJKWVRI7ZDYHVIURPWRP9 ,(&FRPSOLHG+HDUWUDWHDYHUDJLQJ &DOFXODWHGE\XVLQJWKHPRVWUHFHQWEHDWV+HDUWUDWHPHWHUDFFXUDF\DQGUHVSRQVHWRLUUHJXODUUK\WKP 9HQWULFXODUELJHPLQ\7HVWZDYHIRUPQDPHDDPLD ESP Slow alternating ventricular bigeminy (Test waveform name: DDPLEESP Rapid alternating ventricular bigeminy (Test waveform QDPHDDPLFESP Bidirectional systoles (Test waveform name: aami3d*):  ESP * The test waveforms can be download at http://www. physionet.orgResponse time of heart rate meter to change in heart rate: +5FKDQJHIURPWRESPWRVHFRQGV +5FKDQJHIURPWRESPWRVHFRQGV3DFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\ZLWKRXWRYHUVKRRW &RPSOLHVZLWKWKHDPSOLWXGHVRISDFHPDNHUSXOVHVWRP9DQGZLGWKVWRPVVSHFL¿HGLQ,(&3DFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\ZLWKRYHUVKRRW 2YHUVKRRWDPSOLWXGHVDQGWLPHFRQVWDQWVRIP9PVWRP9PV$VGH¿QHGE\PHWKRG%RI,(&WKLVFRUUHVSRQGVWRWKHSDFHPDNHUSXOVHVDPSOLWXGHVDQGZLGWKVRIP9PVWRDPSOLWXGHVP9PVECG Display and Heart Rate Count)UHTXHQF\FKDUDFWHULVWLF ¿OWHURQWR+]¿OWHURIIWR+]+HDUWUDWHGHWHFWLRQPHWKRG $YHUDJH456GHWHFWLRQ WRPVDPSOLWXGHP9UDWHWREHDWVPLQ WRPVDPSOLWXGHP9UDWHWREHDWVPLQ
90 Operator’s Manual ZM-520PA/521PA/530PA/531PA+HDUWUDWHFRXQWLQJUDQJH WREHDWVPLQ+HDUWUDWHFRXQWLQJDFFXUDF\ EHDWVPLQWREHDWVPLQ(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHURespiration MeasurementMeasuring method: Impedance methodMeasuring lead: Between R and F,PSHGDQFHUDQJH WRȍ([FLWRUFXUUHQW WR$SSN+]5HVSLUDWLRQUDWHPHDVXULQJDFFXUDF\ FRXQWVPLQDWWRFRXQWVPLQ5HVSLUDWLRQUDWHFRXQWLQJUDQJH WRFRXQWVPLQ(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHUSpO2 Measurement (ISO 9919: 2005 compliance)0HDVXULQJUDQJH WR6S22 'HFODUHGUDQJH WR6S220LQLPXPGLVSOD\UDQJH 6S22'LVSOD\XSGDWHF\FOH (YHU\VHFRQGV0HDVXULQJDFFXUDF\UPV $FFXUDF\DVVXUDQFHWHPSHUDWXUHWR&7RWDODFFXUDF\LQFOXGLQJSUREH 6S226S226S226S22  6S226S226S226S22  XQGHU6S22QRWVSHFL¿HG$FFXUDF\RIWKHWUDQVPLWWHU 6S226S226S226S22  6S226S226S226S22  XQGHU6S22QRWVSHFL¿HG3XOVHUDWHGHFODUHGUDQJH WRESP3XOVHUDWHGLVSOD\UDQJH WRESP3XOVHUDWHDFFXUDF\UPV ESP(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHUNOTE• 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 91Response time: Selectable from “Slow”, “Normal” and “Fast”. 7KHIROORZLQJJUDSKVVKRZUHVSRQVHWLPHIRUV6S22 change.Pulse Rate = 70 bpm60657075808590951000 10 20 30 40 50 60 70 80 90 100 110 120 130 140Time (seconds)SpO2 (%)SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow60657075808590951000 10 20 30 40 50 60 70 80 90 100 110 120 130 140SpO2 Reference SpO2 Fast SpO2 NormalPulse Rate = 140 bpmTime (seconds)SpO2 (%)SpO2 Slow
92 Operator’s Manual ZM-520PA/521PA/530PA/531PA7KHIROORZLQJJUDSKVKRZVUHVSRQVHWLPHIRUESPVSXOVHUDWHFKDQJHSpO2 = 97607080901001101201301401500 102030405060708090100110120Time (seconds)PR (bpm)PR Reference PRTransmitter)&&UHJXODWLRQ )&&SDUW6XESDUW+ Wireless Medical Telemetry Service (WMTS))LHOGVWUHQJWKOLPLWV P9PDWPUndesired emissions: FCC part 95 95.1115 (b) (1), (2):  0+] ȝ9PDWP 0+] ȝ9PDWPAntenna: InternalTransmission channel: Indicated on the transmitter7UDQVPLVVLRQIUHTXHQF\UDQJH WR0+]&KDQQHOVSDFLQJ N+]RUN+]N+]ZKHQLQWHUOHDYHG0RGXODWLRQ )6.IUHTXHQF\VKLIWNH\LQJType of emission: F1D2FFXSLHGEDQGZLGWK WRN+](IIHFWLYHUDGLDWHGSRZHU P:
Operator’s Manual ZM-520PA/521PA/530PA/531PA 93Power Requirements5DWHGYROWDJH 96KXWGRZQYROWDJH WR92SHUDWLQJYROWDJH 6KXWGRZQYROWDJHWR9%DWWHU\W\SH 7ZR$$/5W\SHDONDOLQHGU\FHOOSULPDU\EDWWHULHV%DWWHU\OLIHWLPHZLWKDONDOLQHEDWWHULHVDWURRPWHPSHUDWXUH =03$ DSSUR[LPDWHO\GD\V =03$ DSSUR[LPDWHO\GD\VPHDVXULQJ(&*UHVSLUDWLRQDQG SpO2)  DSSUR[LPDWHO\GD\VPHDVXULQJ(&*DQGUHVSLUDWLRQDimension and Weight'LPHQVLRQ :î+î'PP:HLJKW DERXWJH[FOXGLQJEDWWHULHVDQGRWKHUDFFHVVRULHV DERXWJLQFOXGLQJEDWWHULHVH[FOXGLQJRWKHUDFFHVVRULHVEnvironmentOperating environment7HPSHUDWXUH WR&WR)+XPLGLW\ WRQRQFRQGHQVLQJ$WPRVSKHULFSUHVVXUH WRK3DStorage and transport environment7HPSHUDWXUH íWR&íWR)+XPLGLW\ WR$WPRVSKHULFSUHVVXUH WRK3DWater resistance:DWHUGRHVQRWJHWLQVLGHWKHWUDQVPLWWHUZKHQLPPHUVHGLQZDWHUXSWRFPGHHSIRUPLQXWHVSafety Standards6DIHW\VWDQGDUG &$1&6$&1R0  &$1&6$&1R6  &$1&6$&1R%  &$1&6$&1R  &$1&6$&1R  ,(&  ,(&$PHQGPHQW  ,(&$PHQGPHQW  ,(&  ,(&  ,62  8/
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Operator’s Manual ZM-520PA/521PA/530PA/531PA 95Electromagnetic Immunity7KLVPRGHO=03$=03$LVLQWHQGHGIRUXVHLQWKHHOHFWURPDJQHWLFHQYLURQPHQWVSHFL¿HGEHORZ7KHFXVWRPHURUWKHXVHURI=03$RU=03$VKRXOGDVVXUHWKDWLWLVXVHGin such an environment.Immunity test IEC 60601 test levelCompliance levelElectromagnetic environment - guidance(OHFWURVWDWLFGLVFKDUJH(6',(&rN9FRQWDFWrN9DLUrN9FRQWDFWrN9DLUFloors should be wood, concrete RUFHUDPLFWLOH,IÀRRUVDUHcovered with synthetic material, the relative humidity should be at OHDVW(OHFWULFDOIDVWtransient/burst,(&rN9IRUSRZHUsupply linesrN9IRULQSXWoutput linesNot applicable—Surge,(&rN9GLIIHUHQWLDOmoderN9FRPPRQPRGHNot applicable—9ROWDJHGLSVVKRUWinterruptions and voltage variations on power supply input lines,(&UT!GLSLQUTIRUF\FOHVUTGLSLQUT) for 5 cyclesUTGLSLQUT) for 25 cyclesUT!GLSLQUT) for 5 sNot applicable—Power frequency+]PDJQHWLF¿HOG,(&3 A/m 3 A/m 3RZHUIUHTXHQF\PDJQHWLF¿HOGVshould be at levels characteristic of a typical location in a typical commercial or hospital environment.127(UT is the AC mains voltage prior to application of the test level.Avoiding Electromagnetic Interference (Impedance Respiration)Impedance respiration measurement is very sensitive and affected by electromagnetic interference. 7HFKQRORJLFDOOLPLWDWLRQVGRQRWDOORZLPPXQLW\OHYHOVKLJKHUWKDQ9PIRUUDGLDWHG5)HOHFWURPDJQHWLF¿HOGV(OHFWURPDJQHWLF¿HOGVZLWK¿HOGVWUHQJWKVDERYH9PPD\FDXVHmeasurement error. Do not use electrically radiating equipment near the impedance respiration measurements.
96 Operator’s Manual ZM-520PA/521PA/530PA/531PAImmunity test IEC 60601 test levelCompliance levelElectromagnetic environment - guidanceConducted RF ,(&Radiated RF,(&9UPVN+]WR0+]9P0+]WR*+]9UPV9P0+]WR*+]9P0+]WR*+]IRUrespiration)Portable and mobile RF communications equipment should be used no closer WRDQ\SDUWRI=03$=03$including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter. Recommended separation distanced = 1.2 P d = 1.2 30+]WR0+]d = 2.3 30+]WR*+](d = 3.5 30+]WR0+]IRUrespirationG  30+]WR*+]IRU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).)LHOGVWUHQJWKVIURP¿[HG5)WUDQVPLWWHUV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 HTXLSPHQWPDUNHGZLWKWKHIROORZLQJsymbol:127( $W0+]DQG0+]WKHKLJKHUIUHTXHQF\UDQJHDSSOLHV127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLVDIIHFWHGE\ DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOH*1 )LHOGVWUHQJWKVIURP¿[HGWUDQVPLWWHUVVXFKDVEDVHVWDWLRQVIRUUDGLRFHOOXODUFRUGOHVVWHOHSKRQHVDQGODQGPRELOHUDGLRVDPDWHXUUDGLR$0DQG)0UDGLREURDGFDVWDQG79EURDGFDVWFDQQRWEHSUHGLFWHGWKHRUHWLFDOO\ZLWKDFFXUDF\7RDVVHVVWKHHOHFWURPDJQHWLFHQYLURQPHQWGXHWR¿[HG5)WUDQVPLWWHUVDQHOHFWURPDJQHWLFVLWHVXUYH\VKRXOGEHFRQVLGHUHG,IWKHPHDVXUHG¿HOGVWUHQJWKLQWKHORFDWLRQLQZKLFK=03$=03$LVXVHGH[FHHGVWKHDSSOLFDEOH5)FRPSOLDQFHOHYHODERYH=03$ =03$VKRXOGEHREVHUYHGWRYHULI\QRUPDORSHUDWLRQ,IDEQRUPDOSHUIRUPDQFHLVREVHUYHGDGGLWLRQDOPHDVXUHVPD\EHQHFHVVDU\VXFKDVUHRULHQWLQJRUUHORFDWLQJ=03$=03$*2 2YHUWKHIUHTXHQF\UDQJHN+]WR0+]¿HOGVWUHQJWKVVKRXOGEHOHVVWKDQ9PIRUUHVSLUDWLRQDQG9PIRUDOORWKHUIXQFWLRQV
Operator’s Manual ZM-520PA/521PA/530PA/531PA 97Recommended Separation Distances between Portable and Mobile RF Communications Equipment7KH=03$=03$LVLQWHQGHGIRUXVHLQDQHOHFWURPDJQHWLFHQYLURQPHQWLQZKLFKUDGLDWHG5)GLVWXUEDQFHVDUHFRQWUROOHG7KHFXVWRPHURUWKHXVHURI=03$=03$can help prevent electromagnetic interference by maintaining a minimum distance between SRUWDEOHDQGPRELOH5)FRPPXQLFDWLRQVHTXLSPHQWWUDQVPLWWHUVDQG=03$=03$DVrecommended below, according to the maximum output power of the communications equipment.Rated maximum output power of transmitter(W)Separation distance according to frequency of transmitter (m)150 kHz to 80 MHzd = 1.2 P80 MHz to 800 MHzd = 1.2 P(For respiration:d = 3.5 P)800 MHz to 2.5 GHzd = 2.3 P(For respiration:d = 7.0 P)      1 1.2 1.2 (3.5*)     12 12 (35*) 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)127( $W0+]DQG0+]WKHVHSDUDWLRQGLVWDQFHIRUWKHKLJKHUIUHTXHQF\UDQJHapplies. 127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLVDIIHFWHGE\DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOHRecovery Time after Defibrillation7KHWUDQVPLWWHUUHWXUQVWRWKHQRUPDORSHUDWLQJPRGHZLWKLQVHFRQGVDIWHUGH¿EULOODWLRQ7KHstored settings are not affected.System Composition for EMC Test7KH=03$=03$WUDQVPLWWHULVWHVWHGWRFRPSO\ZLWK,(&DQG$PHQGPHQWZLWKWKHIROORZLQJFRPSRVLWLRQUnits Cable Length=03$=03$WUDQVPLWWHU —%53(&*HOHFWURGHOHDG P7/7¿QJHUSUREH 1.6 m
98 Operator’s Manual ZM-520PA/521PA/530PA/531PAZM-521PA/ZM-531PAMeasured Parameters:DYHIRUPV (&*LPSHGDQFHPHWKRGUHVSLUDWLRQSXOVH1XPHULFGDWD +HDUWUDWHUHVSLUDWLRQUDWH6S22, pulse rateTransmitted Data:DYHIRUPV (&*UHVSLUDWLRQSXOVHZDYHNumeric data: SpO2, pulse rateStatus information: Battery replacement, battery level*, alarm suspended, SDXVHPRQLWRULQJSDWLHQWFRQ¿UPHG(&*OHDGSDFLQJdetection, electrode detachment, electrode impedance*, (&*RIIUHVSLUDWLRQPHWKRGLPSHGDQFH6S22 status, respiration status*, channel ID, time constant (3.2 s), type of transmitter, transmitter code number*, transmitter serial number** Transmitted only when the protocol is “51”.DisplayDisplay size: 2.2 inch TFT color LCD9LHZLQJDUHD +î9PP5HVROXWLRQ +î9GRWVDisplayed Data1XPHULFDQGZDYHIRUPVFUHHQ (&*RQHZDYHIRUPIURPOHDG,,,,,,9DRU9EKHDUWrate, pulse rate, respiration rate, SpO2, message, battery level, 456SXOVHV\QFPDUNSXOVHEDUJUDSK(&*OHDG:DYHIRUPUHYLHZVFUHHQ (&*RUSXOVHZDYHRISDVWPLQXWHV1XPHULFUHYLHZVFUHHQ +HDUWUDWHRUSXOVHUDWHUHVSLUDWLRQUDWHDQG6S22 at 1 minute LQWHUYDOIRUSDVWPLQXWHV&KHFNHOHFWURGHVVFUHHQ (&*IRUFKHFNLQJHOHFWURGHDWWDFKPHQWECGECG MeasurementChannels: 4,QSXWG\QDPLFUDQJH P9RUPRUH(OHFWURGHRIIVHWSRWHQWLDOWROHUDQFH P9RUPRUH,QSXWLPSHGDQFH 0ȍRUPRUHCommon mode rejection ratio: 95 dB or more ,(&FRPSOLHG3DFLQJSXOVHGHWHFWLRQ DPSOLWXGHWRP9GXUDWLRQWRPV ,(&FRPSOLHG %DVHGXSRQSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\
Operator’s Manual ZM-520PA/521PA/530PA/531PA 99'H¿EULOODWLRQSURRI (&*LQSXWSURWHFWHGDJDLQVW:V'&N9 ,(&FRPSOLHG(&*UHFRYHU\WLPHDIWHUGH¿EULOODWLRQ ZLWKLQV(OHFWURGHFRQGLWLRQ 'LVSOD\V&+(&.(/(&752'(6PHVVDJH7DOO7ZDYHUHMHFWLRQFDSDELOLW\ &RPSOLHVZLWKWKHKHLJKWVRI7ZDYHVIURPWRP9 ,(&FRPSOLHG+HDUWUDWHDYHUDJLQJ &DOFXODWHGE\XVLQJWKHPRVWUHFHQWEHDWV+HDUWUDWHPHWHUDFFXUDF\DQGUHVSRQVHWRLUUHJXODUUK\WKP 9HQWULFXODUELJHPLQ\7HVWZDYHIRUPQDPHDDPLD ESP Slow alternating ventricular bigeminy (Test waveform name: DDPLEESP Rapid alternating ventricular bigeminy (Test waveform QDPHDDPLFESP Bidirectional systoles (Test waveform name: aami3d*):  ESP * The test waveforms can be download at http://www. physionet.orgResponse time of heart rate meter to change in heart rate: +5FKDQJHIURPWRESPWRVHFRQGV +5FKDQJHIURPWRESPWRVHFRQGV3DFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\ZLWKRXWRYHUVKRRW &RPSOLHVZLWKWKHDPSOLWXGHVRISDFHPDNHUSXOVHVWRP9DQGZLGWKVWRPVVSHFL¿HGLQ,(&3DFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\ZLWKRYHUVKRRW 2YHUVKRRWDPSOLWXGHVDQGWLPHFRQVWDQWVRIP9PVWRP9PV$VGH¿QHGE\PHWKRG%RI,(&WKLVFRUUHVSRQGVWRWKHSDFHPDNHUSXOVHVDPSOLWXGHVDQGZLGWKVRIP9PVWRDPSOLWXGHVP9PVECG Display and Heart Rate Count)UHTXHQF\FKDUDFWHULVWLF ¿OWHURQWR+]¿OWHURIIWR+]+HDUWUDWHGHWHFWLRQPHWKRG $YHUDJH456GHWHFWLRQ WRPVDPSOLWXGHP9UDWHWREHDWVPLQ WRPVDPSOLWXGHP9UDWHWREHDWVPLQ+HDUWUDWHFRXQWLQJUDQJH WREHDWVPLQ+HDUWUDWHFRXQWLQJDFFXUDF\ EHDWVPLQWREHDWVPLQ(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHU
100 Operator’s Manual ZM-520PA/521PA/530PA/531PARespiration MeasurementMeasuring method: Impedance methodMeasuring lead: Between R and F,PSHGDQFHUDQJH WRȍ([FLWRUFXUUHQW WR$SSN+]5HVSLUDWLRQUDWHPHDVXULQJDFFXUDF\ FRXQWVPLQDWWRFRXQWVPLQ5HVSLUDWLRQUDWHFRXQWLQJUDQJH WRFRXQWVPLQ(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHUSpO2 Measurement (ISO 9919: 2005 compliance)0HDVXULQJUDQJH WR6S22 'HFODUHGUDQJH WR6S220LQLPXPGLVSOD\UDQJH 6S22'LVSOD\XSGDWHF\FOH (YHU\VHFRQGV0HDVXULQJDFFXUDF\UPV $FFXUDF\DVVXUDQFHWHPSHUDWXUHWR&7RWDODFFXUDF\LQFOXGLQJSUREH 6S226S226S226S22  6S226S22 6S226S22  XQGHU6S22QRWVSHFL¿HG$FFXUDF\RIWKHWUDQVPLWWHU 6S226S226S226S22  6S226S226S226S22  XQGHU6S22QRWVSHFL¿HG3XOVHUDWHPHDVXULQJUDQJH WRESP3XOVHUDWHGLVSOD\UDQJH WRESP3XOVHUDWHDFFXUDF\UPV ESP(VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHUNOTE• 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 101Response time: Selectable from “Slow”, “Normal” and “Fast”. 7KHIROORZLQJJUDSKVVKRZUHVSRQVHWLPHIRUV6S22 change.Pulse Rate = 70 bpm60657075808590951000 10 20 30 40 50 60 70 80 90 100 110 120 130 140Time (seconds)SpO2 (%)SpO2 Reference SpO2 Fast SpO2 Normal SpO2 Slow60657075808590951000 10 20 30 40 50 60 70 80 90 100 110 120 130 140SpO2 Reference SpO2 Fast SpO2 NormalPulse Rate = 140 bpmTime (seconds)SpO2 (%)SpO2 Slow
102 Operator’s Manual ZM-520PA/521PA/530PA/531PA7KHIROORZLQJJUDSKVKRZVUHVSRQVHWLPHIRUESPVSXOVHUDWHFKDQJHSpO2 = 97607080901001101201301401500 102030405060708090100110120Time (seconds)PR (bpm)PR Reference PRTransmitter)&&UHJXODWLRQ )&&SDUW6XESDUW+ Wireless Medical Telemetry Service (WMTS))LHOGVWUHQJWKOLPLWV P9PDWPUndesired emissions: FCC part 95 95.1115 (b) (1), (2): 0+]ȝ9PDWP 0+]ȝ9PDWPAntenna: InternalTransmission channel: Indicated on the transmitter7UDQVPLVVLRQIUHTXHQF\UDQJH WR0+] WR0+]&KDQQHOVSDFLQJ N+]RUN+]N+]ZKHQLQWHUOHDYHG0RGXODWLRQ )6.IUHTXHQF\VKLIWNH\LQJType of emission: F1D2FFXSLHGEDQGZLGWK WRN+](IIHFWLYHUDGLDWHGSRZHU P: &DQEHFKDQJHGWRP:LIUHTXLUHG
Operator’s Manual ZM-520PA/521PA/530PA/531PA 103Power Requirements5DWHGYROWDJH 96KXWGRZQYROWDJH WR92SHUDWLQJYROWDJH 6KXWGRZQYROWDJHWR9%DWWHU\W\SH 7ZR$$/5W\SHDONDOLQHGU\FHOOSULPDU\EDWWHULHV%DWWHU\OLIHWLPHZLWKDONDOLQHEDWWHULHVDWURRPWHPSHUDWXUH =03$ DSSUR[LPDWHO\GD\V =03$ DSSUR[LPDWHO\GD\VPHDVXULQJ(&*UHVSLUDWLRQDQG SpO2)  DSSUR[LPDWHO\GD\VPHDVXULQJ(&*DQGUHVSLUDWLRQDimension and Weight'LPHQVLRQ :î+î'PP:HLJKW DERXWJH[FOXGLQJEDWWHULHVDQGRWKHUDFFHVVRULHV DERXWJLQFOXGLQJEDWWHULHVH[FOXGLQJRWKHUDFFHVVRULHVEnvironmentOperating environment7HPSHUDWXUH WR&WR)+XPLGLW\ WRQRQFRQGHQVLQJ$WPRVSKHULFSUHVVXUH WRK3DStorage and transport environment7HPSHUDWXUH íWR&íWR)+XPLGLW\ WR$WPRVSKHULFSUHVVXUH WRK3DWater resistance:DWHUGRHVQRWJHWLQVLGHWKHWUDQVPLWWHUZKHQLPPHUVHGLQZDWHUXSWRFPGHHSIRUPLQXWHVSafety Standards6DIHW\VWDQGDUG &$1&6$&1R0 &$1&6$&1R6 &$1&6$&1R% &$1&6$&1R &$1&6$&1R ,(& ,(&$PHQGPHQW ,(&$PHQGPHQW ,(& ,(& ,62  8/
104 Operator’s Manual ZM-520PA/521PA/530PA/531PA7\SHRISURWHFWLRQDJDLQVWHOHFWULFDOVKRFN ,17(51$//<32:(5('(48,30(17'HJUHHRISURWHFWLRQDJDLQVWHOHFWULFDOVKRFN (&*DQGLPSHGDQFHPHWKRGUHVSLUDWLRQ  '(),%5,//$7,213522)7<3(&)$33/,('3$57 SpO2 '(),%5,//$7,213522)7<3(%)$33/,('3$57Degree of protection against harmful ingress of water:  ,3;QRQSURWHFWHG'HJUHHRIVDIHW\RIDSSOLFDWLRQLQWKHSUHVHQFHRID)/$00$%/($1$(67+(7,&0,;785(:,7+$,525:,7+2;<*(1251,752862;,'(  (TXLSPHQWQRWVXLWDEOHIRUXVHLQWKHSUHVHQFHRI  )/$00$%/($1$(67+(7,&0,;785(:,7+  $,525:,7+2;<*(1251,752862;,'(0RGHRIRSHUDWLRQ &217,1828623(5$7,210((48,30(17W\SH +$1'+(/'DQG3257$%/(Electromagnetic Compatibility,(&,(&$PHQGPHQWElectromagnetic Emissions7KLV0RGHO=03$=03$LVLQWHQGHGIRUXVHLQWKHHOHFWURPDJQHWLFHQYLURQPHQWVSHFL¿HGEHORZ7KHFXVWRPHURUWKHXVHURI=03$=03$VKRXOGDVVXUHWKDWLWLVXVHGLQsuch an environment.Emissions test Compliance Electromagnetic environment - guidanceRF emissionsCISPR 11*URXS =03$=03$XVHV5)HQHUJ\RQO\IRULWVinternal function. Therefore, its RF emissions are very ORZDQGDUHQRWOLNHO\WRFDXVHDQ\LQWHUIHUHQFHLQnearby electronic equipment.RF emissionsCISPR 11Class B =03$=03$LVVXLWDEOHIRUXVHLQDOOestablishments, including domestic establishments.+DUPRQLFHPLVVLRQV,(&Not applicable9ROWDJHÀXFWXDWLRQVÀLFNHUHPLVVLRQV,(&Not applicable
Operator’s Manual ZM-520PA/521PA/530PA/531PA 105Electromagnetic Immunity7KLVPRGHO=03$=03$LVLQWHQGHGIRUXVHLQWKHHOHFWURPDJQHWLFHQYLURQPHQWVSHFL¿HGEHORZ7KHFXVWRPHURUWKHXVHURI=03$=03$VKRXOGDVVXUHWKDWLWLVXVHGLQsuch an environment.Immunity test IEC 60601 test levelCompliance levelElectromagnetic environment - guidance(OHFWURVWDWLFGLVFKDUJH(6',(&rN9FRQWDFWrN9DLUrN9FRQWDFWrN9DLUFloors should be wood, concrete RUFHUDPLFWLOH,IÀRRUVDUHcovered with synthetic material, the relative humidity should be at OHDVW(OHFWULFDOIDVWtransient/burst,(&rN9IRUSRZHUsupply linesrN9IRULQSXWoutput linesNot applicable—Surge,(&rN9GLIIHUHQWLDOmoderN9FRPPRQPRGHNot applicable—9ROWDJHGLSVVKRUWinterruptions and voltage variations on power supply input lines,(&UT!GLSLQUTIRUF\FOHVUTGLSLQUT) for 5 cyclesUTGLSLQUT) for 25 cyclesUT!GLSLQUT) for 5 sNot applicable—Power frequency+]PDJQHWLF¿HOG,(&3 A/m 3 A/m 3RZHUIUHTXHQF\PDJQHWLF¿HOGVshould be at levels characteristic of a typical location in a typical commercial or hospital environment.127(UT is the AC mains voltage prior to application of the test level.Avoiding Electromagnetic Interference (Impedance Respiration)Impedance respiration measurement is very sensitive and affected by electromagnetic interference. 7HFKQRORJLFDOOLPLWDWLRQVGRQRWDOORZLPPXQLW\OHYHOVKLJKHUWKDQ9PIRUUDGLDWHG5)HOHFWURPDJQHWLF¿HOGV(OHFWURPDJQHWLF¿HOGVZLWK¿HOGVWUHQJWKVDERYH9PPD\FDXVHmeasurement error. Do not use electrically radiating equipment near the impedance respiration measurements.
106 Operator’s Manual ZM-520PA/521PA/530PA/531PAImmunity test IEC 60601 test levelCompliance levelElectromagnetic environment - guidanceConducted RF ,(&Radiated RF,(&9UPVN+]WR0+]9P0+]WR*+]9UPV9P0+]WR*+]9P0+]WR*+]IRUrespiration)Portable and mobile RF communications equipment should be used no closer WRDQ\SDUWRI=03$=03$including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter. Recommended separation distanced = 1.2 P d = 1.2 30+]WR0+]d = 2.3 30+]WR*+](d = 3.5 30+]WR0+]IRUrespirationG  30+]WR*+]IRU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).)LHOGVWUHQJWKVIURP¿[HG5)WUDQVPLWWHUV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 HTXLSPHQWPDUNHGZLWKWKHIROORZLQJsymbol:127( $W0+]DQG0+]WKHKLJKHUIUHTXHQF\UDQJHDSSOLHV127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLVDIIHFWHGE\ DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOH
Operator’s Manual ZM-520PA/521PA/530PA/531PA 107*1 )LHOGVWUHQJWKVIURP¿[HGWUDQVPLWWHUVVXFKDVEDVHVWDWLRQVIRUUDGLRFHOOXODUFRUGOHVVWHOHSKRQHVDQGODQGPRELOHUDGLRVDPDWHXUUDGLR$0DQG)0UDGLREURDGFDVWDQG79EURDGFDVWFDQQRWEHSUHGLFWHGWKHRUHWLFDOO\ZLWKDFFXUDF\7RDVVHVVWKHHOHFWURPDJQHWLFHQYLURQPHQWGXHWR¿[HG5)WUDQVPLWWHUVDQHOHFWURPDJQHWLFVLWHVXUYH\VKRXOGEHFRQVLGHUHG,IWKHPHDVXUHG¿HOGVWUHQJWKLQWKHORFDWLRQLQZKLFK=03$=03$LVXVHGH[FHHGVWKHDSSOLFDEOH5)FRPSOLDQFHOHYHODERYH=03$=0531PA should be observed to verify normal operation. If abnormal performance is observed, additional PHDVXUHVPD\EHQHFHVVDU\VXFKDVUHRULHQWLQJRUUHORFDWLQJ=03$=03$*2 2YHUWKHIUHTXHQF\UDQJHN+]WR0+]¿HOGVWUHQJWKVVKRXOGEHOHVVWKDQ9PIRUUHVSLUDWLRQDQG9PIRUDOORWKHUIXQFWLRQVRecommended Separation Distances between Portable and Mobile RF Communications Equipment=03$=03$LVLQWHQGHGIRUXVHLQDQHOHFWURPDJQHWLFHQYLURQPHQWLQZKLFKUDGLDWHG5)GLVWXUEDQFHVDUHFRQWUROOHG7KHFXVWRPHURUWKHXVHURI=03$=03$FDQKHOSSUHYHQWelectromagnetic interference by maintaining a minimum distance between portable and mobile 5)FRPPXQLFDWLRQVHTXLSPHQWWUDQVPLWWHUVDQG=03$=03$DVUHFRPPHQGHGEHORZaccording to the maximum output power of the communications equipment.Rated maximum output power of transmitter(W)Separation distance according to frequency of transmitter (m)150 kHz to 80 MHzd = 1.2 P80 MHz to 800 MHzd = 1.2 P(For respiration:d = 3.5 P)800 MHz to 2.5 GHzd = 2.3 P(For respiration:d = 7.0 P)      1 1.2 1.2 (3.5*)     12 12 (35*) 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)127( $W0+]DQG0+]WKHVHSDUDWLRQGLVWDQFHIRUWKHKLJKHUIUHTXHQF\UDQJHapplies. 127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLVDIIHFWHGE\DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOHRecovery Time after Defibrillation7KHWUDQVPLWWHUUHWXUQVWRWKHQRUPDORSHUDWLQJPRGHZLWKLQVHFRQGVDIWHUGH¿EULOODWLRQ7KHstored settings are not affected.
108 Operator’s Manual ZM-520PA/521PA/530PA/531PASystem Composition for EMC Test7KH=03$=03$WUDQVPLWWHULVWHVWHGWRFRPSO\ZLWK,(&DQG$PHQGPHQWZLWKWKHIROORZLQJFRPSRVLWLRQUnits Cable Length=03$=03$WUDQVPLWWHU —%53(&*HOHFWURGHOHDG P7/7¿QJHUSUREH 1.6 m
Operator’s Manual ZM-520PA/521PA/530PA/531PA 109Standard AccessoriesName Model Q’ty Supply CodeStrap — 1 Y233
110 Operator’s Manual ZM-520PA/521PA/530PA/531PAOptionsCAUTIONOnly use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the transmitter cannot be guaranteed.Transmitter4,3.FKDQQHOZULWHUECG/RESPName Purpose Length (m) Model Q’ty Supply Code(OHFWURGHlead3 electrodes $+$clip type  %53$ 1 K911A6 electrodes $+$clip type  %53$ 1 K912A
Operator’s Manual ZM-520PA/521PA/530PA/531PA 111SpO2 Name Cable Length Model Q’ty Supply CodeFinger probe (reusable) P 7/7 13+1.6 m P225F0XOWLVLWHSUREHUHXVDEOH 1.6 m 7/7 13*Finger probe (reusable) P 7/7 1 P311A1.6 m 7/7 1 P311CSpO2 probe (for adult, disposable) P 7/7 24 3$1.6 m 7/7 24 3(SpO2 probe (for child, disposable) P 7/7 24 3%1.6 m 7/7 24 3)SpO2 probe (for neonate/adult, disposable)P 7/7 24 3&1.6 m 7/7 24 3*SpO2 probe (for child/infant, disposable)P 7/7 24 3'1.6 m 7/7 24 3+SpO2 probe (for adult/neonate, disposable)P 7/6 53$1.6 m 7/6 53%SpO2 probe (for child/infant, disposable)P 7/6 5 P229A1.6 m 7/6 5 P229BCOTTONY tape — —  P259)RDPWDSHIRU7/6666 ——4 uSDFNDJHV 3$WWDFKPHQWWDSHIRU7/77 ——3 uSDFNDJHV P263Probe fastener — <63  3
112 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmission Frequencies&KDQQHOWRTransmissionFrequency(MHz)Channel No.                            TransmissionFrequency(MHz)Channel No.                            TransmissionFrequency(MHz)Channel No.                            
Operator’s Manual ZM-520PA/521PA/530PA/531PA 113TransmissionFrequency(MHz)Channel No.                          9111  9112  9113  9114  9115  9116   TransmissionFrequency(MHz)Channel No. 9119   9121  9122  9123  9124  9125  9126    9129   9131  9132  9133  9134  9135  9136    9139   9141  9142  9143  9144  9145  9146    9149   9151 TransmissionFrequency(MHz)Channel No. 9152  9153  9154  9155  9156    9159   9161  9162  9163  9164  9165  9166    9169                
114 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmissionFrequency(MHz)Channel No.       9191  9192  9193  9194  9195  9196    9199             9211  9212  9213  9214  9215  9216  TransmissionFrequency(MHz)Channel No.  9219   9221  9222  9223  9224  9225  9226    9229   9231  9232  9233  9234  9235  9236    9239   9241  9242  9243  9244  9245  9246   611.1125 9249  TransmissionFrequency(MHz)Channel No. 9251  9252 611.1625 9253  9254  9255  9256 611.2125   9259  611.2625 9261  9262  9263  9264 611.3125 9265  9266   611.3625 9269    611.4125    611.4625    611.5125   
Operator’s Manual ZM-520PA/521PA/530PA/531PA 115TransmissionFrequency(MHz)Channel No. 611.5625    611.6125   9291  9292 611.6625 9293  9294  9295  9296    9299             9311  9312 611.9125 9313  9314  9315  9316 TransmissionFrequency(MHz)Channel No.611.9625   9319   9321  9322  9323  9324  9325  9326   612.1125 9329   9331  9332 612.1625 9333  9334  9335  9336 612.2125   9339  612.2625 9341  9342  9343  9344 612.3125 9345  9346   612.3625 9349 TransmissionFrequency(MHz)Channel No.  9351  9352 612.4125 9353  9354  9355  9356 612.4625   9359  612.5125 9361  9362  9363  9364 612.5625 9365  9366   612.6125 9369    612.6625          
116 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmissionFrequency(MHz)Channel No.         9391  9392 612.9125 9393  9394  9395  9396 612.9625   9399          613.1125   9411  9412 613.1625 9413  9414  9415 TransmissionFrequency(MHz)Channel No. 9416 613.2125   9419  613.2625 9421  9422  9423  9424 613.3125 9425  9426   613.3625 9429   9431  9432 613.4125 9433  9434  9435  9436 613.4625   9439  613.5125 9441  9442  9443  9444 613.5625 9445  9446   TransmissionFrequency(MHz)Channel No.613.6125 9449   9451  9452 613.6625 9453  9454  9455  9456    9459   9461  9462  9463  9464  9465  9466    9469    613.9125    613.9625  
Operator’s Manual ZM-520PA/521PA/530PA/531PA 117&KDQQHO(WR(Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( (1395.1125 ( ( ( (1395.1625 ( ( ( (1395.2125 ( ( ( (1395.2625 ( ( ( (1395.3125 ( ( ( (1395.3625 ( ( ( (1395.4125 (Transmission Frequency (MHz)Channel No. ( ( (1395.4625 ( ( ( (1395.5125 ( ( ( (1395.5625 ( ( ( (1395.6125 ( ( ( (1395.6625 ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( (1395.9125 ( ( ( (1395.9625 ( ( ( ( ( ( ( ( ( ( ( (1396.1125 ( ( ( (1396.1625 ( ( ( (1396.2125 (
118 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmission Frequency (MHz)Channel No. ( ( (1396.2625 ( ( ( (1396.3125 ( ( ( (1396.3625 ( ( ( (1396.4125 ( ( ( (1396.4625 ( ( ( (1396.5125 ( ( ( (1396.5625 ( ( ( (1396.6125 ( ( (Transmission Frequency (MHz)Channel No. (1396.6625 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1396.9125 ( ( ( (1396.9625 ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (
Operator’s Manual ZM-520PA/521PA/530PA/531PA 119Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (
120 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1399.1125 ( ( ( (1399.1625 ( ( (Transmission Frequency (MHz)Channel No. (1399.2125 ( ( ( (1399.2625 ( ( ( (1399.3125 ( ( ( (1399.3625 ( ( ( (1399.4125 ( ( ( (1399.4625 ( ( ( (1399.5125 ( ( ( (1399.5625 ( ( ( (1399.6125 (Transmission Frequency (MHz)Channel No. ( ( (1399.6625 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1399.9125 ( ( ( (1399.9625 ( (
Operator’s Manual ZM-520PA/521PA/530PA/531PA 121&KDQQHO(WR(Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (
122 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( (1429.1125 ( ( ( (1429.1625 ( ( ( (1429.2125 ( ( ( (1429.2625 ( ( ( (1429.3125 ( ( ( (1429.3625 ( ( ( (1429.4125 ( ( ( (1429.4625 ( ( (
Operator’s Manual ZM-520PA/521PA/530PA/531PA 123Transmission Frequency (MHz)Channel No. (1429.5125 ( ( ( (1429.5625 ( ( ( (1429.6125 ( ( ( (1429.6625 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1429.9125 (Transmission Frequency (MHz)Channel No. ( ( (1429.9625 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (Transmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (
124 Operator’s Manual ZM-520PA/521PA/530PA/531PATransmission Frequency (MHz)Channel No. ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1431.1125 ( ( ( (1431.1625 ( ( (Transmission Frequency (MHz)Channel No. (1431.2125 ( ( ( (1431.2625 ( ( ( (1431.3125 ( ( ( (1431.3625 ( ( ( (1431.4125 ( ( ( (1431.4625 ( ( ( (1431.5125 ( ( ( (1431.5625 ( ( ( (1431.6125 (Transmission Frequency (MHz)Channel No. ( ( (1431.6625 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (1431.9125 ( ( ( (1431.9625 ( (
Serial NumberModelYour RepresentativeContact information is accurate as of Jan 2015. Visit www.nihonkohden.com for the latest information.The model and serial number of your instrument are identified on the rear or bottom of the unit.Write the model and serial number in the spaces provided below. Whenever you call your representative concerningthis instrument, mention these two pieces of information for quick and accurate service. ManufacturerNIHON KOHDEN CORPORATION1-31-4 Nishiochiai, Shinjuku-ku Tokyo 161-8560, JapanPhone +81 3-5996-8036 Fax +81 3-5996-8100 North and South AmericaNIHON KOHDEN AMERICA, INC.15353 Barranca Parkway, Irvine, CA 92618, U.S.A.Toll-free +1-800-325-0283 Phone +1 949-580-1555 Fax +1 949-580-1550NIHON KOHDEN LATIN AMERICA S.A.S Carrera 16 No.93A-36 Of. 802. Bogota D.C., ColombiaPhone +57 1-300-1742 Fax +57 1-300-1825NIHON KOHDEN DO BRASIL LTDA. Rua Gomes de Carvalho1507-Bloco A 9 andar-cjto 91A Vila OlimpiaCEP 04547-005 Sao Paulo-SP. BrasilPhone +55 11-3841-9943 Fax +55 11-3044-0463Europe European RepresentativeNIHON KOHDEN EUROPE GmbHRaiffeisenstrasse 10, D-61191 Rosbach, GermanyPhone +49 6003-827-0 Fax +49 6003-827-599NIHON KOHDEN FRANCE SARL8, rue Francois Delage, 94 230 Cachan, FrancePhone +33 1-49-08-05-50 Fax +33 1-49-08-93-32NIHON KOHDEN IBERICA S.L.C/Ulises 75A, E-28043 Madrid, SpainPhone +34 91-7-161080 Fax +34 91-3-004676NIHON KOHDEN ITALIA S.r.l.Via Fratelli Bronzetti 28, 24124 Bergamo, Italy Phone +39 035-219543 Fax +39 035-232546NIHON KOHDEN UK LTDTrident Court 118, 1 Oakcroft RoadChessington, Surrey KT9 1BD, UKPhone +44 20-8391-6800 Fax +44 20-8391-6809AsiaSHANGHAI KOHDEN MEDICAL ELECTRONIC INSTRUMENT CORP. 567 Huancheng Bei RoadShanghai Comprehensive Industrial Development ZoneShanghai 201401, ChinaPhone +86 21-5743-6998Fax +86 21-5743-6939 NIHON KOHDEN SINGAPORE PTE LTD1 Maritime Square, #10-34 HarbourFront CentreSingapore 099253Phone +65 6376-2210 Fax +65 6376-2264NIHON KOHDEN INDIA PVT. LTD. 308, Tower A, Spazedge, Sector 47, Sohna RoadGurgaon-122 002 Haryana, IndiaToll-free +91 1800-103-8182 Phone +91 124-493-1000 Fax +91 124-493-1029NIHON KOHDEN MIDDLE EAST FZE P.O.Box 261516, JAFZA View 19Room 308 Jebel Ali Free Zone, Dubai, U.A.EPhone +971 4-884-0080 Fax +971 4-880-0122NIHON KOHDEN KOREA, INC.5F Miso Bldg.890-47 Daechi-dong, Gangnam-gu, Seoul, 135-280 KoreaPhone +82 2-3273-2310 Fax +82 2-3273-2352

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