Nihon Kohden ZM-540PAA TRANSMITTER User Manual

Nihon Kohden Corporation TRANSMITTER

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ZM 540PAA User Manual HTML Version

(Short-Term Confidential) User Manual

Transmitter

ZM-540PA, ZM-541PA

OPERATOR’S MANUAL

0614-902754H

Printed:

1st Edition: 01 Jul 2009

9th Edition: XX Oct 2015

Transmitter ZM-540PA, ZM-541PA

About This Manual

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.

The Transmitter ZM-540P comes with the following manuals. Refer to the manual depending

on your needs.

Operator’s Manual (this manual)

Describes the operation and settings of Transmitter ZM-540P. Read this manual before use.

Administrator’s Guide

For administrators. Describes advanced settings and installation procedure of Product Name.

Read the Operator’s Manual together with this guide.

Service Manual

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Accompanying Documentation

The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No

part of this document may be reproduced, stored, or transmitted in any form or by any means

(electronic, mechanical, photocopied, recorded, or otherwise) without the prior written permission

of Nihon Kohden.

This product stores personal patient information. Manage the information appropriately.

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resemblance to any person living or dead is purely coincidental.

The contents of this manual are subject to change without notice.

If you have any comments or suggestions on this manual, please contact us at:

www.nihonkohden.com

Contents-1

ZM-540PA, ZM-541PA Operator’s Manual

Contents

Unpacking......................................................................................................i

GENERAL HANDLING PRECAUTIONS .......................................................I

WARRANTY POLICY ...................................................................................II

EMC RELATED CAUTION ........................................................................ VI

Conventions Used in this Manual and Instrument .................................... VIII

Intended Use ................................................................................................1

General ...................................................................................................1

Receiving Monitor ...................................................................................3

Panel Description .........................................................................................4

Front Panel .............................................................................................4

Rear Panel ..............................................................................................6

Top Panel ................................................................................................7

Bottom Panel ..........................................................................................7

Important Safety Information ........................................................................9

General ...................................................................................................9

Output Signal ........................................................................................15

Battery ..................................................................................................15

Transmitter Channel Management .......................................................16

For Patients Using Implantable Pacemaker .........................................17

ECG Monitoring ....................................................................................17

SpO2 Monitoring ....................................................................................18

NIBP Monitoring ....................................................................................23

Maintenance .........................................................................................26

Preparation on Transmitter .........................................................................27

Batteries ................................................................................................ 27

Handling Batteries ..........................................................................27

Battery Lifetime ...............................................................................27

Installing and Replacing Batteries ..................................................28

Situations Requiring Battery Replacement ....................................29

Battery Level Indication ..................................................................30

Turning On the Transmitter ...................................................................31

Check Items Before Use .................................................................31

Check Items After Power On ..........................................................32

Check Items After Use ....................................................................33

Turning Off the Transmitter ...................................................................33

Changing the Transmitter Channel .......................................................34

Contents-2

ZM-540PA, ZM-541PA Operator’s Manual

Changing Parameter and System Setup Settings ......................................35

Notes on Parameter Settings ................................................................35

Changing PARAMETER SETUP Settings ............................................36

Parameter Setup Setting List ..........................................................36

Displaying the PARAMETER SETUP Screen ................................37

Changing Parameter Setup Settings ..............................................38

Changing SYSTEM SETUP Settings ....................................................44

System Setup Setting List ...............................................................44

Displaying the SYSTEM SETUP Screen ........................................45

Changing System Setup Settings ...................................................46

Initializing Settings ................................................................................50

Attaching Electrodes, SpO2 Probe and NIBP Cuff to the Patient ...............51

Attachment Examples ...........................................................................51

Selecting Electrode Leads and Disposable Electrodes ........................52

Connecting the Electrode Lead to the Transmitter .........................53

Electrode Position ...........................................................................53

Attaching Electrodes to the Patient and Connecting the

Electrode Leads to Disposable Electrodes.....................................57

Checking ECG on the Transmitter Screen .....................................58

Attaching the SpO2 Probe .....................................................................59

Selecting the SpO2 Probe ...............................................................59

Connecting the SpO2 Probe to the Transmitter ..............................62

Attaching the Probe to the Patient ..................................................63

Attaching the NIBP Cuff ........................................................................65

Selecting the NIBP Cuff ..................................................................65

Connecting the NIBP Cuff to the Transmitter .................................69

Attaching the NIBP Cuff to the Patient ...........................................71

Locking the Keys on the Transmitter ..........................................................77

Monitoring ...................................................................................................78

Screen Descriptions ..............................................................................78

Check Electrodes Screen ...............................................................79

Numeric and Waveform Screen ......................................................80

Waveform Review Screen ..............................................................81

Numeric Review Screen .................................................................82

Display Off ......................................................................................82

Basic Monitoring Operation ..................................................................83

Using the Function Key ...................................................................83

Suspending Alarms on the Receiving Monitor ...............................84

Pausing Monitoring .........................................................................85

Resuming Monitoring after Pause ..................................................87

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Turning the Display Off ...................................................................88

Contents-3

ZM-540PA, ZM-541PA Operator’s Manual

Turning the Display On after It was Turned Off ..............................89

ECG and Respiration Monitoring ..........................................................89

Turning ECG Measurement On/Off ................................................92

Turning Respiration Measurement On/Off......................................92

Electrode Detachment ....................................................................92

SpO2 Monitoring ....................................................................................93

Monitoring SpO2 during NIBP Measurement ..................................98

NIBP Monitoring ....................................................................................99

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Selecting the Measurement Mode and Interval ..............................99

Measuring NIBP ............................................................................101

Monitoring SpO2 during NIBP Measurement ................................106

Indication and Message List .....................................................................107

Indication ............................................................................................107

Messages ...........................................................................................107

Message Display Priority .............................................................. 111

Troubleshooting ........................................................................................ 112

Transmitter ..........................................................................................112

ECG/Respiration .................................................................................113

SpO2 ..................................................................................................114

NIBP....................................................................................................114

Maintenance ............................................................................................. 116

1. External Check ...............................................................................116

2. Transmitter Channel .......................................................................117

3. Transmitting/Receiving Signal ........................................................117

4. Display ............................................................................................118

5. Key Operation .................................................................................119

6. ECG Check .....................................................................................120

7. Respiration Check ..........................................................................121

8. SpO2 Check ....................................................................................121

9. NIBP Check ....................................................................................123

10. NIBP Cuff for Attaching Transmitter to Patient Arm ......................127

Maintenance Check Sheet ..................................................................128

Lifetime and Disposal ...............................................................................129

Disposing of Used Batteries ...............................................................129

Battery Lifetime .............................................................................129

Disposal ........................................................................................129

Disposing of Electrodes, SpO2 Probes and NIBP Cuffs ......................129

Disposing of Transmitter .....................................................................129

Cleaning, Disinfection and Sterilization ....................................................130

Transmitter and Electrode Leads ........................................................130

Contents-4

ZM-540PA, ZM-541PA Operator’s Manual

Cleaning ........................................................................................130

Disinfection ...................................................................................130

SpO2 Probe .........................................................................................131

NIBP Cuff ............................................................................................131

Periodic Inspection ...................................................................................132

Repair Parts Availability Policy .................................................................132

6SHFL¿FDWLRQV ...........................................................................................133

ZM-540PA ...........................................................................................133

Measured Parameters ..................................................................133

Transmitted Data...........................................................................133

Displayed Data ..............................................................................133

ECG ..............................................................................................133

ECG Display and Heart Rate Count .............................................134

Respiration Measurement .............................................................134

SpO2 Measurement (ISO 9919: 2005 compliant) .........................134

Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999

compliant) .....................................................................................136

Transmitter ....................................................................................137

Power Requirements ....................................................................137

Dimensions and Weight ................................................................137

Environment .................................................................................. 137

Safety Standards ..........................................................................138

Electromagnetic Compatibility ......................................................138

Electromagnetic Emissions ..........................................................139

Electromagnetic Immunity ............................................................139

Recommended Separation Distances between Portable and

Mobile RF Communications Equipment .......................................141

5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ ................................................142

System Composition for EMC Test ...............................................142

ZM-541PA ...........................................................................................143

Measured Parameters ..................................................................143

Transmitted Data...........................................................................143

Display ..........................................................................................143

Displayed Data ..............................................................................143

ECG ..............................................................................................143

Respiration Measurement .............................................................144

SpO2 Measurement (ISO 9919: 2005 compliant) .........................144

Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999

compliant) .....................................................................................146

Transmitter .................................................................................... 147

Power Requirements ....................................................................147

Dimensions and Weight ................................................................147

Contents-5

ZM-540PA, ZM-541PA Operator’s Manual

Environment .................................................................................. 147

Safety Standards ..........................................................................148

Electromagnetic Compatibility ......................................................148

Electromagnetic Emissions ..........................................................149

Electromagnetic Immunity ............................................................149

Recommended Separation Distances between Portable and

Mobile RF Communications Equipment .......................................151

5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ ................................................152

System Composition for EMC Test ...............................................152

Standard Accessories ...............................................................................153

Options .....................................................................................................154

Transmitter ..........................................................................................154

ECG/RESP .........................................................................................154

SpO2 ..................................................................................................155

NIBP....................................................................................................156

Transmission Frequencies .......................................................................157

ZM-540PA, ZM-541PA Operator’s Manual

Check that all the items are included in the package. If there are any missing

items, contact your Nihon Kohden representative.

The name and quantity are described under the illustration.

ZM-540PA or ZM-541PA

transmitter (1)

NIBP cuff for adult,

standard (1) Strap (1)

Certification

Operator’s manual (1) &HUWL¿FDWLRQ

For the standard accessories and consumables, only use Nihon Kohden

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Unpacking

ZM-540PA, ZM-541PA Operator’s Manual

GENERAL HANDLING PRECAUTIONS

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Use only Nihon Kohden approved products with this device. Use of non-approved

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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.

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3. Before Operation

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4. During Operation

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5. To Shutdown After Use

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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.

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ZM-540PA, ZM-541PA Operator’s Manual

8. Maintenance and Inspection

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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.

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transducers from the instrument to avoid possible damage.

WARRANTY POLICY

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CAUTION

United States law restricts this product to sale by or on the order of a physician.

III

ZM-540PA, ZM-541PA Operator’s Manual

Equipment Authorization Requirement

Compliance with FCC/IC Requirements

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CAUTION

(English)

To comply with the FCC/IC 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.

(Français)

Pour respecter les normes relatives aux radiofréquences FCC/IC, ce dispositif

ne doit pas être situé ou utilisé à proximité d’une autre antenne ou d’un autre

émetteur si ce n’est selon les procédures mentionnées pour le multi-

transmetteur FCC/IC ou décrites dans la documentation.

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.

ZM-540PA, ZM-541PA Operator’s Manual

Compliance with IC Requirements

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ZM-540PA, ZM-541PA Operator’s Manual

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ZM-541PA only

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“This equipment shall not be operated in the areas of Sydney, Nova Scotia, or Gander,

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information.”

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« L’utilisation de cet équipement est interdite à Sydney, Nouvelle-Écosse de même qu’à

Gander, Terre-Neuve et Labrador. Veuillez contacter le bureau local d’Industrie Canada

pour de plus amples renseignements ».

ZM-540PA, ZM-541PA Operator’s Manual

EMC RELATED CAUTION

This equipment and/or system complies with IEC 60601-1-2 International Standard

for electromagnetic compatibility for medical electrical equipment and/or system.

However, an electromagnetic environment that exceeds the limits or levels stipulated

in 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. Keep the emitter source

such as cellular phone away from the equipment and/or system, or turn off the

cellular phone.

2. Radio-frequency interference from other equipment through the AC power supply of

the equipment and/or system:

Identify the cause of this interference and if possible remove this interference

source. If this is not possible, use a different power supply.

3. 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. A humid room can

help lessen this problem.

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.

6. Use with other equipment:

When the equipment and/or system is adjacent to or stacked with other equipment,

the equipment and/or system may affect the other equipment. Before use, check

that the equipment and/or system operates normally with the other equipment.

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equipment and/or system, it may cause increased electromagnetic emission or

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VII

ZM-540PA, ZM-541PA Operator’s Manual

Caution - continued

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increased electromagnetic emission or decreased electromagnetic immunity. Only

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9. Measurement with excessive sensitivity:

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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.

VIII

ZM-540PA, ZM-541PA Operator’s Manual

Warnings and Cautions

Level Description

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Conventions Used in this Manual and Instrument

ZM-540PA, ZM-541PA Operator’s Manual

Explanations of the Symbols in this Manual and Instrument

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applied part

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manual

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applied part

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Symbol Description Symbol Description

Full battery

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%DWWHU\IXOO Alarm suspended

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ZM-540PA, ZM-541PA Operator’s Manual

Intended Use

General

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=03$ WR0+]FKDQQHOQXPEHUWR

=03$WR0+]FKDQQHOQXPEHU(WR(

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   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.

WARNING

Do not diagnose a patient based only on data

acquired by the transmitter. Overall judgement

must be performed by a physician who

understands the features, limitations and

characteristics of the transmitter and by reading

the biomedical signals acquired by other

instruments.

WARNING

Do not use this transmitter for monitoring a patient.

Monitor the patient on a receiving monitor. This

transmitter displays the waveforms and measured

values but does not have an alarm function.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

Do not use the same transmitter for more than one

patient at the same time. Do not connect different

sensors from different patients to the same

transmitter.

• Do not use the same channel for different

patients. If the same channel is used for two

patients, the two patients’ data will be lost due to

mutual modulation interference, or another

patient’s data may appear on the receiving

monitor screen.

• Do not use two transmitters with adjacent

channels in the same hospital. If transmitters

with adjacent channels are used, their radio

waves interfere with each other.

CAUTION

Signal loss and artifact may occur because of the

multipath cancellation* when using a transmitter.

CAUTION

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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

IDGLQJRIHOHFWULF¿HOGVWUHQJWKIRUH[DPSOHSHRSOHPRYLQJPD\LQWHUIHUH

with the transmitter signal and may be mistaken as an arrhythmia on the

receiving monitor.

• ,IWKHWUDQVPLWWHULVXVHGRXWVLGHWKHVSHFL¿HGHQYLURQPHQWLWVSHUIRUPDQFH

cannot be guaranteed.

ZM-540PA, ZM-541PA Operator’s Manual

• For details on antennas and antenna construction, contact your Nihon

Kohden representative. You can also refer to the Telemetry System

Installation Guide.

Receiving Monitor

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NOTE • For details on the receiving monitor and upgrade information, contact your

Nihon Kohden representative.

• The transmitter does not give any patient alarm, only a “no battery” alarm.

Patient alarms must be managed on the receiving monitor.

ZM-540PA, ZM-541PA Operator’s Manual

Panel Description

Front Panel

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1 LCD

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2 Infrared receiver

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3 Screen key

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$IWHUSRZHURQ6WDUWXSĺ&KHFN

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:DYHIRUPUHYLHZĺ1XPHULFUHYLHZĺ

'LVSOD\RIIĺ&KHFNHOHFWURGHV«

$IWHUDXWRGLVSOD\RII1XPHULFDQG

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NH\FDQFHOVFKDQJLQJVHWWLQJRUH[LWVWKH

VFUHHQ

4 Function key

'HSHQGLQJRQWKHVHWWLQJRQWKH

WUDQVPLWWHUWKLVNH\VXVSHQGVDODUPV

SDXVHVPRQLWRULQJRQWKHUHFHLYLQJ

PRQLWRURUWUDQVPLWV³3DWLHQWFRQ¿UPHG´

PHVVDJH

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ZM-540PA, ZM-541PA Operator’s Manual

5HIHUWRWKH:$51,1*

RQWKHQH[WSDJH

5 NIBP Start/Stop key

6WDUWVVWRSV1,%3PHDVXUHPHQWLQ

VHOHFWHGPRGH

6 NIBP Interval key

6HOHFWV1,%3PHDVXUHPHQWPRGH

7 Lead/Scroll keys

2QWKHQXPHULFDQGZDYHIRUPVFUHHQ

WKHVHNH\VFKDQJHWKH(&*OHDG

2QWKHZDYHIRUPUHYLHZVFUHHQWKHVH

NH\VVFUROOGDWD

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FXUVRU

8 Battery case

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WARNING

Close the battery case cover during operation. If

the transmitter is used with the battery case cover

open, anyone who touches the opened battery

case may receive an electrical shock when

defibrillation is performed. Touching the opened

battery case may cause electrostatic discharge

and intermittently interfere with the waveform or

data.

ZM-540PA, ZM-541PA Operator’s Manual

Rear Panel

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Lock plate

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WARNING

This transmitter is not waterproof. If detergent or

liquid spills into the transmitter, stop using it and

contact your Nihon Kohden representative. If a wet

transmitter is used, the patient or operator may

receive an electrical shock or injury.

ZM-540PA, ZM-541PA Operator’s Manual

Top Panel

RALL

NIBP socket

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ECG/impedance RESP socket

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Bottom Panel

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SpO2 socket

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Channel number label

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WKHWUDQVPLWWHU

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

Before defibrillation, all persons must keep clear of

the bed and must not touch the patient or any

equipment or cord connected to the patient. Failure

to follow this warning may cause electrical shock or

injury.

WARNING

When performing defibrillation, discharge as far as

possible from electrodes, patches and any gel,

cream or medicine on the chest of the patient. If

there is a possibility that the defibrillator paddle

could touch these materials, remove them from the

patient. If the defibrillator paddle directly contacts

these materials, the discharged energy may cause

skin burn to the patient.

WARNING

When the transmitter is used with an

electrosurgical unit (ESU), firmly attach the entire

area of the ESU return plate. Otherwise, the

current from the ESU flows into the electrodes of

the transmitter, causing electrical burn where the

electrodes are attached. For details, refer to the

ESU manual.

Do not shake or swing the transmitter while holding

the leads or cables connected to the transmitter.

The transmitter may come off and injure someone

or damage surrounding instruments.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Important Safety Information

General

WARNING

Never use the transmitter in the presence of any

flammable anesthetic gas or high concentration

oxygen atmosphere. Failure to follow this warning

may cause explosion or fire.

WARNING

When performing MRI test, remove all electrodes

and probe from the patient which are connected to

this transmitter. Failure to follow this warning may

cause skin burn on the patient. For details, refer to

the MRI manual.

WARNING

Never use the transmitter in a hyperbaric oxygen

chamber. Failure to follow this warning may cause

explosion or fire.

WARNING

Do not take this transmitter into the MRI test room.

This transmitter is not designed to be used during

MRI tests.

WARNING

Before defibrillation, all persons must keep clear of

the bed and must not touch the patient or any

equipment or cord connected to the patient. Failure

to follow this warning may cause electrical shock or

injury.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When performing defibrillation, discharge as far as

possible from electrodes, patches and any gel,

cream or medicine on the chest of the patient. If

there is a possibility that the defibrillator paddle

could touch these materials, remove them from the

patient. If the defibrillator paddle directly contacts

these materials, the discharged energy may cause

skin burn to the patient.

WARNING

When the transmitter is used with an

electrosurgical unit (ESU), firmly attach the entire

area of the ESU return plate. Otherwise, the

current from the ESU flows into the electrodes of

the transmitter, causing electrical burn where the

electrodes are attached. For details, refer to the

ESU manual.

WARNING

Do not use the same transmitter for more than one

patient at the same time. Do not connect different

sensors from different patients to the same

transmitter.

WARNING

This transmitter is not waterproof. If detergent or

liquid spills into the transmitter, stop using it and

contact your Nihon Kohden representative. If a wet

transmitter is used, the patient or operator may

receive an electrical shock or injury.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

Close the battery case cover during operation. If

the transmitter is used with the battery case cover

open, anyone who touches the opened battery

case may receive an electrical shock when

defibrillation is performed. Touching the opened

battery case may cause electrostatic discharge

and intermittently interfere with the waveform or

data.

WARNING

When the signal is unstable, keep the patient

under close observation. When the signal is

unstable, the monitoring and alarm are not reliable

and the receiving monitor cannot detect a sudden

change of the patient’s condition. This may cause

critical changes in the patient condition to be

overlooked. Install an appropriate antenna system

to ensure stable signal condition.

WARNING

While the “ALARMS SUSPENDED” message is

displayed on the transmitter, all alarms on the

receiving monitor are suspended so keep the

patient under close observation.

WARNING

When the patient returns to the bed, turn on the

transmitter and check that the monitoring is

resumed on the receiving monitor.

WARNING

If 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.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

Do not allow the conductive part of the connector

which is connected to the patient to contact other

conductive parts including earth. This causes

leakage current and incorrect measurement value

and leads to wrong diagnosis.

WARNING

After admitting a patient on the central monitor and

attaching electrodes and sensors on the patient

and connecting cables to the transmitter, check

that there is no error messages and that the

waveforms and numeric data are appropriately

displayed on the transmitter and central monitor

screen. If there is an error message, or waveform

or numeric data is not appropriate, check the

electrodes and sensors attachment, patient

condition and settings on the transmitter and

remove the cause.

Only use Nihon Kohden specified electrodes,

electrode leads, SpO2 probes, and NIBP cuffs.

Otherwise, the maximum performance from the

transmitter cannot be guaranteed.

CAUTION

Do not reuse disposable parts and accessories.

CAUTION

For handling and precautions on electrodes,

electrode leads, SpO2 probes and NIBP cuffs, refer

to the manual.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

The measurement values and displayed

waveforms on the transmitter and receiving

monitor may be different due to timing delay of the

display or difference in detection settings.

CAUTION

Do not shake or swing the transmitter while holding

the leads or cables connected to the transmitter.

The transmitter may come off and injure someone

or damage surrounding instruments.

CAUTION

Signal loss and artifact may occur because of the

multipath cancellation* when using a transmitter.

CAUTION

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Turn off the power of mobile phones, small

wireless devices and other devices which produce

strong electromagnetic interference around a

patient (except for devices allowed by the hospital

administrator). Radio waves from devices such as

mobile phones or small wireless devices may be

mistaken as pulse waves or respiration waves and

the displayed data may be incorrect.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

When 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.

CAUTION

• Do not use the same channel for different

patients. If the same channel is used for two

patients, the two patients’ data will be lost due to

mutual modulation interference, or another

patient’s data may appear on the receiving

monitor screen.

• Do not use two transmitters with adjacent

channels in the same hospital. If transmitters

with adjacent channels are used, their radio

waves interfere with each other.

CAUTION

When 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.

CAUTION

When 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.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Always lock the battery cover while using the

transmitter. Otherwise the battery cover may come

off and correct measurement might not be

performed.

CAUTION

Output Signal

WARNING

Do not use the output signal from the receiving

monitor as the synchronization signal for other

equipment such as IABP, MRI, echocardiography

or defibrillator. There may be time delay between

the monitor and the other equipment caused by

waveform transmission delay and spike noise may

interfere on the output signal and be mistaken as a

trigger.

Battery

Battery replacement must be performed by the

operator. When replacing the batteries of a

transmitter that is currently used for a patient,

disconnect the electrode leads from the transmitter

before replacing batteries or do not touch the

patient during replacement.

CAUTION

Refer to the battery and battery charger manuals

for details on handling the batteries.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Transmitter Channel Management

WARNING

The following actions must be taken to properly

receive the transmitter signal of the correct patient

on the receiving instrument. Otherwise, there may

be signal loss or signals may mix causing a serious

accident, such as monitoring a different patient.

• Assign a channel administrator in the hospital

and only he or she should manage channel

assignment.

• The channel administrator must manage the

channels in the facility so that there is no signal

interference.

• When the transmitter channel is changed, the

channel administrator must check that the

channel on the receiving monitor is also

changed and the signal is properly received.

• The channel administrator must replace the

channel number label on the transmitter with the

new one after changing the channel.

ZM-540PA, ZM-541PA Operator’s Manual

For Patients Using Implantable Pacemaker

WARNING

The bioelectric impedance measurement sensor of

a minute ventilation rate-adaptive implantable

pacemaker may be affected by transmitter which is

connected to the same patient. If this occurs, the

pacemaker may pace at its maximum rate and the

transmitter may give incorrect data to the monitor.

If this occurs, disconnect the electrode leads from

the patient or change the setting on the pacemaker

by referring to the pacemaker’s manual. For more

details, contact your pacemaker representative or

Nihon Kohden representative.

ECG Monitoring

WARNING

Turn the pacing pulse detection to ON on the

receiving monitor when monitoring a pacemaker

patient. Otherwise the pacemaker pulse is not

rejected. However, even when the pacing pulse

detection is set to ON, the pacemaker pulse might

not be rejected. When the pacemaker pulse is not

rejected, the pacemaker pulse is detected as QRS

and false heart rate may be indicated or critical

arrhythmia such as asystole may be overlooked.

Keep pacemaker patients under close observation.

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UHIHUWRWKH³6SHFL¿FDWLRQV(&*´VHFWLRQ

WARNING

Even when the pacing pulse detection is set to ON

on the receiving monitor, the pacemaker pulse can

be overlooked or detected as QRS. You cannot

confirm the pacemaker operation only from the

detected pacemaker pulse.

ZM-540PA, ZM-541PA Operator’s Manual

Only use Nihon Kohden specified electrodes and

electrode leads. When other type of electrodes or

electrode leads are used, the “CHECK

ELECTRODES” message may be displayed and

ECG monitoring may stop.

CAUTION

When 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.

CAUTION

SpO2 Monitoring

WARNING

SpO2 measurement may be incorrect in the

following cases.

• When the patient’s carboxyhemoglobin or

methemoglobin increases abnormally.

• When dye is injected in the blood.

• During CPR.

• When measuring at a site with venous pulse.

• When there is body movement.

• When the pulse wave is small (insufficient

peripheral circulation).

WARNING

When monitoring SpO2 of a patient who is

receiving photodynamic therapy, the light from the

finger probe sensor may cause a burn.

Photodynamic therapy uses a photosensitizing

agent that has a side effect of photosensitivity.

7KH6S22SUREHVPDQXIDFWXUHGE\1LKRQ.RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKH

UDQJHRIDQGQP7KHPD[LPXPOLJKWLQWHQVLW\LVOHVVWKDQP:

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When not monitoring SpO2, disconnect the SpO2

cable from the transmitter. Otherwise, noise from

the probe sensor may interfere and incorrect data

is displayed on the screen.

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.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

Check the circulation condition by observing the

skin color at the measurement site and pulse

waveform. Change the measurement site every 8

hours for disposable probes and every 4 hours for

reusable probes (every 8 hours for TL-631T series

probe). The skin temperature may increase at the

attached site by 2 or 3°C (4 or 5°F) and cause a

burn or pressure necrosis. When using the probe

on the following patients, take extreme care and

change the measurement site more frequently

according to symptoms and degree.

• Patient with a fever

• Patient with insufficient peripheral circulation

• Neonate or low birth weight infant with delicate

skin

The disposable probe is not sterilized. Use the

disposable probe only for a single patient. Never

reuse the disposable probe for another patient

because it causes cross infection.

CAUTION

If the attachment site is dirty with blood or bodily

fluids, clean the attachment site before attaching

the probe. If there is nail polish on the attachment

site, remove the polish. Otherwise, the amount of

transmitted light decreases, and measured value

may be incorrect or measurement cannot be

performed.

CAUTION

If the skin gets irritated or redness appears on the

skin from the probe, change the attachment site or

stop using the probe. Take extreme care for the

patients with delicate skin.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

While a patient is on medication which causes

vasodilation, the pulse waveform may change and

in rare cases the SpO2 value might not be

displayed.

CAUTION

NIBP and SpO2 can be measured on the same

limb, but the SpO2 monitoring might not be

accurate during NIBP measurement. Be careful

when reading the SpO2 values.*

CAUTION

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Normal external light does not affect monitoring but

strong light such as a surgical light or sunlight may

affect monitoring. If affected, cover the measuring

site with a blanket.

CAUTION

When a message indicates a faulty probe, stop

monitoring and replace the probe with a new one.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Handle the probe cable according to the following

cautions. Failure to follow these cautions may

cause cable discontinuity or short circuit of the

probe cable which may cause incorrect

measurement data or inability to perform

measurement. Also in rare cases, the probe

temperature may increase and cause skin burn on

the patient. If the probe cable is damaged, replace

the probe with a new one.

 'RQRWSXOORUEHQGWKHSUREHFDEOH

 'RQRWOHWFDVWHUIHHWUXQRYHUWKHSUREHFDEOH

CAUTION

Do not use a probe which is deteriorated by aging.

Accurate measurement cannot be performed.

CAUTION

Do not use a damaged or disassembled probe. It

causes incorrect measurement and may injure the

patient.

CAUTION

When the probe is attached on an appropriate site

with sufficient thickness and the error message

confirming the probe attachment repeatedly

appears, the probe may be deteriorated. Replace it

with a new one.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

NIBP Monitoring

WARNING

Be careful when measuring NIBP on a patient with

known bleeding disorders or coagulation. After

NIBP measurement, there may be dot

hemorrhage, or circulatory disorder by thrombus

where the cuff is attached.

WARNING

NIBP measurement may be incorrect in the

following situations.

• When using an ESU

• Body movement

• Small pulse wave

• Too many arrhythmias

• Shaking from an external source

• Rapid blood pressure change

• During CPR

• Slow pulse

• Low blood pressure

• Small pulse pressure

• Cuff is too tight or too loose

• Cuff does not fit the arm

• Cuff is wrapped over thick clothing

• Cuff is deteriorated

• Arterial sclerosis

• Poor perfusion

• Diabetes

• Age

• Pregnancy

• Pre-eclampsia

• Renal disease

• Shivering

• Trembling

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When performing NIBP measurements in STAT

mode or 5 minute intervals, periodically remove the

cuff from the patient for ventilation. The skin

temperature may increase at the cuff attachment

site by 2 or 3°C (4 or 5°F). When measuring a

patient with a fever or peripheral circulation

insufficiency, it may cause a burn.

WARNING

Do not attach the NIBP cuff on a limb which is

being used for intravascular access or therapy, or

an arterio-venous (A-V) shunt. It may cause reflux

of blood or medicinal solution or block injection of

medicinal solution due to poor blood circulation.

WARNING

Do not attach the NIBP cuff on an arm which is the

same side as a mastectomy. It may cause

circulatory disorder such as swelling from poor

blood circulation.

WARNING

While measuring NIBP, if the NIBP cuff and other

medical equipment are attached to the same limb,

the medical equipment might not function

temporarily.

WARNING

While measuring NIBP, check the patient condition

and confirm that the NIBP cuff does not affect

blood circulation.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When performing long term measurement at

intervals less than 5 minutes, perform

measurements while observing the state of the

patient, blood vessels and limb to ensure adequate

circulation. Congestion may occur at the

measurement site. When performing periodic

measurement for a long time, periodically check

the circulation condition.

Do not wrap the cuff on an arm or thigh which is

used for injection. NIBP measurement on an arm

or thigh which is used for injection may cause

reflux of blood and stop injection.

CAUTION

Do not wrap the cuff too tight. It may cause poor

blood circulation and congestion. If the cuff is

wrapped too loosely, the NIBP value may increase.

CAUTION

Do not attach the cuff to the site where there is

injury or inflammation. If the skin gets irritated or

redness appears on the skin from the cuff, change

the attachment site or stop using the cuff. Take

extreme care on the patients with delicate skin.

CAUTION

When using an extension hose, check that the

extension hose is not bent or squeezed.

Otherwise, the cuff might not inflate or deflate. If

the cuff cannot deflate, it may cause congestion on

the patient at the cuff attachment site.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

When performing NIBP measurement repeatedly,

have a rest between measurements to recover

adequate circulation.

CAUTION

Maintenance

If detergent or liquid spills into the transmitter, stop

cleaning or disinfecting it and contact your Nihon

Kohden representative. The transmitter needs to

be checked for safety and function before use.

CAUTION

Before maintenance, cleaning or disinfection, turn

the transmitter power off and remove the batteries.

Failure to follow this instruction may result in

electrical shock and transmitter malfunction.

CAUTION

Never disassemble or repair the transmitter. If

there is any problem with the transmitter, contact

your Nihon Kohden representative.

CAUTION

Dispose of Nihon Kohden products according to

your local laws and your facility’s guidelines for

waste disposal. Otherwise, it may affect the

environment. If there is a possibility that the

product may have been contaminated with

infection, dispose of it as medical waste according

to your local laws and your facility’s guidelines for

medical waste. Otherwise, it may cause infection.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Preparation on Transmitter

Batteries

Handling Batteries

WARNING

Do not handle the batteries with wet hands.

WARNING

When the transmitter is not in use, remove the

batteries. When the batteries are installed, battery

power is consumed even when measurement is

not performed. When NiMH batteries are left in the

transmitter when it is not used, the batteries may

overdischarge and leak liquid which makes the

batteries unusable and damages the transmitter.

Refer to the battery and battery charger manuals

for details on handling the batteries.

CAUTION

NOTE • Remove the batteries from the transmitter before disposing of it.

• Use either new alkaline batteries or fully charged rechargeable NiMH

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that have been stored for long periods may result in short battery life or

reduced performance resulting in unstable measurement.

Battery Lifetime

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ZM-540PA, ZM-541PA Operator’s Manual

Recommended batteries

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Installing and Replacing Batteries

Battery replacement must be performed by the

operator. When replacing the batteries of a

transmitter that is currently used for a patient,

disconnect the electrode leads from the transmitter

before replacing batteries or do not touch the

patient during replacement.

CAUTION

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NOTE • Replace all batteries at the same time.

• Do not use different types of batteries together.

• ,QVHUWWKHEDWWHULHVZLWKWKHFRUUHFWSRODULW\DQGí

• The capacity of rechargeable NiMH batteries is reduced if the batteries are

recharged before they are fully discharged. For details, refer to the battery

operator’s manual.

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EDWWHU\FDVHREVHUYLQJWKHFRUUHFWSRODULW\

ZM-540PA, ZM-541PA Operator’s Manual

NOTE: ,QVHUWWKHíHQGRIWKHEDWWHU\¿UVWDQG

press it against the spring. If you try to force

WKHHQGRIWKHEDWWHU\LQ¿UVWDVVKRZQ

it will deform the spring and damage the

battery and transmitter.

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Always lock the battery cover while using the

transmitter. Otherwise the battery cover may come

off and correct measurement might not be

performed.

CAUTION

Situations Requiring Battery Replacement

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• 7KHWUDQVPLWWHUJHQHUDWHVDFRQVWDQWDODUPFRQWLQXRXV³SHHS´VRXQG

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• 7KHUHFHLYLQJPRQLWRUGLVSOD\VDEDWWHU\UHSODFHPHQWPHVVDJH

NOTE: The battery replacement message or icon on the transmitter disappears after

a short time depending on the type of battery. When the battery replacement

indication appears, immediately replace the transmitter battery with a new

one.

SpringSpring

Good Bad

ZM-540PA, ZM-541PA Operator’s Manual

Battery Level Indication

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Indication Battery Level Message on the Receiving Monitor

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GLVSOD\HG

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&DQQRWPHDVXUH1,%3

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7KHUHLVQRLQGLFDWLRQRQWKHPRQLWRU

ZM-540PA, ZM-541PA Operator’s Manual

Turning On the Transmitter

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NOTE: Check that the “COMMUNICATION LOSS” message is not displayed on the

central monitor.

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Check Items Before Use

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Operating Environment

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LWZLWKLQWKHXVDJHHQYLURQPHQWUDQJH

ZM-540PA, ZM-541PA Operator’s Manual

Appearance

• 7KHUHDUHQRGDPDJHGRUGLUW\SDUWVRQWKHRXWVLGHRIWKHWUDQVPLWWHU/&'NH\VVRFNHWV

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• 7KHHOHFWURGHVHOHFWURGHOHDG6S22SUREHDQG1,%3FXIIDUHQRWEURNHQ

Batteries

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• 7KHEDWWHU\FDVHFRYHULV¿UPO\FORVHG

Channel Setting

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Other

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Check Items After Power On

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Power On

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Daily Check

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ZM-540PA, ZM-541PA Operator’s Manual

Check Items After Use

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Before Turning Power Off

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Storage

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Turning Off the Transmitter

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ZM-540PA, ZM-541PA Operator’s Manual

Changing the Transmitter Channel

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WARNING

The following actions must be taken to properly

receive the transmitter signal of the correct patient

on the receiving instrument. Otherwise, there may

be signal loss or signals may mix causing a serious

accident, such as monitoring a different patient.

• Assign a channel administrator in the hospital

and only he or she should manage channel

assignment.

• The channel administrator must manage the

channels in the facility so that there is no signal

interference.

• When the transmitter channel is changed, the

channel administrator must check that the

channel on the receiving monitor is also

changed and the signal is properly received.

• The channel administrator must replace the

channel number label on the transmitter with the

new one after changing the channel.

NOTE • The software version of the QI-901PK channel writer must be 02-01 or later

to change the channel on the transmitter.

• The channel writer must be used outside the patient environment.

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Channel

ZM-540PA, ZM-541PA Operator’s Manual

Changing Parameter and System Setup Settings

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personnel.

Notes on Parameter Settings

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SpO2 Probe Attachment Site INHIBIT SpO2 DURING NIBP SETTING

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ZM-540PA, ZM-541PA Operator’s Manual

Changing PARAMETER SETUP Settings

Parameter Setup Setting List

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Setting Item Description Settings

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NOTE: When “PROTOCOL” of the transmitter

is set to 57 and the receiving monitor

is able to receive protocol 57, ECG

measurement on the receiving monitor

is automatically set to OFF when this

setting is set to OFF on the transmitter.

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ZM-540PA, ZM-541PA Operator’s Manual

Displaying the PARAMETER SETUP Screen

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PARAMETER SETUP screen - page 1

Setting item

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ZM-540PA, ZM-541PA Operator’s Manual

Changing Parameter Setup Settings

ECG ELECTRODES

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ZM-540PA, ZM-541PA Operator’s Manual

ECG MEASUREMENT

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NOTE: When “PROTOCOL” of the transmitter is set to 57 and the receiving monitor

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automatically set to OFF when this setting is set to OFF on the transmitter.

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0($685(0(17´

ZM-540PA, ZM-541PA Operator’s Manual

SpO2 RESPONSE

6HOHFWWKH6S22UHVSRQVHPRGHIURP)$671250$/RU6/2:)RUGHWDLOVRQWKHUHVSRQVH

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WKLVPDQXDO

NOTE: When measurement condition is unstable due to strenuous movement of the

patient, etc., response may become slower in all modes.

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WKHŹNH\WRPRYHWKHFXUVRUWR³6S22

5(63216(´³6S225(63216(´LVRQWKH

VHFRQGSDJHRIWKH3$5$0(7(56(783

VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFW³)$67´³1250$/´

RU³6/2:´

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKH

VHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³6S22

5(63216(´

INHIBIT SpO2 DURING NIBP

7XUQ6S22PRQLWRULQJRQRURIIGXULQJ1,%3PHDVXUHPHQW

:KHQWKH6S22SUREHLVDWWDFKHGWRWKHVDPHOLPEDVWKH1,%3FXIIDQGWKLVVHWWLQJLVVHWWR

2))WKHSXOVHPD\EHFRPHXQVWDEOHDQG6S22RU35DODUPPD\RFFXU,WLVUHFRPPHQGHGWR

VHWWKLVVHWWLQJWR21VRWKDW6S22LVQRWPHDVXUHGGXULQJ1,%3PHDVXUHPHQW

:KHQWKH6S22SUREHLVDWWDFKHGWRWKHRWKHUOLPEIURPWKH1,%3FXIIWKLVVHWWLQJFDQEHVHW

WR2))

NOTE: When this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the

“Monitoring SpO2 during NIBP Measurement” section.

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6S22'85,1*1,%3´³,1+,%,76S22'85,1*1,%3´LVRQWKHVHFRQGSDJHRIWKH

3$5$0(7(56(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFW³21´RU³2))´

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1+,%,7

6S22'85,1*1,%3´

PARAMETER SETUP screen - page 2

ZM-540PA, ZM-541PA Operator’s Manual

SELECTABLE INTERVALS (min)

:KHQWKH1,%3,17(59$/NH\LVSUHVVHGWKHPHDVXUHPHQWPRGHFKDQJHVDFFRUGLQJWRWKH

PRGHVVHOHFWHGLQWKLVLWHP0$18$/PRGHLVDOUHDG\VHOHFWHGIRUWKHPRGHVHOHFWLRQ

1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKH

ŹNH\WRPRYHWKHFXUVRUWR³6(/(&7$%/(

,17(59$/6´³6(/(&7$%/(,17(59$/6´

LVRQWKHWKLUGSDJHRIWKH3$5$0(7(56(783

VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWRUXQVHOHFWWKHPRGH

7KHVHOHFWHGPRGHVDUHKLJKOLJKWHG

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG

VHWWLQJ7KHFXUVRUUHWXUQVWR³6(/(&7$%/(

,17(59$/6´

INITIAL INTERVAL (min)

6HOHFWWKHLQLWLDO1,%3PHDVXUHPHQWPRGHDWSRZHURQ

1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³,1,7,$/

,17(59$/´³,1,7,$/,17(59$/´LVRQWKHWKLUGSDJHRIWKH3$5$0(7(56(783

VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWWKHPRGH2QO\WKHPRGHRULQWHUYDOVHOHFWHGIRU

³6(/(&7$%/(,17(59$/6´DUHDYDLODEOH

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1,7,$/

,17(59$/´

PARAMETER SETUP screen - page 3

ZM-540PA, ZM-541PA Operator’s Manual

NIBP MODE AFTER STAT (min)

6HOHFWWKH1,%3PHDVXUHPHQWPRGHDIWHUFRPSOHWLQJWKH67$7PHDVXUHPHQW

1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³1,%3

02'($)7(567$7´³1,%302'($)7(567$7´LVRQWKHWKLUGSDJHRIWKH

3$5$0(7(56(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWWKHPRGH2QO\WKHPRGHRULQWHUYDOVHOHFWHGIRU

³6(/(&7$%/(,17(59$/6´DUHDYDLODEOH

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³1,%3

02'($)7(567$7´

START/FINISH SOUND

7XUQRQRURIIWKHVRXQGIRU1,%3PHDVXUHPHQWVWDUWDQG¿QLVK

1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKH

ŹNH\WRPRYHWKHFXUVRUWR³67$57),1,6+

6281'´³67$57),1,6+6281'´LVRQWKH

IRXUWKSDJHRIWKH3$5$0(7(56(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\7KHFXUVRUPRYHVWR

³67$57´

3 3UHVVWKHŹNH\WRWXUQ³21´RU³2))´WKH

VRXQGIRU1,%3PHDVXUHPHQWVWDUW

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHWWLQJIRU

³67$57´7KHFXUVRUPRYHVWR³),1,6+´

5 3UHVVWKHŹNH\WRWXUQ³21´RU³2))´WKH

VRXQGIRU1,%3PHDVXUHPHQW¿QLVK

6 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG

VHWWLQJ7KHFXUVRUUHWXUQVWR³67$57),1,6+

6281'´

PARAMETER SETUP screen - page 4

ZM-540PA, ZM-541PA Operator’s Manual

OLD NIBP DATA/AFTER (min)

6HOHFWZKHWKHUWRGLPRUKLGHWKH1,%3GDWDDIWHUPHDVXUHPHQWDQGKRZORQJWRZDLWDIWHU

1,%3PHDVXUHPHQWWRGLPRUKLGHLW

1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³2/'

1,%3'$7$$)7(5´³2/'1,%3'$7$$)7(5´LVRQWKHIRXUWKSDJHRIWKH

3$5$0(7(56(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\7KHFXUVRUPRYHVWR³'$7$´

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³$)7(5´

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6 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³2/'1,%3

'$7$$)7(5´

INITIAL CUFF PRESSURE (mmHg)

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1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³,1,7,$/

&8))35(6685(´³,1,7,$/&8))35(6685(´LVRQWKHIRXUWKSDJHRIWKH

3$5$0(7(56(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWWKHLQÀDWLRQSUHVVXUH

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1,7,$/

&8))35(6685(´

ZM-540PA, ZM-541PA Operator’s Manual

Changing SYSTEM SETUP Settings

System Setup Setting List

7KHIDFWRU\GHIDXOWVHWWLQJVDUHXQGHUOLQHG

Setting Item Description Settings

35272&2/

6HOHFWWKHWUDQVPLWWLQJSURWRFRO

1HZSURWRFRO$FHQWUDOPRQLWRUZLWKDQ

25*$25*$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

SDWLHQWUHFHLYHUFDQUHFHLYHWKLVSURWRFRO

NOTE: When 57 is set, the receiving monitor

must be able to receive protocol 57.

Otherwise, signals from the transmitter

cannot be received.

, 42

%5,*+71(66 6HOHFWWKHVFUHHQEULJKWQHVV '$5.,

%5,*+7

35(6685(81,7 6HOHFWWKHXQLWIRU1,%3 PP+JN3D

)81&7,21.(<

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6863(1'$/$503$86(

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6863(1'$/$50

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PLQXWHV

&21),50

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2)) 1RIXQFWLRQ

NOTE: “SUSPEND ALARM & PAUSE” and

“CONFIRM” can only be set when

PROTOCOL is set to 57.

6863(1'

$/$50

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6863(1'

$/$50

&21),50

2))

$8725(680(

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VV,

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6(/(&7$%/(

6&5((17,0(

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6HOHFWWKHGLVSOD\WLPHRXWSHULRG ,



ZM-540PA, ZM-541PA Operator’s Manual

Displaying the SYSTEM SETUP Screen

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VFUHHQDSSHDUV

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5 &KDQJHVHWWLQJV

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press the Ż or ŹNH\WKHQSUHVVWKH)XQFWLRQ

NH\

• 7RVHOHFWDQGUHJLVWHUWKHVHWWLQJSUHVVWKHŻ

or ŹNH\WKHQSUHVVWKH)XQFWLRQNH\

• 7RFDQFHOFKDQJLQJWKHVHWWLQJRIWKHVHOHFWHG

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6 :KHQFKDQJLQJVHWWLQJVRQWKH6<67(06(783

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WRWKH0(18VFUHHQ

7 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR

³(;,7´

8 3UHVVWKH)XQFWLRQNH\7KHQXPHULFDQG

ZDYHIRUPVFUHHQDSSHDUV

Cursor

MENU screen

SYSTEM SETUP screen - page 1

Setting

Setting item

ZM-540PA, ZM-541PA Operator’s Manual

Changing System Setup Settings

PROTOCOL

6HOHFWWKHWUDQVPLWWLQJSURWRFRO)RUGLIIHUHQFHVEHWZHHQSURWRFROVUHIHUWRWKHWDEOHEHORZ

1HZSURWRFRO$FHQWUDOPRQLWRUZLWKDQ25*$25*$RU25*$

PXOWLSOHSDWLHQWUHFHLYHUZKRVHVRIWZDUHYHUVLRQRUODWHUFDQUHFHLYHWKLVSURWRFRO

2OGSURWRFRO$FHQWUDOPRQLWRUZLWK25*$25*$RU25*$PXOWLSOH

SDWLHQWUHFHLYHUFDQUHFHLYHWKLVSURWRFRO

NOTE: When 57 is set, the receiving monitor must be able to receive protocol 57.

Otherwise, signals from the transmitter cannot be received.

Differences Between Protocols

Function Protocol 42 Protocol 57

6HWWLQJ(&*0($685(0(17WR2))RQWKH

WUDQVPLWWHUDXWRPDWLFDOO\WXUQVRIIWKH(&*

PHDVXUHPHQWVHWWLQJRQWKHUHFHLYLQJPRQLWRU

1R(&*PHDVXUHPHQW

PXVWEHWXUQHGRIIRQ

WKHUHFHLYLQJPRQLWRU

<HV

3DXVHPRQLWRULQJRQWKHUHFHLYLQJPRQLWRUIURP

the transmitter No <HV

7UDQVPLW³3$7,(17&21),50('´PHVVDJH No <HV

'LVSOD\EDWWHU\OHYHORIWKHWUDQVPLWWHURQWKH

UHFHLYLQJPRQLWRU No <HV

7UDQVPLW6S22PHVVDJHV 6RPHPHVVDJHVUHIHU

WRWKH³,QGLFDWLRQDQG

0HVVDJH/LVW´VHFWLRQ

$OOPHVVDJHV

1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR

³35272&2/´

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFW³´RU³´

Setting

Cursor

ZM-540PA, ZM-541PA Operator’s Manual

NOTE: FUNCTION KEY (on the second page

of the SYSTEM SETUP screen) can be

set to “SUSPEND ALARM & PAUSE”

or “CONFIRM” only when PROTOCOL

is “57”. If PROTOCOL is changed to

“42”, FUNCTION KEY is automatically

changed to “OFF”.

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG

VHWWLQJ7KHFXUVRUUHWXUQVWR³35272&2/´

BRIGHTNESS

6HOHFWWKHVFUHHQEULJKWQHVV

1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³%5,*+71(66´

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFW³'$5.´RU³%5,*+7´

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR

³%5,*+71(66´

PRESSURE UNIT

6HOHFWWKHXQLWIRU1,%3

1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³35(6685(81,7´

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFW³PP+J´RU³N3D´

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR

³35(6685(81,7´

ZM-540PA, ZM-541PA Operator’s Manual

FUNCTION KEY

6HOHFWWKHIXQFWLRQRIWKH)XQFWLRQNH\)RUGHWDLOVRQXVLQJWKHVHIXQFWLRQVUHIHUWR³%DVLF

0RQLWRULQJ2SHUDWLRQ´LQWKH³0RQLWRULQJ´VHFWLRQ

6863(1'$/$503$86( 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV

3DXVHVPRQLWRULQJRQWKHWUDQVPLWWHUDQGUHFHLYLQJPRQLWRU

6863(1'$/$50 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV

&21),50 'LVSOD\VWKH³3$7,(17&21),50('´PHVVDJHRQWKH

WUDQVPLWWHUVFUHHQDQGWUDQVPLWVWKHPHVVDJHWRWKHUHFHLYLQJ

PRQLWRU

2)) 1RIXQFWLRQ

NOTE: “SUSPEND ALARM & PAUSE” and “CONFIRM” can only be set when

PROTOCOL is set to 57.

1 2QWKH6<67(06(783VFUHHQSUHVVWKHŹ

NH\WRPRYHWKHFXUVRUWR³)81&7,21.(<´

³)81&7,21.(<´LVRQWKHVHFRQGSDJHRIWKH

6<67(06(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWWKHIXQFWLRQ

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG

VHWWLQJ7KHFXUVRUUHWXUQVWR³)81&7,21

.(<´

AUTO RESUME AFTER PAUSE

6HOHFWWKHLQWHUYDOWRUHVXPHPRQLWRULQJDIWHU3$86(:KHQHLWKHURIWKHIROORZLQJFRQGLWLRQV

LVPHWPRQLWRULQJUHVXPHVRQWKHUHFHLYLQJPRQLWRU

• +HDUWUDWHLVSURSHUO\PRQLWRUHGIRUWKHVHOHFWHGLQWHUYDO

• 6 S 2 2LVSURSHUO\PRQLWRUHGIRUWKHVHOHFWHGLQWHUYDO

• 1,%3LVSURSHUO\PHDVXUHGDQGWKH6<6',$RU0$3YDOXHLVGLVSOD\HG

1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³$8725(680($)7(53$86(´³$872

5(680($)7(53$86(´LVRQWKHVHFRQGSDJHRIWKH6<67(06(783VFUHHQ

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŹNH\WRVHOHFWWKHLQWHUYDO

4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³$872

5(680($)7(53$86(´

SYSTEM SETUP screen - page 2

ZM-540PA, ZM-541PA Operator’s Manual

SELECTABLE SCREEN TIME OUT PERIOD (min)

6HOHFWWKHGLVSOD\WLPHRXWSHULRG,IQRNH\LVSUHVVHGIRUWKHVHOHFWHGWLPHWKHGLVSOD\LV

DXWRPDWLFDOO\WXUQHGRII7KHVHOHFWHGWLPHLVVKRZQRQWKH6HOHFW6FUHHQ7LPH2XW3HULRG

VFUHHQ5HIHUWRWKH³7XUQLQJWKH'LVSOD\2II´VHFWLRQIRUGHWDLOV

1 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

2 3UHVVWKH)XQFWLRQNH\

3 3UHVVWKHŻRUŹNH\WRVHOHFWWLPHRXWSHULRG

4 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´

SYSTEM SETUP screen - page 2

ZM-540PA, ZM-541PA Operator’s Manual

Initializing Settings

'RWKHIROORZLQJSURFHGXUHWRLQLWLDOL]HDOOVHWWLQJVH[FHSWIRUFKDQQHOWRWKHIDFWRU\GHIDXOW

VHWWLQJV

1 7XUQRIIWKHWUDQVPLWWHUE\UHPRYLQJDEDWWHU\

2 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKH

WUDQVPLWWHUE\LQVHUWLQJWKHEDWWHU\7KH0(18

VFUHHQDSSHDUV

3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR

³6<67(0,1,7,$/,=(´

4 3UHVVWKH)XQFWLRQNH\WRHQWHUWKH6<67(0

,1,7,$/,=(VFUHHQ

5 3UHVVWKH)XQFWLRQNH\$FRQ¿UPDWLRQPHVVDJH

DSSHDUV

7RUHWXUQWRWKH0(18VFUHHQZLWKRXW

LQLWLDOL]LQJSUHVVWKH6FUHHQNH\

6 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

ZM-540PA, ZM-541PA Operator’s Manual

Attaching Electrodes, SpO2 Probe and NIBP

Cuff to the Patient

7KHWUDQVPLWWHUFDQEHDWWDFKHGWRDQDUPRIWKHSDWLHQWRUSODFHGRQWKHEHGVLGH7KHUHTXLUHG

OHQJWKRIWKHHOHFWURGHOHDGVDQG6S22SUREHFDEOHGHSHQGVRQKRZWKHWUDQVPLWWHULVWREH

DWWDFKHGWRWKHSDWLHQW

NOTE: Monitoring SpO2 during NIBP Measurement

When the SpO2 probe is attached to the same limb as the NIBP cuff, the

EORRGÀRZGHFUHDVHVGXULQJ1,%3PHDVXUHPHQWDQGSXOVHZDYHFDQQRW

be detected and SpO2 cannot be monitored properly. When “INHIBIT SpO2

DURING NIBP” on the PARAMETER SETUP screen is set to ON (factory

default setting), SpO2 monitoring is paused during NIBP measurement to

avoid SpO2 alarm occurrence. However, when monitoring SpO2 on the same

limb as NIBP, be careful when reading SpO2 values.

When monitoring SpO2 is important, attach the probe to the limb to which the

NIBP cuff or catheter is not attached.

Attachment Examples

When transmitter is attached on an arm When transmitter is placed on a bed

NOTE: When placing the transmitter on a

bedside, place it on a stable and

ÀDWSODFH,IWKHWUDQVPLWWHUIDOOV

off, it may be damaged.

ZM-540PA, ZM-541PA Operator’s Manual

Selecting Electrode Leads and Disposable Electrodes

Only use Nihon Kohden specified electrodes and

electrode leads. When other type of electrodes or

electrode leads are used, the “CHECK

ELECTRODES” message may be displayed and

ECG monitoring may stop.

CAUTION

7KHIROORZLQJRSWLRQDOHOHFURGHVDQGHOHFWURGHOHDGVFDQEHXVHGZLWKWKHWUDQVPLWWHU

Disposable Electrode Electrode Lead Note

Vitrode

7KHH[DPSOHLV9LWURGH&

%53$

7KUHHHOHFWURGHV

&OLSW\SH

%53$

7KUHHHOHFWURGHV

&OLSW\SH

%53$

6L[HOHFWURGHV

&OLSW\SH

%53$

6L[HOHFWURGHV

Snap type

5HIHUWRWKH³2SWLRQV´VHFWLRQZKHQRUGHULQJWKHGLVSRVDEOHHOHFWURGHVDQGHOHFWURGHOHDGV

ZM-540PA, ZM-541PA Operator’s Manual

Connecting the Electrode Lead to the Transmitter

&RQQHFWWKHHOHFWURGHOHDGWRWKH(&*5(63VRFNHWRQWKHWUDQVPLWWHU

NOTE: Hold the sides of the transmitter when connecting or disconnecting the

electrode lead. Pressing the display while holding the transmitter may

damage the transmitter.

When transmitter is

attached on an arm

Do not shake or swing the transmitter while holding

the leads or cables connected to the transmitter.

The transmitter may come off and injure someone

or damage surrounding instruments.

CAUTION

Hold the connector of the electrode lead when

connecting/disconnecting the electrode lead. If you

disconnect the electrode lead by pulling the lead, it

damages the electrode lead.

CAUTION

Electrode Position

)ROORZWKHSK\VLFLDQ¶VLQVWUXFWLRQVIRUHOHFWURGHSODFHPHQWZKHQDYDLODEOH

)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

NOTE: The optimum electrode positions for ECG measurement are not always

optimum for respiration measurement. Select positions that are suitable for

both ECG and respiration measurement or positions which give priority to

either ECG or respiration measurement.

ZM-540PA, ZM-541PA Operator’s Manual

Electrode Positions for ECG Monitoring

Six Electrodes

7KH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IRUP\RFDUGLDOLVFKHPLFPRQLWRULQJ

RA/R LA/L

RL/RF LL/F

Va/Ca

Vb/Cb

Electrode Position Symbol Lead Color

AHA IEC AHA IEC

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5LJKWLQIUDFODYLFXODUIRVVD 5$ 5 :KLWH 5HG

%HORZORZHVWULERQWKHOHIWDQWHULRUD[LOODU\OLQH // F5HG *UHHQ

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)LIWKLQWHUFRVWDOVSDFHRQWKHOHIWPLGFODYLFXODUOLQH

9SRVLWLRQRIVWDQGDUGOHDGV Va &D %URZQ

blue :KLWH

EURZQ

/HIWDQWHULRUD[LOODU\OLQHDWWKHVDPHOHYHODV9D9

SRVLWLRQRIVWDQGDUGOHDGV Vb &E %URZQ

RUDQJH

:KLWH

EODFN

ZM-540PA, ZM-541PA Operator’s Manual

/HDG3RVLWLRQ

Standard limb leads

Monopolar limb leads

Monopolar chest leads

ead

Lead I Lead II Lead III

aVR lead aVL lead aVF lead

V1 to V

leads

V1 to V6 leads

RA RA RA

LALA

LL LL

N (RL)

N (RL) N (RL) N (RL)

N (RL)

Three Electrodes

• /HDG0,,ZKLFKLVVLPLODUWRVWDQGDUGOHDG,,XVHGZKHQ(&*PHDVXUHPHQWKDVSULRULW\

Electrode Position Symbol Lead Color

AHA IEC AHA IEC

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OHIWDQWHULRUD[LOODU\OLQH // F5HG *UHHQ

L/LA

(N)

R/RA

(−)

F/LL

(+)

ZM-540PA, ZM-541PA Operator’s Manual

• /HDG0,ZKLFKLVVLPLODUWRVWDQGDUG

OHDG,

• &KDQJH)//DQG//$RIOHDG0,,

R/RA

(−)

L/LA

(N)

F/LL

(+)

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• &KDQJH55$DQG//$RIOHDG0,,

L/LA

(N)

R/RA

(−)

F/LL

(+)

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Electrode Positions for Respiration Monitoring

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R or RA F or LL

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R/RA

(−)

F/LL

(+)

R/RA

(−)

F/LL

(+)

ZM-540PA, ZM-541PA Operator’s Manual

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R or RA F or LL

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R or RA F or LL

/RZHVWULERQWKHULJKW

DQWHULRUD[LOODU\OLQH

/RZHVWULERQWKHOHIWDQWHULRU

D[LOODU\OLQH

Attaching Electrodes to the Patient and Connecting the Electrode Leads

to Disposable Electrodes

Prepare the Patient Skin

6KDYHRIIH[FHVVLYHERG\KDLU

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.

• 'RQRWSODFHHOHFWURGHVRQDZRXQGRURQDQLQÀDPHGZULQNOHGRUXQHYHQ

skin surface.

Attaching Electrodes to the Patient

Do not reuse disposable parts and accessories.

CAUTION

R/RA

(−)

F/LL

(+)

R/RA

(−)

F/LL

(+)

ZM-540PA, ZM-541PA Operator’s Manual

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 cannot be obtained.

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1 &DUHIXOO\UHPRYHWKHEDFNLQJSDSHUIURPWKH

HOHFWURGH$YRLGWRXFKLQJWKHDGKHVLYHVXUIDFH

2 3ODFHWKHHOHFWURGHRQWKHSUHYLRXVO\FOHDQHGVNLQ

3D\DWWHQWLRQWRWKHHOHFWURGHOHDGFRORUDQGV\PERO

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4 )DVWHQWKHHOHFWURGHOHDGZLUHZLWKVXUJLFDOWDSH

ZLWKDQH[WUDOHQJWKRIZLUHEHWZHHQWKHWDSH

DQGWKHHOHFWURGH7KLVOHVVHQVWKHPRYHPHQWRI

HOHFWURGHOHDGVE\ERG\PRYHPHQWDQGKHOSVVWDEOH

PRQLWRULQJ

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

GHWDLOVRQWKHVFUHHQUHIHUWRWKH³6FUHHQ'HVFULSWLRQV´VHFWLRQ

ZM-540PA, ZM-541PA Operator’s Manual

Attaching the SpO2 Probe

Selecting the SpO2 Probe

6HOHFWDQDSSURSULDWHSUREHIRUWKHSDWLHQW

Only use Nihon Kohden specified electrodes,

electrode leads and SpO2 probes. Otherwise, the

maximum performance from the transmitter cannot

be guaranteed.

CAUTION

Do not use a damaged or disassembled probe. It

causes incorrect measurement and may injure the

patient.

CAUTION

Reusable 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 P

Adult or child

NJRUPRUH

)LQJHU

P

)LQJHUSUREH

7/77/7

Attachment

tape

7/7

P

Adult or child

NJRUPRUH

7/7

P

ZM-540PA, ZM-541PA Operator’s Manual

Probe Cable Length Patient Attachment

Site

)LQJHUSUREH

7/77/7

Attachment

tape

7/7

P

Adult or child

NJRUPRUH )LQJHURUWRH

7/7

P

0XOWLVLWHSUREH7/7

Attachment

tape

P

$GXOWRULQIDQW

NJRUPRUH )LQJHURUWRH

Neonate

NJRUOHVV ,QVWHSDQGVROH

Disposable Probes

The disposable probe is not sterilized. Use the

disposable probe only for a single patient. Never

reuse the disposable probe for another patient

because it causes cross infection.

CAUTION

Probe Patient Attachment Site

6S22SUREH7/67/6

Attachment tape

40 mm

&DEOHOHQJWK 7/6 P

 7/6 P

Adult

NJRUPRUH )LQJHU

Neonate

NJRUOHVV ,QVWHSDQGVROH

ZM-540PA, ZM-541PA Operator’s Manual

Probe Patient Attachment Site

6S22SUREH7/67/6

35 mm

Attachment tape

&DEOHOHQJWK 7/6 P

 7/6 P

Adult or child

WRNJ )LQJHU

,QIDQW

WRNJ 7RH

6S22SUREH7/77/7

&DEOHOHQJWK 7/7 P

 7/7P

Adult

NJRUPRUH )LQJHURUWRH

6S22SUREH7/77/7

&DEOHOHQJWK 7/7 P

 7/7P

&KLOG

WRNJ )LQJHURUWRH

6S22SUREH7/77/7

&DEOHOHQJWK 7/7 P

 7/7P

Neonate

NJRUOHVV ,QVWHSDQGVROH

Adult

NJRUPRUH )LQJHURUWRH

6S22SUREH7/77/7

&DEOHOHQJWK 7/7 P

 7/7P

,QIDQW

WRNJ )LQJHURUWRH

ZM-540PA, ZM-541PA Operator’s Manual

Connecting the SpO2 Probe to the Transmitter

&RQQHFWWKHSUREHWRWKH6S22VRFNHWRQWKHWUDQVPLWWHU

NOTE: Hold the connector of the probe cable when connecting or disconnecting the

probe. Pulling the cable may damage the probe.

When transmitter is attached on an arm

Do not shake or swing the transmitter while holding

the leads or cables connected to the transmitter.

The transmitter may come off and injure someone

or damage surrounding instruments.

CAUTION

Do not use a damaged or disassembled probe. It

causes incorrect measurement and may injure the

patient.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Attaching the Probe to the Patient

$WWDFKWKHSUREHWRWKHSDWLHQWE\UHIHUULQJWRWKHSUREH¶VPDQXDO0DNHVXUHWKDWWKHOLJKW

HPLWWHUDQGSKRWRGHWHFWRURIWKHSUREHIDFHHDFKRWKHUDWWKHDWWDFKPHQWVLWH

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.

WARNING

Check the circulation condition by observing the

skin color at the measurement site and pulse

waveform. Change the measurement site every 8

hours for disposable probes and every 4 hours for

reusable probes (every 8 hours for TL-631T series

probe). The skin temperature may increase at the

attached site by 2 or 3°C (4 or 5°F) and cause a

burn or pressure necrosis. When using the probe

on the following patients, take extreme care and

change the measurement site more frequently

according to symptoms and degree.

• Patient with a fever

• Patient with insufficient peripheral circulation

• Neonate or low birth weight infant with delicate

skin

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When monitoring SpO2 of a patient who is

receiving photodynamic therapy, the light from the

finger probe sensor may cause a burn.

Photodynamic therapy uses a photosensitizing

agent that has a side effect of photosensitivity.

7KH6S22SUREHVPDQXIDFWXUHGE\1LKRQ.RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKH

UDQJHRIDQGQP7KHPD[LPXPOLJKWLQWHQVLW\LVOHVVWKDQP:

If the attachment site is dirty with blood or bodily

fluids, clean the attachment site before attaching

the probe. If there is nail polish on the attachment

site, remove the polish. Otherwise, the amount of

transmitted light decreases, and measured value

may be incorrect or measurement cannot be

performed.

CAUTION

When the probe is attached on an appropriate site

with sufficient thickness and the error message

confirming the probe attachment repeatedly

appears, the probe may be deteriorated. Replace it

with a new one.

CAUTION

If the skin gets irritated or redness appears on the

skin from the probe, change the attachment site or

stop using the probe. Take extreme care for the

patients with delicate skin.

CAUTION

Do not use a probe which is deteriorated by aging.

Accurate measurement cannot be performed.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Attaching the NIBP Cuff

Selecting the NIBP Cuff

6HOHFWWKH1,%3FXIIDSSURSULDWHIRUWKHSDWLHQW

NOTE: NIBP cannot be measured on neonates using this transmitter.

Reusable Cuffs

:KHQDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPDVSHFLDO1,%3FXIILVUHTXLUHG$QRSWLRQDO

<13H[WHQVLRQKRVHPLVDYDLODEOHWRH[WHQGWKHOHQJWKEHWZHHQWKH1,%3VRFNHWRQ

WKHWUDQVPLWWHUDQG1,%3FXIIHJZKHQQRWDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPDQG

SODFLQJWKHWUDQVPLWWHURQDEHGVLGH

Reusable Cuff Model Width (cm) Air Hose Length (cm)

For adult Standard <33 



/DUJH <33 

Width

Air hose

ZM-540PA, ZM-541PA Operator’s Manual

:KHQQRWDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPWKHIROORZLQJFXIIVFDQEHXVHG7RXVH

WKHVHFXIIVDQRSWLRQDO<13H[WHQVLRQKRVHPLVUHTXLUHG

Reusable Cuff Model Width (cm) Air Hose Length (cm)

)RULQIDQW <37 



For child

Small <37 

Standard <37 

<37

For adult Standard <37 

<37

/DUJH <37 

Width

Air hose

ZM-540PA, ZM-541PA Operator’s Manual

Disposable Cuffs

Disposable cuffs are not sterilized. If necessary,

sterilize the cuff using glutaraldehyde solution.

CAUTION

Disposable Cuff Model Width (cm) Air Hose Length (cm)

)RULQIDQW <33 6



For child <33 8

For adult

Small <33 

Standard <33 

0HGLXP

ODUJH <33 

/DUJH <33 

([WUDODUJH <33 

Width

Air hose

Extension Hose

When using an extension hose, check that the

extension hose is not bent or squeezed.

Otherwise, the cuff might not inflate or deflate. If

the cuff cannot deflate, it may cause congestion on

the patient at the cuff attachment site.

CAUTION

YN-990P extension hose, 150 cm

ZM-540PA, ZM-541PA Operator’s Manual

Reference for selecting a cuff

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NOTE • If a range of arm circumference appropriate for the cuff is prescribed, use a

cuff within that range.

• To obtain accurate measured values, select a wide cuff which can be

attached to the upper arm. Measuring with a very narrow cuff may result in

measured values higher than the actual values.

• The YP-503P NIBP cuff is for standard size adult. Do not use this cuff when

LWGRHVQRW¿WWKHSDWLHQW

10 20 30 40 50

10 20 30 40 50 60

Cuff width (cm)

Arm circumference (cm)

Infants YP-960T

Children small YP-961T

Children standard YP-962T

YP-702T

Adults standard YP-503P (cuff for transmitter)

YP-963T, YP-703T

Adults large YP-504P (cuff for transmitter)

YP-964T

Cuff Width and Arm Circumference

Reusable Cuffs

Cuff width (cm)

Arm circumference (cm)

Children standard YP-811P

Adults large YP-815P

Disposable Cuffs

Infants YP-810P

Adults small YP-812P

Adults standard YP-813P

Adults medium large YP-814P

Adults extra large YP-816P

ZM-540PA, ZM-541PA Operator’s Manual

Connecting the NIBP Cuff to the Transmitter

When Using YP-503P/YP-504P NIBP Cuff

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YP-503P/YP-504P NIBP cuff

Front cover Air hose

D ring

Belt

Belt for the strap

Lock plate pocket Front cover open

Lock plate

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NOTE: Do not roll up or put weight on the cuff when

the lock plate is attached to it. The lock plate

may break if the cuff is rolled up or weight is

put on it when the lock plate attached.

Top tab

Bottom tab

ZM-540PA, ZM-541PA Operator’s Manual

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ZM-540PA, ZM-541PA Operator’s Manual

When Using YP-810P series Disposable Cuffs or YP-702T/703T or YP-960T series

Reusable Cuffs

To use these NIBP cuffs, an optional YN-990P extension hose (1.5 m) is required.

NOTE: Connect the joints properly. If there is an air leak, NIBP cannot be measured

properly.

1 Connect the NIBP cuff to the extension hose.

2 Connect the other end of the extension hose to

the NIBP socket on the transmitter. Turn the joint

clockwise until it clicks.

To disconnect the cuff from the transmitter, turn the

hose joint counterclockwise.

Attaching the NIBP Cuff to the Patient

WARNING

Be careful when measuring NIBP on a patient with

known bleeding disorders or coagulation. After

NIBP measurement, there may be dot

hemorrhage, or circulatory disorder by thrombus

where the cuff is attached.

Do not wrap the cuff on an arm or thigh which is

used for injection. NIBP measurement on an arm

or thigh which is used for injection may cause

reflux of blood and stop injection.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

Do not attach the cuff to the site where there is

injury or inflammation. If the skin gets irritated or

redness appears on the skin from the cuff, change

the attachment site or stop using the cuff. Take

extreme care on the patients with delicate skin.

CAUTION

Do not wrap the cuff too tight. It may cause poor

blood circulation and congestion. If the cuff is

wrapped too loosely, the NIBP value may increase.

CAUTION

Do not reuse disposable parts and accessories.

CAUTION

NIBP and SpO2 can be measured on the same

limb, but the SpO2 monitoring might not be

accurate during NIBP measurement. Be careful

when reading the SpO2 values.*

CAUTION

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ZM-540PA, ZM-541PA Operator’s Manual

NOTE • Measuring NIBP at a site other than the upper arm gives different values

from those measured at the upper arm. When making diagnosis based on

the NIBP values, measure NIBP on an upper arm.

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wrapped around a bare upper arm.

• Do not use an abnormal cuff. The cuff deteriorates from use and cleaning.

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it with a new one.

• Refer to the NIBP cuff manual for details.

Cuff Position

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When placing the transmitter on

a bed, make sure that the hose is

not bent.

Heart

ZM-540PA, ZM-541PA Operator’s Manual

Attaching the Transmitter on an Arm (Using the YP-503P/YP-504P NIBP Cuff)

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NOTE: The cuff must not wrap around the

elbow.

Belt

D ring End of cuff

ZM-540PA, ZM-541PA Operator’s Manual

Attaching the Strap to the Transmitter

NOTE • Use the strap to prevent the transmitter from falling.

• Do not attach the clip to hard objects such as thick cloth or zipper. It will

break the clip.

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Belt for the strap on the NIBP cuff

ZM-540PA, ZM-541PA Operator’s Manual

Placing the Transmitter on the Bed (Using the YP-810P series Disposable Cuffs or

YP-702T/703T or YP-960T series Reusable Cuffs)

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ZM-540PA, ZM-541PA Operator’s Manual

Locking the Keys on the Transmitter

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ZM-540PA, ZM-541PA Operator’s Manual

Monitoring

The measurement values and displayed

waveforms on the transmitter and receiving

monitor may be different due to timing delay of the

display or difference in detection settings.

CAUTION

NOTE • The waveforms displayed on the check electrodes screen are just to check

that the electrode or probe is attached to the patient properly. Do not use

the displayed waveforms for other purposes.

• Do not let the transmitter directly touch the patient’s skin. The transmitter

temperature rises and this may cause burn to the patient.

Screen Descriptions

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GLVSOD\RIIĺFKHFNHOHFWURGHV

Screen key

ZM-540PA, ZM-541PA Operator’s Manual

Check Electrodes Screen

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Channel number

Battery level

ECG waveform

Filter: Off

Sweep speed: 12.5 mm/s

Waveform sensitivity: 0.5 cm/1 mV

Lead

Detached electrode

position

Message

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electrode position appear

RQWKHVFUHHQ

NOTE: When ECG measurement is set to OFF on the PARAMETER SETUP screen,

the check electrodes screen does not appear.

ZM-540PA, ZM-541PA Operator’s Manual

Numeric and Waveform Screen

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Heart rate

QRS sync mark

Pulse bar graph

SpO2

Respiration rate

NIBP values

ECG waveform

Filter: On

Sweep speed: 12.5 mm/s

Waveform sensitivity: Auto

Waveform

sensitivity

ECG lead

NIBP measurement

mode

When ECG and respiration measurement is turned off

Pulse rate

Pulse sync mark

SpO2

Pulse wave

sensitivity

Pulse waveform

Sweep speed: 12.5 mm/s

Waveform sensitivity: Auto

NIBP values

NIBP measurement

mode

ZM-540PA, ZM-541PA Operator’s Manual

NOTE: The pulse wave amplitude varies according to the ratio of the pulsation

component to the entire transmitted IR signal. When the pulsation component

ratio is 1%, the pulse wave amplitude is about 5 mm at ×1 sensitivity on the

screen.

Waveform Review Screen

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ECG lead

Displayed

page

Compressed ECG waveform

7.5 s × 4 traces per page, total 20 pages

Older data

Newer data

Time range of the displayed waveform

(time before the waveform review screen is displayed)

Waveform sensitivity

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ZM-540PA, ZM-541PA Operator’s Manual

Numeric Review Screen

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NOTE: NIBP measured values are not saved.

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ZM-540PA, ZM-541PA Operator’s Manual

Basic Monitoring Operation

Using the Function Key

Function key

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SETUP screen of the transmitter must be set to 57 and the receiving monitor

must be able to receive protocol 57. A central monitor with an ORG-9100A

series multiple patient receiver whose software version 02-01 or later can

receive this protocol.

ZM-540PA, ZM-541PA Operator’s Manual

Suspending Alarms on the Receiving Monitor

WARNING

While the “ALARMS SUSPENDED” message is

displayed on the transmitter, all alarms on the

receiving monitor are suspended so keep the

patient under close observation.

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ZM-540PA, ZM-541PA Operator’s Manual

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Pausing Monitoring

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NOTE: To use the Function key for pause, “PROTOCOL” on the SYSTEM screen of

the transmitter must be set to 57 and the receiving monitor must be able to

receive protocol 57.

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ZM-540PA, ZM-541PA Operator’s Manual

7RSDXVHPRQLWRULQJ

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ZM-540PA, ZM-541PA Operator’s Manual

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Resuming Monitoring after Pause

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WARNING

When the patient returns to the bed, turn on the

transmitter and check that the monitoring is

resumed on the receiving monitor.

WARNING

If 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.

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ZM-540PA, ZM-541PA Operator’s Manual

Turning the Display Off

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ZM-540PA, ZM-541PA Operator’s Manual

Turning the Display On after It was Turned Off

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ECG and Respiration Monitoring

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Heart rate

QRS sync mark Respiration rate

ECG lead

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ECG waveform Filter: On

Sweep speed: 12.5 mm/s

Waveform sensitivity: Auto

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ZM-540PA, ZM-541PA Operator’s Manual

WARNING

The bioelectric impedance measurement sensor of

a minute ventilation rate-adaptive implantable

pacemaker may be affected by transmitter which is

connected to the same patient. If this occurs, the

pacemaker may pace at its maximum rate and the

transmitter may give incorrect data to the monitor.

If this occurs, disconnect the electrode leads from

the patient or change the setting on the pacemaker

by referring to the pacemaker’s manual. For more

details, contact your pacemaker representative or

Nihon Kohden representative.

WARNING

Turn the pacing pulse detection to ON on the

receiving monitor when monitoring a pacemaker

patient. Otherwise the pacemaker pulse is not

rejected. However, even when the pacing pulse

detection is set to ON, the pacemaker pulse might

not be rejected. When the pacemaker pulse is not

rejected, the pacemaker pulse is detected as QRS

and false heart rate may be indicated or critical

arrhythmia such as asystole may be overlooked.

Keep pacemaker patients under close observation.

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WARNING

Even when the pacing pulse detection is set to ON

on the receiving monitor, the pacemaker pulse can

be overlooked or detected as QRS. You cannot

confirm the pacemaker operation only from the

detected pacemaker pulse.

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When the transmitter is used with an

electrosurgical unit (ESU), firmly attach the entire

area of the ESU return plate. Otherwise, the

current from the ESU flows into the electrodes of

the transmitter, causing electrical burn where the

electrodes are attached. For details, refer to the

ESU manual.

Turn off the power of mobile phones, small

wireless devices and other devices which produce

strong electromagnetic interference around a

patient (except for devices allowed by the hospital

administrator). Radio waves from devices such as

mobile phones or small wireless devices may be

mistaken as pulse waves or respiration waves and

the displayed data may be incorrect.

CAUTION

When the “NOISE” message is displayed on the

receiving monitor, ECG is not monitored and the

ECG alarm does not function. Remove the cause

by checking the electrodes, electrode leads,

patient’s body movement, EMG and peripheral

instruments grounding. Also make sure that an

electric blanket is not used.

CAUTION

NOTE • Noise generated from an electrosurgical unit may interfere on an ECG

waveform, but will not damage it.

• 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.

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the waveform recovery may be slow.

• ECG cannot be monitored on a neonate using this transmitter.

ZM-540PA, ZM-541PA Operator’s Manual

Turning ECG Measurement On/Off

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When “PROTOCOL” on the SYSTEM screen is set to 57:

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When “PROTOCOL” on the SYSTEM screen is set to 42:

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Turning Respiration Measurement On/Off

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Electrode Detachment

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When 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.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

SpO2 Monitoring

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Pulse bar graphSpO2

NOTE: During SpO2 monitoring, the transmitter constantly checks the light intensity

of the probe and adjusts the light intensity to maintain optimum measurement

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seconds.

ZM-540PA, ZM-541PA Operator’s Manual

Measuring Principle

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300 400 500 600 700 800 900 1,000

200

100

0.1

0.05

Extinction Coefficient (cm)-1 (mmol/L)-1

Wavelength (nm: 10-9m)

Oxyhemoglobin

Deoxyhemoglobin

SpO2

660 nm

940 nm

0% 100%

Light Absorption

Time

Tissue, venous blood

Arterial blood

Fig. 1

Fig. 3

Fig. 2

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

SpO2 measurement may be incorrect in the

following cases.

• When the patient’s carboxyhemoglobin or

methemoglobin increases abnormally.

• When dye is injected in the blood.

• During CPR.

• When measuring at a site with venous pulse.

• When there is body movement.

• When the pulse wave is small (insufficient

peripheral circulation).

WARNING

Check the circulation condition by observing the

skin color at the measurement site and pulse

waveform. Change the measurement site every 8

hours for disposable probes and every 4 hours for

reusable probes (every 8 hours for TL-631T series

probe). The skin temperature may increase at the

attached site by 2 or 3°C (4 or 5°F) and cause a

burn or pressure necrosis. When using the probe

on the following patients, take extreme care and

change the measurement site more frequently

according to symptoms and degree.

• Patient with a fever

• Patient with insufficient peripheral circulation

• Neonate or low birth weight infant with delicate

skin

WARNING

When monitoring SpO2 of a patient who is

receiving photodynamic therapy, the light from the

finger probe sensor may cause a burn.

Photodynamic therapy uses a photosensitizing

agent that has a side effect of photosensitivity.

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ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When not monitoring SpO2, disconnect the SpO2

cable from the transmitter. Otherwise, noise from

the probe sensor may interfere and incorrect data

is displayed on the screen.

Turn off the power of mobile phones, small

wireless devices and other devices which produce

strong electromagnetic interference around a

patient (except for devices allowed by the hospital

administrator). Radio waves from devices such as

mobile phones or small wireless devices may be

mistaken as pulse waves or respiration waves and

the displayed data may be incorrect.

CAUTION

Handle the probe cable according to the following

cautions. Failure to follow these cautions may

cause cable discontinuity or short circuit of the

probe cable which may cause incorrect

measurement data or inability to perform

measurement. Also in rare cases, the probe

temperature may increase and cause skin burn on

the patient. If the probe cable is damaged, replace

the probe with a new one.

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CAUTION

Normal external light does not affect monitoring but

strong light such as a surgical light or sunlight may

affect monitoring. If affected, cover the measuring

site with a blanket.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

When the probe is attached on an appropriate site

with sufficient thickness and the error message

confirming the probe attachment repeatedly

appears, the probe may be deteriorated. Replace it

with a new one.

CAUTION

When a message indicates a faulty probe, stop

monitoring and replace the probe with a new one.

CAUTION

While a patient is on medication which causes

vasodilation, the pulse waveform may change and

in rare cases the SpO2 value might not be

displayed.

CAUTION

When 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.

CAUTION

When 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.

CAUTION

ZM-540PA, ZM-541PA Operator’s Manual

NOTE  ,QRUGHUWRPDLQWDLQVXI¿FLHQWEORRGFLUFXODWLRQNHHSWKHPHDVXUHPHQWVLWH

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”.

• Unlike ECG monitoring, detection of arrhythmia and asystole is not

available when monitoring SpO2 only. If SpO2 is monitored without ECG,

PR and SpO2 alarms do not occur during asystole because PR and SpO2

values are not measured when there is no pulse. 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.

Monitoring SpO2 during NIBP Measurement

NIBP and SpO2 can be measured on the same

limb, but the SpO2 monitoring might not be

accurate during NIBP measurement. Be careful

when reading the SpO2 values.*

CAUTION

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NOTE • When continuous SpO2 monitoring is necessary, attach the probe to the

limb to which the NIBP cuff is not attached and set “INHIBIT SpO2 DURING

NIBP” on the PARAMETER SETUP screen to OFF.

• When the probe is attached to the same limb as the NIBP cuff, set the sync

source to a parameter other than SpO2 on the receiving monitor.

• When monitoring SpO2 during STAT NIBP measurement, attach the probe

to the limb to which the NIBP cuff is not attached.

ZM-540PA, ZM-541PA Operator’s Manual

NIBP Monitoring

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Selecting the Measurement Mode and Interval

Measurement Modes

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Selected mode

(key color: blue)

Modes selected

at “SELECTABLE

INTERVALS” on the

PARAMETERS SETUP

screen

(key color: white)

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ZM-540PA, ZM-541PA Operator’s Manual

Manual Measurement

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3$5$0(7(56(783VFUHHQ

Auto Measurement

,Q$XWRPRGHPHDVXUHPHQWLVSHUIRUPHGDXWRPDWLFDOO\DWWKHSUHVHWWLPHLQWHUYDOV

,Q$XWRPRGHDVLQJOHPHDVXUHPHQWFDQEHSHUIRUPHGE\SUHVVLQJWKH1,%36WDUW6WRSNH\

EHWZHHQDXWRPHDVXUHPHQWV

101

ZM-540PA, ZM-541PA Operator’s Manual

Measuring NIBP

WARNING

Be careful when measuring NIBP on a patient with

known bleeding disorders or coagulation. After

NIBP measurement, there may be dot

hemorrhage, or circulatory disorder by thrombus

where the cuff is attached.

WARNING

NIBP measurement may be incorrect in the

following situations.

• When using an ESU

• Body movement

• Small pulse wave

• Too many arrhythmias

• Shaking from an external source

• Rapid blood pressure change

• During CPR

• Slow pulse

• Low blood pressure

• Small pulse pressure

• Cuff is too tight or too loose

• Cuff does not fit the arm

• Cuff is wrapped over thick clothing

• Cuff is deteriorated

• Arterial sclerosis

• Poor perfusion

• Diabetes

• Age

• Pregnancy

• Pre-eclampsia

• Renal disease

• Shivering

• Trembling

102

ZM-540PA, ZM-541PA Operator’s Manual

WARNING

When performing NIBP measurements in STAT

mode or 5 minute intervals, periodically remove the

cuff from the patient for ventilation. The skin

temperature may increase at the cuff attachment

site by 2 or 3°C (4 or 5°F). When measuring a

patient with a fever or peripheral circulation

insufficiency, it may cause a burn.

WARNING

When performing long term measurement at

intervals less than 5 minutes, perform

measurements while observing the state of the

patient, blood vessels and limb to ensure adequate

circulation. Congestion may occur at the

measurement site. When performing periodic

measurement for a long time, periodically check

the circulation condition.

When performing NIBP measurement repeatedly,

have a rest between measurements to recover

adequate circulation.

CAUTION

NOTE • When measuring patients who are conscious, help the patient to relax.

Measurement may not be accurate if the patient’s arm is tense or if the

patient talks.

• The data for measurement on a leg tends to be higher than measurement

on the arm. When making diagnosis based on the NIBP values, measure

NIBP on an upper arm.

• Do not apply pressure to the cuff or air hose. NIBP may not be measured

correctly because of noise or NIBP measurement may stop due to the

NIBP safety circuit.

• When the transmitter is attached to the patient arm and the NIBP

measurement is performed when moving, tell the patient to relax and keep

quiet. Otherwise, measurement may be stopped or remeasurement is

repeated due to body movement.

• If there is an abnormal noise generated during measurement, stop using

the transmitter and contact your Nihon Kohden representative.

103

ZM-540PA, ZM-541PA Operator’s Manual

• Do not measure NIBP of a patient on whom an IABP is being used.

Measurement may be incorrect due to the mixing of the patient’s own pulse

and IABP pulse.

• NIBP cannot be measured on a neonate using this transmitter.

For Accurate NIBP Measurement

• 0DNHVXUHWKHSDWLHQWLVFRPIRUWDEO\VHDWHG'RQRWSHUIRUPPHDVXUHPHQWLPPHGLDWHO\

DIWHUWKHSDWLHQWLVVHDWHG.HHSWKHSDWLHQWLQWKHUHVWLQJVWDWHIRU¿YHPLQXWHVEHIRUH

PHDVXUHPHQW

• 0DNHVXUHWKHSDWLHQWKDVOHJVXQFURVVHGIHHWGRZQRQWKHÀRRUDQGEDFNDQGEDFNDUP

VXSSRUWHGGXULQJPHDVXUHPHQW

1 3UHVVWKH1,%3,QWHUYDONH\WRGLVSOD\WKH1,%3PRGHVHWWLQJVFUHHQ

NIBP Interval key

2 6HOHFWWKHPHDVXUHPHQWPRGHE\SUHVVLQJWKH1,%3,QWHUYDONH\RUDQGNH\V

Selected mode

(key color: blue)

3 3UHVVWKH)XQFWLRQNH\

104

ZM-540PA, ZM-541PA Operator’s Manual

4 3UHVVWKH1,%36WDUW6WRSNH\WRSHUIRUPPHDVXUHPHQW

NIBP Start/Stop key

7KHFXIILVLQÀDWHGDQGWKHLQÀDWLRQSUHVVXUHLVGLVSOD\HGRQWKHVFUHHQ

,QÀDWLRQSUHVVXUH

,QPDQXDOPRGH 0HDVXUHPHQWLVSHUIRUPHGRQFH

,Q67$7PRGH 0HDVXUHPHQWLVSHUIRUPHGUHSHDWHGO\IRUPLQXWHV

,QDXWRPRGH 7KH¿UVWPHDVXUHPHQWLVSHUIRUPHGZKHQWKH1,%36WDUW6WRS

NH\LVSUHVVHG7KHVHFRQGPHDVXUHPHQWLVSHUIRUPHGZKHQWKH

FXUUHQWWLPHLQWKHWUDQVPLWWHUUHDFKHVWKHVHOHFWHGWLPHLQWHUYDO

7RVWRSPHDVXUHPHQWGXULQJPHDVXUHPHQWSUHVVWKH1,%36WDUW6WRSNH\DJDLQ

,Q67$7PRGHDIWHUFRPSOHWLQJWKH67$7PHDVXUHPHQWWKHPHDVXUHPHQWPRGH

FKDQJHVWRWKHPRGHVHWIRU³1,%302'($)7(567$7´RQWKH3$5$0(7(5

6(783VFUHHQ

,QDXWRPRGHWRVWRSPHDVXUHPHQWLQDXWRPRGHFKDQJHWKHPRGHWRPDQXDO7RFDQFHO

RQHPHDVXUHPHQWSUHVVWKH1,%36WDUW6WRSNH\GXULQJPHDVXUHPHQW

$IWHUWKHPHDVXUHPHQWLVFRPSOHWHWKHPHDVXUHGGDWDLVGLVSOD\HGRQWKHVFUHHQDQGLV

WUDQVPLWWHGWRWKHPRQLWRU

105

ZM-540PA, ZM-541PA Operator’s Manual

Systolic value Diastolic value

MAP value

NIBP measurement

mode

:KHQ(&*DQG6S22DUHQRWPRQLWRUHG(&*PHDVXUHPHQWLVWXUQHGRIIDQG6S22 probe is

QRWFRQQHFWHGWRWKHWUDQVPLWWHUWKHSXOVHUDWHDWWKHHQGRI1,%3PHDVXUHPHQWLVGLVSOD\HG

$EX]]HUFDQEHVHWWRVRXQGDWWKHVWDUWDQGHQGRI1,%3PHDVXUHPHQW5HIHUWRWKH

³&KDQJLQJ3$5$0(7(56(7836HWWLQJV´VHFWLRQ

Auto Mode Measurement

:KHQDXWRPRGHPHDVXUHPHQWLVVHOHFWHG³67$1'%<´PHVVDJHLVGLVSOD\HGRQWKHVFUHHQ

XQWLOWKH1,%36WDUWNH\LVSUHVVHGIRUWKH¿UVWWLPH

STANDBY message

106

ZM-540PA, ZM-541PA Operator’s Manual

$WLPHEDUDSSHDUVWRLQGLFDWHWKHLQWHUYDOEHWZHHQDXWRPRGHPHDVXUHPHQWV

Time bar indicating

the interval between

measurements

'XULQJDXWRPRGHPHDVXUHPHQWWKHPHDVXUHPHQWPRGHFDQEHFKDQJHG'XULQJWKHLQWHUYDO

SUHVVWKH1,%3,QWHUYDONH\WRFKDQJHWKHPRGH:KHQ³0$18$/´LVGLVSOD\HGIRUPRUH

WKDQRQHVHFRQGWKHPHDVXUHPHQWLQDXWRPRGHLVVWRSSHG

Data Display After NIBP Measurement

:KHQWKHWLPHVHWDW³2/'1,%3'$7$´RQWKH3$5$0(7(56(783VFUHHQHODSVHVDIWHU

WKHODVWPHDVXUHPHQWWKH1,%3GDWDLVGLPPHGRUKLGGHQ:KHWKHUWRGLPRUKLGHWKHROGGDWD

FDQDOVREHVHOHFWHGDW³2/'1,%3'$7$´5HIHUWRWKH³&KDQJLQJ3$5$0(7(56(783

6HWWLQJV´VHFWLRQ

Monitoring SpO2 during NIBP Measurement

:KHQWKH6S22SUREHLVDWWDFKHGWRWKHVDPHOLPEDVWKH1,%3FXIIWKHEORRGÀRZGHFUHDVHV

GXULQJ1,%3PHDVXUHPHQWDQGSXOVHZDYHFDQQRWEHGHWHFWHGDQG6S22 cannot be monitored

SURSHUO\:KHQ³,1+,%,76S22'85,1*1,%3´RQWKH3$5$0(7(56(783VFUHHQLVVHW

WR21IDFWRU\GHIDXOWVHWWLQJ6S22PRQLWRULQJLVSDXVHGGXULQJ1,%3PHDVXUHPHQWWRDYRLG

6S22DODUPRFFXUUHQFH+RZHYHUZKHQPRQLWRULQJ6S22RQWKHVDPHOLPEDVWKH1,%3EH

FDUHIXOZKHQUHDGLQJ6S22YDOXHV

107

ZM-540PA, ZM-541PA Operator’s Manual

Indication and Message List

Indication

Indication Cause Countermeasure

)XOO\FKDUJHGEDWWHULHV

—

%DWWHULHVDUHIXOO

%DWWHULHVDUHZHDN 5HSODFHWKHEDWWHULHV

%DWWHULHVDUHYHU\ZHDN

&DQQRWPHDVXUH1,%3

$ODUPVRQWKHUHFHLYLQJ

PRQLWRUZHUHVXVSHQGHG

E\SUHVVLQJWKH)XQFWLRQ

NH\RQWKHWUDQVPLWWHU

$ODUPVUHVXPHZKHQ

WKHVXVSHQGLQWHUYDO

HODSVHV7RFDQFHODODUP

suspension, press the

)XQFWLRQNH\DJDLQ

Messages

:KHQ³35272&2/´RQWKH6<67(0VFUHHQLVVHWWRDOOPHVVDJHVDUHWUDQVPLWWHGWR

WKHUHFHLYLQJPRQLWRU:KHQ³35272&2/´LVVHWWRWKHPHVVDJHVPDUNHGZLWKDUHQRW

WUDQVPLWWHGWRWKHUHFHLYLQJPRQLWRU

Message Cause Countermeasure

$,5/($. 7KHFXIIDQGH[WHQVLRQKRVHDUHQRW

properly connected &RQQHFWWKHPSURSHUO\

7KHFXIIKRVHRUH[WHQVLRQKRVHLV

QRWSURSHUO\FRQQHFWHGWRWKH1,%3

VRFNHW

7KHFXIIRUH[WHQVLRQKRVHLV

GDPDJHG

5HSODFHZLWKDQHZRQH

$/$506

6863(1'('

$ODUPVRQWKHUHFHLYLQJPRQLWRULV

VXVSHQGHGE\SUHVVLQJWKH)XQFWLRQ

NH\RQWKHWUDQVPLWWHU

$ODUPVUHVXPHZKHQWKHPLQXWH

VXVSHQGLQWHUYDOHODSVHV7RFDQFHO

alarm suspension, press the Function

NH\DJDLQ

%$77(5<:($. 'HDGEDWWHULHV 5HSODFHEDWWHULHV

108

ZM-540PA, ZM-541PA Operator’s Manual

Message Cause Countermeasure

&$1127

'(7(&738/6(

GLVSOD\HGLQEOXH

3RRUEORRGFLUFXODWLRQIRU

PHDVXULQJWKH6S22YDOXH

&KHFNWKHSDWLHQWFRQGLWLRQSUREH

DWWDFKPHQWRUFKDQJHWKHDWWDFKPHQW

VLWH

7KHSUREHLVDWWDFKHGWRRWLJKWO\DQG

LVREVWUXFWLQJWKHEORRGFLUFXODWLRQ

5HDWWDFKWKHSUREH

7KHSUREHLVQRWDWWDFKHGWRWKH

patient properly Attach the probe to the patient

SURSHUO\

³/,*+7,17(5)(5(1&(´

³&+(&.352%(6,7(´RU

³'(7(&7,1*38/6(´PHVVDJHLV

GLVSOD\HGIRUPRUHWKDQVHFRQGV

5HIHUWRWKHFDXVHDQG

FRXQWHUPHDVXUHIRUHDFKPHVVDJHLQ

WKLV0HVVDJHVWDEOHDQGUHPRYHWKH

FDXVH

&$1127

'(7(&738/6(

GLVSOD\HGLQSLQN

7KHSDWLHQW¶VSXOVHZDYHLVWRR

VPDOOWRPHDVXUH1,%3

0HDVXUHE\SDOSDWLRQRU

DXVFXOWDWLRQ

7KHFXIILVQRWZUDSSHGRQWKH

patient properly :UDSWKHFXIIRQWKHSDWLHQWSURSHUO\

&+(&.

(/(&752'(6

(OHFWURGHOHDGLVGLVFRQQHFWHGIURP

the electrode Firmly connect the electrode lead to

WKHHOHFWURGH

(OHFWURGHOHDGLVGLVFRQQHFWHGIURP

the transmitter Firmly connect the electrode lead to

WKHWUDQVPLWWHU

(OHFWURGHOHDGGLVFRQWLQXLW\ 5HSODFHWKHHOHFWURGHOHDGZLWKD

QHZRQH

(OHFWURGHLVQRW¿UPO\DWWDFKHGWR

WKHVNLQ

5HSODFHWKHHOHFWURGHZLWKDQHZ

RQH

3RODUL]DWLRQYROWDJHLVDEQRUPDOO\

KLJK

&+(&.352%( 7KHSUREHLVQRWDWWDFKHGWRWKH

patient properly Attach the probe to the patient

SURSHUO\

7KHSUREHLVQRWDWWDFKHGDWWKH

appropriate site Attach the probe to an appropriate

VLWHLQGLFDWHGLQWKHSUREHPDQXDO

7KHSUREHLVGLVFRQQHFWHGIURPWKH

transmitter &RQQHFWWKHSUREHFDEOHWRWKH

WUDQVPLWWHU

7KHSUREHLVSDVWLWVH[SLUDWLRQGDWH 5HSODFHWKHSUREHZLWKDQHZRQH

&+(&.352%(

6,7(

7KHSUREHLVQRWDWWDFKHGDWWKH

appropriate site Attach the probe to an appropriate

VLWHLQGLFDWHGLQWKHSUREHPDQXDO

7KHSUREHLVGHWHULRUDWHG 5HSODFHWKHSUREHZLWKDQHZRQH

7KHSUREHLVSDVWLWVH[SLUDWLRQGDWH

&8))

2&&/86,21

7UDQVPLWWHUPDOIXQFWLRQ ,PPHGLDWHO\UHPRYHWKHFXIIIURP

the patient and contact your Nihon

.RKGHQUHSUHVHQWDWLYH

109

ZM-540PA, ZM-541PA Operator’s Manual

Message Cause Countermeasure

'(7(&7,1*

38/6(

6HDUFKLQJIRUWKHFRUUHFWSXOVHZDYH

IRU6S22PRQLWRULQJ

:DLWXQWLOWKHSXOVHZDYHLVGHWHFWHG

7KH6S22YDOXHFDQQRWEHREWDLQHG

EHFDXVHWKHZDYHIRUPLVXQVWDEOH

Attach the probe to the patient

SURSHUO\

7KHSUREHLVQRWDWWDFKHGWRWKH

patient properly

+,*+&8))

35(66

(QRUPRXVSUHVVXUHZDVDSSOLHGE\

WKHSUHVVXUHRIWKHFXII

5HPRYHWKHFDXVH

,1)/$7,21

35(66/2:

,QVXI¿FLHQWFXIILQÀDWLRQSUHVVXUH :DLWIRUWKHUHPHDVXUHPHQWWR

EHSHUIRUPHGZLWKLQFUHDVHGFXII

LQÀDWLRQSUHVVXUH

/,*+7

,17(5)(5(1&(

7KH6S22 measurement site is under

ÀXRUHVFHQWOLJKWVXUJLFDOOLJKW

VXQOLJKWRURWKHUVWURQJOLJKW

&RYHUWKHPHDVXUHPHQWVLWHZLWKD

EODQNHWRUFORWK

&RQVLGHUDEOHERG\PRYHPHQW :KHQWKHPHVVDJHLVGLVSOD\HG

IUHTXHQWO\FKHFNWKHSDWLHQW

FRQGLWLRQDQGLIQHFHVVDU\FKDQJH

WKHDWWDFKPHQWVLWH

7KHSUREHLVQRWDWWDFKHGWRWKH

patient properly

6S22PRQLWRULQJLVSDXVHGIRU1,%3

measurement :DLWIRU1,%3PHDVXUHPHQWWR

¿QLVK

0($67,0(

287

7KH1,%3PHDVXULQJWLPHH[FHHGHG

WKHVSHFL¿HGWLPHGXHWRDUUK\WKPLD

ERG\PRYHPHQWYLEUDWLRQRUFXII

RUDLUKRVHEHLQJVTXHH]HG

5HPRYHWKHFDXVHLIWKHFDXVH

LVERG\PRYHPHQWYLEUDWLRQRU

VTXHH]LQJRIFXIIRUKRVH

1,%302'8/(

(5525

0RGXOHPDOIXQFWLRQ &RQWDFW\RXU1LKRQ.RKGHQ

UHSUHVHQWDWLYH

121,%3

&+$1*(

%$77(5,(6

1,%3FDQQRWEHPHDVXUHGGXHWR

ORZEDWWHU\

5HSODFHEDWWHULHVZLWKQHZRQHV

3$7,(17

&21),50('

)XQFWLRQNH\LVSUHVVHGDQGWKH

³3$7,(17&21),50('´VLJQDOLV

WUDQVPLWWHGWRWKHUHFHLYLQJPRQLWRU

ZKHQ³3$7,(17´LVDVVLJQHGDV

WKHIXQFWLRQIRUWKH)XQFWLRQNH\RQ

WKH6<67(06(783VFUHHQ

—

352%(

)$,/85(

7KHSUREHLVSDVWLWVH[SLUDWLRQGDWH 5HSODFHWKHSUREHZLWKDQHZRQH

3UREHLVGDPDJHGRUVKRUWFLUFXLWHG

5(0($685,1* 1,%3LVEHLQJUHPHDVXUHGGXH

WRDUUK\WKPLDERG\PRYHPHQW

YLEUDWLRQRUFXIIRUDLUKRVHEHLQJ

VTXHH]HG

,IWKHPHVVDJHVWLOODSSHDUVDIWHU

UHPHDVXUHPHQWUHPRYHWKHFDXVH

LIWKHFDXVHLVERG\PRYHPHQW

YLEUDWLRQRUVTXHH]LQJRIFXIIRU

KRVH

110

ZM-540PA, ZM-541PA Operator’s Manual

Message Cause Countermeasure

6$)(7<

&,5&8,7(5525

7KH1,%3VDIHW\FLUFXLWHUURU ,PPHGLDWHO\UHPRYHWKHFXIIIURP

the patient and contact your Nihon

.RKGHQUHSUHVHQWDWLYH

6$)(7<

&,5&8,7

5811,1*

:KHQWKLV

PHVVDJHLV

displayed,

measurement

cannot be

SHUIRUPHGIRU

VHFRQGV

1,%3PHDVXUHPHQWVWRSSHGE\WKH

VDIHW\FLUFXLW

&KHFNWKDWWKHKRVHLVQRWEHQWRU

VTXHH]HG

:DLWVHFRQGVWKHQSHUIRUP

UHPHDVXUHPHQW,IWKHPHVVDJHVWLOO

appears, contact your Nihon Kohden

UHSUHVHQWDWLYH

6S2202'8/(

(5525

7UDQVPLWWHUIDLOXUH &RQWDFW\RXU1LKRQ.RKGHQ

UHSUHVHQWDWLYH

6<62872)

5$1*(

7KHV\VWROLFEORRGSUHVVXUH

H[FHHGHGWKHWRPP+J

UDQJHDQGWKHEORRGSUHVVXUHFDQQRW

EHPHDVXUHG

0HDVXUHE\SDOSDWLRQRU

DXVFXOWDWLRQ

:($.38/6(

GLVSOD\HGLQEOXH

3RRUSHULSKHUDOFLUFXODWLRQ &KHFNWKHSDWLHQWFRQGLWLRQDQG

FKDQJHWKHSUREHDWWDFKPHQWVLWH

7KHSUREHLVDWWDFKHGWRRWLJKWO\DQG

LVREVWUXFWLQJWKHEORRGFLUFXODWLRQ

&KHFNWKHSUREHDWWDFKPHQW

FRQGLWLRQDQGLIQHFHVVDU\UHDWWDFK

WKHSUREH

:($.38/6(

GLVSOD\HGLQSLQN

7KHSDWLHQW¶VSXOVHZDYHLVWRR

VPDOOWRPHDVXUH1,%3

0HDVXUH1,%3E\SDOSDWLRQRU

DXVFXOWDWLRQ

7KHFXIILVZUDSSHGWRRORRVHO\ :UDSWKHFXIISURSHUO\

7KHFXIIVL]HLVQRWDSSURSULDWH 8VHWKHDSSURSULDWHFXII

=(52,1* 1,%3]HUREDODQFHLVEHLQJDGMXVWHG 'RQRWWRXFKWKHFXIIGXULQJ]HURLQJ

:DLWIRUWKHPHVVDJHWRGLVDSSHDU

111

ZM-540PA, ZM-541PA Operator’s Manual

Message Display Priority

:KHQPRUHWKDQRQHPHVVDJHFRQGLWLRQRFFXUVRQWKHWUDQVPLWWHURQO\WKHPHVVDJHZLWKWKH

KLJKHVWSULRULW\LVGLVSOD\HG

Priority Message

+LJK 3$7,(17&21),50('

6$)(7<&,5&8,75811,1*

&8))2&&/86,21

352%()$,/85(

&+(&.(/(&752'(6

1,%302'8/((5525

6<62872)5$1*(

+,*+&8))35(66

$,5/($.

0($67,0(287

&$1127'(7(&738/6(1,%3

6S2202'8/((5525

&+(&.352%(

&+(&.352%(6,7(

&$1127'(7(&738/6(6S22

/,*+7,17(5)(5(1&(

5(0($685,1*

,1)/$7,2135(66/2:

:($.38/6(1,%3

=(52,1*

121,%3&+$1*(%$77(5,(6

'(7(&7,1*38/6(

:($.38/6(6S22

$/$5066863(1'('

%$77(5<:($.

/RZ %$77(5<:($.

112

ZM-540PA, ZM-541PA Operator’s Manual

Troubleshooting

,IDSUREOHPRFFXUVXVHWKHIROORZLQJWDEOHVWR¿QGDQG¿[LW,IWKHSUREOHPVWLOOUHPDLQVDIWHU

WURXEOHVKRRWLQJDFFRUGLQJWRWKHVHWDEOHVFRQWDFW\RXU1LKRQ.RKGHQUHSUHVHQWDWLYH

Transmitter

Problem Cause Countermeasure

1RWKLQJLVGLVSOD\HG

RQWKH/&'DIWHU

WXUQLQJWKHSRZHU

RQ

%DWWHULHVDUHQRWLQVWDOOHG

FRUUHFWO\7KHEDWWHU\SRODULW\

LVZURQJ

,QVWDOOWKHEDWWHULHVFRUUHFWO\

%DWWHULHVDUHFRPSOHWHO\

GLVFKDUJHG

5HSODFHWKHEDWWHULHVZLWKQHZRQHV

/&'LVGLI¿FXOWWR

VHHWRRGDUNRUWRR

OLJKW

/&'EULJKWQHVVLVQRW

DSSURSULDWH

&KDQJHWKH/&'EULJKWQHVVRQWKH

6<67(06(783VFUHHQ5HIHUWRWKH

³&KDQJLQJ6<67(06(7836HWWLQJV´

VHFWLRQ

1RWKLQJLV

displayed on the

UHFHLYLQJPRQLWRU

DIWHUWXUQLQJWKH

WUDQVPLWWHUSRZHU

RQ

7KHFKDQQHORIWKHWUDQVPLWWHU

DQGPRQLWRUGRHVQRWPDWFK

6HWWKHFRUUHFWFKDQQHORQWKHPRQLWRU

7KHVRIWZDUHYHUVLRQRIWKH

PXOWLSOHSDWLHQWUHFHLYHURU

FHQWUDOPRQLWRULVROG

8SJUDGHWKHPXOWLSOHSDWLHQWUHFHLYHU

RUFHQWUDOPRQLWRUVRIWZDUHWRUHFHLYH

VLJQDOIURPWKHWUDQVPLWWHU7KH

VRIWZDUHYHUVLRQPXVWEHRUODWHU

3URWRFRORQWKHWUDQVPLWWHUDQG

PRQLWRUGRHVQRWPDWFK

Set the same protocol on the transmitter

DQGPRQLWRU

6LJQDOUHFHLYLQJ

FRQGLWLRQLVSRRU

$QRWKHUWUDQVPLWWHUZLWKWKH

VDPHFKDQQHOLVXVHGQHDUE\

7XUQWKHWUDQVPLWWHUSRZHURII,IWKH

PRQLWRUVWLOOUHFHLYHVDVLJQDOWKHUHLVD

KLJKSUREDELOLW\WKDWDQRWKHUWUDQVPLWWHU

RIWKHVDPHFKDQQHOLVXVHGQHDUE\

)ROORZWKHLQVWUXFWLRQRI\RXU

channel administrator and use another

WUDQVPLWWHUZLWKDGLIIHUHQWFKDQQHO

6LJQDOVRIDQRWKHUSDWLHQWDUH

PL[LQJ

)ROORZWKHLQVWUXFWLRQVRI\RXU

channel administrator and use another

WUDQVPLWWHURIDGLIIHUHQWFKDQQHO

7KHWUDQVPLWWHULVGDPDJHG &RQWDFW\RXU1LKRQ.RKGHQ

UHSUHVHQWDWLYH

113

ZM-540PA, ZM-541PA Operator’s Manual

ECG/Respiration

Problem Cause Countermeasure

7KHKHDUWUDWHLV

XQVWDEOH

3DFLQJGHWHFWLRQVHWWLQJRQWKH

PRQLWRULVQRWFRUUHFW

7XUQRIIWKHSDFLQJGHWHFWLRQVHWWLQJ

RQWKHPRQLWRU:KHQPRQLWRULQJD

SDFHPDNHUSDWLHQWWXUQRQSDFLQJ

GHWHFWLRQ

7KH³&+(&.

(/(&752'(6´

PHVVDJHDSSHDUV

RQWKHUHFHLYLQJ

PRQLWRU

(OHFWURGHOHDGLVGLVFRQQHFWHG

IURPWKHHOHFWURGH

Firmly connect the electrode lead to the

HOHFWURGH

(OHFWURGHOHDGGLVFRQWLQXLW\ 5HSODFHWKHHOHFWURGHOHDGZLWKDQHZ

RQH

(OHFWURGHLVQRW¿UPO\DWWDFKHG

WRWKHVNLQ

5HSODFHWKHHOHFWURGHZLWKDQHZRQH

3RODUL]DWLRQYROWDJHLV

DEQRUPDOO\KLJK

8VH1LKRQ.RKGHQVSHFL¿HG

HOHFWURGHV

(&*EDVHOLQHLV

WKLFN$&KXP

7KHJHORQWKHHOHFWURGHLVGULHG

RXW

5HSODFHWKHHOHFWURGHZLWKDQHZRQH

7KHJHORQWKHHOHFWURGHLV

FRPLQJRII

$QHOHFWULFEODQNHWLVXVHG &RYHUWKHEODQNHWZLWKDVKLHOGFRYHU

7KHKXP¿OWHULVVHWWR2))RQ

WKHPRQLWRU

6HWWKH¿OWHUWR21

7KHKHDUWUDWHRID

SDWLHQWZKRLVXVLQJ

DQHOHFWULFEODQNHW

is unstable on the

UHFHLYLQJPRQLWRU

3DFLQJSXOVHGHWHFWLRQLVWXUQHG

21RQWKHUHFHLYLQJPRQLWRU

7XUQ2))WKHSDFLQJSXOVHGHWHFWLRQRQ

WKHUHFHLYLQJPRQLWRU

No heart rate or

(&*LVGLVSOD\HG

³(&*0($685(0(17´

RQWKH3$5$0(7(56(783

VFUHHQLVVHWWR2))

,I(&*PRQLWRULQJLVQHFHVVDU\VHW

³(&*0($685(0(17´WR21

5HVSLUDWLRQ

ZDYHIRUP

measurement is

XQVWDEOH

7KHJHORQWKHHOHFWURGHLVGULHG

RXW

5HSODFHWKHHOHFWURGHZLWKDQHZRQH

7KHJHORQWKHHOHFWURGHLV

FRPLQJRII

No respiration rate

LVGLVSOD\HG

³5(630($685(0(17´

RQWKH3$5$0(7(56(783

VFUHHQLVVHWWR2))

,IUHVSLUDWLRQPRQLWRULQJLVQHFHVVDU\

VHW³5(630($685(0(17´WR21

114

ZM-540PA, ZM-541PA Operator’s Manual

SpO2

Problem Cause Countermeasure

6S22 data is

unstable and not

UHOLDEOH

7KHSUREHVL]HLVQRW

DSSURSULDWHIRUWKHSDWLHQW

8VHWKHDSSURSULDWHSUREHIRUWKH

SDWLHQW

3UREHDWWDFKPHQWFRQGLWLRQ

LVSRRU7KHSUREHLVSDUWO\

GHWDFKHGIURPWKHVNLQ([WHUQDO

OLJKWLVHQWHULQJWKHSUREH

)LUPO\DWWDFKWKHSUREHDFFRUGLQJWR

WKHSURFHGXUHLQWKHSUREHRSHUDWRU¶V

PDQXDO

0HDVXUHPHQWVLWHLVGLUW\

3DWLHQWLVZHDULQJQDLOSROLVK

5HPRYHGLUWDQGQDLOSROLVK

7KHSUREHLVDWWDFKHGWRWKH

VDPHOLPEWKDWLVXVHGIRU1,%3

PHDVXUHPHQW

$WWDFKWKHSUREHWRWKHRSSRVLWHOLPE

$YRLGDVLWHZKHUHEORRGFLUFXODWLRQ

FRQGLWLRQFKDQJHVJUHDWO\

NIBP

Problem Cause Countermeasure

&XIILQÀDWLRQ

pressure is less than

PP+J

7KHFXIIKRVHLVQRWFRQQHFWHG

WRWKH1,%3VRFNHWSURSHUO\

&RQQHFWWKHFXIIKRVHWRWKHVRFNHW

SURSHUO\

7KHFXIILVQRWZUDSSHGDURXQG

WKHDUPRULVZUDSSHGWRR

ORRVHO\

:UDSWKHFXIIDURXQGWKHXSSHUDUP

7KHFXIIGRHVQRW

LQÀDWHZKHQWKH

1,%36WDUW6WRSNH\

LVSUHVVHG

7KHFXIIKRVHLVQRWFRQQHFWHG

WRWKH1,%3VRFNHW

&RQQHFWWKHFXIIKRVHWRWKHVRFNHW

¿UPO\

7KHFXIIKRVHRUH[WHQVLRQKRVH

PD\EHIROGHGRUVTXHH]HG

ZKHQWKHFXIISUHVVXUHGLVSOD\

RQWKHVFUHHQLQFUHDVHVTXLFNO\

EXWWKHDFWXDOFXIIGRHVQRW

LQÀDWH

&KHFNWKHFXIIKRVHDQGDLUKRVH

Abnormal

measurement results

DUHGLVSOD\HG

7KHFXIIVL]HLVQRWFRUUHFW 6HOHFWWKHFXIIZKLFK¿WVWKHSDWLHQW¶V

OLPEFLUFXPIHUHQFH

7KHFXIILVQRWZUDSSHGDURXQG

WKHDUPFRUUHFWO\

:UDSWKHFXIIDURXQGWKHXSSHUDUP

QRWWRRWLJKWO\RUWRRORRVHO\

1,%3GDWDLVQRWFRUUHFW

EHFDXVHRIERG\PRYHPHQW

3UHYHQWWKHSDWLHQWIURPPRYLQJGXULQJ

PHDVXUHPHQW

9LEUDWLRQRQWKHFXII &KHFNWKDWQRWKLQJLVWRXFKLQJWKHFXII

GXULQJPHDVXUHPHQW

&KDQJHWKHPHDVXULQJVLWH

115

ZM-540PA, ZM-541PA Operator’s Manual

Problem Cause Countermeasure

7KHFXIILVVXGGHQO\

GHÀDWHGGXULQJ

LQÀDWLRQ

7KH1,%36WDUW6WRSNH\LV

SUHVVHGGXULQJLQÀDWLRQ —

Auto mode

measurement does

QRWVWDUWHYHQZKHQ

WKHWLPHLQWHUYDOKDV

SDVVHG

7KH1,%3,QWHUYDONH\LV

pressed and the measurement

PRGHLVFKDQJHG

&KHFNWKHPHDVXUHPHQWPRGHDQG

LQWHUYDO

7KHFXIIVXGGHQO\

LQÀDWHV

7KHPHDVXUHPHQWPRGHLVVHWWR

DXWRPRGH

&KHFNWKHWLPHLQWHUYDO,IQHFHVVDU\

VWRSPHDVXUHPHQW

&DQQRWFRQQHFWFXII

WRWKHDLUKRVH

8QVSHFL¿HGFXIILVXVHG 8VHDFXIIVSHFL¿HGE\1LKRQ.RKGHQ

&DQQRWPHDVXUH

1,%3

9LEUDWLRQRQWKHFXII &KHFNWKDWQRWKLQJLVWRXFKLQJWKHFXII

GXULQJPHDVXUHPHQW

7KHFXIIKRVHRUH[WHQVLRQKRVH

LVEHQWRUVTXHH]HG

5HPRYHWKHFDXVH

7KHFXIIKDVZRUQRXW 8VHDQHZFXII

%ORRGFRQJHVWLRQ

RFFXUV

0HDVXULQJRYHUDORQJSHULRGRI

WLPHDWVKRUWLQWHUYDOV

,QFUHDVHWKHPHDVXULQJLQWHUYDO

'RQRWPHDVXUH1,%3RYHUDORQJWLPH

7KURPEXVRFFXUV 0HDVXULQJRQDSDWLHQWZLWK

NQRZQEOHHGLQJGLVRUGHUVRU

FRDJXODWLRQ

'RQRWSHUIRUP1,%3PHDVXUHPHQWRQ

VXFKDSDWLHQW

1,%3GDWDRQWKH

VFUHHQLVRUGDUN

7KHWLPHVHWIRU³2/'1,%3

'$7$´RQWKH3$5$0(7(5

6(783VFUHHQHODSVHGIURPWKH

ODVWPHDVXUHPHQW

:KHQ1,%3LVPHDVXUHGDJDLQWKHGDWD

LVGLVSOD\HGLQQRUPDOEULJKWQHVV

7KUHHORXGSLS

VRXQGVLQGLFDWLQJ

1,%3PHDVXUHPHQW

FDQQRWEHVWDUWHG

7KHFXIILVQRWGHÀDWHGHQRXJK

WRVWDUWDQRWKHUPHDVXUHPHQW

:DLWVHFRQGVDQGPHDVXUHDJDLQ

116

ZM-540PA, ZM-541PA Operator’s Manual

Maintenance

7RXVHWKHWUDQVPLWWHULQVDIHDQGRSWLPXPFRQGLWLRQSHUIRUPPDLQWHQDQFHFKHFNDWOHDVWRQFH

HYHU\\HDU

7KHWUDQVPLWWHUFRQWDLQVSDUWVZKLFKJUDGXDOO\GHWHULRUDWHZLWKXVH2ULJLQDOSHUIRUPDQFH

PLJKWQRWEHGHOLYHUHGLIDQ\SDUWRIWKHWUDQVPLWWHULVGHWHULRUDWHG3HUIRUPUHJXODU

PDLQWHQDQFHFKHFNVWRDVVXUHFRQWLQXHGVDIHRSHUDWLRQ

7KHIROORZLQJXQLWVDUHQHFHVVDU\IRUVRPHFKHFNLQJLWHPV

• $;*YLWDOVLJQVLPXODWRU

• $;76S22FKHFNHU

• (OHFWULFRUPHUFXU\PDQRPHWHU

• P/GXPP\FXII

• 5HFHLYLQJPRQLWRU

Never disassemble or repair the transmitter. If

there is any problem with the transmitter, contact

your Nihon Kohden representative.

CAUTION

Before maintenance, cleaning or disinfection, turn

the transmitter power off and remove the batteries.

Failure to follow this instruction may result in

electrical shock and transmitter malfunction.

CAUTION

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

• 7KHUHLVQRGDPDJHRUGLUWRQWKHRXWVLGHRIWKHWUDQVPLWWHU

• 7KHEDWWHU\FDVHFRYHULVQRWGDPDJHGDQGFDQEHFORVHG¿UPO\

117

ZM-540PA, ZM-541PA Operator’s Manual

• 1RNH\VDUHGDPDJHG

• 1,%3VRFNHWLVQRWGDPDJHG

• 1RHOHFWURGHOHDGVDUHGDPDJHG

• 7KHUHDUHQREORRGRUFKHPLFDOVRQWKHWUDQVPLWWHU

• 7KHVSULQJVLQWKHEDWWHU\FRPSDUWPHQWDUHQRWGDPDJHGRUGHWDFKHG

• 7HUPLQDOVLQWKHEDWWHU\FDVHDUHQRWFRUURGHG

2. Transmitter Channel

• 7KHFKDQQHOQXPEHUODEHORQWKHWUDQVPLWWHULVQRWWRUQRUUHPRYHG

• 7KHFKDQQHORIWKHWUDQVPLWWHUPDWFKHVWKHODEHO

 7KHWUDQVPLWWHUFKDQQHOLVGLVSOD\HGLQWKHXSSHUOHIWFRUQHURIWKHVFUHHQ7KHFKDQQHO

QXPEHUDOVRDSSHDUVRQWKHVWDUWXSVFUHHQ

Channel numbers

Startup screen Numeric and waveform screen

3. Transmitting/Receiving Signal

8VHWKH$;*YLWDOVLJQVLPXODWRUDQGUHFHLYLQJPRQLWRU

1 &RQQHFWWKHYLWDOVLJQVLPXODWRUWRWKHWUDQVPLWWHURQO\ZLWKWKHHOHFWURGHOHDGV

2 3ODFHWKHWUDQVPLWWHUWRPIURPWKHUHFHLYLQJPRQLWRU

3 6HWWKHFKDQQHORQWKHUHFHLYLQJPRQLWRUWRWKHFKDQQHORIWKHWUDQVPLWWHU

118

ZM-540PA, ZM-541PA Operator’s Manual

4 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU

5 &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU

6 7XUQRIIWKHWUDQVPLWWHU

7 &KHFNWKDWWKH(&*GLVDSSHDUVIURPWKHUHFHLYLQJPRQLWRU

4. Display

&KHFNWKDWWKHUHDUHQRGRWVPLVVLQJRQWKHVFUHHQ

1 7XUQRIIWKHWUDQVPLWWHU

2 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHU7KH0(18VFUHHQDSSHDUV

3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\

Cursor

4 3UHVVWKHŻ or ŹNH\WRPRYHWKHFXUVRUWR³/&'7(67´DQGSUHVVWKH)XQFWLRQNH\

119

ZM-540PA, ZM-541PA Operator’s Manual

5 (DFKWLPHWKHŹNH\LVSUHVVHGWKHVFUHHQFKDQJHVDVEHORZ&KHFNWKDWQRGRWVDUH

PLVVLQJ

red

green

blue

ĺ

6 3UHVVWKH6FUHHQNH\WRUHWXUQWRWKH0$18$/&+(&.VFUHHQ

7 3UHVVWKH6FUHHQNH\DJDLQWRUHWXUQWRWKH0(18VFUHHQ

5. Key Operation

1 7XUQRIIWKHWUDQVPLWWHU

2 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHU7KH0(18VFUHHQDSSHDUV

3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\

Cursor

120

ZM-540PA, ZM-541PA Operator’s Manual

4 3UHVVWKHŻ or ŹNH\WRPRYHWKHFXUVRUWR³.(<&+(&.´DQGSUHVVWKH)XQFWLRQNH\

5 3UHVVHDFKNH\RQHDWDWLPHDQGFKHFNWKDWWKHSUHVVHGNH\LVKLJKOLJKWHGRQWKHVFUHHQ

Example:

:KHQWKH)XQFWLRQNH\LV

SUHVVHGWKHNH\QDPHLV

KLJKOLJKWHG

6 $IWHUFKHFNLQJSUHVVDQGKROGWKH6FUHHQNH\WRUHWXUQWRWKH0$18$/&+(&.

VFUHHQ

6. ECG Check

1 &RQQHFWWKHYLWDOVLJQVLPXODWRUWRWKHWUDQVPLWWHURQO\ZLWKWKHHOHFWURGHOHDGV

AX-400G

2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU

121

ZM-540PA, ZM-541PA Operator’s Manual

3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU

4 &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU

7. Respiration Check

1 &RQQHFWWKHYLWDOVLJQVLPXODWRUWRWKHWUDQVPLWWHURQO\ZLWKWKHHOHFWURGHOHDGV

AX-400G

2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU

3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU

4 &KHFNWKDWWKHUHVSLUDWLRQZDYHIRUPRIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU

8. SpO2 Check

6S22FDQEHFKHFNHGZLWKWKH$;76S22FKHFNHURU$;*YLWDOVLJQVLPXODWRU

With the AX-300T SpO2 Checker

1 &RQQHFWWKH6S22FKHFNHUWRWKHWUDQVPLWWHURQO\ZLWKWKH6S22FRQQHFWLRQFDEOH

AX-300T

2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU

3 7XUQRQWKHWUDQVPLWWHUDQG6S22FKHFNHU

4 &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ

122

ZM-540PA, ZM-541PA Operator’s Manual

5 &KHFNWKDW6S22DQGSXOVHUDWHRQWKHWUDQVPLWWHULVZLWKLQWKHIROORZLQJUDQJH

SpO2 on the SpO2 Checker Range

6S221

 WR6S22GLJLWV

 WR6S22GLJLWV

 WR6S22GLJLWV

3XOVHUDWH

EHDWVPLQ WREHDWVPLQEHDWPLQ

EHDWVPLQ WREHDWVPLQEHDWPLQ

1 7KH6S22FKHFNE\WKH6S22FKHFNHULVDIIHFWHGE\WKHFKHFNHU¶VWROHUDQFHWRWKH

6S22PHDVXULQJDFFXUDF\RIWKHWUDQVPLWWHU7KHPHDVXUHPHQWDFFXUDF\LVGHVFULEHG

LQWKH³6SHFL¿FDWLRQV´VHFWLRQ)RUGHWDLOVUHIHUWRWKH6S22FKHFNHUPDQXDO

6 &KHFNWKDWWKH6S22DQGSXOVHZDYHIRUPRIWKHWUDQVPLWWHUDSSHDURQWKHUHFHLYLQJ

PRQLWRU

With the AX-400G Vital Sign Simulator

1 &RQQHFWWKHYLWDOVLJQVLPXODWRUWRWKHWUDQVPLWWHURQO\ZLWKWKH6S22FRQQHFWLRQFDEOH

AX-400G

2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU

3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU

4 &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ

123

ZM-540PA, ZM-541PA Operator’s Manual

5 &KHFNWKDW6S22DQG(&*RQWKHWUDQVPLWWHULVZLWKLQWKHIROORZLQJUDQJH

Vital Sign Simulator Range

6S221

 WR6S22GLJLWV

 WR6S22GLJLWV

 WR6S22GLJLWV

(&* 1250$/ WREHDWVPLQEHDWVPLQ

17KH6S22FKHFNE\WKHYLWDOVLJQVLPXODWRULVDIIHFWHGE\WKHVLPXODWRU¶VWROHUDQFH

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PDQXDO

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9. NIBP Check

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NOTE: $LUOHDNVIURPWKHUXEEHUEDOOGXULQJLQÀDWLRQ8VHDFOLSRQWKHDLUKRVH

of the rubber ball to stop air leaking.

Dummy cuff (700 cc)

Electric manometer

Clip

Rubber ball

2 7XUQRQWKHHOHFWULFPDQRPHWHU

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124

ZM-540PA, ZM-541PA Operator’s Manual

4 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\

Cursor

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125

ZM-540PA, ZM-541PA Operator’s Manual

7 3UHVVWKHŻ or ŹNH\WRPRYHWKHFXUVRUWR³$,5/($.$872´DQGSUHVVWKH

)XQFWLRQNH\

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8 &KHFNWKHIROORZLQJ

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126

ZM-540PA, ZM-541PA Operator’s Manual

11 5HPRYHWKHFOLSIURPWKHDLUKRVHRIWKHUXEEHUEDOO

Electric manometer

Rubber ball

Remove

clip

Dummy cuff (700 cc)

12 %\VTXHH]LQJWKHUXEEHUEDOOLQFUHDVHSUHVVXUHXSWRPP+JRQWKHPDQRPHWHU

13 &KHFNWKHIROORZLQJ

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127

ZM-540PA, ZM-541PA Operator’s Manual

10. NIBP Cuff for Attaching Transmitter to Patient Arm

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QHZRQH

Appearance

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• 7KHUHDUHQREURNHQVWLWFKHVRQWKHFXII

• 7KHODEHORQWKHFXIILVUHDGDEOH

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• 7KHFRQQHFWRURQWKHLQÀDWLRQEDJLVQRWGDPDJHG

128

ZM-540PA, ZM-541PA Operator’s Manual

Maintenance Check Sheet

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,QVWUXPHQW1DPHTransmitter

,QVWUXPHQW0RGHOZM-540PA, ZM-541PA

,QVWUXPHQW6HULDO1XPEHU

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Overall Judgement

Ƒ2.

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129

ZM-540PA, ZM-541PA Operator’s Manual

Lifetime and Disposal

Dispose of Nihon Kohden products according to

your local laws and your facility’s guidelines for

waste disposal. Otherwise, it may affect the

environment. If there is a possibility that the

product may have been contaminated with

infection, dispose of it as medical waste according

to your local laws and your facility’s guidelines for

medical waste. Otherwise, it may cause infection.

CAUTION

Disposing of Used Batteries

Battery Lifetime

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Disposal

NOTE: Remove the batteries before disposing of the transmitter.

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Disposing of Electrodes, SpO2 Probes and NIBP Cuffs

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Disposing of Transmitter

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ODZVIRUGLVSRVDO

130

ZM-540PA, ZM-541PA Operator’s Manual

Cleaning, Disinfection and Sterilization

Transmitter and Electrode Leads

If detergent or liquid spills into the transmitter, stop

cleaning or disinfecting it and contact your Nihon

Kohden representative. The transmitter needs to

be checked for safety and function before use.

CAUTION

NOTE • The transmitter cannot be sterilized. Sterilizing the transmitter may damage

it.

• When cleaning or disinfecting the transmitter, disconnect it from the

patient and remove the batteries beforehand. Otherwise it may result in

malfunction.

• Do not let the NIBP socket get wet during cleaning and disinfection.

• Do not use a hair dryer etc. to dry the transmitter when it is wet. Doing

so may cause the transmitter to deform or become damaged. It may also

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• Do not use volatile liquids such as thinner or benzine because these will

cause the materials to deform or crack.

• $YRLGXVLQJÀDPPDEOHGLVLQIHFWDQWVVXFKDVHWKDQROLQDFORVHGSODFH

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• Wipe the transmitter with a dry cloth before use and dry it completely after

cleaning and disinfecting.

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Cleaning

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Disinfection

Do not immerse the electrode lead connector in

liquid.

CAUTION

131

ZM-540PA, ZM-541PA Operator’s Manual

:LSHWKHRXWVLGHVXUIDFHRIWKHWUDQVPLWWHUDQGHOHFWURGHOHDGZLWKDQRQDEUDVLYHFORWK

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SpO2 Probe

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NIBP Cuff

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132

ZM-540PA, ZM-541PA Operator’s Manual

Periodic Inspection

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Repair Parts Availability Policy

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133

ZM-540PA, ZM-541PA Operator’s Manual

6SHFL¿FDWLRQV

ZM-540PA

Measured Parameters

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Transmitted Data

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code number*, transmitter serial number*

 7UDQVPLWWHGRQO\ZKHQWKHSURWRFROLV³´

Display

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Displayed Data

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ECG

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134

ZM-540PA, ZM-541PA Operator’s Manual

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135

ZM-540PA, ZM-541PA Operator’s Manual

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NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T,

TL-271T and TL-631T SpO2 probes. The testing was performed during

induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2

Africans, 1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age:

21 to 34), (5 women and 11 men) under the condition of no motion. Arterial

blood was sampled and measured by a CO-oximeter. The difference

between SpO2 measured by the SpO2 probe and functional SaO2

measured by a CO-oximeter was calculated using the root-mean-square

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measurements.

• A pulse oximeter tester that generates simulated signals can be used to

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a replacement for human signals for testings accuracy.

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Pulse Rate = 70 bpm

100

0 10 20 30 40 50 60 70 80 90 100 110 120 130 140

Time (seconds)

SpO

(%)

SpO

Reference SpO

Fast SpO

Normal SpO

Slow

136

ZM-540PA, ZM-541PA Operator’s Manual

100

0 10 20 30 40 50 60 70 80 90 100 110 120 130 140

SpO

Reference SpO

Fast SpO

Normal

Pulse Rate = 140 bpm

Time (seconds)

SpO

(%)

SpO

Slow

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SpO

= 97

100

110

120

130

140

150

0 102030405060708090100110120

Time (seconds)

PR (bpm)

PR Reference PR

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Dimensions and Weight

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138

ZM-540PA, ZM-541PA Operator’s Manual

Environment

Operating environment

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Storage and transport environment

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Safety Standards

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139

ZM-540PA, ZM-541PA Operator’s Manual

Electromagnetic Emissions

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level Electromagnetic

environment - guidance

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140

ZM-540PA, ZM-541PA Operator’s Manual

Avoiding Electromagnetic Interference (Impedance Respiration)

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141

ZM-540PA, ZM-541PA Operator’s Manual

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Recommended Separation Distances between Portable and Mobile RF

Communications Equipment

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Rated maximum

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Separation distance according to frequency of transmitter (m)

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(1)RUUHVSLUDWLRQ

127( $W0+]DQG0+]WKHVHSDUDWLRQGLVWDQFHIRU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

142

ZM-540PA, ZM-541PA Operator’s Manual

5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ

7KHWUDQVPLWWHUUHWXUQVWRWKHQRUPDORSHUDWLQJPRGHZLWKLQVHFRQGVDIWHUGH¿EULOODWLRQ

7KHVWRUHGVHWWLQJVDUHQRWDIIHFWHG

System Composition for EMC Test

7KH=03$WUDQVPLWWHULVWHVWHGWRFRPSO\ZLWK,(&DQG$PHQGPHQW

ZLWKWKHIROORZLQJFRPSRVLWLRQ,IDQ\SDUWZKLFKLVQRWVSHFL¿HGE\1LKRQ.RKGHQLV

XVHGWKH(0&VSHFL¿FDWLRQVPLJKWQRWFRPSO\

Units Cable Length

=03$WUDQVPLWWHU —

<331,%3FXII P

%53(&*HOHFWURGHOHDG P

7/7¿QJHUSUREH P

143

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ZM-541PA

Measured Parameters

:DYHIRUPV (&*LPSHGDQFHPHWKRGUHVSLUDWLRQSXOVH

1XPHULFGDWD +HDUWUDWHUHVSLUDWLRQUDWH6S221,%3SXOVHUDWH

Transmitted Data

:DYHIRUPV (&*UHVSLUDWLRQSXOVHZDYH

1XPHULFGDWD 6S221,%3SXOVHUDWH

6WDWXVLQIRUPDWLRQ %DWWHU\UHSODFHPHQWEDWWHU\OHYHODODUPVXVSHQGHG

SDXVHPRQLWRULQJSDWLHQWFRQ¿UPHG(&*OHDG

SDFLQJGHWHFWLRQHOHFWURGHGHWDFKPHQWHOHFWURGH

LPSHGDQFH(&*RIIUHVSLUDWLRQPHWKRG

LPSHGDQFH6S22VWDWXV1,%3VWDWXVFKDQQHO,'

WLPHFRQVWDQWVW\SHRIWUDQVPLWWHUWUDQVPLWWHU

code number*, transmitter serial number*

7UDQVPLWWHGRQO\ZKHQWKHSURWRFROLV³´

Display

'LVSOD\VL]H LQFK7)7FRORU/&'

9LHZLQJDUHD +î9PP

5HVROXWLRQ +î9GRWV

Displayed Data

1XPHULFDQGZDYHIRUPVFUHHQ (&*RQHZDYHIRUPIURPOHDG,,,,,,9DRU

9EKHDUWUDWHSXOVHUDWHUHVSLUDWLRQUDWH6S22,

1,%3V\VWROLFGLDVWROLF0$3PHVVDJHEDWWHU\

OHYHO456SXOVHV\QFPDUNSXOVHEDUJUDSK1,%3

PHDVXUHPHQWPRGHDQGVWDWXVLQIRUPDWLRQ(&*OHDG

:DYHIRUPUHYLHZVFUHHQ (&*RUSXOVHZDYHRISDVWPLQXWHV

1XPHULFUHYLHZVFUHHQ +HDUWUDWHRUSXOVHUDWHUHVSLUDWLRQUDWHDQG6S22DW

PLQXWHLQWHUYDOIRUSDVWPLQXWHV

&+(&.(/(&752'(VFUHHQ (&*IRUFKHFNLQJHOHFWURGHDWWDFKPHQW

ECG

ECG Measurement

&KDQQHOV 

,QSXWG\QDPLFUDQJH P9RUPRUH

(OHFWURGHRIIVHWSRWHQWLDOWROHUDQFH P9RUPRUH

,QSXWLPSHGDQFH 0ȍRUPRUH

&RPPRQPRGHUHMHFWLRQUDWLR G%RUPRUH

 ,(&FRPSOLDQW

3DFLQJSXOVHGHWHFWLRQ DPSOLWXGHWRP9GXUDWLRQWRPV

 ,(&FRPSOLDQW

 %DVHGXSRQSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\

'H¿EULOODWLRQSURRI (&*LQSXWSURWHFWHGDJDLQVW:V'&N9

 ,(&FRPSOLDQW

144

ZM-540PA, ZM-541PA Operator’s Manual

(&*UHFRYHU\WLPHDIWHUGH¿EULOODWLRQ ZLWKLQV

(OHFWURGHFRQGLWLRQ 'LVSOD\V&+(&.(/(&752'(6PHVVDJH

7DOO7ZDYHUHMHFWLRQFDSDELOLW\ 

&RPSOLHVZLWKWKHKHLJKWVRI7ZDYHVIURPWRP9

 ,(&FRPSOLDQW

3DFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\ZLWKRXWRYHUVKRRW

 &RPSOLHVZLWKWKHDPSOLWXGHVRISDFHPDNHUSXOVHVWR

P9DQGZLGWKVWRPV$VGH¿QHGE\PHWKRG

%RI,(&WKLVFRUUHVSRQGV

WRWKHSDFHPDNHUSXOVHVDPSOLWXGHVDQGZLGWKVRI

P9PVWRDPSOLWXGHVP9PV

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

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+HDUWUDWHGHWHFWLRQPHWKRG $YHUDJH

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EHDWVPLQ

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EHDWVPLQ

+HDUWUDWHFRXQWLQJUDQJH WREHDWVPLQ

+HDUWUDWHFRXQWLQJDFFXUDF\ EHDWVPLQWREHDWVPLQ

 (VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHU

Respiration Measurement

0HDVXULQJPHWKRG ,PSHGDQFHPHWKRG

0HDVXULQJOHDG %HWZHHQ5DQG)

,PSHGDQFHUDQJH NȍRUOHVV

5HVSLUDWLRQUDWHPHDVXULQJDFFXUDF\ FRXQWVPLQDWWRFRXQWVPLQ

5HVSLUDWLRQUDWHFRXQWLQJUDQJH WRFRXQWVPLQ

 (VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHU

SpO2 Measurement (ISO 9919: 2005 compliant)

0HDVXULQJUDQJH WR6S22

'HFODUHGUDQJH WR6S22

0LQLPXPGLVSOD\UDQJH 6S22

'LVSOD\XSGDWHF\FOH (YHU\VHFRQGV

0HDVXULQJ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¿HG

145

ZM-540PA, ZM-541PA Operator’s Manual

3XOVHUDWHPHDVXULQJUDQJH WRESP

3XOVHUDWHGLVSOD\UDQJH WRESP

3XOVHUDWHDFFXUDF\UPV ESP

 (VVHQWLDOSHUIRUPDQFHRIWKLVWUDQVPLWWHU

NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T,

TL-271T and TL-631T SpO2 probes. The testing was performed during

induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2 Africans,

1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age: 21 to 34),

(5 women and 11 men) under the condition of no motion. Arterial blood

was sampled and measured by a CO-oximeter. The difference between

SpO2 measured by the SpO2 probe and functional SaO2 measured

by a CO-oximeter was calculated using the root-mean-square (rms)

PHWKRGDFFRUGLQJWR,627KLVPHDVXUHPHQWDFFXUDF\¿JXUH

represents 2/3 of all test measurements.

• A pulse oximeter tester that generates simulated signals can be used to

FKHFNWKHGLIIHUHQFHIURPWKHGHVLJQVSHFL¿FDWLRQEXWLWFDQQRWEHXVHGDV

a replacement for human signals for testings accuracy.

5HVSRQVHWLPH

 6HOHFWDEOHIURP³6ORZ´³1RUPDO´DQG³)DVW´

 7KHIROORZLQJJUDSKVVKRZUHVSRQVHWLPHIRUV6S22FKDQJH

Pulse Rate = 70 bpm

100

0 10 20 30 40 50 60 70 80 90 100 110 120 130 140

Time (seconds)

SpO

(%)

SpO

Reference SpO

Fast SpO

Normal SpO

Slow

146

ZM-540PA, ZM-541PA Operator’s Manual

100

0 10 20 30 40 50 60 70 80 90 100 110 120 130 140

SpO

Reference SpO

Fast SpO

Normal

Pulse Rate = 140 bpm

Time (seconds)

SpO

(%)

SpO

Slow

 7KHIROORZLQJJUDSKVKRZVWKHUHVSRQVHWLPHH[DPSOHZKHQSXOVHUDWHFKDQJHV

ESPV

SpO

= 97

100

110

120

130

140

150

0 102030405060708090100110120

Time (seconds)

PR (bpm)

PR Reference PR

Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999 compliant)

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149

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*+]IRU

UHVSLUDWLRQ

3RUWDEOHDQGPRELOH5)

FRPPXQLFDWLRQVHTXLSPHQWVKRXOG

EHXVHGQRFORVHUWRDQ\SDUWRIWKH

=03$LQFOXGLQJFDEOHVWKDQ

the recommended separation distance

FDOFXODWHGIURPWKHHTXDWLRQDSSOLFDEOH

WRWKHIUHTXHQF\RIWKHWUDQVPLWWHU

Recommended separation

distance

G  3

G  30+]WR0+]

G  30+]WR*+]

G  30+]WR0+]IRU

respiration

G  30+]WR*+]IRU

UHVSLUDWLRQ

ZKHUH3LVWKHPD[LPXPRXWSXW

SRZHUUDWLQJRIWKHWUDQVPLWWHU

LQZDWWV:DFFRUGLQJWRWKH

WUDQVPLWWHUPDQXIDFWXUHUDQGGLVWKH

recommended separation distance in

PHWHUVP

)LHOGVWUHQJWKVIURP¿[HG5)

transmitters, as deter mined by an

HOHFWURPDJQHWLFVLWHVXUYH\1, should be

OHVVWKDQWKHFRPSOLDQFHOHYHOLQHDFK

IUHTXHQF\UDQJH2

,QWHUIHUHQFHPD\RFFXULQWKHYLFLQLW\

RIHTXLSPHQWPDUNHGZLWKWKH

IROORZLQJV\PERO

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

151

ZM-540PA, ZM-541PA Operator’s Manual

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WKH=03$LVXVHG

H[FHHGVWKHDSSOLFDEOH5)FRPSOLDQFHOHYHODERYHWKH=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WKH=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

7KH=03$LVLQWHQGHGIRUXVHLQDQHOHFWURPDJQHWLFHQYLURQPHQWLQZKLFKUDGLDWHG5)

GLVWXUEDQFHVDUHFRQWUROOHG7KHFXVWRPHURUWKHXVHURIWKH=03$FDQKHOSSUHYHQW

HOHFWURPDJQHWLFLQWHUIHUHQFHE\PDLQWDLQLQJDPLQLPXPGLVWDQFHEHWZHHQSRUWDEOHDQGPRELOH

5)FRPPXQLFDWLRQVHTXLSPHQWWUDQVPLWWHUVDQGWKH=03$DVUHFRPPHQGHGEHORZ

DFFRUGLQJWRWKHPD[LPXPRXWSXWSRZHURIWKHFRPPXQLFDWLRQVHTXLSPHQW

Rated maximum

output power of

transmitter (W)

Separation distance according to frequency of transmitter (m)

N+]WR0+]

G  3

0+]WR0+]

G  3

)RUUHVSLUDWLRQG  3

0+]WR*+]

G  3

)RUUHVSLUDWLRQG  3

  1 1

  1 1

  1 1

  1 1

  1 1

)RUWUDQVPLWWHUVUDWHGDWDPD[LPXPRXWSXWSRZHUQRWOLVWHGDERYHWKHUHFRPPHQGHGVHSDUDWLRQ

GLVWDQFHGLQPHWHUVPFDQEHHVWLPDWHGXVLQJWKHHTXDWLRQDSSOLFDEOHWRWKHIUHTXHQF\RI

WKHWUDQVPLWWHUZKHUH3LVWKHPD[LPXPRXWSXWSRZHUUDWLQJRIWKHWUDQVPLWWHULQZDWWV:

DFFRUGLQJWRWKHWUDQVPLWWHUPDQXIDFWXUHU

(1)RUUHVSLUDWLRQ

127( $W0+]DQG0+]WKHVHSDUDWLRQGLVWDQFHIRU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

152

ZM-540PA, ZM-541PA Operator’s Manual

5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ

7KHWUDQVPLWWHUUHWXUQVWRWKHQRUPDORSHUDWLQJPRGHZLWKLQVHFRQGVDIWHUGH¿EULOODWLRQ

7KHVWRUHGVHWWLQJVDUHQRWDIIHFWHG

System Composition for EMC Test

7KH=03$WUDQVPLWWHULVWHVWHGWRFRPSO\ZLWK,(&DQG$PHQGPHQW

ZLWKWKHIROORZLQJFRPSRVLWLRQ,IDQ\SDUWZKLFKLVQRWVSHFL¿HGE\1LKRQ.RKGHQLV

XVHGWKH(0&VSHFL¿FDWLRQVPLJKWQRWFRPSO\

Units Cable Length

=03$WUDQVPLWWHU —

<331,%3FXII P

%53(&*HOHFWURGHOHDG P

7/7¿QJHUSUREH P

153

ZM-540PA, ZM-541PA Operator’s Manual

Standard Accessories

No. Name Model Qty Supply Code

 1,%3FXIIIRUDGXOWVWDQGDUG <33  6&

2 Strap —  <

7KHIROORZLQJSDUWVDUHDYDLODEOHIRUUHSODFHPHQW

/RFNSODWHLVDVWDQGDUG

DFFHVVRU\RIWKH

<33DQG<33

1,%3FXIIV

No. Name Model Qty Code No.

 %DWWHU\FDVHFRYHU —



4/RFNSODWH 

154

ZM-540PA, ZM-541PA Operator’s Manual

Options

Only use Nihon Kohden specified electrodes,

electrode leads and SpO2 probes. Otherwise, the

maximum performance from the transmitter cannot

be guaranteed.

CAUTION

Transmitter

• 4,3.FKDQQHOZULWHU

ECG/RESP

Application Model Qty Supply Code

HOHFWURGHVFOLSW\SHOHDGOHQJWKFP %53$  .$

HOHFWURGHVVQDSW\SHOHDGOHQJWKFP %53$  .%

HOHFWURGHVFOLSW\SHOHDGOHQJWKFP %53$  .$

HOHFWURGHVVQDSW\SHOHDGOHQJWKFP %53$  .$

155

ZM-540PA, ZM-541PA Operator’s Manual

SpO2

Name Lead

Length Model Qty Supply

Code

)LQJHUSUREHUHXVDEOH

P

7/7



3+

P 3)

0XOWLVLWHSUREHUHXVDEOH P 7/7 3*

)LQJHUSUREHUHXVDEOH

P 7/7 3$

P 7/7 3&

6S22SUREHIRUDGXOWGLVSRVDEOH

P 7/7

3$

P 7/7 3(

6S22SUREHIRUFKLOGGLVSRVDEOH

P 7/7 3%

P 7/7 3)

6S22 probe

IRUQHRQDWHDGXOWGLVSRVDEOH

P 7/7 3&

P 7/7 3*

6S22 probe

IRULQIDQWGLVSRVDEOH

P 7/7 3'

P 7/7 3+

6S22 probe

IRUQHRQDWHDGXOWGLVSRVDEOH

P 7/6



3$

P 7/6 3%

6S22 probe

IRUFKLOGLQIDQWGLVSRVDEOH

P 7/6 3$

P 7/6 3%

&27721<WDSH

——

20 3

)RDPWDSHIRU7/6666 î 3&

$WWDFKPHQWWDSHIRU7/77 î 3

3UREHIDVWHQHU <63  3

156

ZM-540PA, ZM-541PA Operator’s Manual

NIBP

Name Width

(cm)

Air

Hose

Length

(cm)

Model Qty Supply

Code

&XIIIRUDGXOWIRU

DWWDFKLQJWUDQVPLWWHUWR

patient arm

Standard   <331 6&

/DUJH   <331 6'

&XIIIRULQIDQW   <37  6$

&XIIIRUFKLOG

Small   <37  6%

Standard   <37  6$

 <37  6&

&XIIIRUDGXOW Standard   <37  6%

 <37  6%

/DUJH   <37  6&

'LVSRVDEOHFXIIIRULQIDQW 6 <33 20 6&

'LVSRVDEOHFXIIIRUFKLOG 8 <33 20 6'

'LVSRVDEOHFXIIIRUDGXOW

Small   <33 20 6(

Standard   <33 20 6)

0HGLXP

ODUJH   <33 20 6*

/DUJH   <33 20 6+

([WUDODUJH   <33 20 6,

([WHQVLRQKRVH — <13  6

1 7KHORFNSODWHLVSURYLGHGZLWKWKHVH1,%3FXIIV

157

ZM-540PA/ZM-541PA Operator’s Manual

Transmission Frequencies

&KDQQHOWR

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

158

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

159

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

160

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 

 

 

 

 

 

 

 

 

 

 

 

 

 

161

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

162

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

&KDQQHO(WR(

163

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

164

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

165

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

166

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

&KDQQHO(WR(

NOTE: In Canada, transmission frequencies from 1429.5 MHz to 1431.9750 MHz

cannot be used due to the IC (Industry Canada) regulations. ZM-541PA can

only use channels up to E698 in Canada.

167

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

168

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

169

ZM-540PA/ZM-541PA Operator’s Manual

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Channel

(HEX) Frequency

(MHz)

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

( 

Serial Number

Model

Your Representative

Contact 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 concerning

this instrument, mention these two pieces of information for quick and accurate service.

Manufacturer

NIHON KOHDEN CORPORATION

1-31-4 Nishiochiai, Shinjuku-ku Tokyo 161-8560, Japan

Phone +81 3-5996-8036

Fax +81 3-5996-8100

North and South America

NIHON KOHDEN AMERICA, INC.

15353 Barranca Parkway, Irvine, CA 92618, U.S.A.

Toll-free +1-800-325-0283

Phone +1 949-580-1555

Fax +1 949-580-1550

NIHON KOHDEN LATIN AMERICA S.A.S

Carrera 16 No.93A-36 Of. 802. Bogota D.C., Colombia

Phone +57 1-300-1742

Fax +57 1-300-1825

NIHON KOHDEN DO BRASIL LTDA.

Rua Gomes de Carvalho

1507-Bloco A 9 andar-cjto 91A Vila Olimpia

CEP 04547-005 Sao Paulo-SP. Brasil

Phone +55 11-3841-9943

Fax +55 11-3044-0463

Europe

European Representative

NIHON KOHDEN EUROPE GmbH

Raiffeisenstrasse 10, D-61191 Rosbach, Germany

Phone +49 6003-827-0

Fax +49 6003-827-599

NIHON KOHDEN FRANCE SARL

8, rue Francois Delage, 94 230 Cachan, France

Phone +33 1-49-08-05-50

Fax +33 1-49-08-93-32

NIHON KOHDEN IBERICA S.L.

C/Ulises 75A, E-28043 Madrid, Spain

Phone +34 91-7-161080

Fax +34 91-3-004676

NIHON KOHDEN ITALIA S.r.l.

Via Fratelli Bronzetti 28, 24124 Bergamo, Italy

Phone +39 035-219543

Fax +39 035-232546

NIHON KOHDEN UK LTD

Trident Court 118, 1 Oakcroft Road

Chessington, Surrey KT9 1BD, UK

Phone +44 20-8391-6800

Fax +44 20-8391-6809

Asia

SHANGHAI KOHDEN

MEDICAL ELECTRONIC INSTRUMENT CORP.

567 Huancheng Bei Road

Shanghai Comprehensive Industrial Development Zone

Shanghai 201401, China

Phone +86 21-5743-6998

Fax +86 21-5743-6939

NIHON KOHDEN SINGAPORE PTE LTD

1 Maritime Square, #10-34 HarbourFront Centre

Singapore 099253

Phone +65 6376-2210

Fax +65 6376-2264

NIHON KOHDEN INDIA PVT. LTD.

308, Tower A, Spazedge, Sector 47, Sohna Road

Gurgaon-122 002 Haryana, India

Toll-free +91 1800-103-8182

Phone +9

1 1

24-493-1000

Fax +9

1 1

24-493-1029

NIHON KOHDEN MIDDLE EAST FZE

P.O.Box 261516, JAFZA View 19

Room 308 Jebel Ali Free Zone, Dubai, U.A.E

Phone +9

71 4-

884-0080

Fax +9

71 4-

880-0122

NIHON KOHDEN KOREA, INC.

5F Miso Bldg.

890-47 Daechi-dong, Gangnam-gu, Seoul, 135-280 Korea

Phone +82 2-3273-2310

Fax +82 2-3273-2352

ZM-540PA, ZM-541PA_0614-902754H

Nihon Kohden ZM-540PAA TRANSMITTER User Manual

Nihon Kohden Corporation TRANSMITTER

(Short-Term Confidential) User Manual

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