Nihon Kohden ZM-541PA Medical Telemetry Transmitter User Manual OM ZM 540 541PA

Nihon Kohden Corporation Medical Telemetry Transmitter OM ZM 540 541PA

ZM 541PA User Manual PDF Download & Text

Users Manual

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Transmitter
ZM-540PA/ZM-541PA
If you have any comments or suggestions on this
manual, please contact us at:
www.nihonkohden.com
0614-902754
Copyright Notice
The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No part
of this document may be reproduced, stored, or transmitted in any form or by any means (electronic,
mechanical, photocopied, recorded, or otherwise) without the prior written permission of Nihon
Kohden.
GENERAL HANDLING PRECAUTIONS
This device is intended for use only by qualiﬁed medical personnel.
Use only Nihon Kohden approved products with this device. Use of non-approved
products or in a non-approved manner may affect the performance speciﬁcations
of the device. This includes, but is not limited to, batteries, recording paper, pens,
extension cables, electrode leads, input boxes and AC power.
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
2. When installing or storing the instrument, take the following precautions:
(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive humidity and
temperatures, poorly ventilated areas, and dust, saline or sulphuric air.
(2) Place the instrument on an even, level ﬂoor. Avoid vibration and mechanical shock, even
during transport.
(3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage.
(4) The power line source to be applied to the instrument must correspond in frequency and
voltage to product speciﬁcations, and have sufﬁcient current capacity.
(5) Choose a room where a proper grounding facility is available.
3. Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is in combination with other instruments to avoid
misdiagnosis or other problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using
batteryoperated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the
patient’s safety.
(3) Avoid direct contact between the instrument housing and the patient.
5. To Shutdown After Use
(1) Turn power off with all controls returned to their original positions.
(2) Remove the cords gently; do not use force to remove them.
(3) Clean the instrument together with all accessories for their next use.
Operator’s Manual ZM-540PA/541PA
6. The instrument must receive expert, professional attention for maintenance and repairs.
When the instrument is not functioning properly, it should be clearly marked to avoid
operation while it is out of order.
7. The instrument must not be altered or modiﬁed in any way.
8. Maintenance and Inspection
(1) The instrument and parts must undergo regular maintenance inspection at least every 6
months.
(2) If stored for extended periods without being used, make sure prior to operation that the
instrument is in perfect operating condition.
(3) Technical information such as parts list, descriptions, calibration instructions or other
information is available for qualiﬁed user technical personnel upon request from your Nihon
Kohden representative.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to
the application and/or location of electrodes and/or transducers to avoid possible burn to
the patient.
10. When the instrument is used with a deﬁbrillator, make sure that the instrument is
protected against deﬁbrillator discharge. If not, remove patient cables and/or transducers
from the instrument to avoid possible damage.
ii
Operator’s Manual ZM-540PA/541PA
WARRANTY POLICY
Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and
workmanship for one year from the date of delivery. However, consumable materials such as
recording paper, ink, stylus and battery are excluded from the warranty.
NKC or its authorized agents will repair or replace any products which prove to be defective during
the warranty period, provided these products are used as prescribed by the operating instructions
given in the operator’s and service manuals.
No other party is authorized to make any warranty or assume liability for NKC’s products.
NKC will not recognize any other warranty, either implied or in writing. In addition, service,
technical modiﬁcation or any other product change performed by someone other than NKC or its
authorized agents without prior consent of NKC may be cause for voiding this warranty.
Defective products or parts must be returned to NKC or its authorized agents, along with an
explanation of the failure. Shipping costs must be pre-paid.
This warranty does not apply to products that have been modiﬁed, disassembled, reinstalled or
repaired without Nihon Kohden approval or which have been subjected to neglect or accident,
damage due to accident, ﬁre, lightning, vandalism, water or other casualty, improper installation or
application, or on which the original identiﬁcation marks have been removed.
In the USA and Canada other warranty policies may apply.
CAUTION
United States law restricts this product to sale by or on the order of a physician.
Operator’s Manual ZM-540PA/541PA
iii
Equipment Authorization Requirement
This device complies with Part 15 of the FCC (Federal Communications Commission) Rules.
Operation is subject to the following two conditions:
(1) this device may not cause harmful interference, and
(2) this device must accept any interference received, including interference that may cause
undesired operation.
This device complies with Part 95 Subpart H of the FCC Rules to be used in wireless medical
telemetry service.
Operation of this equipment requires the prior coordination with a frequency coordinator designated
by FCC for the Wireless Medical Telemetry Service.
CAUTION
To comply with the FCC radio frequency (RF) exposure compliance requirements, no
change to the antenna or the device is permitted. Any change to the antenna or the
device could result in the device, exceeding the RF exposure requirements and void
user’s authority to operate this device.
NOTE
• Use this device only indoors.
• This device has been tested and complies with FCC radiation exposure limits set forth
for an uncontrolled environment. The RF transmission power from the antenna conforms
to the general public FCC RF Exposure Guidelines in Supplement C to OET65 limit of
Speciﬁc Absorption Rate (SAR) 1.6 W/kg. The maximum SAR value measured from this
device was extremely smaller than 1.6 W/kg. This device must not be located together
with or operated in conjunction with any other unspeciﬁed antenna or transmitter.
• The devices require registration and deployment by an authorized frequency coordinator.
The ASHE (American Society for Healthcare Engineering) has been designated by the
FCC to manage the WMTS frequencies. This device has frequency bands which may
not be used in some areas. For details, contact your Nihon Kohden representative. For
details on the guidelines, refer to the ASHE home page.
iv
Operator’s Manual ZM-540PA/541PA
EMC RELATED CAUTION
This equipment and/or system complies with IEC 60601-2 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.
Operator’s Manual ZM-540PA/541PA
6. Use with other equipment:
When the equipment and/or system is adjacent to or stacked with other equipment,
the equipment and/or system may affect the other equipment. Before use, check
that the equipment and/or system operates normally with the other equipment.
7. Use of unspeciﬁed accessory, transducer and/or cable:
When an unspeciﬁed accessory, transducer and/or cable is connected to this
equipment and/or system, it may cause increased electromagnetic emission
or decreased electromagnetic immunity. The speciﬁed conﬁguration of this
equipment and/or system complies with the electromagnetic requirements with the
speciﬁed conﬁguration. Only use this equipment and/or system with the speciﬁed
conﬁguration.
8. Use of unspeciﬁed conﬁguration:
When the equipment and/or system is used with the unspeciﬁed system
conﬁguration different than the conﬁguration of EMC testing, it may cause
increased electromagnetic emission or decreased electromagnetic immunity.
Only use this equipment and/or system with the speciﬁed conﬁguration.
9. Measurement with excessive sensitivity:
The equipment and/or system is designed to measure bioelectrical signals with
a speciﬁed sensitivity. If the equipment and/or system is used with excessive
sensitivity, artifact may appear by electromagnetic interference and this may
cause mis-diagnosis. When unexpected artifact appears, inspect the surrounding
electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon
Kohden representative for additional suggestions.
vi
Operator’s Manual ZM-540PA/541PA
Conventions Used in this Manual and Instrument
Warnings, Cautions and Notes
Warnings, cautions and notes are used in this manual to alert or signal the reader to speciﬁc
information.
WARNING
A warning alerts the user to the possible injury or death associated with the use or
misuse of the instrument.
CAUTION
A caution alerts the user to possible injury or problems with the instrument associated
with its use or misuse such as instrument malfunction, instrument failure, damage to
the instrument, or damage to other property.
NOTE
A note provides speciﬁc information, in the form of recommendations, prerequirements,
alternative methods or supplemental information.
Operator’s Manual ZM-540PA/541PA
vii
Explanations of the Symbols in this Manual and Instrument
The following symbols found in this manual/instrument bear the respective descriptions as given.
On Panel
Symbol
Description
Symbol
Description
Change screen
Deﬁbrillation proof type BF
applied part
Attention, consult operator’s
manual
Deﬁbrillation proof type CF
applied part
Moves cursor, scrolls data
Serial number
Direction for attaching battery
cover
Year of manufacture
Direction for inserting battery
RF transmitter
Non-ionizing radiation
Direct current
CSA mark
On LCD
Symbol
viii
Description
Symbol
Description
Full battery
Battery very weak
Replace battery
Battery 2/3 full
Alarm suspended
Low battery
NIBP cannot be measured
QRS/pulse sync mark
Operator’s Manual ZM-540PA/541PA
Intended Use
General
The ZM-540PA and ZM-541PA transmitter transmits ECG, respiration and pulse waveforms, SpO2
and NIBP data from a patient to a Nihon Kohden monitor for continuous monitoring. The front LCD
displays ECG (or pulse wave), numeric values of monitoring parameters, NIBP measuring mode and
interval, messages and battery condition.* It also displays the compressed waveform and numeric
data of the latest 10 minutes.
* Essential performance of this transmitter.
The difference between the ZM-540PA and ZM-541PA is the transmission frequency range.
ZM-540PA: 608.0250 MHz (channel number 9002) to 613.9750 MHz (channel number 9478)
ZM-541PA: 1395.0250 MHz (channel number E002) to 1399.9750 MHz (channel number E398)
1427.0250 MHz (channel number E502) to 1431.9750 MHz (channel number E898)
The transmitter channel can be changed with a QI-901PK channel writer.
Read the operator’s manual for the receiving monitor together with this manual before use.
WARNING
Do not use the same transmitter on more than one patient at the same time. Do not
connect different sensors on different patients to the same transmitter.
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
Be aware that signal loss and artifact may occur because of the multipath
cancellation* when using a transmitter.
* Multipath Cancellation (Standing Wave Interference)
When a radio wave reﬂects off a surface, there may be some points in the room where the
Operator’s Manual ZM-540PA/541PA
reﬂected and direct waves are exactly out of phase. At these points in the room, the reﬂected
and direct waves cancel each other out so that the signal strength is 0. This is called “multipath
cancellation” or “standing wave interference”. Locations where signal loss occurs are called “null
spots”. If the transmitter is moving or nearby people or objects are moving, null spots can occur
anytime and anywhere.
NOTE
• To prevent interference between channels, assign a channel administrator in the hospital
and only he or she should manage channel assignment.
• Use Nihon Kohden parts and accessories to assure maximum performance from your
instrument.
• For stable signal reception, it is recommended to use a diversity antenna system on the
receiving monitor. Otherwise, spike noise from transient fading of electric ﬁeld strength
(for example, people moving) may interfere with the transmitter signal and may be
mistaken as an arrhythmia on the receiving monitor.
• For details on antennas and antenna construction, contact your Nihon Kohden
representative. You can also refer to the Telemetry System Installation Guide.
• Do not diagnose a patient based on only part of the monitoring data on the transmitter or
only on the data acquired by the transmitter. Overall judgment must be performed by a
physician who understands the features, limitations and characteristics of the transmitter
by reading this operator’s manual thoroughly and by reading the biomedical signals
acquired by other instruments.
Receiving Monitor
Any Nihon Kohden receiving monitor (central monitor with multiple patient receiver) can receive
signals from this transmitter as long as the protocol version and channel setting are the same on the
receiving monitor and transmitter.
NOTE
• For details on the receiving monitor and upgrade information, contact your Nihon Kohden
representative.
• The transmitter does not give any patient alarm, only a “no battery” alarm. Patient alarms
must be managed on the receiving monitor.
Operator’s Manual ZM-540PA/541PA
Panel Description
Front Panel
Refer to the WARNING
on the next page.
No.
Name
Description
LCD
Displays numeric values, ECG or pulse wave, NIBP measuring
mode and interval, messages and battery status. For details, refer to
the “Screen Descriptions” section.
Infrared receiver
Used for upgrading the transmitter software.
Screen key
Toggles the screen in the following order.
After power on: Start up → Check electrodes → Numeric and
waveform → Waveform review → Numeric review → Display off
→ Check electrodes …
After auto display off: Numeric and waveform → Waveform
review → Numeric review → Display off → Check electrodes →
Numeric and waveform …
On a SETUP or CHECK screen, this key cancels changing setting
or exits the screen.
Operator’s Manual ZM-540PA/541PA
4
Refer to the WARNING
below.
No.
Name
Description
Function key
Depending on the setting on the transmitter, this key suspends
alarms, pauses monitoring on the receiving monitor or transmits
“Patient conﬁrmed” message.
On a SETUP screen, this key registers the selected setting and
moves the cursor to the next setting item.
On a CHECK screen, this key starts or stops maintenance test.
NIBP Start/Stop key
Starts/stops NIBP measurement in selected mode.
NIBP Interval key
Selects NIBP measurement mode.
Lead/Scroll keys
On the numeric and waveform screen, these keys change the ECG
lead.
On the waveform review screen, these keys scroll data.
On a SETUP screen, these keys move the cursor.
Battery case
Contains three 1.5 V dry cell batteries (AA TYPE).
WARNING
Close the battery case cover during operation. If the transmitter is used with the
battery case cover open, anyone who touches the opened battery case may receive
an electrical shock when deﬁbrillation is performed. Touching the opened battery case
may cause electrostatic discharge and intermittently interfere with the waveform or
data.
Operator’s Manual ZM-540PA/541PA
Rear Panel
Lock plate
Fastens the transmitter to an NIBP cuff.
Refer to the symbol
page.
Refer to the WARNING
below.
WARNING
This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop
using it and contact your Nihon Kohden representative. If a wet transmitter is used,
the patient or operator may receive an electrical shock or injury.
Operator’s Manual ZM-540PA/541PA
Top Panel
Refer to the WARNING on the
next page.
Refer to the WARNING on the
next page.
Refer to the symbol
page.
NIBP socket:
Connects the cuff
hose.
Refer to the symbol page.
ECG/impedance RESP socket:
Connects the electrode lead for measuring
ECG and/or respiration (impedance).
Bottom Panel
Channel number label:
Indicates the channel number of the
transmitter. Attach the channel number label
to the panel of the receiving monitor.
Refer to the symbol page.
Refer to the WARNING
on the next page.
SpO2 socket:
Connects the SpO2
probe.
Operator’s Manual ZM-540PA/541PA
WARNING
WARNING
Before deﬁbrillation, all persons must
keep clear of the bed and must not
touch the patient or any equipment or
cord connected to the patient. Failure
to follow this warning may cause
electrical shock or injury.
When performing deﬁbrillation,
discharge as far as possible from
electrodes, patches and any gel,
cream or medicine on the chest of the
patient. If there is a possibility that the
deﬁbrillator paddle could touch these
materials, remove them from the
patient. If the deﬁbrillator paddle
directly contacts these materials, the
discharged energy may cause skin
burn to the patient.
WARNING
CAUTION
When the transmitter is used with an
electrosurgical unit (ESU), ﬁrmly
attach the entire area of the ESU
return plate. Otherwise, the current
from the ESU ﬂows into the electrodes
of the transmitter, causing electrical
burn where the electrodes are
attached. For details, refer to the ESU
manual.
Do not shake or swing the transmitter
while holding the leads or cables
connected to the transmitter. The
transmitter may come off and injure
someone or damage surrounding
instruments.
Operator’s Manual ZM-540PA/541PA
Important Safety Information
General
WARNING
WARNING
Never use the transmitter in the
presence of any ﬂammable anesthetic
gas or high concentration oxygen
atmosphere. Failure to follow this
warning may cause explosion or ﬁre.
Never use the transmitter in a
hyperbaric oxygen chamber. Failure to
follow this warning may cause
explosion or ﬁre.
WARNING
WARNING
Do not take this transmitter into the
MRI test room. This transmitter is not
designed to be used during MRI tests.
When performing MRI test, remove all
electrodes, probe and cuff from the
patient which are used with this
transmitter. Failure to follow this
warning may cause skin burn on the
patient. For details, refer to the MRI
manual.
WARNING
WARNING
Before deﬁbrillation, all persons must
keep clear of the bed and must not
touch the patient or any equipment or
cord connected to the patient. Failure
to follow this warning may cause
electrical shock or injury.
When performing deﬁbrillation,
discharge as far as possible from
electrodes, patches and any gel,
cream or medicine on the chest of the
patient. If there is a possibility that the
deﬁbrillator paddle could touch these
materials, remove them from the
patient. If the deﬁbrillator paddle
directly contacts these materials, the
discharged energy may cause skin
burn to the patient.
Operator’s Manual ZM-540PA/541PA
WARNING
WARNING
When the transmitter is used with an
electrosurgical unit (ESU), ﬁrmly
attach the entire area of the ESU
return plate. Otherwise, the current
from the ESU ﬂows into the electrodes
of the transmitter, causing electrical
burn where the electrodes are
attached. For details, refer to the ESU
manual.
This transmitter is not waterproof. If
detergent or liquid spills into the
transmitter, stop using it and contact
your Nihon Kohden representative. If a
wet transmitter is used, the patient or
operator may receive an electrical
shock or injury.
WARNING
WARNING
Close the battery case cover during
operation. If the transmitter is used
with the battery case cover open,
anyone who touches the opened
battery case may receive an electrical
shock when deﬁbrillation is performed.
Touching the opened battery case
may cause electrostatic discharge and
intermittently interfere with the
waveform or data.
Do not use the same transmitter on
more than one patient at the same
time. Do not connect different sensors
on different patients to the same
transmitter.
CAUTION
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
CAUTION
The measurement values and
displayed waveforms on the
transmitter and receiving monitor may
be different due to timing delay of the
display or difference in detection
settings.
Do not shake or swing the transmitter
while holding the leads or cables
connected to the transmitter. The
transmitter may come off and injure
someone or damage surrounding
instruments.
Operator’s Manual ZM-540PA/541PA
CAUTION
CAUTION
Be aware that signal loss and artifact
may occur because of the multipath
cancellation* when using a transmitter.
Turn off the power of mobile phones,
small wireless devices and other
devices which produce strong
electromagnetic interference around a
patient (except for devices allowed by
the hospital administrator). Radio
waves from devices such as mobile
phones or small wireless devices may
be mistaken as pulse waves and the
displayed data may be incorrect.
* Multipath Cancellation (Standing Wave
Interference)
When a radio wave reﬂects off a surface,
there may be some points in the room where
the reﬂected and direct waves are exactly
out of phase. At these points in the room, the
reﬂected and direct waves cancel each other
out so that the signal strength is 0. This is
called “multipath cancellation” or “standing
wave interference”. Locations where signal
loss occurs are called “null spots”. If the
transmitter is moving or nearby people or
objects are moving, null spots can occur
anytime and anywhere.
CAUTION
• Do not use the same channel
for different patients. If the same
channel is used for two patients, the
two patients’ data will be lost due to
mutual modulation interference, or
another patient’s data may appear
on the receiving monitor screen.
• Do not use two transmitters with
adjacent channels in the same
hospital. If transmitters with
adjacent channels are used, their
radio waves interfere with each
other.
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.
10
Operator’s Manual ZM-540PA/541PA
Battery
CAUTION
CAUTION
Battery replacement must be
performed by the operator. When
replacing the batteries of a transmitter
that is currently used for a patient,
disconnect the electrode leads from
the transmitter before replacing
batteries or do not touch the patient
during replacement.
Refer to the battery and battery
charger manuals for details on
handling the batteries.
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.
Operator’s Manual ZM-540PA/541PA
11
For Patients Using Implantable Pacemaker
WARNING
Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac
Monitoring and Diagnostic Equipment*
The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive
implantable pacemaker may be affected by transmitter which is connected to the
same patient. If this occurs, the pacemaker may pace at its maximum rate and the
transmitter may give incorrect data to the monitor. If this occurs, disconnect the
electrode leads from the patient or change the setting on the pacemaker by referring
to the pacemaker’s manual. For more details, contact your pacemaker representative
or Nihon Kohden representative.
* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric
impedance measurement (BIM). Many medical devices in addition to pacemakers use this
technology. When one of these devices is used on a patient with an active, minute ventilation rateadaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals created
in the patient, resulting in an elevated pacing rate.
For more information, see the FDA web site.
http://www.fda.gov/cdrh/safety.html
ECG Monitoring
12
CAUTION
CAUTION
Only use Nihon Kohden speciﬁed
electrodes and electrode leads. When
other electrodes or electrode leads
are used, the “CHECK
ELECTRODES” message may appear
and monitoring may stop.
When the “ELECTRODE OFF” or
“CHECK ELECTRODES” message is
displayed on the receiving monitor,
ECG is not monitored properly and
the ECG alarm does not function.
Check the electrode, electrode leads,
and if necessary, replace with new
ones.
Operator’s Manual ZM-540PA/541PA
SpO2 Monitoring
WARNING
WARNING
SpO2 measurement may be incorrect
in the following cases.
• When the patient’s
carboxyhemoglobin or
methemoglobin increases
abnormally.
• When dye is injected in the blood.
• When using an electrosurgical unit.
• During CPR.
• When measuring at a site with
venous pulse.
• When there is body movement.
• When the pulse wave is small
(insufﬁcient peripheral circulation).
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
WARNING
• When using the TL-201T ﬁnger
probe, do not fasten the probe and
cable to the ﬁnger by wrapping
with tape. This may cause burn,
congestion or pressure necrosis
from poor blood circulation.
• When using probes other than the
TL-201T ﬁnger probe, to avoid poor
circulation, do not wrap the tape too
tight. Check the blood circulation
condition by observing the skin
color and congestion at the skin
peripheral to the probe attachment
site. Even for short-term monitoring,
there may be burn or pressure
necrosis from poor blood circulation,
especially on neonates or low
birth weight infants whose skin is
delicate. Accurate measurement
cannot be performed on a site with
poor peripheral circulation.
Check the circulation condition by
observing the skin color at the
measurement site and pulse
waveform. Change the measurement
site every 8 hours for disposable
probes and every 4 hours for reusable
probes (every 8 hours for TL-630T/TL631T 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 peripheral circulation
insufﬁciency
• Neonate or low birth weight infant
with delicate skin
Operator’s Manual ZM-540PA/541PA
13
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.
CAUTION
CAUTION
Refer to the probe instruction manual
for details.
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
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.*
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.
* Monitoring SpO2 during NIBP Measurement
When the SpO2 probe is attached to the
same limb as the NIBP cuff, the blood
ﬂow decreases during NIBP measurement
and pulse wave cannot 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 the
NIBP, be careful when reading SpO2 values.
14
CAUTION
Normal external light does not affect
monitoring but strong light such as a
surgical light or sunlight may affect
monitoring. If affected, cover the
measuring site with a blanket.
CAUTION
When a message indicates a faulty
probe, stop monitoring and replace
the probe with a new one.
Operator’s Manual ZM-540PA/541PA
CAUTION
Do not use a damaged or
disassembled probe. It causes
incorrect measurement and may
injure the patient.
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
Do not pull or bend the probe cable,
and do not put caster feet on the
probe cable. Do not immerse the
disposable probe cable in chemical
solutions or water. Failure to follow
these instructions may cause cable
discontinuity, short circuit, skin burn
on the patient and incorrect
measurement data. Replace any
broken probe with a new one.
Operator’s Manual ZM-540PA/541PA
CAUTION
Do not use a probe which is
deteriorated by aging. Accurate
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
When the probe is attached on an
appropriate site with sufﬁcient
circulation and the error message
conﬁrming the probe attachment
repeatedly appears, the probe may be
deteriorated. Replace it with a new
one.
15
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
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.
CAUTION
CAUTION
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.
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.
16
WARNING
NIBP measurement may be incorrect
in the following cases.
• When using an electrosurgical unit
• When there is body movement
• When the pulse wave is small
(insufﬁcient peripheral circulation)
• Too many arrhythmias
• When there is vibration
• When there is a rapid blood
pressure change
• During CPR
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.
Operator’s Manual ZM-540PA/541PA
CAUTION
When performing NIBP measurement
repeatedly, have a rest between
measurements to recover adequate
circulation.
Maintenance
CAUTION
This transmitter is not waterproof. If
detergent or liquid spills into the
transmitter, stop cleaning or
disinfecting it and contact your Nihon
Kohden representative. The
transmitter needs to be checked for
safety and function before use.
Operator’s Manual ZM-540PA/541PA
CAUTION
Never disassemble or repair the
transmitter. Disassembly and repair
must be performed by qualiﬁed
service personnel.
17
Preparation on Transmitter
Batteries
WARNING and CAUTION for Handling Batteries
CAUTION
CAUTION
Refer to the battery and battery
charger manuals for details on
handling the batteries.
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.
CAUTION
Do not handle the batteries with wet
hands.
NOTE
Remove the batteries from the transmitter before disposing of it.
Battery Lifetime
Use three AA type alkaline dry cell batteries. NiMH batteries can also be used but the lifetime of
alkaline batteries is longer. The lifetime of NiMH batteries is about 1/2 of alkaline batteries (when
fully charged).
With new Nihon Kohden recommended alkaline batteries, the transmitter can continuously measure
ECG, respiration, SpO2 and NIBP for approximately 1 day. The measurement is performed at room
temperature, NIBP is measured in auto mode at 60 minute intervals and SpO2 is measured on an
index ﬁnger of a male patient with weight 60 kg. Operation time depends on the thickness of the
SpO2 probe attachment site.
Recommended batteries
NiMH secondary: SANYO HR-3UF (W)
Battery charger: SANYO NC-M55
Alkaline primary: Nihon Kohden Medipower (equivalent to Panasonic LR6 (G))
18
Operator’s Manual ZM-540PA/541PA
Installing (Replacing) Batteries
CAUTION
Battery replacement must be performed by the operator. When replacing the batteries
of a transmitter that is currently used for a patient, disconnect the electrode leads
from the transmitter before replacing batteries or do not touch the patient during
replacement.
If electrode leads are attached to the patient and the person replacing batteries touches the patient
during battery replacement, excess patient leakage current may ﬂow into the patient.
NOTE
•
•
•
•
Replace all batteries at the same time.
Do not use different types of batteries together.
Insert the batteries with the correct polarity (+ and –).
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.
Operator’s Manual ZM-540PA/541PA
1.
Remove the battery case cover.
2.
Insert three new or fully charged batteries into
the battery case observing the correct polarity.
19
3.
Close the cover.
The transmitter is automatically turned on when the
batteries are installed and the cover is closed.
Situations Requiring Battery Replacement
Replace the batteries when any of the following occurs:
• The transmitter displays the “BATTERY WEAK” message or “
” icon.
• The transmitter generates a constant alarm (continuous “peep” sound).
• The transmitter LCD does not display anything when the power is turned on.
• The receiving monitor displays a battery replacement message.
Battery Level Indication
The following icons on the LCD indicate the battery level. When “PROTOCOL” on the SYSTEM
SETUP screen is set to 57, the battery level indication is transmitted to the receiving monitor.
Indication
Battery Level
Message on the Receiving Monitor
Fully charged batteries
Batteries are 2/3 full.
There is no message on the monitor.
Batteries are low. NIBP cannot
be measured. Replace batteries.
Batteries are very weak.
No indication Dead batteries
Message requiring battery replacement is
displayed.
No signal can be transmitted to the monitor.
There is no indication on the monitor.
Turning On the Transmitter
When the batteries are installed correctly, the power is turned on. A one second “peep” sounds and
the startup screen appears, then the check electrodes screen appears. (There is no “peep” sound
when there is no battery power.)
20
Operator’s Manual ZM-540PA/541PA
After checking that the ECG is stable on the check electrodes screen, press the Screen key to display
the numeric and waveform screen.
For details on the screen, refer to the “Screen Descriptions” section.
Check Items Before Use
Before turning on the transmitter power, check the following to conﬁrm that the transmitter can be
used in normal and safe condition.
Appearance
• There are no damaged or dirty parts on the outside of the transmitter (LCD, keys, sockets, battery
case cover, battery case, lock plate, etc.).
• The transmitter is completely dry.
• The electrodes, electrode lead, SpO2 probe and NIBP cuff are not broken.
Batteries
• The battery polarity is correct.
• The battery case spring is ﬁrmly attached and the battery is not loose.
• The battery case cover is ﬁrmly closed.
Channel Setting
• The transmitter channel matches the receiving monitor channel.
• There is no nearby transmitter with the same channel.
Operator’s Manual ZM-540PA/541PA
21
Check Items After Power On
After turning on the power, check the following.
Power On
• The transmitter generates a one second “peep” sound and the startup screen appears.
• The transmitter displays the check electrodes screen.
• The transmitter is not too hot.
• The transmitter does not display the “BATTERY WEAK” message.
• The transmitter does not interfere with the operation of other medical instruments.
Daily Check
• The “signal loss” message is not displayed on the receiving monitor when the transmitter is inside
the receiving range of the monitor.
• The battery replacement message is not displayed on the monitor.
• The keys on the transmitter function properly.
• The LCD brightness is appropriate. To adjust brightness, refer to the “Changing SYSTEM SETUP
Settings” section.
Check Items After Use
To use the transmitter in safe and optimum condition for next time, check the following.
Before Turning Power Off
• Temporarily changed settings are changed back to the previous settings.
• There was no malfunction on the transmitter.
Storage
• ECG electrode leads, SpO2 probe and NIBP cuff are cleaned and disinfected.
• If the transmitter got wet, liquid is wiped off and the transmitter is thoroughly dried.
• There are enough consumables, such as disposable electrodes.
• The transmitter power is turned off by removing batteries from the transmitter.
• Dead batteries are disposed of properly.
Turning Off the Transmitter
To turn off the power, remove batteries. When the power is turned off, the saved waveform and
numeric data are deleted.
22
Operator’s Manual ZM-540PA/541PA
Changing the Transmitter Channel
The channel of the transmitter can be changed with an optional QI-901PK Channel Writer.
WARNING
The following actions must be taken to properly receive the transmitter signal of the
correct patient on the receiving instrument. Otherwise, there may be signal loss or
signals may mix causing a serious accident, such as monitoring a different patient.
• Assign a channel administrator in the hospital and only he or she should manage
channel assignment.
• The channel administrator must manage the channels in the facility so that there is
no signal interference.
• When the transmitter channel is changed, the channel administrator must check
that the channel on the receiving monitor is also changed and the signal is properly
received.
• The channel administrator must replace the channel number label on the
transmitter with the new one after changing the channel.
NOTE
• The software version of the QI-901PK channel writer must be 02-01 or later to change
the channel on the transmitter.
• The channel writer must be used outside the patient environment.
The channel is displayed in the upper left corner of the screen.
Channel
Operator’s Manual ZM-540PA/541PA
23
Changing Parameter and System Setup Settings
The initial settings on the PARAMETER SETUP and SYSTEM SETUP screens can only be
changed before monitoring. Changing these settings during monitoring interrupts monitoring.
NOTE
Changing Parameter and System Setup settings must be done by qualiﬁed personnel.
Notes on Parameter Settings
When monitoring NIBP and SpO2, the following setting must be set as indicated in the table
to properly transmit the monitoring data to the receiving monitor. Otherwise, SpO2 cannot be
monitored properly during NIBP measurement.
Some receiving monitors require the software to be upgraded. For details, contact your Nihon
Kohden representative.
SpO2 probe attachment site
INHIBIT SpO2 DURING NIBP setting
Probe attached to the same limb as the cuff*
ON
Probe attached to the limb without cuff
OFF
* When the SpO2 probe is attached to the same limb as the NIBP cuff and the cuff is inﬂated,
the SpO2 value becomes unstable and SpO2 or PR alarm may occur.
24
Operator’s Manual ZM-540PA/541PA
Changing PARAMETER SETUP Settings
Parameter Setup Setting List
The factory default settings are underlined.
Setting Item
Description
ECG ELECTRODES Select the electrode lead type.
LEAD TYPE
Select the type of ECG leads.
Turn ECG monitoring on or off. When electrodes are
attached to the patient and ECG leads are connected,
ECG monitoring starts even when this setting is set to
OFF.
If this setting is set to OFF, the same setting on the
receiving monitor must also be set to OFF.
ECG
MEASUREMENT
NOTE
When “PROTOCOL” on 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.
Turn respiration monitoring on or off.
RESP
When this setting is set to OFF, the same setting on the
MEASUREMENT
receiving monitor is automatically set to OFF.
Select the SpO2 response mode.
FAST:
Select this for special applications that
require a fast response. FAST is suitable
for detecting short apnea.
SpO2 RESPONSE
NORMAL: For normal monitoring.
SLOW:
Select this when you need to suppress a
rapid change in SpO2.
INHIBIT SpO2
Turn SpO2 monitoring on or off during NIBP
DURING NIBP
measurement.
SELECTABLE
Select the NIBP measurement modes for the mode
INTERVALS (min)
selection.
INITIAL INTERVAL Select the initial NIBP measurement mode at power
(min)
on.
NIBP MODE AFTER Select the NIBP measurement mode after completing
STAT (min)
STAT measurement.
START/FINISH
SOUND
Turn ON or OFF the sound for NIBP measurement
start/ﬁnish.
Operator’s Manual ZM-540PA/541PA
Settings
IEC, AHA
AUTO, 6 LEADS
ON, OFF
ON, OFF
FAST, NORMAL,
SLOW
ON, OFF
STAT, 5, 10, 15,
30, 60, 120, 240
MANUAL, 5, 10,
15, 30, 60, 120,
240
MANUAL, 5, 10,
15, 30, 60, 120,
240
START: ON, OFF
FINISH: ON, OFF
25
Setting Item
Description
Settings
Select whether to hide or dim the NIBP data after
DATA: HIDE,
OLD NIBP DATA/
measurement and how long to wait after measurement DIM
AFTER (min)
to dim or hide it.
AFTER: 5, 10, 30
INITIAL CUFF
120, 150, 180,
Select the NIBP cuff inﬂation pressure.
PRESSURE (mmHg)
210, 240
Displaying the PARAMETER SETUP Screen
1.
Turn off the transmitter by removing one
battery.
2.
While pressing the Function key, turn on
the transmitter (install the battery). The
MENU screen appears.
3.
Press the key to move the cursor to
“PARAMETER SETUP”.
4.
Press the Function key to enter
PARAMETER SETUP. The current
settings are highlighted.
5.
Change settings:
• To move the cursor and select the setting
item, press the or key then press
the Function key.
• To select and register the setting, press
the or key then press the Function
key.
• To cancel changing the setting of the
selected item, press the Screen key.
6.
When changing settings on the
PARAMETER SETUP screen is complete,
press the Screen key to return to the
MENU screen.
Cursor Setting item Setting
▼
▼
7.
Press the
8.
Press the Function key. The numeric and waveform screen appears.
26
or
▼
▼
▼
PARAMETER SETUP screen - page 1
▼
MENU screen
▼
Cursor
key to move the cursor to “EXIT”.
Operator’s Manual ZM-540PA/541PA
Changing Parameter Setup Settings
ECG ELECTRODES
Select the electrode lead type.
Cursor
On the PARAMETER SETUP screen,
press the key to move the cursor to
“ECG ELECTRODES”.
2.
Press the Function key. The cursor moves
to the selection item.
3.
Press the
4.
Press the Function key to register the
selected setting. The cursor returns to
“ECG ELECTRODES”.
▼
1.
Selected setting
▼
Cursor Setting item
key to select “IEC” or “AHA”.
▼
LEAD TYPE
Select the type of ECG leads. In normal use, select “AUTO”. When using DIN type lead with 6
electrodes, select “6 LEADS”.
1.
On the PARAMETER SETUP screen, press the
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “LEAD TYPE”.
▼
key to move the cursor to “LEAD TYPE”.
key to select “AUTO” or “6 LEADS”.
Operator’s Manual ZM-540PA/541PA
27
ECG MEASUREMENT
Turn ECG monitoring on or off. When electrodes are attached to the patient and ECG leads are
connected, ECG monitoring starts even when this setting is set to OFF.
If this setting is set to OFF, the same setting on the receiving monitor must also be set to OFF.
NOTE
▼
When “PROTOCOL” on the transmitter is set to 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.
1.
On the PARAMETER SETUP screen, press the
MEASUREMENT”.
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “ECG
MEASUREMENT”.
▼
key to move the cursor to “ECG
key to select “ON” or “OFF”.
▼
RESP MEASUREMENT
Turn respiration monitoring on or off. When this setting is set to OFF, the same setting on the
receiving monitor is automatically set to OFF.
1.
On the PARAMETER SETUP screen, press the
MEASUREMENT”.
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “RESP
MEASUREMENT”.
28
▼
key to move the cursor to “RESP
key to select “ON” or “OFF”.
Operator’s Manual ZM-540PA/541PA
SpO2 RESPONSE
Select the SpO2 response mode.
FAST:
Select this for special applications that require a fast response. FAST is suitable for
detecting short apnea.
NORMAL: For normal monitoring.
SLOW:
Select this when you need to suppress a rapid change in SpO2.
On the PARAMETER SETUP screen,
press the key to move the cursor to
“SpO2 RESPONSE”. “SpO2 RESPONSE”
is on the second page of the PARAMETER
SETUP screen.
2.
Press the Function key.
3.
Press the key to select “FAST”,
“NORMAL” or “SLOW”.
4.
Press the Function key to register the
selected setting. The cursor returns to
“SpO2 RESPONSE”.
PARAMETER SETUP screen - page 2
▼
▼
1.
INHIBIT SpO2 DURING NIBP
Turn SpO2 monitoring on or off during NIBP measurement.
When the SpO2 probe is attached to the same limb as the NIBP cuff and this setting is set to OFF, the
pulse may become unstable and SpO2 or PR alarm may occur. It is recommended to set this setting
to ON so that SpO2 is not measured during NIBP measurement.
When the SpO2 probe is attached to the other limb from the NIBP cuff, this setting can be set to
OFF.
NOTE
▼
When this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the “Monitoring SpO2
during NIBP Measurement” section.
On the PARAMETER SETUP screen, press the key to move the cursor to “INHIBIT
SpO2 DURING NIBP”. “INHIBIT SpO2 DURING NIBP” is on the second page of the
PARAMETER SETUP screen.
2.
Press the Function key.
3.
Press the
▼
1.
key to select “ON” or “OFF”.
Operator’s Manual ZM-540PA/541PA
29
4.
Press the Function key to register the selected setting. The cursor returns to “INHIBIT SpO2
DURING NIBP”.
SELECTABLE INTERVALS (min)
When the NIBP INTERVAL key is pressed, the measurement mode changes according to the modes
selected in this item. MANUAL mode is already selected for the mode selection.
On the PARAMETER SETUP screen,
press the key to move the cursor
to “SELECTABLE INTERVALS”.
“SELECTABLE INTERVALS” is on the
third page of the PARAMETER SETUP
screen.
2.
Press the Function key.
3.
Press the key to select or unselect the
mode. The selected modes are highlighted.
4.
Press the Function key to register the
selected setting. The cursor returns to
“SELECTABLE INTERVALS”.
PARAMETER SETUP screen - page 3
▼
▼
1.
▼
INITIAL INTERVAL (min)
Select the initial NIBP measurement mode at power on.
On the PARAMETER SETUP screen, press the key to move the cursor to “INITIAL
INTERVAL”. “INITIAL INTERVAL” is on the third page of the PARAMETER SETUP screen.
2.
Press the Function key.
3.
Press the key to select the mode. Only the mode or interval selected for “SELECTABLE
INTERVALS” are available.
4.
Press the Function key to register the selected setting. The cursor returns to “INITIAL
INTERVAL”.
▼
1.
1.
30
▼
NIBP MODE AFTER STAT (min)
Select the NIBP measurement mode after completing the STAT measurement.
On the PARAMETER SETUP screen, press the key to move the cursor to “NIBP MODE
AFTER STAT”. “NIBP MODE AFTER STAT” is on the third page of the PARAMETER
SETUP screen.
Operator’s Manual ZM-540PA/541PA
Press the Function key.
3.
Press the key to select the mode. Only the mode or interval selected for “SELECTABLE
INTERVALS” are available.
4.
Press the Function key to register the selected setting. The cursor returns to “NIBP MODE
AFTER STAT”.
▼
2.
START/FINISH SOUND
Turn on or off the sound for NIBP measurement start and ﬁnish.
On the PARAMETER SETUP screen,
press the key to move the cursor to
“START/FINISH SOUND”. “START/
FINISH SOUND” is on the fourth page of
the PARAMETER SETUP screen.
2.
Press the Function key. The cursor moves
to “START”.
3.
Press the key to turn “ON” or “OFF” the
sound for NIBP measurement start.
4.
Press the Function key to register the
setting for “START”. The cursor moves to
“FINISH”.
5.
Press the key to turn “ON” or “OFF” the
sound for NIBP measurement ﬁnish.
6.
Press the Function key to register the
selected setting. The cursor returns to
“START/FINISH SOUND”.
▼
▼
1.
▼
PARAMETER SETUP screen - page 4
▼
OLD NIBP DATA/AFTER (min)
Select whether to dim or hide the NIBP data after measurement and how long to wait after NIBP
measurement to dim or hide it.
1.
On the PARAMETER SETUP screen, press the key to move the cursor to “OLD NIBP
DATA/AFTER”. “OLD NIBP DATA/AFTER” is on the fourth page of the PARAMETER
SETUP screen.
2.
Press the Function key. The cursor moves to “DATA”.
Operator’s Manual ZM-540PA/541PA
31
▼
key to select “HIDE” or “DIM” the NIBP data.
Press the
4.
Press the Function key to register the setting for “DATA”. The cursor moves to “AFTER”.
5.
Press the
6.
Press the Function key to register the selected setting. The cursor returns to “OLD NIBP DATA/
AFTER”.
▼
3.
key to select the interval after NIBP measurement to dim or hide.
▼
INITIAL CUFF PRESSURE (mmHg)
Select the NIBP cuff inﬂation pressure.
On the PARAMETER SETUP screen, press the key to move the cursor to “INITIAL CUFF
PRESSURE”. “INITIAL CUFF PRESSURE” is on the fourth page of the PARAMETER
SETUP screen.
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “INITIAL CUFF
PRESSURE”.
▼
1.
key to select the inﬂation pressure.
Changing SYSTEM SETUP Settings
System Setup Setting List
The factory default settings are underlined.
Setting Item
PROTOCOL
Description
Select the transmitting protocol.
57: New protocol. A central monitor with ORG9100A/9110A/9700A multiple patient receiver whose
software version 02-01 or later can receive this
protocol.
42: Old protocol. A central monitor with ORG9100A/9110A/9700A multiple patient receiver can
receive this protocol.
Settings
57, 42
NOTE
When 57 is set, the receiving monitor must be able
to receive protocol 57. Otherwise, signals from the
transmitter cannot be received.
32
Operator’s Manual ZM-540PA/541PA
Setting Item
Description
BRIGHTNESS
Select the screen brightness.
PRESSURE UNIT
Select the unit for NIBP.
Select the function of the Function key.
SUSPEND ALARM & PAUSE:
Suspends alarm on the receiving monitor for 2
minutes. Pauses monitoring on the transmitter and
receiving monitor.
SUSPEND ALARM:
Suspends alarm on the receiving monitor for 2
minutes.
CONFIRM:
Displays the “PATIENT CONFIRMED” message
on the transmitter screen and transmits the
message to the receiving monitor.
OFF: No function.
FUNCTION KEY
Settings
DARK,
BRIGHT
mmHg, kPa
SUSPEND
ALARM
& PAUSE,
SUSPEND
ALARM,
CONFIRM,
OFF
NOTE
“SUSPEND ALARM & PAUSE” and “CONFIRM” can
only be set when PROTOCOL is set to 57.
AUTO RESUME
AFTER PAUSE
Select the interval to resume monitoring after PAUSE.
Operator’s Manual ZM-540PA/541PA
10 s, 30 s, 1
min, 2 min, 3
min, OFF
33
Displaying the SYSTEM SETUP Screen
1.
Turn off the transmitter by removing one
battery.
2.
While pressing the Function key, turn on
the transmitter (install the battery). The
MENU screen appears.
3.
Press the key to move the cursor to
“SYSTEM SETUP”.
4.
Press the Function key to enter SYSTEM
SETUP. The current settings are
highlighted.
5.
Change settings.
• To move the cursor and select the setting
item, press the or key then press
the Function key.
• To select and register the setting, press
the or key then press the Function
key.
• To cancel changing the setting of the
selected item, press the Screen key.
▼
Cursor
Setting
▼
▼
▼
Setting item
▼
MENU screen
▼
The SYSTEM SETUP screen has two
pages. To display the second page,
press the key when the cursor is at
“PRESSURE UNIT”.
SYSTEM SETUP screen - page 1
7.
Press the
“EXIT”.
8.
Press the Function key. The numeric and
waveform screen appears.
or
▼
When changing settings on the SYSTEM
SETUP screen is complete, press the
Screen key to return to the MENU screen.
▼
34
6.
key to move the cursor to
Operator’s Manual ZM-540PA/541PA
Changing System Setup Settings
PROTOCOL
Select the transmitting protocol. For differences between protocols, refer to the table below.
57: New protocol. A central monitor with ORG-9100A/9110A/9700A multiple patient receiver
whose software version 02-01 or later can receive this protocol.
42: Old protocol. A central monitor with ORG-9100A/9110A/9700A multiple patient receiver can
receive this protocol.
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
Cursor
Setting
Operator’s Manual ZM-540PA/541PA
No
Yes
No
Yes
No
Yes
Some messages (refer
to the “Indication and All messages
Message List” section)
▼
Transmit SpO2 messages
Protocol 42
Protocol 57
No (ECG measurement
must be turned off on Yes
the receiving monitor)
1.
Press the key to move the cursor to
“PROTOCOL”.
2.
Press the Function key.
3.
Press the
▼
Function
Setting ECG MEASUREMENT to OFF on the
transmitter automatically turns off the ECG
measurement setting on the receiving monitor
Pause monitoring on the receiving monitor from
the transmitter
Transmit “PATIENT CONFIRMED” message
Display battery level of the transmitter on the
receiving monitor
key to select “57” or “42”.
35
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.
Press the Function key to register the
selected setting. The cursor returns to
“PROTOCOL”.
▼
BRIGHTNESS
Select the screen brightness.
1.
Press the
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “BRIGHTNESS”.
▼
key to move the cursor to “BRIGHTNESS”.
key to select “DARK” or “BRIGHT”.
▼
PRESSURE UNIT
Select the unit for NIBP.
key to move the cursor to “PRESSURE UNIT”.
Press the
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “PRESSURE
UNIT”.
36
▼
1.
key to select “mmHg” or “kPa”.
Operator’s Manual ZM-540PA/541PA
FUNCTION KEY
Select the function of the Function key.
SUSPEND ALARM & PAUSE: Suspends alarm on the receiving monitor for 2 minutes. Pauses
monitoring on the transmitter and receiving monitor.
SUSPEND ALARM:
Suspends alarm on the receiving monitor for 2 minutes.
CONFIRM:
Displays the “PATIENT CONFIRMED” message on the
transmitter screen and transmits the message to the receiving
monitor.
OFF:
No function.
NOTE
“SUSPEND ALARM & PAUSE” and “CONFIRM” can only be set when PROTOCOL is set to
57.
On the SYSTEM SETUP screen, press the
key to move the cursor to “FUNCTION
KEY”. “FUNCTION KEY” is on the
second page of the SYSTEM SETUP
screen.
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the
selected setting. The cursor returns
“FUNCTION KEY”.
SYSTEM SETUP screen - page 2
▼
▼
1.
key to select the function.
▼
AUTO RESUME AFTER PAUSE
Select the interval to resume monitoring after PAUSE.
Press the key to move the cursor to “AUTO RESUME AFTER PAUSE”. “AUTO RESUME
AFTER PAUSE” is on the second page of the SYSTEM SETUP screen.
2.
Press the Function key.
3.
Press the
4.
Press the Function key to register the selected setting. The cursor returns to “AUTO RESUME
AFTER PAUSE”.
▼
1.
key to select interval.
Operator’s Manual ZM-540PA/541PA
37
Initializing Settings
Do the following procedure to initialize all settings, except for channel, to the factory default
settings.
1.
Turn off the transmitter by removing a
battery.
2.
While pressing the Function key, turn on
the transmitter (put back the battery). The
MENU screen appears.
3.
Press the key to move the cursor to
“SYSTEM INITIALIZE”.
4.
Press the Function key to enter SYSTEM
INITIALIZE screen.
5.
Press the Function key to initialize settings.
The conﬁrmation message appears.
▼
Cursor
To return to the MENU screen without
initializing, press the Screen key.
Press the Function key to initialize settings.
▼
6.
To cancel initializing, press the key. The
screen returns to the MENU screen.
38
Operator’s Manual ZM-540PA/541PA
Attaching Electrodes, SpO2 Probe and NIBP Cuff
to the Patient
The transmitter can be attached to an arm of the patient or placed on the bedside. The required
length of the electrode leads and SpO2 probe cable depends on how the transmitter is to be attached
to the patient.
NOTE
Monitoring SpO2 during NIBP Measurement
When the SpO2 probe is attached to the same limb as the NIBP cuff, the blood ﬂow
decreases during NIBP measurement and pulse wave cannot 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 bedside
NOTE
When placing the transmitter on a bedside,
place it on a stable and ﬂat place. If the
transmitter falls off, it may be damaged.
Operator’s Manual ZM-540PA/541PA
39
Attaching Electrodes
Selecting Electrode Lead
CAUTION
Only use Nihon Kohden speciﬁed electrodes and electrode leads. When other
electrodes or electrode leads are used, the “CHECK ELECTRODES” message may
appear and monitoring may stop.
The following electrode leads can be used on the transmitter (option).
BR-903PA, 3 electrodes, clip type
BR-906PA, 6 electrodes, clip type
Connecting the Electrode Lead to the Transmitter
Connect the electrode lead to the ECG/RESP socket on the transmitter.
When transmitter is attached on an arm
40
CAUTION
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.
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.
Operator’s Manual ZM-540PA/541PA
Electrode Position
Follow the physician’s instructions for electrode placement when available.
For ECG monitoring, electrodes are attached only on the chest to allow patient movement and
obtain continuous stable ECG. The following leads are examples. When also monitoring respiration,
refer to the “Electrode Position for Respiration Monitoring” section.
NOTE
The optimum electrode positions for ECG measurement are not always optimum for
respiration measurement. Select positions that are suitable for both ECG and respiration
measurement or positions which give priority to either ECG or respiration measurement.
Electrode Positions for ECG Monitoring
Six Electrodes
The 6-electrode method with lead II and lead V5 is effective for monitoring myocardial ischemia.
You can improve monitoring accuracy considerably by adding lead V4 to this combination. Va and
Vb can be at any position of the standard 12 leads V1 to V6, but V4 and V5 are most appropriate for
myocardial ischemic monitoring.
LA/L
RA/R
Va/Ca
Vb/Cb
RL/RF
LL/F
Electrode Position
Symbol
AHA
IEC
Lead Color
AHA
IEC
Left infraclavicular fossa
LA
Black
Yellow
Right infraclavicular fossa
RA
White
Red
Below lowest rib on the left anterior axillary line
LL
Red
Green
Right anterior axillary line at the same level as LL/F
RL
RF
Green
Black
Va
Ca
Brown-blue
Whitebrown
Vb
Cb
Brownorange
White-black
Fifth intercostal space on the left midclavicular line.
(V4 position of standard 12 leads)
Left anterior axillary line at the same level as Va.
(V5 position of standard 12 leads)
Operator’s Manual ZM-540PA/541PA
41
Lead Position
Standard limb leads
Lead I
RA
Lead II
LA
Lead III
RA
LL
RA
LA
LL
LL
N (RL)
N (RL)
Monopolar limb leads
aVR lead
RA
N (RL)
aVL lead
aVF lead
RA
LA
RA
LA
N (RL)
LA
LL
LL
LL
LA
N (RL)
N (RL)
Monopolar chest leads
V1 to V6 leads
to
RA
LA
LL
N (RL)
Three Electrodes
• Lead MII, which is similar to standard lead II, used when ECG measurement has priority
Symbol
AHA
IEC
Electrode Position
Left infraclavicular
fossa
Right infraclavicular
fossa
Below lowest rib
on the left anterior
axillary line
42
Lead Color
AHA
IEC
LA
Black
Yellow
RA
White
Red
LL
Red
Green
Operator’s Manual ZM-540PA/541PA
• Lead MI, which is similar to standard lead I
Change F/LL and L/LA of lead MII.
• Lead MIII, which is similar to standard lead
III
Change R/RA and L/LA of lead MII.
If the electrode positions above are not available due to chest surgery, attach the electrodes to the
root of the limbs or below the clavicles for stable ECG monitoring.
Electrode Positions for Respiration Monitoring
Place the R/RA and F/LL electrodes so that the lungs are between the electrodes.
Position 1
In this position, respiration measurement is available; however, there is a difference in amplitude
between different patients.
R or RA
Right infraclavicular fossa
F or LL
Fifth intercostal space on the
left midclavicular line, V4
Position 2
In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead MII.
This position can be generally recommended.
R or RA
Right infraclavicular fossa
Operator’s Manual ZM-540PA/541PA
F or LL
Fifth intercostal space on the
left midaxillary line, V6
43
Position 3
In this position, the respiration waveform is optimum, but the ECG lead is unusual.
R or RA
Right midaxillary at the
horizontal level of V6
F or LL
Fifth intercostal space on the
left midaxillary line, V6
Position 4
In this position, the respiration measurement is inﬂuenced by the impedance variation of the
abdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that the
waveform is inverted in phase compared with the chest movement (the waveform goes down during
inspiration). It is difﬁcult to measure the ECG at the same time.
R or RA
Lowest rib on the right
anterior axillary line
F or LL
Lowest rib on the left anterior
axillary line
Attaching Electrodes to the Patient and Connecting the Electrode Leads to
Disposable Electrodes
Prepare the Patient Skin
Shave off excessive body hair.
To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistened with
alcohol. Thoroughly dry the skin with a clean cotton pad.
NOTE
• For a patient with frequent body movement, rub the sites with Skinpure skin preparation
gel. However, do not use Skinpure skin preparation gel on sensitive skin.
• Do not place electrodes on a wound or on an inﬂamed, wrinkled or uneven skin surface.
Attaching Electrodes to the Patient
CAUTION
Do not reuse disposable parts and accessories.
NOTE
• To maintain good contact between the electrode and skin, check that the paste of the
44
Operator’s Manual ZM-540PA/541PA
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.
Refer to the electrode operator’s manual for details.
1. Carefully remove the backing paper from the electrode.
Avoid touching the adhesive surface.
2. Place the electrode on the previously cleaned skin. Pay
attention to the electrode lead color and symbol.
3. Clip the electrode lead to the electrode.
4. Fasten the electrode lead wire with surgical tape with an
extra length of wire between the tape and the electrode.
This lessens the movement of electrode leads by body
movement and helps stable monitoring.
Checking ECG on the Transmitter Screen
After attaching electrodes and connecting ECG leads, check that the electrodes are properly attached
to the patient and the ECG waveform is acquired on the check electrodes screen. For details on the
screen, refer to the “Screen Descriptions” section.
Attaching the SpO2 Probe
Selecting the SpO2 Probe
Select an appropriate probe for the patient.
CAUTION
Only use Nihon Kohden speciﬁed
electrodes, electrode leads, SpO2
probes, and NIBP cuffs. Otherwise,
the maximum performance from the
transmitter cannot be guaranteed.
Operator’s Manual ZM-540PA/541PA
CAUTION
Do not use a damaged or
disassembled probe. It causes
incorrect measurement and may
injure the patient.
45
Reusable Probes
When using a TL-201T ﬁnger probe, choose the appropriate cable length for attachment.
Probe
Finger probe TL-201T
Cable Length
0.6 m
Patient
Adult or child
20 kg or more
Attachment Site
Finger
Adult or infant
3 kg or more
Finger or toe
Neonate
3 kg or less
Instep and sole
1.6 m
Multi-site probe TL-220T
Attachment tape
Finger probe
TL-630T1, TL-630T3,
TL-631T1, TL-631T3
TL-630T1, TL631T1: 0.6 m
TL-630T1/630T3: Finger or toe
Adult or child
50 kg or more
Attachment tape
TL-631T1/631T3:
Adult or child
20 kg or more
TL-630T3, TL631T3: 1.6 m
Disposable Probes
CAUTION
The disposable probe is not sterilized. Use the disposable probe only for a single
patient. Never reuse the disposable probe for another patient because it causes cross
infection.
46
Operator’s Manual ZM-540PA/541PA
Probe
Patient
Adult
30 kg or more
Attachment Site
Finger or toe
TL-252T
Child
3 to 40 kg
Finger or toe
TL-253T
Neonate
3 kg or less
Instep and sole
TL-051S, TL-052S
Adult
50 kg or more
Finger
Neonate
3 kg or less
Instep and sole
Adult or child
15 to 50 kg
Finger
Infant
3 to 15 kg
Toe
TL-251T
40 mm
Cable length TL-051S: 0.8 m
TL-052S: 1.6 m
TL-061S, TL-062S
35 mm
Cable length TL-061S: 0.8 m
TL-062S: 1.6 m
Operator’s Manual ZM-540PA/541PA
47
Probe
TL-271T, TL-271T3
Cable length TL-271T: 0.8 m
TL-271T3: 1.6 m
TL-272T, TL-272T3
Cable length TL-272T: 0.8 m
TL-272T3: 1.6 m
TL-273T, TL-273T3
Patient
Adult
30 kg or more
Attachment Site
Finger or toe
Child
10 to 50 kg
Neonate
3 kg or less
Instep and sole
Adult
40 kg or more
Finger or toe
Cable length TL-273T: 0.8 m
TL-273T3: 1.6 m
TL-274T, TL-274T3
Infant
3 to 20 kg
Cable length TL-274T: 0.8 m
TL-274T3: 1.6 m
48
Operator’s Manual ZM-540PA/541PA
Connecting the SpO2 Probe to the Transmitter
Connect the probe to the SpO2 socket on the transmitter.
When transmitter is attached on an arm
CAUTION
Do not shake or swing the transmitter
while holding the leads or cables
connected to the transmitter. The
transmitter may come off and injure
someone or damage surrounding
instruments.
CAUTION
Do not use a damaged or
disassembled probe. It causes
incorrect measurement and may
injure the patient.
Attaching the Probe to the Patient
Attach the probe to the patient by referring to the probe’s manual. Make sure that the light emitter
and photo detector of the probe face each other at the attachment site.
Operator’s Manual ZM-540PA/541PA
49
WARNING
WARNING
• When using the TL-201T ﬁnger
probe, do not fasten the probe and
cable to the ﬁnger by wrapping
with tape. This may cause burn,
congestion or pressure necrosis
from poor blood circulation.
• When using probes other than the
TL-201T ﬁnger probe, to avoid poor
circulation, do not wrap the tape too
tight. Check the blood circulation
condition by observing the skin
color and congestion at the skin
peripheral to the probe attachment
site. Even for short-term monitoring,
there may be burn or pressure
necrosis from poor blood circulation,
especially on neonates or low
birth weight infants whose skin is
delicate. Accurate measurement
cannot be performed on a site with
poor peripheral circulation.
Check the circulation condition by
observing the skin color at the
measurement site and pulse
waveform. Change the measurement
site every 8 hours for disposable
probes and every 4 hours for reusable
probes (every 8 hours for TL-630T/TL631T 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 peripheral circulation
insufﬁciency
• 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.
50
Operator’s Manual ZM-540PA/541PA
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
When the probe is attached on an
appropriate site with sufﬁcient
circulation and the error message
conﬁrming the probe attachment
repeatedly appears, the probe may be
deteriorated. Replace it with a new
one.
CAUTION
Do not use a probe which is
deteriorated by aging. Accurate
measurement cannot be performed.
CAUTION
Refer to the probe instruction manual
for details.
Operator’s Manual ZM-540PA/541PA
51
Attaching the NIBP Cuff
Selecting the NIBP Cuff
Select the NIBP cuff appropriate for the patient.
NOTE
NIBP cannot be measured on neonates using this transmitter.
Reusable Cuffs
When attaching the transmitter to the patient arm, a special NIBP cuff is required. An optional
YN-990P extension hose (1.5 m) is available to extend the length between the NIBP socket on the
transmitter and NIBP cuff (e.g. when not attaching the transmitter to the patient arm and placing the
transmitter on a bedside).
Reusable Cuff
For adult
Model
Width (cm)
Air Hose Length (cm)
Standard
YP-503P
13
15
Large
YP-504P
15
15
Air hose
Width
When not attaching the transmitter to the patient arm, the following cuffs can be used. To use these
cuffs, an optional YN-990P extension hose (1.5 m) is required.
Reusable Cuff
For infant
For child
For adult
Model
Width (cm)
YP-960T
Small
YP-961T
Standard
YP-962T
10
Standard
YP-963T
13
Large
YP-964T
15
Air Hose Length (cm)
15
Width
Air hose
52
Operator’s Manual ZM-540PA/541PA
Disposable Cuffs
CAUTION
Disposable cuffs are not sterilized. If necessary, sterilize the cuff using glutaraldehyde
solution.
When not attaching the transmitter to the patient arm, the following disposable cuffs can be used.
To use these cuffs, an optional YN-990P extension hose (1.5 m) is required.
Model
Width (cm)
Air Hose Length (cm)
For infant
Reusable Cuff
YP-810P
17
For child
YP-811P
17
Small
YP-812P
10
17
Standard
YP-813P
14
20
Medium large
YP-814P
15
20
Large
YP-815P
17
20
For adult
Width
Air hose
Extension Hose
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.
YN-990P extension hose, 150 cm
Operator’s Manual ZM-540PA/541PA
53
Reference for selecting a cuff
The AHA (American Heart Association) recommends that the cuff width be 40% of the
circumference of the upper arm. Refer to the following graph and select the cuff which suits the
patient’s arm.
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 it does not ﬁt
the patient.
Cuff Width and Arm Circumference
Reusable Cuffs
Adults large YP-504P (cuff for transmitter)
YP-964T
Cuff width (cm)
15
Adults standard YP-503P (cuff for transmitter)
YP-963T
10
Children standard YP-962T
Children small YP-961T
Infants YP-960T
10
20
30
40
50
60
Arm circumference (cm)
Disposable Cuffs
Cuff width (cm)
20
Adults large YP-815P
15
Adults medium large YP-814P
Adults standard YP-813P
10
Adults small YP-812P
Children standard YP-811P
Infants YP-810P
54
10
20
30
40
50
60
Arm circumference (cm)
Operator’s Manual ZM-540PA/541PA
Connecting the NIBP Cuff to the Transmitter
When Using YP-503P/YP-504P NIBP Cuff
To attach the YP-503P/YP-504P NIBP cuff to the transmitter, the lock plate is required.
YP-503P/YP-504P NIBP cuff
Air hose
Front cover
D ring
Belt
Belt for the strap
Lock plate pocket
Front cover open
Lock plate
Top tab
For attaching the NIBP cuff to the transmitter
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.
Bottom tab
Operator’s Manual ZM-540PA/541PA
55
1. Remove the lock plate from the
transmitter.
2. Insert the lock plate into the lock
plate pocket on the NIBP cuff.
3. Attach the transmitter to the lock
plate by inserting the tabs on the
lock plate into the slots on the
transmitter.
4. Cover the transmitter with the
front cover of the NIBP cuff.
5. Connect the air hose to the NIBP
socket on the transmitter. Turn
the cuff connector joint until it
clicks.
56
Operator’s Manual ZM-540PA/541PA
When Using Disposable Cuffs 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.
CAUTION
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.
Operator’s Manual ZM-540PA/541PA
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
Do not reuse disposable parts and
accessories.
57
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.*
* Monitoring SpO2 during NIBP Measurement
When the SpO2 probe is attached to the
same limb as the NIBP cuff, the blood
ﬂow decreases during NIBP measurement
and pulse wave cannot 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 the
NIBP, be careful when reading SpO2 values.
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.
• To accurately detect the pulsatile ﬂow of the artery, the cuff should be wrapped around a
bare upper arm.
• Do not use an abnormal cuff. The cuff deteriorates from use and cleaning. Before use,
check the cuff and conﬁrm that there is no ﬂaw, crack or hole in it. Be careful not to
damage the inﬂation bag. If the inﬂation bag has a hole or a ﬂaw, it may burst during use.
Dispose of an abnormal cuff and replace it with a new one.
• Refer to the NIBP cuff manual for details.
Cuff Position
When placing the transmitter on
a bed, make sure that the hose is
not bent.
Heart
58
Place the cuffed upper arm (brachium) at the same height
as the patient’s heart. If the cuff is not at the same level as
the heart, the weight of the blood affects the blood pressure
reading. The pressure difference per unit height is 0.7
mmHg/cm. The blood pressure reading decreases when the
arm is higher than the heart and increases when lower.
The best measuring condition is when the patient is lying on
his/her back with arms and legs relaxed. If the cuff position
cannot be on the same level as the heart, the displayed blood
pressure reading must be mathematically adjusted.
Operator’s Manual ZM-540PA/541PA
Attaching the Transmitter on an Arm (Using the YP-503P/504P NIBP Cuff)
1. Attach the NIBP cuff to the transmitter. Refer
to the “Connecting the NIBP Cuff to the
Transmitter” section.
2. Before putting the cuff over the arm, insert the
end of the cuff into the belt and then through the
D ring as shown at left.
Belt
D ring
End of cuff
3. Put the patient arm through the cuff. Fold back
the cuff at the D ring and fasten it using the
velcro tape.
Make sure that the cuff is not attached on a joint.
NOTE
The cuff must not wrap around the elbow.
Operator’s Manual ZM-540PA/541PA
59
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.
Attach a strap provided with the transmitter to the NIBP cuff and patient clothes.
To open the clip, ﬁrmly
pull out the tab in
direction of the arrow.
To adjust the strap length,
push down the tab on the
adjuster and slide.
1.
Adjust the length of the strap.
2.
Clip one end of the strap to the belt for the strap on the NIBP cuff.
3.
Clip the other end of the strap to the patient’s clothes as shown left.
Belt for the strap on the NIBP cuff
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Operator’s Manual ZM-540PA/541PA
Placing the Transmitter on the Bed (Using the Disposable Cuffs or YP-960T series Reusable
Cuffs)
ARTERY ▼
1. Put the cuff on the upper arm so that the ▼ mark
of “ARTERY ▼” aligns with the artery of the
patient.
2. Wrap the cuff so that “INDEX
within the “
RANGE
”.
RANGE
Operator’s Manual ZM-540PA/541PA
” is not within the “
If “Index
”, change the cuff size.
” comes
RANGE
61
Locking the Keys on the Transmitter
▼
Press the
appears.
and
▼
To prevent the patient from pressing the keys on the transmitter during monitoring, you can lock the
keys.
keys at the same time and hold for more than 3 seconds. The key lock screen
When there is no key operation for one minute after locking the keys, the display turns off.
62
▼
▼
To unlock the keys:
Press the and keys at the same time and hold for more than 3 seconds.
Operator’s Manual ZM-540PA/541PA
Monitoring
CAUTION
The measurement values and displayed waveforms on the transmitter and receiving
monitor may be different due to timing delay of the display or difference in detection
settings.
Screen Descriptions
When the transmitter is turned on, the startup screen appears, then the check electrodes screen
appears to check the electrode attachment.
The screen changes in the following order each time the Screen key is pressed.
Check electrodes → numeric and waveform → waveform review → numeric review → display off
→ check electrodes . . .
Screen key
The screen automatically turns off when there is no key operation for 2 minutes on the check
electrodes screen or 1 minute on other screens.
When the display is off and the Screen key is pressed, the numeric and waveform screen appears.
When the Screen key is pressed within 5 minutes after the display off, the screen before the display
off appears.
Operator’s Manual ZM-540PA/541PA
63
Check Electrodes Screen
You can check whether the electrodes are properly attached to the patient and the ECG waveform is
acquired.
When 6 leads are used, I, II, Va and Vb lead waveforms are displayed.
When 3 leads are used, only II lead waveform is displayed.
Battery level
Channel number
Lead
ECG waveform
Filter:
off
Sweep speed:
12.5 mm/s
Waveform sensitivity: 0.5 cm/1 mV
Message
Detached
electrode position
When electrodes are
detached, the “CHECK
ELECTRODES”
message and detached
electrode position appear
on the screen.
NOTE
When ECG measurement is set to OFF on the PARAMETER SETUP screen, the check
electrodes screen does not appear.
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Operator’s Manual ZM-540PA/541PA
Numeric and Waveform Screen
▼
▼
Numeric values and waveforms of the monitoring parameters are displayed. You can change the
ECG lead with the and keys.
Respiration rate
SpO2
Pulse bar graph
QRS sync mark
Heart rate
NIBP measurement
mode
NIBP values
ECG lead
ECG waveform
Filter:
on
Sweep speed:
12.5 mm/s
Waveform sensitivity: auto
Waveform
sensitivity
When ECG and respiration measurement is turned off
Pulse rate
SpO2
Pulse bar graph
Pulse sync mark
NIBP measurement
mode
NIBP values
Pulse wave
sensitivity
Pulse waveform
Sweep speed:
12.5 mm/s
Waveform sensitivity: auto
Operator’s Manual ZM-540PA/541PA
65
NOTE
The pulse wave amplitude varies according to the ratio of the pulsation component to the
entire transmitted IR signal. When the pulsation component ratio is 1%, the pulse wave
amplitude is about 5 mm at ×1 sensitivity on the screen.
Waveform Review Screen
ECG full disclosure for up to 10 minutes can be saved and reviewed. When ECG measurement is
turned off and SpO2 is monitored, the pulse waveform is saved.
When ECG lead is changed on the numeric and waveform screen, the ECG full disclosure of the
changed lead is saved.
The saved data is deleted when the transmitter is turned off.
Time range of the displayed waveform
(time before the waveform review
screen is displayed)
Displayed
page
Older data
ECG lead
Newer data
▼
To scroll the waveform, press the
66
or
▼
Waveform sensitivity
Compressed ECG waveform
7.5 s x 4 traces per page, total of 20 pages
key. The waveform is scrolled by 30 seconds.
Operator’s Manual ZM-540PA/541PA
Numeric Review Screen
Numeric data of heart rate (or pulse rate when ECG is turned off), SpO2 and respiration rate for up
to 10 minutes are saved at 1 minute intervals.
NOTE
NIBP measured values are not saved.
The saved data is deleted when the transmitter is turned off.
Older data
Time before the numeric
review screen is displayed
Newer data
Display Off
The display can be turned off any time. To turn off the display, press the Screen key several times
until the following screen appears then wait 5 seconds.
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67
Basic Monitoring Operation
Using the Function Key
Function key
One of the following functions can be assigned to the Function key on the SYSTEM SETUP screen.
Refer to the “Changing SYSTEM SETUP Settings” section.
SUSPEND ALARM: Suspends alarms on the receiving monitor before they occur for 2 minutes.
PAUSE:
Pauses monitoring on the transmitter and receiving monitor.
CONFIRM:
Transmits the signal that the patient is conﬁrmed and displays the “PATIENT
CONFIRMED” message on the transmitter.
NOTE
To use the Function key for PAUSE or CONFIRM, you must set “PROTOCOL” on the
SYSTEM SETUP screen of the transmitter to 57 and the receiving monitor must be able to
receive protocol 57.
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Operator’s Manual ZM-540PA/541PA
Suspending Alarms on the Receiving Monitor
When the FUNCTION KEY is set to “SUSPEND ALARM” or “SUSPEND ALARM & PAUSE”
on the SYSTEM SETUP screen, alarms can be suspended for 2 minutes on the receiving monitor
before they occur.
2.
▼
To suspend alarms:
1. Press the Function key. The “Suspend alarms” conﬁrmation screen appears.
Press the key to suspend alarms.
To cancel suspending alarms and return to the previous screen, press the Screen key.
When the alarms are suspended, the “ALARMS SUSPENDED” message and alarm suspended icon
with the remaining minutes in alarm suspension appear on the transmitter screen.
Message
Icon
To cancel suspending alarms during 2 minute alarm suspension:
1. Press the Function key while the “ALARMS SUSPENDED” message is displayed. The
conﬁrmation screen appears.
Operator’s Manual ZM-540PA/541PA
69
▼
2.
Press the key to cancel alarm suspension.
Press the Screen key to not cancel alarm suspension.
Pause Monitoring
When the FUNCTION KEY is set to “SUSPEND ALARM & PAUSE” on the SYSTEM SETUP
screen, you can pause monitoring on the receiving monitor from the transmitter when the patient
cannot be monitored, such as during X-ray examination.
NOTE
To use the Function key for PAUSE, you must set “PROTOCOL” on the SYSTEM SETUP
screen of the transmitter to 57 and the receiving monitor must be able to receive protocol
57.
To pause monitoring:
1. Press the Function key. The “Suspend alarms” conﬁrmation screen appears.
2.
70
Press the Function key for 3 seconds to display the “Pause monitoring” conﬁrmation screen.
Operator’s Manual ZM-540PA/541PA
▼
3.
Press the key to pause monitoring.
To cancel pause monitoring, press the Screen key.
4.
Wait about 5 seconds until the “Turn power off” screen appears.
5.
Turn off the transmitter.
If the transmitter is not turned off and monitoring continues for the interval set for “AUTO
RESUME AFTER PAUSE” on the SYSTEM SETUP screen, pause monitoring is cancelled and
monitoring continues.
Resume Monitoring after Pause
To resume monitoring after pause, check that the electrodes, electrode leads and probe are attached
to the patient then turn on the transmitter.
Operator’s Manual ZM-540PA/541PA
71
Conﬁrming Patient
When the FUNCTION KEY is set to “CONFIRM” on the SYSTEM SETUP screen, you can
transmit signal to the receiving monitor to indicate that the patient is conﬁrmed by a medical staff by
pressing the Function key.
Message
Turning the Display Off
The display can be turned off any time. To turn off the display, press the Screen key several times
until the following screen appears then wait 5 seconds.
5 second time bar until the display turns off
Turning the Display On after It was Turned Off
Press the Screen key. The numeric and waveform screen appears. If the screen is turned off on the
“Keys locked” screen, the “Keys locked” screen appears.
When the Screen key is pressed within 5 minutes after the display was turned off, the previous
screen appears.
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Operator’s Manual ZM-540PA/541PA
ECG and Respiration Monitoring
When the electrodes are attached and the ECG leads are connected, the heart rate, ECG waveform,
respiration rate and respiration waveform appear on the receiving monitor. Refer to the operator’s
manual of the receiving monitor for details.
When 6 leads are used on this transmitter, up to 8 lead (I, II, III, aVR, aVL, aVF, Va and Vb) of
ECG waveforms can be displayed on the receiving monitor. The heart rate is also measured.
When 3 leads are used, one channel ECG waveform of lead II can be displayed on the receiving
monitor. Refer to the operator’s manual of the monitor for details.
QRS sync mark
Respiration rate
▼
ECG lead
You can change the
ECG lead with the
and keys.
▼
ECG waveform
Heart rate
Filter:
on
Sweep speed:
12.5 mm/s
Waveform sensitivity: auto
WARNING
Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac
Monitoring and Diagnostic Equipment*
The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive
implantable pacemaker may be affected by transmitter which is connected to the
same patient. If this occurs, the pacemaker may pace at its maximum rate and the
transmitter may give incorrect data to the monitor. If this occurs, disconnect the
electrode leads from the patient or change the setting on the pacemaker by referring
to the pacemaker’s manual. For more details, contact your pacemaker representative
or Nihon Kohden representative.
* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric
Operator’s Manual ZM-540PA/541PA
73
impedance measurement (BIM). Many medical devices in addition to pacemakers use this
technology. When one of these devices is used on a patient with an active, minute ventilation rateadaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals created
in the patient, resulting in an elevated pacing rate.
For more information, see the FDA web site.
http://www.fda.gov/cdrh/safety.html
WARNING
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.
CAUTION
Turn off the power of mobile phones, small wireless devices and other devices which
produce strong electromagnetic interference around a patient (except for devices
allowed by the hospital administrator). Radio waves from devices such as mobile
phones or small wireless devices may be mistaken as pulse waves and the displayed
data may be incorrect.
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.
• ECG cannot be monitored on a neonate using this transmitter.
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Operator’s Manual ZM-540PA/541PA
Turning ECG Measurement On/Off
ECG measurement can be turned on or off on the PARAMETER SETUP screen. When electrodes
are attached to the patient and ECG leads are connected, ECG monitoring starts even when ECG is
turned off.
When PROTOCOL on the SYSTEM SETUP screen is set to 57:
ECG measurement on the receiving monitor is automatically set to off.
NOTE
ECG measurement on the transmitter cannot be turned on or off from the receiving
monitor.
When PROTOCOL on the SYSTEM SETUP screen is set to 42:
If ECG measurement is turned off on the transmitter, ECG measurement on the receiving monitor
must also be turned off.
Turning Respiration Measurement On/Off
Respiration measurement can be turned on or off on the PARAMETER SETUP screen. If respiration
measurement is turned off, respiration measurement on the receiving monitor is also turned off.
Electrode Detachment
In the following conditions, the “CHECK ELECTRODES” message is displayed on the transmitter
and receiving monitor.
• Electrode is detached from skin.
• Electrode lead is disconnected from the electrode.
• Polarization voltage between the electrode and skin is excessively high.
In these cases, check the cause and if necessary, replace electrodes with new ones.
CAUTION
When the “ELECTRODE OFF” or “CHECK ELECTRODES” message is displayed on
the receiving monitor, ECG is not monitored properly and the ECG alarm does not
function. Check the electrode, electrode leads, and if necessary, replace with new
ones.
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75
SpO2 Monitoring
When monitoring starts, SpO2 and pulse waveform are sent to the monitor and SpO2 and pulse level
bar graph are displayed on the transmitter screen. When ECG is not measured, pulse waveform and
pulse rate are also displayed.
SpO2
Pulse bar graph
Filter:
on
Sweep speed:
12.5 mm/s
Waveform sensitivity: auto
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Operator’s Manual ZM-540PA/541PA
WARNING
WARNING
SpO2 measurement may be incorrect
in the following cases.
• When the patient’s
carboxyhemoglobin or
methemoglobin increases
abnormally.
• When dye is injected in the blood.
• When using an electrosurgical unit.
• During CPR.
• When measuring at a site with
venous pulse.
• When there is body movement.
• When the pulse wave is small
(insufﬁcient peripheral circulation).
Check the circulation condition by
observing the skin color at the
measurement site and pulse
waveform. Change the measurement
site every 8 hours for disposable
probes and every 4 hours for reusable
probes (every 8 hours for TL-630T/TL631T 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 peripheral circulation
insufﬁciency
• Neonate or low birth weight infant
with delicate skin
WARNING
WARNING
When monitoring SpO2 of a patient
who is receiving photodynamic
therapy, the light from the ﬁnger probe
sensor may cause a burn.
Photodynamic therapy uses a
photosensitizing agent that has a side
effect of photosensitivity.
When not monitoring SpO2,
disconnect the SpO2 cable from the
transmitter. Otherwise, noise from the
probe sensor may interfere and
incorrect data is displayed on the
screen.
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77
CAUTION
CAUTION
Turn off the power of mobile phones,
small wireless devices and other
devices which produce strong
electromagnetic interference around a
patient (except for devices allowed by
the hospital administrator). Radio
waves from devices such as mobile
phones or small wireless devices may
be mistaken as pulse waves and the
displayed data may be incorrect.
Do not pull or bend the probe cable,
and do not put caster feet on the
probe cable. Do not immerse the
disposable probe cable in chemical
solutions or water. Failure to follow
these instructions may cause cable
discontinuity, short circuit, skin burn
on the patient and incorrect
measurement data. Replace any
broken probe with a new one.
CAUTION
CAUTION
Normal external light does not affect
monitoring but strong light such as a
surgical light or sunlight may affect
monitoring. If affected, cover the
measuring site with a blanket.
When the probe is attached on an
appropriate site with sufﬁcient
circulation and the error message
conﬁrming the probe attachment
repeatedly appears, the probe may be
deteriorated. Replace it with a new
one.
CAUTION
CAUTION
When a message indicates a faulty
probe, stop monitoring and replace
the probe with a new one.
While a patient is on medication which
causes vasodilation, the pulse
waveform may change and in rare
cases the SpO2 value might not be
displayed.
NOTE
In order to maintain sufﬁcient blood circulation, keep the measurement site warm by
covering it with a blanket or something similar. Warming the site is effective, especially for a
patient with a small pulse amplitude.
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Operator’s Manual ZM-540PA/541PA
Monitoring SpO2 during NIBP Measurement
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.
When the SpO2 probe is attached to the same limb as the NIBP cuff, the blood ﬂow decreases
during NIBP measurement and pulse wave cannot 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.
When SpO2 monitoring is paused during NIBP measurement, the SpO2 value just before the start of
NIBP measurement and an
mark are displayed on the transmitter for 30 seconds.
When NIBP measurement is not completed after 30 seconds, “– – –” is displayed for the SpO2 value.
The same data also appears on the monitor screen.
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.
Operator’s Manual ZM-540PA/541PA
79
NIBP Monitoring
Selecting the Initial Cuff Inﬂation Pressure
The initial cuff inﬂation pressure can be changed on the PARAMETER SETUP screen. The default
setting is 180 mmHg. To change the setting, refer to the “Changing PARAMETER SETUP Settings”
section.
Selecting the Measurement Mode and Interval
Measurement Modes
There are three measurement modes: manual, auto and STAT. The selected mode or interval is
displayed on the screen.
▼
▼
The measurement mode and interval can be changed by pressing the NIBP Interval key.
When the key is pressed, the NIBP mode setting screen appears. The measurement modes selected
at “SELECTABLE INTERVALS” on the PARAMETER SETUP screen are displayed (key color:
white). Select the measurement mode with the and keys or NIBP Interval key and press the
Function key.
Selected mode
(key color: blue)
Modes selected
at “SELECTABLE
INTERVALS” on the
PARAMETERS SETUP
screen
(key color: white)
To select the modes to be displayed on the NIBP mode setting screen, refer to the “Changing
PARAMETER SETUP Settings” section.
Manual Measurement
In Manual mode, a single NIBP measurement is performed when the NIBP Start/Stop key is pressed.
STAT (Continuous) Measurement
In STAT mode, measurement is continuously repeated for 15 minutes after the NIBP Start/Stop key
is pressed.
When the STAT measurement for 15 minutes is completed, the measurement mode automatically
changes to the Manual mode or Auto mode of selected interval depending on the “NIBP MODE
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Operator’s Manual ZM-540PA/541PA
AFTER STAT” setting on the PARAMETER SETUP screen. The default setting is Manual mode.
Refer to the “Changing Parameter Setup Settings” section.
The STAT measurement completes within 15 minutes. When more than 12 minutes elapse from the
start of measurement, there will be no more measurement performed and the measurement mode
changes to the mode selected for “NIBP MODE AFTER STAT” on the PARAMETER SETUP
screen.
Auto Measurement
In Auto mode, measurement is performed automatically at the preset time intervals.
In Auto mode, a single measurement can be performed by pressing the NIBP Start/Stop key between
auto measurements.
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
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
NIBP measurement may be incorrect
in the following cases.
• When using an electrosurgical unit
• When there is body movement
• When the pulse wave is small
(insufﬁcient peripheral circulation)
• Too many arrhythmias
• When there is vibration
• When there is a rapid blood
pressure change
• During CPR
CAUTION
When performing NIBP measurement
repeatedly, have a rest between
measurements to recover adequate
circulation.
Operator’s Manual ZM-540PA/541PA
81
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.
• 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.
1.
Press the NIBP Interval key to display the NIBP mode setting screen.
▼
2.
Select the measurement mode by pressing the NIBP Interval key or
and
▼
NIBP Interval key
keys.
Selected mode
(key color: blue)
3.
Press the Function key.
4.
Press the NIBP Start/Stop key to perform measurement.
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Operator’s Manual ZM-540PA/541PA
NIBP Start/Stop key
The cuff is inﬂated and the inﬂation pressure is displayed on the screen.
Inﬂation pressure
In manual mode: Measurement is performed once.
In STAT mode: Measurement is performed repeatedly for 15 minutes.
In auto mode:
The ﬁrst measurement is performed when the NIBP Start/Stop key is
pressed. The second measurement is performed when the current time in the
transmitter reaches the selected time interval.
To stop measurement during measurement, press the NIBP Start/Stop key again.
In STAT mode, after completing the STAT measurement, the measurement mode changes to the
mode set for “NIBP MODE AFTER STAT” on the PARAMETER SETUP screen.
In auto mode, to stop measurement in auto mode, change the mode to manual. To cancel one
measurement, press the NIBP Start/Stop key during measurement.
After the measurement is complete, the measured data is displayed on the screen and is transmitted
to the monitor.
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83
Systolic value
Diastolic value
NIBP measurement
mode
MAP value
When ECG and SpO2 are not monitored (ECG measurement is turned off and SpO2 probe is not
connected to the transmitter), the pulse rate at the end of NIBP measurement is displayed.
A buzzer can be set to sound at the start and end of NIBP measurement. Refer to the “Changing
PARAMETER SETUP Settings” section.
Auto Mode Measurement
When auto mode measurement is selected, “STANDBY” message is displayed on the screen until
the NIBP Start key is pressed for the ﬁrst time.
STANDBY message
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Operator’s Manual ZM-540PA/541PA
A time bar appears to indicate the interval between auto mode measurements.
Time bar indicating
the interval between
measurements
During auto mode measurement, the measurement mode can be changed. During the interval, press
the NIBP Interval key to change the mode. When “MANUAL” is displayed for more than one
second, the measurement in auto mode is stopped.
Data Display After NIBP Measurement
When the time set at “OLD NIBP DATA” on the PARAMETER SETUP screen elapses after the last
measurement, the NIBP data is dimmed or hidden. Whether to dim or hide the old data can also be
selected at “OLD NIBP DATA”. Refer to the “Changing PARAMETER SETUP Settings” section.
Data Display on the Receiving Monitor
When the “BATTERY” message is displayed on the receiving monitor, NIBP might not have
been measured according to the NIBP interval setting. Therefore, the NIBP data displayed on the
receiving monitor might not be updated. In this case, check the measurement time of the NIBP data
displayed on the receiving monitor.
Monitoring SpO2 during NIBP Measurement
When the SpO2 probe is attached to the same limb as the NIBP cuff, the blood ﬂow decreases
during NIBP measurement and pulse wave cannot 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 the NIBP, be careful when
reading SpO2 values.
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85
Indication and Message List
Indication
Indication
Cause
Countermeasure
Fully charged batteries
——
Batteries are 2/3 full.
Batteries are low. NIBP cannot be
measured.
Replace batteries.
Batteries are very weak.
Alarms on the receiving monitor
were suspended by pressing the
Function key on the transmitter.
Alarms resume when the suspend interval
elapses. To cancel alarm suspension, press
the Function key again.
Messages
When PROTOCOL on the SYSTEM SETUP screen is set to 57, all messages are transmitted.
When PROTOCOL is set to 42, the messages marked with * are not transmitted.
Message
AIR LEAK
Cause
The cuff and extension hose are not
properly connected.
The cuff hose (or extension hose) is
not properly connected to the NIBP
socket.
Countermeasure
Connect them properly.
The cuff or extension hose is damaged. Replace with a new one.
ALARMS
SUSPENDED
Alarms on the receiving monitor is
suspended by pressing the Function
key on the transmitter.
Alarms resume when the 2 minute
suspend interval elapses. To cancel
alarm suspension, press the Function
key again.
BATTERY
WEAK
Dead batteries
Replace batteries.
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Operator’s Manual ZM-540PA/541PA
Message
Cause
Poor blood circulation for measuring
the SpO2 value.
The probe is attached too tightly and is
CANNOT
obstructing the blood circulation.
DETECT
The probe is not attached to the patient
PULSE*
properly.
(displayed in blue)
“LIGHT INTERFERENCE”,
“CHECK PROBE SITE” or
“DETECTING PULSE” message is
displayed for more than 30 seconds.
The patient’s pulse wave is too small
CANNOT
to measure NIBP.
DETECT PULSE
The cuff is not wrapped on the patient
(displayed in pink)
properly.
Electrode lead is disconnected from
the electrode.
Electrode lead is disconnected from
the transmitter.
CHECK
Electrode lead discontinuity.
ELECTRODES
Electrode is not ﬁrmly attached to the
skin.
Polarization voltage is abnormally
high.
The probe is not attached to the patient
properly.
The probe is not attached at the
CHECK PROBE appropriate site.
The probe is disconnected from the
transmitter.
CHECK PROBE
SITE*
Reattach the probe.
Attach the probe to the patient
properly.
Refer to the cause and
countermeasure for each message in
this Messages table and remove the
cause.
Measure by palpation or auscultation.
Wrap the cuff on the patient properly.
Firmly connect the electrode lead to
the electrode.
Firmly connect the electrode lead to
the transmitter.
Replace the electrode lead with a
new one.
Replace the electrode with a new
one.
Attach the probe to the patient
properly.
Attach the probe to an appropriate
site indicated in the probe manual.
Connect the probe cable to the
transmitter.
The probe is past its expiration date.
Replace the probe with a new one.
The probe is not attached at the
appropriate site.
Attach the probe to an appropriate
site indicated in the probe manual.
The probe is deteriorated.
The probe is past its expiration date.
CUFF
OCCLUSION
Countermeasure
Check the patient condition, probe
attachment or change the attachment
site.
Transmitter malfunction.
Operator’s Manual ZM-540PA/541PA
Replace the probe with a new one.
Immediately remove the cuff from
the patient and contact your Nihon
Kohden representative.
87
Message
DETECTING
PULSE
HIGH CUFF
PRESS
INFLATION
PRESS LOW
Cause
Searching for the correct pulse wave
for SpO2 monitoring.
The SpO2 value cannot be obtained
because the waveform is unstable.
The probe is not attached to the patient
properly.
Enormous pressure was applied by the
pressure of the cuff.
Insufﬁcient cuff inﬂation pressure.
The SpO2 measurement site is under
LIGHT
ﬂuorescent light, surgical light,
INTERFERENCE
sunlight, or other strong light.
Countermeasure
Wait until the pulse wave is detected.
Attach the probe to the patient
properly.
Remove the cause.
Wait for the remeasurement to
be performed with increased cuff
inﬂation pressure.
Cover the measurement site with a
blanket or cloth.
When the message is displayed
frequently, check the patient condition
The probe is not attached to the patient and, if necessary, change the
properly.
attachment site.
SpO2 monitoring is paused for NIBP
Wait for NIBP measurement to ﬁnish.
measurement.
The NIBP measuring time exceeded
Remove the cause if the cause
the speciﬁed time due to arrhythmia,
is body movement, vibration or
body movement, vibration or, cuff or
squeezing of cuff or hose.
air hose being squeezed.
Contact your Nihon Kohden
Module malfunction.
representative.
Considerable body movement.
MEAS TIMEOUT
NIBP MODULE
ERROR
NO NIBP
CHANGE
BATTERIES
PATIENT
CONFIRMED*
PROBE
FAILURE*
88
NIBP cannot be measured due to low
battery.
Function key is pressed and the
“PATIENT CONFIRMED” signal is
transmitted to the receiving monitor.
(When “PATIENT” is assigned as the
function for the Function key on the
SYSTEM SETUP screen.)
The probe is past its expiration date.
Probe is damaged or short-circuited.
Replace batteries with new ones.
——
Replace the probe with a new one.
Operator’s Manual ZM-540PA/541PA
Message
Cause
Countermeasure
If the message still appears after
remeasurement, remove the cause
NIBP is being remeasured due to
REMEASURING arrhythmia, body movement, vibration if the cause is body movement,
vibration or squeezing of cuff or
or, cuff or air hose being squeezed.
hose.
Immediately remove the cuff from
SAFETY
The NIBP safety circuit error.
the patient and contact your Nihon
CIRCUIT ERROR
Kohden representative.
Check that the hose is not bent or
SAFETY
squeezed.
CIRCUIT
RUNNING
(When this
NIBP measurement stopped by the
message is
Wait 40 seconds, then perform
safety circuit.
displayed,
remeasurement. If the message still
measurement
appears, contact your Nihon Kohden
cannot be
representative.
performed for 40
seconds.)
SpO2 MODULE
Contact your Nihon Kohden
Transmitter failure.
representative.
ERROR*
The maximum blood pressure cannot
be measured even when the cuff
SYS OUT OF
Measure by palpation or auscultation.
inﬂation pressure exceeded 280 mmHg
RANGE
when using adult cuff.
Check the patient condition and
Poor peripheral circulation.
change the probe attachment site.
WEAK PULSE*
Check the probe attachment
(displayed in blue) The probe is attached too tightly and is
condition and if necessary, reattach
obstructing the blood circulation.
the probe.
The patient’s pulse wave is too small
to measure NIBP.
WEAK PULSE
(displayed in pink) The cuff is wrapped too loosely.
ZEROING
Measure NIBP by palpation or
auscultation.
Wrap the cuff properly.
The cuff size is not appropriate.
Use the appropriate cuff.
NIBP zero balance is being adjusted.
Do not touch the cuff during zeroing.
Wait for the message to disappear.
Operator’s Manual ZM-540PA/541PA
89
Message Display Priority
When more than one message condition occurs on the transmitter, only the message with the highest
priority is displayed.
Priority
Highest
Message
PATIENT CONFIRMED
SAFETY CIRCUIT RUNNING
CUFF OCCLUSION
PROBE FAILURE
CHECK ELECTRODES
NIBP MODULE ERROR
SYS OUT OF RANGE
HIGH CUFF PRESS
AIR LEAK
MEAS TIME OUT
CANNOT DETECT PULSE (NIBP)
SpO2 MODULE ERROR
CHECK PROBE
CHECK PROBE SITE
CANNOT DETECT PULSE (SpO2)
LIGHT INTERFERENCE
REMEASURING
INFLATION PRESS LOW
WEAK PULSE (NIBP)
ZEROING
NO NIBP CHANGE BATTERIES
DETECTING PULSE
WEAK PULSE (SpO2)
ALARMS SUSPENDED
Lowest
90
BATTERY WEAK
Operator’s Manual ZM-540PA/541PA
Troubleshooting
If a problem occurs, use the following to ﬁnd and ﬁx it. If the problem still remains after checking
the following, contact your Nihon Kohden representative.
Transmitter
Problem
Nothing is displayed
on the LCD after
turning the power
on.
LCD is difﬁcult to
see (too dark or too
light).
Cause
Batteries are not installed
correctly. The battery polarity is
wrong.
Batteries are completely
discharged.
LCD brightness is not
appropriate.
Nothing is displayed
on the receiving
monitor after turning
the transmitter
power on.
The channel of the transmitter
and monitor does not match.
The software version of the
multiple patient receiver or
central monitor is old.
Signal receiving
condition is poor.
Protocol on the transmitter and
monitor does not match.
Protocol on the transmitter is
set to 57 but the monitor cannot
receive protocol 57.
Another transmitter with the
same channel is used nearby.
Signals of another patient are
mixing.
The transmitter is damaged.
Operator’s Manual ZM-540PA/541PA
Countermeasure
Install the batteries correctly.
Replace the batteries with new ones.
Change the LCD brightness on the
SYSTEM SETUP screen. Refer to the
“Changing SYSTEM SETUP Settings”
section.
Set the correct channel on the monitor.
Upgrade the multiple patient receiver
or central monitor software to receive
signal from the transmitter. The software
version must be 01-09 or later.
Set the same protocol on the transmitter
and monitor.
Set the protocol on the transmitter to 42.
Refer to the “System Setup Setting List”
section.
Turn the transmitter power off. If the
monitor still receives a signal, there is a
high probability that another transmitter
of the same channel is used nearby.
Follow the instruction of your
channel administrator and use another
transmitter with a different channel.
Follow the instructions of your
channel administrator and use another
transmitter of a different channel.
Contact your Nihon Kohden
representative.
91
ECG/Respiration
Problem
Cause
The heart rate is
unstable.
Pacing detection setting on the
monitor is not correct.
No respiration rate
is displayed.
“RESP MEASUREMENT”
on the PARAMETER SETUP
screen is set to OFF.
Countermeasure
Turn off the pacing detection setting on the
monitor. When monitoring a pacemaker
patient, turn on pacing detection.
The “CHECK
Electrode lead is disconnected Firmly connect the electrode lead to the
ELECTRODES”
from the electrode.
electrode.
message appears
Electrode lead discontinuity
Replace the electrode lead with a new one.
on the receiving
Electrode is not ﬁrmly attached Replace the electrode with a new one.
monitor.
to the skin.
Polarization voltage is
Use Nihon Kohden speciﬁed electrodes.
abnormally high.
ECG baseline is
The gel on the electrode is dried Replace the electrode with a new one.
thick (AC hum)
out.
The gel on the electrode is
coming off.
An electric blanket is used.
Cover the blanket with a shield cover.
The hum ﬁlter is set to OFF on Set the ﬁlter to ON.
the monitor
The heart rate of a Pacing pulse detection is turned Turn OFF the pacing pulse detection on
the receiving monitor.
patient who is using ON on the receiving monitor.
an electric blanket
is unstable on the
receiving monitor.
No heart rate or
“ECG MEASUREMENT”
If ECG monitoring is necessary, set “ECG
ECG is displayed.
on the PARAMETER SETUP
MEASUREMENT” to ON.
screen is set to OFF.
The gel on the electrode is dried Replace the electrode with a new one.
Respiration
out.
waveform
measurement is
The gel on the electrode is
unstable.
coming off.
92
If respiration monitoring is necessary, set
“RESP MEASUREMENT” to ON.
Operator’s Manual ZM-540PA/541PA
SpO2
Problem
SpO2 data is unstable
and not reliable.
Cause
Countermeasure
The probe size is not
appropriate for the patient.
Probe attachment condition
is poor. The probe is partly
detached from the skin.
External light is entering the
probe.
Measurement site is dirty.
Patient is wearing nail polish.
The probe is attached to the
same limb that is used for NIBP
measurement.
Use the appropriate probe for the
patient.
Firmly attach the probe according to
the procedure in the probe operator’s
manual.
Problem
Cause
Cuff inﬂation pressure The cuff hose is not connected
is less than 10 mmHg. to the NIBP socket properly.
The cuff is not wrapped around
the arm or is wrapped too
loosely.
The cuff hose is not connected
The cuff does not
inﬂate when the NIBP to the NIBP socket.
Start/Stop key is
The cuff hose or extension hose
pressed.
may be folded or squeezed
when the cuff pressure display
on the screen increases quickly
but the actual cuff does not
inﬂate.
The cuff size is not correct.
Abnormal
measurement results
are displayed.
The cuff is not wrapped around
the arm correctly.
NIBP data is not correct
because of body movement.
Vibration on the cuff.
Countermeasure
Connect the cuff hose to the socket
properly.
Wrap the cuff around the upper arm.
Remove dirt and nail polish.
Attach the probe to the opposite limb.
Avoid a site where blood circulation
condition changes greatly.
NIBP
Operator’s Manual ZM-540PA/541PA
Connect the cuff hose to the socket
ﬁrmly.
Check the cuff hose and air hose.
Select the cuff which ﬁts the patient’s
limb circumference.
Wrap the cuff around the upper arm, not
too tightly or too loosely.
Prevent the patient from moving during
measurement.
Check that nothing is touching the cuff
during measurement.
Change the measuring site.
93
Problem
The cuff is suddenly
deﬂated during
inﬂation.
Auto mode
measurement does
not start even when
the time interval has
passed.
The cuff suddenly
inﬂates.
Cannot connect cuff to
the air hose.
Cause
The NIBP Start/Stop key is
pressed during inﬂation.
The NIBP Interval key is
pressed and the measurement
mode is changed.
Countermeasure
—
Check the measurement mode and
interval.
The measurement mode is set to Check the time interval. If necessary,
auto mode.
stop measurement.
Unspeciﬁed cuff is used.
Use a cuff speciﬁed by Nihon Kohden.
Cannot measure NIBP. Vibration on the cuff.
Check that nothing is touching the cuff
during measurement.
The cuff hose or extension hose Remove the cause.
is bent or squeezed.
The cuff has worn out.
Use a new cuff.
Blood congestion
Measuring over a long period of Increase the measuring interval.
occurs.
time at short intervals.
Do not measure NIBP over a long time.
Do not perform NIBP measurement on
Thrombus occurs.
Measuring on a patient with
such a patient.
known bleeding disorders or
coagulation.
When NIBP is measured again, the data
NIBP data on the
The time set for “OLD NIBP
is displayed in normal brightness.
screen is --- or dark.
DATA” on the PARAMETER
SETUP screen elapsed from the
last measurement.
Three loud pip sounds The cuff is not deﬂated enough Wait 30 seconds and measure again.
to start another measurement.
indicating NIBP
measurement cannot
be started.
94
Operator’s Manual ZM-540PA/541PA
Maintenance
To use the transmitter in safe and optimum condition, perform maintenance check every six months.
The following units are necessary for some checking items.
• AX-400G Vital Sign Simulator
• AX-300T SpO2 Checker
• Electric or mercury manometer
• 700 mL dummy cuff
• Receiving monitor
CAUTION
Never disassemble or repair the transmitter. Disassembly and repair must be
performed by qualiﬁed service personnel.
NOTE
• The measurement accuracy of the above units must be managed to perform accurate
maintenance check.
• For details on the operation of the above units, refer to the manuals provided with these
units.
A maintenance check sheet is provided at the end of this section. Make a copy of this check sheet
before performing maintenance check.
1. External Check
• There is no damage or dirt on the outside of the transmitter.
• The battery case cover is not damaged, the spring is ﬁrmly attached and the battery case cover can
be closed ﬁrmly.
• No keys are damaged.
• NIBP socket is not damaged.
• No electrode leads are damaged.
• There are no blood or chemicals on the transmitter.
2. Transmitter Channel
• The channel number label on the transmitter is not torn or removed.
• The channel of the transmitter matches the label.
The transmitter channel is displayed in the upper left corner of the screen. The channel number
also appears on the startup screen.
Operator’s Manual ZM-540PA/541PA
95
Channel number
Startup screen
Numeric and waveform screen
3. Transmitting/Receiving Signal
Use the AX-400G vital sign simulator and receiving monitor.
1.
Connect the vital sign simulator to the transmitter.
AX-400G
2.
Place the transmitter 2 to 3 m from the receiving monitor.
3.
Set the channel on the receiving monitor to the channel of the transmitter.
4.
Turn on the transmitter and vital sign simulator.
5.
Check that the ECG of the transmitter appears on the receiving monitor.
6.
Turn off the transmitter.
7.
Check that the ECG disappears from the receiving monitor.
4. Display
Check that there are no dots missing on the screen.
1.
Turn off the transmitter.
2.
While pressing the Function key, turn on the transmitter. The MENU screen appears.
96
Operator’s Manual ZM-540PA/541PA
Press the
▼
3.
key to move the cursor to “MANUAL CHECK” and press the Function key.
Press the
or
5.
Each time the
key to move the cursor to “LCD TEST” and press the Function key.
▼
▼
4.
▼
Cursor
key is pressed, the screen changes as below. Check that no dots are missing.
→
red
→
→
green
→
blue
6.
Press the Screen key to return to the MANUAL CHECK screen.
7.
Press the Screen key again to return to the MENU screen.
Operator’s Manual ZM-540PA/541PA
→
→
→
→...
97
5. Key Operation
Turn off the transmitter.
2.
While pressing the Function key, turn on the transmitter. The MENU screen appears.
3.
Press the
▼
1.
key to move the cursor to “MANUAL CHECK” and press the Function key.
▼
or
▼
Cursor
4.
Press the
key to move the cursor to “KEY CHECK” and press the Function key.
5.
Press each key one at a time and check that the pressed key is highlighted on the screen.
Example: when
the Function key is
pressed, the key name
is highlighted
6.
98
After checking, press and hold the Screen key to return to the MANUAL CHECK screen.
Operator’s Manual ZM-540PA/541PA
6. ECG Check
1.
Connect the vital sign simulator to the transmitter.
AX-400G
2.
Place the transmitter 1 m from the receiving monitor.
3.
Turn on the transmitter and vital sign simulator.
4.
Check that the ECG of the transmitter appears on the receiving monitor.
7. Respiration Check
1.
Connect the vital sign simulator to the transmitter.
AX-400G
2.
Place the transmitter 1 m from the receiving monitor.
3.
Turn on the transmitter and vital sign simulator.
4.
Check that the respiration waveform of the transmitter appears on the receiving monitor.
Operator’s Manual ZM-540PA/541PA
99
8. SpO2 Check
1.
Connect the SpO2 checker to the transmitter.
AX-300T
2.
Place the transmitter 1 m from the receiving monitor.
3.
Turn on the transmitter and SpO2 checker.
4.
Check that the pulse bar graph appears on the transmitter screen.
5.
Check that SpO2 and pulse rate on the transmitter is within the following range.
SpO2 on the SpO2 Checker
SpO2
Pulse rate
97%
80%
70%
60 beats/min
120 beats/min
Range
95 to 99%SpO2 (±2 digit)
78 to 82%SpO2 (±2 digit)
67 to 73%SpO2 (±3 digit)
57 to 62 beats/min (±3%/±1 beat/min)
115 to 124 beats/min (±3%/±1 beat/min)
NOTE
The above range includes the error margin of the SpO2 checker. Therefore, the range is ±1
digit outside the SpO2 measuring accuracy of the transmitter in the “Speciﬁcations” section.
6.
100
Check that the SpO2 and pulse waveform of the transmitter appear on the receiving monitor.
Operator’s Manual ZM-540PA/541PA
9. NIBP Check
Check that the transmitter displays the correct cuff pressure and that there is no air leak. The
following procedure uses an electric manometer.
1.
Connect the electric manometer and dummy cuff to the transmitter.
NOTE
Air leaks from the rubber ball during inﬂation. Use a clip on the air hose of the rubber ball to
stop air leaking.
Clip
Rubber ball
Electric manometer
Dummy cuff (700 cc)
Turn on the electric manometer.
3.
While pressing the Function key, turn on the transmitter. The MENU screen appears.
4.
Press the
▼
2.
key to move the cursor to “MANUAL CHECK” and press the Function key.
Cursor
Operator’s Manual ZM-540PA/541PA
101
Press the
▼
7.
or
or
▼
Press the
▼
6.
key to move the cursor to “NIBP HARDWARE TEST” and press the
▼
Press the or
Function key.
▼
▼
5.
key to move the cursor to “AIR LEAK TEST” and press the Function key.
key to move the cursor to “AIR LEAK (AUTO)” and press the Function key.
The transmitter inﬂates the cuff up to about 250 mmHg and measures air leakage from 60
seconds to 120 seconds after inﬂation.
102
Operator’s Manual ZM-540PA/541PA
8.
Check the following.
• The value for “AIR LEAK (AUTO)” is below 10 mmHg.
• The difference between the pressure value displayed on the manometer and transmitter is
within ±6 mmHg.
10. NIBP Cuff for Attaching Transmitter to Patient Arm
The NIBP cuff is a consumable. Check the following and when necessary, replace it with a new one.
Appearance
• There are no dirty parts.
• There are no broken stitches on the cuff.
• The label on the cuff is readable.
• The velcro tape on the cuff is not removed and there are no broken stitches.
• The lock plate is not damaged and functions properly.
Inﬂation bag
• The inﬂation bag is not torn or damaged.
• There is no water inside the inﬂation bag.
• The connector on the inﬂation bag is not damaged.
Operator’s Manual ZM-540PA/541PA
103
Maintenance Check Sheet
Hospital/Organization:
Service Personnel:
Instrument Name: Transmitter
Instrument Model: ZM-540PA/ZM-541PA
Instrument Serial Number:
Hardware Revision Number:
Software Revision Number:
1. External Check
OK
No
2. Transmitter Channel
OK
No
3. Transmitting/Receiving Signal
OK
No
4. Display
OK
No
5. Key Operation
OK
No
6. ECG Check
OK
No
7. Respiration Check
OK
No
8. SpO2 Check
OK
No
9. NIBP Check
OK
No
10. NIBP Cuff for Attaching Transmitter to Patient Arm
OK
No
Overall Judgement
□ OK
□ Can be used but needs maintenance
□ Maintenance required. Cannot be used.
104
Operator’s Manual ZM-540PA/541PA
Lifetime and Disposal
CAUTION
Dispose of the transmitter, options and accessories as speciﬁed by Nihon Kohden.
Otherwise, it causes infection or environmental contamination.
Disposing of Used Batteries
Battery Lifetime
Replace the batteries when the battery replacement indication appears on the transmitter. When
using rechargeable batteries, recharge them.
Disposal
NOTE
Remove the batteries before disposing of the transmitter.
Before disposing of the batteries, check with your local solid waste ofﬁcials for details in your area
for proper disposal. It may be illegal to dispose of these batteries in the municipal waste stream.
Disposing of Electrodes, SpO2 Probes and NIBP Cuffs
Refer to the manual for each item.
Disposing of Transmitter
Remove the batteries from the transmitter and dispose of the transmitter following your local laws
for disposal.
Operator’s Manual ZM-540PA/541PA
105
Cleaning, Disinfection and Sterilization
Transmitter and Electrode Leads
CAUTION
This transmitter is not waterproof. If detergent or liquid spills into the transmitter, stop
cleaning or disinfecting it and contact your Nihon Kohden representative. The
transmitter needs to be checked for safety and function before use.
NOTE
The transmitter cannot be sterilized. Sterilizing the transmitter may damage it.
Before cleaning or disinfecting, remove the batteries from the transmitter. Be careful not to let any
liquid get inside the transmitter.
Cleaning
Wipe the transmitter and electrode leads with a soft cloth moistened with disinfecting alcohol or
neutral detergent diluted with water. After cleaning, dry them completely.
Use cotton swab moistened with neutral detergent diluted with water to clean inside the battery
compartment.
Disinfection
CAUTION
Do not immerse the electrode lead connector in liquid.
Wipe the outside surface of the transmitter and electrode lead with a non-abrasive cloth moistened
with any of the disinfectants listed below. For details on the disinfectants, refer to the instruction
provided with the disinfectants. Use the recommended concentration.
Disinfectant
Glutaraldehyde solution
Alkyldiaminoethylglycine hydrochloride
Benzalkonium chloride
Benzethonium chloride solution
Chlorhexidine gluconate solution
106
Concentration (%)
2.0
0.5
0.2
0.2
0.5
Operator’s Manual ZM-540PA/541PA
SpO2 Probe
Refer to the probe manual.
YP-503P/YP-504P NIBP Cuffs
NOTE
•
•
•
•
Do not autoclave the cuff.
Use only glutaraldehyde solution.
Never allow liquid to get inside the inﬂation bag.
Do not sterilize or disinfect the cuff with ultraviolet light or ozone.
Cleaning
To clean the cuff, remove the lock plate and carefully pull out the inﬂation bag from the cloth cover.
Cloth cover: Wash with neutral detergent and water. Thoroughly dry it. When washing in a washing
machine, put it in a net.
Inﬂation bag: Wipe with a soft cloth or cotton moistened with isopropyl alcohol. Thoroughly dry it.
Disinfection
To disinfect the cuff, use glutaraldehyde solution. Use the recommended concentration of the
disinfectant. Refer to the disinfectant manual for details. After disinfection, clean the cuff as
described above.
Repair Parts Availability Policy
Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain the
performance of the instrument) for a period of 8 years from the date of delivery. In that period NKC
or its authorized agents will repair the instrument. This period may be shorter than 8 years if a board
or part necessary for the faulty section is not available.
Operator’s Manual ZM-540PA/541PA
107
Speciﬁcations
ZM-540PA
Measuring Parameters
Measuring waveforms:
Measuring numeric data:
ECG, respiration in impedance method, pulse
Heart rate, respiration rate, SpO2, NIBP, pulse rate
Transmitting Data
Waveform data:
Numeric data:
Status information:
ECG, respiration, pulse wave
SpO2, NIBP, pulse rate
Battery replacement, battery level*, alarm suspended,
pause monitoring*, patient conﬁrmed*, ECG lead, pacing
detection, electrode detachment, electrode impedance*,
ECG off*, respiration method (impedance)*, SpO2 status,
NIBP status, channel ID, time constant (3.2 s), type of
transmitter, transmitter code number*, transmitter serial
number*
* The items marked with * are transmitted only when the protocol is “57”.
Display
Display size:
Viewing area:
Resolution:
2.2 inch TFT color LCD
44.16 (H) × 33.12 (V) mm
320 (H) × 240 (V) dots
Displayed Data
Numeric and waveform screen:
Waveform review screen:
Numeric review screen:
Check electrodes screen:
ECG (one waveform from lead I, II, III, Va or Vb), heart
rate, pulse rate, respiration rate, SpO2, NIBP (systolic,
diastolic, MAP), message, battery level, QRS/pulse sync
mark, pulse bar graph, NIBP measurement mode and status
information, ECG lead
ECG or pulse wave of past 10 minutes
Heart rate or pulse rate, respiration rate and SpO2 at 1
minute interval for past 10 minutes
ECG for checking electrode attachment
ECG
ECG measurement
Channels:
108
Operator’s Manual ZM-540PA/541PA
Input dynamic range:
Electrode offset potential tolerance:
Input impedance:
Common mode rejection ratio:
±10 mV or more
±500 mV or more
5 MΩ or more
95 dB or more
IEC 60601-2-27 50.102.10 complied
Pacing pulse detection:
amplitude ±2 to 700 mV, duration 0.1 to 2 ms
IEC 60601-2-27: 2005 complied
Based upon pacemaker pulse rejection capability
Deﬁbrillation-proof:
ECG input protected against 400 Ws/DC 5 kV
IEC 60601-2-27 17.101 complied
ECG recovery time after deﬁbrillation: within 10 s
Electrode condition:
Displays CHECK ELECTRODES message
Tall T-wave rejection capability:
Complies with the heights of T-waves from 0 to 1.6 mV
IEC 60601-2-27: 2005 50.102.17 complied
Pacemaker pulse rejection capability, without overshoot:
Complies with the amplitudes of pacemaker pulses ±2 to
±700 mV and widths 0.1 to 2 ms (As deﬁned by method B
of IEC 60601-2-27: 2005 50.102.13, this corresponds to the
pacemaker pulses amplitudes and widths of ±2.8 mV/2 ms
to amplitudes ±45.6 mV/0.1 ms.)
Pacemaker pulse rejection capability, with overshoot:
Overshoot amplitudes and time constants of ±0.12
mV/100 ms to ±2 mV/4 ms (As deﬁned by method B of
IEC 60601-2-27: 2005 50.102.13, this corresponds to the
pacemaker pulses amplitudes and widths of ±2.8 mV/2 ms
to amplitudes ±45.6 mV/0.1 ms.)
ECG display and heart rate count
Frequency characteristic:
Heart rate detection method:
QRS detection:
ﬁlter on: 1 to 18 Hz, ﬁlter off: 0.05 to 60 Hz
Average
70 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 200 beats/min
40 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 250 beats/min
Heart rate counting range:
0, 15 to 300 beats/min
Heart rate counting accuracy*:
±2 beats/min, (0, 15 to 300 beats/min)
* Essential performance of this transmitter
Respiration Measurement
Measuring method:
Impedance method
Measuring lead:
Between R and F
Impedance range:
2 kΩ or less
Respiration rate measuring accuracy*: ±2 counts/min (at 0 to 150 counts/min)
Respiration rate counting range:
0 to 150 counts/min
* Essential performance of this transmitter
Operator’s Manual ZM-540PA/541PA
109
SpO2 Measurement (ISO 9919: 2005 complied)
Measuring range:
Declared range:
Minimum display range:
Display update cycle:
Measuring accuracy (rms)*:
Total accuracy including probe:
0 to 100%SpO2
70 to 100%SpO2
1%SpO2
Every 3 seconds
Accuracy assurance temperature: 18 to 40ºC
80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±2%SpO2
70%SpO2 ≤ %SpO2 < 80%SpO2: ±3%SpO2
under 70%SpO2: not speciﬁed
Accuracy of the transmitter:
80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±1%SpO2
50%SpO2 ≤ %SpO2 < 80%SpO2: ±2%SpO2
under 50%SpO2: not speciﬁed
Pulse rate measuring range:
30 to 300 bpm
Pulse rate display range:
30 to 300 bpm
Pulse rate accuracy (rms)*:
±3% ±1 bpm
* Essential performance of this transmitter
NOTE
• The SpO2 measuring accuracy was tested using the TL-201T, TL-260T, TL-271T and
TL-631T SpO2 probes. The testing was performed during induced hypoxia on healthy
volunteers (Ethnicity: 10 Caucasians, 2 Africans, 1 Asian and 3 Indians), (Skin: 8 light,
4 medium, 4 dark), (Age: 21 to 34), (5 women and 11 men) under the condition of no
motion. Arterial blood was sampled and measured by a CO-oximeter. The difference
between SpO2 measured by the SpO2 probe and functional SaO2 measured by a COoximeter was calculated using the root-mean-square (rms) method according to ISO
9919: 2005. This measurement accuracy ﬁgure represents 2/3 of all test measurements.
• A pulse oximeter tester that generates simulated signals can be used to check the
difference from the design speciﬁcation, but it cannot be used as a replacement for
human signals for testings accuracy.
Response time:
Selectable from “Slow”, “Normal” and “Fast”.
The following graphs show the response time example when SpO2 changes 0.6%/s.
110
Operator’s Manual ZM-540PA/541PA
Pulse Rate = 70 bpm
SpO2 Reference
SpO2 Fast
SpO2 Normal
SpO2 Slow
100
95
SpO2 (%)
90
85
80
75
70
65
60
10
20
30
40
50
60
70
80
90
100
110
120
130
140
Time (seconds)
Pulse Rate = 140 bpm
SpO2 Reference
SpO2 Fast
SpO2 Normal
SpO2 Slow
100
95
SpO2 (%)
90
85
80
75
70
65
60
10
20
30
40
50
60
70
80
90
100
110
120
130
140
Time (seconds)
The following graph shows the response time example when pulse rate changes 10 bpm/s.
SpO2 = 97
PR Reference
PR
150
140
PR (bpm)
130
120
110
100
90
80
70
60
10
20
30
40
50
60
70
80
90
100
110
120
Time (seconds)
Operator’s Manual ZM-540PA/541PA
111
Non Invasive Blood Pressure, NIBP (IEC 60601-2-30: 1999 complied)
Measuring method:
Measurement mode:
Intended patient type:
Measuring range:
Pressure display range:
Measuring accuracy*:
Cuff inﬂation time:
Oscillometric
Manual, STAT (≤ 15 min), Periodic
Adult, child
0 to 300 mmHg
0 to 300 mmHg
±3 mmHg (0 mmHg ≤ NIBP ≤ 300 mmHg)
AAMI SP-10: 2002 complied
≤ 20 s (700 cc), 0 to 200 mmHg
≤ 15 s (70 cc), 0 to 200 mmHg
≤ 5 mmHg (250 cc at 250 mmHg inﬂation for 10 seconds)
≤ 3 mmHg/min (700 cc at 300 mmHg inﬂation)
Deﬂate immediately after power down
Pressure retention:
Air leakage:
Power discontinuity:
Safety
Maximum pressurization value cuff inﬂation limiter: 300 to 330 mmHg
Cuff inﬂation time limiter:
≤ 180 s
Interval time limiter:
≤ 30 s
* Essential performance of this transmitter
Transmitter
FCC regulation:
Field strength limits:
Undesired emissions:
Antenna:
Transmission channel:
Transmission frequency range:
Channel spacing:
Modulation:
Type of emission:
Occupied bandwidth:
Effective radiated power:
FCC part 95 Subpart H
Wireless Medical Telemetry Service (WMTS)
< 200 mV/m (at 3 m)
below 960 MHz: < 200 μV/m (at 3 m)
above 960 MHz: < 500 μV/m (at 3 m)
Internal
Indicated on the transmitter
608.0250 to 613.9750 MHz
50 kHz or 37.5 kHz (12.5 kHz when interleaved)
FSK (frequency shift keying)
F1D
< 20 kHz
1.0 mW
Power Requirements
Rated voltage:
Operating voltage:
Battery type:
3.6 V
3.2 to 4.8 V
Three AA (R6) type NiMH secondary batteries
Three AA (R6) type alkaline dry cell primary batteries
Battery lifetime (with alkaline batteries, at room temperature):
approximately 1 day
(measuring ECG, respiration, SpO2 of approximately 60 kg
weight adult male patient at the index ﬁnger, NIBP at 60
minute intervals)
112
Operator’s Manual ZM-540PA/541PA
Dimension and Weight
Dimension:
Weight:
114 W × 125 H × 63 D (mm)
about 340 g (excluding batteries and other accessories)
about 410 g (including batteries, excluding other
accessories)
Environment
Operating environment
Temperature:
Humidity:
Atmospheric pressure:
5 to 40°C, 41 to 104°F
30 to 85% (noncondensing)
700 to 1060 hPa
Storage and transport environment
Temperature:
Humidity:
Atmospheric pressure:
−20 to +65°C, −4 to +149°F
10 to 95%
700 to 1060 hPa
Safety Standards
Safety standard:
CAN/CSA-C22.2 No. 601-1 M90
CAN/CSA-C22.2 No. 601-1. 1S1-94
CAN/CSA-C22.2 No. 601-1. 1B-90
CAN/CSA-C22.2 No. 60601-2-49-04
CAN/CSA-C22.2 No. 60601-2-27-06
CAN/CSA-C22.2 No. 60601-2-30-02
IEC 60601-1:1988
IEC 60601-1 Amendment 1: 1991
IEC 60601-1 Amendment 2: 1995
IEC 60601-2-27: 2005
IEC 60601-2-30: 1999
IEC 60601-2-49: 2001
ISO 9919: 2005
Type of protection against electrical shock:
INTERNALLY POWERED EQUIPMENT
Degree of protection against electrical shock:
ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED
PART
SpO2 and NIBP:
DEFIBRILLATION-PROOF TYPE BF APPLIED
PART
Degree of protection against harmful ingress of water: IPX0 (Ordinary equipment)
Degree of safety of application in the presence of a FLAMMABLE ANAESTHETIC MIXTURE
WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE:
Equipment not suitable for use in the presence of
FLAMMABLE ANAESTHETIC MIXTURE WITH
AIR, OR WITH OXYGEN OR NITROUS OXIDE
Operator’s Manual ZM-540PA/541PA
113
Mode of operation:
CONTINUOUS OPERATION
Electromagnetic Compatibility
IEC 60601-1-2: 2001
IEC 60601-1-2 Amendment 1: 2004
Electromagnetic Emissions
This Model ZM-540PA is intended for use in the electromagnetic environment speciﬁed below.
The customer or the user of the ZM-540PA should assure that it is used in such an environment.
Emissions test
RF emissions
CISPR 11
RF emissions
CISPR 11
Harmonic emissions
IEC 61000-3-2
Voltage ﬂuctuations/
ﬂicker emissions
IEC 61000-3-3
114
Compliance
Electromagnetic environment - guidance
Group 1
The ZM-540PA uses RF energy only for its internal
function. Therefore, its RF emissions are very
low and are not likely to cause any interference in
nearby electronic equipment.
Class B
The ZM-540PA is suitable for use in all
establishments, including domestic establishments.
Not applicable
Not applicable
Operator’s Manual ZM-540PA/541PA
Electromagnetic Immunity
This Model ZM-540PA is intended for use in the electromagnetic environment speciﬁed below.
The customer or the user of the ZM-540PA should assure that it is used in such an environment.
Immunity test
Electrostatic
discharge (ESD)
IEC 61000-4-2
IEC 60601 test
level
±6 kV contact
±8 kV air
Compliance
level
±6 kV contact
±8 kV air
Not applicable
±2 kV for power
supply lines
±1 kV for input/output
lines
Not applicable
Surge
±1 kV differential
IEC 61000-4-5
mode
±2 kV common mode
Voltage dips, short <5% UT (>95% dip in Not applicable
interruptions and UT) for 0.5 cycle
voltage variations
on power supply
40% UT (60% dip in
input lines
UT) for 5 cycles
IEC 61000-4-11
70% UT (30% dip in
UT) for 25 cycles
Electrical fast
transient/ burst
IEC 61000-4-4
<5% UT (>95% dip in
UT) for 5 s
3 A/m
Electromagnetic
environment - guidance
Floors should be wood, concrete
or ceramic tile. If ﬂoors are
covered with synthetic material,
the relative humidity should be at
least 30%.
—
—
—
Power frequency magnetic ﬁelds
should be at levels characteristic
of a typical location in a
typical commercial or hospital
environment.
NOTE: UT is the AC mains voltage prior to application of the test level
Power frequency
(50/60 Hz)
magnetic ﬁeld
IEC 61000-4-8
3 A/m
Avoiding Electromagnetic Interference (Impedance Respiration)
Impedance respiration measurement is very sensitive and affected by electromagnetic interference.
Technological limitations do not allow immunity levels higher than 1 V/m for radiated RF
electromagnetic ﬁelds. Electromagnetic ﬁelds with ﬁeld strengths above 1 V/m may cause
measurement error. Do not use electrically radiating equipment near the impedance respiration
measurements.
Operator’s Manual ZM-540PA/541PA
115
Immunity test
IEC 60601 test
level
Compliance
level
Electromagnetic environment
- guidance
Portable and mobile RF communications
equipment should be used no closer to any
part of the ZM-540PA, including cables,
than the recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6
3 Vrms
3 Vrms
150 kHz to 80 MHz
d = 1.2㺕P
Radiated RF
IEC 61000-4-3
3 V/m
3 V/m 80 MHz to
80 MHz to 2.5 GHz 2.5 GHz
d = 1.2㺕P 80 MHz to 800 MHz
d = 2.3㺕P 800 MHz to 2.5 GHz
(1 V/m 80 MHz
to 2.5 GHz for
respiration)
(d = 3.5㺕P 80 MHz to 800 MHz for
respiration
d = 7.0㺕P 800 MHz to 2.5 GHz for
respiration)
where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).
Field strengths from ﬁxed RF transmitters,
as deter mined by an electromagnetic
site survey*1, should be less than the
compliance level in each frequency
range*2.
Interference may occur in the vicinity of
equipment marked with the following
symbol:
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reﬂection from structures, objects and people.
*1 Field strengths from ﬁxed transmitters, such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to ﬁxed RF transmitters, an
electromagnetic site survey should be considered. If the measured ﬁeld strength in the location in which
the ZM-540PA is used exceeds the applicable RF compliance level above, the ZM-540PA should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be
necessary, such as re-orienting or relocating the ZM-540PA.
*2 Over the frequency range 150 kHz to 80 MHz, ﬁeld strengths should be less than 1 V/m for respiration
and 3 V/m for all other functions.
116
Operator’s Manual ZM-540PA/541PA
Recommended Separation Distances between Portable and Mobile RF
Communications Equipment
The ZM-540PA is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the ZM-540PA can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the ZM-540PA as recommended below, according to
the maximum output power of the communications equipment.
Separation distance according to frequency of transmitter (m)
Rated maximum output
power of transmitter
(W)
150 kHz to 80 MHz
d = 1.2㺕P
80 MHz to 800 MHz
d = 1.2㺕P
800 MHz to 2.5 GHz
d = 2.3㺕P
(For respiration:
d = 3.5㺕P)
(For respiration:
d = 7.0㺕P)
0.01
0.12
0.12 (0.35*)
0.23 (0.7*)
0.1
0.38
0.38 (1.1*)
0.73 (2.2*)
1.2
1.2 (3.5*)
2.3 (7.0*)
10
3.8
3.8 (11*)
7.3 (22*)
100
12
12 (35*)
23 (70*)
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be estimated using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according
to the transmitter manufacturer.
(* For respiration)
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reﬂection from structures, objects and people.
Recovery Time after Deﬁbrillation
The transmitter returns to the normal operating mode within 10 seconds after deﬁbrillation. The
stored settings are not affected.
System Composition for EMC Test
The ZM-540PA bedside monitor is tested to comply with IEC 60601-1-2: 2001 with the following
composition.
Units
ZM-540PA transmitter
YP-503P NIBP cuff
BR-906P ECG electrode lead
TL-201T ﬁnger probe
Operator’s Manual ZM-540PA/541PA
Cable length
—
0.15 m
0.8 m
1.6 m
117
ZM-541PA
Measuring Parameters
Measuring waveforms:
Measuring numeric data:
ECG, respiration in impedance method, pulse
Heart rate, respiration rate, SpO2, NIBP, pulse rate
Transmitting Data
Waveform data:
Numeric data:
Status information:
ECG, respiration, pulse wave
SpO2, NIBP, pulse rate
Battery replacement, battery level*, alarm suspended,
pause monitoring*, patient conﬁrmed*, ECG lead, pacing
detection, electrode detachment, electrode impedance*,
ECG off*, respiration method (impedance)*, SpO2 status,
NIBP status, channel ID, time constant (3.2 s), type of
transmitter, transmitter code number*, transmitter serial
number*
* The items marked with * are transmitted only when the protocol is “57”.
Display
Display size:
Viewing area:
Resolution:
2.2 inch TFT color LCD
44.16 (H) × 33.12 (V) mm
320 (H) × 240 (V) dots
Displayed Data
Numeric and waveform screen:
Waveform review screen:
Numeric review screen:
CHECK ELECTRODE screen:
ECG (one waveform from lead I, II, III, Va or Vb), heart
rate, pulse rate, respiration rate, SpO2, NIBP (systolic,
diastolic, MAP), message, battery level, QRS/pulse sync
mark, pulse bar graph, NIBP measurement mode and status
information, ECG lead
ECG or pulse wave of past 10 minutes
Heart rate or pulse rate, respiration rate and SpO2 at 1
minute interval for past 10 minutes
ECG for checking electrode attachment
ECG
ECG measurement
Channels:
Input dynamic range:
Electrode offset potential tolerance:
Input impedance:
Common mode rejection ratio:
118
±10 mV or more
±500 mV or more
5 MΩ or more
95 dB or more
IEC 60601-2-27 50.102.10 complied
Operator’s Manual ZM-540PA/541PA
Pacing pulse detection:
amplitude ±2 to 700 mV, duration 0.1 to 2 ms
IEC 60601-2-27: 2005 complied
Based upon pacemaker pulse rejection capability
Deﬁbrillation-proof:
ECG input protected against 400 Ws/DC 5 kV
IEC 60601-2-27 17.101 complied
ECG recovery time after deﬁbrillation: within 10 s
Electrode condition:
Displays CHECK ELECTRODES message
Tall T-wave rejection capability:
Complies with the heights of T-waves from 0 to 1.6 mV
IEC 60601-2-27: 2005 50.102.17 complied
Pacemaker pulse rejection capability, without overshoot:
Complies with the amplitudes of pacemaker pulses ±2 to
±700 mV and widths 0.1 to 2 ms (As deﬁned by method B
of IEC 60601-2-27: 2005 50.102.13, this corresponds to the
pacemaker pulses amplitudes and widths of ±2.8 mV/2 ms
to amplitudes ±45.6 mV/0.1 ms.)
Pacemaker pulse rejection capability, with overshoot:
Overshoot amplitudes and time constants of ±0.12
mV/100 ms to ±2 mV/4 ms (As deﬁned by method B of
IEC 60601-2-27: 2005 50.102.13, this corresponds to the
pacemaker pulses amplitudes and widths of ±2.8 mV/2 ms
to amplitudes ±45.6 mV/0.1 ms.)
ECG display and heart rate count
Frequency characteristic:
Heart rate detection method:
QRS detection:
ﬁlter on: 1 to 18 Hz, ﬁlter off: 0.05 to 60 Hz
Average
70 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 200 beats/min
40 to 120 ms: amplitude ≥ 0.5 mV, rate 30 to 250 beats/min
Heart rate counting range:
0, 15 to 300 beats/min
Heart rate counting accuracy*:
±2 beats/min, (0, 15 to 300 beats/min)
* Essential performance of this transmitter
Respiration Measurement
Measuring method:
Impedance method
Measuring lead:
Between R and F
Impedance range:
2 kΩ or less
Respiration rate measuring accuracy*: ±2 counts/min (at 0 to 150 counts/min)
Respiration rate counting range:
0 to 150 counts/min
* Essential performance of this transmitter
SpO2 Measurement (ISO 9919: 2005 complied)
Measuring range:
Declared range:
Minimum display range:
0 to 100%SpO2
70 to 100%SpO2
1%SpO2
Operator’s Manual ZM-540PA/541PA
119
Display update cycle:
Every 3 seconds
Measuring accuracy (rms)*:
Accuracy assurance temperature: 18 to 40ºC
Total accuracy including probe: 80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±2%SpO2
70%SpO2 ≤ %SpO2 < 80%SpO2: ±3%SpO2
under 70%SpO2: not speciﬁed
Accuracy of the transmitter:
80%SpO2 ≤ %SpO2 ≤ 100%SpO2: ±1%SpO2
50%SpO2 ≤ %SpO2 < 80%SpO2: ±2%SpO2
under 50%SpO2: not speciﬁed
Pulse rate measuring range:
30 to 300 bpm
Pulse rate display range:
30 to 300 bpm
Pulse rate accuracy (rms)*:
±3% ±1 bpm
* Essential performance of this transmitter
NOTE
• The SpO2 measuring accuracy was tested using the TL-201T, TL-260T, TL-271T and
TL-631T SpO2 probes. The testing was performed during induced hypoxia on healthy
volunteers (Ethnicity: 10 Caucasians, 2 Africans, 1 Asian and 3 Indians), (Skin: 8 light,
4 medium, 4 dark), (Age: 21 to 34), (5 women and 11 men) under the condition of no
motion. Arterial blood was sampled and measured by a CO-oximeter. The difference
between SpO2 measured by the SpO2 probe and functional SaO2 measured by a COoximeter was calculated using the root-mean-square (rms) method according to ISO
9919: 2005. This measurement accuracy ﬁgure represents 2/3 of all test measurements.
• A pulse oximeter tester that generates simulated signals can be used to check the
difference from the design speciﬁcation, but it cannot be used as a replacement for
human signals for testings accuracy.
Response time:
Selectable from “Slow”, “Normal” and “Fast”.
The following graphs show the response time example when SpO2 changes 0.6%/s.
Pulse Rate = 70 bpm
SpO2 Reference
SpO2 Fast
SpO2 Normal
SpO2 Slow
100
95
SpO2 (%)
90
85
80
75
70
65
60
10
20
30
40
50
60
70
80
90
100
110
120
130
140
Time (seconds)
120
Operator’s Manual ZM-540PA/541PA
Pulse Rate = 140 bpm
SpO2 Reference
SpO2 Fast
SpO2 Normal
SpO2 Slow
100
95
SpO2 (%)
90
85
80
75
70
65
60
10
20
30
40
50
60
70
80
90
100
110
120
130
140
Time (seconds)
The following graph shows the response time example when pulse rate changes 10 bpm/s.
SpO2 = 97
PR Reference
PR
150
140
PR (bpm)
130
120
110
100
90
80
70
60
10
20
30
40
50
60
70
80
90
100
110
120
Time (seconds)
Non Invasive Blood Pressure, NIBP (IEC 60601-2-30: 1999 complied)
Measuring method:
Measurement mode:
Intended patient type:
Measuring range:
Pressure display range:
Measuring accuracy*:
Cuff inﬂation time:
Pressure retention:
Air leakage:
Power discontinuity:
Oscillometric
Manual, STAT (≤ 15 min), Periodic
Adult, child
0 to 300 mmHg
0 to 300 mmHg
±3 mmHg (0 mmHg ≤ NIBP ≤ 300 mmHg)
AAMI SP-10: 2002 complied
≤ 20 s (700 cc), 0 to 200 mmHg
≤ 15 s (70 cc), 0 to 200 mmHg
≤ 5 mmHg (250 cc at 250 mmHg inﬂation for 10 seconds)
≤ 3 mmHg/min (700 cc at 300 mmHg inﬂation)
Deﬂate immediately after power down
Operator’s Manual ZM-540PA/541PA
121
Safety
Maximum pressurization value cuff inﬂation limiter: 300 to 330 mmHg
Cuff inﬂation time limiter:
≤ 180 s
Interval time limiter:
≤ 30 s
* Essential performance of this transmitter
Transmitter
FCC regulation:
Field strength limits:
Undesired emissions:
Antenna:
Transmission channel:
Transmission frequency range:
Channel spacing:
Modulation:
Type of emission:
Occupied bandwidth:
Effective radiated power:
FCC part 95 Subpart H
Wireless Medical Telemetry Service (WMTS)
< 740 mV/m (at 3 m)
below 960 MHz: < 200 μV/m (at 3 m)
above 960 MHz: < 500 μV/m (at 3 m)
Internal
Indicated on the transmitter
1395.0250 to 1399.9750 MHz
1427.0250 to 1431.9750 MHz
50 kHz or 37.5 kHz (12.5 kHz when interleaved)
FSK (frequency shift keying)
F1D
< 20 kHz
5.0 mW
Can be changed to 1.0 mW if required
Power Requirements
Rated voltage:
Operating voltage:
Battery type:
3.6 V
3.2 to 4.8 V
Three AA (R6) type NiMH secondary batteries
Three AA (R6) type alkaline dry cell primary batteries
Battery lifetime (with alkaline batteries, at room temperature):
approximately 1 day
(measuring ECG, respiration, SpO2 of approximately 60 kg
weight adult male patient at the index ﬁnger, NIBP at 60
minute intervals)
Dimension and Weight
Dimension:
Weight:
122
114 W × 125 H × 63 D (mm)
about 340 g (excluding batteries and other accessories)
about 410 g (including batteries, excluding other
accessories)
Operator’s Manual ZM-540PA/541PA
Environment
Operating environment
Temperature:
Humidity:
Atmospheric pressure:
5 to 40°C, 41 to 104°F
30 to 85% (noncondensing)
700 to 1060 hPa
Storage and transport environment
Temperature:
Humidity:
Atmospheric pressure:
−20 to +65°C, −4 to +149°F
10 to 95%
700 to 1060 hPa
Safety Standards
Safety standard:
CAN/CSA-C22.2 No. 601-1 M90
CAN/CSA-C22.2 No. 601-1. 1S1-94
CAN/CSA-C22.2 No. 601-1. 1B-90
CAN/CSA-C22.2 No. 60601-2-49-04
CAN/CSA-C22.2 No. 60601-2-27-06
CAN/CSA-C22.2 No. 60601-2-30-02
IEC 60601-1:1988
IEC 60601-1 Amendment 1: 1991
IEC 60601-1 Amendment 2: 1995
IEC 60601-2-27: 2005
IEC 60601-2-30: 1999
IEC 60601-2-49: 2001
ISO 9919: 2005
Type of protection against electrical shock:
INTERNALLY POWERED EQUIPMENT
Degree of protection against electrical shock:
ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED
PART
SpO2 and NIBP:
DEFIBRILLATION-PROOF TYPE BF APPLIED
PART
Degree of protection against harmful ingress of water: IPX0 (Ordinary equipment)
Degree of safety of application in the presence of a FLAMMABLE ANAESTHETIC MIXTURE
WITH AIR, OR WITH OXYGEN OR NITROUS OXIDE:
Equipment not suitable for use in the presence of
FLAMMABLE ANAESTHETIC MIXTURE WITH
AIR, OR WITH OXYGEN OR NITROUS OXIDE
Mode of operation:
CONTINUOUS OPERATION
Electromagnetic Compatibility
IEC 60601-1-2: 2001
IEC 60601-1-2 Amendment 1: 2004
Operator’s Manual ZM-540PA/541PA
123
Electromagnetic Emissions
This Model ZM-541PA is intended for use in the electromagnetic environment speciﬁed below.
The customer or the user of the ZM-541PA should assure that it is used in such an environment.
Emissions test
RF emissions
CISPR 11
RF emissions
CISPR 11
Harmonic emissions
IEC 61000-3-2
Voltage ﬂuctuations/
ﬂicker emissions
IEC 61000-3-3
124
Compliance
Electromagnetic environment - guidance
Group 1
The ZM-541PA uses RF energy only for its internal
function. Therefore, its RF emissions are very
low and are not likely to cause any interference in
nearby electronic equipment.
Class B
The ZM-541PA is suitable for use in all
establishments, including domestic establishments.
Not applicable
Not applicable
Operator’s Manual ZM-540PA/541PA
Electromagnetic Immunity
This Model ZM-541PA is intended for use in the electromagnetic environment speciﬁed below.
The customer or the user of the ZM-541PA should assure that it is used in such an environment.
Immunity test
Electrostatic
discharge (ESD)
IEC 61000-4-2
IEC 60601 test
level
±6 kV contact
±8 kV air
Compliance
level
±6 kV contact
±8 kV air
Not applicable
±2 kV for power
supply lines
±1 kV for input/output
lines
Not applicable
Surge
±1 kV differential
IEC 61000-4-5
mode
±2 kV common mode
Voltage dips, short <5% UT (>95% dip in Not applicable
interruptions and UT) for 0.5 cycle
voltage variations
on power supply
40% UT (60% dip in
input lines
UT) for 5 cycles
IEC 61000-4-11
70% UT (30% dip in
UT) for 25 cycles
Electrical fast
transient/ burst
IEC 61000-4-4
<5% UT (>95% dip in
UT) for 5 s
3 A/m
Electromagnetic
environment - guidance
Floors should be wood, concrete
or ceramic tile. If ﬂoors are
covered with synthetic material,
the relative humidity should be at
least 30%.
—
—
—
Power frequency magnetic ﬁelds
should be at levels characteristic
of a typical location in a
typical commercial or hospital
environment.
NOTE: UT is the AC mains voltage prior to application of the test level
Power frequency
(50/60 Hz)
magnetic ﬁeld
IEC 61000-4-8
3 A/m
Avoiding Electromagnetic Interference (Impedance Respiration)
Impedance respiration measurement is very sensitive and affected by electromagnetic interference.
Technological limitations do not allow immunity levels higher than 1 V/m for radiated RF
electromagnetic ﬁelds. Electromagnetic ﬁelds with ﬁeld strengths above 1 V/m may cause
measurement error. Do not use electrically radiating equipment near the impedance respiration
measurements.
Operator’s Manual ZM-540PA/541PA
125
Immunity test
IEC 60601 test
level
Compliance
level
Electromagnetic environment
- guidance
Portable and mobile RF communications
equipment should be used no closer to any
part of the ZM-541PA, including cables,
than the recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6
3 Vrms
3 Vrms
150 kHz to 80 MHz
d = 1.2㺕P
Radiated RF
IEC 61000-4-3
3 V/m
3 V/m 80 MHz to
80 MHz to 2.5 GHz 2.5 GHz
d = 1.2㺕P 80 MHz to 800 MHz
d = 2.3㺕P 800 MHz to 2.5 GHz
(1 V/m 80 MHz
to 2.5 GHz for
respiration)
(d = 3.5㺕P 80 MHz to 800 MHz for
respiration
d = 7.0㺕P 800 MHz to 2.5 GHz for
respiration)
where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).
Field strengths from ﬁxed RF transmitters,
as deter mined by an electromagnetic
site survey*1, should be less than the
compliance level in each frequency
range*2.
Interference may occur in the vicinity of
equipment marked with the following
symbol:
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reﬂection from structures, objects and people.
*1 Field strengths from ﬁxed transmitters, such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to ﬁxed RF transmitters, an
electromagnetic site survey should be considered. If the measured ﬁeld strength in the location in which
the ZM-541PA is used exceeds the applicable RF compliance level above, the ZM-541PA should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be
necessary, such as re-orienting or relocating the ZM-541PA.
*2 Over the frequency range 150 kHz to 80 MHz, ﬁeld strengths should be less than 1 V/m for respiration
and 3 V/m for all other functions.
126
Operator’s Manual ZM-540PA/541PA
Recommended Separation Distances between Portable and Mobile RF
Communications Equipment
The ZM-541PA is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the ZM-541PA can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the ZM-541PA as recommended below, according to
the maximum output power of the communications equipment.
Separation distance according to frequency of transmitter (m)
Rated maximum output
power of transmitter
(W)
150 kHz to 80 MHz
d = 1.2㺕P
80 MHz to 800 MHz
d = 1.2㺕P
800 MHz to 2.5 GHz
d = 2.3㺕P
(For respiration:
d = 3.5㺕P)
(For respiration:
d = 7.0㺕P)
0.01
0.12
0.12 (0.35*)
0.23 (0.7*)
0.1
0.38
0.38 (1.1*)
0.73 (2.2*)
1.2
1.2 (3.5*)
2.3 (7.0*)
10
3.8
3.8 (11*)
7.3 (22*)
100
12
12 (35*)
23 (70*)
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be estimated using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according
to the transmitter manufacturer.
(* For respiration)
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reﬂection from structures, objects and people.
Recovery Time after Deﬁbrillation
The transmitter returns to the normal operating mode within 10 seconds after deﬁbrillation. The
stored settings are not affected.
System Composition for EMC Test
The ZM-541PA bedside monitor is tested to comply with IEC 60601-1-2: 2001 with the following
composition.
Units
ZM-541PA transmitter
YP-503P NIBP cuff
BR-906P ECG electrode lead
TL-201T ﬁnger probe
Operator’s Manual ZM-540PA/541PA
Cable length
—
0.15 m
0.8 m
1.6 m
127
Standard Accessories
No.
Name
1 NIBP cuff for adult, standard
2 Strap
Model
YP-503P
—
Q’ty
Supply Code No.
S937C
Y236
The following parts are available for replacement.
Lock plate is a standard accessory of
the YP-503P and YP504P NIBP cuff.
No.
Name
3 Battery case cover
4 Lock plate
128
Model
—
—
Q’ty
Supply Code No.
6143-901517A
6113-049585
Operator’s Manual ZM-540PA/541PA
Options
CAUTION
Only use Nihon Kohden speciﬁed electrodes, electrode leads, SpO2 probes, and
NIBP cuffs. Otherwise, the maximum performance from the transmitter cannot be
guaranteed.
Transmitter
• Channel writer, QI-901PK
• NIBP cuff for adult, large (width 15 cm) (for attaching transmitter to patient arm), YP-504P,
supply code no. S937D
ECG/RESP
Name
Electrode
lead
Application
3 electrodes, clip type,
lead length 80 cm
6 electrodes, clip type,
lead length 80 cm
Operator’s Manual ZM-540PA/541PA
Model
Q’ty
Supply Code No.
BR-903PA
K911A
BR-906PA
K912A
129
SpO2
Name
Finger probe (reusable)
Multi-site probe (reusable)
Finger probe (reusable)
SpO2 probe (for adult, disposable)
SpO2 probe (for child, disposable)
SpO2 probe (for neonate, disposable)
SpO2 probe (for adult, disposable)
SpO2 probe (for child, disposable)
SpO2 probe (for neonate/adult,
disposable)
SpO2 probe (for child/infant,
disposable)
SpO2 probe (for adult/neonate,
disposable)
SpO2 probe (for child/infant,
disposable)
COTTONY tape
Foam tape for TL-051S/052S/
061S/062S
Attachment tape for TL-220T/
251T/252T/253T/630T/631T
Probe fastener
130
Cable
length
0.6 m
1.6 m
1.6 m
0.6 m
1.6 m
0.6 m
1.6 m
1.6 m
0.8 m
1.6 m
0.8 m
1.6 m
0.8 m
1.6 m
0.8 m
1.6 m
0.8 m
1.6 m
0.8 m
1.6 m
—
Model/
Code No.
20
Supply
Code No.
P225H
P225F
P225G
P310A
P310C
P311A
P311C
P201A
P201B
P201C
P203A
P203E
P203B
P203F
P203C
P203G
P203D
P203H
P228A
P228B
P229A
P229B
P259
4 × 25 packages
P260
3 × 30 packages
P263
30
P267
Q’ty
TL-201T
TL-220T
TL-630T1
TL-630T3
TL-631T1
TL-631T3
TL-251T
TL-252T
TL-253T
TL-271T
TL-271T3
TL-272T
TL-272T3
TL-273T
TL-273T3
TL-274T
TL-274T3
TL-051S
TL-052S
TL-061S
TL-062S
340703
24
—
YS-093P2
Operator’s Manual ZM-540PA/541PA
NIBP
Width
(cm)
Name
Cuff for adult, for
attaching transmitter to
patient arm
Cuff for infant
Cuff for child
Cuff for adult
Standard
Large
Small
Standard
Standard
Large
Disposable cuff for infant
Disposable cuff for child
Disposable cuff for adult
Small
Standard
Medium
large
Large
Extension hose
Air Hose
Length
(cm)
13
15
Model
Q’ty
YP-503P*
15
YP-504P*
10
13
15
10
14
17
17
17
20
YP-960T
YP-961T
YP-962T
YP-963T
YP-964T
YP-810P
YP-811P
YP-812P
YP-813P
15
20
YP-814P
17
—
20
150
YP-815P
YN-990P
15
Supply
Code No.
S937C
20
S937D
S943A
S943B
S943C
S944B
S944C
S945C
S945D
S946E
S946F
S946G
S946H
S903
* The lock plate is provided with these NIBP cuffs.
Operator’s Manual ZM-540PA/541PA
131
Transmission Frequencies
Channel: 9002 to 9478
Transmission
Transmission
Transmission
frequency
Channel No.
frequency
Channel No.
frequency
Channel No.
(MHz)
(MHz)
(MHz)
608.0250
608.0375
608.0500
608.0625
608.0750
608.0875
608.1000
608.1125
608.1250
608.1375
608.1500
608.1625
608.1750
608.1875
608.2000
608.2125
608.2250
608.2375
608.2500
608.2625
608.2750
608.2875
608.3000
608.3125
608.3250
608.3375
608.3500
608.3625
608.3750
608.3875
608.4000
608.4125
608.4250
132
9002
9003
9004
9005
9006
9007
9008
9009
9010
9011
9012
9013
9014
9015
9016
9017
9018
9019
9020
9021
9022
9023
9024
9025
9026
9027
9028
9029
9030
9031
9032
9033
9034
608.4375
608.4500
608.4625
608.4750
608.4875
608.5000
608.5125
608.5250
608.5375
608.5500
608.5625
608.5750
608.5875
608.6000
608.6125
608.6250
608.6375
608.6500
608.6625
608.6750
608.6875
608.7000
608.7125
608.7250
608.7375
608.7500
608.7625
608.7750
608.7875
608.8000
608.8125
608.8250
608.8375
9035
9036
9037
9038
9039
9040
9041
9042
9043
9044
9045
9046
9047
9048
9049
9050
9051
9052
9053
9054
9055
9056
9057
9058
9059
9060
9061
9062
9063
9064
9065
9066
9067
608.8500
608.8625
608.8750
608.8875
608.9000
608.9125
608.9250
608.9375
608.9500
608.9625
608.9750
608.9875
609.0000
609.0125
609.0250
609.0375
609.0500
609.0625
609.0750
609.0875
609.1000
609.1125
609.1250
609.1375
609.1500
609.1625
609.1750
609.1875
609.2000
609.2125
609.2250
609.2375
609.2500
9068
9069
9070
9071
9072
9073
9074
9075
9076
9077
9078
9079
9080
9081
9082
9083
9084
9085
9086
9087
9088
9089
9090
9091
9092
9093
9094
9095
9096
9097
9098
9099
9100
Operator’s Manual ZM-540PA/541PA
Transmission
Transmission
Transmission
frequency
Channel No.
frequency
Channel No.
frequency
Channel No.
(MHz)
(MHz)
(MHz)
609.2625
609.2750
609.2875
609.3000
609.3125
609.3250
609.3375
609.3500
609.3625
609.3750
609.3875
609.4000
609.4125
609.4250
609.4375
609.4500
609.4625
609.4750
609.4875
609.5000
609.5125
609.5250
609.5375
609.5500
609.5625
609.5750
609.5875
609.6000
609.6125
609.6250
9101
9102
9103
9104
9105
9106
9107
9108
9109
9110
9111
9112
9113
9114
9115
9116
9117
9118
9119
9120
9121
9122
9123
9124
9125
9126
9127
9128
9129
9130
609.7125
609.7250
609.7375
609.7500
609.7625
609.7750
609.7875
609.8000
609.8125
609.8250
609.8375
609.8500
609.8625
609.8750
609.8875
609.9000
609.9125
609.9250
609.9375
609.9500
609.9625
609.9750
609.9875
610.0000
610.0125
610.0250
610.0375
610.0500
610.0625
610.0750
9137
9138
9139
9140
9141
9142
9143
9144
9145
9146
9147
9148
9149
9150
9151
9152
9153
9154
9155
9156
9157
9158
9159
9160
9161
9162
9163
9164
9165
9166
610.1625
610.1750
610.1875
610.2000
610.2125
610.2250
610.2375
610.2500
610.2625
610.2750
610.2875
610.3000
610.3125
610.3250
610.3375
610.3500
610.3625
610.3750
610.3875
610.4000
610.4125
610.4250
610.4375
610.4500
610.4625
610.4750
610.4875
610.5000
610.5125
610.5250
9173
9174
9175
9176
9177
9178
9179
9180
9181
9182
9183
9184
9185
9186
9187
9188
9189
9190
9191
9192
9193
9194
9195
9196
9197
9198
9199
9200
9201
9202
609.6375
9131
610.0875
9167
610.5375
9203
609.6500
9132
610.1000
9168
610.5500
9204
9205
609.6625
9133
610.1125
9169
610.5625
609.6750
9134
610.1250
9170
610.5750
9206
9207
9208
609.6875
9135
610.1375
9171
610.5875
609.7000
9136
610.1500
9172
610.6000
Operator’s Manual ZM-540PA/541PA
133
Transmission
Transmission
Transmission
frequency
Channel No.
frequency
Channel No.
frequency
Channel No.
(MHz)
(MHz)
(MHz)
610.6125
9209
610.6250
9210
611.0750
9246
611.5250
9282
610.6375
610.6500
610.6625
610.6750
610.6875
610.7000
610.7125
610.7250
610.7375
610.7500
610.7625
610.7750
610.7875
610.8000
610.8125
610.8250
610.8375
610.8500
610.8625
610.8750
610.8875
610.9000
610.9125
610.9250
610.9375
610.9500
610.9625
610.9750
610.9875
611.0000
611.0125
611.0250
611.0375
611.0500
9211
9212
9213
9214
9215
9216
9217
9218
9219
9220
9221
9222
9223
9224
9225
9226
9227
9228
9229
9230
9231
9232
9233
9234
9235
9236
9237
9238
9239
9240
9241
9242
9243
9244
611.0875
611.1000
611.1125
611.1250
611.1375
611.1500
611.1625
611.1750
611.1875
611.2000
611.2125
611.2250
611.2375
611.2500
611.2625
611.2750
611.2875
611.3000
611.3125
611.3250
611.3375
611.3500
611.3625
611.3750
611.3875
611.4000
611.4125
611.4250
611.4375
611.4500
611.4625
611.4750
611.4875
611.5000
9247
9248
9249
9250
9251
9252
9253
9254
9255
9256
9257
9258
9259
9260
9261
9262
9263
9264
9265
9266
9267
9268
9269
9270
9271
9272
9273
9274
9275
9276
9277
9278
9279
9280
611.5375
611.5500
611.5625
611.5750
611.5875
611.6000
611.6125
611.6250
611.6375
611.6500
611.6625
611.6750
611.6875
611.7000
611.7125
611.7250
611.7375
611.7500
611.7625
611.7750
611.7875
611.8000
611.8125
611.8250
611.8375
611.8500
611.8625
611.8750
611.8875
611.9000
611.9125
611.9250
611.9375
611.9500
9283
9284
9285
9286
9287
9288
9289
9290
9291
9292
9293
9294
9295
9296
9297
9298
9299
9300
9301
9302
9303
9304
9305
9306
9307
9308
9309
9310
9311
9312
9313
9314
9315
9316
134
611.0625
9245
611.5125
9281
Operator’s Manual ZM-540PA/541PA
Transmission
Transmission
Transmission
frequency
Channel No.
frequency
Channel No.
frequency
Channel No.
(MHz)
(MHz)
(MHz)
611.9625
611.9750
611.9875
612.0000
612.0125
612.0250
612.0375
612.0500
612.0625
612.0750
612.0875
612.1000
612.1125
612.1250
612.1375
612.1500
612.1625
612.1750
612.1875
612.2000
612.2125
612.2250
612.2375
612.2500
612.2625
612.2750
612.2875
612.3000
612.3125
612.3250
612.3375
612.3500
612.3625
612.3750
612.3875
612.4000
9317
9318
9319
9320
9321
9322
9323
9324
9325
9326
9327
9328
9329
9330
9331
9332
9333
9334
9335
9336
9337
9338
9339
9340
9341
9342
9343
9344
9345
9346
9347
9348
9349
9350
9351
9352
612.4125
612.4250
612.4375
612.4500
612.4625
612.4750
612.4875
612.5000
612.5125
612.5250
612.5375
612.5500
612.5625
612.5750
612.5875
612.6000
612.6125
612.6250
612.6375
612.6500
612.6625
612.6750
612.6875
612.7000
612.7125
612.7250
612.7375
612.7500
612.7625
612.7750
612.7875
612.8000
612.8125
612.8250
612.8375
612.8500
Operator’s Manual ZM-540PA/541PA
9353
9354
9355
9356
9357
9358
9359
9360
9361
9362
9363
9364
9365
9366
9367
9368
9369
9370
9371
9372
9373
9374
9375
9376
9377
9378
9379
9380
9381
9382
9383
9384
9385
9386
9387
9388
612.8625
612.8750
612.8875
612.9000
612.9125
612.9250
612.9375
612.9500
612.9625
612.9750
612.9875
613.0000
613.0125
613.0250
613.0375
613.0500
613.0625
613.0750
613.0875
613.1000
613.1125
613.1250
613.1375
613.1500
613.1625
613.1750
613.1875
613.2000
613.2125
613.2250
613.2375
613.2500
613.2625
613.2750
613.2875
613.3000
9389
9390
9391
9392
9393
9394
9395
9396
9397
9398
9399
9400
9401
9402
9403
9404
9405
9406
9407
9408
9409
9410
9411
9412
9413
9414
9415
9416
9417
9418
9419
9420
9421
9422
9423
9424
135
Transmission
Transmission
Transmission
frequency
Channel No.
frequency
Channel No.
frequency
Channel No.
(MHz)
(MHz)
(MHz)
136
613.3125
9425
613.5375
9443
613.7625
9461
613.3250
9426
613.5500
9444
613.7750
9462
613.3375
9427
613.5625
9445
613.7875
9463
613.3500
9428
613.5750
9446
613.8000
9464
613.3625
9429
613.5875
9447
613.8125
9465
613.3750
9430
613.6000
9448
613.8250
9466
613.3875
9431
613.6125
9449
613.8375
9467
613.4000
9432
613.6250
9450
613.8500
9468
613.4125
9433
613.6375
9451
613.8625
9469
613.4250
9434
613.6500
9452
613.8750
9470
613.4375
9435
613.6625
9453
613.8875
9471
613.4500
9436
613.6750
9454
613.9000
9472
613.4625
9437
613.6875
9455
613.9125
9473
613.4750
9438
613.7000
9456
613.9250
9474
613.4875
9439
613.7125
9457
613.9375
9475
613.5000
9440
613.7250
9458
613.9500
9476
613.5125
9441
613.7375
9459
613.9625
9477
613.5250
9442
613.7500
9460
613.9750
9478
Operator’s Manual ZM-540PA/541PA
Channel: E002 to E398
Transmission
frequency
(MHz)
1395.0250
1395.0375
1395.0500
1395.0625
1395.0750
1395.0875
1395.1000
1395.1125
1395.1250
1395.1375
1395.1500
1395.1625
1395.1750
1395.1875
1395.2000
1395.2125
1395.2250
1395.2375
1395.2500
1395.2625
1395.2750
1395.2875
1395.3000
1395.3125
1395.3250
1395.3375
1395.3500
1395.3625
1395.3750
1395.3875
1395.4000
1395.4125
1395.4250
1395.4375
1395.4500
Channel
No.
E002
E003
E004
E005
E006
E007
E008
E009
E010
E011
E012
E013
E014
E015
E016
E017
E018
E019
E020
E021
E022
E023
E024
E025
E026
E027
E028
E029
E030
E031
E032
E033
E034
E035
E036
Transmission
frequency
(MHz)
1395.4625
1395.4750
1395.4875
1395.5000
1395.5125
1395.5250
1395.5375
1395.5500
1395.5625
1395.5750
1395.5875
1395.6000
1395.6125
1395.6250
1395.6375
1395.6500
1395.6625
1395.6750
1395.6875
1395.7000
1395.7125
1395.7250
1395.7375
1395.7500
1395.7625
1395.7750
1395.7875
1395.8000
1395.8125
1395.8250
1395.8375
1395.8500
1395.8625
1395.8750
1395.8875
Operator’s Manual ZM-540PA/541PA
Channel
No.
E037
E038
E039
E040
E041
E042
E043
E044
E045
E046
E047
E048
E049
E050
E051
E052
E053
E054
E055
E056
E057
E058
E059
E060
E061
E062
E063
E064
E065
E066
E067
E068
E069
E070
E071
Transmission
frequency
(MHz)
Channel
No.
1395.9000
1395.9125
1395.9250
1395.9375
1395.9500
1395.9625
1395.9750
1395.9875
1396.0000
1396.0125
1396.0250
1396.0375
1396.0500
1396.0625
1396.0750
1396.0875
1396.1000
1396.1125
1396.1250
1396.1375
1396.1500
1396.1625
1396.1750
1396.1875
1396.2000
1396.2125
1396.2250
1396.2375
1396.2500
1396.2625
1396.2750
1396.2875
1396.3000
1396.3125
1396.3250
E072
E073
E074
E075
E076
E077
E078
E079
E080
E081
E082
E083
E084
E085
E086
E087
E088
E089
E090
E091
E092
E093
E094
E095
E096
E097
E098
E099
E100
E101
E102
E103
E104
E105
E106
137
Transmission
frequency
(MHz)
1396.3375
1396.3500
1396.3625
1396.3750
1396.3875
1396.4000
1396.4125
1396.4250
1396.4375
1396.4500
1396.4625
1396.4750
1396.4875
1396.5000
1396.5125
1396.5250
1396.5375
1396.5500
1396.5625
1396.5750
1396.5875
1396.6000
1396.6125
1396.6250
1396.6375
1396.6500
1396.6625
1396.6750
1396.6875
1396.7000
1396.7125
1396.7250
1396.7375
1396.7500
1396.7625
1396.7750
138
Channel
No.
E107
E108
E109
E110
E111
E112
E113
E114
E115
E116
E117
E118
E119
E120
E121
E122
E123
E124
E125
E126
E127
E128
E129
E130
E131
E132
E133
E134
E135
E136
E137
E138
E139
E140
E141
E142
Transmission
frequency
(MHz)
1396.7875
1396.8000
1396.8125
1396.8250
1396.8375
1396.8500
1396.8625
1396.8750
1396.8875
1396.9000
1396.9125
1396.9250
1396.9375
1396.9500
1396.9625
1396.9750
1396.9875
1397.0000
1397.0125
1397.0250
1397.0375
1397.0500
1397.0625
1397.0750
1397.0875
1397.1000
1397.1125
1397.1250
1397.1375
1397.1500
1397.1625
1397.1750
1397.1875
1397.2000
1397.2125
1397.2250
Channel
No.
E143
E144
E145
E146
E147
E148
E149
E150
E151
E152
E153
E154
E155
E156
E157
E158
E159
E160
E161
E162
E163
E164
E165
E166
E167
E168
E169
E170
E171
E172
E173
E174
E175
E176
E177
E178
Transmission
frequency
(MHz)
1397.2375
1397.2500
1397.2625
1397.2750
1397.2875
1397.3000
1397.3125
1397.3250
1397.3375
1397.3500
1397.3625
1397.3750
1397.3875
1397.4000
1397.4125
1397.4250
1397.4375
1397.4500
1397.4625
1397.4750
1397.4875
1397.5000
1397.5125
1397.5250
1397.5375
1397.5500
1397.5625
1397.5750
1397.5875
1397.6000
1397.6125
1397.6250
1397.6375
1397.6500
1397.6625
1397.6750
Channel
No.
E179
E180
E181
E182
E183
E184
E185
E186
E187
E188
E189
E190
E191
E192
E193
E194
E195
E196
E197
E198
E199
E200
E201
E202
E203
E204
E205
E206
E207
E208
E209
E210
E211
E212
E213
E214
Operator’s Manual ZM-540PA/541PA
Transmission
frequency
(MHz)
Channel
No.
Transmission
frequency
(MHz)
Channel
No.
Transmission
frequency
(MHz)
Channel
No.
1397.6875
1397.7000
1397.7125
1397.7250
1397.7375
1397.7500
1397.7625
1397.7750
1397.7875
1397.8000
E215
E216
E217
E218
E219
E220
E221
E222
E223
E224
1398.1375
1398.1500
1398.1625
1398.1750
1398.1875
1398.2000
1398.2125
1398.2250
1398.2375
1398.2500
E251
E252
E253
E254
E255
E256
E257
E258
E259
E260
1398.5875
1398.6000
1398.6125
1398.6250
1398.6375
1398.6500
1398.6625
1398.6750
1398.6875
1398.7000
E287
E288
E289
E290
E291
E292
E293
E294
E295
E296
1397.8125
1397.8250
1397.8375
1397.8500
1397.8625
1397.8750
1397.8875
1397.9000
1397.9125
1397.9250
1397.9375
1397.9500
1397.9625
1397.9750
1397.9875
1398.0000
1398.0125
1398.0250
1398.0375
1398.0500
1398.0625
1398.0750
1398.0875
1398.1000
1398.1125
1398.1250
E225
E226
E227
E228
E229
E230
E231
E232
E233
E234
E235
E236
E237
E238
E239
E240
E241
E242
E243
E244
E245
E246
E247
E248
E249
E250
1398.2625
1398.2750
1398.2875
1398.3000
1398.3125
1398.3250
1398.3375
1398.3500
1398.3625
1398.3750
1398.3875
1398.4000
1398.4125
1398.4250
1398.4375
1398.4500
1398.4625
1398.4750
1398.4875
1398.5000
1398.5125
1398.5250
1398.5375
1398.5500
1398.5625
1398.5750
E261
E262
E263
E264
E265
E266
E267
E268
E269
E270
E271
E272
E273
E274
E275
E276
E277
E278
E279
E280
E281
E282
E283
E284
E285
E286
1398.7125
1398.7250
1398.7375
1398.7500
1398.7625
1398.7750
1398.7875
1398.8000
1398.8125
1398.8250
1398.8375
1398.8500
1398.8625
1398.8750
1398.8875
1398.9000
1398.9125
1398.9250
1398.9375
1398.9500
1398.9625
1398.9750
1398.9875
1399.0000
1399.0125
1399.0250
E297
E298
E299
E300
E301
E302
E303
E304
E305
E306
E307
E308
E309
E310
E311
E312
E313
E314
E315
E316
E317
E318
E319
E320
E321
E322
Operator’s Manual ZM-540PA/541PA
139
Transmission
frequency
(MHz)
1399.0375
1399.0500
1399.0625
1399.0750
1399.0875
1399.1000
1399.1125
1399.1250
1399.1375
1399.1500
1399.1625
1399.1750
1399.1875
1399.2000
1399.2125
1399.2250
1399.2375
1399.2500
1399.2625
1399.2750
1399.2875
1399.3000
1399.3125
1399.3250
1399.3375
1399.3500
1399.3625
1399.3750
1399.3875
1399.4000
1399.4125
1399.4250
1399.4375
1399.4500
140
Channel
No.
E323
E324
E325
E326
E327
E328
E329
E330
E331
E332
E333
E334
E335
E336
E337
E338
E339
E340
E341
E342
E343
E344
E345
E346
E347
E348
E349
E350
E351
E352
E353
E354
E355
E356
Transmission
frequency
(MHz)
1399.4625
1399.4750
1399.4875
1399.5000
1399.5125
1399.5250
1399.5375
1399.5500
1399.5625
1399.5750
1399.5875
1399.6000
1399.6125
1399.6250
1399.6375
1399.6500
1399.6625
1399.6750
1399.6875
1399.7000
1399.7125
1399.7250
1399.7375
1399.7500
1399.7625
1399.7750
1399.7875
1399.8000
1399.8125
1399.8250
1399.8375
1399.8500
1399.8625
1399.8750
Channel
No.
E357
E358
E359
E360
E361
E362
E363
E364
E365
E366
E367
E368
E369
E370
E371
E372
E373
E374
E375
E376
E377
E378
E379
E380
E381
E382
E383
E384
E385
E386
E387
E388
E389
E390
Transmission
frequency
(MHz)
1399.8875
1399.9000
1399.9125
1399.9250
1399.9375
1399.9500
1399.9625
1399.9750
Channel
No.
E391
E392
E393
E394
E395
E396
E397
E398
Operator’s Manual ZM-540PA/541PA
Channel: E502 to E898
Transmission
frequency
(MHz)
1427.0250
1427.0375
1427.0500
1427.0625
1427.0750
1427.0875
1427.1000
1427.1125
1427.1250
1427.1375
1427.1500
1427.1625
1427.1750
1427.1875
1427.2000
1427.2125
1427.2250
1427.2375
1427.2500
1427.2625
1427.2750
1427.2875
1427.3000
1427.3125
1427.3250
1427.3375
1427.3500
1427.3625
1427.3750
1427.3875
1427.4000
1427.4125
1427.4250
1427.4375
E502
E503
E504
E505
E506
E507
E508
E509
E510
E511
E512
E513
E514
E515
E516
E517
E518
E519
E520
E521
E522
E523
E524
E525
E526
E527
E528
E529
E530
E531
E532
E533
E534
Transmission
frequency
(MHz)
1427.4500
1427.4625
1427.4750
1427.4875
1427.5000
1427.5125
1427.5250
1427.5375
1427.5500
1427.5625
1427.5750
1427.5875
1427.6000
1427.6125
1427.6250
1427.6375
1427.6500
1427.6625
1427.6750
1427.6875
1427.7000
1427.7125
1427.7250
1427.7375
1427.7500
1427.7625
1427.7750
1427.7875
1427.8000
1427.8125
1427.8250
1427.8375
1427.8500
E535
1427.8625
Channel
No.
Operator’s Manual ZM-540PA/541PA
E536
E537
E538
E539
E540
E541
E542
E543
E544
E545
E546
E547
E548
E549
E550
E551
E552
E553
E554
E555
E556
E557
E558
E559
E560
E561
E562
E563
E564
E565
E566
E567
E568
Transmission
frequency
(MHz)
1427.8750
1427.8875
1427.9000
1427.9125
1427.9250
1427.9375
1427.9500
1427.9625
1427.9750
1427.9875
1428.0000
1428.0125
1428.0250
1428.0375
1428.0500
1428.0625
1428.0750
1428.0875
1428.1000
1428.1125
1428.1250
1428.1375
1428.1500
1428.1625
1428.1750
1428.1875
1428.2000
1428.2125
1428.2250
1428.2375
1428.2500
1428.2625
1428.2750
E569
1428.2875
Channel
No.
Channel
No.
E570
E571
E572
E573
E574
E575
E576
E577
E578
E579
E580
E581
E582
E583
E584
E585
E586
E587
E588
E589
E590
E591
E592
E593
E594
E595
E596
E597
E598
E599
E600
E601
E602
E603
141
Transmission
frequency
(MHz)
1428.3000
1428.3125
1428.3250
1428.3375
1428.3500
1428.3625
1428.3750
1428.3875
1428.4000
1428.4125
1428.4250
1428.4375
1428.4500
1428.4625
1428.4750
1428.4875
1428.5000
1428.5125
1428.5250
1428.5375
1428.5500
1428.5625
1428.5750
1428.5875
1428.6000
1428.6125
1428.6250
1428.6375
1428.6500
1428.6625
1428.6750
1428.6875
1428.7000
1428.7125
1428.7250
1428.7375
142
Channel
No.
E604
E605
E606
E607
E608
E609
E610
E611
E612
E613
E614
E615
E616
E617
E618
E619
E620
E621
E622
E623
E624
E625
E626
E627
E628
E629
E630
E631
E632
E633
E634
E635
E636
E637
E638
E639
Transmission
frequency
(MHz)
1428.7500
1428.7625
1428.7750
1428.7875
1428.8000
1428.8125
1428.8250
1428.8375
1428.8500
1428.8625
1428.8750
1428.8875
1428.9000
1428.9125
1428.9250
1428.9375
1428.9500
1428.9625
1428.9750
1428.9875
1429.0000
1429.0125
1429.0250
1429.0375
1429.0500
1429.0625
1429.0750
1429.0875
1429.1000
1429.1125
1429.1250
1429.1375
1429.1500
1429.1625
1429.1750
1429.1875
Channel
No.
E640
E641
E642
E643
E644
E645
E646
E647
E648
E649
E650
E651
E652
E653
E654
E655
E656
E657
E658
E659
E660
E661
E662
E663
E664
E665
E666
E667
E668
E669
E670
E671
E672
E673
E674
E675
Transmission
frequency
(MHz)
1429.2000
1429.2125
1429.2250
1429.2375
1429.2500
1429.2625
1429.2750
1429.2875
1429.3000
1429.3125
1429.3250
1429.3375
1429.3500
1429.3625
1429.3750
1429.3875
1429.4000
1429.4125
1429.4250
1429.4375
1429.4500
1429.4625
1429.4750
1429.4875
1429.5000
1429.5125
1429.5250
1429.5375
1429.5500
1429.5625
1429.5750
1429.5875
1429.6000
1429.6125
1429.6250
1429.6375
Channel
No.
E676
E677
E678
E679
E680
E681
E682
E683
E684
E685
E686
E687
E688
E689
E690
E691
E692
E693
E694
E695
E696
E697
E698
E699
E700
E701
E702
E703
E704
E705
E706
E707
E708
E709
E710
E711
Operator’s Manual ZM-540PA/541PA
Transmission
frequency
(MHz)
1429.6500
1429.6625
1429.6750
1429.6875
1429.7000
1429.7125
1429.7250
1429.7375
1429.7500
1429.7625
1429.7750
1429.7875
1429.8000
1429.8125
1429.8250
1429.8375
1429.8500
1429.8625
1429.8750
1429.8875
1429.9000
1429.9125
1429.9250
1429.9375
1429.9500
1429.9625
1429.9750
1429.9875
1430.0000
1430.0125
1430.0250
1430.0375
1430.0500
1430.0625
1430.0750
1430.0875
Channel
No.
E712
E713
E714
E715
E716
E717
E718
E719
E720
E721
E722
E723
E724
E725
E726
E727
E728
E729
E730
E731
E732
E733
E734
E735
E736
E737
E738
E739
E740
E741
E742
E743
E744
E745
E746
E747
Transmission
frequency
(MHz)
1430.1000
1430.1125
1430.1250
1430.1375
1430.1500
1430.1625
1430.1750
1430.1875
1430.2000
1430.2125
1430.2250
1430.2375
1430.2500
1430.2625
1430.2750
1430.2875
1430.3000
1430.3125
1430.3250
1430.3375
1430.3500
1430.3625
1430.3750
1430.3875
1430.4000
1430.4125
1430.4250
1430.4375
1430.4500
1430.4625
1430.4750
1430.4875
1430.5000
1430.5125
1430.5250
1430.5375
Operator’s Manual ZM-540PA/541PA
Channel
No.
E748
E749
E750
E751
E752
E753
E754
E755
E756
E757
E758
E759
E760
E761
E762
E763
E764
E765
E766
E767
E768
E769
E770
E771
E772
E773
E774
E775
E776
E777
E778
E779
E780
E781
E782
E783
Transmission
frequency
(MHz)
1430.5500
1430.5625
1430.5750
1430.5875
1430.6000
1430.6125
1430.6250
1430.6375
1430.6500
1430.6625
1430.6750
1430.6875
1430.7000
1430.7125
1430.7250
1430.7375
1430.7500
1430.7625
1430.7750
1430.7875
1430.8000
1430.8125
1430.8250
1430.8375
1430.8500
1430.8625
1430.8750
1430.8875
1430.9000
1430.9125
1430.9250
1430.9375
1430.9500
1430.9625
1430.9750
1430.9875
Channel
No.
E784
E785
E786
E787
E788
E789
E790
E791
E792
E793
E794
E795
E796
E797
E798
E799
E800
E801
E802
E803
E804
E805
E806
E807
E808
E809
E810
E811
E812
E813
E814
E815
E816
E817
E818
E819
143
Transmission
frequency
(MHz)
1431.0000
1431.0125
1431.0250
1431.0375
1431.0500
1431.0625
1431.0750
1431.0875
1431.1000
1431.1125
1431.1250
1431.1375
1431.1500
1431.1625
1431.1750
1431.1875
1431.2000
1431.2125
1431.2250
1431.2375
1431.2500
1431.2625
1431.2750
1431.2875
1431.3000
1431.3125
1431.3250
1431.3375
1431.3500
1431.3625
1431.3750
1431.3875
1431.4000
1431.4125
1431.4250
144
Channel
No.
E820
E821
E822
E823
E824
E825
E826
E827
E828
E829
E830
E831
E832
E833
E834
E835
E836
E837
E838
E839
E840
E841
E842
E843
E844
E845
E846
E847
E848
E849
E850
E851
E852
E853
E854
Transmission
frequency
(MHz)
1431.4375
1431.4500
1431.4625
1431.4750
1431.4875
1431.5000
1431.5125
1431.5250
1431.5375
1431.5500
1431.5625
1431.5750
1431.5875
1431.6000
1431.6125
1431.6250
1431.6375
1431.6500
1431.6625
1431.6750
1431.6875
1431.7000
1431.7125
1431.7250
1431.7375
1431.7500
1431.7625
1431.7750
1431.7875
1431.8000
1431.8125
1431.8250
1431.8375
1431.8500
1431.8625
Channel
No.
E855
E856
E857
E858
E859
E860
E861
E862
E863
E864
E865
E866
E867
E868
E869
E870
E871
E872
E873
E874
E875
E876
E877
E878
E879
E880
E881
E882
E883
E884
E885
E886
E887
E888
E889
Transmission
frequency
(MHz)
1431.8750
1431.8875
1431.9000
1431.9125
1431.9250
1431.9375
1431.9500
1431.9625
1431.9750
Channel
No.
E890
E891
E892
E893
E894
E895
E896
E897
E898
Operator’s Manual ZM-540PA/541PA

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Manifest Placed X Resolution    : 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00
Manifest Placed Y Resolution    : 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00, 72.00
Manifest Placed Resolution Unit : Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches
Manifest Reference Instance ID  : uuid:b77c2a50-4a1c-49e8-870b-bafb74e85fd2, uuid:b77c2a50-4a1c-49e8-870b-bafb74e85fd2, uuid:e88451f9-d989-48e5-8d4b-af774243178a, uuid:7a9a7801-103a-4f57-8ef9-f91f7ef190c0, uuid:f4927192-0845-488b-bcff-f7397508fa23, uuid:01adecfd-286d-46ab-afce-5e0bba0d0620, uuid:71c31040-d088-484c-b775-592dcf56617b, uuid:71c31040-d088-484c-b775-592dcf56617b, uuid:ef8babeb-0117-4dc8-b519-225ef6421da2, uuid:ef8babeb-0117-4dc8-b519-225ef6421da2, uuid:2a7d0c18-7780-40c3-8756-562fe0301ea1, uuid:dc7bc059-3ee9-4a76-aa45-a745b2812f0a, uuid:90619dff-4e12-4d29-ad12-e00a7d8b8047, uuid:cde80b63-5647-4972-a7c1-f5d19350de8d, uuid:2a7d0c18-7780-40c3-8756-562fe0301ea1, uuid:e1988716-be11-4934-8e61-3cb9f4b08061, uuid:e1988716-be11-4934-8e61-3cb9f4b08061, uuid:0ADDB70EE448DE11851BE0B103435EBC, uuid:f081a1b8-a235-4f6b-920d-f9baceaa0cd9, uuid:25F8CC709449DE1194E4E1F5385B0D25, uuid:3A2ACE77CF48DE11851BE0B103435EBC, uuid:3A2ACE77CF48DE11851BE0B103435EBC, uuid:9C3458254843DE118C08FB0039C43290, uuid:A53458254843DE118C08FB0039C43290, uuid:06DDB70EE448DE11851BE0B103435EBC, uuid:A53458254843DE118C08FB0039C43290, uuid:967FC0B64843DE118C08FB0039C43290, uuid:7FBCC0C94943DE118C08FB0039C43290, uuid:88BCC0C94943DE118C08FB0039C43290, uuid:9C3458254843DE118C08FB0039C43290, uuid:E1BFB77C4B43DE118C08FB0039C43290, uuid:41DF6E62E448DE11851BE0B103435EBC, uuid:44DF6E62E448DE11851BE0B103435EBC, uuid:BE33D2224D43DE118C08FB0039C43290, uuid:9C3458254843DE118C08FB0039C43290, uuid:C233D2224D43DE118C08FB0039C43290, uuid:C633D2224D43DE118C08FB0039C43290, uuid:0fe5f344-9997-45d9-b4fd-a3be94671f14, uuid:bad16a36-b567-437a-b488-6b939bd195d4, uuid:48ce1f7d-05b9-4780-a88a-f2de0647f132, uuid:074a781f-f323-4942-9281-32f0f79f6f9d, uuid:f33f7008-c1a6-42b9-a864-84b77ea36c08, uuid:5fedc2a8-2307-4505-b46d-95d98e9dcd04, uuid:49c02f07-0863-4747-beca-6a2a4ab97440, uuid:577de756-59ec-4598-8b00-158e57afd233, uuid:3fe32c3c-7ffe-4b2b-b3b2-fb06ea33a59e, uuid:3fe32c3c-7ffe-4b2b-b3b2-fb06ea33a59e, uuid:36b324f5-7bf6-4ba1-b946-44205de9662b, uuid:48603d8d-2502-4db5-ae95-e81d0ee1561d, uuid:89919db1-801f-4cd7-a9a7-9cb31ecf7075, uuid:89919db1-801f-4cd7-a9a7-9cb31ecf7075, uuid:7441dbca-2539-4dae-b5ff-c8d2382a851f, uuid:7441dbca-2539-4dae-b5ff-c8d2382a851f, uuid:550f8dfe-81be-4e3f-8f60-565038f0ccd7, uuid:550f8dfe-81be-4e3f-8f60-565038f0ccd7, uuid:ffa85218-128c-45d8-ba5e-1cb8b1c04097, uuid:ffa85218-128c-45d8-ba5e-1cb8b1c04097, uuid:f68d18d0-b555-4b86-9740-86130437c3d2, uuid:020a20f7-77c7-4bc2-b41d-47b9e8c15159, uuid:f68d18d0-b555-4b86-9740-86130437c3d2, uuid:020a20f7-77c7-4bc2-b41d-47b9e8c15159, uuid:0e49f1c4-00b5-42d5-871b-544d5e7745ae, uuid:e5cad8b4-d087-49a7-8800-4d3bf9633064, uuid:18916a9d-78b0-4688-a104-b721d9cc478a, uuid:de780b3e-fca1-4ce3-8c54-5a21e53e80e8, uuid:eb3ce270-0176-407f-8d52-e18174cfee5c, uuid:1b992720-8932-4e9a-a951-eec0eaf40f3b, uuid:dabba8ab-5e83-47b5-8f96-c3a975593dc0, uuid:d06163cc-4243-4c23-9871-4b088a4cea24, 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Create Date                     : 2009:06:19 17:16+09:00
Modify Date                     : 2009:06:19 17:17:06+09:00
Metadata Date                   : 2009:06:19 17:17:06+09:00
Creator Tool                    : Adobe InDesign CS2_J (4.0.5)
Thumbnail Format                : JPEG
Thumbnail Width                 : 256
Thumbnail Height                : 256
Thumbnail Image                 : (Binary data 9211 bytes, use -b option to extract)
Format                          : application/pdf
Title                           : OM_ZM-540_541PA.pdf
Creator                         : Mika
Producer                        : Acrobat Distiller 8.1.0 (Windows)
Trapped                         : False
Page Count                      : 154
Author                          : Mika

EXIF Metadata provided by EXIF.tools

Nihon Kohden ZM-541PA Medical Telemetry Transmitter User Manual OM ZM 540 541PA

Nihon Kohden Corporation Medical Telemetry Transmitter OM ZM 540 541PA

Users Manual

FCC ID Filing: B6BZM-541PA

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