Nihon Kohden ZM-541PAA TRANSMITTER User Manual

Nihon Kohden Corporation TRANSMITTER

(Short-Term Confidential) User Manual

Transmitter
ZM-540PA, ZM-541PA
OPERATOR’S MANUAL
0614-902754H
Printed:
1st Edition: 01 Jul 2009
9th Edition: XX Oct 2015
Transmitter ZM-540PA, ZM-541PA
About This Manual
In order to use this product safely and fully understand all its functions, read this manual before
using the product.
Keep this manual near the instrument or in the reach of the operator and refer to it whenever the
operation is unclear.
The Transmitter ZM-540P comes with the following manuals. Refer to the manual depending
on your needs.
Operator’s Manual (this manual)
Describes the operation and settings of Transmitter ZM-540P. Read this manual before use.
Administrator’s Guide
For administrators. Describes advanced settings and installation procedure of Product Name.
Read the Operator’s Manual together with this guide.
Service Manual
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Accompanying Documentation
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.
This product stores personal patient information. Manage the information appropriately.
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resemblance to any person living or dead is purely coincidental.
The contents of this manual are subject to change without notice.
If you have any comments or suggestions on this manual, please contact us at:
www.nihonkohden.com
Contents-1
ZM-540PA, ZM-541PA Operator’s Manual
Contents
Unpacking......................................................................................................i
GENERAL HANDLING PRECAUTIONS .......................................................I
WARRANTY POLICY ...................................................................................II
EMC RELATED CAUTION ........................................................................ VI
Conventions Used in this Manual and Instrument .................................... VIII
Intended Use ................................................................................................1
General ...................................................................................................1
Receiving Monitor ...................................................................................3
Panel Description .........................................................................................4
Front Panel .............................................................................................4
Rear Panel ..............................................................................................6
Top Panel ................................................................................................7
Bottom Panel ..........................................................................................7
Important Safety Information ........................................................................9
General ...................................................................................................9
Output Signal ........................................................................................15
Battery ..................................................................................................15
Transmitter Channel Management .......................................................16
For Patients Using Implantable Pacemaker .........................................17
ECG Monitoring ....................................................................................17
SpO2 Monitoring ....................................................................................18
NIBP Monitoring ....................................................................................23
Maintenance .........................................................................................26
Preparation on Transmitter .........................................................................27
Batteries ................................................................................................ 27
Handling Batteries ..........................................................................27
Battery Lifetime ...............................................................................27
Installing and Replacing Batteries ..................................................28
Situations Requiring Battery Replacement ....................................29
Battery Level Indication ..................................................................30
Turning On the Transmitter ...................................................................31
Check Items Before Use .................................................................31
Check Items After Power On ..........................................................32
Check Items After Use ....................................................................33
Turning Off the Transmitter ...................................................................33
Changing the Transmitter Channel .......................................................34
Contents-2
ZM-540PA, ZM-541PA Operator’s Manual
Changing Parameter and System Setup Settings ......................................35
Notes on Parameter Settings ................................................................35
Changing PARAMETER SETUP Settings ............................................36
Parameter Setup Setting List ..........................................................36
Displaying the PARAMETER SETUP Screen ................................37
Changing Parameter Setup Settings ..............................................38
Changing SYSTEM SETUP Settings ....................................................44
System Setup Setting List ...............................................................44
Displaying the SYSTEM SETUP Screen ........................................45
Changing System Setup Settings ...................................................46
Initializing Settings ................................................................................50
Attaching Electrodes, SpO2 Probe and NIBP Cuff to the Patient ...............51
Attachment Examples ...........................................................................51
Selecting Electrode Leads and Disposable Electrodes ........................52
Connecting the Electrode Lead to the Transmitter .........................53
Electrode Position ...........................................................................53
Attaching Electrodes to the Patient and Connecting the
Electrode Leads to Disposable Electrodes.....................................57
Checking ECG on the Transmitter Screen .....................................58
Attaching the SpO2 Probe .....................................................................59
Selecting the SpO2 Probe ...............................................................59
Connecting the SpO2 Probe to the Transmitter ..............................62
Attaching the Probe to the Patient ..................................................63
Attaching the NIBP Cuff ........................................................................65
Selecting the NIBP Cuff ..................................................................65
Connecting the NIBP Cuff to the Transmitter .................................69
Attaching the NIBP Cuff to the Patient ...........................................71
Locking the Keys on the Transmitter ..........................................................77
Monitoring ...................................................................................................78
Screen Descriptions ..............................................................................78
Check Electrodes Screen ...............................................................79
Numeric and Waveform Screen ......................................................80
Waveform Review Screen ..............................................................81
Numeric Review Screen .................................................................82
Display Off ......................................................................................82
Basic Monitoring Operation ..................................................................83
Using the Function Key ...................................................................83
Suspending Alarms on the Receiving Monitor ...............................84
Pausing Monitoring .........................................................................85
Resuming Monitoring after Pause ..................................................87
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Turning the Display Off ...................................................................88
Contents-3
ZM-540PA, ZM-541PA Operator’s Manual
Turning the Display On after It was Turned Off ..............................89
ECG and Respiration Monitoring ..........................................................89
Turning ECG Measurement On/Off ................................................92
Turning Respiration Measurement On/Off......................................92
Electrode Detachment ....................................................................92
SpO2 Monitoring ....................................................................................93
Monitoring SpO2 during NIBP Measurement ..................................98
NIBP Monitoring ....................................................................................99
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Selecting the Measurement Mode and Interval ..............................99
Measuring NIBP ............................................................................101
Monitoring SpO2 during NIBP Measurement ................................106
Indication and Message List .....................................................................107
Indication ............................................................................................107
Messages ...........................................................................................107
Message Display Priority .............................................................. 111
Troubleshooting ........................................................................................ 112
Transmitter ..........................................................................................112
ECG/Respiration .................................................................................113
SpO2 ..................................................................................................114
NIBP....................................................................................................114
Maintenance ............................................................................................. 116
1. External Check ...............................................................................116
2. Transmitter Channel .......................................................................117
3. Transmitting/Receiving Signal ........................................................117
4. Display ............................................................................................118
5. Key Operation .................................................................................119
6. ECG Check .....................................................................................120
7. Respiration Check ..........................................................................121
8. SpO2 Check ....................................................................................121
9. NIBP Check ....................................................................................123
10. NIBP Cuff for Attaching Transmitter to Patient Arm ......................127
Maintenance Check Sheet ..................................................................128
Lifetime and Disposal ...............................................................................129
Disposing of Used Batteries ...............................................................129
Battery Lifetime .............................................................................129
Disposal ........................................................................................129
Disposing of Electrodes, SpO2 Probes and NIBP Cuffs ......................129
Disposing of Transmitter .....................................................................129
Cleaning, Disinfection and Sterilization ....................................................130
Transmitter and Electrode Leads ........................................................130
Contents-4
ZM-540PA, ZM-541PA Operator’s Manual
Cleaning ........................................................................................130
Disinfection ...................................................................................130
SpO2 Probe .........................................................................................131
NIBP Cuff ............................................................................................131
Periodic Inspection ...................................................................................132
Repair Parts Availability Policy .................................................................132
6SHFL¿FDWLRQV ...........................................................................................133
ZM-540PA ...........................................................................................133
Measured Parameters ..................................................................133
Transmitted Data...........................................................................133
Displayed Data ..............................................................................133
ECG ..............................................................................................133
ECG Display and Heart Rate Count .............................................134
Respiration Measurement .............................................................134
SpO2 Measurement (ISO 9919: 2005 compliant) .........................134
Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999
compliant) .....................................................................................136
Transmitter ....................................................................................137
Power Requirements ....................................................................137
Dimensions and Weight ................................................................137
Environment .................................................................................. 137
Safety Standards ..........................................................................138
Electromagnetic Compatibility ......................................................138
Electromagnetic Emissions ..........................................................139
Electromagnetic Immunity ............................................................139
Recommended Separation Distances between Portable and
Mobile RF Communications Equipment .......................................141
5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ ................................................142
System Composition for EMC Test ...............................................142
ZM-541PA ...........................................................................................143
Measured Parameters ..................................................................143
Transmitted Data...........................................................................143
Display ..........................................................................................143
Displayed Data ..............................................................................143
ECG ..............................................................................................143
Respiration Measurement .............................................................144
SpO2 Measurement (ISO 9919: 2005 compliant) .........................144
Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999
compliant) .....................................................................................146
Transmitter .................................................................................... 147
Power Requirements ....................................................................147
Dimensions and Weight ................................................................147
Contents-5
ZM-540PA, ZM-541PA Operator’s Manual
Environment .................................................................................. 147
Safety Standards ..........................................................................148
Electromagnetic Compatibility ......................................................148
Electromagnetic Emissions ..........................................................149
Electromagnetic Immunity ............................................................149
Recommended Separation Distances between Portable and
Mobile RF Communications Equipment .......................................151
5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ ................................................152
System Composition for EMC Test ...............................................152
Standard Accessories ...............................................................................153
Options .....................................................................................................154
Transmitter ..........................................................................................154
ECG/RESP .........................................................................................154
SpO2 ..................................................................................................155
NIBP....................................................................................................156
Transmission Frequencies .......................................................................157
i
ZM-540PA, ZM-541PA Operator’s Manual
Check that all the items are included in the package. If there are any missing
items, contact your Nihon Kohden representative.
The name and quantity are described under the illustration.
ZM-540PA or ZM-541PA
transmitter (1)
NIBP cuff for adult,
standard (1) Strap (1)
Certification
Operator’s manual (1) &HUWL¿FDWLRQ
For the standard accessories and consumables, only use Nihon Kohden
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Unpacking
I
ZM-540PA, ZM-541PA Operator’s Manual
GENERAL HANDLING PRECAUTIONS
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Use only Nihon Kohden approved products with this device. Use of non-approved
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of the device. This includes, but is not limited to, batteries, recording paper, pens,
extension cables, electrode leads, input boxes and AC power.
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
2. When installing or storing the instrument, take the following precautions.
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3. Before Operation
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4. During Operation
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5. To Shutdown After Use
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6. The instrument must receive expert, professional attention for maintenance and
repairs. When the instrument is not functioning properly, it should be clearly marked
to avoid operation while it is out of order.
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ZM-540PA, ZM-541PA Operator’s Manual
8. Maintenance and Inspection
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9. When the instrument is used with an electrosurgical instrument, pay careful attention
to the application and/or location of electrodes and/or transducers to avoid possible
burn to the patient.
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transducers from the instrument to avoid possible damage.
WARRANTY POLICY
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CAUTION
United States law restricts this product to sale by or on the order of a physician.
III
ZM-540PA, ZM-541PA Operator’s Manual
Equipment Authorization Requirement
Compliance with FCC/IC Requirements
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CAUTION
(English)
To comply with the FCC/IC radio frequency (RF) exposure compliance
requirements, no change to the antenna or the device is permitted. Any change
to the antenna or the device could result in the device, exceeding the RF
exposure requirements and void user’s authority to operate this device.
(Français)
Pour respecter les normes relatives aux radiofréquences FCC/IC, ce dispositif
ne doit pas être situé ou utilisé à proximité d’une autre antenne ou d’un autre
émetteur si ce n’est selon les procédures mentionnées pour le multi-
transmetteur FCC/IC ou décrites dans la documentation.
NOTE
Use this device only indoors.
This device has been tested and complies with FCC radiation exposure limits set
forth for an uncontrolled environment. The RF transmission power from the antenna
conforms to the general public FCC RF Exposure Guidelines limit of Specific
Absorption Rate (SAR) 1.6 W/kg. The maximum SAR value measured from this
device was extremely smaller than 1.6 W/kg. This device must not be located
together with or operated in conjunction with any other unspecified antenna or
transmitter.
The devices require registration and deployment by an authorized frequency
coordinator. The ASHE (American Society for Healthcare Engineering) has been
designated by the FCC to manage the WMTS frequencies. This device has
frequency bands which may not be used in some areas. For details, contact your
Nihon Kohden representative. For details on the guidelines, refer to the ASHE home
page.
IV
ZM-540PA, ZM-541PA Operator’s Manual
Compliance with IC Requirements
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V
ZM-540PA, ZM-541PA Operator’s Manual
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ZM-541PA only
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“This equipment shall not be operated in the areas of Sydney, Nova Scotia, or Gander,
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information.”
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« L’utilisation de cet équipement est interdite à Sydney, Nouvelle-Écosse de même qu’à
Gander, Terre-Neuve et Labrador. Veuillez contacter le bureau local d’Industrie Canada
pour de plus amples renseignements ».
VI
ZM-540PA, ZM-541PA Operator’s Manual
EMC RELATED CAUTION
This equipment and/or system complies with IEC 60601-1-2 International Standard
for electromagnetic compatibility for medical electrical equipment and/or system.
However, an electromagnetic environment that exceeds the limits or levels stipulated
in IEC 60601-1-2, can cause harmful interference to the equipment and/or system or
cause the equipment and/or system to fail to perform its intended function or degrade
its intended performance. Therefore, during the operation of the equipment and/or
system, if there is any undesired deviation from its intended operational performance,
you must avoid, identify and resolve the adverse electromagnetic effect before
continuing to use the equipment and/or system.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an
authorized radio station or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source
such as cellular phone away from the equipment and/or system, or turn off the
cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of
the equipment and/or system:
Identify the cause of this interference and if possible remove this interference
source. If this is not possible, use a different power supply.
3. Effect of direct or indirect electrostatic discharge:
Make sure all users and patients in contact with the equipment and/or system are
free from direct or indirect electrostatic energy before using it. A humid room can
help lessen this problem.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the
equipment and/or system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is
installed, it may induce an excessive voltage in the equipment and/or system. In
such a case, disconnect the AC power cord from the equipment and/or system and
operate the equipment and/or system by battery power, or use an uninterruptible
power supply.
6. Use with other equipment:
When the equipment and/or system is adjacent to or stacked with other equipment,
the equipment and/or system may affect the other equipment. Before use, check
that the equipment and/or system operates normally with the other equipment.
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equipment and/or system, it may cause increased electromagnetic emission or
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VII
ZM-540PA, ZM-541PA Operator’s Manual
Caution - continued
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increased electromagnetic emission or decreased electromagnetic immunity. Only
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9. Measurement with excessive sensitivity:
The equipment and/or system is designed to measure bioelectrical signals with
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sensitivity, artifact may appear by electromagnetic interference and this may
cause mis-diagnosis. When unexpected artifact appears, inspect the surrounding
electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon
Kohden representative for additional suggestions.
VIII
ZM-540PA, ZM-541PA Operator’s Manual
Warnings and Cautions
Level Description
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CAUTION
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Conventions Used in this Manual and Instrument
IX
ZM-540PA, ZM-541PA Operator’s Manual
Explanations of the Symbols in this Manual and Instrument
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applied part
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manual
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On LCD
Symbol Description Symbol Description
Full battery
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1
ZM-540PA, ZM-541PA Operator’s Manual
Intended Use
General
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=03$ WR0+]FKDQQHOQXPEHUWR
=03$WR0+]FKDQQHOQXPEHU(WR(
 WR0+]FKDQQHOQXPEHU(WR(
)RU&DQDGD WR0+]FKDQQHOQXPEHU(WR(
  WR0+]FKDQQHOQXPEHU(WR(
NOTE The transmitter channel can be changed with a QI-901PK channel writer.
Read the operator’s manual for the receiving monitor together with this
manual before use.
WARNING
Do not diagnose a patient based only on data
acquired by the transmitter. Overall judgement
must be performed by a physician who
understands the features, limitations and
characteristics of the transmitter and by reading
the biomedical signals acquired by other
instruments.
WARNING
Do not use this transmitter for monitoring a patient.
Monitor the patient on a receiving monitor. This
transmitter displays the waveforms and measured
values but does not have an alarm function.
2
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
Do not use the same transmitter for more than one
patient at the same time. Do not connect different
sensors from different patients to the same
transmitter.
Do not use the same channel for different
patients. If the same channel is used for two
patients, the two patients’ data will be lost due to
mutual modulation interference, or another
patient’s data may appear on the receiving
monitor screen.
Do not use two transmitters with adjacent
channels in the same hospital. If transmitters
with adjacent channels are used, their radio
waves interfere with each other.
CAUTION
Signal loss and artifact may occur because of the
multipath cancellation* when using a transmitter.
CAUTION
 0XOWLSDWK&DQFHOODWLRQ6WDQGLQJ:DYH,QWHUIHUHQFH
:KHQDUDGLRZDYHUHÀHFWVRIIDVXUIDFHWKHUHPD\EHVRPHSRLQWVLQWKHURRPZKHUHWKH
UHÀHFWHGDQGGLUHFWZDYHVDUHH[DFWO\RXWRISKDVH$WWKHVHSRLQWVLQWKHURRPWKHUHÀHFWHG
DQGGLUHFWZDYHVFDQFHOHDFKRWKHURXWVRWKDWWKHVLJQDOVWUHQJWKLVGHFUHDVHG/RFDWLRQV
ZKHUHVLJQDOORVVRFFXUVDUHFDOOHG³QXOOVSRWV´,IWKHWUDQVPLWWHULVPRYLQJRUQHDUE\
SHRSOHRUREMHFWVDUHPRYLQJQXOOVSRWVFDQRFFXUDQ\WLPHDQGDQ\ZKHUH
NOTE To prevent interference between channels, assign a channel administrator
in the hospital and only he or she should manage channel assignment.
Use Nihon Kohden parts and accessories to assure maximum performance
from your instrument.
For stable signal reception, it is recommended to use a diversity antenna
system on the receiving monitor. Otherwise, spike noise from transient
IDGLQJRIHOHFWULF¿HOGVWUHQJWKIRUH[DPSOHSHRSOHPRYLQJPD\LQWHUIHUH
with the transmitter signal and may be mistaken as an arrhythmia on the
receiving monitor.
,IWKHWUDQVPLWWHULVXVHGRXWVLGHWKHVSHFL¿HGHQYLURQPHQWLWVSHUIRUPDQFH
cannot be guaranteed.
3
ZM-540PA, ZM-541PA Operator’s Manual
For details on antennas and antenna construction, contact your Nihon
Kohden representative. You can also refer to the Telemetry System
Installation Guide.
Receiving Monitor
$Q\1LKRQ.RKGHQUHFHLYLQJPRQLWRUFHQWUDOPRQLWRUZLWKPXOWLSOHSDWLHQWUHFHLYHUFDQ
UHFHLYHVLJQDOVIURPWKLVWUDQVPLWWHUDVORQJDVWKHSURWRFROYHUVLRQDQGFKDQQHOVHWWLQJDUHWKH
VDPHRQWKHUHFHLYLQJPRQLWRUDQGWUDQVPLWWHU
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.
4
ZM-540PA, ZM-541PA Operator’s Manual
Panel Description
Front Panel
1
2
3
4
5
6
7
8
5HIHUWRWKH:$51,1*
RQWKHQH[WSDJH
1 LCD
'LVSOD\VQXPHULFYDOXHV(&*RUSXOVH
ZDYH1,%3PHDVXULQJPRGHDQGLQWHUYDO
PHVVDJHVDQGEDWWHU\VWDWXV)RUGHWDLOV
UHIHUWRWKH³6FUHHQ'HVFULSWLRQV´VHFWLRQ
2 Infrared receiver
8VHGIRUXSJUDGLQJWKHWUDQVPLWWHU
VRIWZDUH
3 Screen key
7RJJOHVWKHVFUHHQLQWKHIROORZLQJRUGHU
$IWHUSRZHURQ6WDUWXSĺ&KHFN
HOHFWURGHVĺ1XPHULFDQGZDYHIRUPĺ
:DYHIRUPUHYLHZĺ1XPHULFUHYLHZĺ
'LVSOD\RIIĺ&KHFNHOHFWURGHV«
$IWHUDXWRGLVSOD\RII1XPHULFDQG
ZDYHIRUPĺ:DYHIRUPUHYLHZĺ
1XPHULFUHYLHZĺ'LVSOD\RIIĺ&KHFN
HOHFWURGHVĺ1XPHULFDQGZDYHIRUP«
2QD6(783RU&+(&.VFUHHQWKLV
NH\FDQFHOVFKDQJLQJVHWWLQJRUH[LWVWKH
VFUHHQ
4 Function key
'HSHQGLQJRQWKHVHWWLQJRQWKH
WUDQVPLWWHUWKLVNH\VXVSHQGVDODUPV
SDXVHVPRQLWRULQJRQWKHUHFHLYLQJ
PRQLWRURUWUDQVPLWV³3DWLHQWFRQ¿UPHG´
PHVVDJH
2QD6(783VFUHHQWKLVNH\UHJLVWHUVWKH
VHOHFWHGVHWWLQJDQGPRYHVWKHFXUVRUWR
WKHQH[WVHWWLQJLWHP
2QD&+(&.VFUHHQWKLVNH\VWDUWVRU
VWRSVPDLQWHQDQFHWHVW
5
ZM-540PA, ZM-541PA Operator’s Manual
1
2
3
4
5
6
7
8
5HIHUWRWKH:$51,1*
RQWKHQH[WSDJH
5 NIBP Start/Stop key
6WDUWVVWRSV1,%3PHDVXUHPHQWLQ
VHOHFWHGPRGH
6 NIBP Interval key
6HOHFWV1,%3PHDVXUHPHQWPRGH
7 Lead/Scroll keys
2QWKHQXPHULFDQGZDYHIRUPVFUHHQ
WKHVHNH\VFKDQJHWKH(&*OHDG
2QWKHZDYHIRUPUHYLHZVFUHHQWKHVH
NH\VVFUROOGDWD
2QD6(783VFUHHQWKHVHNH\VPRYHWKH
FXUVRU
8 Battery case
&RQWDLQVWKUHH9GU\FHOOEDWWHULHV
$$7<3(
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.
6
ZM-540PA, ZM-541PA Operator’s Manual
Rear Panel
5HIHUWRWKH³([SODQDWLRQVRI
WKH6\PEROVLQWKLV0DQXDO
DQG,QVWUXPHQW´VHFWLRQ
5HIHUWRWKH:$51,1*EHORZ
Lock plate
)DVWHQVWKHWUDQVPLWWHUWRDQ1,%3FXII
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.
7
ZM-540PA, ZM-541PA Operator’s Manual
Top Panel
LA
RALL
RL
Va
Vb
NIBP socket
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5HIHUWRWKH:$51,1*RQWKH
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WKH6\PEROVLQWKLV0DQXDO
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5HIHUWRWKH:$51,1*RQWKH
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5HIHUWRWKH³([SODQDWLRQVRI
WKH6\PEROVLQWKLV0DQXDO
DQG,QVWUXPHQW´VHFWLRQ
ECG/impedance RESP socket
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Bottom Panel
5HIHUWRWKH:$51,1*
RQWKHQH[WSDJH
5HIHUWRWKH³([SODQDWLRQVRIWKH6\PEROVLQ
WKLV0DQXDODQG,QVWUXPHQW´VHFWLRQ
SpO2 socket
&RQQHFWVWKH6S22
SUREH
Channel number label
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WKHWUDQVPLWWHU
8
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
Before defibrillation, all persons must keep clear of
the bed and must not touch the patient or any
equipment or cord connected to the patient. Failure
to follow this warning may cause electrical shock or
injury.
WARNING
When performing defibrillation, discharge as far as
possible from electrodes, patches and any gel,
cream or medicine on the chest of the patient. If
there is a possibility that the defibrillator paddle
could touch these materials, remove them from the
patient. If the defibrillator paddle directly contacts
these materials, the discharged energy may cause
skin burn to the patient.
WARNING
When the transmitter is used with an
electrosurgical unit (ESU), firmly attach the entire
area of the ESU return plate. Otherwise, the
current from the ESU flows into the electrodes of
the transmitter, causing electrical burn where the
electrodes are attached. For details, refer to the
ESU manual.
Do not shake or swing the transmitter while holding
the leads or cables connected to the transmitter.
The transmitter may come off and injure someone
or damage surrounding instruments.
CAUTION
9
ZM-540PA, ZM-541PA Operator’s Manual
Important Safety Information
General
WARNING
Never use the transmitter in the presence of any
flammable anesthetic gas or high concentration
oxygen atmosphere. Failure to follow this warning
may cause explosion or fire.
WARNING
When performing MRI test, remove all electrodes
and probe from the patient which are connected to
this transmitter. Failure to follow this warning may
cause skin burn on the patient. For details, refer to
the MRI manual.
WARNING
Never use the transmitter in a hyperbaric oxygen
chamber. Failure to follow this warning may cause
explosion or fire.
WARNING
Do not take this transmitter into the MRI test room.
This transmitter is not designed to be used during
MRI tests.
WARNING
Before defibrillation, all persons must keep clear of
the bed and must not touch the patient or any
equipment or cord connected to the patient. Failure
to follow this warning may cause electrical shock or
injury.
10
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When performing defibrillation, discharge as far as
possible from electrodes, patches and any gel,
cream or medicine on the chest of the patient. If
there is a possibility that the defibrillator paddle
could touch these materials, remove them from the
patient. If the defibrillator paddle directly contacts
these materials, the discharged energy may cause
skin burn to the patient.
WARNING
When the transmitter is used with an
electrosurgical unit (ESU), firmly attach the entire
area of the ESU return plate. Otherwise, the
current from the ESU flows into the electrodes of
the transmitter, causing electrical burn where the
electrodes are attached. For details, refer to the
ESU manual.
WARNING
Do not use the same transmitter for more than one
patient at the same time. Do not connect different
sensors from different patients to the same
transmitter.
WARNING
This transmitter is not waterproof. If detergent or
liquid spills into the transmitter, stop using it and
contact your Nihon Kohden representative. If a wet
transmitter is used, the patient or operator may
receive an electrical shock or injury.
11
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
Close the battery case cover during operation. If
the transmitter is used with the battery case cover
open, anyone who touches the opened battery
case may receive an electrical shock when
defibrillation is performed. Touching the opened
battery case may cause electrostatic discharge
and intermittently interfere with the waveform or
data.
WARNING
When the signal is unstable, keep the patient
under close observation. When the signal is
unstable, the monitoring and alarm are not reliable
and the receiving monitor cannot detect a sudden
change of the patient’s condition. This may cause
critical changes in the patient condition to be
overlooked. Install an appropriate antenna system
to ensure stable signal condition.
WARNING
While the “ALARMS SUSPENDED” message is
displayed on the transmitter, all alarms on the
receiving monitor are suspended so keep the
patient under close observation.
WARNING
When the patient returns to the bed, turn on the
transmitter and check that the monitoring is
resumed on the receiving monitor.
WARNING
If the transmitter is not turned off and monitoring
continues for the selected interval, pause
monitoring is canceled and monitoring continues.
Check that the monitoring is resumed on the
receiving monitor.
12
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
Do not allow the conductive part of the connector
which is connected to the patient to contact other
conductive parts including earth. This causes
leakage current and incorrect measurement value
and leads to wrong diagnosis.
WARNING
After admitting a patient on the central monitor and
attaching electrodes and sensors on the patient
and connecting cables to the transmitter, check
that there is no error messages and that the
waveforms and numeric data are appropriately
displayed on the transmitter and central monitor
screen. If there is an error message, or waveform
or numeric data is not appropriate, check the
electrodes and sensors attachment, patient
condition and settings on the transmitter and
remove the cause.
Only use Nihon Kohden specified electrodes,
electrode leads, SpO2 probes, and NIBP cuffs.
Otherwise, the maximum performance from the
transmitter cannot be guaranteed.
CAUTION
Do not reuse disposable parts and accessories.
CAUTION
For handling and precautions on electrodes,
electrode leads, SpO2 probes and NIBP cuffs, refer
to the manual.
CAUTION
13
ZM-540PA, ZM-541PA Operator’s Manual
The measurement values and displayed
waveforms on the transmitter and receiving
monitor may be different due to timing delay of the
display or difference in detection settings.
CAUTION
Do not shake or swing the transmitter while holding
the leads or cables connected to the transmitter.
The transmitter may come off and injure someone
or damage surrounding instruments.
CAUTION
Signal loss and artifact may occur because of the
multipath cancellation* when using a transmitter.
CAUTION
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UHÀHFWHGDQGGLUHFWZDYHVDUHH[DFWO\RXWRISKDVH$WWKHVHSRLQWVLQWKHURRPWKHUHÀHFWHG
DQGGLUHFWZDYHVFDQFHOHDFKRWKHURXWVRWKDWWKHVLJQDOVWUHQJWKLVGHFUHDVHG/RFDWLRQV
ZKHUHVLJQDOORVVRFFXUVDUHFDOOHG³QXOOVSRWV´,IWKHWUDQVPLWWHULVPRYLQJRUQHDUE\
SHRSOHRUREMHFWVDUHPRYLQJQXOOVSRWVFDQRFFXUDQ\WLPHDQGDQ\ZKHUH
Turn off the power of mobile phones, small
wireless devices and other devices which produce
strong electromagnetic interference around a
patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as
mobile phones or small wireless devices may be
mistaken as pulse waves or respiration waves and
the displayed data may be incorrect.
CAUTION
14
ZM-540PA, ZM-541PA Operator’s Manual
When monitoring respiration is needed, measure
respiration with an instrument. The transmitter
calculates SpO2 of arterial blood based on the
principle of pulse oximeter and does not measure
respiration.
CAUTION
Do not use the same channel for different
patients. If the same channel is used for two
patients, the two patients’ data will be lost due to
mutual modulation interference, or another
patient’s data may appear on the receiving
monitor screen.
Do not use two transmitters with adjacent
channels in the same hospital. If transmitters
with adjacent channels are used, their radio
waves interfere with each other.
CAUTION
When monitoring SpO2 only, detection of
arrhythmia and asystole is not available and
arrhythmia alarms such as ASYSTOLE, VF or VT
are not available. If the patient requires ECG
monitoring, monitor the ECG.
CAUTION
When monitoring SpO2 only (without ECG
monitoring), turn on both the upper and lower limit
alarms for PR and SpO2 on the receiving monitor. If
the patient’s pulse is not detected during asystole
or other condition, a “CANNOT DETECT PULSE”
or “CHECK PROBE” alarm occurs instead of an
SpO2 limit alarm. Furthermore, if the patient has no
pulse, noise from probe movement could be
misjudged as a pulse and cause an incorrect PR or
SpO2 value to be displayed.
CAUTION
15
ZM-540PA, ZM-541PA Operator’s Manual
Always lock the battery cover while using the
transmitter. Otherwise the battery cover may come
off and correct measurement might not be
performed.
CAUTION
Output Signal
WARNING
Do not use the output signal from the receiving
monitor as the synchronization signal for other
equipment such as IABP, MRI, echocardiography
or defibrillator. There may be time delay between
the monitor and the other equipment caused by
waveform transmission delay and spike noise may
interfere on the output signal and be mistaken as a
trigger.
Battery
Battery replacement must be performed by the
operator. When replacing the batteries of a
transmitter that is currently used for a patient,
disconnect the electrode leads from the transmitter
before replacing batteries or do not touch the
patient during replacement.
CAUTION
Refer to the battery and battery charger manuals
for details on handling the batteries.
CAUTION
16
ZM-540PA, ZM-541PA Operator’s Manual
Transmitter Channel Management
WARNING
The following actions must be taken to properly
receive the transmitter signal of the correct patient
on the receiving instrument. Otherwise, there may
be signal loss or signals may mix causing a serious
accident, such as monitoring a different patient.
Assign a channel administrator in the hospital
and only he or she should manage channel
assignment.
The channel administrator must manage the
channels in the facility so that there is no signal
interference.
When the transmitter channel is changed, the
channel administrator must check that the
channel on the receiving monitor is also
changed and the signal is properly received.
The channel administrator must replace the
channel number label on the transmitter with the
new one after changing the channel.
17
ZM-540PA, ZM-541PA Operator’s Manual
For Patients Using Implantable Pacemaker
WARNING
The bioelectric impedance measurement sensor of
a minute ventilation rate-adaptive implantable
pacemaker may be affected by transmitter which is
connected to the same patient. If this occurs, the
pacemaker may pace at its maximum rate and the
transmitter may give incorrect data to the monitor.
If this occurs, disconnect the electrode leads from
the patient or change the setting on the pacemaker
by referring to the pacemaker’s manual. For more
details, contact your pacemaker representative or
Nihon Kohden representative.
ECG Monitoring
WARNING
Turn the pacing pulse detection to ON on the
receiving monitor when monitoring a pacemaker
patient. Otherwise the pacemaker pulse is not
rejected. However, even when the pacing pulse
detection is set to ON, the pacemaker pulse might
not be rejected. When the pacemaker pulse is not
rejected, the pacemaker pulse is detected as QRS
and false heart rate may be indicated or critical
arrhythmia such as asystole may be overlooked.
Keep pacemaker patients under close observation.
 )RUWKHSDFHPDNHUSXOVHUHMHFWLRQFDSDELOLW\RIWKH=03$DQG=03$WUDQVPLWWHUV
UHIHUWRWKH³6SHFL¿FDWLRQV(&*´VHFWLRQ
WARNING
Even when the pacing pulse detection is set to ON
on the receiving monitor, the pacemaker pulse can
be overlooked or detected as QRS. You cannot
confirm the pacemaker operation only from the
detected pacemaker pulse.
18
ZM-540PA, ZM-541PA Operator’s Manual
Only use Nihon Kohden specified electrodes and
electrode leads. When other type of electrodes or
electrode leads are used, the “CHECK
ELECTRODES” message may be displayed and
ECG monitoring may stop.
CAUTION
When the “CHECK ELECTRODES” message is
displayed on the receiving monitor, ECG is not
monitored properly and the ECG alarm does not
function. Check the electrode, electrode leads, and
if necessary, replace with new ones.
CAUTION
SpO2 Monitoring
WARNING
SpO2 measurement may be incorrect in the
following cases.
When the patient’s carboxyhemoglobin or
methemoglobin increases abnormally.
When dye is injected in the blood.
• During CPR.
When measuring at a site with venous pulse.
When there is body movement.
When the pulse wave is small (insufficient
peripheral circulation).
WARNING
When monitoring SpO2 of a patient who is
receiving photodynamic therapy, the light from the
finger probe sensor may cause a burn.
Photodynamic therapy uses a photosensitizing
agent that has a side effect of photosensitivity.
7KH6S22SUREHVPDQXIDFWXUHGE\1LKRQ.RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKH
UDQJHRIDQGQP7KHPD[LPXPOLJKWLQWHQVLW\LVOHVVWKDQP:
19
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When not monitoring SpO2, disconnect the SpO2
cable from the transmitter. Otherwise, noise from
the probe sensor may interfere and incorrect data
is displayed on the screen.
WARNING
When using the TL-201T finger probe, do not
fasten the probe and cable to the finger by
wrapping with tape. This may cause burn,
congestion or pressure necrosis from poor blood
circulation.
When using probes other than the TL-201T
finger probe, to avoid poor circulation, do not
wrap the tape too tight. Check the blood
circulation condition by observing the skin color
and congestion at the skin peripheral to the
probe attachment site. Even for short-term
monitoring, there may be burn or pressure
necrosis from poor blood circulation, especially
on neonates or low birth weight infants whose
skin is delicate. Accurate measurement cannot
be performed on a site with poor peripheral
circulation.
20
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse
waveform. Change the measurement site every 8
hours for disposable probes and every 4 hours for
reusable probes (every 8 hours for TL-631T series
probe). The skin temperature may increase at the
attached site by 2 or 3°C (4 or 5°F) and cause a
burn or pressure necrosis. When using the probe
on the following patients, take extreme care and
change the measurement site more frequently
according to symptoms and degree.
Patient with a fever
Patient with insufficient peripheral circulation
Neonate or low birth weight infant with delicate
skin
The disposable probe is not sterilized. Use the
disposable probe only for a single patient. Never
reuse the disposable probe for another patient
because it causes cross infection.
CAUTION
If the attachment site is dirty with blood or bodily
fluids, clean the attachment site before attaching
the probe. If there is nail polish on the attachment
site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
performed.
CAUTION
If the skin gets irritated or redness appears on the
skin from the probe, change the attachment site or
stop using the probe. Take extreme care for the
patients with delicate skin.
CAUTION
21
ZM-540PA, ZM-541PA Operator’s Manual
While a patient is on medication which causes
vasodilation, the pulse waveform may change and
in rare cases the SpO2 value might not be
displayed.
CAUTION
NIBP and SpO2 can be measured on the same
limb, but the SpO2 monitoring might not be
accurate during NIBP measurement. Be careful
when reading the SpO2 values.*
CAUTION
 0RQLWRULQJ6S22GXULQJ1,%30HDVXUHPHQW
:KHQWKH6S22SUREHLVDWWDFKHGWRWKHVDPHOLPEDVWKH1,%3FXIIWKHEORRGÀRZ
GHFUHDVHVGXULQJ1,%3PHDVXUHPHQWDQGSXOVHZDYHFDQQRWEHGHWHFWHGDQG6S22 cannot
EHPRQLWRUHGSURSHUO\:KHQ³,1+,%,76S22'85,1*1,%3´RQWKH3$5$0(7(5
6(783VFUHHQLVVHWWR21IDFWRU\GHIDXOWVHWWLQJ6S22PRQLWRULQJLVSDXVHGGXULQJ1,%3
PHDVXUHPHQWWRDYRLG6S22DODUPRFFXUUHQFH+RZHYHUZKHQPRQLWRULQJ6S22 on the same
OLPEDVWKH1,%3EHFDUHIXOZKHQUHDGLQJ6S22YDOXHV
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring
site with a blanket.
CAUTION
When a message indicates a faulty probe, stop
monitoring and replace the probe with a new one.
CAUTION
22
ZM-540PA, ZM-541PA Operator’s Manual
Handle the probe cable according to the following
cautions. Failure to follow these cautions may
cause cable discontinuity or short circuit of the
probe cable which may cause incorrect
measurement data or inability to perform
measurement. Also in rare cases, the probe
temperature may increase and cause skin burn on
the patient. If the probe cable is damaged, replace
the probe with a new one.
 'RQRWSXOORUEHQGWKHSUREHFDEOH
 'RQRWOHWFDVWHUIHHWUXQRYHUWKHSUREHFDEOH
CAUTION
Do not use a probe which is deteriorated by aging.
Accurate measurement cannot be performed.
CAUTION
Do not use a damaged or disassembled probe. It
causes incorrect measurement and may injure the
patient.
CAUTION
When the probe is attached on an appropriate site
with sufficient thickness and the error message
confirming the probe attachment repeatedly
appears, the probe may be deteriorated. Replace it
with a new one.
CAUTION
23
ZM-540PA, ZM-541PA Operator’s Manual
NIBP Monitoring
WARNING
Be careful when measuring NIBP on a patient with
known bleeding disorders or coagulation. After
NIBP measurement, there may be dot
hemorrhage, or circulatory disorder by thrombus
where the cuff is attached.
WARNING
NIBP measurement may be incorrect in the
following situations.
When using an ESU
• Body movement
Small pulse wave
Too many arrhythmias
Shaking from an external source
Rapid blood pressure change
• During CPR
• Slow pulse
Low blood pressure
Small pulse pressure
Cuff is too tight or too loose
Cuff does not fit the arm
Cuff is wrapped over thick clothing
Cuff is deteriorated
• Arterial sclerosis
• Poor perfusion
• Diabetes
• Age
• Pregnancy
• Pre-eclampsia
• Renal disease
• Shivering
• Trembling
24
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When performing NIBP measurements in STAT
mode or 5 minute intervals, periodically remove the
cuff from the patient for ventilation. The skin
temperature may increase at the cuff attachment
site by 2 or 3°C (4 or 5°F). When measuring a
patient with a fever or peripheral circulation
insufficiency, it may cause a burn.
WARNING
Do not attach the NIBP cuff on a limb which is
being used for intravascular access or therapy, or
an arterio-venous (A-V) shunt. It may cause reflux
of blood or medicinal solution or block injection of
medicinal solution due to poor blood circulation.
WARNING
Do not attach the NIBP cuff on an arm which is the
same side as a mastectomy. It may cause
circulatory disorder such as swelling from poor
blood circulation.
WARNING
While measuring NIBP, if the NIBP cuff and other
medical equipment are attached to the same limb,
the medical equipment might not function
temporarily.
WARNING
While measuring NIBP, check the patient condition
and confirm that the NIBP cuff does not affect
blood circulation.
25
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When performing long term measurement at
intervals less than 5 minutes, perform
measurements while observing the state of the
patient, blood vessels and limb to ensure adequate
circulation. Congestion may occur at the
measurement site. When performing periodic
measurement for a long time, periodically check
the circulation condition.
Do not wrap the cuff on an arm or thigh which is
used for injection. NIBP measurement on an arm
or thigh which is used for injection may cause
reflux of blood and stop injection.
CAUTION
Do not wrap the cuff too tight. It may cause poor
blood circulation and congestion. If the cuff is
wrapped too loosely, the NIBP value may increase.
CAUTION
Do not attach the cuff to the site where there is
injury or inflammation. If the skin gets irritated or
redness appears on the skin from the cuff, change
the attachment site or stop using the cuff. Take
extreme care on the patients with delicate skin.
CAUTION
When using an extension hose, check that the
extension hose is not bent or squeezed.
Otherwise, the cuff might not inflate or deflate. If
the cuff cannot deflate, it may cause congestion on
the patient at the cuff attachment site.
CAUTION
26
ZM-540PA, ZM-541PA Operator’s Manual
When performing NIBP measurement repeatedly,
have a rest between measurements to recover
adequate circulation.
CAUTION
Maintenance
If detergent or liquid spills into the transmitter, stop
cleaning or disinfecting it and contact your Nihon
Kohden representative. The transmitter needs to
be checked for safety and function before use.
CAUTION
Before maintenance, cleaning or disinfection, turn
the transmitter power off and remove the batteries.
Failure to follow this instruction may result in
electrical shock and transmitter malfunction.
CAUTION
Never disassemble or repair the transmitter. If
there is any problem with the transmitter, contact
your Nihon Kohden representative.
CAUTION
Dispose of Nihon Kohden products according to
your local laws and your facility’s guidelines for
waste disposal. Otherwise, it may affect the
environment. If there is a possibility that the
product may have been contaminated with
infection, dispose of it as medical waste according
to your local laws and your facility’s guidelines for
medical waste. Otherwise, it may cause infection.
CAUTION
27
ZM-540PA, ZM-541PA Operator’s Manual
Preparation on Transmitter
Batteries
Handling Batteries
WARNING
Do not handle the batteries with wet hands.
WARNING
When the transmitter is not in use, remove the
batteries. When the batteries are installed, battery
power is consumed even when measurement is
not performed. When NiMH batteries are left in the
transmitter when it is not used, the batteries may
overdischarge and leak liquid which makes the
batteries unusable and damages the transmitter.
Refer to the battery and battery charger manuals
for details on handling the batteries.
CAUTION
NOTE Remove the batteries from the transmitter before disposing of it.
Use either new alkaline batteries or fully charged rechargeable NiMH
EDWWHULHV8VLQJXQVSHFL¿HGEDWWHULHVSUHYLRXVO\XVHGEDWWHULHVRUEDWWHULHV
that have been stored for long periods may result in short battery life or
reduced performance resulting in unstable measurement.
Battery Lifetime
8VHWKUHH$$W\SHDONDOLQHGU\FHOOEDWWHULHV1L0+EDWWHULHVFDQDOVREHXVHGEXWWKHOLIHWLPH
RIDONDOLQHEDWWHULHVLVORQJHU7KHOLIHWLPHRI1L0+EDWWHULHVLVDERXWRIDONDOLQHEDWWHULHV
ZKHQIXOO\FKDUJHG
:LWKQHZ1LKRQ.RKGHQUHFRPPHQGHGDONDOLQHEDWWHULHVWKHWUDQVPLWWHUFDQFRQWLQXRXVO\
PHDVXUH(&*UHVSLUDWLRQ6S22DQG1,%3IRUDSSUR[LPDWHO\GD\7KHPHDVXUHPHQWLV
SHUIRUPHGDWURRPWHPSHUDWXUH1,%3LVPHDVXUHGLQDXWRPRGHDWPLQXWHLQWHUYDOVDQG
6S22LVPHDVXUHGRQDQLQGH[¿QJHURIDPDOHSDWLHQWZLWKZHLJKWNJ2SHUDWLRQWLPH
GHSHQGVRQWKHWKLFNQHVVRIWKH6S22SUREHDWWDFKPHQWVLWH
28
ZM-540PA, ZM-541PA Operator’s Manual
Recommended batteries
1L0+VHFRQGDU\ 3DQDVRQLFHQHORRS
$ONDOLQHSULPDU\ 1LKRQ.RKGHQ0HGLSRZHUHTXLYDOHQWWR3DQDVRQLF/5*
Installing and Replacing Batteries
Battery replacement must be performed by the
operator. When replacing the batteries of a
transmitter that is currently used for a patient,
disconnect the electrode leads from the transmitter
before replacing batteries or do not touch the
patient during replacement.
CAUTION
,IHOHFWURGHOHDGVDUHDWWDFKHGWRWKHSDWLHQWDQGWKHSHUVRQUHSODFLQJEDWWHULHVWRXFKHVWKH
SDWLHQWGXULQJEDWWHU\UHSODFHPHQWH[FHVVSDWLHQWOHDNDJHFXUUHQWPD\ÀRZLQWRWKHSDWLHQW
NOTE Replace all batteries at the same time.
Do not use different types of batteries together.
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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.
1 5HPRYHWKHEDWWHU\FDVHFRYHU
2 ,QVHUWWKUHHQHZRUIXOO\FKDUJHGEDWWHULHVLQWRWKH
EDWWHU\FDVHREVHUYLQJWKHFRUUHFWSRODULW\
29
ZM-540PA, ZM-541PA Operator’s Manual
NOTE: ,QVHUWWKHíHQGRIWKHEDWWHU\¿UVWDQG
press it against the spring. If you try to force
WKHHQGRIWKHEDWWHU\LQ¿UVWDVVKRZQ
it will deform the spring and damage the
battery and transmitter.
3 &ORVHWKHFRYHU
7KHWUDQVPLWWHULVDXWRPDWLFDOO\WXUQHGRQZKHQWKH
EDWWHULHVDUHLQVWDOOHGDQGWKHFRYHULVFORVHG
Always lock the battery cover while using the
transmitter. Otherwise the battery cover may come
off and correct measurement might not be
performed.
CAUTION
Situations Requiring Battery Replacement
5HSODFHWKHEDWWHULHVZKHQDQ\RIWKHIROORZLQJRFFXUV
7KHWUDQVPLWWHUGLVSOD\VWKH³%$77(5<:($.´PHVVDJHRU LFRQ
7KHWUDQVPLWWHUJHQHUDWHVDFRQVWDQWDODUPFRQWLQXRXV³SHHS´VRXQG
7KHWUDQVPLWWHU/&'GRHVQRWGLVSOD\DQ\WKLQJZKHQWKHSRZHULVWXUQHGRQ
7KHUHFHLYLQJPRQLWRUGLVSOD\VDEDWWHU\UHSODFHPHQWPHVVDJH
NOTE: The battery replacement message or icon on the transmitter disappears after
a short time depending on the type of battery. When the battery replacement
indication appears, immediately replace the transmitter battery with a new
one.
SpringSpring
Good Bad
30
ZM-540PA, ZM-541PA Operator’s Manual
Battery Level Indication
7KHIROORZLQJLFRQVRQWKHGLVSOD\LQGLFDWHWKHEDWWHU\OHYHO:KHQWKHVFUHHQLVWXUQHGRII
SUHVVWKH6FUHHQNH\WRFKHFNWKHEDWWHU\OHYHO:KHQ³35272&2/´RIWKH6<67(06(783
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Indication Battery Level Message on the Receiving Monitor
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%DWWHULHVDUHIXOO
%DWWHULHVDUHZHDN
5HSODFHEDWWHULHV
0HVVDJHUHTXLULQJEDWWHU\UHSODFHPHQWLV
GLVSOD\HG
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&DQQRWPHDVXUH1,%3
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No indication 'HDGEDWWHULHV 1RVLJQDOFDQEHWUDQVPLWWHGWRWKHPRQLWRU
7KHUHLVQRLQGLFDWLRQRQWKHPRQLWRU
31
ZM-540PA, ZM-541PA Operator’s Manual
Turning On the Transmitter
:KHQWKHEDWWHULHVDUHLQVWDOOHGFRUUHFWO\WKHSRZHULVWXUQHGRQ$³SHHS´VRXQGVIRURQH
VHFRQGWKHVWDUWXSVFUHHQDSSHDUVWKHQWKHFKHFNHOHFWURGHVVFUHHQDSSHDUV7KHUHLVQR
³SHHS´VRXQGZKHQWKHUHLVQREDWWHU\SRZHU
NOTE: Check that the “COMMUNICATION LOSS” message is not displayed on the
central monitor.
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GLVSOD\WKHQXPHULFDQGZDYHIRUPVFUHHQ
)RUGHWDLOVRQWKHVFUHHQUHIHUWRWKH³6FUHHQ'HVFULSWLRQV´VHFWLRQ
Check Items Before Use
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FDQEHXVHGLQQRUPDODQGVDIHFRQGLWLRQ
Operating Environment
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XVDJHHQYLURQPHQWUDQJHSODFHWKHWUDQVPLWWHULQWKHXVDJHHQYLURQPHQWIRUVXI¿FLHQWWLPHIRU
LWWRDGMXVWWRWKHURRPWHPSHUDWXUHEHIRUHXVH,IWKHWUDQVPLWWHUPD\EHXVHGFRQVWDQWO\VWRUH
LWZLWKLQWKHXVDJHHQYLURQPHQWUDQJH
32
ZM-540PA, ZM-541PA Operator’s Manual
Appearance
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7KHHOHFWURGHVHOHFWURGHOHDG6S22SUREHDQG1,%3FXIIDUHQRWEURNHQ
Batteries
7KHEDWWHU\SRODULW\LVFRUUHFW
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7KHEDWWHU\FDVHFRYHULV¿UPO\FORVHG
Channel Setting
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33
ZM-540PA, ZM-541PA Operator’s Manual
Check Items After Use
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Before Turning Power Off
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34
ZM-540PA, ZM-541PA Operator’s Manual
Changing the Transmitter Channel
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WARNING
The following actions must be taken to properly
receive the transmitter signal of the correct patient
on the receiving instrument. Otherwise, there may
be signal loss or signals may mix causing a serious
accident, such as monitoring a different patient.
Assign a channel administrator in the hospital
and only he or she should manage channel
assignment.
The channel administrator must manage the
channels in the facility so that there is no signal
interference.
When the transmitter channel is changed, the
channel administrator must check that the
channel on the receiving monitor is also
changed and the signal is properly received.
The channel administrator must replace the
channel number label on the transmitter with the
new one after changing the channel.
NOTE The software version of the QI-901PK channel writer must be 02-01 or later
to change the channel on the transmitter.
The channel writer must be used outside the patient environment.
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Channel
35
ZM-540PA, ZM-541PA Operator’s Manual
Changing Parameter and System Setup Settings
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personnel.
Notes on Parameter Settings
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36
ZM-540PA, ZM-541PA Operator’s Manual
Changing PARAMETER SETUP Settings
Parameter Setup Setting List
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Setting Item Description Settings
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NOTE: When “PROTOCOL” of the transmitter
is set to 57 and the receiving monitor
is able to receive protocol 57, ECG
measurement on the receiving monitor
is automatically set to OFF when this
setting is set to OFF on the transmitter.
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37
ZM-540PA, ZM-541PA Operator’s Manual
Displaying the PARAMETER SETUP Screen
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38
ZM-540PA, ZM-541PA Operator’s Manual
Changing Parameter Setup Settings
ECG ELECTRODES
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39
ZM-540PA, ZM-541PA Operator’s Manual
ECG MEASUREMENT
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NOTE: When “PROTOCOL” of the transmitter is set to 57 and the receiving monitor
is able to receive protocol 57, ECG measurement on the receiving monitor is
automatically set to OFF when this setting is set to OFF on the transmitter.
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40
ZM-540PA, ZM-541PA Operator’s Manual
SpO2 RESPONSE
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WLPHUHIHUWRWKH³6SHFL¿FDWLRQV6S220HDVXUHPHQW,62FRPSOLDQW´VHFWLRQLQ
WKLVPDQXDO
NOTE: When measurement condition is unstable due to strenuous movement of the
patient, etc., response may become slower in all modes.
1 2QWKH3$5$0(7(56(783VFUHHQSUHVV
WKHŹNH\WRPRYHWKHFXUVRUWR³6S22
5(63216(´³6S225(63216(´LVRQWKH
VHFRQGSDJHRIWKH3$5$0(7(56(783
VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFW³)$67´³1250$/´
RU³6/2:´
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKH
VHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³6S22
5(63216(´
INHIBIT SpO2 DURING NIBP
7XUQ6S22PRQLWRULQJRQRURIIGXULQJ1,%3PHDVXUHPHQW
:KHQWKH6S22SUREHLVDWWDFKHGWRWKHVDPHOLPEDVWKH1,%3FXIIDQGWKLVVHWWLQJLVVHWWR
2))WKHSXOVHPD\EHFRPHXQVWDEOHDQG6S22RU35DODUPPD\RFFXU,WLVUHFRPPHQGHGWR
VHWWKLVVHWWLQJWR21VRWKDW6S22LVQRWPHDVXUHGGXULQJ1,%3PHDVXUHPHQW
:KHQWKH6S22SUREHLVDWWDFKHGWRWKHRWKHUOLPEIURPWKH1,%3FXIIWKLVVHWWLQJFDQEHVHW
WR2))
NOTE: When this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the
“Monitoring SpO2 during NIBP Measurement” section.
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³,1+,%,7
6S22'85,1*1,%3´³,1+,%,76S22'85,1*1,%3´LVRQWKHVHFRQGSDJHRIWKH
3$5$0(7(56(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFW³21´RU³2))´
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1+,%,7
6S22'85,1*1,%3´
PARAMETER SETUP screen - page 2
41
ZM-540PA, ZM-541PA Operator’s Manual
SELECTABLE INTERVALS (min)
:KHQWKH1,%3,17(59$/NH\LVSUHVVHGWKHPHDVXUHPHQWPRGHFKDQJHVDFFRUGLQJWRWKH
PRGHVVHOHFWHGLQWKLVLWHP0$18$/PRGHLVDOUHDG\VHOHFWHGIRUWKHPRGHVHOHFWLRQ
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKH
ŹNH\WRPRYHWKHFXUVRUWR³6(/(&7$%/(
,17(59$/6´³6(/(&7$%/(,17(59$/6´
LVRQWKHWKLUGSDJHRIWKH3$5$0(7(56(783
VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWRUXQVHOHFWWKHPRGH
7KHVHOHFWHGPRGHVDUHKLJKOLJKWHG
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG
VHWWLQJ7KHFXUVRUUHWXUQVWR³6(/(&7$%/(
,17(59$/6´
INITIAL INTERVAL (min)
6HOHFWWKHLQLWLDO1,%3PHDVXUHPHQWPRGHDWSRZHURQ
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³,1,7,$/
,17(59$/´³,1,7,$/,17(59$/´LVRQWKHWKLUGSDJHRIWKH3$5$0(7(56(783
VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWWKHPRGH2QO\WKHPRGHRULQWHUYDOVHOHFWHGIRU
³6(/(&7$%/(,17(59$/6´DUHDYDLODEOH
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1,7,$/
,17(59$/´
PARAMETER SETUP screen - page 3
42
ZM-540PA, ZM-541PA Operator’s Manual
NIBP MODE AFTER STAT (min)
6HOHFWWKH1,%3PHDVXUHPHQWPRGHDIWHUFRPSOHWLQJWKH67$7PHDVXUHPHQW
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³1,%3
02'($)7(567$7´³1,%302'($)7(567$7´LVRQWKHWKLUGSDJHRIWKH
3$5$0(7(56(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWWKHPRGH2QO\WKHPRGHRULQWHUYDOVHOHFWHGIRU
³6(/(&7$%/(,17(59$/6´DUHDYDLODEOH
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³1,%3
02'($)7(567$7´
START/FINISH SOUND
7XUQRQRURIIWKHVRXQGIRU1,%3PHDVXUHPHQWVWDUWDQG¿QLVK
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKH
ŹNH\WRPRYHWKHFXUVRUWR³67$57),1,6+
6281'´³67$57),1,6+6281'´LVRQWKH
IRXUWKSDJHRIWKH3$5$0(7(56(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\7KHFXUVRUPRYHVWR
³67$57´
3 3UHVVWKHŹNH\WRWXUQ³21´RU³2))´WKH
VRXQGIRU1,%3PHDVXUHPHQWVWDUW
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHWWLQJIRU
³67$57´7KHFXUVRUPRYHVWR³),1,6+´
5 3UHVVWKHŹNH\WRWXUQ³21´RU³2))´WKH
VRXQGIRU1,%3PHDVXUHPHQW¿QLVK
6 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG
VHWWLQJ7KHFXUVRUUHWXUQVWR³67$57),1,6+
6281'´
PARAMETER SETUP screen - page 4
43
ZM-540PA, ZM-541PA Operator’s Manual
OLD NIBP DATA/AFTER (min)
6HOHFWZKHWKHUWRGLPRUKLGHWKH1,%3GDWDDIWHUPHDVXUHPHQWDQGKRZORQJWRZDLWDIWHU
1,%3PHDVXUHPHQWWRGLPRUKLGHLW
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³2/'
1,%3'$7$$)7(5´³2/'1,%3'$7$$)7(5´LVRQWKHIRXUWKSDJHRIWKH
3$5$0(7(56(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\7KHFXUVRUPRYHVWR³'$7$´
3 3UHVVWKHŹNH\WRVHOHFW³+,'(´RU³',0´WKH1,%3GDWD
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHWWLQJIRU³'$7$´7KHFXUVRUPRYHVWR
³$)7(5´
5 3UHVVWKHŹNH\WRVHOHFWWKHLQWHUYDODIWHU1,%3PHDVXUHPHQWWRGLPRUKLGH
6 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³2/'1,%3
'$7$$)7(5´
INITIAL CUFF PRESSURE (mmHg)
6HOHFWWKH1,%3FXIILQÀDWLRQSUHVVXUH
1 2QWKH3$5$0(7(56(783VFUHHQSUHVVWKHŹNH\WRPRYHWKHFXUVRUWR³,1,7,$/
&8))35(6685(´³,1,7,$/&8))35(6685(´LVRQWKHIRXUWKSDJHRIWKH
3$5$0(7(56(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWWKHLQÀDWLRQSUHVVXUH
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³,1,7,$/
&8))35(6685(´
44
ZM-540PA, ZM-541PA Operator’s Manual
Changing SYSTEM SETUP Settings
System Setup Setting List
7KHIDFWRU\GHIDXOWVHWWLQJVDUHXQGHUOLQHG
Setting Item Description Settings
35272&2/
6HOHFWWKHWUDQVPLWWLQJSURWRFRO
1HZSURWRFRO$FHQWUDOPRQLWRUZLWKDQ
25*$25*$RU25*$PXOWLSOH
SDWLHQWUHFHLYHUZKRVHVRIWZDUHYHUVLRQRU
ODWHUFDQUHFHLYHWKLVSURWRFRO
2OGSURWRFRO$FHQWUDOPRQLWRUZLWKDQ
25*$25*$RU25*$PXOWLSOH
SDWLHQWUHFHLYHUFDQUHFHLYHWKLVSURWRFRO
NOTE: When 57 is set, the receiving monitor
must be able to receive protocol 57.
Otherwise, signals from the transmitter
cannot be received.
, 42
%5,*+71(66 6HOHFWWKHVFUHHQEULJKWQHVV '$5.,
%5,*+7
35(6685(81,7 6HOHFWWKHXQLWIRU1,%3 PP+JN3D
)81&7,21.(<
6HOHFWWKHIXQFWLRQRIWKH)XQFWLRQNH\
6863(1'$/$503$86(
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DQGUHFHLYLQJPRQLWRU
6863(1'$/$50
 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRU
PLQXWHV
&21),50
 'LVSOD\VWKH³3$7,(17&21),50('´
PHVVDJHRQWKHWUDQVPLWWHUVFUHHQDQGWUDQVPLWV
WKHPHVVDJHWRWKHUHFHLYLQJPRQLWRU
2)) 1RIXQFWLRQ
NOTE: “SUSPEND ALARM & PAUSE” and
“CONFIRM” can only be set when
PROTOCOL is set to 57.
6863(1'
$/$50
3$86(,
6863(1'
$/$50
&21),50
2))
$8725(680(
$)7(53$86( 6HOHFWWKHLQWHUYDOWRUHVXPHPRQLWRULQJDIWHU3$86(
VV,
PLQPLQ
PLQ
6(/(&7$%/(
6&5((17,0(
2873(5,2'PLQ
6HOHFWWKHGLVSOD\WLPHRXWSHULRG ,

45
ZM-540PA, ZM-541PA Operator’s Manual
Displaying the SYSTEM SETUP Screen
1 7XUQRIIWKHWUDQVPLWWHUE\UHPRYLQJRQHEDWWHU\
2 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKH
WUDQVPLWWHUE\LQVHUWLQJWKHEDWWHU\7KH0(18
VFUHHQDSSHDUV
3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR
³6<67(06(783´
4 3UHVVWKH)XQFWLRQNH\WRHQWHU6<67(0
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5 &KDQJHVHWWLQJV
7RPRYHWKHFXUVRUDQGVHOHFWWKHVHWWLQJLWHP
press the Ż or ŹNH\WKHQSUHVVWKH)XQFWLRQ
NH\
7RVHOHFWDQGUHJLVWHUWKHVHWWLQJSUHVVWKHŻ
or ŹNH\WKHQSUHVVWKH)XQFWLRQNH\
7RFDQFHOFKDQJLQJWKHVHWWLQJRIWKHVHOHFWHG
LWHPSUHVVWKH6FUHHQNH\
7KH6<67(06(783VFUHHQKDVWZRSDJHV7R
GLVSOD\WKHVHFRQGSDJHSUHVVWKHŹNH\ZKHQ
WKHFXUVRULVDW³35(6685(81,7´
6 :KHQFKDQJLQJVHWWLQJVRQWKH6<67(06(783
VFUHHQLVFRPSOHWHSUHVVWKH6FUHHQNH\WRUHWXUQ
WRWKH0(18VFUHHQ
7 3UHVVWKHŻRUŹNH\WRPRYHWKHFXUVRUWR
³(;,7´
8 3UHVVWKH)XQFWLRQNH\7KHQXPHULFDQG
ZDYHIRUPVFUHHQDSSHDUV
Cursor
MENU screen
SYSTEM SETUP screen - page 1
Setting
Setting item
46
ZM-540PA, ZM-541PA Operator’s Manual
Changing System Setup Settings
PROTOCOL
6HOHFWWKHWUDQVPLWWLQJSURWRFRO)RUGLIIHUHQFHVEHWZHHQSURWRFROVUHIHUWRWKHWDEOHEHORZ
1HZSURWRFRO$FHQWUDOPRQLWRUZLWKDQ25*$25*$RU25*$
PXOWLSOHSDWLHQWUHFHLYHUZKRVHVRIWZDUHYHUVLRQRUODWHUFDQUHFHLYHWKLVSURWRFRO
2OGSURWRFRO$FHQWUDOPRQLWRUZLWK25*$25*$RU25*$PXOWLSOH
SDWLHQWUHFHLYHUFDQUHFHLYHWKLVSURWRFRO
NOTE: When 57 is set, the receiving monitor must be able to receive protocol 57.
Otherwise, signals from the transmitter cannot be received.
Differences Between Protocols
Function Protocol 42 Protocol 57
6HWWLQJ(&*0($685(0(17WR2))RQWKH
WUDQVPLWWHUDXWRPDWLFDOO\WXUQVRIIWKH(&*
PHDVXUHPHQWVHWWLQJRQWKHUHFHLYLQJPRQLWRU
1R(&*PHDVXUHPHQW
PXVWEHWXUQHGRIIRQ
WKHUHFHLYLQJPRQLWRU
<HV
3DXVHPRQLWRULQJRQWKHUHFHLYLQJPRQLWRUIURP
the transmitter No <HV
7UDQVPLW³3$7,(17&21),50('´PHVVDJH No <HV
'LVSOD\EDWWHU\OHYHORIWKHWUDQVPLWWHURQWKH
UHFHLYLQJPRQLWRU No <HV
7UDQVPLW6S22PHVVDJHV 6RPHPHVVDJHVUHIHU
WRWKH³,QGLFDWLRQDQG
0HVVDJH/LVW´VHFWLRQ
$OOPHVVDJHV
1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR
³35272&2/´
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFW³´RU³´
Setting
Cursor
47
ZM-540PA, ZM-541PA Operator’s Manual
NOTE: FUNCTION KEY (on the second page
of the SYSTEM SETUP screen) can be
set to “SUSPEND ALARM & PAUSE”
or “CONFIRM” only when PROTOCOL
is “57”. If PROTOCOL is changed to
“42”, FUNCTION KEY is automatically
changed to “OFF”.
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG
VHWWLQJ7KHFXUVRUUHWXUQVWR³35272&2/´
BRIGHTNESS
6HOHFWWKHVFUHHQEULJKWQHVV
1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³%5,*+71(66´
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFW³'$5.´RU³%5,*+7´
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR
³%5,*+71(66´
PRESSURE UNIT
6HOHFWWKHXQLWIRU1,%3
1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³35(6685(81,7´
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFW³PP+J´RU³N3D´
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR
³35(6685(81,7´
48
ZM-540PA, ZM-541PA Operator’s Manual
FUNCTION KEY
6HOHFWWKHIXQFWLRQRIWKH)XQFWLRQNH\)RUGHWDLOVRQXVLQJWKHVHIXQFWLRQVUHIHUWR³%DVLF
0RQLWRULQJ2SHUDWLRQ´LQWKH³0RQLWRULQJ´VHFWLRQ
6863(1'$/$503$86( 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV
3DXVHVPRQLWRULQJRQWKHWUDQVPLWWHUDQGUHFHLYLQJPRQLWRU
6863(1'$/$50 6XVSHQGVDODUPRQWKHUHFHLYLQJPRQLWRUIRUPLQXWHV
&21),50 'LVSOD\VWKH³3$7,(17&21),50('´PHVVDJHRQWKH
WUDQVPLWWHUVFUHHQDQGWUDQVPLWVWKHPHVVDJHWRWKHUHFHLYLQJ
PRQLWRU
2)) 1RIXQFWLRQ
NOTE: “SUSPEND ALARM & PAUSE” and “CONFIRM” can only be set when
PROTOCOL is set to 57.
1 2QWKH6<67(06(783VFUHHQSUHVVWKHŹ
NH\WRPRYHWKHFXUVRUWR³)81&7,21.(<´
³)81&7,21.(<´LVRQWKHVHFRQGSDJHRIWKH
6<67(06(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWWKHIXQFWLRQ
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG
VHWWLQJ7KHFXUVRUUHWXUQVWR³)81&7,21
.(<´
AUTO RESUME AFTER PAUSE
6HOHFWWKHLQWHUYDOWRUHVXPHPRQLWRULQJDIWHU3$86(:KHQHLWKHURIWKHIROORZLQJFRQGLWLRQV
LVPHWPRQLWRULQJUHVXPHVRQWKHUHFHLYLQJPRQLWRU
+HDUWUDWHLVSURSHUO\PRQLWRUHGIRUWKHVHOHFWHGLQWHUYDO
6 S 2 2LVSURSHUO\PRQLWRUHGIRUWKHVHOHFWHGLQWHUYDO
1,%3LVSURSHUO\PHDVXUHGDQGWKH6<6',$RU0$3YDOXHLVGLVSOD\HG
1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³$8725(680($)7(53$86(´³$872
5(680($)7(53$86(´LVRQWKHVHFRQGSDJHRIWKH6<67(06(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŹNH\WRVHOHFWWKHLQWHUYDO
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHGVHWWLQJ7KHFXUVRUUHWXUQVWR³$872
5(680($)7(53$86(´
SYSTEM SETUP screen - page 2
49
ZM-540PA, ZM-541PA Operator’s Manual
SELECTABLE SCREEN TIME OUT PERIOD (min)
6HOHFWWKHGLVSOD\WLPHRXWSHULRG,IQRNH\LVSUHVVHGIRUWKHVHOHFWHGWLPHWKHGLVSOD\LV
DXWRPDWLFDOO\WXUQHGRII7KHVHOHFWHGWLPHLVVKRZQRQWKH6HOHFW6FUHHQ7LPH2XW3HULRG
VFUHHQ5HIHUWRWKH³7XUQLQJWKH'LVSOD\2II´VHFWLRQIRUGHWDLOV
1 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR
³6(/(&7$%/(6&5((17,0(2873(5,2'
PLQ´,WLVRQWKHWKLUGSDJHRIWKH6<67(0
6(783VFUHHQ
2 3UHVVWKH)XQFWLRQNH\
3 3UHVVWKHŻRUŹNH\WRVHOHFWWLPHRXWSHULRG
4 3UHVVWKH)XQFWLRQNH\WRUHJLVWHUWKHVHOHFWHG
VHWWLQJ7KHFXUVRUUHWXUQVWR³6(/(&7$%/(
6&5((17,0(2873(5,2'PLQ´
SYSTEM SETUP screen - page 2
50
ZM-540PA, ZM-541PA Operator’s Manual
Initializing Settings
'RWKHIROORZLQJSURFHGXUHWRLQLWLDOL]HDOOVHWWLQJVH[FHSWIRUFKDQQHOWRWKHIDFWRU\GHIDXOW
VHWWLQJV
1 7XUQRIIWKHWUDQVPLWWHUE\UHPRYLQJDEDWWHU\
2 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKH
WUDQVPLWWHUE\LQVHUWLQJWKHEDWWHU\7KH0(18
VFUHHQDSSHDUV
3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR
³6<67(0,1,7,$/,=(´
4 3UHVVWKH)XQFWLRQNH\WRHQWHUWKH6<67(0
,1,7,$/,=(VFUHHQ
5 3UHVVWKH)XQFWLRQNH\$FRQ¿UPDWLRQPHVVDJH
DSSHDUV
7RUHWXUQWRWKH0(18VFUHHQZLWKRXW
LQLWLDOL]LQJSUHVVWKH6FUHHQNH\
6 3UHVVWKH)XQFWLRQNH\WRLQLWLDOL]HVHWWLQJV
7RFDQFHOLQLWLDOL]LQJSUHVVWKHŹNH\7KH
VFUHHQUHWXUQVWRWKH0(18VFUHHQ
Cursor
51
ZM-540PA, ZM-541PA Operator’s Manual
Attaching Electrodes, SpO2 Probe and NIBP
Cuff to the Patient
7KHWUDQVPLWWHUFDQEHDWWDFKHGWRDQDUPRIWKHSDWLHQWRUSODFHGRQWKHEHGVLGH7KHUHTXLUHG
OHQJWKRIWKHHOHFWURGHOHDGVDQG6S22SUREHFDEOHGHSHQGVRQKRZWKHWUDQVPLWWHULVWREH
DWWDFKHGWRWKHSDWLHQW
NOTE: Monitoring SpO2 during NIBP Measurement
When the SpO2 probe is attached to the same limb as the NIBP cuff, the
EORRGÀRZGHFUHDVHVGXULQJ1,%3PHDVXUHPHQWDQGSXOVHZDYHFDQQRW
be detected and SpO2 cannot be monitored properly. When “INHIBIT SpO2
DURING NIBP” on the PARAMETER SETUP screen is set to ON (factory
default setting), SpO2 monitoring is paused during NIBP measurement to
avoid SpO2 alarm occurrence. However, when monitoring SpO2 on the same
limb as NIBP, be careful when reading SpO2 values.
When monitoring SpO2 is important, attach the probe to the limb to which the
NIBP cuff or catheter is not attached.
Attachment Examples
When transmitter is attached on an arm When transmitter is placed on a bed
NOTE: When placing the transmitter on a
bedside, place it on a stable and
ÀDWSODFH,IWKHWUDQVPLWWHUIDOOV
off, it may be damaged.
52
ZM-540PA, ZM-541PA Operator’s Manual
Selecting Electrode Leads and Disposable Electrodes
Only use Nihon Kohden specified electrodes and
electrode leads. When other type of electrodes or
electrode leads are used, the “CHECK
ELECTRODES” message may be displayed and
ECG monitoring may stop.
CAUTION
7KHIROORZLQJRSWLRQDOHOHFURGHVDQGHOHFWURGHOHDGVFDQEHXVHGZLWKWKHWUDQVPLWWHU
Disposable Electrode Electrode Lead Note
Vitrode
7KHH[DPSOHLV9LWURGH&
%53$
7KUHHHOHFWURGHV
&OLSW\SH
%53$
7KUHHHOHFWURGHV
&OLSW\SH
%53$
6L[HOHFWURGHV
&OLSW\SH
%53$
6L[HOHFWURGHV
Snap type
5HIHUWRWKH³2SWLRQV´VHFWLRQZKHQRUGHULQJWKHGLVSRVDEOHHOHFWURGHVDQGHOHFWURGHOHDGV
53
ZM-540PA, ZM-541PA Operator’s Manual
Connecting the Electrode Lead to the Transmitter
&RQQHFWWKHHOHFWURGHOHDGWRWKH(&*5(63VRFNHWRQWKHWUDQVPLWWHU
NOTE: Hold the sides of the transmitter when connecting or disconnecting the
electrode lead. Pressing the display while holding the transmitter may
damage the transmitter.
When transmitter is
attached on an arm
Do not shake or swing the transmitter while holding
the leads or cables connected to the transmitter.
The transmitter may come off and injure someone
or damage surrounding instruments.
CAUTION
Hold the connector of the electrode lead when
connecting/disconnecting the electrode lead. If you
disconnect the electrode lead by pulling the lead, it
damages the electrode lead.
CAUTION
Electrode Position
)ROORZWKHSK\VLFLDQ¶VLQVWUXFWLRQVIRUHOHFWURGHSODFHPHQWZKHQDYDLODEOH
)RU(&*PRQLWRULQJHOHFWURGHVDUHDWWDFKHGRQO\RQWKHFKHVWWRDOORZSDWLHQWPRYHPHQW
DQGREWDLQFRQWLQXRXVVWDEOH(&*7KHIROORZLQJOHDGVDUHH[DPSOHV:KHQDOVRPRQLWRULQJ
UHVSLUDWLRQUHIHUWRWKH³(OHFWURGH3RVLWLRQIRU5HVSLUDWLRQ0RQLWRULQJ´VHFWLRQ
NOTE: The optimum electrode positions for ECG measurement are not always
optimum for respiration measurement. Select positions that are suitable for
both ECG and respiration measurement or positions which give priority to
either ECG or respiration measurement.
54
ZM-540PA, ZM-541PA Operator’s Manual
Electrode Positions for ECG Monitoring
Six Electrodes
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LVFKHPLD
<RXFDQLPSURYHPRQLWRULQJDFFXUDF\FRQVLGHUDEO\E\DGGLQJOHDG9WRWKLVFRPELQDWLRQ
9DDQG9EFDQEHDWDQ\SRVLWLRQRIWKHVWDQGDUGOHDGV9WR9EXW9DQG9DUHPRVW
DSSURSULDWHIRUP\RFDUGLDOLVFKHPLFPRQLWRULQJ
RA/R LA/L
RL/RF LL/F
Va/Ca
Vb/Cb
Electrode Position Symbol Lead Color
AHA IEC AHA IEC
/HIWLQIUDFODYLFXODUIRVVD /$ / %ODFN <HOORZ
5LJKWLQIUDFODYLFXODUIRVVD 5$ 5 :KLWH 5HG
%HORZORZHVWULERQWKHOHIWDQWHULRUD[LOODU\OLQH // F5HG *UHHQ
5LJKWDQWHULRUD[LOODU\OLQHDWWKHVDPHOHYHODV//) 5/ 5) *UHHQ %ODFN
)LIWKLQWHUFRVWDOVSDFHRQWKHOHIWPLGFODYLFXODUOLQH
9SRVLWLRQRIVWDQGDUGOHDGV Va &D %URZQ
blue :KLWH
EURZQ
/HIWDQWHULRUD[LOODU\OLQHDWWKHVDPHOHYHODV9D9
SRVLWLRQRIVWDQGDUGOHDGV Vb &E %URZQ
RUDQJH
:KLWH
EODFN
55
ZM-540PA, ZM-541PA Operator’s Manual
/HDG3RVLWLRQ
Standard limb leads
Monopolar limb leads
Monopolar chest leads
L
ead
I
Lead I Lead II Lead III
aVR lead aVL lead aVF lead
V1 to V
6
leads
to
V1 to V6 leads
RA
RA
RA RA RA
RA
RA
LA
LA
LA
LA
LA
LALA
LL
LL
LL
LL LL
LL
LL
N (RL)
N (RL)
N (RL) N (RL) N (RL)
N (RL)
N (RL)
Three Electrodes
/HDG0,,ZKLFKLVVLPLODUWRVWDQGDUGOHDG,,XVHGZKHQ(&*PHDVXUHPHQWKDVSULRULW\
Electrode Position Symbol Lead Color
AHA IEC AHA IEC
/HIWLQIUDFODYLFXODUIRVVD /$ / %ODFN <HOORZ
5LJKWLQIUDFODYLFXODUIRVVD 5$ 5 :KLWH 5HG
%HORZORZHVWULERQWKH
OHIWDQWHULRUD[LOODU\OLQH // F5HG *UHHQ
L/LA
(N)
R/RA
(−)
F/LL
(+)
56
ZM-540PA, ZM-541PA Operator’s Manual
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Electrode Positions for Respiration Monitoring
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R or RA F or LL
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(−)
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57
ZM-540PA, ZM-541PA Operator’s Manual
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R or RA F or LL
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3RVLWLRQ
,QWKLVSRVLWLRQWKHUHVSLUDWLRQPHDVXUHPHQWLVLQÀXHQFHGE\WKHLPSHGDQFHYDULDWLRQRIWKH
DEGRPHQVRWKHFDUGLDFSXOVHZDYHLQFOXGHGLQWKHUHVSLUDWLRQZDYHLVUHGXFHG1RWHWKDWWKH
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GXULQJLQVSLUDWLRQ,WLVGLI¿FXOWWRPHDVXUHWKH(&*DWWKHVDPHWLPH
R or RA F or LL
/RZHVWULERQWKHULJKW
DQWHULRUD[LOODU\OLQH
/RZHVWULERQWKHOHIWDQWHULRU
D[LOODU\OLQH
Attaching Electrodes to the Patient and Connecting the Electrode Leads
to Disposable Electrodes
Prepare the Patient Skin
6KDYHRIIH[FHVVLYHERG\KDLU
7RUHGXFHVNLQLPSHGDQFHFOHDQWKHHOHFWURGHVLWHZLWKFUHDPRUZLWKDFRWWRQSDGPRLVWHQHG
ZLWKDOFRKRO7KRURXJKO\GU\WKHVNLQZLWKDFOHDQFRWWRQSDG
NOTE For a patient with frequent body movement, rub the sites with Skinpure
skin preparation gel. However, do not use Skinpure skin preparation gel on
sensitive skin.
'RQRWSODFHHOHFWURGHVRQDZRXQGRURQDQLQÀDPHGZULQNOHGRUXQHYHQ
skin surface.
Attaching Electrodes to the Patient
Do not reuse disposable parts and accessories.
CAUTION
N
R/RA
(−)
F/LL
(+)
N
R/RA
(−)
F/LL
(+)
58
ZM-540PA, ZM-541PA Operator’s Manual
NOTE To maintain good contact between the electrode and skin, check that the
paste of the disposable electrode is not dry.
When contact between the disposable electrode and skin becomes
poor, replace electrodes with new ones immediately. Otherwise, contact
impedance between the skin and the electrode increases and accurate
ECG cannot be obtained.
5HIHUWRWKHHOHFWURGHRSHUDWRUVPDQXDOIRUGHWDLOV
1 &DUHIXOO\UHPRYHWKHEDFNLQJSDSHUIURPWKH
HOHFWURGH$YRLGWRXFKLQJWKHDGKHVLYHVXUIDFH
2 3ODFHWKHHOHFWURGHRQWKHSUHYLRXVO\FOHDQHGVNLQ
3D\DWWHQWLRQWRWKHHOHFWURGHOHDGFRORUDQGV\PERO
3 &OLSWKHHOHFWURGHOHDGWRWKHHOHFWURGH
4 )DVWHQWKHHOHFWURGHOHDGZLUHZLWKVXUJLFDOWDSH
ZLWKDQH[WUDOHQJWKRIZLUHEHWZHHQWKHWDSH
DQGWKHHOHFWURGH7KLVOHVVHQVWKHPRYHPHQWRI
HOHFWURGHOHDGVE\ERG\PRYHPHQWDQGKHOSVVWDEOH
PRQLWRULQJ
Checking ECG on the Transmitter Screen
$IWHUDWWDFKLQJHOHFWURGHVDQGFRQQHFWLQJ(&*OHDGVFKHFNWKDWWKHHOHFWURGHVDUHSURSHUO\
DWWDFKHGWRWKHSDWLHQWDQGWKH(&*ZDYHIRUPLVDFTXLUHGRQWKHFKHFNHOHFWURGHVVFUHHQ)RU
GHWDLOVRQWKHVFUHHQUHIHUWRWKH³6FUHHQ'HVFULSWLRQV´VHFWLRQ
59
ZM-540PA, ZM-541PA Operator’s Manual
Attaching the SpO2 Probe
Selecting the SpO2 Probe
6HOHFWDQDSSURSULDWHSUREHIRUWKHSDWLHQW
Only use Nihon Kohden specified electrodes,
electrode leads and SpO2 probes. Otherwise, the
maximum performance from the transmitter cannot
be guaranteed.
CAUTION
Do not use a damaged or disassembled probe. It
causes incorrect measurement and may injure the
patient.
CAUTION
Reusable Probes
:KHQXVLQJD7/7¿QJHUSUREHFKRRVHWKHDSSURSULDWHFDEOHOHQJWKIRUDWWDFKPHQW
Probe Cable Length Patient Attachment
Site
)LQJHUSUREH7/7 P
Adult or child
NJRUPRUH
)LQJHU
P
)LQJHUSUREH
7/77/7
Attachment
tape
7/7
P
Adult or child
NJRUPRUH
7/7
P
60
ZM-540PA, ZM-541PA Operator’s Manual
Probe Cable Length Patient Attachment
Site
)LQJHUSUREH
7/77/7
Attachment
tape
7/7
P
Adult or child
NJRUPRUH )LQJHURUWRH
7/7
P
0XOWLVLWHSUREH7/7
Attachment
tape
P
$GXOWRULQIDQW
NJRUPRUH )LQJHURUWRH
Neonate
NJRUOHVV ,QVWHSDQGVROH
Disposable Probes
The disposable probe is not sterilized. Use the
disposable probe only for a single patient. Never
reuse the disposable probe for another patient
because it causes cross infection.
CAUTION
Probe Patient Attachment Site
6S22SUREH7/67/6
Attachment tape
40 mm
&DEOHOHQJWK 7/6 P
7/6 P
Adult
NJRUPRUH )LQJHU
Neonate
NJRUOHVV ,QVWHSDQGVROH
61
ZM-540PA, ZM-541PA Operator’s Manual
Probe Patient Attachment Site
6S22SUREH7/67/6
35 mm
Attachment tape
&DEOHOHQJWK 7/6 P
7/6 P
Adult or child
WRNJ )LQJHU
,QIDQW
WRNJ 7RH
6S22SUREH7/77/7
&DEOHOHQJWK 7/7 P
 7/7P
Adult
NJRUPRUH )LQJHURUWRH
6S22SUREH7/77/7
&DEOHOHQJWK 7/7 P
 7/7P
&KLOG
WRNJ )LQJHURUWRH
6S22SUREH7/77/7
&DEOHOHQJWK 7/7 P
 7/7P
Neonate
NJRUOHVV ,QVWHSDQGVROH
Adult
NJRUPRUH )LQJHURUWRH
6S22SUREH7/77/7
&DEOHOHQJWK 7/7 P
 7/7P
,QIDQW
WRNJ )LQJHURUWRH
62
ZM-540PA, ZM-541PA Operator’s Manual
Connecting the SpO2 Probe to the Transmitter
&RQQHFWWKHSUREHWRWKH6S22VRFNHWRQWKHWUDQVPLWWHU
NOTE: Hold the connector of the probe cable when connecting or disconnecting the
probe. Pulling the cable may damage the probe.
When transmitter is attached on an arm
Do not shake or swing the transmitter while holding
the leads or cables connected to the transmitter.
The transmitter may come off and injure someone
or damage surrounding instruments.
CAUTION
Do not use a damaged or disassembled probe. It
causes incorrect measurement and may injure the
patient.
CAUTION
63
ZM-540PA, ZM-541PA Operator’s Manual
Attaching the Probe to the Patient
$WWDFKWKHSUREHWRWKHSDWLHQWE\UHIHUULQJWRWKHSUREH¶VPDQXDO0DNHVXUHWKDWWKHOLJKW
HPLWWHUDQGSKRWRGHWHFWRURIWKHSUREHIDFHHDFKRWKHUDWWKHDWWDFKPHQWVLWH
WARNING
When using the TL-201T finger probe, do not
fasten the probe and cable to the finger by
wrapping with tape. This may cause burn,
congestion or pressure necrosis from poor blood
circulation.
When using probes other than the TL-201T
finger probe, to avoid poor circulation, do not
wrap the tape too tight. Check the blood
circulation condition by observing the skin color
and congestion at the skin peripheral to the
probe attachment site. Even for short-term
monitoring, there may be burn or pressure
necrosis from poor blood circulation, especially
on neonates or low birth weight infants whose
skin is delicate. Accurate measurement cannot
be performed on a site with poor peripheral
circulation.
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse
waveform. Change the measurement site every 8
hours for disposable probes and every 4 hours for
reusable probes (every 8 hours for TL-631T series
probe). The skin temperature may increase at the
attached site by 2 or 3°C (4 or 5°F) and cause a
burn or pressure necrosis. When using the probe
on the following patients, take extreme care and
change the measurement site more frequently
according to symptoms and degree.
Patient with a fever
Patient with insufficient peripheral circulation
Neonate or low birth weight infant with delicate
skin
64
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When monitoring SpO2 of a patient who is
receiving photodynamic therapy, the light from the
finger probe sensor may cause a burn.
Photodynamic therapy uses a photosensitizing
agent that has a side effect of photosensitivity.
7KH6S22SUREHVPDQXIDFWXUHGE\1LKRQ.RKGHQKDYHWZRZDYHOHQJWKVZLWKSHDNVLQWKH
UDQJHRIDQGQP7KHPD[LPXPOLJKWLQWHQVLW\LVOHVVWKDQP:
If the attachment site is dirty with blood or bodily
fluids, clean the attachment site before attaching
the probe. If there is nail polish on the attachment
site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
performed.
CAUTION
When the probe is attached on an appropriate site
with sufficient thickness and the error message
confirming the probe attachment repeatedly
appears, the probe may be deteriorated. Replace it
with a new one.
CAUTION
If the skin gets irritated or redness appears on the
skin from the probe, change the attachment site or
stop using the probe. Take extreme care for the
patients with delicate skin.
CAUTION
Do not use a probe which is deteriorated by aging.
Accurate measurement cannot be performed.
CAUTION
65
ZM-540PA, ZM-541PA Operator’s Manual
Attaching the NIBP Cuff
Selecting the NIBP Cuff
6HOHFWWKH1,%3FXIIDSSURSULDWHIRUWKHSDWLHQW
NOTE: NIBP cannot be measured on neonates using this transmitter.
Reusable Cuffs
:KHQDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPDVSHFLDO1,%3FXIILVUHTXLUHG$QRSWLRQDO
<13H[WHQVLRQKRVHPLVDYDLODEOHWRH[WHQGWKHOHQJWKEHWZHHQWKH1,%3VRFNHWRQ
WKHWUDQVPLWWHUDQG1,%3FXIIHJZKHQQRWDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPDQG
SODFLQJWKHWUDQVPLWWHURQDEHGVLGH
Reusable Cuff Model Width (cm) Air Hose Length (cm)
For adult Standard <33 

/DUJH <33 
Width
Air hose
66
ZM-540PA, ZM-541PA Operator’s Manual
:KHQQRWDWWDFKLQJWKHWUDQVPLWWHUWRWKHSDWLHQWDUPWKHIROORZLQJFXIIVFDQEHXVHG7RXVH
WKHVHFXIIVDQRSWLRQDO<13H[WHQVLRQKRVHPLVUHTXLUHG
Reusable Cuff Model Width (cm) Air Hose Length (cm)
)RULQIDQW <37 

For child
Small <37 
Standard <37 
<37
For adult Standard <37 
<37
/DUJH <37 
Width
Air hose
67
ZM-540PA, ZM-541PA Operator’s Manual
Disposable Cuffs
Disposable cuffs are not sterilized. If necessary,
sterilize the cuff using glutaraldehyde solution.
CAUTION
Disposable Cuff Model Width (cm) Air Hose Length (cm)
)RULQIDQW <33 6

For child <33 8
For adult
Small <33 
Standard <33 
0HGLXP
ODUJH <33 
/DUJH <33 
([WUDODUJH <33 
Width
Air hose
Extension Hose
When using an extension hose, check that the
extension hose is not bent or squeezed.
Otherwise, the cuff might not inflate or deflate. If
the cuff cannot deflate, it may cause congestion on
the patient at the cuff attachment site.
CAUTION
YN-990P extension hose, 150 cm
68
ZM-540PA, ZM-541PA Operator’s Manual
Reference for selecting a cuff
7KH$+$$PHULFDQ+HDUW$VVRFLDWLRQUHFRPPHQGVWKDWWKHFXIIZLGWKEHRIWKH
FLUFXPIHUHQFHRIWKHXSSHUDUP5HIHUWRWKHIROORZLQJJUDSKDQGVHOHFWWKHFXIIZKLFKVXLWV
WKHSDWLHQW¶VDUP
NOTE If a range of arm circumference appropriate for the cuff is prescribed, use a
cuff within that range.
To obtain accurate measured values, select a wide cuff which can be
attached to the upper arm. Measuring with a very narrow cuff may result in
measured values higher than the actual values.
The YP-503P NIBP cuff is for standard size adult. Do not use this cuff when
LWGRHVQRW¿WWKHSDWLHQW
15
10
5
10 20 30 40 50
0
20
15
10
5
10 20 30 40 50 60
0
60
Cuff width (cm)
Arm circumference (cm)
Infants YP-960T
Children small YP-961T
Children standard YP-962T
YP-702T
Adults standard YP-503P (cuff for transmitter)
YP-963T, YP-703T
Adults large YP-504P (cuff for transmitter)
YP-964T
Cuff Width and Arm Circumference
Reusable Cuffs
Cuff width (cm)
Arm circumference (cm)
Children standard YP-811P
Adults large YP-815P
Disposable Cuffs
Infants YP-810P
Adults small YP-812P
Adults standard YP-813P
Adults medium large YP-814P
Adults extra large YP-816P
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Connecting the NIBP Cuff to the Transmitter
When Using YP-503P/YP-504P NIBP Cuff
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YP-503P/YP-504P NIBP cuff
Front cover Air hose
D ring
Belt
Belt for the strap
Lock plate pocket Front cover open
Lock plate
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WUDQVPLWWHU
NOTE: Do not roll up or put weight on the cuff when
the lock plate is attached to it. The lock plate
may break if the cuff is rolled up or weight is
put on it when the lock plate attached.
Top tab
Bottom tab
70
ZM-540PA, ZM-541PA Operator’s Manual
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1
2
71
ZM-540PA, ZM-541PA Operator’s Manual
When Using YP-810P series Disposable Cuffs or YP-702T/703T or YP-960T series
Reusable Cuffs
To use these NIBP cuffs, an optional YN-990P extension hose (1.5 m) is required.
NOTE: Connect the joints properly. If there is an air leak, NIBP cannot be measured
properly.
1 Connect the NIBP cuff to the extension hose.
2 Connect the other end of the extension hose to
the NIBP socket on the transmitter. Turn the joint
clockwise until it clicks.
To disconnect the cuff from the transmitter, turn the
hose joint counterclockwise.
Attaching the NIBP Cuff to the Patient
WARNING
Be careful when measuring NIBP on a patient with
known bleeding disorders or coagulation. After
NIBP measurement, there may be dot
hemorrhage, or circulatory disorder by thrombus
where the cuff is attached.
Do not wrap the cuff on an arm or thigh which is
used for injection. NIBP measurement on an arm
or thigh which is used for injection may cause
reflux of blood and stop injection.
CAUTION
72
ZM-540PA, ZM-541PA Operator’s Manual
Do not attach the cuff to the site where there is
injury or inflammation. If the skin gets irritated or
redness appears on the skin from the cuff, change
the attachment site or stop using the cuff. Take
extreme care on the patients with delicate skin.
CAUTION
Do not wrap the cuff too tight. It may cause poor
blood circulation and congestion. If the cuff is
wrapped too loosely, the NIBP value may increase.
CAUTION
Do not reuse disposable parts and accessories.
CAUTION
NIBP and SpO2 can be measured on the same
limb, but the SpO2 monitoring might not be
accurate during NIBP measurement. Be careful
when reading the SpO2 values.*
CAUTION
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EHPRQLWRUHGSURSHUO\:KHQ³,1+,%,76S22'85,1*1,%3´RQWKH3$5$0(7(5
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73
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NOTE Measuring NIBP at a site other than the upper arm gives different values
from those measured at the upper arm. When making diagnosis based on
the NIBP values, measure NIBP on an upper arm.
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wrapped around a bare upper arm.
Do not use an abnormal cuff. The cuff deteriorates from use and cleaning.
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it with a new one.
Refer to the NIBP cuff manual for details.
Cuff Position
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DGMXVWHG
When placing the transmitter on
a bed, make sure that the hose is
not bent.
Heart
74
ZM-540PA, ZM-541PA Operator’s Manual
Attaching the Transmitter on an Arm (Using the YP-503P/YP-504P NIBP Cuff)
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NOTE: The cuff must not wrap around the
elbow.
Belt
D ring End of cuff
75
ZM-540PA, ZM-541PA Operator’s Manual
Attaching the Strap to the Transmitter
NOTE Use the strap to prevent the transmitter from falling.
Do not attach the clip to hard objects such as thick cloth or zipper. It will
break the clip.
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Belt for the strap on the NIBP cuff
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ZM-540PA, ZM-541PA Operator’s Manual
Placing the Transmitter on the Bed (Using the YP-810P series Disposable Cuffs or
YP-702T/703T or YP-960T series Reusable Cuffs)
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77
ZM-540PA, ZM-541PA Operator’s Manual
Locking the Keys on the Transmitter
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VFUHHQDSSHDUV
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ZM-540PA, ZM-541PA Operator’s Manual
Monitoring
The measurement values and displayed
waveforms on the transmitter and receiving
monitor may be different due to timing delay of the
display or difference in detection settings.
CAUTION
NOTE The waveforms displayed on the check electrodes screen are just to check
that the electrode or probe is attached to the patient properly. Do not use
the displayed waveforms for other purposes.
Do not let the transmitter directly touch the patient’s skin. The transmitter
temperature rises and this may cause burn to the patient.
Screen Descriptions
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GLVSOD\RIIĺFKHFNHOHFWURGHV
Screen key
79
ZM-540PA, ZM-541PA Operator’s Manual
Check Electrodes Screen
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:KHQOHDGVDUHXVHGRQO\WKHOHDG,,ZDYHIRUPLVGLVSOD\HG
Channel number
Battery level
ECG waveform
Filter: Off
Sweep speed: 12.5 mm/s
Waveform sensitivity: 0.5 cm/1 mV
Lead
Detached electrode
position
Message
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electrode position appear
RQWKHVFUHHQ
NOTE: When ECG measurement is set to OFF on the PARAMETER SETUP screen,
the check electrodes screen does not appear.
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ZM-540PA, ZM-541PA Operator’s Manual
Numeric and Waveform Screen
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WKH(&*OHDGZLWKWKHŻDQGŹNH\V
Heart rate
QRS sync mark
Pulse bar graph
SpO2
Respiration rate
NIBP values
ECG waveform
Filter: On
Sweep speed: 12.5 mm/s
Waveform sensitivity: Auto
Waveform
sensitivity
ECG lead
NIBP measurement
mode
When ECG and respiration measurement is turned off
Pulse rate
Pulse sync mark
SpO2
Pulse wave
sensitivity
Pulse waveform
Sweep speed: 12.5 mm/s
Waveform sensitivity: Auto
NIBP values
NIBP measurement
mode
81
ZM-540PA, ZM-541PA Operator’s Manual
NOTE: The pulse wave amplitude varies according to the ratio of the pulsation
component to the entire transmitted IR signal. When the pulsation component
ratio is 1%, the pulse wave amplitude is about 5 mm at ×1 sensitivity on the
screen.
Waveform Review Screen
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ECG lead
Displayed
page
Compressed ECG waveform
7.5 s × 4 traces per page, total 20 pages
Older data
Newer data
Time range of the displayed waveform
(time before the waveform review screen is displayed)
Waveform sensitivity
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82
ZM-540PA, ZM-541PA Operator’s Manual
Numeric Review Screen
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NOTE: NIBP measured values are not saved.
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VFUHHQLVGLVSOD\HG
Older data
Newer data
Display Off
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10-second time bar
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ZM-540PA, ZM-541PA Operator’s Manual
Basic Monitoring Operation
Using the Function Key
Function key
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SETUP screen of the transmitter must be set to 57 and the receiving monitor
must be able to receive protocol 57. A central monitor with an ORG-9100A
series multiple patient receiver whose software version 02-01 or later can
receive this protocol.
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Suspending Alarms on the Receiving Monitor
WARNING
While the “ALARMS SUSPENDED” message is
displayed on the transmitter, all alarms on the
receiving monitor are suspended so keep the
patient under close observation.
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Message Icon
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Pausing Monitoring
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NOTE: To use the Function key for pause, “PROTOCOL” on the SYSTEM screen of
the transmitter must be set to 57 and the receiving monitor must be able to
receive protocol 57.
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Resuming Monitoring after Pause
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WARNING
When the patient returns to the bed, turn on the
transmitter and check that the monitoring is
resumed on the receiving monitor.
WARNING
If the transmitter is not turned off and monitoring
continues for the selected interval, pause
monitoring is canceled and monitoring continues.
Check that the monitoring is resumed on the
receiving monitor.
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Message
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Turning the Display Off
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NOTE: If longer than “1 min” is selected, it reduces the battery lifetime.
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Turning the Display On after It was Turned Off
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ECG and Respiration Monitoring
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Heart rate
QRS sync mark Respiration rate
ECG lead
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ECG waveform Filter: On
Sweep speed: 12.5 mm/s
Waveform sensitivity: Auto
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WARNING
The bioelectric impedance measurement sensor of
a minute ventilation rate-adaptive implantable
pacemaker may be affected by transmitter which is
connected to the same patient. If this occurs, the
pacemaker may pace at its maximum rate and the
transmitter may give incorrect data to the monitor.
If this occurs, disconnect the electrode leads from
the patient or change the setting on the pacemaker
by referring to the pacemaker’s manual. For more
details, contact your pacemaker representative or
Nihon Kohden representative.
WARNING
Turn the pacing pulse detection to ON on the
receiving monitor when monitoring a pacemaker
patient. Otherwise the pacemaker pulse is not
rejected. However, even when the pacing pulse
detection is set to ON, the pacemaker pulse might
not be rejected. When the pacemaker pulse is not
rejected, the pacemaker pulse is detected as QRS
and false heart rate may be indicated or critical
arrhythmia such as asystole may be overlooked.
Keep pacemaker patients under close observation.
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WARNING
Even when the pacing pulse detection is set to ON
on the receiving monitor, the pacemaker pulse can
be overlooked or detected as QRS. You cannot
confirm the pacemaker operation only from the
detected pacemaker pulse.
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WARNING
When the transmitter is used with an
electrosurgical unit (ESU), firmly attach the entire
area of the ESU return plate. Otherwise, the
current from the ESU flows into the electrodes of
the transmitter, causing electrical burn where the
electrodes are attached. For details, refer to the
ESU manual.
Turn off the power of mobile phones, small
wireless devices and other devices which produce
strong electromagnetic interference around a
patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as
mobile phones or small wireless devices may be
mistaken as pulse waves or respiration waves and
the displayed data may be incorrect.
CAUTION
When the “NOISE” message is displayed on the
receiving monitor, ECG is not monitored and the
ECG alarm does not function. Remove the cause
by checking the electrodes, electrode leads,
patient’s body movement, EMG and peripheral
instruments grounding. Also make sure that an
electric blanket is not used.
CAUTION
NOTE Noise generated from an electrosurgical unit may interfere on an ECG
waveform, but will not damage it.
If an electric blanket is used and incorrect heart rate is displayed on the
monitor, turn off the pacing spike detection on the monitor.
Turn the pacing spike detection to ON on the receiving monitor when
monitoring a pacemaker patient. Pacing pulse is detected by the transmitter
and transmitted to the monitor. If the pacing spike detection is turned OFF,
QRS and pacemaker spike might not be distinguished and pacemaker
failure might not be recognized.
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the waveform recovery may be slow.
ECG cannot be monitored on a neonate using this transmitter.
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Turning ECG Measurement On/Off
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When “PROTOCOL” on the SYSTEM screen is set to 57:
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When “PROTOCOL” on the SYSTEM screen is set to 42:
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Turning Respiration Measurement On/Off
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Electrode Detachment
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When the “CHECK ELECTRODES” message is
displayed on the receiving monitor, ECG is not
monitored properly and the ECG alarm does not
function. Check the electrode, electrode leads, and
if necessary, replace with new ones.
CAUTION
93
ZM-540PA, ZM-541PA Operator’s Manual
SpO2 Monitoring
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Pulse bar graphSpO2
NOTE: During SpO2 monitoring, the transmitter constantly checks the light intensity
of the probe and adjusts the light intensity to maintain optimum measurement
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seconds.
94
ZM-540PA, ZM-541PA Operator’s Manual
Measuring Principle
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300 400 500 600 700 800 900 1,000
200
100
10
1
0.1
0.05
Extinction Coefficient (cm)-1 (mmol/L)-1
Wavelength (nm: 10-9m)
Oxyhemoglobin
Deoxyhemoglobin
SpO2
660 nm
940 nm
0% 100%
Light Absorption
Light Absorption
Time
Tissue, venous blood
Arterial blood
Fig. 1
Fig. 3
Fig. 2
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ZM-540PA, ZM-541PA Operator’s Manual
WARNING
SpO2 measurement may be incorrect in the
following cases.
When the patient’s carboxyhemoglobin or
methemoglobin increases abnormally.
When dye is injected in the blood.
• During CPR.
When measuring at a site with venous pulse.
When there is body movement.
When the pulse wave is small (insufficient
peripheral circulation).
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse
waveform. Change the measurement site every 8
hours for disposable probes and every 4 hours for
reusable probes (every 8 hours for TL-631T series
probe). The skin temperature may increase at the
attached site by 2 or 3°C (4 or 5°F) and cause a
burn or pressure necrosis. When using the probe
on the following patients, take extreme care and
change the measurement site more frequently
according to symptoms and degree.
Patient with a fever
Patient with insufficient peripheral circulation
Neonate or low birth weight infant with delicate
skin
WARNING
When monitoring SpO2 of a patient who is
receiving photodynamic therapy, the light from the
finger probe sensor may cause a burn.
Photodynamic therapy uses a photosensitizing
agent that has a side effect of photosensitivity.
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96
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WARNING
When not monitoring SpO2, disconnect the SpO2
cable from the transmitter. Otherwise, noise from
the probe sensor may interfere and incorrect data
is displayed on the screen.
Turn off the power of mobile phones, small
wireless devices and other devices which produce
strong electromagnetic interference around a
patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as
mobile phones or small wireless devices may be
mistaken as pulse waves or respiration waves and
the displayed data may be incorrect.
CAUTION
Handle the probe cable according to the following
cautions. Failure to follow these cautions may
cause cable discontinuity or short circuit of the
probe cable which may cause incorrect
measurement data or inability to perform
measurement. Also in rare cases, the probe
temperature may increase and cause skin burn on
the patient. If the probe cable is damaged, replace
the probe with a new one.
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CAUTION
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring
site with a blanket.
CAUTION
97
ZM-540PA, ZM-541PA Operator’s Manual
When the probe is attached on an appropriate site
with sufficient thickness and the error message
confirming the probe attachment repeatedly
appears, the probe may be deteriorated. Replace it
with a new one.
CAUTION
When a message indicates a faulty probe, stop
monitoring and replace the probe with a new one.
CAUTION
While a patient is on medication which causes
vasodilation, the pulse waveform may change and
in rare cases the SpO2 value might not be
displayed.
CAUTION
When monitoring SpO2 only, detection of
arrhythmia and asystole is not available and
arrhythmia alarms such as ASYSTOLE, VF or VT
are not available. If the patient requires ECG
monitoring, monitor the ECG.
CAUTION
When monitoring SpO2 only (without ECG
monitoring), turn on both the upper and lower limit
alarms for PR and SpO2 on the receiving monitor. If
the patient’s pulse is not detected during asystole
or other condition, a “CANNOT DETECT PULSE”
or “CHECK PROBE” alarm occurs instead of an
SpO2 limit alarm. Furthermore, if the patient has no
pulse, noise from probe movement could be
misjudged as a pulse and cause an incorrect PR or
SpO2 value to be displayed.
CAUTION
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ZM-540PA, ZM-541PA Operator’s Manual
NOTE  ,QRUGHUWRPDLQWDLQVXI¿FLHQWEORRGFLUFXODWLRQNHHSWKHPHDVXUHPHQWVLWH
warm by covering it with a blanket or something similar. Warming the site is
effective, especially for a patient with a small pulse amplitude.
When monitoring a patient who has an IABP and SpO2 cannot be
measured, monitor the patient on a wired monitor. If the monitor has a
sensitivity mode, set the mode to “MAX”.
Unlike ECG monitoring, detection of arrhythmia and asystole is not
available when monitoring SpO2 only. If SpO2 is monitored without ECG,
PR and SpO2 alarms do not occur during asystole because PR and SpO2
values are not measured when there is no pulse. Furthermore, if the patient
has no pulse, noise from probe movement could be misjudged as a pulse
and cause an incorrect PR or SpO2 value to be displayed.
Monitoring SpO2 during NIBP Measurement
NIBP and SpO2 can be measured on the same
limb, but the SpO2 monitoring might not be
accurate during NIBP measurement. Be careful
when reading the SpO2 values.*
CAUTION
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NOTE When continuous SpO2 monitoring is necessary, attach the probe to the
limb to which the NIBP cuff is not attached and set “INHIBIT SpO2 DURING
NIBP” on the PARAMETER SETUP screen to OFF.
When the probe is attached to the same limb as the NIBP cuff, set the sync
source to a parameter other than SpO2 on the receiving monitor.
When monitoring SpO2 during STAT NIBP measurement, attach the probe
to the limb to which the NIBP cuff is not attached.
99
ZM-540PA, ZM-541PA Operator’s Manual
NIBP Monitoring
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Selecting the Measurement Mode and Interval
Measurement Modes
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Selected mode
(key color: blue)
Modes selected
at “SELECTABLE
INTERVALS” on the
PARAMETERS SETUP
screen
(key color: white)
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100
ZM-540PA, ZM-541PA Operator’s Manual
Manual Measurement
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101
ZM-540PA, ZM-541PA Operator’s Manual
Measuring NIBP
WARNING
Be careful when measuring NIBP on a patient with
known bleeding disorders or coagulation. After
NIBP measurement, there may be dot
hemorrhage, or circulatory disorder by thrombus
where the cuff is attached.
WARNING
NIBP measurement may be incorrect in the
following situations.
When using an ESU
• Body movement
Small pulse wave
Too many arrhythmias
Shaking from an external source
Rapid blood pressure change
• During CPR
• Slow pulse
Low blood pressure
Small pulse pressure
Cuff is too tight or too loose
Cuff does not fit the arm
Cuff is wrapped over thick clothing
Cuff is deteriorated
• Arterial sclerosis
• Poor perfusion
• Diabetes
• Age
• Pregnancy
• Pre-eclampsia
• Renal disease
• Shivering
• Trembling
102
ZM-540PA, ZM-541PA Operator’s Manual
WARNING
When performing NIBP measurements in STAT
mode or 5 minute intervals, periodically remove the
cuff from the patient for ventilation. The skin
temperature may increase at the cuff attachment
site by 2 or 3°C (4 or 5°F). When measuring a
patient with a fever or peripheral circulation
insufficiency, it may cause a burn.
WARNING
When performing long term measurement at
intervals less than 5 minutes, perform
measurements while observing the state of the
patient, blood vessels and limb to ensure adequate
circulation. Congestion may occur at the
measurement site. When performing periodic
measurement for a long time, periodically check
the circulation condition.
When performing NIBP measurement repeatedly,
have a rest between measurements to recover
adequate circulation.
CAUTION
NOTE When measuring patients who are conscious, help the patient to relax.
Measurement may not be accurate if the patient’s arm is tense or if the
patient talks.
The data for measurement on a leg tends to be higher than measurement
on the arm. When making diagnosis based on the NIBP values, measure
NIBP on an upper arm.
Do not apply pressure to the cuff or air hose. NIBP may not be measured
correctly because of noise or NIBP measurement may stop due to the
NIBP safety circuit.
When the transmitter is attached to the patient arm and the NIBP
measurement is performed when moving, tell the patient to relax and keep
quiet. Otherwise, measurement may be stopped or remeasurement is
repeated due to body movement.
If there is an abnormal noise generated during measurement, stop using
the transmitter and contact your Nihon Kohden representative.
103
ZM-540PA, ZM-541PA Operator’s Manual
Do not measure NIBP of a patient on whom an IABP is being used.
Measurement may be incorrect due to the mixing of the patient’s own pulse
and IABP pulse.
NIBP cannot be measured on a neonate using this transmitter.
For Accurate NIBP Measurement
0DNHVXUHWKHSDWLHQWLVFRPIRUWDEO\VHDWHG'RQRWSHUIRUPPHDVXUHPHQWLPPHGLDWHO\
DIWHUWKHSDWLHQWLVVHDWHG.HHSWKHSDWLHQWLQWKHUHVWLQJVWDWHIRU¿YHPLQXWHVEHIRUH
PHDVXUHPHQW
0DNHVXUHWKHSDWLHQWKDVOHJVXQFURVVHGIHHWGRZQRQWKHÀRRUDQGEDFNDQGEDFNDUP
VXSSRUWHGGXULQJPHDVXUHPHQW
1 3UHVVWKH1,%3,QWHUYDONH\WRGLVSOD\WKH1,%3PRGHVHWWLQJVFUHHQ
NIBP Interval key
2 6HOHFWWKHPHDVXUHPHQWPRGHE\SUHVVLQJWKH1,%3,QWHUYDONH\RUDQGNH\V
Selected mode
(key color: blue)
3 3UHVVWKH)XQFWLRQNH\
104
ZM-540PA, ZM-541PA Operator’s Manual
4 3UHVVWKH1,%36WDUW6WRSNH\WRSHUIRUPPHDVXUHPHQW
NIBP Start/Stop key
7KHFXIILVLQÀDWHGDQGWKHLQÀDWLRQSUHVVXUHLVGLVSOD\HGRQWKHVFUHHQ
,QÀDWLRQSUHVVXUH
,QPDQXDOPRGH 0HDVXUHPHQWLVSHUIRUPHGRQFH
,Q67$7PRGH 0HDVXUHPHQWLVSHUIRUPHGUHSHDWHGO\IRUPLQXWHV
,QDXWRPRGH 7KH¿UVWPHDVXUHPHQWLVSHUIRUPHGZKHQWKH1,%36WDUW6WRS
NH\LVSUHVVHG7KHVHFRQGPHDVXUHPHQWLVSHUIRUPHGZKHQWKH
FXUUHQWWLPHLQWKHWUDQVPLWWHUUHDFKHVWKHVHOHFWHGWLPHLQWHUYDO
7RVWRSPHDVXUHPHQWGXULQJPHDVXUHPHQWSUHVVWKH1,%36WDUW6WRSNH\DJDLQ
,Q67$7PRGHDIWHUFRPSOHWLQJWKH67$7PHDVXUHPHQWWKHPHDVXUHPHQWPRGH
FKDQJHVWRWKHPRGHVHWIRU³1,%302'($)7(567$7´RQWKH3$5$0(7(5
6(783VFUHHQ
,QDXWRPRGHWRVWRSPHDVXUHPHQWLQDXWRPRGHFKDQJHWKHPRGHWRPDQXDO7RFDQFHO
RQHPHDVXUHPHQWSUHVVWKH1,%36WDUW6WRSNH\GXULQJPHDVXUHPHQW
$IWHUWKHPHDVXUHPHQWLVFRPSOHWHWKHPHDVXUHGGDWDLVGLVSOD\HGRQWKHVFUHHQDQGLV
WUDQVPLWWHGWRWKHPRQLWRU
105
ZM-540PA, ZM-541PA Operator’s Manual
Systolic value Diastolic value
MAP value
NIBP measurement
mode
:KHQ(&*DQG6S22DUHQRWPRQLWRUHG(&*PHDVXUHPHQWLVWXUQHGRIIDQG6S22 probe is
QRWFRQQHFWHGWRWKHWUDQVPLWWHUWKHSXOVHUDWHDWWKHHQGRI1,%3PHDVXUHPHQWLVGLVSOD\HG
$EX]]HUFDQEHVHWWRVRXQGDWWKHVWDUWDQGHQGRI1,%3PHDVXUHPHQW5HIHUWRWKH
³&KDQJLQJ3$5$0(7(56(7836HWWLQJV´VHFWLRQ
Auto Mode Measurement
:KHQDXWRPRGHPHDVXUHPHQWLVVHOHFWHG³67$1'%<´PHVVDJHLVGLVSOD\HGRQWKHVFUHHQ
XQWLOWKH1,%36WDUWNH\LVSUHVVHGIRUWKH¿UVWWLPH
STANDBY message
106
ZM-540PA, ZM-541PA Operator’s Manual
$WLPHEDUDSSHDUVWRLQGLFDWHWKHLQWHUYDOEHWZHHQDXWRPRGHPHDVXUHPHQWV
Time bar indicating
the interval between
measurements
'XULQJDXWRPRGHPHDVXUHPHQWWKHPHDVXUHPHQWPRGHFDQEHFKDQJHG'XULQJWKHLQWHUYDO
SUHVVWKH1,%3,QWHUYDONH\WRFKDQJHWKHPRGH:KHQ³0$18$/´LVGLVSOD\HGIRUPRUH
WKDQRQHVHFRQGWKHPHDVXUHPHQWLQDXWRPRGHLVVWRSSHG
Data Display After NIBP Measurement
:KHQWKHWLPHVHWDW³2/'1,%3'$7$´RQWKH3$5$0(7(56(783VFUHHQHODSVHVDIWHU
WKHODVWPHDVXUHPHQWWKH1,%3GDWDLVGLPPHGRUKLGGHQ:KHWKHUWRGLPRUKLGHWKHROGGDWD
FDQDOVREHVHOHFWHGDW³2/'1,%3'$7$´5HIHUWRWKH³&KDQJLQJ3$5$0(7(56(783
6HWWLQJV´VHFWLRQ
Monitoring SpO2 during NIBP Measurement
:KHQWKH6S22SUREHLVDWWDFKHGWRWKHVDPHOLPEDVWKH1,%3FXIIWKHEORRGÀRZGHFUHDVHV
GXULQJ1,%3PHDVXUHPHQWDQGSXOVHZDYHFDQQRWEHGHWHFWHGDQG6S22 cannot be monitored
SURSHUO\:KHQ³,1+,%,76S22'85,1*1,%3´RQWKH3$5$0(7(56(783VFUHHQLVVHW
WR21IDFWRU\GHIDXOWVHWWLQJ6S22PRQLWRULQJLVSDXVHGGXULQJ1,%3PHDVXUHPHQWWRDYRLG
6S22DODUPRFFXUUHQFH+RZHYHUZKHQPRQLWRULQJ6S22RQWKHVDPHOLPEDVWKH1,%3EH
FDUHIXOZKHQUHDGLQJ6S22YDOXHV
107
ZM-540PA, ZM-541PA Operator’s Manual
Indication and Message List
Indication
Indication Cause Countermeasure
)XOO\FKDUJHGEDWWHULHV
%DWWHULHVDUHIXOO
%DWWHULHVDUHZHDN 5HSODFHWKHEDWWHULHV
%DWWHULHVDUHYHU\ZHDN
&DQQRWPHDVXUH1,%3
$ODUPVRQWKHUHFHLYLQJ
PRQLWRUZHUHVXVSHQGHG
E\SUHVVLQJWKH)XQFWLRQ
NH\RQWKHWUDQVPLWWHU
$ODUPVUHVXPHZKHQ
WKHVXVSHQGLQWHUYDO
HODSVHV7RFDQFHODODUP
suspension, press the
)XQFWLRQNH\DJDLQ
Messages
:KHQ³35272&2/´RQWKH6<67(0VFUHHQLVVHWWRDOOPHVVDJHVDUHWUDQVPLWWHGWR
WKHUHFHLYLQJPRQLWRU:KHQ³35272&2/´LVVHWWRWKHPHVVDJHVPDUNHGZLWKDUHQRW
WUDQVPLWWHGWRWKHUHFHLYLQJPRQLWRU
Message Cause Countermeasure
$,5/($. 7KHFXIIDQGH[WHQVLRQKRVHDUHQRW
properly connected &RQQHFWWKHPSURSHUO\
7KHFXIIKRVHRUH[WHQVLRQKRVHLV
QRWSURSHUO\FRQQHFWHGWRWKH1,%3
VRFNHW
7KHFXIIRUH[WHQVLRQKRVHLV
GDPDJHG
5HSODFHZLWKDQHZRQH
$/$506
6863(1'('
$ODUPVRQWKHUHFHLYLQJPRQLWRULV
VXVSHQGHGE\SUHVVLQJWKH)XQFWLRQ
NH\RQWKHWUDQVPLWWHU
$ODUPVUHVXPHZKHQWKHPLQXWH
VXVSHQGLQWHUYDOHODSVHV7RFDQFHO
alarm suspension, press the Function
NH\DJDLQ
%$77(5<:($. 'HDGEDWWHULHV 5HSODFHEDWWHULHV
108
ZM-540PA, ZM-541PA Operator’s Manual
Message Cause Countermeasure
&$1127
'(7(&738/6(
GLVSOD\HGLQEOXH
3RRUEORRGFLUFXODWLRQIRU
PHDVXULQJWKH6S22YDOXH
&KHFNWKHSDWLHQWFRQGLWLRQSUREH
DWWDFKPHQWRUFKDQJHWKHDWWDFKPHQW
VLWH
7KHSUREHLVDWWDFKHGWRRWLJKWO\DQG
LVREVWUXFWLQJWKHEORRGFLUFXODWLRQ
5HDWWDFKWKHSUREH
7KHSUREHLVQRWDWWDFKHGWRWKH
patient properly Attach the probe to the patient
SURSHUO\
³/,*+7,17(5)(5(1&(´
³&+(&.352%(6,7(´RU
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GLVSOD\HGIRUPRUHWKDQVHFRQGV
5HIHUWRWKHFDXVHDQG
FRXQWHUPHDVXUHIRUHDFKPHVVDJHLQ
WKLV0HVVDJHVWDEOHDQGUHPRYHWKH
FDXVH
&$1127
'(7(&738/6(
GLVSOD\HGLQSLQN
7KHSDWLHQW¶VSXOVHZDYHLVWRR
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7KHFXIILVQRWZUDSSHGRQWKH
patient properly :UDSWKHFXIIRQWKHSDWLHQWSURSHUO\
&+(&.
(/(&752'(6
(OHFWURGHOHDGLVGLVFRQQHFWHGIURP
the electrode Firmly connect the electrode lead to
WKHHOHFWURGH
(OHFWURGHOHDGLVGLVFRQQHFWHGIURP
the transmitter Firmly connect the electrode lead to
WKHWUDQVPLWWHU
(OHFWURGHOHDGGLVFRQWLQXLW\ 5HSODFHWKHHOHFWURGHOHDGZLWKD
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patient properly Attach the probe to the patient
SURSHUO\
7KHSUREHLVQRWDWWDFKHGDWWKH
appropriate site Attach the probe to an appropriate
VLWHLQGLFDWHGLQWKHSUREHPDQXDO
7KHSUREHLVGLVFRQQHFWHGIURPWKH
transmitter &RQQHFWWKHSUREHFDEOHWRWKH
WUDQVPLWWHU
7KHSUREHLVSDVWLWVH[SLUDWLRQGDWH 5HSODFHWKHSUREHZLWKDQHZRQH
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6,7(
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appropriate site Attach the probe to an appropriate
VLWHLQGLFDWHGLQWKHSUREHPDQXDO
7KHSUREHLVGHWHULRUDWHG 5HSODFHWKHSUREHZLWKDQHZRQH
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the patient and contact your Nihon
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109
ZM-540PA, ZM-541PA Operator’s Manual
Message Cause Countermeasure
'(7(&7,1*
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Attach the probe to the patient
SURSHUO\
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patient properly
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7KH6S22 measurement site is under
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patient properly
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&+$1*(
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1,%3FDQQRWEHPHDVXUHGGXHWR
ORZEDWWHU\
5HSODFHEDWWHULHVZLWKQHZRQHV
3$7,(17
&21),50('
)XQFWLRQNH\LVSUHVVHGDQGWKH
³3$7,(17&21),50('´VLJQDOLV
WUDQVPLWWHGWRWKHUHFHLYLQJPRQLWRU
ZKHQ³3$7,(17´LVDVVLJQHGDV
WKHIXQFWLRQIRUWKH)XQFWLRQNH\RQ
WKH6<67(06(783VFUHHQ
352%(
)$,/85(
7KHSUREHLVSDVWLWVH[SLUDWLRQGDWH 5HSODFHWKHSUREHZLWKDQHZRQH
3UREHLVGDPDJHGRUVKRUWFLUFXLWHG
5(0($685,1* 1,%3LVEHLQJUHPHDVXUHGGXH
WRDUUK\WKPLDERG\PRYHPHQW
YLEUDWLRQRUFXIIRUDLUKRVHEHLQJ
VTXHH]HG
,IWKHPHVVDJHVWLOODSSHDUVDIWHU
UHPHDVXUHPHQWUHPRYHWKHFDXVH
LIWKHFDXVHLVERG\PRYHPHQW
YLEUDWLRQRUVTXHH]LQJRIFXIIRU
KRVH
110
ZM-540PA, ZM-541PA Operator’s Manual
Message Cause Countermeasure
6$)(7<
&,5&8,7(5525
7KH1,%3VDIHW\FLUFXLWHUURU ,PPHGLDWHO\UHPRYHWKHFXIIIURP
the patient and contact your Nihon
.RKGHQUHSUHVHQWDWLYH
6$)(7<
&,5&8,7
5811,1*
:KHQWKLV
PHVVDJHLV
displayed,
measurement
cannot be
SHUIRUPHGIRU
VHFRQGV
1,%3PHDVXUHPHQWVWRSSHGE\WKH
VDIHW\FLUFXLW
&KHFNWKDWWKHKRVHLVQRWEHQWRU
VTXHH]HG
:DLWVHFRQGVWKHQSHUIRUP
UHPHDVXUHPHQW,IWKHPHVVDJHVWLOO
appears, contact your Nihon Kohden
UHSUHVHQWDWLYH
6S2202'8/(
(5525
7UDQVPLWWHUIDLOXUH &RQWDFW\RXU1LKRQ.RKGHQ
UHSUHVHQWDWLYH
6<62872)
5$1*(
7KHV\VWROLFEORRGSUHVVXUH
H[FHHGHGWKHWRPP+J
UDQJHDQGWKHEORRGSUHVVXUHFDQQRW
EHPHDVXUHG
0HDVXUHE\SDOSDWLRQRU
DXVFXOWDWLRQ
:($.38/6(
GLVSOD\HGLQEOXH
3RRUSHULSKHUDOFLUFXODWLRQ &KHFNWKHSDWLHQWFRQGLWLRQDQG
FKDQJHWKHSUREHDWWDFKPHQWVLWH
7KHSUREHLVDWWDFKHGWRRWLJKWO\DQG
LVREVWUXFWLQJWKHEORRGFLUFXODWLRQ
&KHFNWKHSUREHDWWDFKPHQW
FRQGLWLRQDQGLIQHFHVVDU\UHDWWDFK
WKHSUREH
:($.38/6(
GLVSOD\HGLQSLQN
7KHSDWLHQW¶VSXOVHZDYHLVWRR
VPDOOWRPHDVXUH1,%3
0HDVXUH1,%3E\SDOSDWLRQRU
DXVFXOWDWLRQ
7KHFXIILVZUDSSHGWRRORRVHO\ :UDSWKHFXIISURSHUO\
7KHFXIIVL]HLVQRWDSSURSULDWH 8VHWKHDSSURSULDWHFXII
=(52,1* 1,%3]HUREDODQFHLVEHLQJDGMXVWHG 'RQRWWRXFKWKHFXIIGXULQJ]HURLQJ
:DLWIRUWKHPHVVDJHWRGLVDSSHDU
111
ZM-540PA, ZM-541PA Operator’s Manual
Message Display Priority
:KHQPRUHWKDQRQHPHVVDJHFRQGLWLRQRFFXUVRQWKHWUDQVPLWWHURQO\WKHPHVVDJHZLWKWKH
KLJKHVWSULRULW\LVGLVSOD\HG
Priority Message
+LJK 3$7,(17&21),50('
6$)(7<&,5&8,75811,1*
&8))2&&/86,21
352%()$,/85(
&+(&.(/(&752'(6
1,%302'8/((5525
6<62872)5$1*(
+,*+&8))35(66
$,5/($.
0($67,0(287
&$1127'(7(&738/6(1,%3
6S2202'8/((5525
&+(&.352%(
&+(&.352%(6,7(
&$1127'(7(&738/6(6S22
/,*+7,17(5)(5(1&(
5(0($685,1*
,1)/$7,2135(66/2:
:($.38/6(1,%3
=(52,1*
121,%3&+$1*(%$77(5,(6
'(7(&7,1*38/6(
:($.38/6(6S22
$/$5066863(1'('
%$77(5<:($.
/RZ %$77(5<:($.
112
ZM-540PA, ZM-541PA Operator’s Manual
Troubleshooting
,IDSUREOHPRFFXUVXVHWKHIROORZLQJWDEOHVWR¿QGDQG¿[LW,IWKHSUREOHPVWLOOUHPDLQVDIWHU
WURXEOHVKRRWLQJDFFRUGLQJWRWKHVHWDEOHVFRQWDFW\RXU1LKRQ.RKGHQUHSUHVHQWDWLYH
Transmitter
Problem Cause Countermeasure
1RWKLQJLVGLVSOD\HG
RQWKH/&'DIWHU
WXUQLQJWKHSRZHU
RQ
%DWWHULHVDUHQRWLQVWDOOHG
FRUUHFWO\7KHEDWWHU\SRODULW\
LVZURQJ
,QVWDOOWKHEDWWHULHVFRUUHFWO\
%DWWHULHVDUHFRPSOHWHO\
GLVFKDUJHG
5HSODFHWKHEDWWHULHVZLWKQHZRQHV
/&'LVGLI¿FXOWWR
VHHWRRGDUNRUWRR
OLJKW
/&'EULJKWQHVVLVQRW
DSSURSULDWH
&KDQJHWKH/&'EULJKWQHVVRQWKH
6<67(06(783VFUHHQ5HIHUWRWKH
³&KDQJLQJ6<67(06(7836HWWLQJV´
VHFWLRQ
1RWKLQJLV
displayed on the
UHFHLYLQJPRQLWRU
DIWHUWXUQLQJWKH
WUDQVPLWWHUSRZHU
RQ
7KHFKDQQHORIWKHWUDQVPLWWHU
DQGPRQLWRUGRHVQRWPDWFK
6HWWKHFRUUHFWFKDQQHORQWKHPRQLWRU
7KHVRIWZDUHYHUVLRQRIWKH
PXOWLSOHSDWLHQWUHFHLYHURU
FHQWUDOPRQLWRULVROG
8SJUDGHWKHPXOWLSOHSDWLHQWUHFHLYHU
RUFHQWUDOPRQLWRUVRIWZDUHWRUHFHLYH
VLJQDOIURPWKHWUDQVPLWWHU7KH
VRIWZDUHYHUVLRQPXVWEHRUODWHU
3URWRFRORQWKHWUDQVPLWWHUDQG
PRQLWRUGRHVQRWPDWFK
Set the same protocol on the transmitter
DQGPRQLWRU
6LJQDOUHFHLYLQJ
FRQGLWLRQLVSRRU
$QRWKHUWUDQVPLWWHUZLWKWKH
VDPHFKDQQHOLVXVHGQHDUE\
7XUQWKHWUDQVPLWWHUSRZHURII,IWKH
PRQLWRUVWLOOUHFHLYHVDVLJQDOWKHUHLVD
KLJKSUREDELOLW\WKDWDQRWKHUWUDQVPLWWHU
RIWKHVDPHFKDQQHOLVXVHGQHDUE\
)ROORZWKHLQVWUXFWLRQRI\RXU
channel administrator and use another
WUDQVPLWWHUZLWKDGLIIHUHQWFKDQQHO
6LJQDOVRIDQRWKHUSDWLHQWDUH
PL[LQJ
)ROORZWKHLQVWUXFWLRQVRI\RXU
channel administrator and use another
WUDQVPLWWHURIDGLIIHUHQWFKDQQHO
7KHWUDQVPLWWHULVGDPDJHG &RQWDFW\RXU1LKRQ.RKGHQ
UHSUHVHQWDWLYH
113
ZM-540PA, ZM-541PA Operator’s Manual
ECG/Respiration
Problem Cause Countermeasure
7KHKHDUWUDWHLV
XQVWDEOH
3DFLQJGHWHFWLRQVHWWLQJRQWKH
PRQLWRULVQRWFRUUHFW
7XUQRIIWKHSDFLQJGHWHFWLRQVHWWLQJ
RQWKHPRQLWRU:KHQPRQLWRULQJD
SDFHPDNHUSDWLHQWWXUQRQSDFLQJ
GHWHFWLRQ
7KH³&+(&.
(/(&752'(6´
PHVVDJHDSSHDUV
RQWKHUHFHLYLQJ
PRQLWRU
(OHFWURGHOHDGLVGLVFRQQHFWHG
IURPWKHHOHFWURGH
Firmly connect the electrode lead to the
HOHFWURGH
(OHFWURGHOHDGGLVFRQWLQXLW\ 5HSODFHWKHHOHFWURGHOHDGZLWKDQHZ
RQH
(OHFWURGHLVQRW¿UPO\DWWDFKHG
WRWKHVNLQ
5HSODFHWKHHOHFWURGHZLWKDQHZRQH
3RODUL]DWLRQYROWDJHLV
DEQRUPDOO\KLJK
8VH1LKRQ.RKGHQVSHFL¿HG
HOHFWURGHV
(&*EDVHOLQHLV
WKLFN$&KXP
7KHJHORQWKHHOHFWURGHLVGULHG
RXW
5HSODFHWKHHOHFWURGHZLWKDQHZRQH
7KHJHORQWKHHOHFWURGHLV
FRPLQJRII
$QHOHFWULFEODQNHWLVXVHG &RYHUWKHEODQNHWZLWKDVKLHOGFRYHU
7KHKXP¿OWHULVVHWWR2))RQ
WKHPRQLWRU
6HWWKH¿OWHUWR21
7KHKHDUWUDWHRID
SDWLHQWZKRLVXVLQJ
DQHOHFWULFEODQNHW
is unstable on the
UHFHLYLQJPRQLWRU
3DFLQJSXOVHGHWHFWLRQLVWXUQHG
21RQWKHUHFHLYLQJPRQLWRU
7XUQ2))WKHSDFLQJSXOVHGHWHFWLRQRQ
WKHUHFHLYLQJPRQLWRU
No heart rate or
(&*LVGLVSOD\HG
³(&*0($685(0(17´
RQWKH3$5$0(7(56(783
VFUHHQLVVHWWR2))
,I(&*PRQLWRULQJLVQHFHVVDU\VHW
³(&*0($685(0(17´WR21
5HVSLUDWLRQ
ZDYHIRUP
measurement is
XQVWDEOH
7KHJHORQWKHHOHFWURGHLVGULHG
RXW
5HSODFHWKHHOHFWURGHZLWKDQHZRQH
7KHJHORQWKHHOHFWURGHLV
FRPLQJRII
No respiration rate
LVGLVSOD\HG
³5(630($685(0(17´
RQWKH3$5$0(7(56(783
VFUHHQLVVHWWR2))
,IUHVSLUDWLRQPRQLWRULQJLVQHFHVVDU\
VHW³5(630($685(0(17´WR21
114
ZM-540PA, ZM-541PA Operator’s Manual
SpO2
Problem Cause Countermeasure
6S22 data is
unstable and not
UHOLDEOH
7KHSUREHVL]HLVQRW
DSSURSULDWHIRUWKHSDWLHQW
8VHWKHDSSURSULDWHSUREHIRUWKH
SDWLHQW
3UREHDWWDFKPHQWFRQGLWLRQ
LVSRRU7KHSUREHLVSDUWO\
GHWDFKHGIURPWKHVNLQ([WHUQDO
OLJKWLVHQWHULQJWKHSUREH
)LUPO\DWWDFKWKHSUREHDFFRUGLQJWR
WKHSURFHGXUHLQWKHSUREHRSHUDWRUV
PDQXDO
0HDVXUHPHQWVLWHLVGLUW\
3DWLHQWLVZHDULQJQDLOSROLVK
5HPRYHGLUWDQGQDLOSROLVK
7KHSUREHLVDWWDFKHGWRWKH
VDPHOLPEWKDWLVXVHGIRU1,%3
PHDVXUHPHQW
$WWDFKWKHSUREHWRWKHRSSRVLWHOLPE
$YRLGDVLWHZKHUHEORRGFLUFXODWLRQ
FRQGLWLRQFKDQJHVJUHDWO\
NIBP
Problem Cause Countermeasure
&XIILQÀDWLRQ
pressure is less than
PP+J
7KHFXIIKRVHLVQRWFRQQHFWHG
WRWKH1,%3VRFNHWSURSHUO\
&RQQHFWWKHFXIIKRVHWRWKHVRFNHW
SURSHUO\
7KHFXIILVQRWZUDSSHGDURXQG
WKHDUPRULVZUDSSHGWRR
ORRVHO\
:UDSWKHFXIIDURXQGWKHXSSHUDUP
7KHFXIIGRHVQRW
LQÀDWHZKHQWKH
1,%36WDUW6WRSNH\
LVSUHVVHG
7KHFXIIKRVHLVQRWFRQQHFWHG
WRWKH1,%3VRFNHW
&RQQHFWWKHFXIIKRVHWRWKHVRFNHW
¿UPO\
7KHFXIIKRVHRUH[WHQVLRQKRVH
PD\EHIROGHGRUVTXHH]HG
ZKHQWKHFXIISUHVVXUHGLVSOD\
RQWKHVFUHHQLQFUHDVHVTXLFNO\
EXWWKHDFWXDOFXIIGRHVQRW
LQÀDWH
&KHFNWKHFXIIKRVHDQGDLUKRVH
Abnormal
measurement results
DUHGLVSOD\HG
7KHFXIIVL]HLVQRWFRUUHFW 6HOHFWWKHFXIIZKLFK¿WVWKHSDWLHQW¶V
OLPEFLUFXPIHUHQFH
7KHFXIILVQRWZUDSSHGDURXQG
WKHDUPFRUUHFWO\
:UDSWKHFXIIDURXQGWKHXSSHUDUP
QRWWRRWLJKWO\RUWRRORRVHO\
1,%3GDWDLVQRWFRUUHFW
EHFDXVHRIERG\PRYHPHQW
3UHYHQWWKHSDWLHQWIURPPRYLQJGXULQJ
PHDVXUHPHQW
9LEUDWLRQRQWKHFXII &KHFNWKDWQRWKLQJLVWRXFKLQJWKHFXII
GXULQJPHDVXUHPHQW
&KDQJHWKHPHDVXULQJVLWH
115
ZM-540PA, ZM-541PA Operator’s Manual
Problem Cause Countermeasure
7KHFXIILVVXGGHQO\
GHÀDWHGGXULQJ
LQÀDWLRQ
7KH1,%36WDUW6WRSNH\LV
SUHVVHGGXULQJLQÀDWLRQ
Auto mode
measurement does
QRWVWDUWHYHQZKHQ
WKHWLPHLQWHUYDOKDV
SDVVHG
7KH1,%3,QWHUYDONH\LV
pressed and the measurement
PRGHLVFKDQJHG
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LQWHUYDO
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116
ZM-540PA, ZM-541PA Operator’s Manual
Maintenance
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$;*YLWDOVLJQVLPXODWRU
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5HFHLYLQJPRQLWRU
Never disassemble or repair the transmitter. If
there is any problem with the transmitter, contact
your Nihon Kohden representative.
CAUTION
Before maintenance, cleaning or disinfection, turn
the transmitter power off and remove the batteries.
Failure to follow this instruction may result in
electrical shock and transmitter malfunction.
CAUTION
NOTE The measurement accuracy of the above units must be managed to
perform accurate maintenance check.
For details on the operation of the above units, refer to the manuals
provided with these units.
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1. External Check
7KHUHLVQRGDPDJHRUGLUWRQWKHRXWVLGHRIWKHWUDQVPLWWHU
7KHEDWWHU\FDVHFRYHULVQRWGDPDJHGDQGFDQEHFORVHG¿UPO\
117
ZM-540PA, ZM-541PA Operator’s Manual
1RNH\VDUHGDPDJHG
1,%3VRFNHWLVQRWGDPDJHG
1RHOHFWURGHOHDGVDUHGDPDJHG
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7HUPLQDOVLQWKHEDWWHU\FDVHDUHQRWFRUURGHG
2. Transmitter Channel
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QXPEHUDOVRDSSHDUVRQWKHVWDUWXSVFUHHQ
Channel numbers
Startup screen Numeric and waveform screen
3. Transmitting/Receiving Signal
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2 3ODFHWKHWUDQVPLWWHUWRPIURPWKHUHFHLYLQJPRQLWRU
3 6HWWKHFKDQQHORQWKHUHFHLYLQJPRQLWRUWRWKHFKDQQHORIWKHWUDQVPLWWHU
118
ZM-540PA, ZM-541PA Operator’s Manual
4 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU
5 &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU
6 7XUQRIIWKHWUDQVPLWWHU
7 &KHFNWKDWWKH(&*GLVDSSHDUVIURPWKHUHFHLYLQJPRQLWRU
4. Display
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3 3UHVVWKHŹNH\WRPRYHWKHFXUVRUWR³0$18$/&+(&.´DQGSUHVVWKH)XQFWLRQNH\
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119
ZM-540PA, ZM-541PA Operator’s Manual
5 (DFKWLPHWKHŹNH\LVSUHVVHGWKHVFUHHQFKDQJHVDVEHORZ&KHFNWKDWQRGRWVDUH
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7 3UHVVWKH6FUHHQNH\DJDLQWRUHWXUQWRWKH0(18VFUHHQ
5. Key Operation
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120
ZM-540PA, ZM-541PA Operator’s Manual
4 3UHVVWKHŻ or ŹNH\WRPRYHWKHFXUVRUWR³.(<&+(&.´DQGSUHVVWKH)XQFWLRQNH\
5 3UHVVHDFKNH\RQHDWDWLPHDQGFKHFNWKDWWKHSUHVVHGNH\LVKLJKOLJKWHGRQWKHVFUHHQ
Example:
:KHQWKH)XQFWLRQNH\LV
SUHVVHGWKHNH\QDPHLV
KLJKOLJKWHG
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VFUHHQ
6. ECG Check
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AX-400G
2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU
121
ZM-540PA, ZM-541PA Operator’s Manual
3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU
4 &KHFNWKDWWKH(&*RIWKHWUDQVPLWWHUDSSHDUVRQWKHUHFHLYLQJPRQLWRU
7. Respiration Check
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AX-400G
2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU
3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU
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8. SpO2 Check
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With the AX-300T SpO2 Checker
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AX-300T
2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU
3 7XUQRQWKHWUDQVPLWWHUDQG6S22FKHFNHU
4 &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ
122
ZM-540PA, ZM-541PA Operator’s Manual
5 &KHFNWKDW6S22DQGSXOVHUDWHRQWKHWUDQVPLWWHULVZLWKLQWKHIROORZLQJUDQJH
SpO2 on the SpO2 Checker Range
6S221
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3XOVHUDWH
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EHDWVPLQ WREHDWVPLQEHDWPLQ
1 7KH6S22FKHFNE\WKH6S22FKHFNHULVDIIHFWHGE\WKHFKHFNHU¶VWROHUDQFHWRWKH
6S22PHDVXULQJDFFXUDF\RIWKHWUDQVPLWWHU7KHPHDVXUHPHQWDFFXUDF\LVGHVFULEHG
LQWKH³6SHFL¿FDWLRQV´VHFWLRQ)RUGHWDLOVUHIHUWRWKH6S22FKHFNHUPDQXDO
6 &KHFNWKDWWKH6S22DQGSXOVHZDYHIRUPRIWKHWUDQVPLWWHUDSSHDURQWKHUHFHLYLQJ
PRQLWRU
With the AX-400G Vital Sign Simulator
1 &RQQHFWWKHYLWDOVLJQVLPXODWRUWRWKHWUDQVPLWWHURQO\ZLWKWKH6S22FRQQHFWLRQFDEOH
AX-400G
2 3ODFHWKHWUDQVPLWWHUPIURPWKHUHFHLYLQJPRQLWRU
3 7XUQRQWKHWUDQVPLWWHUDQGYLWDOVLJQVLPXODWRU
4 &KHFNWKDWWKHSXOVHEDUJUDSKDSSHDUVRQWKHWUDQVPLWWHUVFUHHQ
123
ZM-540PA, ZM-541PA Operator’s Manual
5 &KHFNWKDW6S22DQG(&*RQWKHWUDQVPLWWHULVZLWKLQWKHIROORZLQJUDQJH
Vital Sign Simulator Range
6S221
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 WR6S22GLJLWV
 WR6S22GLJLWV
(&* 1250$/ WREHDWVPLQEHDWVPLQ
17KH6S22FKHFNE\WKHYLWDOVLJQVLPXODWRULVDIIHFWHGE\WKHVLPXODWRUVWROHUDQFH
WRWKH6S22PHDVXULQJDFFXUDF\RIWKHWUDQVPLWWHU7KHPHDVXUHPHQWDFFXUDF\LV
GHVFULEHGLQWKH³6SHFL¿FDWLRQV´VHFWLRQ)RUGHWDLOVUHIHUWRWKHYLWDOVLJQVLPXODWRU
PDQXDO
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9. NIBP Check
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1 &RQQHFWWKHHOHFWULFPDQRPHWHUDQGGXPP\FXIIWRWKHWUDQVPLWWHU
NOTE: $LUOHDNVIURPWKHUXEEHUEDOOGXULQJLQÀDWLRQ8VHDFOLSRQWKHDLUKRVH
of the rubber ball to stop air leaking.
Dummy cuff (700 cc)
Electric manometer
Clip
Rubber ball
2 7XUQRQWKHHOHFWULFPDQRPHWHU
3 :KLOHSUHVVLQJWKH)XQFWLRQNH\WXUQRQWKHWUDQVPLWWHU7KH0(18VFUHHQDSSHDUV
124
ZM-540PA, ZM-541PA Operator’s Manual
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11 5HPRYHWKHFOLSIURPWKHDLUKRVHRIWKHUXEEHUEDOO
Electric manometer
Rubber ball
Remove
clip
Dummy cuff (700 cc)
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127
ZM-540PA, ZM-541PA Operator’s Manual
10. NIBP Cuff for Attaching Transmitter to Patient Arm
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Maintenance Check Sheet
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129
ZM-540PA, ZM-541PA Operator’s Manual
Lifetime and Disposal
Dispose of Nihon Kohden products according to
your local laws and your facility’s guidelines for
waste disposal. Otherwise, it may affect the
environment. If there is a possibility that the
product may have been contaminated with
infection, dispose of it as medical waste according
to your local laws and your facility’s guidelines for
medical waste. Otherwise, it may cause infection.
CAUTION
Disposing of Used Batteries
Battery Lifetime
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Disposal
NOTE: Remove the batteries before disposing of the transmitter.
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Disposing of Electrodes, SpO2 Probes and NIBP Cuffs
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Disposing of Transmitter
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130
ZM-540PA, ZM-541PA Operator’s Manual
Cleaning, Disinfection and Sterilization
Transmitter and Electrode Leads
If detergent or liquid spills into the transmitter, stop
cleaning or disinfecting it and contact your Nihon
Kohden representative. The transmitter needs to
be checked for safety and function before use.
CAUTION
NOTE The transmitter cannot be sterilized. Sterilizing the transmitter may damage
it.
When cleaning or disinfecting the transmitter, disconnect it from the
patient and remove the batteries beforehand. Otherwise it may result in
malfunction.
Do not let the NIBP socket get wet during cleaning and disinfection.
Do not use a hair dryer etc. to dry the transmitter when it is wet. Doing
so may cause the transmitter to deform or become damaged. It may also
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Do not use volatile liquids such as thinner or benzine because these will
cause the materials to deform or crack.
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Wipe the transmitter with a dry cloth before use and dry it completely after
cleaning and disinfecting.
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Disinfection
Do not immerse the electrode lead connector in
liquid.
CAUTION
131
ZM-540PA, ZM-541PA Operator’s Manual
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SpO2 Probe
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NIBP Cuff
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132
ZM-540PA, ZM-541PA Operator’s Manual
Periodic Inspection
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133
ZM-540PA, ZM-541PA Operator’s Manual
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Measured Parameters
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code number*, transmitter serial number*
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134
ZM-540PA, ZM-541PA Operator’s Manual
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135
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NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T,
TL-271T and TL-631T SpO2 probes. The testing was performed during
induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2
Africans, 1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age:
21 to 34), (5 women and 11 men) under the condition of no motion. Arterial
blood was sampled and measured by a CO-oximeter. The difference
between SpO2 measured by the SpO2 probe and functional SaO2
measured by a CO-oximeter was calculated using the root-mean-square
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measurements.
A pulse oximeter tester that generates simulated signals can be used to
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a replacement for human signals for testings accuracy.
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Pulse Rate = 70 bpm
60
65
70
75
80
85
90
95
100
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140
Time (seconds)
SpO
2
(%)
SpO
2
Reference SpO
2
Fast SpO
2
Normal SpO
2
Slow
136
ZM-540PA, ZM-541PA Operator’s Manual
60
65
70
75
80
85
90
95
100
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140
SpO
2
Reference SpO
2
Fast SpO
2
Normal
Pulse Rate = 140 bpm
Time (seconds)
SpO
2
(%)
SpO
2
Slow
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SpO
2
= 97
60
70
80
90
100
110
120
130
140
150
0 102030405060708090100110120
Time (seconds)
PR (bpm)
PR Reference PR
Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999 compliant)
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138
ZM-540PA, ZM-541PA Operator’s Manual
Environment
Operating environment
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Storage and transport environment
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142
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System Composition for EMC Test
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Units Cable Length
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143
ZM-540PA, ZM-541PA Operator’s Manual
ZM-541PA
Measured Parameters
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Transmitted Data
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code number*, transmitter serial number*
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Displayed Data
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1,%3V\VWROLFGLDVWROLF0$3PHVVDJHEDWWHU\
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ECG
ECG Measurement
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144
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EHDWVPLQ
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SpO2 Measurement (ISO 9919: 2005 compliant)
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145
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3XOVHUDWHPHDVXULQJUDQJH WRESP
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NOTE • The SpO2 measuring accuracy was tested using the TL-201T, TL-260T,
TL-271T and TL-631T SpO2 probes. The testing was performed during
induced hypoxia on healthy volunteers (Ethnicity: 10 Caucasians, 2 Africans,
1 Asian and 3 Indians), (Skin: 8 light, 4 medium, 4 dark), (Age: 21 to 34),
(5 women and 11 men) under the condition of no motion. Arterial blood
was sampled and measured by a CO-oximeter. The difference between
SpO2 measured by the SpO2 probe and functional SaO2 measured
by a CO-oximeter was calculated using the root-mean-square (rms)
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represents 2/3 of all test measurements.
A pulse oximeter tester that generates simulated signals can be used to
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a replacement for human signals for testings accuracy.
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Pulse Rate = 70 bpm
60
65
70
75
80
85
90
95
100
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140
Time (seconds)
SpO
2
(%)
SpO
2
Reference SpO
2
Fast SpO
2
Normal SpO
2
Slow
146
ZM-540PA, ZM-541PA Operator’s Manual
60
65
70
75
80
85
90
95
100
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140
SpO
2
Reference SpO
2
Fast SpO
2
Normal
Pulse Rate = 140 bpm
Time (seconds)
SpO
2
(%)
SpO
2
Slow
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ESPV
SpO
2
= 97
60
70
80
90
100
110
120
130
140
150
0 102030405060708090100110120
Time (seconds)
PR (bpm)
PR Reference PR
Noninvasive Blood Pressure, NIBP (IEC 60601-2-30: 1999 compliant)
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recommended separation distance in
PHWHUVP
)LHOGVWUHQJWKVIURP¿[HG5)
transmitters, as deter mined by an
HOHFWURPDJQHWLFVLWHVXUYH\1, should be
OHVVWKDQWKHFRPSOLDQFHOHYHOLQHDFK
IUHTXHQF\UDQJH2
,QWHUIHUHQFHPD\RFFXULQWKHYLFLQLW\
RIHTXLSPHQWPDUNHGZLWKWKH
IROORZLQJV\PERO
127( $W0+]DQG0+]WKHKLJKHUIUHTXHQF\UDQJHDSSOLHV
127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLV
DIIHFWHGE\DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOH
151
ZM-540PA, ZM-541PA Operator’s Manual
1 )LHOGVWUHQJWKVIURP¿[HGWUDQVPLWWHUVVXFKDVEDVHVWDWLRQVIRUUDGLRFHOOXODUFRUGOHVV
WHOHSKRQHVDQGODQGPRELOHUDGLRVDPDWHXUUDGLR$0DQG)0UDGLREURDGFDVWDQG79
EURDGFDVWFDQQRWEHSUHGLFWHGWKHRUHWLFDOO\ZLWKDFFXUDF\7RDVVHVVWKHHOHFWURPDJQHWLF
HQYLURQPHQWGXHWR¿[HG5)WUDQVPLWWHUVDQHOHFWURPDJQHWLFVLWHVXUYH\VKRXOGEH
FRQVLGHUHG,IWKHPHDVXUHG¿HOGVWUHQJWKLQWKHORFDWLRQLQZKLFKWKH=03$LVXVHG
H[FHHGVWKHDSSOLFDEOH5)FRPSOLDQFHOHYHODERYHWKH=03$VKRXOGEHREVHUYHGWR
YHULI\QRUPDORSHUDWLRQ,IDEQRUPDOSHUIRUPDQFHLVREVHUYHGDGGLWLRQDOPHDVXUHVPD\EH
QHFHVVDU\VXFKDVUHRULHQWLQJRUUHORFDWLQJWKH=03$
2 2YHUWKHIUHTXHQF\UDQJHN+]WR0+]¿HOGVWUHQJWKVVKRXOGEHOHVVWKDQ9PIRU
UHVSLUDWLRQDQG9PIRUDOORWKHUIXQFWLRQV
Recommended Separation Distances between Portable and Mobile RF
Communications Equipment
7KH=03$LVLQWHQGHGIRUXVHLQDQHOHFWURPDJQHWLFHQYLURQPHQWLQZKLFKUDGLDWHG5)
GLVWXUEDQFHVDUHFRQWUROOHG7KHFXVWRPHURUWKHXVHURIWKH=03$FDQKHOSSUHYHQW
HOHFWURPDJQHWLFLQWHUIHUHQFHE\PDLQWDLQLQJDPLQLPXPGLVWDQFHEHWZHHQSRUWDEOHDQGPRELOH
5)FRPPXQLFDWLRQVHTXLSPHQWWUDQVPLWWHUVDQGWKH=03$DVUHFRPPHQGHGEHORZ
DFFRUGLQJWRWKHPD[LPXPRXWSXWSRZHURIWKHFRPPXQLFDWLRQVHTXLSPHQW
Rated maximum
output power of
transmitter (W)
Separation distance according to frequency of transmitter (m)
N+]WR0+]
G  3
0+]WR0+]
G  3
)RUUHVSLUDWLRQG  3
0+]WR*+]
G  3
)RUUHVSLUDWLRQG  3
  1 1
  1 1
 1 1
  1 1
  1 1
)RUWUDQVPLWWHUVUDWHGDWDPD[LPXPRXWSXWSRZHUQRWOLVWHGDERYHWKHUHFRPPHQGHGVHSDUDWLRQ
GLVWDQFHGLQPHWHUVPFDQEHHVWLPDWHGXVLQJWKHHTXDWLRQDSSOLFDEOHWRWKHIUHTXHQF\RI
WKHWUDQVPLWWHUZKHUH3LVWKHPD[LPXPRXWSXWSRZHUUDWLQJRIWKHWUDQVPLWWHULQZDWWV:
DFFRUGLQJWRWKHWUDQVPLWWHUPDQXIDFWXUHU
(1)RUUHVSLUDWLRQ
127( $W0+]DQG0+]WKHVHSDUDWLRQGLVWDQFHIRUWKHKLJKHUIUHTXHQF\UDQJH
DSSOLHV
127( 7KHVHJXLGHOLQHVPD\QRWDSSO\LQDOOVLWXDWLRQV(OHFWURPDJQHWLFSURSDJDWLRQLV
DIIHFWHGE\DEVRUSWLRQDQGUHÀHFWLRQIURPVWUXFWXUHVREMHFWVDQGSHRSOH
152
ZM-540PA, ZM-541PA Operator’s Manual
5HFRYHU\7LPHDIWHU'H¿EULOODWLRQ
7KHWUDQVPLWWHUUHWXUQVWRWKHQRUPDORSHUDWLQJPRGHZLWKLQVHFRQGVDIWHUGH¿EULOODWLRQ
7KHVWRUHGVHWWLQJVDUHQRWDIIHFWHG
System Composition for EMC Test
7KH=03$WUDQVPLWWHULVWHVWHGWRFRPSO\ZLWK,(&DQG$PHQGPHQW
ZLWKWKHIROORZLQJFRPSRVLWLRQ,IDQ\SDUWZKLFKLVQRWVSHFL¿HGE\1LKRQ.RKGHQLV
XVHGWKH(0&VSHFL¿FDWLRQVPLJKWQRWFRPSO\
Units Cable Length
=03$WUDQVPLWWHU
<331,%3FXII P
%53(&*HOHFWURGHOHDG P
7/7¿QJHUSUREH P
153
ZM-540PA, ZM-541PA Operator’s Manual
Standard Accessories
12
No. Name Model Qty Supply Code
 1,%3FXIIIRUDGXOWVWDQGDUG <33 6&
2 Strap  <
7KHIROORZLQJSDUWVDUHDYDLODEOHIRUUHSODFHPHQW
/RFNSODWHLVDVWDQGDUG
DFFHVVRU\RIWKH
<33DQG<33
1,%3FXIIV
34
No. Name Model Qty Code No.
 %DWWHU\FDVHFRYHU

4/RFNSODWH 
154
ZM-540PA, ZM-541PA Operator’s Manual
Options
Only use Nihon Kohden specified electrodes,
electrode leads and SpO2 probes. Otherwise, the
maximum performance from the transmitter cannot
be guaranteed.
CAUTION
Transmitter
4,3.FKDQQHOZULWHU
ECG/RESP
Application Model Qty Supply Code
HOHFWURGHVFOLSW\SHOHDGOHQJWKFP %53$  .$
HOHFWURGHVVQDSW\SHOHDGOHQJWKFP %53$  .%
HOHFWURGHVFOLSW\SHOHDGOHQJWKFP %53$  .$
HOHFWURGHVVQDSW\SHOHDGOHQJWKFP %53$  .$
155
ZM-540PA, ZM-541PA Operator’s Manual
SpO2
Name Lead
Length Model Qty Supply
Code
)LQJHUSUREHUHXVDEOH
P
7/7
3+
P 3)
0XOWLVLWHSUREHUHXVDEOH P 7/7 3*
)LQJHUSUREHUHXVDEOH
P 7/7 3$
P 7/7 3&
6S22SUREHIRUDGXOWGLVSRVDEOH
P 7/7
24
3$
P 7/7 3(
6S22SUREHIRUFKLOGGLVSRVDEOH
P 7/7 3%
P 7/7 3)
6S22 probe
IRUQHRQDWHDGXOWGLVSRVDEOH
P 7/7 3&
P 7/7 3*
6S22 probe
IRULQIDQWGLVSRVDEOH
P 7/7 3'
P 7/7 3+
6S22 probe
IRUQHRQDWHDGXOWGLVSRVDEOH
P 7/6
3$
P 7/6 3%
6S22 probe
IRUFKLOGLQIDQWGLVSRVDEOH
P 7/6 3$
P 7/6 3%
&27721<WDSH
20 3
)RDPWDSHIRU7/6666 î 3&
$WWDFKPHQWWDSHIRU7/77 î 3
3UREHIDVWHQHU <63  3
156
ZM-540PA, ZM-541PA Operator’s Manual
NIBP
Name Width
(cm)
Air
Hose
Length
(cm)
Model Qty Supply
Code
&XIIIRUDGXOWIRU
DWWDFKLQJWUDQVPLWWHUWR
patient arm
Standard   <331 6&
/DUJH   <331 6'
&XIIIRULQIDQW  <37  6$
&XIIIRUFKLOG
Small  <37  6%
Standard   <37  6$
 <37  6&
&XIIIRUDGXOW Standard   <37  6%
 <37  6%
/DUJH   <37  6&
'LVSRVDEOHFXIIIRULQIDQW 6 <33 20 6&
'LVSRVDEOHFXIIIRUFKLOG 8 <33 20 6'
'LVSRVDEOHFXIIIRUDGXOW
Small   <33 20 6(
Standard   <33 20 6)
0HGLXP
ODUJH   <33 20 6*
/DUJH   <33 20 6+
([WUDODUJH   <33 20 6,
([WHQVLRQKRVH  <13  6
1 7KHORFNSODWHLVSURYLGHGZLWKWKHVH1,%3FXIIV
157
ZM-540PA/ZM-541PA Operator’s Manual
Transmission Frequencies
&KDQQHOWR
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
158
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
159
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
160
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
161
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
162
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
&KDQQHO(WR(
163
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
164
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
165
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
166
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
&KDQQHO(WR(
NOTE: In Canada, transmission frequencies from 1429.5 MHz to 1431.9750 MHz
cannot be used due to the IC (Industry Canada) regulations. ZM-541PA can
only use channels up to E698 in Canada.
167
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
168
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
169
ZM-540PA/ZM-541PA Operator’s Manual
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Channel
(HEX) Frequency
(MHz)
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
( 
Serial Number
Model
Your Representative
Contact information is accurate as of Jan 2015. Visit www.nihonkohden.com for the latest information.
The model and serial number of your instrument are identified on the rear or bottom of the unit.
Write the model and serial number in the spaces provided below. Whenever you call your representative concerning
this instrument, mention these two pieces of information for quick and accurate service.
Manufacturer
NIHON KOHDEN CORPORATION
1-31-4 Nishiochiai, Shinjuku-ku Tokyo 161-8560, Japan
Phone +81 3-5996-8036
Fax +81 3-5996-8100
North and South America
NIHON KOHDEN AMERICA, INC.
15353 Barranca Parkway, Irvine, CA 92618, U.S.A.
Toll-free +1-800-325-0283
Phone +1 949-580-1555
Fax +1 949-580-1550
NIHON KOHDEN LATIN AMERICA S.A.S
Carrera 16 No.93A-36 Of. 802. Bogota D.C., Colombia
Phone +57 1-300-1742
Fax +57 1-300-1825
NIHON KOHDEN DO BRASIL LTDA.
Rua Gomes de Carvalho
1507-Bloco A 9 andar-cjto 91A Vila Olimpia
CEP 04547-005 Sao Paulo-SP. Brasil
Phone +55 11-3841-9943
Fax +55 11-3044-0463
Europe
European Representative
NIHON KOHDEN EUROPE GmbH
Raiffeisenstrasse 10, D-61191 Rosbach, Germany
Phone +49 6003-827-0
Fax +49 6003-827-599
NIHON KOHDEN FRANCE SARL
8, rue Francois Delage, 94 230 Cachan, France
Phone +33 1-49-08-05-50
Fax +33 1-49-08-93-32
NIHON KOHDEN IBERICA S.L.
C/Ulises 75A, E-28043 Madrid, Spain
Phone +34 91-7-161080
Fax +34 91-3-004676
NIHON KOHDEN ITALIA S.r.l.
Via Fratelli Bronzetti 28, 24124 Bergamo, Italy
Phone +39 035-219543
Fax +39 035-232546
NIHON KOHDEN UK LTD
Trident Court 118, 1 Oakcroft Road
Chessington, Surrey KT9 1BD, UK
Phone +44 20-8391-6800
Fax +44 20-8391-6809
Asia
SHANGHAI KOHDEN
MEDICAL ELECTRONIC INSTRUMENT CORP.
567 Huancheng Bei Road
Shanghai Comprehensive Industrial Development Zone
Shanghai 201401, China
Phone +86 21-5743-6998
Fax +86 21-5743-6939
NIHON KOHDEN SINGAPORE PTE LTD
1 Maritime Square, #10-34 HarbourFront Centre
Singapore 099253
Phone +65 6376-2210
Fax +65 6376-2264
NIHON KOHDEN INDIA PVT. LTD.
308, Tower A, Spazedge, Sector 47, Sohna Road
Gurgaon-122 002 Haryana, India
Toll-free +91 1800-103-8182
Phone +9
1 1
24-493-1000
Fax +9
1 1
24-493-1029
NIHON KOHDEN MIDDLE EAST FZE
P.O.Box 261516, JAFZA View 19
Room 308 Jebel Ali Free Zone, Dubai, U.A.E
Phone +9
71 4-
884-0080
Fax +9
71 4-
880-0122
NIHON KOHDEN KOREA, INC.
5F Miso Bldg.
890-47 Daechi-dong, Gangnam-gu, Seoul, 135-280 Korea
Phone +82 2-3273-2310
Fax +82 2-3273-2352
ZM-540PA, ZM-541PA_0614-902754H

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