Nihon Kohden ZS-910PA WMTS Transmitter User Manual

Nihon Kohden Corporation WMTS Transmitter

User Manual

TRANSMITTERZS-910PA0614-008543OPERATOR’S MANUALFirst Edition:Printed:
TRANSMITTERZS-910PA0614-008543
Model: ZS-910PAManual code no.: 0614-008543Reader Comment CardWe welcome your comments about this manual. Your comments and suggestionshelp us improve our manuals. Please circle the number for each of the followingstatements corresponding to your evaluation and add comments in the spaceprovided.Fax or send your completed comment card to:Fax: +81 (3) 5996-8100International Div., Sales Promotion Section, Nihon Kohden Corp., 1-31-4, NishiochiaiShinjuku-ku, Tokyo 161-8560, JapanStrongly Agree 1 Disagree 4Agree 2 Strongly Disagree 5Nuetral 3This manual is organized. 1 2345I can find the information I want. 1 2345The information is accurate. 1 2345I can understand the instructions. 1 2345The illustrations are appropriate and helpful. 1 2345The manual length is appropriate. 1 2345Comments:Thank you for your cooperation. We appreciate it very much.Name:Occupation/Position:Hospital/Company:Address:Phone:cutting line
Operator's Manual ZS-910PA iContentsGENERAL HANDLING PRECAUTIONS .........................................iWARRANTY POLICY .................................................................... iiiEMC RELATED CAUTION .............................................................vConventions Used in this Manual and Instrument ....................... viiWarnings, Cautions and Notes ............................................... viiExplanations of the Symbols in this Manual and Instrument viiiIntroduction ......................................................................................... 1Panel Description ................................................................................ 2Top Panel....................................................................................... 2Front Panel .................................................................................... 3Rear Panel .................................................................................... 4Important Safety Information .............................................................. 5General.......................................................................................... 5Battery ........................................................................................... 6For Patients Using Implantable Pacemaker .................................. 7Output Signal ................................................................................ 7Electrodes and Electrode Leads ................................................... 8Maintenance .................................................................................. 8Preparation ......................................................................................... 9Installing (Replacing) a Battery ..................................................... 9Procedure .............................................................................. 10Situations Requiring Battery Replacement ................................. 10WARNING and CAUTION for Battery Handling .......................... 11Attaching a Strap to the Transmitter ............................................ 12Turning On/Off the Transmitter .................................................... 13Turning on the power ............................................................. 13Turning off the power ............................................................. 13
ii Operator's Manual ZS-910PACheck Items Before Use ............................................................. 14Appearance ........................................................................... 14Battery ................................................................................... 14Channel Setting ..................................................................... 14Check Items After the Power On ................................................. 14Power on ................................................................................ 14Basic Operation ..................................................................... 14Monitoring ......................................................................................... 15ECG Monitoring .......................................................................16Measurement Procedure ...............................................................17Selecting Electrode Lead and Disposable Electrode......................17Standard Accessory................................................................17Option .....................................................................................17Connecting the Electrode Lead to the Transmitter ..........................18Selecting the Electrode Position ....................................................19Three Electrodes .....................................................................19Two electrodes ........................................................................21Electrode Position for Respiration Monitoring.................................22Electrode Position Examples ...................................................22Connecting the Electrode Lead and Disposable Electrodes ..........24Prepare the patient skin ...........................................................24Attaching Electrodes to the Patient ................................................24Using Electrode Lead Tube ......................................................25Detection and Display of Measurement Condition .........................26Checking Electrodes ...............................................................26Condition List by Sound ......................................................................27Troubleshooting ...................................................................................28Check After Use .................................................................................30Storage....................................................................................30Lifetime and Disposal ..........................................................................31Disposing of Used Batteries ..........................................................31Replacement ...........................................................................31Disposal ..................................................................................31Disposing of Disposable Electrodes ..............................................31
Operator's Manual ZS-910PA iiiLifetime ....................................................................................31Disposal ..................................................................................31Cleaning, Disinfection and Sterilization................................................32Transmitter and Electrode Lead .....................................................32Cleaning ..................................................................................32Disinfection..............................................................................32Specifications .....................................................................................34ECG measurement..................................................................34Transmitter ..............................................................................34Safety standards .....................................................................34Water resistance .....................................................................35Power requirements.................................................................35Environment ............................................................................36Dimension and Weight .............................................................36Standard Accessories ........................................................................37Options ...............................................................................................38
Operator's Manual ZS-910PA iGENERAL HANDLING PRECAUTIONSThis device is intended for use only by qualified medical personnel.Use only Nihon Kohden approved products with this device. Use ofnon-approved products or in a non-approved manner may affect theperformance specifications of the device. This includes, but is notlimited to, batteries, recording paper, pens, extension cables,electrode leads, input boxes and AC power.Please read these precautions thoroughly before attempting to operatethe instrument.1. To safely and effectively use the instrument, its operation must befully understood.2. When installing or storing the instrument, take the followingprecautions:(1) Avoid moisture or contact with water, extreme atmosphericpressure, excessive humidity and temperatures, poorly ventilatedareas, and dust, saline or sulphuric air.(2) Place the instrument on an even, level floor. Avoid vibration andmechanical shock, even during transport.(3) Avoid placing in an area where chemicals are stored or where thereis danger of gas leakage.(4) The power line source to be applied to the instrument mustcorrespond in frequency and voltage to product specifications, andhave sufficient current capacity.(5) Choose a room where a proper grounding facility is available.3. Before Operation(1) Check that the instrument is in perfect operating order.(2) Check that the instrument is grounded properly.(3) Check that all cords are connected properly.(4) Pay extra attention when the instrument is in combination withother instruments to avoid misdiagnosis or other problems.
ii Operator's Manual ZS-910PA(5) All circuitry used for direct patient connection must be doublychecked.(6) Check that battery level is acceptable and battery condition is goodwhen using battery-operated models.4. During Operation(1) Both the instrument and the patient must receive continual, carefulattention.(2) Turn power off or remove electrodes and/or transducers whennecessary to assure the patient’s safety.(3) Avoid direct contact between the instrument housing and thepatient.5. To Shutdown After Use(1) Turn power off with all controls returned to their original positions.(2) Remove the cords gently; do not use force to remove them.(3) Clean the instrument together with all accessories for their nextuse.6. The instrument must receive expert, professional attention formaintenance and repairs. When the instrument is not functioningproperly, it should be clearly marked to avoid operation while it isout of order.7. The instrument must not be altered or modified in any way.8. Maintenance and Inspection:(1) The instrument and parts must undergo regular maintenanceinspection at least every 6 months.(2) If stored for extended periods without being used, make sure priorto operation that the instrument is in perfect operating condition.(3) Technical information such as parts list, descriptions, calibrationinstructions or other information is available for qualified usertechnical personnel upon request from your Nihon Kohdendistributor.
Operator's Manual ZS-910PA iii9. When the instrument is used with an electrosurgical instrument,pay careful attention to the application and/or location of electrodesand/or transducers to avoid possible burn to the patient.10. When the instrument is used with a defibrillator, make sure that theinstrument is protected against defibrillator discharge. If not,remove patient cables and/or transducers from the instrument toavoid possible damage.WARRANTY POLICYNihon Kohden Corporation (NKC) shall warrant its products against alldefects in materials and workmanship for one year from the date of delivery.However, consumable materials such as recording paper, ink, stylus andbattery are excluded from the warranty.NKC or its authorized agents will repair or replace any products whichprove to be defective during the warranty period, provided these productsare used as prescribed by the operating instructions given in the operator’sand service manuals.No other party is authorized to make any warranty or assume liability forNKC’s products. NKC will not recognize any other warranty, either impliedor in writing. In addition, service, technical modification or any otherproduct change performed by someone other than NKC or its authorizedagents without prior consent of NKC may be cause for voiding thiswarranty.Defective products or parts must be returned to NKC or its authorizedagents, along with an explanation of the failure. Shipping costs must be pre-paid.This warranty does not apply to products that have been modified,disassembled, reinstalled or repaired without Nihon Kohden approval orwhich have been subjected to neglect or accident, damage due to accident,
iv Operator's Manual ZS-910PAfire, lightning, vandalism, water or other casualty, improper installation orapplication, or on which the original identification marks have beenremoved.In the USA and Canada other warranty policies may apply.CAUTIONUnited States law restricts this device to sale by or on the orderof a physician.Equipment Authorization RequirementOperation of this equipment requires the prior coordination with a frequencycoordinator designated by the FCC for the Wireless Medical TelemetryService.
Operator's Manual ZS-910PA vEMC RELATED CAUTIONThis equipment and/or system complies with the InternationalStandard IEC60601-1-2 for electromagnetic compatibility formedical electrical equipment and/or system. However, anelectromagnetic environment that exceeds the limits or levelsstipulated in the IEC60601-1-2, can cause harmful interference tothe equipment and/or system or cause the equipment and/orsystem to fail to perform its intended function or degrade itsintended performance. Therefore, during the operation of theequipment and/or system, if there is any undesired deviationfrom its intended operational performance, you must avoid,identify and resolve the adverse electromagnetic effect beforecontinuing to use the equipment and/or system.The following describes some common interference sources andremedial actions:1.Strong electromagnetic interference from a nearby emittersource such as an authorized radio station or cellular phone:Install the equipment and/or system at another location if it isinterfered with by an emitter source such as an authorizedradio station. Keep the emitter source such as cellular phoneaway from the equipment and/or system.2.Effect of direct or indirect electrostatic discharge:Make sure all users and patients in contact with the equipmentand/or system are free from direct or indirect electrostaticenergy before using it. A humid room can help lessen thisproblem.3.Electromagnetic interference with any radio wave receiversuch as radio or television:If the equipment and/or system interferes with any radio wavereceiver, locate the equipment and/or system as far aspossible from the radio wave receiver.
vi Operator's Manual ZS-910PAConventions Used in this Manual and InstrumentWarnings, Cautions and NotesWarnings, cautions and notes are used in this manual to alert or signal thereader to specific information.WARNINGA warning alerts the user to possible injury or death associatedwith the use or misuse of the instrument.CAUTIONA caution alerts the user to possible injury or problems with theinstrument associated with its use or misuse such as instrumentmalfunction, instrument failure, damage to the instrument, ordamage to other property.NOTEA note provides specific information, in the form ofrecommendations, prerequirements, alternative methods orsupplemental information.If the above suggested remedial actions do not solve theproblem, consult your Nihon Kohden Corporation subsidiary ordistributor for additional suggestions.
Operator's Manual ZS-910PA viiExplanations of the Symbols in this Manual and InstrumentThe following symbols found in this manual/instrument bear therespective descriptions as given.On Main UnitSymbol DescriptionPower ONPower OffDefibrillation proof type CF applied partDCAttention, consult operator’s manualNurse call+
Operator's Manual ZS-910PA 1IntroductionThe ZS-910PA transmits ECG from a patient to a Nihon Kohden monitor.The transmitter can change channels when connected to the QI-901PKchannel writer. Read the operator’s manual for the monitor together with thismanual before operation.CAUTION•••••Do not use the same channel for different patients. Otherwise,two patients’ data will be lost due to mutual modulationinterference, or another patient’s data may appear on thereceiving monitor screen.•••••Do not use transmitters of adjacent channels in a hospital.Otherwise, radio waves from one transmitter affects the receiverof the adjacent channel’s transmitter and there may beinterference.NOTE•••••To prevent interference between channels, assign a channeladministrator in the hospital and only he or she should managechannel assignment.•••••Use Nihon Kohden parts and accessories to assure maximumperformance from your instrument.•••••It is recommended to use a diversity antenna system on thereceiving monitor for stable signal reception. Otherwise, spikenoise from transient fading of electric field strength (for example,people moving) may interfere with the transmitter signal and maybe mistaken as an arrhythmia on the receiving monitor.
2 Operator's Manual ZS-910PAPanel DescriptionTop PanelWARNING•••••Before performing defibrillation, check that the electrode leadsattached to the patient are properly connected to the transmitter.Touching the metal parts of disconnected leads and probescauses serious electrical shock or injury by discharged energy.•••••When performing defibrillation, all persons must keep clear of thebed and must not touch the patient, any equipment connected tothe patient or the metal parts of leads connected to the patient.Failure to follow this warning may result in serious electrical burn,shock or other injury.Input socketConnects the electrode lead.Attach a strapRefer to the WARNING below.Defibrillation proof type CFapplied part
Operator's Manual ZS-910PA 3Front PanelCALL key:When this key is pressed,a “peep” sounds at thetransmitter, and a“CALL” messageappears on the monitor.Depending on thesettings on the monitor,an ECG waveform isrecorded when this key ispressed.Battery caseChannel number label:Indicates the channelnumber of thetransmitter. Attach theaccessory channelnumber label to the panelof the monitor.CAUTIONOnly use your finger to press the CALL key. Do not press the keywith a sharp object. Otherwise the key may be broken.
4 Operator's Manual ZS-910PARear PanelCAUTIONBattery replacement must be performed by medical staff. Whenreplacing the battery of the transmitter currently used for a patient,disconnect electrode leads from the transmitter before replacing thebattery or do not touch the patient during replacement.Refer to theCAUTION below.Tab for opening and closing thebattery case coverBattery case/Power switchContains a battery.Opening/closing the battery case cover turnsthe instrument power off/on.The cover opens out in two steps.Open to one step ( position):Turns the power off. The batterycannot come out.Open to two steps:The battery can be replaced.Cover closed ( position):Turns on the power<ZS-910PA>
Operator's Manual ZS-910PA 5Important Safety InformationWARNING•••••Never use this instrument in the presence of any flammableanesthetic gas or high concentration oxygen atmosphere. Failureto follow this warning may cause explosion or fire.•••••Never use this instrument in a high-pressure oxygen medical caretank. Failure to follow this warning may cause explosion or fire.•••••Do not take this transmitter into the MRI test room. Thistransmitter is not designed to be used during MRI tests.•••••Before performing defibrillation, check that the electrode leadsattached to the patient are properly connected to the transmitter.Touching the metal parts of disconnected leads causes seriouselectrical shock or injury by discharged energy.•••••When performing defibrillation, all persons must keep clear of thebed and must not touch the patient, any equipment connected tothe patient or the metal parts of leads connected to the patient.Failure to follow this warning may result in serious electricalburn, shock or other injury.•••••Before performing defibrillation, remove all electrodes and gelfrom the chest of the patient. If the defibrillator toucheselectrodes or gel, the discharged energy may burn the patient’sskin.•••••When using this instrument with an ESU, refer to the instructionmanual for the ESU. Before measurement, check that the returnplate is correctly attached to the patient and check that theinstrument operates correctly when using with the ESU. If thereturn plate is not attached correctly, it may burn the patient’sskin where the electrodes are attached.General
6 Operator's Manual ZS-910PACAUTION•••••Attach a strap to the transmitter to prevent it from falling.•••••Turn off the power of cellular telephones, small wireless devicesand other devices which produce strong electromagneticinterference around a patient (except for PHS telephones allowedby the hospital administrator). Otherwise, radio waves fromdevices such as cellular telephones or small wireless devicesmay be mistaken as respiration waves and the displayed data maybe incorrect.•••••Do not use the same channel for different patients. Otherwise,two patients’ data will be lost due to mutual modulationinterference, or another patient’s data may appear on thereceiving monitor screen.•••••Do not use transmitters of adjacent channels in a hospital.Otherwise, radio waves from one transmitter affect the receiver ofthe adjacent channel’s transmitter and there may be interference.WARNING•••••Do not dispose of the battery in fire, or it may explode.•••••Do not disassemble the battery. The contents of the battery areharmful and the battery may catch fire.•••••Never short-circuit the + + + + + and −−−−− terminals. The battery mayoverheat and catch fire.•••••Take care that the patient does not swallow batteries.Battery
Operator's Manual ZS-910PA 7CAUTIONBattery replacement must be performed by medical staff. Whenreplacing the battery of the transmitter currently used for a patient,disconnect electrode leads from the transmitter before replacing thebattery or do not touch the patient during replacement.WARNINGInteraction Between Minute Ventilation Rate-Adaptive Pacemakersand Cardiac monitoring and Diagnostic EquipmentThe bioelectric impedance measurement sensor of a minuteventilation rate-adaptive implantable pacemaker may be affected bythe transmitter which is connected to the same patient. If thisoccurs, the pacemaker may pace at its maximum rate and thetransmitter may give incorrect data to the monitor. If this occurs,disconnect the electrode leads from the patient or change thesetting on the pacemaker by referring to the pacemaker’s manual.For more details, contact your pacemaker distributor or NihonKohden distributor.For Patients With an Implantable PacemakerOutput SignalCAUTIONDo not use the output signal from the receiving monitor as thesynchronization signal for other equipment such as IABP, MRI,echocardiography or defibrillation because there may be time delaybetween the monitor and the other equipment caused by waveformtransmission delay and spike noise may interfere on the outputsignal and be mistaken as a trigger.
8 Operator's Manual ZS-910PACAUTIONDo not disassemble the transmitter when performing maintenanceand inspection. Do not repair the transmitter. When there is anyproblem with the transmitter after maintenance and inspection,contact your Nihon Kohden distributor.MaintenanceWARNINGIf detergents or dirty liquid get on the transmitter, clean it and dry itcompletely before use. If a wet transmitter is used, the patient oranyone in contact with the transmitter may receive an electricshock.Electrodes and Electrode LeadsCAUTION•••••Use Nihon Kohden specified electrodes and electrode leads. Withelectrodes and electrode leads other than specified ones, themessage indicating checking electrodes appears and monitoringmay stop.•••••Do not reuse disposable products.•••••Do not shake or swing the transmitter holding the leads/cablesconnected to the transmitter. The transmitter may come off andinjure a person or damage surrounding instruments.•••••When the message indicating checking electrodes is displayed onthe receiving monitor, check electrodes and electrode leads andremove the cause.While the message is displayed, there is no ECG monitoring andno alarms.
Operator's Manual ZS-910PA 9PreparationInstalling (Replacing) a BatteryUse one AA type alkaline dry cell battery. Manganese dry cell battery, NiCdrechargeable battery or NiMH battery can also be used.With a new alkaline battery, the ZS-910PA transmitter can continuouslymeasure ECG for approximately 5 days.CAUTIONBattery replacement must be performed by medical staff. Whenreplacing the battery of the transmitter currently used for a patient,disconnect electrode leads from the transmitter before replacing thebattery or do not touch the patient during replacement.NOTE•••••Tell the patient not to open or close the battery case cover.•••••Insert the battery with the correct polarity (+ and −−−−−).If electrode leads are attached to the patient and a person replacing thebattery touches the patient during battery replacement, patient leakage currentover the amount allowed for the defibrillation proof type CF applied part mayflow.
10 Operator's Manual ZS-910PASituations Requiring Battery ReplacementReplace the batteries when any of the following occurs:•With the power ON, the transmitter generates a constant alarm (continuoushigh-pitched sound).•The receiving monitor displays the battery replacement message on thescreen.•The transmitter does not generate a “peep” sound when the power is turnedon (when the battery case cover is closed).Procedure1. Open the battery case cover by pulling the tabuntil it clicks twice and until the cover stops.The cover opens two steps.When replacing the battery, take out the oldbattery.3. Close the cover. Confirm that there is a “peep”sound for about one second.2. Insert one alkaline dry cell battery (LR6) into thebattery case observing the correct polarity.NOTEDo not use the transmitter if the battery casecover is lost.
Operator's Manual ZS-910PA 11WARNING and CAUTION for Battery HandlingWARNING•••••Do not dispose of the battery in fire, or it may explode.•••••Do not disassemble the battery. The contents of the battery areharmful and the battery may catch fire.•••••Never short-circuit the + + + + + and −−−−− terminals. The battery mayoverheat and catch fire.•••••Take care that the patient does not swallow batteries.CAUTIONWhen the transmitter is not in use, remove the battery or turn thepower OFF. With the power ON, battery power is consumed evenif measurement is not performed.Especially, when NiCd or NiMH batteries remain in the transmitterwhen the transmitter is not in use, the battery may becomeunusable from overdischarge and leak liquid which will damagethe transmitter.NOTE•••••Remove the battery before disposing of the transmitter.•••••The capacity of manganese, NiCd and NiMH batteries is less thanthat of alkaline batteries and the battery lifetime is shorter.Type LifetimeManganese About 1/2 of alkaline batteriesNiCd About 1/3 of alkaline batteries(when fully charged)NiMH About 1/2 of alkaline batteries(when fully charged)•••••When using rechargeable NiCd batteries or NiMH batteries, shallowcharging/discharging shortens battery capacity. For details, refer tothe battery operator’s manual.
12 Operator's Manual ZS-910PAAttaching a Strap to the TransmitterCAUTIONAttach a strap to the transmitter to prevent the transmitter fromfalling.NOTEDo not attach the clip to hard objects such as thick cloth or a zipper.It will break the clip.Attach a strap to the transmitter and fasten the clip to the patient clothes’s or bedsheets.NOTE•••••If the transmitter falls off, it may become damaged.•••••If the transmitter falls on the patient foot, it will injure the patient.•••••When the transmitter falls into water or a toilet, clean anddisinfect the transmitter.To open the clip, firmly pull out thetab in the direction of the arrow.
Operator's Manual ZS-910PA 13Turning the Transmitter On/OffThe transmitter power is turned on or off by closing or opening the batterycase cover.Turning on the powerTo turn on the power, close the battery case cover. After about a one second“peep” sound, the power is turned on and transmission starts.Turning off the powerThere are two ways of turning off the power.Normal power off1. Open the battery case cover until it clicks twice and until the cover stops.2. Take out the battery and close the cover. When not using the transmitter,remove the battery and store the transmitter.Temporary power offOpen the battery case cover until it clicks once. At this position, the batterydoes not fall out if the transmitter is upside down.
14 Operator's Manual ZS-910PACheck Items Before UseBefore turning on the transmitter power switch, check the following toconfirm that the transmitter can be used in normal and safe condition.Appearance•There are no damaged or dirty points on the outside of the transmitter andthe CALL key.•The battery case cover is not lost.•The transmitter is completely dry.•The electrode lead is not broken.•There are no damaged or dirty points on the disposable electrodes.Battery•The battery polarity is correct.•The battery case spring is firmly fixed and the battery is not loose.Channel Setting•The transmitter channel corresponds to that of the receiving monitor.•No other transmitter in the surrounding area has the same channel.Check Items After the Power OnAfter turning on the power, check the following.Power on•There are no broken points on the battery case cover.•The transmitter generates about a one second “peep” sound.•The transmitter does not generate a continuous high-pitched sound.•The transmitter does not produce excessive heat.•The transmitter does not interfere with the operation of medical instrumentsused near it.Basic Operation•The “signal loss” message is not displayed on the monitor when thetransmitter is inside the receiving range of the monitor.•A “peep” sounds at the transmitter and a “CALL” message appears at thereceiving monitor when the CALL key is pressed and the transmitter isinside the receiving range of the monitor.•The battery replacement message is not displayed on the monitor.
Operator's Manual ZS-910PA 15MonitoringWARNING•••••Interaction Between Minute Ventilation Rate-Adaptive Pacemakersand Cardiac monitoring and Diagnostic EquipmentThe bioelectric impedance measurement sensor of a minuteventilation rate-adaptive implantable pacemaker may be affectedby the transmitter which is connected to the same patient. If thisoccurs, the pacemaker may pace at its maximum rate and thetransmitter may give incorrect data to the monitor. If this occurs,disconnect the electrode leads from the patient or change thesetting on the pacemaker by referring to the pacemaker’s manual.For more details, contact your pacemaker distributor or NihonKohden distributor.•••••When using this instrument with an ESU, refer to the instructionmanual for the ESU. Before measurement, check that the returnplate is correctly attached to the patient and check that theinstrument operates correctly when using with the ESU. If thereturn plate is not attached correctly, it may burn the patient’s skinwhere the electrodes are attached.CAUTIONTurn off the power of cellular telephones, small wireless devicesand other devices which produce strong electromagneticinterference around a patient (except for PHS telephones allowedby the hospital administrator). Otherwise, radio waves fromdevices such as cellular telephones or small wireless devicesmay be mistaken as respiration waves and the displayed data maybe incorrect.
16 Operator's Manual ZS-910PANOTE•••••Noise overlaps when the transmitter is used with the ESU, but itdoes not cause instrument trouble.•••••If an electric blanket is used and incorrect heart rate is displayedon the receiving monitor, turn off the pacing pulse detection onthe monitor.ECG MonitoringThis transmitter sends the ECG waveform detected between the R/RA electrodeand F/LL electrode to the monitor. The monitor displays the ECG waveformand measures heart rate, etc.Refer to the operator’s manual of the monitor for details.
Operator's Manual ZS-910PA 17OptionMeasurement Procedure1. Select the type of electrode lead and disposable electrode according to thepurpose.2. Connect the electrode lead to the transmitter.3. Connect disposable electrodes to the electrode lead and attach electrodes tothe patient.After steps 1 to 3 are finished, monitoring automatically starts.Selecting Electrode Lead and Disposable ElectrodeCAUTIONUse Nihon Kohden specified electrodes and electrode leads. Withelectrodes and electrode leads other than specified ones, themessage indicating checking electrodes appears and monitoringmay stop.Disposable electrode VitrodeElectrode leadBR-913PA BR-903PA BR-902PA BR-912PA3 electrodes 3 electrodes, 2 electodes, 2 electrodes,snap type clip type clip type snap type
18 Operator's Manual ZS-910PAConnecting the Electrode Lead to the TransmitterConnect the electrode lead to the input socket on the transmitter.CAUTION•••••Do not shake or swing the transmitter holding the leads/cablesconnected to the transmitter. The transmitter may come off andinjure a person or damage surrounding instruments.•••••Hold the connector of the electrode lead when connecting/disconnecting the electrode lead. If you disconnect the electrodelead holding the lead, it damages the electrode lead.
Operator's Manual ZS-910PA 19Selecting the Electrode PositionFollow the physician’s instructions for electrode placement when available.For ECG monitoring, electrodes are attached only on the chest to allow patientmovement and obtain continuous stable ECG. Following leads are examples.When also monitoring respiration, refer to “Electrode Position for RespirationMonitoring”.NOTEThe optimum electrode positions for ECG measurement of a patientare not always optimum for respiration measurement of the patient.Select positions suitable for both ECG and respirationmeasurements, or positions which have priority for onemeasurement.Three Electrodes•Lead MII, which is similar to standard lead II, used when ECG measurementhas prioritySymbol Lead ColorElectrode Position AHA IEC AHA IECLeft infraclavicular fossa LA L Black YellowRight infraclavicular fossa RA R White RedBelow lowest rib on the leftanterior axillary line LL F Red Green
20 Operator's Manual ZS-910PA•Lead MI, which is similar to standard lead IChange F/LL and L/LA of the lead MII.•Lead MIII, which is similar to standard lead III.Change R/RA and L/LA of the lead MII.If the electrode position shown above is not available due to chest surgery,attach the electrodes to the root of the limbs or below the clavicles for stableECG monitoring.
Operator's Manual ZS-910PA 21Two electrodesWith the optional BR-912P and BR-902P electrode leads, measurement withtwo electrodes is available. The L/LA electrode is not used.This is effective for a neonate or a patient whose body area is small and difficultto attach three electrodes.(ex.) Lead MII, which is similar to standard lead IISymbol Lead ColorElectrode Position AHA IEC AHA IECRight infraclavicular fossa RA R White RedBelow lowest rib on the leftanterior axillary line LL F Red GreenDifference between measurement with two electrodes and three electrodesMeasurement with two electrodes is less stable than measurement with threeelectrodes because of hum overlapping and body movement. Pay sufficientattention to this point. If ECG of necessary quality cannot be obtained, measurewith three electrodes.
22 Operator's Manual ZS-910PAConnecting the Electrode Lead and DisposableElectrodesPrepare the patient skinShave off excessive body hair.To reduce skin impedance, clean the electrode site with cream or with a gauzemoistened with alcohol. Thoroughly dry the skin with a clean cotton pad.NOTE•••••For a patient with frequent body movement, rub the sites withSkinpure skin preparation gel. However, do not use Skinpure skinpreparation gel for sensitive skin.•••••Do not place electrodes on a wound or on an inflamed, wrinkled oruneven skin surface.Attaching Electrodes to the PatientCAUTIONDo not reuse disposable products.NOTE•••••To maintain good contact between the electrode and skin, checkthat the paste of the disposable electrode is not dry.•••••When contact between the disposable electrode and skinbecomes poor, replace electrodes with new ones immediately.Otherwise, contact impedance between the skin and the electrodeincreases and the correct ECG cannot be obtained.Refer to the electrode operator’s manual for details.
Operator's Manual ZS-910PA 23(ex. Attaching Vitrode C disposable electrode)1. Connect the electrode lead to the electrode.2. Carefully remove the backing paper from theelectrode. Avoid touching the adhesivesurface.3. Place the electrode on the previously cleanedskin. Pay attention to the electrode lead colorand symbol.4. Fasten the electrode lead wire with surgicaltape with an extra length of wire between thetape and the electrode. This lessens themovement of electrode leads by bodymovement and helps stable monitoring.Using Electrode Lead Tube (Option)The electrode lead tube can prevent the electrodeleads from getting tangled during monitoring.During monitoring, slide the tube toward thetransmitter. When not using the transmitter, slidethe tube toward the lead clips or snaps.If the tube comes off the electrode leads easily, bindthe tube with tape to firmly attach it to theelectrode leads.electrode lead tube
24 Operator's Manual ZS-910PASet one electrode lead into one opening of thetube.Detection and Display of Measurement ConditionChecking ElectrodesThe message indicating checking electrodes is displayed on the screen of themonitor when:•An electrode is detached from skin.•An electrode lead is disconnected.•Polarization voltage between an electrode and skin is excessively high.In these cases, check the cause and if necessary, replace electrodes with newones.CAUTIONWhen the message indicating checking electrodes is displayed onthe receiving monitor, check electrodes and electrode leads andremove the cause.While the message is being displayed, there is no ECG monitoringand no alarms.NOTEWhen the L/LA electrode is detached from the skin or L/LAelectrode lead is disconnected, the message indicating checkingelectrodes does not appear on the receiving monitor. If humoverlaps or waveform is unstable for body movement, check theL/LA electrode and electrode lead condition.
Operator's Manual ZS-910PA 25Condition List by SoundSound Cause CountermeasureSingle “peep” sound The CALL key is pressed.The sound lasts while thekey is pressed.---Continuous “peep” sound Battery is completelydischarged. Replace the batterywith a new one.To stop the sound,turn off the power.One second “peep” sound The power is turned on. ---Changing the Transmitter ChannelThe transmitter channel can be changed when the transmitter is connected tothe QI-901PK channel writer. Refer to the operator’s manual of the QI-901PKchannel writer for details.WARNINGThe following action must be taken to properly receive the transmittersignal of the correct patient on the receiving monitor. Otherwise,there may be signal loss or signals may mix. This causes a seriousaccident, such as monitoring a different patient.•••••Assign a channel administrator in the hospital and only he or sheshould manage channel assignment on his or her responsibility.•••••The channel administrator must manage the channels in the facilityso that there is no signal interference.•••••When the transmitter channel is changed, the channel administratormust check that the channel on the receiving monitor is alsochanged and that the signal is properly received.•••••The channel administrator must replace the channel number labelon the transmitter with the new one after changing the channel.
26 Operator's Manual ZS-910PATroubleshootingIf the problem still remains after checking the following, contact your NihonKohden distributor.Problem Cause CountermeasureBatteries are notinstalled correctly.The battery polarity iswrong.Install the batteries correctly.The power cannot beturned on.Batteries are completelydischarged. Replace the batteries withnew ones.Nothing is displayedon the monitor afterturning the transmitterpower on.The channel of thetransmitter and monitordoes not match.Set the correct channel onthe monitor.Electrode lead is notconnected to thetransmitter.Connect the electrode leadto the transmitter.Another transmitter ofthe same channel isused nearby.Turn the transmitter poweroff. If the monitor stillreceives a signal, there is ahigh probability that anothertransmitter of the samechannel is used nearby.Follow the instruction ofyour channel administratorand use another transmitterof a different channel.Signals are mixing. Follow the instruction ofyour channel administratorand use another transmitterof a different channel.Transmitter radio waveis temporarily cut bypeople and objectsmoving.It is recommended to use adiversity antenna system.Signal receivingcondition is poor.The transmitter isbroken. Contact your Nihon Kohdendistributor.
Operator's Manual ZS-910PA 27Problem Cause CountermeasureThe gel on the electrodeis dried out.The gel on the electrodeis coming off.Replace the electrode with anew one.Electric blanket is used. Cover the blanket with ashield cover.ECG baseline is thick.(Hum is overlapping)Hum filter is set to OFFon the monitor Set the filter to ON.The heart rate of apatient using anelectric blanket isincorrect on thereceiving monitor.The pacing pulsedetection is ON on themonitor.Turn off the pacing pulsedetectionThe transmitter isdropped in water or atoilet--- Clean and disinfect thetransmitter.Refer to “Cleaning andDisinfection” in this manual.Use the strap to preventfalling.
28 Operator's Manual ZS-910PACheck After UseTo use the instrument in safe and optimum condition, perform inspection afteruse.CAUTIONDo not disassemble the transmitter when performing maintenanceand inspection. Do not repair the transmitter. When there is anyproblem with the transmitter after maintenance and inspection,contact your Nihon Kohden distributor.Storage•ECG electrode leads are cleaned and disinfected.•When the transmitter gets wet, liquid is wiped off and the transmitter isthoroughly dried.•There are enough consumables, such as disposable electrodes.•The power is turned off.•The batteries are removed from the transmitter when it will not be used fora long time.•Dead batteries are disposed of properly.
Operator's Manual ZS-910PA 29Lifetime and DisposalDisposing of Used BatteriesReplacementWhen the battery replacement message is displayed on the receiving monitor,the battery are running out.Replace the battery with a new one. When using a rechargeable battery,recharge it.Disposal NOTERemove the battery before disposing of the transmitter.Before disposing of batteries, check with your local solid waste officials fordetails in your area for proper disposal. It may be illegal to dispose of thesebatteries in the municipal waste stream.Disposing of Disposable ElectrodesLifetimeReplace the disposable electrodes with new ones 48 hours after the start ofusage. Otherwise, the gel on the electrode gets dry and adhesive propertydecreases. This increases skin electrode contact impedance and causes incorrectmeasurement.Replace the electrodes with new ones even before 48 hours if the contactbetween skin and electrode becomes poor.DisposalFollow your local laws for disposing of medical waste.
30 Operator's Manual ZS-910PACleaning, Disinfection and SterilizationTransmitter and Electrode LeadWARNINGIf detergents or dirty liquid get on the transmitter, clean it and dry itcompletely before use. If a wet transmitter is used, the patient oranyone in contact with the transmitter may receive an electricshock.CAUTION•••••Before cleaning or disinfecting the transmitter, remove the battery.•••••The transmitter cannot be sterilized.CleaningWipe the transmitter and electrode leads with a soft cloth moistened withdisinfecting alcohol or neutral detergent diluted with water. If the surface isvery dirty, wash with running water. After cleaning, dry them completely.DisinfectionCAUTION•••••Do not immerse the electrode lead connector in liquid.•••••Do not disinfect with hypochlorous acid.•••••Use the recommended concentration.Wipe the outside surface of the transmitter and electrode lead with a non-abrasive cloth moistened with any of the disinfectants listed on the next page.Use the recommended concentration.
Operator's Manual ZS-910PA 31Disinfectant Concentration (%)Glutaraldehyde solution 2.0Hydrochloric alkyl diaminoethylglycine 0.5Benzalkonium chloride 0.2Benzethonium chloride solution 0.2Chlorohexidine gluconate solution 0.5
32 Operator's Manual ZS-910PASpecificationsECG measurementChannels: 1Input range: ±5mV or moreDC offset: ±500mV or moreInput impedance: 5 MΩ or more (5Hz)Pacing pulse detection: ANSI/AAMI EC13Based upon pacemaker pulse rejectioncapabilityTransmitterFCC regulation: FCC part 95 Subpart-HWireless Medical Telemetry Service(WMTS)Field strength limits: <200 mV/m(at 3 m)Undesired emission: below 960 MHz: 200µV/m (at 3 m)above 960 MHz: 500µV/m (at 3 m)Antenna: ECG electrode leadTransmission channel: indicated on the transmitterTransmission frequency range:608.0125 to 613.9875 MHzChannel spacing: 25kHz (12.5 kHz when interleave)Type of emission: F1DOccupied bandwidth:<8.5 kHzEffective radiated power: 1.0 mW (conducted)Safety standardsSafety standard: CSA C22.2 No.601-1 M90 (1994)IEC 60601-1 (1988)IEC 60601-1 Amendment1 (1991)IEC 60601-1 Amendment2 (1995)IEC 60601-1-2 (1993)IEC 60601-2-27 (1994)
Operator's Manual ZS-910PA 33According to the type of protectionagainst electrical shock: INTERNALLY POWEREDEQUIPMENTAccording to the degree of protectionagainst electrical shock: DEFIBRILLATION-PROOFTYPE CF APPLIED PARTAccording to the degree of protectionagainst harmful ingress of water: Ordinary equipmentAccording to the degree of safety ofapplication in the presence of aFLAMMABLE ANAESTHETICMIXTURE WITH AIR, OR WITHOXYGEN OR NITROUS OXIDE: Equipment not suitable for use in thepresence of FLAMMABLEANAESTHETIC MIXTURE WITH AIR,OR WITH OXYGEN OR NITROUSOXIDEAccording to the mode of operation: CONTINUOUS OPERATIONWater resistanceWater does not get inside the transmitter except for the battery case whenimmersed in water up to 30 cm deep for 3 minutes.Power requirementsBattery type: One AA type alkaline dry cell battery recommended,One manganese dry cell battery,One NiCd rechargeable battery,One NiMH batteryBattery lifetime: ZS-910PA approximately 5 days(with an alkaline battery)
34 Operator's Manual ZS-910PAEnvironmentOperating environmentOperating temperature: 5 to 40°C, 41 to 104°FOperating humidity: 30 to 85% (non-condensing)Operating atmospheric pressure: 70 to 106 kPaOperating voltage: 0.9V to 1.6VStorage environmentStorage temperature: −20 to 65°C, −4 to 149°FStorage humidity: 15 to 95% (non-condensing)Storage atmospheric pressure: 70 to 106 kPaDimension and WeightDimension: 54 W × 85 H × 22 D (mm)Weight: about 85 g (without battery)
Operator's Manual ZS-910PA 35
36 Operator's Manual ZS-910PANo Name Model Q’ty Supply code1strap --- 1 Y233Standard AccessoriesAttach the channel number label to the monitor, too.
Operator's Manual ZS-910PA 37Name Application Model Q’ty Supplycode3 electrodes,snap type,lead length 80 cmBR-913P 1 K910A3 electrodes,clip type,lead length 80 cmBR-903P 1 K9112 electrodes,clip type,lead length 80 cmBR-902P 1 K907AElectrodelead2 electrodes,snap type,lead length 80 cmBR-912P 1 K908AElectrode lead tube --- 1 K120Bs-150 1 box(30 × 5 package) G201C-150 1 box(30 × 5 package) G204D-90 1 box(3 × 30 package) G217F-150M 1 box(3 × 50 package) G210DG-600 1 box(30 × 20 package) G221GeneralJ-150 1 box(30 × 5 package) G250Vitrode,disposableelectrodeNeonatePremature baby F-150S 1 box(3 × 50 package) G210COptionsCAUTIONUse only Nihon Kohden electrodes and electrode leads. Otherwise,the message indicating checking electrodes appears andmonitoring may stop.

Navigation menu