Nihon Kohden ZS-940PA Telemetry Medical Transmitter User Manual Cover 2 ZS940PA OM pmd

Nihon Kohden Corporation Telemetry Medical Transmitter Cover 2 ZS940PA OM pmd

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User Manual

TRANSMITTER

ZS-940PA

0614-009355

Model: ZS-940PA

Manual code no.: 0614-009355

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Operator's Manual ZS-940PA i

GENERAL HANDLING PRECAUTIONS

This device is intended for use only by qualified medical personnel.

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

products or in a non-approved manner may affect the performance specifications of

the device. This includes, but is not limited to, batteries, recording paper, pens,

extension cables, electrode leads, input boxes and AC power.

Please read these precautions thoroughly before attempting to operate the instrument.

1. To safely and effectively use the instrument, its operation must be fully understood.

2. When installing or storing the instrument, take the following precautions:

(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive

humidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air.

(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock,

even during transport.

(3) Avoid placing in an area where chemicals are stored or where there is danger of gas

leakage.

(4) The power line source to be applied to the instrument must correspond in frequency

and voltage to product specifications, and have sufficient current capacity.

(5) Choose a room where a proper grounding facility is available.

3. Before Operation

(1) Check that the instrument is in perfect operating order.

(2) Check that the instrument is grounded properly.

(3) Check that all cords are connected properly.

(4) Pay extra attention when the instrument is in combination with other instruments to

avoid misdiagnosis or other problems.

(5) All circuitry used for direct patient connection must be doubly checked.

(6) Check that battery level is acceptable and battery condition is good when using battery-

operated models.

4. During Operation

(1) Both the instrument and the patient must receive continual, careful attention.

(2) Turn power off or remove electrodes and/or transducers when necessary to assure the

patient’s safety.

(3) Avoid direct contact between the instrument housing and the patient.

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.

ii Operator's Manual ZS-940PA

(3) Clean the instrument together with all accessories for their next use.

6. The instrument must receive expert, professional attention for maintenance and

repairs. When the instrument is not functioning properly, it should be clearly

marked to avoid operation while it is out of order.

7. The instrument must not be altered or modified in any way.

8. Maintenance and Inspection:

(1) The instrument and parts must undergo regular maintenance inspection at least every 6

months.

(2) If stored for extended periods without being used, make sure prior to operation that the

instrument is in perfect operating condition.

(3) Technical information such as parts list, descriptions, calibration instructions or other

information is available for qualified user technical personnel upon request from your

Nihon Kohden distributor.

9. When the instrument is used with an electrosurgical instrument, pay careful

attention to the application and/or location of electrodes and/or transducers to avoid

possible burn to the patient.

10. When the instrument is used with a defibrillator, make sure that the instrument is

protected against defibrillator discharge. If not, remove patient cables and/or

transducers from the instrument to avoid possible damage.

Operator's Manual ZS-940PA iii

WARRANTY POLICY

Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and

workmanship for one year from the date of delivery. However, consumable materials such as

recording paper, ink, stylus and battery are excluded from the warranty.

NKC or its authorized agents will repair or replace any products which prove to be defective

during the warranty period, provided these products are used as prescribed by the operating

instructions given in the operator’s and service manuals.

No other party is authorized to make any warranty or assume liability for NKC’s products.

NKC will not recognize any other warranty, either implied or in writing. In addition, service,

technical modification or any other product change performed by someone other than NKC or

its authorized agents without prior consent of NKC may be cause for voiding this warranty.

Defective products or parts must be returned to NKC or its authorized agents, along with an

explanation of the failure. Shipping costs must be pre-paid.

This warranty does not apply to products that have been modified, disassembled, reinstalled or

repaired without Nihon Kohden approval or which have been subjected to neglect or accident,

damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation

or application, or on which the original identification marks have been removed.

In the USA and Canada other warranty policies may apply.

CAUTION

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

Equipment Authorization Requirement

Operation of this equipment requires the prior coordination with a frequency coordinator

designated by FCC for the Wireless Medical Telemetry Service.

iv Operator's Manual ZS-940PA

EMC RELATED CAUTION

This equipment and/or system complies with the International Standard

IEC60601-1-2 for electromagnetic compatibility for medical electrical equipment

and/or system. However, an electromagnetic environment that exceeds the

limits or levels stipulated in the IEC60601-1-2, can cause harmful interference to

the equipment and/or system or cause the equipment and/or system to fail to

perform its intended function or degrade its intended performance. Therefore,

during the operation of the equipment and/or system, if there is any undesired

deviation from its intended operational performance, you must avoid, identify

and resolve the adverse electromagnetic effect before continuing to use the

equipment and/or system.

The following describes some common interference sources and remedial

actions:

1.Strong electromagnetic interference from a nearby emitter source such as an

authorized radio station or cellular phone:

Install the equipment and/or system at another location if it is interfered with

by an emitter source such as an authorized radio station. Keep the emitter

source such as cellular phone away from the equipment and/or system.

2.Effect of direct or indirect electrostatic discharge:

Make sure all users and patients in contact with the equipment and/or system

are free from direct or indirect electrostatic energy before using it.

3.Electromagnetic interference with any radio wave receiver such as radio or

television:

If the equipment and/or system interferes with any radio wave receiver, locate

the equipment and/or system as far as possible from the radio wave receiver.

If the above suggested remedial actions do not solve the problem, consult your

Nihon Kohden Corporation subsidiary or distributor for additional suggestions.

Operator's Manual ZS-940PA v

Conventions Used in this Manual and Instrument

Warnings, Cautions and Notes

Warnings, cautions and notes are used in this manual to alert or signal the reader to specific

information.

WARNING

A warning alerts the user to the possible injury or death associated with the use

or misuse of the instrument.

CAUTION

A caution alerts the user to possible injury or problems with the instrument

associated with its use or misuse such as instrument malfunction, instrument

failure, damage to the instrument, or damage to other property.

NOTE

A note provides specific information, in the form of recommendations,

prerequirements, alternative methods or supplemental information.

vi Operator's Manual ZS-940PA

Symbol Description Symbol Description

Full battery Replace battery

NIBP cannot be measured

Replace battery Check electrode

Symbol Description Symbol Description

Defibrillation proof type BF

applied part Direct current

Defibrillation proof type CF

applied part Serial number

Attention, consult operator’s

manual Year of manufacture

Direction for attaching

battery cover CSA mark

On LCD

Explanations of the Symbols in this Manual and Instrument

The following symbols found in this manual/instrument bear the respective descriptions as

given.

On Panel

Symbol Description Symbol Description

Battery position Attention, consult operator’s

manual

Inside Battery Case

Operator's Manual ZS-940PA 1

Introduction

The ZS-940PA transmitter transmits ECG, respiration, SpO2, NIBP and pulse waveform from a

patient to a Nihon Kohden monitor for continuous monitoring. The transmitter can change

channels when connected to the QI-901PK channel writer. The front LCD displays SpO2%,

NIBP, pulse rate, pulse waveform amplitude, electrode condition mark, battery condition and

NIBP measuring mode and interval.

Read the operator’s manual for the receiving monitor together with this manual before operation.

CAUTION

• Do not use the same channel for different patients. Otherwise, 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 transmitters of adjacent channels in a hospital. Otherwise, radio

waves from one transmitter affect the receiver of the adjacent channel’s

transmitter and there may be interference.

NOTE

• To prevent interference between channels, assign a channel administrator in

the hospital and only he or she should manage channel assignment.

• Use Nihon Kohden parts and accessories to assure maximum performance

from your instrument.

• For stable signal reception, it is recommended to use a diversity antenna

system on the receiving monitor. Otherwise, spike noise from transient fading

of electric field strength (for example, people moving) may interfere with the

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

monitor.

• NIBP cannot be measured on a neonate. (ECG, respiration and SpO2 can be

monitored on a neonate.)

2 Operator's Manual ZS-940PA

Panel Description

Front Panel

LCD:

Displays measuring data, settings and

other information.

Battery case:

Contains three 1.5 V AA batteries.

NIBP START/STOP key:

Starts/stops NIBP measurement in

selected mode.

NIBP INTERVAL key:

Selects NIBP measurement mode.

WARNING

Close the battery case cover during operation.

If the transmitter is used with the battery case cover open, the patient may get

an electrical shock when defibrillation is performed, and electrostatic discharge

by the patient may intermittently interfere with the waveform or data.

Refer to the WARNING below.

(This symbol is attached to the rear of the

battery case cover.)

Operator's Manual ZS-940PA 3

Rear Panel

Lock plate:

Fastens the transmitter to an NIBP cuff.

Refer to the WARNING below.

WARNING

If detergent or liquid spills into the transmitter, stop using it and contact your

Nihon Kohden distributor. If a wet transmitter is used, the patient or anyone in

contact with the transmitter may receive an electric shock or patient leakage

current over the allowed amount may flow.

4 Operator's Manual ZS-940PA

Top Panel

ECG/impedance RESP socket:

Connects the electrode lead for

measuring ECG and/or respiration

by the impedance method.

NIBP socket:

Connects the cuff hose.

Refer to the symbol page.

Refer to the WARNING on the

next page.

Refer to the WARNING on the

next page.

Refer to the symbol

page.

Channel number label:

Indicates the channel number of the

transmitter. Attach the channel number label

to the panel of the monitor.

SpO2 socket:

Connects the SpO2

probe.

Bottom Panel

Refer to the WARNING on the next

page.

Refer to the symbol page.

Operator's Manual ZS-940PA 5

WARNING

• Before performing defibrillation, check that the electrode leads and SpO2

probe attached to the patient are properly connected to the transmitter.

Touching the metal parts of disconnected leads and probes causes serious

electrical shock or injury by discharged energy.

• When performing defibrillation, all persons must keep clear of the bed and

must not touch the patient, any equipment connected to the patient or the

metal parts of leads and probes connected to the patient. Failure to follow this

warning may result in serious electrical burn, shock or other injury.

• When performing defibrillation, discharge as far as possible from electrodes

and medicine on the chest of the patient. If there is a possibility that the

defibrillator paddle could touch electrodes and medicine, remove electrodes

and medicine from the patient. If the defibrillator contacts these materials, the

discharged energy may cause serious electrical burn on the patient.

• When using this transmitter with an ESU, the ESU return plate and the

electrodes for monitoring must be firmly attached to the patient. If the return

plate is not attached correctly, it may burn the patient’s skin where the

electrodes are attached. Refer to the instruction manual for the ESU.

CAUTION

Do not shake or swing the transmitter holding the leads/cables connected to the

transmitter. The transmitter may come off and injure someone or damage

surrounding instruments.

6 Operator's Manual ZS-940PA

LCD

LOCK

KEYS

1234

No. Name Description

1 NIBP SYS Displays NIBP systolic value.

2 NIBP DIA Displays NIBP diastolic value.

3 NIBP MEAN Displays NIBP mean value.

“CUFF” is displayed with the cuff inflation pressure during

measurement.

4 Check electrode mark Appears when an electrode or electrode lead becomes

detached during ECG measurement.

5 Battery replacement mark Appears when the batteries are weak. For details, refer to

the “Battery Condition Indication” section.

6 Message display area Displays messages.

7 NIBP measurement mode Displays NIBP measurement mode. When set to auto mode,

the measurement interval is displayed.

8 NIBP interval bar graph In auto NIBP measurement, the remaining time from the last

measurement to the next measurement is displayed as a bar

graph.

9 Pulse level bar graph Displays pulse level in 7 steps.

10 %SpO2Displays SpO2 data.

11 PR Displays pulse rate when NIBP or SpO2 is measured. When

the SpO2 probe is attached to the patient, the real time pulse

rate is displayed. When the SpO2 probe is not attached to the

patient, the pulse rate at the end of NIBP measurement is

displayed.

Operator's Manual ZS-940PA 7

Notes on Parameter Settings

When monitoring NIBP and SpO2, the following settings must be set as indicated in the table to

properly transmit the monitoring data to the receiving monitor. Otherwise, data cannot be

displayed on the receiving monitor even when NIBP and SpO2 are measured on the transmitter.

Some monitors require the software to be upgraded. For details, contact your Nihon Kohden

distributor.

TYPE setting INHIBIT SpO2 DURING NIBP setting SpO2 probe attachment site

ON Probe can be attached to the

same limb as the cuff

A*1

OFF Probe must be attached to the

limb without cuff*2

*1Always set to “A”.

*2When the SpO2 probe is attached to the same limb as the NIBP cuff and the cuff is inflated,

the SpO2 value becomes unstable and SpO2 or PR alarm may occur.

8 Operator's Manual ZS-940PA

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

because 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.

Important Safety Information

General

WARNING

• Never use this transmitter in the presence of any flammable anesthetic gas or

high concentration oxygen atmosphere. Failure to follow this warning may

cause explosion or fire.

• Never use this transmitter in a high-pressure oxygen medical care tank.

Failure to follow this warning may cause explosion or fire.

• Do not take this transmitter into the MRI test room. This transmitter is not

designed to be used during MRI tests.

• If detergent or liquid spills into the transmitter, stop using it and contact your

Nihon Kohden distributor. If a wet transmitter is used, the patient or anyone in

contact with the transmitter may receive an electric shock or patient leakage

current over the allowed amount may flow.

• Before cleaning or disinfecting the transmitter, remove the batteries from the

transmitter.

• The transmitter cannot be sterilized.

Operator's Manual ZS-940PA 9

Installing (Replacing) Batteries

WARNING and CAUTION for Battery Handling

WARNING

• Do not dispose of the battery in fire because it may explode.

• Do not use a disassembled or damaged battery. The contents of the battery

are harmful and the battery may catch fire.

• If the contents of the battery contact the skin or clothes, immediately wash it

thoroughly with water.

• Never short-circuit the + and – terminals. The battery may overheat and catch

fire.

• Take care that the patient does not swallow batteries.

CAUTION

• Refer to the battery and battery charger manuals for details on handling the

batteries.

• Do not handle the batteries with wet hands.

• When the transmitter is not in use, remove batteries. When batteries are

installed, battery power is consumed even if measurement is not performed.

Especially, when NiMH batteries remain in the transmitter when the

transmitter is not in use, the battery may become unusable from

overdischarge and leak liquid which will damage the transmitter.

• The battery charger must be used outside the patient environment.

Battery Lifetime

Use three AA type alkaline dry cell batteries. NiMH rechargeable batteries can also be used.

Preparation

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO2ECG only

NiMH secondary 2 days 2 days 2.5 days

Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is measured in auto

mode at 60 minute intervals and SpO2 is measured on an index finger of a male patient with

weight 60 kg.

Operation time depends on the thickness of SpO2 probe attachment site.

10 Operator's Manual ZS-940PA

NOTE

When using rechargeable NiMH batteries, shallow charging/discharging

shortens battery capacity. For details, refer to the battery operator’s manual.

Installing (Replacing) Batteries

CAUTION

Battery replacement must be performed by medical staff. When replacing

batteries of the transmitter currently used for a patient, disconnect electrode

leads from the transmitter before replacing batteries or do not touch the patient

during replacement.

If electrode leads are attached to the patient and a person replacing batteries touches the patient

during battery replacement, patient leakage current over the allowed amount may flow.

CAUTION

• Replace all batteries at the same time.

• Do not use different types of batteries together.

NOTE

Insert the batteries with the correct polarity (+ and –).

Procedure

1. Remove the battery case cover.

2. Insert three new or fully charged batteries into the

battery case observing the correct polarity.

Operator's Manual ZS-940PA 11

3. Close the cover.

NOTE

Remove the batteries before disposing of the

transmitter.

Situations Requiring Battery Replacement

Replace the batteries when any of the following occurs.

• The transmitter LCD displays the “ ” or “ ”mark.

• The transmitter generates a constant alarm (continuous “peep” sound).

• The transmitter LCD does not display anything when the power is turned on.

• The monitor displays the battery replacement message on the screen.

Battery Condition Indication

The battery condition is indicated as follows.

Indication Condition Receiving Monitor

Fully charged battery Batteries are full. There is no indication on

the monitor.

Batteries are low. Replace

batteries.

Batteries are low. NIBP cannot

be measured. Replace batteries.

Message requiring battery replacement is

displayed.

indication Dead batteries No signal can be transmitted to the monitor.

There is no indication on the monitor.

12 Operator's Manual ZS-940PA

Turning the Transmitter On/Off

Turning On the Power

When the batteries are installed correctly, the power is

turned on. A one second “peep” sounds and the startup

screen appears. (There is no “peep” sound when there is

no battery power.)

NOTE

Replace the batteries when the LCD displays

the “ ” or “ ”mark.

Turning Off the Power

To turn off the power, remove batteries.

Peep

Check Items Before Use

Before turning on the transmitter power, check the following to confirm that the transmitter can

be used in normal and safe condition.

Appearance

• There are no damaged or dirty parts on the outside of the transmitter (Power switch, LCD,

keys, sockets, battery case cover, battery case, lock plate, etc.).

• The transmitter is completely dry.

• The electrode lead, SpO2 probe and NIBP cuff are not broken.

• There are no damaged or dirty parts on the disposable SpO2 probe, disposable electrodes or

disposable NIBP cuff.

Batteries

• The battery polarity is correct.

• The battery case spring is firmly fixed and the battery is not loose.

• The battery case cover is firmly closed.

Channel Setting

• The transmitter channel corresponds to those of the receiving monitor.

• There is no transmitter in the surrounding area with the same channel.

Operator's Manual ZS-940PA 13

Check Items After Power On

After turning on the power, check the following.

Power On

• The Power switch is not broken.

• The transmitter generates about a one second “peep” sound and the startup screen appears.

• The transmitter does not generate a continuous “peep” sound.

• The transmitter does not give excessive heat.

• The transmitter LCD displays a “ ” mark.

• The transmitter does not interfere with the operation of other medical instruments in use.

Basic Operation

• The “signal loss” message is not displayed on the receiving monitor when the transmitter is

inside the receiving range of the monitor.

• The battery replacement message is not displayed on the monitor.

• The keys on the transmitter function properly.

Check Items After Use

To use the transmitter in safe and optimum condition for next time, check the following.

Before Turning Power Off

• Temporarily changed settings are changed back to the previous settings.

• There was no malfunction on the transmitter.

Storage

• ECG electrode leads, SpO2 probe and NIBP cuff are cleaned and disinfected.

• When the transmitter gets wet, liquid is wiped off and the transmitter is thoroughly dried.

• There are enough consumables, such as disposable electrodes.

• The transmitter power is turned off.

• The batteries are removed from the transmitter when it will not be used for a long time.

• Dead batteries are disposed of properly.

14 Operator's Manual ZS-940PA

Changing the Transmitter Channel

The channel of the transmitter can be changed. The optional QI-901PK Channel Writer is

required.

WARNING

The following action 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 on his or her responsibility.

• 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 ZS-940PA transmitter.

To check the transmitter channel, refer to “CHANNEL/TYPE” in the “Changing System Setup

Settings” section.

Operator's Manual ZS-940PA 15

Changing Parameter Setup Settings

The initial settings on the PARAMETER SETUP screen must be changed before monitoring.

Changing these settings during monitoring interrupts monitoring.

Parameter Setup Setting List

The factory default settings are underlined.

Setting Item Description Settings

SELECTABLE

INTERVALS

Select the NIBP measurement modes for

the mode selection.

STAT, 5, 10, 15, 30, 60,

120, 240

INITIAL

INTERVAL

Select the initial NIBP measurement

mode at power on.

MAN., 5 min, 10 min,

15 min, 30 min, 60 min,

120 min, 240 min

INITIAL CUFF

PRESS Select the NIBP cuff inflation pressure.

120 mmHg, 150 mmHg,

180 mmHg, 210 mmHg,

240 mmHg

NIBP MODE

AFTER STAT

Select the NIBP measurement mode

after completing STAT measurement.

MAN., 5 min, 10 min,

15 min, 30 min

START/FINISH

SOUND

Turn ON or OFF the sound for NIBP

measurement start/finish. ON, OFF/ON, OFF

OLD NIBP DATA

AFTER

Select whether to hide or dim the NIBP

data after measurement and how long to

wait after measurement to dim or hide it.

DATA: HIDE, DIM

AFTER: 5 min, 10 min,

30 min

INHIBIT SpO2

DURING NIBP

Turn SpO2 monitoring on or off during

NIBP measurement. ON, OFF

2ND PARAMETER Set SpO2 and PR display order. SpO2, PR

Displaying the PARAMETER SETUP Screen

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.

The SETUP screen appears.

16 Operator's Manual ZS-940PA

3. Press the NIBP START/STOP key to enter the PARAMETER SETUP screen.

When the cursor is moved to “EXIT” by pressing the NIBP INTERVAL key and the NIBP

START/STOP key is pressed, the startup screen appears, then the monitoring screen

appears.

4. To select or change a setting, press the NIBP START/STOP key.

To move the cursor, press the NIBP INTERVAL key.

Selects or changes setting

Moves cursor

When the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and the

NIBP START/STOP key is pressed, the SETUP screen appears.

Changing Settings

SELECTABLE INTERVALS

During monitoring, when the NIBP INTERVAL key is pressed, the measurement mode changes

according to the modes selected in this item. MANUAL mode is already selected for the mode

selection.

1. Press the NIBP INTERVAL key to move the

cursor to the desired mode.

2. Press the NIBP START/STOP key to select or

unselect the mode. Selectable modes are: STAT,

5, 10, 15, 30, 60, 120 and 240 min.

Operator's Manual ZS-940PA 17

INITIAL INTERVAL

Select the initial NIBP measurement mode at power on.

1. Press the NIBP INTERVAL key to move the

cursor to “INITIAL INTERVAL”.

2. Press the NIBP START/STOP key to select

the mode. Selectable modes are the modes

selected for “SELECTABLE INTERVALS”

and “STAT” and “MAN.” (MANUAL).

INITIAL CUFF PRESS

Select the NIBP cuff inflation pressure.

1. Press the NIBP INTERVAL key to move the

cursor to “INITIAL CUFF PRESS”.

2. Press the NIBP START/STOP key to select

the inflation pressure from 120, 150, 180, 210

and 240 mmHg.

NIBP MODE AFTER STAT

Select the NIBP measurement mode after completing the STAT measurement.

1. Press the NIBP INTERVAL key to move the

cursor to “NIBP MODE AFTER STAT”.

2. Press the NIBP START/STOP key to select

the mode. The selected mode is automatically

selected for “SELECTABLE INTERVALS”

as well.

18 Operator's Manual ZS-940PA

START/FINISH SOUND

Turn on or off the sound for NIBP measurement start and finish.

Start sound End sound

1. Press the NIBP INTERVAL key to move the

cursor to “START/FINISH SOUND”.

2. Press the NIBP START/STOP key to turn ON

or OFF.

OLD NIBP DATA/AFTER

Select whether to dim or hide the NIBP data after measurement and how long to wait after NIBP

measurement to dim or hide it.

1. Press the NIBP INTERVAL key to move the

cursor to “OLD NIBP DATA/AFTER”.

2. Press the NIBP START/STOP key to select the

setting.

DATA: DIM NIBP data is dimmed after the “AFTER” interval.

HIDE NIBP data is hidden after the “AFTER” interval. “– – –” is displayed on the

screen.

AFTER: Select the interval after NIBP measurement to dim or hide.

Dimmed Hidden

Operator's Manual ZS-940PA 19

INHIBIT SpO2 DURING NIBP

Set whether or not to monitor SpO2 during NIBP measurement.

When the SpO2 probe is attached to the same limb as the NIBP cuff and this setting is set to

OFF, the pulse may become unstable and SpO2 or PR alarm may occur. It is recommended to

set this setting to ON so that SpO2 is not measured during NIBP measurement.

When the SpO2 probe is attached to the other limb from the NIBP cuff, this setting can be set to

OFF.

NOTE

• When the “CHANNEL/TYPE” on the SYSTEM SETUP screen is set to “8”, this

“INHIBIT SpO2 DURING NIBP” setting becomes invalid and SpO2 is monitored

during NIBP measurement.

• When this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the “Monitoring

SpO2 during NIBP Measurement” section.

1. Press the NIBP INTERVAL key to move the

cursor to “INHIBIT SpO2 DURING NIBP”.

2. Press the NIBP START/STOP key to select

“ON” or “OFF”.

ON: Stops SpO2 monitoring during NIBP measurement.

OFF: SpO2 is monitored during NIBP measurement.

2ND PARAMETER

Set the display order of SpO2 and PR.

When set to SpO2When set to PR

1. Press the NIBP INTERVAL key to move the

cursor to “2ND PARAMETER”.

2. Press the NIBP START/STOP key to select

“SpO2” or “PR”.

20 Operator's Manual ZS-940PA

Changing System Setup Settings

NOTE

Changing System Setup settings must be done only by a qualified personnel.

System Setup Setting List

The factory default settings are underlined.

Setting Item Description Settings

CHANNEL/TYPE Displays the transmitter channel and select the

TYPE. A, 8

PRESSURE UNIT Select the units for NIBP. mmHg, kPa

LANGUAGE Select the language for screen display. JPN, ENG

SYSTEM

INITIALIZE

Initializes all settings to the factory default

settings.

Displaying the SYSTEM SETUP Screen

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.

The SETUP screen appears.

3. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.

4. Press the NIBP START/STOP key to enter the

SYSTEM SETUP screen.

When the cursor is moved to “EXIT” by

pressing the NIBP INTERVAL key and the

NIBP START/STOP key is pressed, the startup

screen appears, then the monitoring screen

appears.

Operator's Manual ZS-940PA 21

5. To select or change a setting, press the NIBP START/STOP key.

To move the cursor, press the NIBP INTERVAL key.

Selects or changes setting

Moves cursor

When the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and the

NIBP START/STOP key is pressed, the SETUP screen appears.

Changing Settings

CHANNEL/TYPE

Select “A” for TYPE. The channel of this transmitter is also displayed.

1. On the SYSTEM SETUP screen, press the NIBP START/STOP key to select “A”.

Channel of this transmitter

NOTE

Always select “A” for TYPE. If “8” is selected,

NIBP data cannot be properly transmitted to

the receiving monitor.

PRESSURE UNIT

Select the unit for NIBP.

1. Press the NIBP INTERVAL key to move the

cursor to “PRESSURE UNIT”.

2. Press the NIBP START/STOP key to select

“mmHg” or “kPa”.

22 Operator's Manual ZS-940PA

LANGUAGE

Select the language for screen display.

1. Press the NIBP INTERVAL key to move the

cursor to “LANGUAGE”.

2. Press the NIBP START/STOP key to select the

language.

SYSTEM INITIALIZE

Do the following procedure to initialize the settings to the factory default settings.

1. Press the NIBP INTERVAL key to move the cursor to “SYSTEM INITIALIZE”.

2. Press the NIBP START/STOP key. The “EXECUTE” message appears.

3. Press the NIBP START/STOP key to initialize the settings to the factory default settings.

Operator's Manual ZS-940PA 23

Attaching NIBP Cuff, Electrodes and SpO2 Probe

to the Patient

The transmitter can be attached to an arm of the patient or placed on the bedside. The required

length of the electrode leads and SpO2 probe cable depends on how the transmitter is to be

attached to the patient.

NOTE

Monitoring SpO2 during NIBP Measurement

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

flow decreases during NIBP measurement and pulse wave cannot be detected

and SpO2 cannot be monitored properly. When “INHIBIT SpO2 DURING NIBP” on

the PARAMETER SETUP screen is set to ON (factory default setting), SpO2

monitoring is paused during NIBP measurement to avoid SpO2 alarm

occurrence. However, when monitoring SpO2 on the same limb as NIBP, be

careful when reading SpO2 values.

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

NIBP cuff or catheter is not attached.

Attachment Examples

When transmitter is attached on an

arm

When transmitter is placed on a bedside

NOTE

When placing the transmitter on a bedside,

place it on a stable and flat place. If the

transmitter falls off, it may be damaged.

24 Operator's Manual ZS-940PA

Attaching the NIBP Cuff

Selecting the NIBP Cuff

Select the NIBP cuff appropriate for the patient.

NOTE

NIBP cannot be measured on neonates using this transmitter.

Reusable Cuffs

When attaching the transmitter to the patient arm, a special NIBP cuff is required. An optional

YN-990P extension hose (1.5 m) is available to extend the length between the NIBP socket on

the transmitter and NIBP cuff (e.g. when not attaching the transmitter to the patient arm and

placing the transmitter on a bedside).

Reusable cuff Model Width (cm) Air hose length (cm)

Standard YP-943P 13 15

For adult Large YP-944P 15 15

When not attaching the transmitter to the patient arm, the following cuffs can be used. To use

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

Reusable cuff Model Width (cm) Air hose length (cm)

For infants YP-960T 5

Small YP-961T 7

For

children Standard YP-962T 10

Standard YP-963T 13

For adults Large YP-964T 15

Width

Air hose

Operator's Manual ZS-940PA 25

Disposable Cuffs

CAUTION

The disposable cuffs are not sterilized. If necessary, sterilize the disposable

cuffs using glutaraldehyde solution by following the instructions for the

glutaraldehyde.

When not attaching the transmitter to the patient arm, the following disposable cuffs can be used.

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

YN-990P extension hose, 150 cm

Width

Reusable cuff Model Width (cm) Air hose length (cm)

For infants YP-910P 6

For children YP-912P 9

Small YP-913P 12

Standard YP-914P 14

For adults

Large YP-915P 16

Extension Hose

CAUTION

When using an extension hose, check that the extension hose is not bent or

squeezed. Otherwise, the cuff may not inflate or deflate. If the cuff cannot

deflate, it may cause congestion on the patient at the cuff attachment site.

Air hose

26 Operator's Manual ZS-940PA

Reference for selecting a cuff

The AHA (American Heart Association) recommends that the cuff width be 40% of the

circumference of the upper arm. Refer to the following graph and select the cuff which suits the

patient’s arm.

NOTE

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

cuff within that range.

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

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

values higher than the actual values.

• The YP-943P NIBP cuff is for standard size adult. Do not use this cuff when it

does not fit the patient.

10 20 30 40 50

10 20 30 40 50 60

Cuff width (cm)

Arm circumference (cm)

Infants YP-960T

Children small YP-961T

Children standard YP-962T

Adults standard YP-943P (cuff for transmitter)

YP-963T

Adults large YP-944P (cuff for transmitter)

YP-964T

Cuff Width and Arm Circumference

Reusable Cuffs

Cuff width (cm)

Arm circumference (cm)

Infants YP-910P

Children standard YP-912P

Adults standard YP-914P

Adults large YP-915P

Disposable Cuffs

Adults small YP-913P

Operator's Manual ZS-940PA 27

Connecting the NIBP Cuff to the Transmitter

When Using YP-943P/944P NIBP Cuff

To attach the YP-943P/944P NIBP cuff to the transmitter, the lock plate is required.

D ring

Belt

Air hose

Front cover

Front cover open

Belt for the strap

Lock plate pocket

For attaching the NIBP cuff to the transmitter

NOTE

Do not roll up or put weight on the cuff with the lock

plate attached to it. Otherwise, the lock plate may

break.

Lock plate

YP-943P/944P NIBP cuff

Top tab

Bottom tab

28 Operator's Manual ZS-940PA

1. Remove the lock plate from the

transmitter.

2. Insert the lock plate into the lock plate

pocket on the NIBP cuff.

3. Attach the transmitter to the lock plate

by inserting the tabs on the lock plate

into the slots on the transmitter.

4. Cover the transmitter with the front

cover of the NIBP cuff.

5. Connect the air hose to the NIBP socket

on the transmitter. Turn the cuff

connector joint until it clicks.

Operator's Manual ZS-940PA 29

When Using YP-960T series or YP-910P series NIBP Cuff

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 was attached.

CAUTION

• Do not wrap the cuff on an arm or thigh which is used for injection. NIBP

measurement on an arm or thigh which is used for injection may cause a

reflux of blood and stop injection.

• Do not wrap the cuff too tight. It may cause poor blood circulation and

congestion. If the cuff is wrapped too loosely, the NIBP value may be

increased.

• If the skin gets irritated or redness appears on the skin from the cuff, change

the attachment site or stop using the cuff.

30 Operator's Manual ZS-940PA

• NIBP and SpO2 can be measured on the same limb, but the SpO2 monitoring

may not be accurate during NIBP measurement. Be careful when reading the

SpO2 values.*

• Do not reuse disposable cuffs.

* Monitoring SpO2 during NIBP Measurement

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

during NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitored

properly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen is

set to ON (factory default setting), SpO2 monitoring is paused during NIBP measurement to

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

NIBP, be careful when reading SpO2 values.

NOTE

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

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

values, measure NIBP on an upper arm.

• To accurately detect the pulsatile flow of the artery, the cuff should be

wrapped around a bare upper arm.

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

Before use, check the cuff and confirm that there is no flaw, crack or hole in it.

Be careful not to damage the inflation bag. If the inflation bag has a hole or a

flaw, it may burst during use. Dispose of an abnormal cuff and replace it with

a new one.

• Refer to the NIBP cuff manual for details.

Cuff Position

Place the cuffed upper arm (brachium) at the same height as

the patient’s heart. If the cuff is not at the same level as the

heart, the weight of the blood affects the blood pressure

reading. The pressure difference per unit height is 0.7

mmHg/cm. The blood pressure reading decreases when the

arm is higher than the heart and increases when lower.

The best measuring condition is when the patient is lying on

his/her back with arms and legs relaxed. If the cuff position

cannot be on the same level as the heart, the displayed blood

pressure reading must be mathematically adjusted.

Heart

When placing the

transmitter on a bed, make

sure that the hose is not

bent.

Operator's Manual ZS-940PA 31

Using the YP-943P/944P NIBP Cuff

1. Attach the NIBP cuff to the transmitter. Refer to

the “Connecting the NIBP Cuff to the

Transmitter” section.

2. Insert the end of the cuff into the belt and then

through the D ring as shown at left.

3. Fold back the cuff at the D ring and fasten it

using the velcro tape.

Make sure that the cuff is not attached on a joint.

NOTE

The cuff must not wrap around the elbow.

D ring

Belt

End of cuff

32 Operator's Manual ZS-940PA

Attaching the Strap to the Transmitter

NOTE

• Use the strap to prevent the transmitter from falling.

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

the clip.

Attach a strap provided with the transmitter to the NIBP cuff and patient clothes.

To open the clip, firmly

pull out the tab in

direction of the arrow. To adjust the strap length,

push down the tab on the

adjuster and slide.

1. Adjust the length of the strap.

2. Clip one end of the strap to the belt for the strap

on the NIBP cuff.

3. Clip the other end of the strap to the patient’s

clothes as shown left.

Belt for the strap on the NIBP cuff

Operator's Manual ZS-940PA 33

Attaching Electrodes

Selecting Electrode Lead

CAUTION

Use Nihon Kohden specified electrodes and electrode leads. With electrodes

and electrode leads other than specified ones, the “CHECK ELECTRODE”

message appears and monitoring may stop.

The following electrode leads can be used on the transmitter (option).

ARTERY

RANGE

Using the YP-960T series Reusable Cuffs or YP-910P series Disposable Cuffs

1. Put the cuff on the upper arm so that the

mark of “ARTERY ” aligns with the artery

of the patient.

2. Wrap the cuff so that “INDEX ” comes

within the “ RANGE ”.

If “Index ” is not within the “ RANGE

”, change the cuff size.

BR-903PA,

3 electrodes,

clip type

BR-913PA,

3 electrodes,

snap type

BR-902PA,

2 electrodes,

clip type

BR-912PA,

2 electrodes,

snap type

34 Operator's Manual ZS-940PA

Connecting the Electrode Lead to the Transmitter

Connect the electrode lead to the ECG/RESP socket on the transmitter.

When the transmitter is attached on an arm

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.

Selecting the Electrode Position

Follow the physician’s instructions for electrode placement when available.

For ECG monitoring, electrodes are attached only on the chest to allow patient movement and

obtain continuous stable ECG. Following leads are examples. When also monitoring

respiration, refer to the “Electrode Position for Respiration Monitoring” section.

NOTE

The optimum electrode positions for ECG measurement of a patient are not

always optimum for respiration measurement of the patient. Select positions

suitable for both ECG and respiration measurements, or positions which have

priority for one measurement.

Operator's Manual ZS-940PA 35

Three Electrodes

• Lead MII, which is similar to standard lead II, used when ECG measurement has priority

Symbol Lead Color

Electrode Position AHA IEC AHA IEC

Left infraclavicular fossa LA L Black Yellow

Right infraclavicular fossa RA R White Red

Below lowest rib on the left

anterior axillary line LL F Red Green

• Lead MI, which is similar to standard

lead I

Change 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 stable ECG monitoring.

36 Operator's Manual ZS-940PA

Two Electrodes

With the optional BR-912PA and BR-902PA electrode leads, measurement with two electrodes

is available. L/LA electrode is not used.

This is effective for a neonate or a patient whose body area is small and difficult to attach three

electrodes.

(ex.) Lead MII, which is similar to standard lead II

Difference between measurement with two electrodes and three electrodes

Measurement with two electrodes is less stable than measurement with three electrodes because

of noise and body movement. Pay attention to this point. If ECG of necessary quality cannot be

obtained, measure with three electrodes.

Attaching Electrodes to the Patient and Connecting the Electrode Leads to

Disposable Electrodes

Prepare the Patient Skin

Shave off excessive body hair.

To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistened

with alcohol. Thoroughly dry the skin with a clean cotton pad.

NOTE

• For a patient with frequent body movement, rub the sites with Skinpure skin

preparation gel. However, do not use Skinpure skin preparation gel on

sensitive skin.

• Do not place electrodes on a wound or on an inflamed, wrinkled or uneven skin

surface.

Symbol Lead Color

Electrode Position AHA IEC AHA IEC

Right infraclavicular fossa RA R White Red

Below lowest rib on the left

anterior axillary line LL F Red Green

Operator's Manual ZS-940PA 37

Attaching Electrodes to the Patient

CAUTION

Do not reuse disposable products.

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 the correct ECG cannot be

obtained.

Refer to the electrode operator’s manual for details.

1. Carefully remove the backing paper from the

electrode. Avoid touching the adhesive

surface.

2. Place the electrode on the previously cleaned

skin. Pay attention to the electrode lead color

and symbol.

3. Clip the electrode lead to the electrode.

4. Fasten the electrode lead wire with surgical

tape with an extra length of wire between the

tape and the electrode. This lessens the

movement of electrode leads by body

movement and helps stable monitoring.

38 Operator's Manual ZS-940PA

Electrode Position for Respiration Monitoring

Place the R/RA and F/LL electrodes so that the lungs are between the electrodes.

NOTE

The optimum electrode positions for ECG measurement of a patient are not

always optimum for respiration measurement of the patient. Select positions

suitable for both ECG and respiration measurements, or positions which have

priority for one measurement.

Electrode Position Examples

Position 1

In this position, respiration measurement is available; however, there is a difference in amplitude

between different patients.

R or RA F or LL

Right infraclavicular

fossa

Fifth intercostal space on the

left midclavicular line, V4

Position 2

In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead

MII. This position can be generally recommended.

R or RA F or LL

Right infraclavicular

fossa

Fifth intercostal space on the

left midaxillary line, V6

Position 3

In this position, the respiration waveform is optimum, but the ECG lead is unusual.

R or RA F or LL

Right midaxillary at the

horizontal level of V4

Fifth intercostal space on the

left midaxillary line, V6

Operator's Manual ZS-940PA 39

Position 4

In this position, the respiration measurement is influenced by the impedance variation of the

abdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that the

waveform is inverted in phase compared with the chest movement (the waveform goes down

during inspiration). It is difficult to measure the ECG at the same time.

Attaching the SpO2 Probe

Selecting the SpO2 Probe

Select an appropriate probe for the patient.

CAUTION

• Use Nihon Kohden specified SpO2 probe to assure maximum performance

from your instrument.

• Do not use damaged or disassembled probe. It causes incorrect

measurement and may hurt the patient.

Reusable Probes

When using a TL-201T finger probe, choose the appropriate cable length for attachment.

R or RA F or LL

Lowest rib on the right

anterior axillary line

Lowest rib on the left

anterior axillary line

Probe Cable Length Patient Attachment site

0.6 m

Finger probe TL-201T

1.6 m

Adult or children

20 kg or more

Finger

Adult or Infant

3 kg or more

Finger or toeMulti-site probe TL-220T

Neonate

3 kg or less

Instep and sole

Attachment tape

40 Operator's Manual ZS-940PA

Disposable Probes

CAUTION

• Use the disposable probe only for one patient. Never reuse the disposable

probe for another patient because it causes cross infection.

• Disposable probes are not sterilized.

Probe Patient Attachment site

TL-251T Adult

30 kg or more

Finger or toe

TL-252T Child

3 to 40 kg

Finger or toe

TL-253T Neonate

3 kg or less

Instep and sole

Low birth weight infant

1 kg or less

Instep and

sole

Attachment

tape S

Neonate or Child

3 kg or more

Finger or toe Attachment

tape S

Multi-site Y probe TL-260T

Neonate

3 kg or less

Instep and

sole

Attachment

tape L

Adult

50 kg or more

FingerTL-051S/052S

Cable length TL-051S: 80 cm

TL-052S: 160 cm

Neonate

3 kg or less

Instep and sole

Child or Adult

15 to 50 kg

FingerTL-061S/062S

Cable length TL-061S: 80 cm

TL-062S: 160 cm

Infant

3 to 15 kg

Toe

Attachment tape

40 mm

35 mm

Operator's Manual ZS-940PA 41

CAUTION

Hold the connector when connecting/disconnecting the probe. If you disconnect

the SpO2 probe by pulling the cable, it damages the cable.

Attaching the Probe to the Patient

Attach the probe to the patient by referring to the probe’s manual. Make sure that the light

emitter and photo detector of the probe face each other at the attachment site.

WARNING

• When using a TL-201T finger probe, do not fasten it to a finger by wrapping the

probe to the site with some tape. It may cause poor blood circulation,

congestion, pressure necrosis or burn.

• When using probes other than a TL-201T finger probe, 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.

Connecting the SpO2 Probe to the Transmitter

Connect the probe to the SpO2 socket on the transmitter.

When the transmitter is attached on an arm

42 Operator's Manual ZS-940PA

• Check the circulation condition by observing the skin color of the measuring

site and the pulse waveform. Change the measuring site every 8 hours for

disposable probes and every 4 hours for reusable probes. 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.

• A patient with a fever

• A patient with a peripheral circulation insufficiency

• Neonate or low birth weight infant with delicate skin

CAUTION

• If the attachment site is dirty with blood, 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 the

measured data may be incorrect or measurement cannot be performed.

• If the skin gets irritated or redness appears on the skin from the probe,

change the attachment site or stop using the probe.

• When the probe is attached on an appropriate site with sufficient circulation,

but the error message confirming the probe attachment repeatedly appears,

the probe may be deteriorated. Replace it with a new one.

• Do not use a probe that is deteriorated by aging. Accurate measurement

cannot be performed.

• When using probes other than a TL-201T finger probe on a neonate, be careful

when removing the adhesive tape from neonatal skin.

• When removing a probe taped to the skin, do not pull the cable. Otherwise the

cable may break.

• When removing the probe from the attachment tape, do not pull the sensor

cable. Otherwise the cable may get damaged.

• Before using the TL-260T multi-site Y probe, be sure to attach the probe to the

sponge attachment tape S or L. Do not use the probe without the sponge

attachment tape attached. It causes incorrect measurement and may damage

the attachment site on the skin.

• When fixing the TL-260T multi-site Y probe with the sponge attachment tape,

confirm that the adhesive part of the tape is not on the skin. The adhesive may

cause oversensitive symptoms on the skin such as redness or itch. If the

adhesive touches the skin, remove it carefully and slowly because neonatal

skin is very delicate.

• Do not use a dirty sponge attachment tape. The measurement value may be

incorrect.

• Refer to the probe instruction manual for details.

Operator's Manual ZS-940PA 43

Locking the Keys on the Transmitter

To prevent the patient from pressing the keys on the transmitter during monitoring, you can lock

the NIBP START/STOP and NIBP INTERVAL keys.

1. Press the NIBP INTERVAL key for about 3 seconds.

2. A “pip, pip” sounds and the “LOCK KEYS” message is displayed on the LCD.

LOCK

KEYS

Pip, pip

When the NIBP START/STOP key or NIBP INTERVAL key is pressed while the keys are

locked, the “PRESS INT. KEY 3S TO UNLOCK” message appears.

To unlock the keys:

1. Press the NIBP INTERVAL key for about 3 seconds.

2. A “pip, pip” sounds and the keys are unlocked. The “UNLOCK KEYS” message appears

and the keys are unlocked.

44 Operator's Manual ZS-940PA

When preparation is done, monitoring starts.

NIBP Oscillometric Method

NIBP is measured from the change in amplitude pattern of pulsatile oscillation in cuff pressure

as the cuff pressure is reduced from above systolic to below diastolic pressure. The occlusive-

oscillometry method uses this to determine the systolic, diastolic and mean arterial pressure.

NIBP Monitoring

Selecting the Initial Cuff Inflation Pressure

The initial cuff inflation pressure can be changed on the PARAMETER SETUP screen. The

default setting is 180 mmHg. To change the setting, refer to the “Changing Parameter Setup

Settings” section.

Selecting the Measurement Mode and Interval

Measurement Modes

There are three measurement modes: manual, auto and STAT. The selected mode or interval is

displayed at the lower right of the screen.

The measurement mode and interval can be changed by pressing the NIBP INTERVAL key.

When the key is pressed, the measurement mode changes according to the modes selected at

“SELECTABLE INTERVALS” on the PARAMETER SETUP screen. MANUAL mode is

already selected for the mode selection.

To select the modes for the mode selection, refer to the “Changing Parameter Setup Settings”

section.

Manual Measurement

In Manual mode, a single NIBP measurement is performed when the NIBP START/STOP key

is pressed.

STAT (Continuous) Measurement

In STAT mode, measurement is continuously repeated for 15 minutes after the NIBP START/

STOP key is pressed.

When the STAT measurement for 15 minutes is completed, the measurement mode automatically

changes to the Manual mode or Auto mode of selected interval depending on the “NIBP MODE

Monitoring

Operator's Manual ZS-940PA 45

AFTER STAT” setting on the PARAMETER SETUP screen. The default setting is Manual

mode. Refer to the “Changing Parameter Setup Settings” section.

The STAT measurement completes within 15 minutes. When more than 12 minutes elapse from

the start of measurement, there will be no more measurement performed and the measurement

mode changes to the mode selected for “NIBP MODE AFTER STAT” on the PARAMETER

SETUP screen.

Auto Measurement

In Auto mode, measurement is performed automatically at the preset time intervals.

In Auto mode, a single measurement can be performed by pressing the NIBP START/STOP key

between auto measurements.

Measuring NIBP

WARNING

• Be careful when measuring NIBP on a patient with known bleeding disorders

or coagulation. After NIBP measurement, there may be dot hemorrhage, or

circulatory disorder by thrombus where cuff is attached.

• NIBP measurement may be incorrect in the following cases.

• When using an electrical surgery unit.

• When there is body movement.

• When the pulse wave is small (insufficient peripheral circulation).

• Too many arrhythmia.

• When there is vibration.

• When there is a rapid blood pressure change.

• During CPR.

• When performing NIBP measurements in STAT mode or 5 minute intervals,

periodically remove the cuff from the patient for ventilation. Otherwise, the

skin temperature may increase at the cuff attachment site by 2 or 3°C (4 or

5°F). When measuring a patient with a fever or peripheral circulation

insufficiency, it may cause a burn.

CAUTION

When performing NIBP measurement repeatedly, have a rest between

measurements to recover adequate circulation.

46 Operator's Manual ZS-940PA

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 distributor.

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

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

and IABP pulse.

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

1. Select the measurement mode by pressing the NIBP INTERVAL key.

2. Press the NIBP START/STOP key to perform measurement.

Operator's Manual ZS-940PA 47

The cuff is inflated and the inflation pressure is displayed on the screen.

In manual mode: Measurement is performed once.

In STAT mode: Measurement is performed repeatedly for 15 minutes.

In auto mode: The first measurement is performed when the NIBP START/STOP key

is pressed. The second measurement is performed when the current time

in the transmitter reaches the selected time interval.

To stop measurement during measurement, press the NIBP START/STOP key again.

In STAT mode, after completing the STAT measurement, the measurement mode changes to

the mode set for “NIBP MODE AFTER STAT” on the PARAMETER SETUP screen.

In auto mode, to stop measurement in auto mode, change the mode to manual. To cancel

one measurement, press the NIBP START/STOP key during measurement.

After the measurement is complete, the measured data is displayed on the screen and is

transmitted to the monitor.

Inflation pressure

When SpO2 is not monitored, the pulse rate at the end of NIBP measurement is displayed.

During auto mode measurement, the measurement mode can be changed. During the interval,

press the NIBP INTERVAL key to change the mode. When “MANUAL” is displayed for more

than one second, the measurement in auto mode is stopped.

A buzzer can be set to sound at the start and end of NIBP measurement. Refer to the “Changing

Parameter Setup Settings” section.

48 Operator's Manual ZS-940PA

Data Display After NIBP Measurement

When the time set at “OLD NIBP DATA” on the PARAMETER SETUP screen elapses after

the last measurement, the NIBP data is dimmed or hidden. Whether to dim or hide the old data

can also be selected at “OLD NIBP DATA”. Refer to the “Changing Parameter Setup Settings”

section.

Monitoring SpO2 during NIBP Measurement

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

during NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitored

properly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen is set

to ON (factory default setting), SpO2 monitoring is paused during NIBP measurement to avoid

SpO2 alarm occurrence. However, when monitoring SpO2 on the same limb as the NIBP, be

careful when reading SpO2 values.

ECG and Respiration Monitoring

When the electrodes are attached and the ECG leads are connected to the electrodes, heart rate,

ECG, respiration rate and respiration waveform appear on the monitor.

WARNING

Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac

monitoring and Diagnostic Equipment*

The bioelectric impedance measurement sensor of a minute ventilation rate-

adaptive implantable pacemaker may be affected by the 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 distributor or Nihon Kohden distributor.

* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric

impedance measurement (BIM). Many medical devices in addition to pacemakers use this

technology. When one of these devices is used on a patient with an active, minute ventilation

rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals

created in the patient, resulting in an elevated pacing rate.

For more information, see the FDA web site.

http://www.fda.gov/cdrh/safety.html

Operator's Manual ZS-940PA 49

WARNING

When using this transmitter with an ESU, the ESU return plate and the

electrodes for monitoring must be firmly attached to the patient. If the return

plate is not attached correctly, it may burn the patient’s skin where the

electrodes are attached. Refer to the instruction manual for the ESU.

CAUTION

Turn off the power of cell telephones, small wireless devices and other devices

which produce strong electromagnetic interference. Otherwise, the waveforms

and measurements are affected by such interference and the displayed data

may be incorrect.

NOTE

• Noise generated from an electrosurgery 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 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 may not be distinguished and pacemaker failure may

not be recognized.

Electrode Detachment

The “ ” mark is displayed on the LCD of the transmitter or the “CHECK ELECTRODE”

message is displayed on the screen of the monitor in the following conditions.

• Electrode is detached from skin.

• Electrode lead is disconnected from the electrode.

• Polarization voltage between the electrode and skin is excessively high.

In these cases, check the cause and if necessary, replace electrodes with new ones.

CAUTION

When the “ELECTRODE OFF” or “CHECK ELECTRODE” message is displayed

on the receiving monitor, check electrodes and electrode leads and remove the

cause. While the “ELECTRODE OFF” or “CHECK ELECTRODE” message is

being displayed, there is no ECG monitoring and no alarms.

50 Operator's Manual ZS-940PA

SpO2 Monitoring

When monitoring starts, SpO2 and pulse waveform are sent to the monitor and SpO2, pulse rate

and pulse level bar graph are displayed on the transmitter LCD.

WARNING

• Measurement may be incorrect in the following cases.

• When the patient’s carboxyhemoglobin or methemoglobin increases

abnormally.

• When dye is injected in the blood.

• When using an electrical surgery unit.

• During CPR.

• When there is body movement.

• When there is vibration.

• When measuring at a site where there are venous pulses.

• When the pulse wave is small (insufficient peripheral circulation).

• When using an IABP (intra-aortic balloon pump).

• Check the circulation condition by observing the skin color of the measuring

site and pulse waveform. Change the measuring site every 8 hours for

disposable probes and every 4 hours for reusable probes. 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.

• A patient with a fever

• A patient with peripheral circulation insufficiency

• Neonate or low birth weight infant with delicate skin

• When not monitoring SpO2, disconnect the SpO2 cable from the transmitter.

Otherwise, noise may interfere from the probe sensor and incorrect data is

displayed on the screen.

CAUTION

• Turn off the power of cell telephones, small wireless devices and other devices

which produce strong electromagnetic interference. Otherwise, the

waveforms and measurements are affected by such interference and the

displayed data may be incorrect.

• Normally external light does not affect monitoring, however, strong light such

as an operating lamp or sunlight may affect monitoring. If affected, cover the

measuring site with a blanket.

• Do not pull or bend the probe cable, and do not run over the probe cable with

Operator's Manual ZS-940PA 51

caster feet. Do not immerse the probe cable in detergents or water. Failure to

follow these cautions may cause cable discontinuity, short circuit, skin burn

on the patient and incorrect measurement data. Replace any broken probe

with a new one.

• When the probe is attached on an appropriate site with sufficient circulation

and the error message confirming the probe attachment repeatedly appears,

the probe may be deteriorated. Replace it with a new one.

• When the probe failure message appears on the screen, replace it with a new

one. Otherwise SpO2 data may not be accurate.

• While a patient is on medication which causes vasodilation, the pulse

waveform may change and in rare cases the SpO2 value may not be displayed.

NOTE

In order to maintain sufficient blood circulation, keep the measurement site

warm by covering it with a blanket or something similar. Warming the site is

effective, especially for a patient with a small pulse amplitude.

SpO2 and PR Display Order

You can select the display order for SpO2 and PR (pulse rate) on the LCD. Refer to the

“Changing Parameter Setup Settings” section.

Monitoring SpO2 during NIBP Measurement

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

during NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitored

properly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen is set

to ON (factory default setting), SpO2 monitoring is paused during NIBP measurement to avoid

SpO2 alarm occurrence. However, when monitoring SpO2 on the same limb as NIBP, be careful

when reading SpO2 values.

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

catheter is not attached.

When SpO2 monitoring is paused during NIBP measurement, the SpO2 value just before the

start of NIBP measurement and an mark are displayed on the transmitter for 30 seconds.

When NIBP measurement is not completed after 30 seconds, “– – –” is displayed for the SpO2

value. The same data also appears on the monitor screen.

52 Operator's Manual ZS-940PA

NOTE

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

which the NIBP cuff is not attached and set “INHIBIT SpO2 DURING NIBP” on

the PARAMETER SETUP screen to OFF.

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

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

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

the limb to which the NIBP cuff is not attached.

Operator's Manual ZS-940PA 53

Display and Message List

Indication Cause Countermeasure

Fully charged battery

Batteries are low.

Batteries are low. NIBP cannot be measured.

indication Dead batteries

Replace batteries.

Battery Indication

ECG

Indication Cause Countermeasure

Electrode lead is disconnected from the

electrode.

Firmly connect the electrode

lead to the electrode.

Electrode lead is disconnected from the

transmitter.

Firmly connect the electrode

lead to the transmitter.

Electrode lead discontinuity. Replace the electrode lead

with a new one.

Electrode is not firmly attached to the skin.

Polarization voltage is abnormally high.

Replace the electrode with a

new one.

54 Operator's Manual ZS-940PA

Message Cause Countermeasure

During NIBP

measurement

SpO2 monitoring is paused for

NIBP measurement.

Wait for NIBP measurement to

finish.

Considerable body movement.

Detecting

body

movement The probe is not attached to

the patient properly.

When the message is displayed

frequently, check the patient

condition and, if necessary, change

the attachment site.

The probe is not attached to

the patient properly.

Attach the probe to the patient

properly.

SpO2 CHECK

PROBE The probe is disconnected

from the SpO2 socket on the

transmitter.

Connect the probe to the SpO2

socket.

The probe is not attached at

the appropriate site.

Attach the probe to a site 6 to 14

mm thick.

SpO2 CHECK

PROBE SITE Probe is expired. Replace the probe with a new one.

Searching for the correct pulse

wave.

Wait until the pulse wave is

detected.

The SpO2 value cannot be

obtained because the

waveform is unstable.

SpO2 DETECTING

PULSE

The probe is not attached to

the patient properly.

Attach the probe to the patient

properly.

SpO2 LIGHT

INTERFERENCE

SpO2 measurement site is

under fluorescent light,

surgical light, sunlight, etc.

Cover the measurement site with a

blanket or cloth.

Probe is expired. Replace the probe with a new one.

SpO2 PROBE

FAILURE Probe is damaged or short-

circuited. Replace the probe with a new one.

Poor peripheral circulation. Check the patient condition and

change the attachment site.

SpO2 WEAK PULSE The probe is attached too

tightly and is obstructing the

blood circulation.

Check the probe attachment

condition and if necessary,

reattach the probe.

SpO2

Operator's Manual ZS-940PA 55

NIBP

Message Cause Countermeasure

The cuff and extension hose are not

properly connected.

The cuff hose (or extension hose) is

not properly connected to the NIBP

socket.

Connect them properly.

NIBP AIR LEAK

The cuff or extension hose is

damaged. Replace with a new one.

The patient’s pulse wave is small. Measure by palpation or auscultation.

NIBP CANNOT

DETECT PULSE The cuff is not wrapped on the

patient properly. Wrap the cuff on the patient properly.

NIBP CUFF

OCCLUSION Transmitter malfunction.

Immediately remove the cuff from the

patient and contact your Nihon Kohden

distributor.

NIBP HIGH CUFF

PRESS

Enormous pressure was applied by

the pressure of the cuff. Remove the cause.

NIBP INFLATION

PRESS LOW Insufficient cuff inflation pressure.

Wait for the remeasurement to be

performed with increased cuff inflation

pressure.

NIBP MEAS TIME-

OUT

The measuring time exceeded the

specified time due to arrhythmia,

body movement, vibration or, cuff

or air hose being squeezed.

Remove the cause if the cause is body

movement, vibration or squeezing of

cuff or hose.

NIBP MODULE

FAILURE Module malfunction. Contact your Nihon Kohden

distributor.

NIBP REMEASURING

NIBP is being remeasured due to

arrhythmia, body movement,

vibration or, cuff or air hose being

squeezed.

If the message still appears after

remeasurement, remove the cause if

the cause is body movement, vibration

or squeezing of cuff or hose.

Check that the hose is not bent or

squeezed.

NIBP SAFETY

CIRCUIT RUNNING

(When this message is

displayed, measurement

cannot be performed for

40 seconds.)

Measurement stopped by the safety

circuit.

Wait 40 seconds, then perform

remeasurement. If the message still

appears, contact your Nihon Kohden

distributor.

NIBP SYS OUT OF

RANGE

The maximum blood pressure

cannot be measured even when the

cuff inflation pressure exceeded 280

mmHg when using adult cuff.

Measure by palpation or auscultation.

The patient’s pulse wave is too

small. Measure by palpation or auscultation.

The cuff is wrapped too loosely. Wrap the cuff properly.

NIBP WEAK PULSE

The cuff size is not appropriate. Use the appropriate cuff.

NIBP ZEROING NIBP zero balance is being

adjusted.

Do not touch the cuff during zeroing.

Wait for the message to disappear.

56 Operator's Manual ZS-940PA

If the problem still remains after checking the following, contact your Nihon Kohden distributor.

Transmitter

Problem Cause Countermeasure

Batteries are not installed

correctly. The battery

polarity is wrong.

Install the batteries correctly.Nothing is

displayed on the

LCD after

turning the

power on.

Batteries are completely

discharged.

Replace the batteries with new ones.

The channel of the

transmitter and monitor

does not match.

Set the correct channel on the monitor.Nothing is

displayed on the

monitor after

turning the

transmitter

power on.

The “TYPE” on the

SYSTEM SETUP screen

is not set to “A”.

Check that the “TYPE” is set to “A”.

Refer to the “Notes on Parameter

Settings” and “Changing System Setup

Settings” sections.

Another transmitter of the

same channel is used

nearby.

Turn the transmitter power off. If the

monitor still receives a signal, there is a

high probability that another transmitter

of the same channel is used nearby.

Follow the instruction of your channel

administrator and use another transmitter

of a different channel.

Signals are mixing. Follow the instructions of your channel

administrator and use another transmitter

of a different channel.

Signal receiving

condition is

oor.

The transmitter is

damaged.

Contact your Nihon Kohden distributor.

Troubleshooting

Operator's Manual ZS-940PA 57

ECG

Problem Cause Countermeasure

The heart rate is

unstable.

Pacing detection setting on the

monitor is not correct.

Turn off the pacing detection setting

on the monitor.

When monitoring a pacemaker

patient, turn on pacing detection.

Electrode lead is disconnected

from the electrode.

Firmly connect the electrode lead to

the electrode.

Electrode lead discontinuity Replace the electrode lead with a new

one.

Electrode is not firmly

attached to the skin.

Replace the electrode with a new one.

The “CHECK

ELECTRODE”

message appears

on the receiving

monitor.

Polarization voltage is

abnormally high.

Use Nihon Kohden specified

electrodes.

The gel on the electrode is

dried out.

The gel on the electrode is

coming off.

Replace the electrode with a new one.

Electric blanket is used. Cover the blanket with a shield cover.

ECG baseline is

thick.

(Hum is

overlapping)

Hum filter is set to OFF on the

monitor

Set the filter to ON.

The gel on the electrode is

dried out.

Respiration

waveform

measurement is

unstable.

The gel on the electrode is

coming off.

Replace the electrode with a new one.

SpO2

Problem Cause Countermeasure

The probe size is not

appropriate for the patient.

Use the appropriate probe for the patient.

Probe attachment condition

is poor. Probe is partly

detached from the skin.

External light gets in.

Firmly attach the probe according to the

procedure in the probe operator’s manual.

Measurement site is dirty.

Patient is wearing nail

polish.

Remove dirt and nail polish.

When the probe and cuff are attached to

the same limb, set “INHIBIT SpO2

DURING NIBP” setting on the

PARAMETER SETUP screen to ON.

SpO2 data is

unstable and

not reliable.

Probe is attached to the

same limb that is used for

NIBP measurement.

Attach the probe to the opposite limb.

Avoid a site where blood circulation

condition changes greatly.

58 Operator's Manual ZS-940PA

NIBP

Problem Cause Countermeasure

The cuff hose is not connected

to the NIBP socket properly.

Connect the cuff hose to the socket

properly.

Cuff inflation

pressure is less than

10 mmHg. The cuff is not wrapped

around the arm or is wrapped

too loosely.

Wrap the cuff around the upper

arm.

The cuff hose is not connected

to the NIBP socket.

Connect the cuff hose to the socket

firmly.

The cuff does not

inflate when the

NIBP START/STOP

key is pressed.

The cuff hose or extension

hose may be folded or

squeezed when the cuff

pressure display on the screen

increases quickly but the

actual cuff does not inflate.

Check the cuff hose and air hose.

The cuff size is not correct. Select the cuff which fits the

patient’s limb circumference.

The cuff is not wrapped

around the arm correctly.

Wrap the cuff around the upper

arm, not too tightly or too loosely.

NIBP data is not correct

because of body movement.

Prevent the patient from moving

during measurement.

Check that nothing is touching the

cuff during measurement.

Abnormal

measurement results

are displayed.

Vibration on the cuff.

Change the measuring site.

The cuff is suddenly

deflated during

inflation.

The NIBP START/STOP key

is pressed during inflation.

Auto mode

measurement does

not start even when

the time interval has

passed.

The NIBP INTERVAL key is

pressed and the measurement

mode is changed.

Check the measurement mode and

interval.

The cuff suddenly

inflates.

The measurement mode is set

to auto mode.

Check the time interval. If

necessary, stop measurement.

Cannot connect cuff

to the air hose.

Unspecified cuff is used. Use a cuff specified by Nihon

Kohden.

Operator's Manual ZS-940PA 59

Problem Cause Countermeasure

Vibration on the cuff. Check that nothing is touching the

cuff during measurement.

The cuff hose or extension

hose is bent or squeezed.

Remove the cause.

Cannot measure

NIBP.

The cuff has worn out. Use a new cuff.

Increase the measuring interval.Blood congestion

occurs.

Measuring over a long

period of time at short

intervals.

Do not measure NIBP over a long

time.

Thrombus occurs. Measuring on a patient

with known bleeding

disorders or coagulation.

Do not perform NIBP measurement

on such a patient.

NIBP data on the

screen is --- or dark.

The time set for “OLD

NIBP DATA” on the

PARAMETER SETUP

screen elapsed from the last

measurement.

When NIBP is measured again, the

data is displayed in normal

brightness.

Three loud pip

sounds indicting

NIBP measurement

cannot be started.

The cuff is not deflated

enough to start another

measurement.

Wait 30 seconds and measure again.

Numeric data is

displayed but NIBP

messages are not

displayed on the

monitor.

The “TYPE” on the

SYSTEM SETUP screen is

not set to “A”.

Check that the “TYPE” is set to “A”.

Refer to the “Notes on Parameter

Settings” and “Changing System

Setup Settings” sections.

60 Operator's Manual ZS-940PA

To use the instrument in safe and optimum condition, perform maintenance check once every six

months.

CAUTION

Do not disassemble the transmitter when performing maintenance and

inspection. Do not repair the transmitter. When there is any problem with the

transmitter after maintenance and inspection, contact your Nihon Kohden

distributor.

A maintenance check sheet is provided at the end of this section. Make a copy of this check

sheet before performing maintenance check.

1. External Check

• There are no damaged or dirty parts on the outside of the transmitter.

• The battery case cover is not damaged, the spring is firmly fixed and the battery case cover

can be closed firmly.

• NIBP socket is not damaged.

• Keys are not damaged.

• Electrode leads are not damaged.

• There is no blood or chemicals on the transmitter.

2. Transmitter Channel

Check that the channel of the transmitter and the label match.

1. Check that the channel number label attached to the transmitter is not torn or removed.

Maintenance

Channel label

Operator's Manual ZS-940PA 61

2. Remove one battery.

3. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.

The SETUP screen appears.

4. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.

5. Press the NIBP START/STOP key to enter

the SYSTEM SETUP screen. The channel of

this transmitter is displayed.

6. Check that the channel displayed on the LCD

matches the label on the transmitter.

Channel

62 Operator's Manual ZS-940PA

3. LCD Display

Check that there are no dots missing on the LCD.

1. Remove one battery.

2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.

The SETUP screen appears.

3. Press the NIBP INTERVAL key twice to move the cursor to “MANUAL CHECK”.

4. Press the NIBP START/STOP key to

enter the MANUAL CHECK screen.

5. Check that the cursor is on “LCD

TEST” and press the NIBP START/

STOP key.

Operator's Manual ZS-940PA 63

6. Every time the NIBP INTERVAL key is pressed, the screen changes as below. Check that

there are no dots missing.

When the NIBP START/STOP key is pressed, the screen returns to the MANUAL

CHECK screen.

4. Switch and Key Operation

Power Switch

Check that the Power switch turns the power on and off.

NIBP START/STOP Key

1. Attach the NIBP cuff to your upper arm.

2. Press the NIBP START/STOP key. Check that the cuff inflates and deflates properly.

3. Press the NIBP START/STOP key again. During inflation, press the NIBP START/STOP

key to check that the cuff deflates properly.

NIBP INTERVAL Key

1. Press the NIBP INTERVAL key and check that the NIBP measuring mode can be changed.

2. Select any interval and press the NIBP START/STOP key to perform auto measurement.

Check that the NIBP is measured at the selected interval.

64 Operator's Manual ZS-940PA

5. NIBP Cuff for Attaching Transmitter to Patient Arm

The NIBP cuff is a consumable. Check the following and when necessary, replace it with a new

one.

Appearance

• There are no dirty parts.

• There are no broken stitches on the cuff.

• The label on the cuff is readable.

• The velcro tape on the cuff is not removed and there are no broken stitches.

• The lock plate is not damaged and functions properly.

Inflation bag

• The inflation bag is not torn or damaged.

• There is no water inside the inflation bag.

• The connector on the inflation bag is not damaged.

Operator's Manual ZS-940PA 65

Maintenance Check Sheet

Hospital/Organization:

Service Personnel:

Instrument Name: Transmitter

Instrument Model: ZS-940PA

Instrument Serial Number:

Hardware Revision Number:

Software Revision Number:

1. External Check OK No

2. Transmitter Channel OK No

3. LCD Display OK No

4. Switch and Key Operation OK No

5. NIBP Cuff for Attaching Transmitter to Patient Arm OK No

Overall Judgement

Can be used but needs maintenance

Maintenance required. Cannot be used.

66 Operator's Manual ZS-940PA

Repair Parts Availability Policy

Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain the

performance of the instrument) for a period of 8 years from the date of delivery. In that period

NKC or its authorized agents will repair the instrument. This period may be shorter than 8 years

if the board or part necessary for the faulty section is not available.

Operator's Manual ZS-940PA 67

Disposing of Used Batteries

Battery Lifetime

Replace the batteries when the battery replacement indication appears on the transmitter. When

using rechargeable batteries, recharge them.

Lifetime and Disposal

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO2ECG only

NiMH secondary 2 days 2 days 2.5 days

Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is measured in auto

mode at 60 minute intervals and SpO2 is measured on an index finger of a male patient with

weight 60 kg.

Operation time depends on the thickness of SpO2 probe attachment site.

Disposal

NOTE

Remove the batteries before disposing of the transmitter.

Before disposing of the batteries, check with your local solid waste officials for details in your

area for proper disposal. It may be illegal to dispose of these batteries in the municipal waste

stream.

Disposing of Electrodes, SpO2 Probes and NIBP Cuffs

Refer to the manual of each item.

68 Operator's Manual ZS-940PA

Transmitter and Electrode Leads

CAUTION

• If detergent or liquid spills into the transmitter, stop using it and contact your

Nihon Kohden distributor. If a wet transmitter is used, the patient or anyone in

contact with the transmitter may receive an electric shock or patient leakage

current over the allowed amount may flow.

• Before cleaning or disinfecting the transmitter, remove the batteries from the

transmitter.

• The transmitter cannot be sterilized.

Cleaning

Wipe the transmitter and electrode leads with a soft cloth moistened with disinfecting alcohol or

neutral detergent diluted with water. After cleaning, dry them completely.

Disinfection

CAUTION

• 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 below. Use the recommended concentration.

Disinfectant Concentration (%)

Glutaraldehyde solution 2.0

Hydrochloric alkyl diaminoethylglycine 0.5

Benzalkonium chloride 0.2

Benzethonium chloride solution 0.2

Chlorohexidine gluconate solution 0.5

Cleaning, Disinfection and Sterilization

Operator's Manual ZS-940PA 69

SpO2 Probe

Refer to the probe manual.

YP-943P/944P NIBP Cuffs

CAUTION

• Do not autoclave.

• Use only glutaraldehyde solution.

• Never allow liquid to get inside the rubber cuff.

• Do not sterilize or disinfect the cuff with ultraviolet light or ozone.

Cleaning

To clean the cuff, remove the lock plate and carefully pull out the inflation bag from the cloth

cover.

Cloth cover: Wash with neutral detergent and water. Thoroughly dry it. When washing in a

washing machine, put it in a net.

Inflation bag: Wipe with a soft cloth or cotton moistened with disinfecting alcohol.

Thoroughly dry it.

Disinfection

To disinfect the cuff, use glutaraldehyde solution. Use the recommended concentration of the

disinfectant. Refer to the disinfectant manual for details. After disinfection, clean the cuff as

described above.

70 Operator's Manual ZS-940PA

Measuring Parameters

Measuring waveforms: ECG, Respiration in impedance method, pulse

Measuring numeric data: SpO2, NIBP, pulse rate

Transmitting Data

Waveform data: ECG, respiration, pulse wave

Numeric data: SpO2 and NIBP

Status information: Battery replacement, channel ID, type of transmitter, check

electrodes, abnormal polarization voltage, pacing data, SpO2

light interference

Displayed Data

SpO2, NIBP, pulse rate, pulse wave bar graph, check electrode, battery replacement, NIBP

measurement mode and status information

ECG Measurement

Channels: 1

Input range: ±5 mV or more

DC offset: ±500 mV or more

Input impedance: 5 MΩ or more (5 Hz)

Pacing pulse detection: ANSI/AAMI EC13

Based upon Pacemaker pulse rejection Capability

Respiration Measurement

Measuring method: Impedance method

Impedance range: 0 to 2 kΩ or less

SpO2 Measurement

Display range: Depends on the receiving monitor

Measuring range: 0 to 100%, in 1% steps

Minimum display range: 1%

Measuring accuracy (When the measuring accuracy of the SpO2 probe is not considered):

±1 (80% ≤ SpO2 ≤ 100%)

±2 (50% ≤ SpO2 < 80%)

Less than 50% is not specified.

(When considering the measuring accuracy of the SpO2 probe):

±2 (80% ≤ SpO2 ≤ 100%)

±3 (70% ≤ SpO2 < 80%)

Less than 70% is not specified.

Specifications

Operator's Manual ZS-940PA 71

NIBP Measurement

Displayed items: Systolic, diastolic, mean

Cuff pressure display range: 0 to 300 mmHg

Measurement modes: Manual, STAT, auto at 5, 10, 15, 30, 60, 120 or 240 minute

interval

Pulse Rate

Measuring range: 30 to 200 beats/minute ±8 beats/min (NIBP)

30 to 200 beats/min ±3% ±1 beat/min (SpO2)

Transmitter

FCC regulation: FCC part 95 Subpart H

Wireless Medical Telemetry Service (WMTS)

Field strength limits: <200 mV/m (at 3 m)

Undesired emission: below 960 MHz: 200 µV/m (at 3 m)

above 960 MHz: 500 µV/m (at 3 m)

Antenna: Internal

Transmission channel: indicated on the transmitter

Transmission frequency range: 608.0125 to 613.9875 MHz

Channel spacing: 25 kHz (12.5 kHz when interleave)

Type of emission: F1D

Occupied bandwidth: <8.5 kHz

Effective radiated power: 1.0 mW (conducted)

Power Requirements

Operating voltage: 3.2 to 4.8 V

Battery type: Three AA type NiMH secondary batteries

Three AA type alkaline dry cell primary batteries

Battery lifetime:

Type Lifetime (Measuring parameters)

ECG, SpO2, NIBP ECG, SpO2ECG only

NiMH secondary 2 days 2 days 2.5 days

Alkaline primary 1 day 2.5 days 3 days

The above data is when new batteries are used at room temperature, NIBP is

measured in auto mode at 60 minute intervals and SpO2 is measured on an index

finger of a male patient with weight 60 kg.

Operation time depends on the thickness of SpO2 probe attachment site.

Dimension and Weight

Dimension: 114 W × 103 H × 58 D (mm)

Weight: about 350 g (including batteries)

72 Operator's Manual ZS-940PA

Environment

Operating environment

Operating temperature: 5 to 40°C, 41 to 104°F

When using NIBP cuff, 10 to 40°C, 50 to 104°F

Operating humidity: 30 to 85% (non-condensing)

Operating atmospheric pressure: 70 to 106 kPa

Storage environment

Storage temperature: −20 to 65°C, −4 to 149°F

Storage humidity: 10 to 95%

Storage atmospheric pressure: 70 to 106 kPa

Electromagnetic Compatibility

IEC 60601-1-2 (1993) - Collateral Standard: Electromagnetic compatibility - Requirement and

tests

Emissions: CISPR11 Group 1, Class B

Safety Standards

Safety standard: CAN/CSA-C22.2 No. 601-1 M90 (1990)

CAN/CSA-C22.2 No. 601-1. 1S1-94 (1994)

CAN/CSA-C22.2 No. 601-1. 1B-90 (R2002)

IEC 60601-1 (1988)

IEC 60601-1 Amendment1 (1991)

IEC 60601-1 Amendment2 (1995)

IEC 60601-1-2 (1993)

IEC 60601-2-27 (1994)

IEC 60601-2-30 (1999)

According to the type of protection

against electrical shock: INTERNALLY POWERED EQUIPMENT

According to the degree of protection

against electrical shock:

ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIED

PART

SpO2 and NIBP: DEFIBRILLATION-PROOF TYPE BF APPLIED

PART

According to the degree of protection

against harmful ingress of water: IPX0 (Ordinary equipment)

According to the degree of safety of

application in the presence of a

FLAMMABLE ANAESTHETIC

MIXTURE WITH AIR, OR WITH

OXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence of

FLAMMABLE ANAESTHETIC MIXTURE WITH

AIR, OR WITH OXYGEN OR NITROUS OXIDE

According to the mode of operation: CONTINUOUS OPERATION

Operator's Manual ZS-940PA 73

Standard Accessories

No. Name Model Q’ty Supply Code No.

1 NIBP cuff for adult, standard YP-943P 1 S938B

2 Strap --- 1 Y236

No. Name Model Q’ty Supply Code No.

3 Battery case cover 1 6144-012004

4 Lock plate 1 6113-049585

The following parts are available for replacement.

Lock plate is a

standard accessory of

the YP-943P/944P

NIBP cuff.

74 Operator's Manual ZS-940PA

CAUTION

Use only Nihon Kohden electrodes, electrode leads, SpO2 probes and NIBP cuffs

to assure maximum performance from your instrument.

Transmitter

Channel writer, QI-901PK

ECG/RESP

Options

Name Application Model Q’ty Supply Code No.

3 electrodes,clip type,

lead length 80 cm BR-903PA 1 K911A

3 electrodes, snap type,

lead length 80 cm BR-913PA 1 K910B

2 electrodes,clip type,

lead length 80 cm BR-902PA 1 K907B

Electrode

lead

2 electrodes,snap type,

lead length 80 cm BR-912PA 1 K908B

Operator's Manual ZS-940PA 75

SpO2

Name Cable

length

Model/

Code No. Q’ty Supply

Code No.

0.6 m P225H

Finger probe (reusable) 1.6

TL-201T P225F

Multi-site probe (reusable) TL-220T

P225G

SpO2 probe (for adult, disposable) TL-251T P201A

SpO2 probe (for child, disposable) TL-252T P201B

SpO2 probe (for neonate,

disposable) TL-253T P201C

Multi-site Y probe

(for low birth weight infant/child/

neonate, disposable)

1.6 m

TL-260T P205A

0.8 m TL-051S P228A

SpO2 probe(for adult/neonate,

disposable) 1.6 m TL-052S P228B

0.8 m TL-061S P229A

SpO2 probe (for child/infant,

disposable) 1.6

TL-062S

P229B

COTTONY tape 340703 20 P259

Foam tape for TL-051S/052S/

061S/062S 4 × 25 package P260

Attachment tape for TL-220T/

251T/252T/253T 3 × 30 package P263

Attachment tape S for TL-260T P260A

Attachment tape L for TL-260T

--- ---

24 P260B

Name Width

(cm)

Air Hose

Length

(cm)

Model Q’ty

Supply

Code

No.

Standard 13 YP-943P* S938B

Cuff for adult, for

attaching transmitter to

patient arm Large 15 15 YP-944P* 1S938C

Cuff for infants 5 YP-960T S943A

Small 7 YP-961T S943B

Cuff for children Standard 10 YP-962T S943C

Standard 13 YP-963T S944B

Cuff for adult Large 15

YP-964T

S944C

Disposable cuff for infants 6 YP-910P ---

Disposable cuff for children 9 YP-912P ---

Small 12 YP-913P ---

Standard 14 YP-914P ---

Disposable cuff for adults

Large 16

YP-915P

---

Extension hose 150 YN-990P 1 S903

NIBP

* The lock plate is provided with these NIBP cuffs.

76 Operator's Manual ZS-940PA

Transmission Frequencies

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

608.0000 --- 608.3750 9030 608.7500 9060

608.0125 9001 608.3875 9031 608.7625 9061

608.0250 9002 608.4000 9032 608.7750 9062

608.0375 9003 608.4125 9033 608.7875 9063

608.0500 9004 608.4250 9034 608.8000 9064

608.0625 9005 608.4375 9035 608.8125 9065

608.0750 9006 608.4500 9036 608.8250 9066

608.0875 9007 608.4625 9037 608.8375 9067

608.1000 9008 608.4750 9038 608.8500 9068

608.1125 9009 608.4875 9039 608.8625 9069

608.1250 9010 608.5000 9040 608.8750 9070

608.1375 9011 608.5125 9041 608.8875 9071

608.1500 9012 608.5250 9042 608.9000 9072

608.1625 9013 608.5375 9043 608.9125 9073

608.1750 9014 608.5500 9044 608.9250 9074

608.1875 9015 608.5625 9045 608.9375 9075

608.2000 9016 608.5750 9046 608.9500 9076

608.2125 9017 608.5875 9047 608.9625 9077

608.2250 9018 608.6000 9048 608.9750 9078

608.2375 9019 608.6125 9049 608.9875 9079

608.2500 9020 608.6250 9050 609.0000 9080

608.2625 9021 608.6375 9051 609.0125 9081

608.2750 9022 608.6500 9052 609.0250 9082

608.2875 9023 608.6625 9053 609.0375 9083

608.3000 9024 608.6750 9054 609.0500 9084

608.3125 9025 608.6875 9055 609.0625 9085

608.3250 9026 608.7000 9056 609.0750 9086

608.3375 9027 608.7125 9057 609.0875 9087

608.3500 9028 608.7250 9058 609.1000 9088

608.3625 9029 608.7375 9059 609.1125 9089

Operator's Manual ZS-940PA 77

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

609.1250 9090 609.5375 9123 609.9500 9156

609.1375 9091 609.5500 9124 609.9625 9157

609.1500 9092 609.5625 9125 609.9750 9158

609.1625 9093 609.5750 9126 609.9875 9159

609.1750 9094 609.5875 9127 610.0000 9160

609.1875 9095 609.6000 9128 610.0125 9161

609.2000 9096 609.6125 9129 610.0250 9162

609.2125 9097 609.6250 9130 610.0375 9163

609.2250 9098 609.6375 9131 610.0500 9164

609.2375 9099 609.6500 9132 610.0625 9165

609.2500 9100 609.6625 9133 610.0750 9166

609.2625 9101 609.6750 9134 610.0875 9167

609.2750 9102 609.6875 9135 610.1000 9168

609.2875 9103 609.7000 9136 610.1125 9169

609.3000 9104 609.7125 9137 610.1250 9170

609.3125 9105 609.7250 9138 610.1375 9171

609.3250 9106 609.7375 9139 610.1500 9172

609.3375 9107 609.7500 9140 610.1625 9173

609.3500 9108 609.7625 9141 610.1750 9174

609.3625 9109 609.7750 9142 610.1875 9175

609.3750 9110 609.7875 9143 610.2000 9176

609.3875 9111 609.8000 9144 610.2125 9177

609.4000 9112 609.8125 9145 610.2250 9178

609.4125 9113 609.8250 9146 610.2375 9179

609.4250 9114 609.8375 9147 610.2500 9180

609.4375 9115 609.8500 9148 610.2625 9181

609.4500 9116 609.8625 9149 610.2750 9182

609.4625 9117 609.8750 9150 610.2875 9183

609.4750 9118 609.8875 9151 610.3000 9184

609.4875 9119 609.9000 9152 610.3125 9185

609.5000 9120 609.9125 9153 610.3250 9186

609.5125 9121 609.9250 9154 610.3375 9187

609.5250 9122 609.9375 9155 610.3500 9188

78 Operator's Manual ZS-940PA

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

610.3625 9189 610.7750 9222 611.1875 9255

610.3750 9190 610.7875 9223 611.2000 9256

610.3875 9191 610.8000 9224 611.2125 9257

610.4000 9192 610.8125 9225 611.2250 9258

610.4125 9193 610.8250 9226 611.2375 9259

610.4250 9194 610.8375 9227 611.2500 9260

610.4375 9195 610.8500 9228 611.2625 9261

610.4500 9196 610.8625 9229 611.2750 9262

610.4625 9197 610.8750 9230 611.2875 9263

610.4750 9198 610.8875 9231 611.3000 9264

610.4875 9199 610.9000 9232 611.3125 9265

610.5000 9200 610.9125 9233 611.3250 9266

610.5125 9201 610.9250 9234 611.3375 9267

610.5250 9202 610.9375 9235 611.3500 9268

610.5375 9203 610.9500 9236 611.3625 9269

610.5500 9204 610.9625 9237 611.3750 9270

610.5625 9205 610.9750 9238 611.3875 9271

610.5750 9206 610.9875 9239 611.4000 9272

610.5875 9207 611.0000 9240 611.4125 9273

610.6000 9208 611.0125 9241 611.4250 9274

610.6125 9209 611.0250 9242 611.4375 9275

610.6250 9210 611.0375 9243 611.4500 9276

610.6375 9211 611.0500 9244 611.4625 9277

610.6500 9212 611.0625 9245 611.4750 9278

610.6625 9213 611.0750 9246 611.4875 9279

610.6750 9214 611.0875 9247 611.5000 9280

610.6875 9215 611.1000 9248 611.5125 9281

610.7000 9216 611.1125 9249 611.5250 9282

610.7125 9217 611.1250 9250 611.5375 9283

610.7250 9218 611.1375 9251 611.5500 9284

610.7375 9219 611.1500 9252 611.5625 9285

610.7500 9220 611.1625 9253 611.5750 9286

610.7625 9221 611.1750 9254 611.5875 9287

Operator's Manual ZS-940PA 79

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

611.6000 9288 612.0125 9321 612.4250 9354

611.6125 9289 612.0250 9322 612.4375 9355

611.6250 9290 612.0375 9323 612.4500 9356

611.6375 9291 612.0500 9324 612.4625 9357

611.6500 9292 612.0625 9325 612.4750 9358

611.6625 9293 612.0750 9326 612.4875 9359

611.6750 9294 612.0875 9327 612.5000 9360

611.6875 9295 612.1000 9328 612.5125 9361

611.7000 9296 612.1125 9329 612.5250 9362

611.7125 9297 612.1250 9330 612.5375 9363

611.7250 9298 612.1375 9331 612.5500 9364

611.7375 9299 612.1500 9332 612.5625 9365

611.7500 9300 612.1625 9333 612.5750 9366

611.7625 9301 612.1750 9334 612.5875 9367

611.7750 9302 612.1875 9335 612.6000 9368

611.7875 9303 612.2000 9336 612.6125 9369

611.8000 9304 612.2125 9337 612.6250 9370

611.8125 9305 612.2250 9338 612.6375 9371

611.8250 9306 612.2375 9339 612.6500 9372

611.8375 9307 612.2500 9340 612.6625 9373

611.8500 9308 612.2625 9341 612.6750 9374

611.8625 9309 612.2750 9342 612.6875 9375

611.8750 9310 612.2875 9343 612.7000 9376

611.8875 9311 612.3000 9344 612.7125 9377

611.9000 9312 612.3125 9345 612.7250 9378

611.9125 9313 612.3250 9346 612.7375 9379

611.9250 9314 612.3375 9347 612.7500 9380

611.9375 9315 612.3500 9348 612.7625 9381

611.9500 9316 612.3625 9349 612.7750 9382

611.9625 9317 612.3750 9350 612.7875 9383

611.9750 9318 612.3875 9351 612.8000 9384

611.9875 9319 612.4000 9352 612.8125 9385

612.0000 9320 612.4125 9353 612.8250 9386

80 Operator's Manual ZS-940PA

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

USA

BAND

CHANNEL

SPACING

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

Transmission

frequency

(MHz)

12.5kHz step

Channel No.

612.8375 9387 613.2500 9420 613.6625 9453

612.8500 9388 613.2625 9421 613.6750 9454

612.8625 9389 613.2750 9422 613.6875 9455

612.8750 9390 613.2875 9423 613.7000 9456

612.8875 9391 613.3000 9424 613.7125 9457

612.9000 9392 613.3125 9425 613.7250 9458

612.9125 9393 613.3250 9426 613.7375 9459

612.9250 9394 613.3375 9427 613.7500 9460

612.9375 9395 613.3500 9428 613.7625 9461

612.9500 9396 613.3625 9429 613.7750 9462

612.9625 9397 613.3750 9430 613.7875 9463

612.9750 9398 613.3875 9431 613.8000 9464

612.9875 9399 613.4000 9432 613.8125 9465

613.0000 9400 613.4125 9433 613.8250 9466

613.0125 9401 613.4250 9434 613.8375 9467

613.0250 9402 613.4375 9435 613.8500 9468

613.0375 9403 613.4500 9436 613.8625 9469

613.0500 9404 613.4625 9437 613.8750 9470

613.0625 9405 613.4750 9438 613.8875 9471

613.0750 9406 613.4875 9439 613.9000 9472

613.0875 9407 613.5000 9440 613.9125 9473

613.1000 9408 613.5125 9441 613.9250 9474

613.1125 9409 613.5250 9442 613.9375 9475

613.1250 9410 613.5375 9443 613.9500 9476

613.1375 9411 613.5500 9444 613.9625 9477

613.1500 9412 613.5625 9445 613.9750 9478

613.1625 9413 613.5750 9446 613.9875 9479

613.1750 9414 613.5875 9447 614.0000 ---

613.1875 9415 613.6000 9448

613.2000 9416 613.6125 9449

613.2125 9417 613.6250 9450

613.2250 9418 613.6375 9451

613.2375 9419 613.6500 9452

Nihon Kohden ZS-940PA Telemetry Medical Transmitter User Manual Cover 2 ZS940PA OM pmd

Nihon Kohden Corporation Telemetry Medical Transmitter Cover 2 ZS940PA OM pmd

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