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

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TRANSMITTER
ZS-940PA
0614-009355
Model:
ZS-940PA
Manual code no.:
0614-009355
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GENERAL HANDLING PRECAUTIONS
This device is intended for use only by qualified medical personnel.
Use only Nihon Kohden approved products with this device. Use of non-approved
products or in a non-approved manner may affect the performance specifications of
the device. This includes, but is not limited to, batteries, recording paper, pens,
extension cables, electrode leads, input boxes and AC power.
Please read these precautions thoroughly before attempting to operate the instrument.
1.
To safely and effectively use the instrument, its operation must be fully understood.
2.
When installing or storing the instrument, take the following precautions:
(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive
humidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air.
(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock,
even during transport.
(3) Avoid placing in an area where chemicals are stored or where there is danger of gas
leakage.
(4) The power line source to be applied to the instrument must correspond in frequency
and voltage to product specifications, and have sufficient current capacity.
(5) Choose a room where a proper grounding facility is available.
3.
Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is in combination with other instruments to
avoid misdiagnosis or other problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using batteryoperated models.
4.
During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the
patient’s safety.
(3) Avoid direct contact between the instrument housing and the patient.
5.
To Shutdown After Use
(1) Turn power off with all controls returned to their original positions.
(2) Remove the cords gently; do not use force to remove them.
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.
ii
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
iii
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.
iv
Operator's Manual ZS-940PA
Conventions Used in this Manual and Instrument
Warnings, Cautions and Notes
Warnings, cautions and notes are used in this manual to alert or signal the reader to specific
information.
WARNING
A warning alerts the user to the possible injury or death associated with the use
or misuse of the instrument.
CAUTION
A caution alerts the user to possible injury or problems with the instrument
associated with its use or misuse such as instrument malfunction, instrument
failure, damage to the instrument, or damage to other property.
NOTE
A note provides specific information, in the form of recommendations,
prerequirements, alternative methods or supplemental information.
Operator's Manual ZS-940PA
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
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
Inside Battery Case
Symbol
Description
Symbol
vi
Description
Description
Attention, consult operator’s
manual
Battery position
On LCD
Symbol
Description
Symbol
Description
Full battery
Replace battery
NIBP cannot be measured
Replace battery
Check electrode
Operator's Manual ZS-940PA
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.)
Operator's Manual ZS-940PA
Panel Description
Front Panel
LCD:
Displays measuring data, settings and
other information.
NIBP START/STOP key:
Starts/stops NIBP measurement in
selected mode.
NIBP INTERVAL key:
Selects NIBP measurement mode.
Refer to the WARNING below.
(This symbol is attached to the rear of the
battery case cover.)
Battery case:
Contains three 1.5 V AA batteries.
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.
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
Top Panel
Refer to the WARNING on the
next page.
Refer to the WARNING on the
next page.
NIBP socket:
Connects the cuff hose.
Refer to the symbol page.
Refer to the symbol
page.
ECG/impedance RESP socket:
Connects the electrode lead for
measuring ECG and/or respiration
by the impedance method.
Bottom Panel
Channel number label:
Indicates the channel number of the
transmitter. Attach the channel number label
to the panel of the monitor.
Refer to the symbol page.
SpO2 socket:
Connects the SpO2
probe.
Refer to the WARNING on the next
page.
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
LCD
Name
NIBP SYS
NIBP DIA
NIBP MEAN
Check electrode mark
Battery replacement mark
Message display area
NIBP measurement mode
NIBP interval bar graph
9 Pulse level bar graph
10 %SpO 2
11 PR
LOCK
KEYS
10
11
No.
4 5
Description
Displays NIBP systolic value.
Displays NIBP diastolic value.
Displays NIBP mean value.
“CUFF” is displayed with the cuff inflation pressure during
measurement.
Appears when an electrode or electrode lead becomes
detached during ECG measurement.
Appears when the batteries are weak. For details, refer to
the “Battery Condition Indication” section.
Displays messages.
Displays NIBP measurement mode. When set to auto mode,
the measurement interval is displayed.
In auto NIBP measurement, the remaining time from the last
measurement to the next measurement is displayed as a bar
graph.
Displays pulse level in 7 steps.
Displays SpO2 data.
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
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
ON
A*1
OFF
SpO2 probe attachment site
Probe can be attached to the
same limb as the cuff
Probe must be attached to the
limb without cuff*2
* 1 Always set to “A”.
* 2 When the SpO2 probe is attached to the same limb as the NIBP cuff and the cuff is inflated,
the SpO2 value becomes unstable and SpO2 or PR alarm may occur.
Operator's Manual ZS-940PA
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.
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.
Operator's Manual ZS-940PA
Preparation
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.
Type
NiMH secondary
Alkaline primary
Lifetime (Measuring parameters)
ECG, SpO2, NIBP
ECG, SpO2
ECG only
2 days
2 days
2.5 days
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.
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.
10
Insert three new or fully charged batteries into the
battery case observing the correct polarity.
Operator's Manual ZS-940PA
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
Fully charged battery
No
indication
Receiving Monitor
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.
Dead batteries
No signal can be transmitted to the monitor.
There is no indication on the monitor.
Operator's Manual ZS-940PA
11
Turning the Transmitter On/Off
Peep
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.
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.
12
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
13
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.
14
Operator's Manual ZS-940PA
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
SELECTABLE
INTERVALS
Description
Select the NIBP measurement modes for
the mode selection.
INITIAL
INTERVAL
Select the initial NIBP measurement
mode at power on.
INITIAL CUFF
PRESS
Select the NIBP cuff inflation pressure.
NIBP MODE
AFTER STAT
START/FINISH
SOUND
OLD NIBP DATA
AFTER
INHIBIT SpO2
DURING NIBP
2ND PARAMETER
Select the NIBP measurement mode
after completing STAT measurement.
Turn ON or OFF the sound for NIBP
measurement start/finish.
Select whether to hide or dim the NIBP
data after measurement and how long to
wait after measurement to dim or hide it.
Turn SpO2 monitoring on or off during
NIBP measurement.
Set SpO2 and PR display order.
Settings
STAT, 5, 10, 15, 30, 60,
120, 240
MAN., 5 min, 10 min,
15 min, 30 min, 60 min,
120 min, 240 min
120 mmHg, 150 mmHg,
180 mmHg, 210 mmHg,
240 mmHg
MAN., 5 min, 10 min,
15 min, 30 min
ON, OFF/ON, OFF
DATA: HIDE, DIM
AFTER: 5 min, 10 min,
30 min
ON, OFF
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.
Operator's Manual ZS-940PA
15
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.
16
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
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).
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.
INITIAL CUFF PRESS
Select the NIBP cuff inflation pressure.
NIBP MODE AFTER STAT
Select the NIBP measurement mode after completing the STAT measurement.
Operator's Manual ZS-940PA
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.
17
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.
DATA:
AFTER:
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.
DIM NIBP data is dimmed after the “AFTER” interval.
HIDE NIBP data is hidden after the “AFTER” interval. “– – –” is displayed on the
screen.
Select the interval after NIBP measurement to dim or hide.
Dimmed
18
1.
Hidden
Operator's Manual ZS-940PA
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.
ON:
OFF:
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”.
Stops SpO2 monitoring during NIBP measurement.
SpO2 is monitored during NIBP measurement.
2ND PARAMETER
Set the display order of SpO2 and PR.
When set to SpO2
Operator's Manual ZS-940PA
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”.
When set to PR
19
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
CHANNEL/TYPE
PRESSURE UNIT
LANGUAGE
SYSTEM
INITIALIZE
Description
Displays the transmitter channel and select the
TYPE.
Select the units for NIBP.
Select the language for screen display.
Initializes all settings to the factory default
settings.
Settings
A, 8
mmHg, kPa
JPN, ENG
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.
20
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
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”.
21
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.
22
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
23
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
Standard
For adult
Large
Model
YP-943P
Width (cm)
13
Air hose length (cm)
15
YP-944P
15
15
Air hose
Width
When not attaching the transmitter to the patient arm, the following cuffs can be used. To use
these cuffs, an optional YN-990P extension hose (1.5 m) is required.
Reusable cuff
For infants
Model
YP-960T
Width (cm)
Small
YP-961T
Standard
YP-962T
10
Standard
YP-963T
13
Large
YP-964T
15
For
children
For adults
Air hose length (cm)
15
Width
Air hose
24
Operator's Manual ZS-940PA
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.
Reusable cuff
For infants
Model
YP-910P
For children
For adults
Width (cm)
YP-912P
Small
YP-913P
12
Standard
YP-914P
14
Large
YP-915P
16
Air hose length (cm)
20
Width
Air hose
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.
YN-990P extension hose, 150 cm
Operator's Manual ZS-940PA
25
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.
Cuff Width and Arm Circumference
Reusable Cuffs
Adults large YP-944P (cuff for transmitter)
YP-964T
Cuff width (cm)
15
Adults standard YP-943P (cuff for transmitter)
YP-963T
10
Children standard YP-962T
Children small YP-961T
Infants YP-960T
10
20
30
40
50
60
Arm circumference (cm)
Disposable Cuffs
Cuff width (cm)
20
Adults large YP-915P
15
Adults standard YP-914P
Adults small YP-913P
10
Children standard YP-912P
Infants YP-910P
26
10
20
30
40
50
60
Arm circumference (cm)
Operator's Manual ZS-940PA
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.
YP-943P/944P NIBP cuff
Front cover
Air hose
D ring
Belt
Belt for the strap
Lock plate pocket
Front cover open
Lock plate
Top tab
For attaching the NIBP cuff to the transmitter
NOTE
Do not roll up or put weight on the cuff with the lock
plate attached to it. Otherwise, the lock plate may
break.
Bottom tab
Operator's Manual ZS-940PA
27
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.
28
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
29
• 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
When placing the
transmitter on a bed, make
sure that the hose is not
bent.
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.
Heart
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.
30
Operator's Manual ZS-940PA
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.
Belt
D ring
End of cuff
Make sure that the cuff is not attached on a joint.
NOTE
The cuff must not wrap around the elbow.
Operator's Manual ZS-940PA
31
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.
Belt for the strap on the NIBP cuff 1.
32
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.
Operator's Manual ZS-940PA
Using the YP-960T series Reusable Cuffs or YP-910P series Disposable Cuffs
ARTERY
1.
Put the cuff on the upper arm so that the
mark of “ARTERY ” aligns with the artery
of the patient.
2.
Wrap the cuff so that “INDEX
within the “
RANGE ”.
” comes
If “Index ” is not within the “
”, change the cuff size.
RANGE
RANGE
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).
BR-903PA,
3 electrodes,
clip type
BR-913PA,
3 electrodes,
snap type
Operator's Manual ZS-940PA
BR-902PA,
2 electrodes,
clip type
BR-912PA,
2 electrodes,
snap type
33
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.
34
Operator's Manual ZS-940PA
Three Electrodes
• Lead MII, which is similar to standard lead II, used when ECG measurement has priority
Electrode Position
Left infraclavicular fossa
Right infraclavicular fossa
Below lowest rib on the left
anterior axillary line
• Lead MI, which is similar to standard
lead I
Change F/LL and L/LA of the lead
MII.
Symbol
AHA
IEC
LA
RA
LL
Lead Color
AHA
IEC
Black
Yellow
White
Red
Red
Green
• 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.
Operator's Manual ZS-940PA
35
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
Electrode Position
Right infraclavicular fossa
Below lowest rib on the left
anterior axillary line
Symbol
AHA
IEC
RA
LL
Lead Color
AHA
IEC
White
Red
Red
Green
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.
36
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
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.
37
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
Right infraclavicular
fossa
F or LL
Fifth intercostal space on the
left midclavicular line, V4
Position 2
In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead
MII. This position can be generally recommended.
R or RA
Right infraclavicular
fossa
F or LL
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
Right midaxillary at the
horizontal level of V4
38
F or LL
Fifth intercostal space on the
left midaxillary line, V6
Operator's Manual ZS-940PA
Position 4
In this position, the respiration measurement is influenced by the impedance variation of the
abdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that the
waveform is inverted in phase compared with the chest movement (the waveform goes down
during inspiration). It is difficult to measure the ECG at the same time.
R or RA
Lowest rib on the right
anterior axillary line
F or LL
Lowest rib on the left
anterior axillary line
Attaching 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.
Probe
Cable Length
Patient
Attachment site
Finger probe TL-201T
Adult or children Finger
20 kg or more
0.6 m
1.6 m
Multi-site probe TL-220T
Operator's Manual ZS-940PA
Attachment tape
Adult or Infant
3 kg or more
Finger or toe
Neonate
3 kg or less
Instep and sole
39
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
Adult
30 kg or more
Attachment site
Finger or toe
TL-252T
Child
3 to 40 kg
Finger or toe
TL-253T
Neonate
3 kg or less
Instep and sole
Multi-site Y probe TL-260T
Low birth weight infant
1 kg or less
Neonate or Child
3 kg or more
Neonate
3 kg or less
Adult
50 kg or more
Instep and
sole
Finger or toe
Neonate
3 kg or less
Instep and sole
Child or Adult
15 to 50 kg
Finger
Infant
3 to 15 kg
Toe
TL-251T
Attachment tape
TL-051S/052S
40 mm
Cable length TL-051S: 80 cm
TL-052S: 160 cm
TL-061S/062S
35 mm
Cable length TL-061S: 80 cm
TL-062S: 160 cm
40
Instep and
sole
Finger
Attachment
tape S
Attachment
tape S
Attachment
tape L
Operator's Manual ZS-940PA
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
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 shortterm 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.
Operator's Manual ZS-940PA
41
• 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.
42
Operator's Manual ZS-940PA
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.
Pip, pip
LOCK
KEYS
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.
Operator's Manual ZS-940PA
43
Monitoring
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 occlusiveoscillometry 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
44
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
45
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.
46
Operator's Manual ZS-940PA
The cuff is inflated and the inflation pressure is displayed on the screen.
Inflation pressure
In manual mode: Measurement is performed once.
In STAT mode: Measurement is performed repeatedly for 15 minutes.
In auto mode:
The first measurement is performed when the NIBP START/STOP key
is pressed. The second measurement is performed when the current time
in the transmitter reaches the selected time interval.
To stop measurement during measurement, press the NIBP START/STOP key again.
In STAT mode, after completing the STAT measurement, the measurement mode changes to
the mode set for “NIBP MODE AFTER STAT” on the PARAMETER SETUP screen.
In auto mode, to stop measurement in auto mode, change the mode to manual. To cancel
one measurement, press the NIBP START/STOP key during measurement.
After the measurement is complete, the measured data is displayed on the screen and is
transmitted to the monitor.
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.
Operator's Manual ZS-940PA
47
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 rateadaptive 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
48
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
49
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
50
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
51
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.
52
Operator's Manual ZS-940PA
Display and Message List
Battery Indication
Indication
Cause
Countermeasure
Fully charged battery
Batteries are low.
Batteries are low. NIBP cannot be measured.
No
indication
Replace batteries.
Dead batteries
ECG
Indication
Cause
Electrode lead is disconnected from the
electrode.
Electrode lead is disconnected from the
transmitter.
Electrode lead discontinuity.
Electrode is not firmly attached to the skin.
Polarization voltage is abnormally high.
Operator's Manual ZS-940PA
Countermeasure
Firmly connect the electrode
lead to the electrode.
Firmly connect the electrode
lead to the transmitter.
Replace the electrode lead
with a new one.
Replace the electrode with a
new one.
53
SpO2
Message
During NIBP
measurement
Detecting
body
movement
SpO2 CHECK
PROBE
SpO2 CHECK
PROBE SITE
SpO2 DETECTING
PULSE
SpO2 LIGHT
INTERFERENCE
SpO2 PROBE
FAILURE
Cause
SpO2 monitoring is paused for
NIBP measurement.
Considerable body movement.
The probe is not attached to
the patient properly.
The probe is not attached to
the patient properly.
The probe is disconnected
from the SpO2 socket on the
transmitter.
The probe is not attached at
the appropriate site.
Probe is expired.
Searching for the correct pulse
wave.
The SpO2 value cannot be
obtained because the
waveform is unstable.
The probe is not attached to
the patient properly.
SpO2 measurement site is
under fluorescent light,
surgical light, sunlight, etc.
Probe is expired.
Probe is damaged or shortcircuited.
Poor peripheral circulation.
SpO2 WEAK PULSE
54
The probe is attached too
tightly and is obstructing the
blood circulation.
Countermeasure
Wait for NIBP measurement to
finish.
When the message is displayed
frequently, check the patient
condition and, if necessary, change
the attachment site.
Attach the probe to the patient
properly.
Connect the probe to the SpO2
socket.
Attach the probe to a site 6 to 14
mm thick.
Replace the probe with a new one.
Wait until the pulse wave is
detected.
Attach the probe to the patient
properly.
Cover the measurement site with a
blanket or cloth.
Replace the probe with a new one.
Replace the probe with a new one.
Check the patient condition and
change the attachment site.
Check the probe attachment
condition and if necessary,
reattach the probe.
Operator's Manual ZS-940PA
NIBP
Message
NIBP AIR LEAK
Cause
The cuff and extension hose are not
properly connected.
The cuff hose (or extension hose) is
not properly connected to the NIBP
socket.
The cuff or extension hose is
damaged.
Countermeasure
Connect them properly.
Replace with a new one.
The patient’s pulse wave is small.
Measure by palpation or auscultation.
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 TIMEOUT
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.
NIBP REMEASURING
NIBP is being remeasured due to
arrhythmia, body movement,
vibration or, cuff or air hose being
squeezed.
NIBP SAFETY
CIRCUIT RUNNING
(When this message is
displayed, measurement
cannot be performed for
40 seconds.)
Measurement stopped by the safety
circuit.
NIBP CANNOT
DETECT PULSE
NIBP SYS OUT OF
RANGE
NIBP WEAK PULSE
NIBP ZEROING
The maximum blood pressure
cannot be measured even when the
cuff inflation pressure exceeded 280
mmHg when using adult cuff.
The patient’s pulse wave is too
small.
Contact your Nihon Kohden
distributor.
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.
Wait 40 seconds, then perform
remeasurement. If the message still
appears, contact your Nihon Kohden
distributor.
Measure by palpation or auscultation.
Measure by palpation or auscultation.
The cuff is wrapped too loosely.
Wrap the cuff properly.
The cuff size is not appropriate.
Use the appropriate cuff.
NIBP zero balance is being
adjusted.
Do not touch the cuff during zeroing.
Wait for the message to disappear.
Operator's Manual ZS-940PA
55
Troubleshooting
If the problem still remains after checking the following, contact your Nihon Kohden distributor.
Transmitter
Problem
Nothing is
displayed on the
LCD after
turning the
power on.
Nothing is
displayed on the
monitor after
turning the
transmitter
power on.
Cause
Batteries are not installed
correctly. The battery
polarity is wrong.
Batteries are completely
discharged.
The channel of the
transmitter and monitor
does not match.
The “TYPE” on the
SYSTEM SETUP screen
is not set to “A”.
Signal receiving
condition is poor.
Another transmitter of the
same channel is used
nearby.
Signals are mixing.
The transmitter is
damaged.
56
Countermeasure
Install the batteries correctly.
Replace the batteries with new ones.
Set the correct channel on the monitor.
Check that the “TYPE” is set to “A”.
Refer to the “Notes on Parameter
Settings” and “Changing System Setup
Settings” sections.
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.
Follow the instructions of your channel
administrator and use another transmitter
of a different channel.
Contact your Nihon Kohden distributor.
Operator's Manual ZS-940PA
ECG
Problem
The heart rate is
unstable.
Cause
Pacing detection setting on the
monitor is not correct.
The “CHECK
ELECTRODE”
message appears
on the receiving
monitor.
Electrode lead is disconnected
from the electrode.
Electrode lead discontinuity
ECG baseline is
thick.
(Hum is
overlapping)
Respiration
waveform
measurement is
unstable.
Electrode is not firmly
attached to the skin.
Polarization voltage is
abnormally high.
The gel on the electrode is
dried out.
The gel on the electrode is
coming off.
Electric blanket is used.
Hum filter is set to OFF on the
monitor
The gel on the electrode is
dried out.
The gel on the electrode is
coming off.
Countermeasure
Turn off the pacing detection setting
on the monitor.
When monitoring a pacemaker
patient, turn on pacing detection.
Firmly connect the electrode lead to
the electrode.
Replace the electrode lead with a new
one.
Replace the electrode with a new one.
Use Nihon Kohden specified
electrodes.
Replace the electrode with a new one.
Cover the blanket with a shield cover.
Set the filter to ON.
Replace the electrode with a new one.
SpO2
Problem
SpO2 data is
unstable and
not reliable.
Cause
The probe size is not
appropriate for the patient.
Probe attachment condition
is poor. Probe is partly
detached from the skin.
External light gets in.
Measurement site is dirty.
Patient is wearing nail
polish.
Probe is attached to the
same limb that is used for
NIBP measurement.
Countermeasure
Use the appropriate probe for the patient.
Firmly attach the probe according to the
procedure in the probe operator’s manual.
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.
Attach the probe to the opposite limb.
Avoid a site where blood circulation
condition changes greatly.
Operator's Manual ZS-940PA
57
NIBP
Problem
Cuff inflation
pressure is less than
10 mmHg.
The cuff does not
inflate when the
NIBP START/STOP
key is pressed.
Abnormal
measurement results
are displayed.
Cause
The cuff hose is not connected
to the NIBP socket properly.
The cuff is not wrapped
around the arm or is wrapped
too loosely.
The cuff hose is not connected
to the NIBP socket.
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.
The cuff size is not correct.
The cuff is not wrapped
around the arm correctly.
NIBP data is not correct
because of body movement.
Vibration on the cuff.
The cuff is suddenly
deflated during
inflation.
Auto mode
measurement does
not start even when
the time interval has
passed.
The cuff suddenly
inflates.
Cannot connect cuff
to the air hose.
58
Countermeasure
Connect the cuff hose to the socket
properly.
Wrap the cuff around the upper
arm.
Connect the cuff hose to the socket
firmly.
Check the cuff hose and air hose.
Select the cuff which fits the
patient’s limb circumference.
Wrap the cuff around the upper
arm, not too tightly or too loosely.
Prevent the patient from moving
during measurement.
Check that nothing is touching the
cuff during measurement.
Change the measuring site.
The NIBP START/STOP key
is pressed during inflation.
The NIBP INTERVAL key is
pressed and the measurement
mode is changed.
Check the measurement mode and
interval.
The measurement mode is set
to auto mode.
Unspecified cuff is used.
Check the time interval. If
necessary, stop measurement.
Use a cuff specified by Nihon
Kohden.
Operator's Manual ZS-940PA
Problem
Cannot measure
NIBP.
Blood congestion
occurs.
Thrombus occurs.
NIBP data on the
screen is --- or dark.
Three loud pip
sounds indicting
NIBP measurement
cannot be started.
Numeric data is
displayed but NIBP
messages are not
displayed on the
monitor.
Cause
Vibration on the cuff.
The cuff hose or extension
hose is bent or squeezed.
The cuff has worn out.
Measuring over a long
period of time at short
intervals.
Measuring on a patient
with known bleeding
disorders or coagulation.
The time set for “OLD
NIBP DATA” on the
PARAMETER SETUP
screen elapsed from the last
measurement.
The cuff is not deflated
enough to start another
measurement.
The “TYPE” on the
SYSTEM SETUP screen is
not set to “A”.
Operator's Manual ZS-940PA
Countermeasure
Check that nothing is touching the
cuff during measurement.
Remove the cause.
Use a new cuff.
Increase the measuring interval.
Do not measure NIBP over a long
time.
Do not perform NIBP measurement
on such a patient.
When NIBP is measured again, the
data is displayed in normal
brightness.
Wait 30 seconds and measure again.
Check that the “TYPE” is set to “A”.
Refer to the “Notes on Parameter
Settings” and “Changing System
Setup Settings” sections.
59
Maintenance
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.
Channel label
60
Operator's Manual ZS-940PA
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
Operator's Manual ZS-940PA
61
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”.
62
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
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.
Operator's Manual ZS-940PA
63
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.
64
Operator's Manual ZS-940PA
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
OK
Can be used but needs maintenance
Maintenance required. Cannot be used.
Operator's Manual ZS-940PA
65
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.
66
Operator's Manual ZS-940PA
Lifetime and Disposal
Disposing of Used Batteries
Battery Lifetime
Replace the batteries when the battery replacement indication appears on the transmitter. When
using rechargeable batteries, recharge them.
Type
NiMH secondary
Alkaline primary
Lifetime (Measuring parameters)
ECG, SpO2, NIBP
ECG, SpO2
ECG only
2 days
2 days
2.5 days
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.
Operator's Manual ZS-940PA
67
Cleaning, Disinfection and Sterilization
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
Glutaraldehyde solution
Hydrochloric alkyl diaminoethylglycine
Benzalkonium chloride
Benzethonium chloride solution
Chlorohexidine gluconate solution
68
Concentration (%)
2.0
0.5
0.2
0.2
0.5
Operator's Manual ZS-940PA
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.
Operator's Manual ZS-940PA
69
Specifications
Measuring Parameters
Measuring waveforms:
Measuring numeric data:
Transmitting Data
Waveform data:
Numeric data:
Status information:
ECG, Respiration in impedance method, pulse
SpO2, NIBP, pulse rate
ECG, respiration, pulse wave
SpO2 and NIBP
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:
Input range:
DC offset:
Input impedance:
Pacing pulse detection:
±5 mV or more
±500 mV or more
5 MΩ or more (5 Hz)
ANSI/AAMI EC13
Based upon Pacemaker pulse rejection Capability
Respiration Measurement
Measuring method:
Impedance range:
Impedance method
0 to 2 kΩ or less
SpO2 Measurement
Display range:
Measuring range:
Minimum display range:
Depends on the receiving monitor
0 to 100%, in 1% steps
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.
70
Operator's Manual ZS-940PA
NIBP Measurement
Displayed items:
Cuff pressure display range:
Measurement modes:
Systolic, diastolic, mean
0 to 300 mmHg
Manual, STAT, auto at 5, 10, 15, 30, 60, 120 or 240 minute
interval
Pulse Rate
30 to 200 beats/minute ±8 beats/min (NIBP)
Measuring range:
30 to 200 beats/min ±3% ±1 beat/min (SpO2)
Transmitter
FCC regulation:
Field strength limits:
Undesired emission:
Antenna:
Transmission channel:
Transmission frequency range:
Channel spacing:
Type of emission:
Occupied bandwidth:
Effective radiated power:
Power Requirements
Operating voltage:
Battery type:
FCC part 95 Subpart H
Wireless Medical Telemetry Service (WMTS)
<200 mV/m (at 3 m)
below 960 MHz: 200 µV/m (at 3 m)
above 960 MHz: 500 µV/m (at 3 m)
Internal
indicated on the transmitter
608.0125 to 613.9875 MHz
25 kHz (12.5 kHz when interleave)
F1D
<8.5 kHz
1.0 mW (conducted)
3.2 to 4.8 V
Three AA type NiMH secondary batteries
Three AA type alkaline dry cell primary batteries
Battery lifetime:
Type
NiMH secondary
Alkaline primary
Lifetime (Measuring parameters)
ECG, SpO2, NIBP
ECG, SpO2
ECG only
2 days
2 days
2.5 days
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:
Weight:
Operator's Manual ZS-940PA
114 W × 103 H × 58 D (mm)
about 350 g (including batteries)
71
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
72
Operator's Manual ZS-940PA
Standard Accessories
No.
Name
NIBP cuff for adult, standard
Strap
Model
YP-943P
---
Q’ty
Supply Code No.
S938B
Y236
The following parts are available for replacement.
Lock plate is a
standard accessory of
the YP-943P/944P
NIBP cuff.
No.
Name
Battery case cover
Lock plate
Operator's Manual ZS-940PA
Model
Q’ty
Supply Code No.
6144-012004
6113-049585
73
Options
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
Name
Electrode
lead
74
Application
3 electrodes,clip type,
lead length 80 cm
3 electrodes, snap type,
lead length 80 cm
2 electrodes,clip type,
lead length 80 cm
2 electrodes,snap type,
lead length 80 cm
Model
Q’ty
Supply Code No.
BR-903PA
K911A
BR-913PA
K910B
BR-902PA
K907B
BR-912PA
K908B
Operator's Manual ZS-940PA
SpO2
Cable
length
0.6 m
1.6 m
Name
Finger probe (reusable)
Multi-site probe (reusable)
SpO2 probe (for adult, disposable)
SpO2 probe (for child, disposable)
SpO2 probe (for neonate,
disposable)
Multi-site Y probe
(for low birth weight infant/child/
neonate, disposable)
SpO2 probe(for adult/neonate,
disposable)
SpO2 probe (for child/infant,
disposable)
COTTONY tape
Foam tape for TL-051S/052S/
061S/062S
Attachment tape for TL-220T/
251T/252T/253T
Attachment tape S for TL-260T
Attachment tape L for TL-260T
1.6 m
TL-220T
TL-251T
TL-252T
Supply
Code No.
P225H
P225F
P225G
P201A
P201B
TL-253T
P201C
Model/
Code No.
TL-201T
TL-260T
0.8 m
1.6 m
0.8 m
1.6 m
TL-051S
TL-052S
TL-061S
TL-062S
340703
---
---
Q’ty
P205A
20
P228A
P228B
P229A
P229B
P259
4 × 25 package
P260
3 × 30 package
P263
24
P260A
P260B
NIBP
Width
(cm)
Name
Cuff for adult, for
attaching transmitter to
patient arm
Cuff for infants
Cuff for children
Cuff for adult
Standard
13
Large
15
10
13
15
12
14
16
Small
Standard
Standard
Large
Disposable cuff for infants
Disposable cuff for children
Disposable cuff for adults
Small
Standard
Large
Extension hose
* The lock plate is provided with these NIBP cuffs.
Operator's Manual ZS-940PA
Air Hose
Length
(cm)
15
15
20
150
Model
YP-943P*
YP-944P*
YP-960T
YP-961T
YP-962T
YP-963T
YP-964T
YP-910P
YP-912P
YP-913P
YP-914P
YP-915P
YN-990P
Q’ty
20
Supply
Code
No.
S938B
S938C
S943A
S943B
S943C
S944B
S944C
----------S903
75
Transmission Frequencies
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
Transmission
Transmission
Transmission
12.5kHz step
12.5kHz step
12.5kHz step
frequency
frequency
frequency
Channel No.
Channel No.
Channel No.
(MHz)
(MHz)
(MHz)
608.0000
608.0125
608.0250
608.0375
608.0500
608.0625
608.0750
608.0875
608.1000
608.1125
608.1250
608.1375
608.1500
608.1625
608.1750
608.1875
608.2000
608.2125
608.2250
608.2375
608.2500
608.2625
608.2750
608.2875
608.3000
608.3125
608.3250
608.3375
608.3500
608.3625
76
--9001
9002
9003
9004
9005
9006
9007
9008
9009
9010
9011
9012
9013
9014
9015
9016
9017
9018
9019
9020
9021
9022
9023
9024
9025
9026
9027
9028
9029
608.3750
608.3875
608.4000
608.4125
608.4250
608.4375
608.4500
608.4625
608.4750
608.4875
608.5000
608.5125
608.5250
608.5375
608.5500
608.5625
608.5750
608.5875
608.6000
608.6125
608.6250
608.6375
608.6500
608.6625
608.6750
608.6875
608.7000
608.7125
608.7250
608.7375
9030
9031
9032
9033
9034
9035
9036
9037
9038
9039
9040
9041
9042
9043
9044
9045
9046
9047
9048
9049
9050
9051
9052
9053
9054
9055
9056
9057
9058
9059
608.7500
608.7625
608.7750
608.7875
608.8000
608.8125
608.8250
608.8375
608.8500
608.8625
608.8750
608.8875
608.9000
608.9125
608.9250
608.9375
608.9500
608.9625
608.9750
608.9875
609.0000
609.0125
609.0250
609.0375
609.0500
609.0625
609.0750
609.0875
609.1000
609.1125
9060
9061
9062
9063
9064
9065
9066
9067
9068
9069
9070
9071
9072
9073
9074
9075
9076
9077
9078
9079
9080
9081
9082
9083
9084
9085
9086
9087
9088
9089
Operator's Manual ZS-940PA
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
Transmission
Transmission
Transmission
12.5kHz step
12.5kHz step
12.5kHz step
frequency
frequency
frequency
Channel No.
Channel No.
Channel No.
(MHz)
(MHz)
(MHz)
609.1250
609.1375
609.1500
609.1625
609.1750
609.1875
609.2000
609.2125
609.2250
609.2375
609.2500
609.2625
609.2750
609.2875
609.3000
609.3125
609.3250
609.3375
609.3500
609.3625
609.3750
609.3875
609.4000
609.4125
609.4250
609.4375
609.4500
609.4625
609.4750
609.4875
609.5000
609.5125
609.5250
9090
9091
9092
9093
9094
9095
9096
9097
9098
9099
9100
9101
9102
9103
9104
9105
9106
9107
9108
9109
9110
9111
9112
9113
9114
9115
9116
9117
9118
9119
9120
9121
9122
Operator's Manual ZS-940PA
609.5375
609.5500
609.5625
609.5750
609.5875
609.6000
609.6125
609.6250
609.6375
609.6500
609.6625
609.6750
609.6875
609.7000
609.7125
609.7250
609.7375
609.7500
609.7625
609.7750
609.7875
609.8000
609.8125
609.8250
609.8375
609.8500
609.8625
609.8750
609.8875
609.9000
609.9125
609.9250
609.9375
9123
9124
9125
9126
9127
9128
9129
9130
9131
9132
9133
9134
9135
9136
9137
9138
9139
9140
9141
9142
9143
9144
9145
9146
9147
9148
9149
9150
9151
9152
9153
9154
9155
609.9500
609.9625
609.9750
609.9875
610.0000
610.0125
610.0250
610.0375
610.0500
610.0625
610.0750
610.0875
610.1000
610.1125
610.1250
610.1375
610.1500
610.1625
610.1750
610.1875
610.2000
610.2125
610.2250
610.2375
610.2500
610.2625
610.2750
610.2875
610.3000
610.3125
610.3250
610.3375
610.3500
9156
9157
9158
9159
9160
9161
9162
9163
9164
9165
9166
9167
9168
9169
9170
9171
9172
9173
9174
9175
9176
9177
9178
9179
9180
9181
9182
9183
9184
9185
9186
9187
9188
77
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
Transmission
Transmission
Transmission
12.5kHz step
12.5kHz step
12.5kHz step
frequency
frequency
frequency
Channel No.
Channel No.
Channel No.
(MHz)
(MHz)
(MHz)
610.3625
610.3750
610.3875
610.4000
610.4125
610.4250
610.4375
610.4500
610.4625
610.4750
610.4875
610.5000
610.5125
610.5250
610.5375
610.5500
610.5625
610.5750
610.5875
610.6000
610.6125
610.6250
610.6375
610.6500
610.6625
610.6750
610.6875
610.7000
610.7125
610.7250
610.7375
610.7500
610.7625
78
9189
9190
9191
9192
9193
9194
9195
9196
9197
9198
9199
9200
9201
9202
9203
9204
9205
9206
9207
9208
9209
9210
9211
9212
9213
9214
9215
9216
9217
9218
9219
9220
9221
610.7750
610.7875
610.8000
610.8125
610.8250
610.8375
610.8500
610.8625
610.8750
610.8875
610.9000
610.9125
610.9250
610.9375
610.9500
610.9625
610.9750
610.9875
611.0000
611.0125
611.0250
611.0375
611.0500
611.0625
611.0750
611.0875
611.1000
611.1125
611.1250
611.1375
611.1500
611.1625
611.1750
9222
9223
9224
9225
9226
9227
9228
9229
9230
9231
9232
9233
9234
9235
9236
9237
9238
9239
9240
9241
9242
9243
9244
9245
9246
9247
9248
9249
9250
9251
9252
9253
9254
611.1875
611.2000
611.2125
611.2250
611.2375
611.2500
611.2625
611.2750
611.2875
611.3000
611.3125
611.3250
611.3375
611.3500
611.3625
611.3750
611.3875
611.4000
611.4125
611.4250
611.4375
611.4500
611.4625
611.4750
611.4875
611.5000
611.5125
611.5250
611.5375
611.5500
611.5625
611.5750
611.5875
9255
9256
9257
9258
9259
9260
9261
9262
9263
9264
9265
9266
9267
9268
9269
9270
9271
9272
9273
9274
9275
9276
9277
9278
9279
9280
9281
9282
9283
9284
9285
9286
9287
Operator's Manual ZS-940PA
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
Transmission
Transmission
Transmission
12.5kHz step
12.5kHz step
12.5kHz step
frequency
frequency
frequency
Channel No.
Channel No.
Channel No.
(MHz)
(MHz)
(MHz)
611.6000
611.6125
611.6250
611.6375
611.6500
611.6625
611.6750
611.6875
611.7000
611.7125
611.7250
611.7375
611.7500
611.7625
611.7750
611.7875
611.8000
611.8125
611.8250
611.8375
611.8500
611.8625
611.8750
611.8875
611.9000
611.9125
611.9250
611.9375
611.9500
611.9625
611.9750
611.9875
612.0000
9288
9289
9290
9291
9292
9293
9294
9295
9296
9297
9298
9299
9300
9301
9302
9303
9304
9305
9306
9307
9308
9309
9310
9311
9312
9313
9314
9315
9316
9317
9318
9319
9320
Operator's Manual ZS-940PA
612.0125
612.0250
612.0375
612.0500
612.0625
612.0750
612.0875
612.1000
612.1125
612.1250
612.1375
612.1500
612.1625
612.1750
612.1875
612.2000
612.2125
612.2250
612.2375
612.2500
612.2625
612.2750
612.2875
612.3000
612.3125
612.3250
612.3375
612.3500
612.3625
612.3750
612.3875
612.4000
612.4125
9321
9322
9323
9324
9325
9326
9327
9328
9329
9330
9331
9332
9333
9334
9335
9336
9337
9338
9339
9340
9341
9342
9343
9344
9345
9346
9347
9348
9349
9350
9351
9352
9353
612.4250
612.4375
612.4500
612.4625
612.4750
612.4875
612.5000
612.5125
612.5250
612.5375
612.5500
612.5625
612.5750
612.5875
612.6000
612.6125
612.6250
612.6375
612.6500
612.6625
612.6750
612.6875
612.7000
612.7125
612.7250
612.7375
612.7500
612.7625
612.7750
612.7875
612.8000
612.8125
612.8250
9354
9355
9356
9357
9358
9359
9360
9361
9362
9363
9364
9365
9366
9367
9368
9369
9370
9371
9372
9373
9374
9375
9376
9377
9378
9379
9380
9381
9382
9383
9384
9385
9386
79
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
USA
BAND
CHANNEL
SPACING
Transmission
Transmission
Transmission
12.5kHz step
12.5kHz step
12.5kHz step
frequency
frequency
frequency
Channel No.
Channel No.
Channel No.
(MHz)
(MHz)
(MHz)
612.8375
612.8500
612.8625
612.8750
612.8875
612.9000
612.9125
612.9250
612.9375
612.9500
612.9625
612.9750
612.9875
613.0000
613.0125
613.0250
613.0375
613.0500
613.0625
613.0750
613.0875
613.1000
613.1125
613.1250
613.1375
613.1500
613.1625
613.1750
613.1875
613.2000
613.2125
613.2250
613.2375
80
9387
9388
9389
9390
9391
9392
9393
9394
9395
9396
9397
9398
9399
9400
9401
9402
9403
9404
9405
9406
9407
9408
9409
9410
9411
9412
9413
9414
9415
9416
9417
9418
9419
613.2500
613.2625
613.2750
613.2875
613.3000
613.3125
613.3250
613.3375
613.3500
613.3625
613.3750
613.3875
613.4000
613.4125
613.4250
613.4375
613.4500
613.4625
613.4750
613.4875
613.5000
613.5125
613.5250
613.5375
613.5500
613.5625
613.5750
613.5875
613.6000
613.6125
613.6250
613.6375
613.6500
9420
9421
9422
9423
9424
9425
9426
9427
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---
Operator's Manual ZS-940PA

---

Source Exif Data:

File Type                       : PDF
File Type Extension             : pdf
MIME Type                       : application/pdf
PDF Version                     : 1.3
Linearized                      : No
Create Date                     : 2004:10:07 09:20:18+09:00
Modify Date                     : 2004:10:07 09:20:18+09:00
Page Count                      : 88
Creation Date                   : 2004:10:07 00:20:18Z
Mod Date                        : 2004:10:07 00:20:18Z
Producer                        : Acrobat Distiller 5.0 (Windows)
Author                          : ro4894
Metadata Date                   : 2004:10:07 00:20:18Z
Creator                         : ro4894
Title                           : Cover 2 ZS940PA OM.pmd

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