Professional Documents
Culture Documents
Defibrillator
TEC-5600 series
Operator’s Manual
Defibrillator
TEC-5601/TEC-5611
TEC-5621/TEC-5631
TEC-5600 series
0614-907188C
Printed: 2015/03/05
About This Manual
In order to use this product safely and fully understand all its functions, read this manual before using the
product.
Keep this manual near the instrument or in the reach of the operator and refer to it whenever the operation is
unclear.
Accompanying Documentation
The TEC-5600 series defibrillator comes with the following manuals. Refer to the manual depending on
your needs.
Administrator’s Guide
For administrators. Describes the settings on the SYSTEM SETUP screen. Read the
Operator’s Manual together with this manual.
Service Manual
For qualified service personnel. Describes information on servicing the defibrillator.
Only qualified service personnel can service the defibrillator.
Trademark
The company name and model name are trademarks and registered trademarks of each company.
The mark printed on the SD card that is used in this instrument is a trademark.
Copyright Notice
The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No part of this
document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical,
photocopied, recorded, or otherwise) without the prior written permission of Nihon Kohden.
This product stores personal patient information. Manage and operate the information appropriately.
Patient names on the screen shots and recording examples in this manual are fictional and any resemblance to
any person living or dead is purely coincidental.
If you have any comments or suggestions on this manual, please contact us at: www.nihonkohden.com
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.
Warnings and cautions for individual functions are described on related pages.
Also read those warnings and cautions carefully.
General
WARNING WARNING
Never use the defibrillator in the presence of any Never use the defibrillator in a hyperbaric oxygen
flammable anesthetic gas or high concentration chamber. Failure to follow this warning may cause
oxygen atmosphere. Failure to follow this warning explosion or fire.
may cause explosion or fire.
WARNING
WARNING When the defibrillator is used with an
This defibrillator is for one patient at a time. Do not electrosurgical unit (ESU), firmly attach the entire
monitor multiple patients with different sensors area of the ESU return plate. Otherwise, the
attached. current from the ESU flows into the electrodes of
the defibrillator, causing electrical burn where the
electrodes are attached. For details, refer to the
ESU manual.
WARNING
When performing MRI test, remove all electrodes
and transducers from the patient which are
connected to this instrument. Failure to follow this WARNING
warning may cause skin burn on the patient. For After attaching electrodes, probes and sensors on
details, refer to the MRI manual. the patient and connecting cables to the
defibrillator, check that there are no error
messages and the waveforms and numeric data
WARNING are appropriately displayed on the screen. If there
is an error message, or waveform or numeric data
Do not diagnose a patient based only on data
is not appropriate, check the electrodes, probes
acquired by the defibrillator. Overall judgement
and sensor attachment, patient condition and
must be performed by a physician who
settings on the defibrillator and remove the cause.
understands the features, limitations and
characteristics of the defibrillator and by reading
the biomedical signals acquired by other
instruments.
CAUTION
If the defibrillator is affected by an RF interference
from a cellular phone, small wireless device or
other device, move that device away from the
defibrillator or turn off the power of the device. The
defibrillator may misinterpret radio waves from the
device as ECG signals or pulses and display
incorrect data.
WARNING WARNING
Only use the specified power cord. When the Connect only the specified instrument to the
specified power cord cannot be used or when defibrillator and follow the specified procedure.
equipotential grounding is doubtful (such as in poor Failure to follow this warning may result in
grounding facility), operate the defibrillator on electrical shock or injury to the patient and
battery power. Otherwise, the patient and operator operator, and cause fire or instrument malfunction.
may receive electrical shock or injury.
CAUTION
Before connecting or disconnecting instruments,
make sure that each instrument is turned off and
the power cord is disconnected from the AC
socket. Then remove the battery pack. Otherwise,
the patient or operator may receive electrical shock
or injury.
Turning Power On
CAUTION
When the defibrillator is turned on, check that one
“bong” sounds and the red, yellow and cyan alarm
indicator lamps blink once to show that the alarm
functions properly.
Defibrillation
WARNING WARNING
Before defibrillation, make sure that no one is in The defibrillator generates high voltage. The
contact with either the patient or any metal part of defibrillator must only be operated by trained and
any equipment or cables which supports or is qualified medical personnel.
connected to the patient. Failure to follow this
warning causes serious electrical shock or injury.
WARNING
Perform defibrillation in an ambulance only with the
WARNING vehicle stopped.
Before defibrillation and cardioversion, remove
from the patient all electrodes, probes and trans-
ducers from connectors that do not have a “ ” or
“ ” mark. Otherwise, the operator may receive
electrical shock and the connected instrument may
be damaged.
WARNING
Never perform defibrillation to a person or object
WARNING
other than the patient or discharge test equipment
When using an ESU, use the ECG electrodes for
(test electrode plate or energy checker). When
monitoring. Do not monitor ECG with disposable
performing the defibrillation check using the
pads, external paddles or internal paddles. If ECG
external paddles, keep the paddles in the paddle
is monitored with pads or paddles, high-frequency
holders. Failure to follow this instruction may result
energy from the ESU causes abnormal current to
in electrical shock.
flow in the patient and unexpected discharge. This
may damage the defibrillator.
WARNING
When performing defibrillation on a child, be
careful of the selected energy. High energy may
cause critical damage to the cardiac muscle.
CAUTION CAUTION
If the patient’s body is wet, thoroughly wipe the Before defibrillation, make sure that the patient is
moisture off the skin so that the paddles or pads not in electrical contact with any metal part of a
will not short-circuit each other. Otherwise, delivery bed, stretcher, or other equipment via blood or
of shock may be insufficient. chemical solution on the patient. Such contact may
cause unwanted pathways for the defibrillator
current and cause insufficient delivery of electrical
shock.
WARNING WARNING
Confirm that there is no artifact on the ECG. Check that the vertical dotted line indicating
Artifact may be misinterpreted as QRS and synchronization position is displayed on the rising
discharge might not synchronize with the patient’s slope of every QRS wave (between the Q and R
QRS. points). If the position of the vertical dotted line is
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
WARNING with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
Before using the defibrillator, check that
key.
synchronized cardioversion occurs within 60 ms of
• Change the electrode position.
the peak of the ECG’s R wave with the defibrillator
If the position of the vertical dotted line is incorrect,
and an external monitor connected.
synchronized cardioversion may not be performed
properly and may cause ventricular fibrillation to
the patient.
CAUTION CAUTION
Synchronized cardioversion with the paddle lead When performing synchronized cardioversion,
does not provide stable ECG because it is difficult confirm that SYNC MODE is displayed on the
to hold the paddles steady. Artifact on the ECG defibrillator screen before every discharge.
may be misinterpreted as QRS and discharge Depending on the setting made on the SYSTEM
might not synchronize with the patient’s QRS. SETUP screen, the defibrillator automatically
returns to the asynchronous defibrillation mode
after synchronized cardioversion.
WARNING WARNING
When the patient is a child age 0 to 7, perform While the defibrillator is analyzing the patient’s
defibrillation in AED mode (child mode). ECG, stop CPR and do not move or shake the
When using the defibrillation pads, make sure that patient’s body. If the patient is in a car, stop the car.
the pads do not touch each other. Otherwise, the defibrillator cannot analyze the
patient’s ECG correctly.
WARNING
Only use the AED mode (child mode) for children
age 0 to 7. If the AED mode (child mode) is used
for adults, the discharged energy may be
insufficient.
CAUTION CAUTION
Before ECG analysis or defibrillation, confirm that Asystole is not judged as a shockable rhythm.
the patient is unconscious and has no respiration
and no pulse.
CAUTION
For some ECG waves, the defibrillator may
CAUTION incorrectly judge that defibrillation is not necessary.
Do not perform defibrillation if the electrodes of the When the defibrillator judges that defibrillation is
disposable pads overlap each other or are not necessary, it provides instructions for
short-circuited by anything conductive such as performing CPR. In very rare cases, the
contact gel. Failure to follow this warning may defibrillator may incorrectly judge that defibrillation
cause skin burn or insufficient delivery of shock to is necessary.
the heart.
CAUTION
The defibrillator may not be able to correctly
analyze an ECG of a patient with an implanted
pacemaker. For such a patient, follow a physician’s
instructions.
WARNING WARNING
Before defibrillation, remove everything including Pay careful attention to the energy setting when
electrodes and patches from the patient’s chest. If using the pediatric electrode plates. Applying high
the defibrillator paddle/pad contacts an object on energy with the pediatric electrode plates can
the patient’s chest, the discharged energy may be cause skin burn, because the electrode plates are
insufficient and cause skin burn. small.
WARNING WARNING
Do not hold the paddle handles if your hands are Apply contact gel only to the electrode plates of the
wet or have contact gel on them. This may cause external paddles. Otherwise, it may cause electrical
electrical shock to the operator. shock to the operator.
CAUTION CAUTION
Do not discharge the energy if the electrodes of To prevent skin burn on the patient, apply contact
paddles are short-circuited to each other by gel evenly to the electrode plates of the external
contact gel. Failure to follow this warning may paddles.
cause skin burn or insufficient delivery of shock to
the heart.
WARNING WARNING
Do not discharge with the paddles in the air. This When charging or discharging, grip the internal
may cause electrical shock or damage the paddles between the cable and the guard at the
defibrillator. top of the handle. If the internal paddles are
gripped between the electrode and the guard, the
operator may receive an electrical shock.
WARNING
Before discharging, confirm that the internal
paddles are firmly positioned against the heart. CAUTION
Failure to follow this warning may cause skin burn Do not twist the internal paddle while holding the
or insufficient delivery of shock. electrode or impact strong impact to the paddle.
Doing so can damage or bend the electrode.
CAUTION
Pay careful attention to the selected energy when CAUTION
using internal paddles. Applying high energy to the Sterilize the internal paddles before use. Failure to
heart may cause cardiac muscle necrosis. Low sterilize the paddles may cause serious infection.
energy is recommended.
WARNING WARNING
Before defibrillation, remove everything including Before discharging, confirm that the paddles or
electrodes and patches from the patient’s chest. If pads are firmly pressed against the chest wall.
the defibrillator paddle/pad contacts an object on Failure to follow this warning may cause skin burn
the patient’s chest, the discharged energy may be or insufficient delivery of shock.
insufficient and cause skin burn.
CAUTION
Do not perform defibrillation if the electrodes of the
disposable pads overlap each other or are
short-circuited by anything conductive such as
contact gel. Failure to follow this warning may
cause skin burn or insufficient delivery of shock to
the heart.
WARNING WARNING
Do not use the disposable pads if they are past the If the bag containing disposable pads is torn, do
expiration date on the package. Failure to follow not use the pads. Dispose of the pads. Failure to
this warning may lead to skin burn or insufficient follow this warning may lead to skin burns or
delivery of shock. insufficient delivery of shock.
WARNING WARNING
Do not reuse disposable pads. Failure to follow this Do not use the disposable pads if the gel is dark
warning may lead to skin burn or insufficient brown or dark-brown gel is on the protective sheet.
delivery of shock. Use of such pads may cause insufficient delivery of
shock or skin burn where the pads are attached.
WARNING
• Do not use the disposable pads if the gel has WARNING
become dry. Use disposal pads as soon as possible after
• Do not use the disposable pads if the gel has opening the package. Failure to follow this warning
become abnormal (the gel has become liquified may lead to skin burn or insufficient delivery of
or is coming out of the edges of the pad, etc.). shock.
Failure to follow these warnings may cause skin
burn or insufficient delivery of shock.
CAUTION CAUTION
Do not place heavy objects on the disposable pads When disposable pads are attached to a patient,
or bend the pads. The pads may become damaged replace them every 24 hours. After 24 hours, the
and deteriorated, resulting in skin burn on the gel becomes dry and this may reduce performance
patient. of the pads.
CAUTION CAUTION
Do not attach a disposable pad over another pad. When monitoring ECG with disposable pads,
It may cause skin burn on the patient. check the polarity of the pads before attaching
them on the patient. If the pad polarity is incorrect,
the waveform appears upside-down and this may
cause incorrect judgment by the operator and
CAUTION
delay of treatment.
Store the disposable pads in the environment
described on the package. If stored in an
environment other than specified, the pads will
become unusable.
WARNING CAUTION
Only use Nihon Kohden specified parts and Do not reuse disposable parts and accessories.
accessories, such as connection cords, electrodes,
paddles and probes. Otherwise, the defibrillator
may overheat and be damaged, in which case
monitoring will stop or electrical shock may be
caused.
WARNING WARNING
Do not perform pacing while using an ESU. Before Confirm that there is no artifact on the ECG.
using the ESU, turn the defibrillator power off and Artifact may be misinterpreted as QRS and correct
remove disposable pads from the patient. Other- pacing cannot be performed.
wise, high frequency energy from the ESU causes
abnormal current to flow into the patient and
causes electrical burn, shock or other injury. It also WARNING
damages the defibrillator.
When using the disposable pads for long term
pacing, replace them every hour. Failure to follow
this warning may cause skin burn or insufficient
WARNING energy discharge and pacing current to the heart.
If any disposable pad or connector gets wet, wipe
off moisture before use. If a wet pad or connector
is used, it may cause electrical shock. WARNING
When performing pacing in a vehicle, such as an
ambulance, confirm that noise due to automobile
WARNING vibrations is not misinterpreted as QRS.
Do not touch the disposable pads or the area
around the pads during pacing. Failure to follow
this warning may cause electrical shock.
CAUTION
Check that the pacing pulse is effective, by
observing the ECG on the screen.
Alarms
WARNING WARNING
Do not diagnose a patient based only on alarm A physician must be within the range where he/she
information of the defibrillator. If the alarm is set to can hear the alarm sound of the defibrillator while
off, critical changes in the patient may be over- monitoring a patient on the defibrillator. If the
looked. physician cannot hear the alarm sound, critical
changes on the patient may be overlooked.
WARNING
If more than one medical equipment is used WARNING
together in the same facility, make sure all When an alarm occurs:
equipments have the same alarm default settings • Check the patient first and take necessary
(alarm master). If the medical equipments have measure to ensure patient’s safety.
different alarm default settings and when initialized, • Remove the cause of the alarm.
the alarm settings differ with the other equipments • Check the alarm settings on the defibrillator and
and alarm cannot be managed appropriately in the change the alarm settings if necessary.
facility. If using different alarm default settings
according to areas or wings in the facility, manage
the alarms appropriately. WARNING
Check the alarm settings when you start monitor-
ing a new patient. Check the alarm settings as
WARNING required during monitoring and change them
During alarm suspension (“ALL ALARMS appropriately according to the patient’s condition.
SUSPENDED” or “ALL ALARMS OFF” message The alarm settings return to those specified in
displayed), all alarms are turned off. Be careful Alarm Setting on the SYSTEM SETUP screen
when you suspend the alarm. about 30 minutes after power-off.
CAUTION CAUTION
When the alarm is turned Off for an arrhythmia, When the alarm limit is set to Off, there will be no
there will be no alarm for that arrhythmia type. alarm for that limit. Be careful when you set the
There is no message or mark to indicate that a alarm limit to Off.
certain arrhythmia alarm is turned off. Therefore,
be careful when you turn off an arrhythmia alarm.
CAUTION
After the defibrillator power is turned on,
parameter-related alarms do not function until the
parameters are monitored.
ECG Monitoring
WARNING WARNING
For arrhythmia monitoring, set [ARRHYTHMIA Turn the PACING REJECT to On when monitoring
ANALYSIS] on the ARRHYTHMIA SETUP to ON. a pacemaker patient. Otherwise the pacemaker
Otherwise, there is no sound or indication for pulse is not rejected. However, even when the
arrhythmia alarms (except for Asystole). PACING REJECT is set to On, the pacemaker
pulse might not be rejected. When the pacemaker
pulse is not rejected, the pacemaker pulse is
WARNING detected as QRS and false heart rate may be
indicated or critical arrhythmia such as asystole
Even when the PACING REJECT is set to On, the
may be overlooked. Keep pacemaker patients
pacemaker pulse can be overlooked or detected
under close observation.
as QRS. You cannot confirm the pacemaker
operation only from the detected pacemaker pulse.
For the pacemaker pulse rejection capability of the defibrillator, refer to
“Specifications – Pacemaker Pulse Rejection Capability”.
WARNING
After attaching the electrode to the patient and
connecting the cable to the defibrillator, check that
electrodes are attached to the patient and check
that the cable is connected to the defibrillator
properly. When the electrodes are removed from
the patient, do not touch the metal part of the
electrode with bare hands or let the metal part of
the electrode contact the metal part of the bed or
any other conductive parts. Failure to follow this
warning may cause electrical shock or injury to the
patient by discharged energy.
CAUTION
CAUTION When the “Check Electrodes” message is
When monitoring ECG with disposable pads, displayed, ECG is not monitored properly and the
check the polarity of the pads before attaching ECG alarm does not function. Check the electrode,
them on the patient. If the pad polarity is incorrect, electrode leads and connection cord, and if
the waveform appears upside-down and this may necessary, replace with new ones.
cause incorrect judgment by the operator and
delay of treatment.
CAUTION
At the start of ECG monitoring, check that the
CAUTION dominant QRS is appropriate. Otherwise
If there is any doubt about the arrhythmia analysis, arrhythmia monitoring may be inaccurate.
make the defibrillator relearn the patient’s ECG
and check that the dominant QRS is appropriate.
Otherwise, an important arrhythmia may be
overlooked.
CAUTION
At the start of ECG monitoring, check that the
correct patient type is set for [DETECTION TYPE]
on the QRS SETUP window.
If an inappropriate patient type is set, heart rate
cannot be counted accurately and noise or P waves
may be counted as QRS and cardiac arrest may be
overlooked.
CO2 Monitoring
WARNING
When using the airway adapter or nasal adapter
on a patient with low ventilatory volume, the CO2
may mix in the inspiration due to the airway
adapter’s dead space, resulting in inaccurate
measured values or difficulty in detecting apnea.
Perform ventilation taking into consideration the
dead space of the adapters.
CAUTION CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the The CO2 data may be inaccurate when monitoring
measured value may be incorrect when the a patient with an extremely high respiration rate or
operating temperature changes greatly or there is irregular respiration. Read the measured values
excess condensation in the airway adapter or carefully.
nasal adapter.
CAUTION
CAUTION Only use Nihon Kohden specified CO2 sensor kit.
When the “Adapter Failure” or “Sensor Failure” Otherwise, the maximum performance from the
message is displayed, check the CO2 sensor kit defibrillator cannot be guaranteed.
and replace it if necessary. CO2 cannot be
monitored while the message is displayed.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 With the TG-900P or TG-920P CO2 sensor kit, the
partial pressure of a patient connected to a measured value may be incorrect when the
Jackson Rees, Mapleson D or any other operating temperature changes greatly or there is
respiration circuit where CO2 gas may be present excess condensation in the airway adapter or
during inspiration. The semi-quantitative method nasal adapter.
measures CO2 partial pressure based on the
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired
air contains CO2 gas, the measured CO2 value
may be lower than the actual value.
CAUTION
The TG-900P and TG-920P CO2 sensor kits do not
adjust the measurement value to compensate for
different atmospheric pressure. Be careful when
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for 5.33 kPa
(40 mmHg) CO2 gas when an atmospheric pressure drops 3.3 kPa.
CAUTION
With the TG-970P CO2 sensor kit, measured value
may be incorrect when the operating temperature
changes greatly. In this case, wait for about 30
minutes to acquire correct measurement.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 When measuring CO2 partial pressure of a patient
partial pressure of a patient connected to a with an oxygen mask, set the oxygen supply to
Jackson Rees, Mapleson D or any other 5 L/min or more. If CO2 gas remains in the oxygen
respiration circuit where CO2 gas may be present mask and mixes with the inspired air, the
during inspiration. The semi-quantitative method measured value may be lower than the actual
measures CO2 partial pressure based on the value.
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired CAUTION
air contains CO2 gas, the measured CO2 value
With the TG-900P or TG-920P CO2 sensor kit, the
may be lower than the actual value.
measured value may be incorrect when the
operating temperature changes greatly or there is
excess condensation in the airway adapter or
CAUTION nasal adapter.
The TG-900P and TG-920P CO2 sensor kits do not
adjust the measurement value to compensate for
different atmospheric pressure. Be careful when
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for 5.33 kPa
(40 mmHg) CO2 gas when an atmospheric pressure drops 3.3 kPa.
WARNING WARNING
The only oxygen cannula that can be used with • When you use YG-122T together with an oxygen
YG-122T is manufactured by HUDSON RCI®. Do cannula, check that the oxygen cannula is
not use any other oxygen cannula. Other oxygen correctly attached on the patient by referring to
cannulas cannot be attached and oxygen cannot other parameters and by observing the patient
be delivered to the patient through the nostrils. periodically.
• If arterial oxygen saturation does not increase,
immediately stop using the oxygen cannula with
WARNING the CO2 sensor kit and select another way to
supply oxygen.
Check that the oxygen cannula tube is not bent,
broken, or blocked by the nasal tube. If the ends of
the oxygen cannula tube turn too far up or down, it
causes insufficient O2 supply or the CO2 value may
be incorrect.
CAUTION
When using the YG-121T or YG-122T nasal
adapter on a patient with bleeding disorder, poor
general medical condition or malnutrition, observe
the patient condition all the time. The mouth guide
touches the mouth and may cause pressure sores.
WARNING WARNING
• When using the TL-201T finger probe, do not SpO2 measurement may be incorrect in the
fasten the probe and cable to the finger by following cases.
wrapping with tape. This may cause burn, • When the patient’s carboxyhemoglobin or
congestion or pressure necrosis from poor blood methemoglobin increases abnormally.
circulation. • When dye is injected in the blood.
• When using probes other than the TL-201T finger • When using an electrosurgical unit.
probe, to avoid poor circulation, do not wrap the • During CPR.
tape too tight. Check the blood circulation • When measuring at a site with venous pulse.
condition by observing the skin color and • When there is body movement.
congestion at the skin peripheral to the probe • When the pulse wave is small (insufficient
attachment site. Even for short-term monitoring, peripheral circulation).
there may be burn or pressure necrosis from
poor blood circulation, especially on neonates or
low birth weight infants whose skin is delicate. WARNING
Accurate measurement cannot be performed on
When not monitoring SpO2, disconnect the SpO2
a site with poor peripheral circulation.
connection cord from the input unit. Otherwise,
noise from the probe sensor may interfere and
incorrect data is displayed on the screen.
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse WARNING
waveform. Change the measurement site every 8
When monitoring SpO2 of a patient who is
hours for disposable probes and every 4 hours for
receiving photodynamic therapy, the light from the
reusable probes (every 8 hours for TL-630T3 or
finger probe sensor may cause a burn.
TL-631T3 probe). The skin temperature may
Photodynamic therapy uses a photosensitizing
increase at the attached site by 2 or 3°C (4 or 5°F)
agent that has a side effect of photosensitivity.
and cause a burn or pressure necrosis. When
using the probe on the following patients, take
The SpO2 probe has two wavelengths with peaks in the range of 650 nm
extreme care and change the measurement site
and 950 nm. The maximum light intensity is less than 5.5 mW/sr.
more frequently according to symptoms and
degree.
• Patient with a fever
• Patient with peripheral circulation insufficiency
• Neonate or low birth weight infant with delicate
skin
CAUTION CAUTION
While a patient is on medication which causes If the attachment site is dirty with blood or bodily
vasodilation, the pulse waveform may change and fluids, clean the attachment site before attaching
in rare cases the SpO2 value might not be the probe. If there is nail polish on the attachment
displayed. site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
CAUTION performed.
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring CAUTION
site with a blanket. When the probe is attached on an appropriate site
with sufficient circulation and an error message
about probe attachment repeatedly appears, the
CAUTION probe may be deteriorated. Replace it with a new
When a message indicates a faulty probe or faulty one.
SpO2 connection cord, stop monitoring and replace
the probe or SpO2 connection cord with a new one.
WARNING WARNING
Do not do the following to the battery pack. It may Do not expose the battery pack to direct sunlight or
cause leakage, overheating, explosion, and fire. leave it in a place with high temperature, such as in
• Do not short-circuit the + and – terminals of the a car parked in direct sunlight or in front of a stove.
battery pack. This may cause leakage, overheating, explosion,
• Do not put the battery pack into fire or heat the and fire. Also, the performance and lifetime of the
battery pack. battery pack may become deteriorated.
• Do not disassemble or modify the battery pack.
• Do not give a strong impact to or deform the
battery pack.
WARNING
• Do not use the battery pack with an unspecified
device. If the liquid leaked from the battery pack contacts the
• Do not charge the battery pack with an eyes, mouth, or skin, do not rub. Flush with plenty of
unspecified device. clean water and see a physician immediately.
• Do not charge the battery pack with the wrong
polarity.
• Do not immerse or soak the battery pack in water. WARNING
The following may cause overheating and leakage
of the battery pack.
WARNING • Leaving the battery pack unused for a long
period (about one year)
• Test the battery pack once a month.
• When you start using a new battery pack, write
the date of first use on the attached date label.
• Replace the battery pack with a new one every
two years.
• Defibrillation cannot be performed on battery
power during a battery test. Perform defibrillation
on AC power or use another defibrillator. The
defibrillator may not be able to discharge if the
battery pack is deteriorated or insufficiently
charged.
CAUTION
To keep the battery fully charged, always keep the
power cord connected to the AC outlet even when
the defibrillator is not used. Otherwise, the battery
may discharge and become unusable.
SD Card
WARNING
Do not leave the SD card near the patient or in
reach of children. This may lead to an accident
such as the patient or child swallowing the SD
card.
CAUTION
Before removing an SD card, turn the defibrillator
off. If the SD is removed while the power is on,
data in the SD card may be lost or static electricity
may make it impossible to write data to the card.
CAUTION
Do not touch the thermal head inside the recorder
unit. The thermal head may be damaged by static
electricity or become dirty and cause printing
failure.
Maintenance
WARNING WARNING
Never perform defibrillation to a person or object When performing a basic check, make sure that
other than the patient or discharge test equipment the disposable pads are not attached to the
(test electrode plate or energy checker). When patient. Failure to follow this warning may lead to
performing the defibrillation check using the unintended electrical shock to the patient.
external paddles, keep the paddles in the paddle
holders. Failure to follow this instruction may result
in electrical shock.
CAUTION CAUTION
Before maintenance, cleaning or disinfection, turn Dispose of Nihon Kohden products according to
the defibrillator power off and disconnect the power your local laws and your facility’s guidelines for
cord from the AC socket. Failure to follow this waste disposal. Otherwise, it may affect the
instruction may result in electrical shock and environment. If there is a possibility that the
defibrillator malfunction. product may have been contaminated with
infection, dispose of it as medical waste according
to your local laws and your facility’s guidelines for
CAUTION medical waste. Otherwise, it may cause infection.
Never disassemble or repair the defibrillator. If
there is any problem with the defibrillator, contact
your Nihon Kohden representative. CAUTION
When inserting or removing the battery, disconnect
the power cord from the defibrillator. Otherwise, the
operator may receive electrical shock.
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.
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 combined with other instruments to avoid misdiagnosis or other
problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient's safety.
(3) Avoid direct contact between the instrument housing and the patient.
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.
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.
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.
CAUTION
United States law restricts this product to sale by or on the order of a physician.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station
or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source such as cellular
phone away from the equipment and/or system, or turn off the cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of the equipment
and/or system:
Identify the cause of this interference and if possible remove this interference source. If this is not
possible, use a different power supply.
Make sure all users and patients in contact with the equipment and/or system are free from direct or
indirect electrostatic energy before using it. A humid room can help lessen this problem.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or
system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is installed, it may induce
an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord
from the equipment and/or system and operate the equipment and/or system by battery power, or use
an uninterruptible power supply.
When the equipment and/or system is adjacent to or stacked with other equipment, the equipment
and/or system may affect the other equipment. Before use, check that the equipment and/or system
operates normally with the other equipment.
When an unspecified accessory, transducer and/or cable is connected to this equipment and/or
system, it may cause increased electromagnetic emission or decreased electromagnetic immunity.
The specified configuration of this equipment and/or system complies with the electromagnetic
requirements with the specified configuration. Only use this equipment and/or system with the specified
configuration.
When the equipment and/or system is used with the unspecified system configuration different than
the configuration of EMC testing, it may cause increased electromagnetic emission or decreased
electromagnetic immunity. Only use this equipment and/or system with the specified configuration.
The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If
the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic
interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the
surrounding electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden
representative for additional suggestions.
For EMC compliance, refer to “Specifications - EMC Application Standards” in the Technical Resources section.
The CE mark is a protected conformity mark of the European Community. Products with the CE mark comply
with the requirements of the Medical Device Directive 93/42/EEC.
NOTE about Waste Electrical and Electronic Equipment (WEEE) Directive 2002/96/EC
For the member states of the European Union only:
The purpose of WEEE directive 2002/96/EC is, as a first priority, the prevention of waste electrical and
electronic equipment (WEEE), and in addition, the reuse, recycling and other forms of recovery of such
wastes so as to reduce the disposal of waste.
Contact your Nihon Kohden representative for disposal.
13 and
Standard Accessories, Options
Consumables
6-4
7
Standard Accessories............................................. 13-2 8
Options and Consumables..................................... 13-3
8-1
14 Setting
Settings
Items and Default 8-2
8-3
11
INDEX 12
13
14
15
TEC-5601
Certification
Defibrillator (1) ECG connection cord JC-906P (1) Thermal head cleaner pen (1) Recording paper RQS50-3 (1)
Certification
For the standard accessories and for consumables such as recording paper,
only use Nihon Kohden specified parts and accessories to satisfy the safety and
performance.
For the model, code number and supply code of the standard accessories, refer
to the “Options and Consumables” page of Section 13 “Standard Accessories,
Options and Consumables” in this manual.
Level Description
A warning alerts the user to the possible injury or death associated with the
WARNING use or misuse of the instrument.
A caution alerts the user to possible injury or problems with the instrument
CAUTION associated with its use or misuse such as instrument malfunction, instrument
failure, damage to the instrument, or damage to other property.
Icon Description
Style Description
Press the function key 1 to 5 that corresponds to the key name displayed in
Use/Press the [XXXXX] key.
the window.
“XXXXX”
[XXX] keys
XXXXX keys or
buttons
Example: Use/Press the [NEXT] key.
Introduction......................................................................1-2
1
Composition....................................................................1-5
TEC-5601.......................................................................................1-5
TEC-5611, TEC-5621, TEC-5631...................................................1-5
Symbols...........................................................................1-6
On Defibrillator...............................................................................1-6
Transport Package.................................................................... 1-6
On Screen......................................................................................1-7
JC-865V Pad Adapter.....................................................................1-8
Optional ND-860V Series and ND-890V Series Internal
Paddles..........................................................................................1-8
1. General
Introduction
This defibrillator delivers short-duration high-current electrical shock to
patients to treat ventricular fibrillation and ventricular tachycardia. 1
1
Essential performance in EMC standard
The defibrillator has an ECG input function which allows synchronized
cardioversion and asynchronous defibrillation. TEC-5631 has transcutaneous-
pacing which is useful for treating temporary bradycardia.
The defibrillator is designed so that the operator can directly press the keys and
buttons from the operator position (30 cm from the defibrillator).
The defibrillator operates on either AC power or an optional battery pack for
emergency use.
In addition to manual defibrillation mode, the defibrillator provides easy to use
semiautomatic defibrillation in AED mode.
The defibrillator can also monitor the patient’s condition after defibrillation.
TEC-5611, TEC-5621 and TEC-5631 have ECG measurement. SpO2 monitoring
and CO2 monitoring are available with an optional multi parameter/SpO2 unit.
Examples and explanations in this operator’s manual show TEC-5631 (when
the optional external paddle holder is installed) and the default settings.
WARNING
This defibrillator is for one patient at a time. Do not
monitor multiple patients with different sensors
attached.
WARNING
Do not diagnose a patient based only on data
acquired by the defibrillator. Overall judgement
must be performed by a physician who
understands the features, limitations and
characteristics of the defibrillator and by reading
the biomedical signals acquired by other
instruments.
Some options and accessories of this product may differ depending on the
destination country or region.
Model
TEC-5601 TEC-5611 TEC-5621 TEC-5631
Function
External
Yes No Yes Yes
paddles
Defibrillation Disposable
No Yes Yes Yes
pads 1
Internal paddles No No Option Option
Transcutaneous pacing 1
No No No Yes
ECG measurement
No Yes Yes Yes
(ECG connector)
Synchronized cardioversion No Yes Yes Yes
AED No Yes Yes Yes
Recorder No Yes Yes Yes
SpO2 measurement Option Option Option Option
CO2 measurement Option Option Option Option
External memory (SD card) Option Option Option Option
Bluetooth communication
®
Option Option Option Option
Audio output Yes Yes Yes Yes
Voice recorder Yes Yes Yes Yes
External ECG input Option Option Option Option
Battery Option Option Option Option
1
Disposable pads are sold separately.
Measurement Parameters
TEC-5611, TEC-5621 and TEC-5631 can monitor ECG leads I, II, III, aVR,
aVL, aVF, Ca, and Cb.
The optional QI-564V multi-parameter/SpO2 unit allows monitoring of SpO2 and
CO2.
Features
BIPHASIC waveform defibrillation
This defibrillator provides biphasic waveform defibrillation with Nihon Kohden’s
unique ActiBiphasic technology.
AC or battery operation
An optional battery allow portable use.
Fast charging
The defibrillator charges from 0 to 200 J less than 4 seconds, and from 0 to 270 J
less than 5 seconds. This enables timely defibrillation and cardioversion.
Self-check
• Semiautomatic self-check functions, such as defibrillation check, pacing check,
and recorder check, are provided for brief inspection of the defibrillator before
use.
• The self-test function is provided. The condition of the defibrillator is indicated
by the status indicator. To assure readiness for use, the defibrillator performs a
self-test.
• The user can also check individual functions such as defibrillation, pacing and
recorder.
Bluetooth® module
An optional QI-832V Bluetooth® module can send data from the defibrillator to a
PC or other device.
Composition
1
TEC-5601
Software Other Items
Defibrillator
• QP-551VK defibrillator report • Power cord
viewer software • GELAID
• QS-009V software kit • Cart
• Wall mount
• Basket
• Paste holder kit
• Bed rail hook
TEC-5601
DANG
ER
DANG
ER
ND-860V series, P-511, P-513, P-532, P-530, NKB-301V (YZ-024H9) QM-001D, QM-002D
ND-890V series (with switch) P-700 series
• Power cord
• GELAID 1
• JC-865V pad adapter 1
• BR-903P electrode lead
QI-832V QI-564V • Cart
• Wall mount
Software • Basket
• Paste holder kit
• QP-551VK defibrillator report viewer software • Bed rail hook
• QS-831V upgrade kit (For arrhythmia analysis)
• QS-009V software kit 1
Only for TEC-5621 and TEC-5631
Symbols
The following symbols are used with the defibrillator. The names and
descriptions of each symbol are as shown in the table below.
On Defibrillator
Symbol Description Symbol Description
Recording
Background color: Follow instructions for use
SD card slot Blue
Transport Package
Symbol Description Symbol Description
On Screen
Symbol Description Symbol Description
1
Alternating current Infinite pause duration
Bluetooth connected
The point of implanted pacemaker
pulse output
Bluetooth connected (device type: PC)
Arrhythmia alarm off (other than VF/
VT)
Bluetooth connected (device type:
mobile phone)
VF/VT alarm off
Bluetooth connected (device type:
unknown)
SpO2 pulse wave unstable
Defibrillator......................................................................2-2
2
TEC-5601.......................................................................................2-2
Front Panel.................................................................................2-2
Right Side Panel........................................................................2-3
Left Side Panel...........................................................................2-3
Rear Panel.................................................................................2-3
TEC-5611, TEC-5621, TEC-5631...................................................2-4
Front Panel................................................................................ 2-4
Operation Panel (on the Front Panel)....................................... 2-5
Right Side Panel....................................................................... 2-6
Left Side Panel.......................................................................... 2-6
Rear Panel................................................................................ 2-6
External Paddles............................................................................2-7
Defibrillator
When a function key or a button on the front panel of the defibrillator is pressed,
a pip sounds. There is no pip sound if the KEY SOUND setting of VOLUME in
the SETUP window is set to “0”.
TEC-5601
Front Panel
2 LCD display 3 Alarm indicator 4 Status indicator
1 Handle
5 Control dial
6 Microphone
7 CHARGE button
8 Battery case
14 Speaker
12 Function keys
9 AC power lamp
10 Battery
charging lamp
1 SD card slot
1 SD card slot 2
Insert an SD memory card.
1 SpO2 socket
2 CO2 socket
Rear Panel
1 AC inlet
Connect the supplied power cord.
1 AC inlet
Front Panel
1 Handle
TEC-5611
4 Pad connector
4 Paddle connector
6 Battery case 5 Speaker (TEC-5621, TEC-5631)
1 Handle 5 Speaker
For carrying the defibrillator Outputs sound, alarms and CPR sound.
2 LCD display 6 Battery case
Displays waveforms, alarms and other information and Holds the optional NKB-301V battery pack.
settings.
3 Alarm indicator
Lights or blinks if an alarm is generated.
4 Paddle connector (TEC-5621, TEC-5631)
Connect the optional external paddles, internal paddles,
or pad adapter.
17 PACING 6 CHARGE/AED
OUTPUT up/ button
down keys 7 SHOCK button
11 Function keys
8 AC power lamp
9 Battery charging
lamp
12 Record/stop key
10 Battery charging completion lamp 13 Silence alarms key
1 SD card slot
1 SD card slot Insert an SD memory card.
2 Door release lever
Pull the lever up to open the paper
2 Door release container door.
lever
3 Recorder
1 ECG socket
Connect the ECG connection cord.
2 SpO2 socket (when the QI-564V is
incorporated)
Connect the SpO2 connection cord.
1 ECG socket
3 CO2 socket (when the QI-564V is
incorporated)
2 SpO2 socket Connect the CO2 sensor kit.
3 CO2 socket
Rear Panel
1 AC inlet
Connect the supplied power cord.
1 AC inlet
External Paddles
4 Paddle connector
(TEC-5621, TEC-5631)
3 Handles 3 Handles
4 Shock button
1 Paddle connector
Connect to the paddle connector of the defibrillator.
2 Electrodes
These electrodes deliver energy in direct contact with the
heart.
3 Handles
Keep the handles firmly gripped during charge and
discharge.
Be sure to grip the paddles between the cable and the
guard.
4 Shock button (ND-890V series)
Press to discharge energy. In synchronized cardioversion,
the defibrillator discharges energy at the appropriate
timing after this button is pressed.
On the Defibrillator.........................................................................3-2
Front Panel................................................................................ 3-2
Right Side Panel....................................................................... 3-2
Left Side Panel.......................................................................... 3-2
Rear Panel................................................................................ 3-3
On the External Paddles................................................................3-3
On the JC-865V Pad Adapter.........................................................3-3
On the Internal Paddles (Option)....................................................3-3
Front Panel
Section 12 “Daily Check” (p. 12-2)
Section 6 “Defibrillation,
Synchronized Cardioversion
and AED”
On the Internal Paddles (Option)
TEC-5621, TEC-5631
Section 6-1 “Connecting Paddles/Pads” (p. 6-1-3)
On the External Paddles
ND-860V series (Without switch)
Section 6 “Defibrillation, Synchronized
Cardioversion and AED”
TEC-5621, TEC-5631
Section 6-1 “Connecting Paddles/Pads” (p. 6-1-3)
• If the battery pack temperature becomes too high because Disposal of Batteries
of long charging time, etc., the battery charging lamp
The batteries usable in this defibrillator are nickel-metal
and battery charging completion lamp will start blinking.
hydride (Ni-MH) batteries.
Immediately stop charging, move the defibrillator to a
Before disposing of a battery pack, contact your Nihon
cooler place, then resume charging. The defibrillator
Kohden representative, because the proper means of
automatically starts charging when the battery pack
disposal differs depending on your local laws. The battery
temperature drops.
pack will be recycled for environmental protection.
• After using the battery pack, charge the battery pack 3
Before disposing of the defibrillator, make sure that the
immediately. Leaving the battery pack uncharged
battery pack is removed from it.
causes excessive discharge and the battery pack might
become unusable.
• Always charge the battery pack using this defibrillator. If
another device is used for charging, it may cause battery Recording Paper
pack malfunction.
NOTE: Always use the specified genuine products for
Checking the Battery Pack the recording paper.
• Replace the battery pack every 2 years. In order to ensure Model name of the specified recording paper:
emergency use of the defibrillator on battery power, RQS50-3
perform a battery test once a month.
• Check the battery pack’s appearance every 6 months for
prevention of accidents with the battery pack. If there is
any damage such as crack, deformation, or wire breakage
on the battery pack or if the battery pack leaks, replace
the battery pack with a new one. If the battery pack is
dirty with dust, clean it. RQS50-3
Storage of the Battery Pack When handling the recording paper, be careful of the
following:
• If the defibrillator will be stored with the battery pack
inside it, leave the defibrillator connected to an AC power • Organic solvents and plastics may develop color on the
source. If the defibrillator will be stored not connected white surface or cause the recording paper to fade.
to an AC power source, remove the battery pack before Examples of color-developing materials containing
storage. organic solvents:
• If the defibrillator will not be used for more than 6 Adhesives, paste, felt-tip pens, and semi-dry diazo paper.
months, remove the battery pack to prevent leakage Examples of color-fading materials made of soft vinyl
or corrosion. Store the battery pack at an ambient chloride:
temperature between −20°C (−4°F) and +35°C (+95°F) Document cases, albums, and desk pads.
and low humidity.
Examples of color-fading materials containing
• When a battery pack will not be used for over one month, plastics:
fully charge it before use. Even if the battery pack was Erasers, adhesive tapes, and some fluorescent pens.
fully charged before short-term storage, the batteries self-
discharge and operation time decreases during storage. • When pasting the recording paper, use paste with a
starch base, PVA base, arabic gum base paste, CMC base
• To ensure full performance of the defibrillator, replace the synthetic paste, or paper bond.
battery pack every 2 years.
• Do not apply high pressure to the recording paper.
• When a battery pack is stored for a long time, charge it Rubbing or scratching the surface with a hard object
every 6 months. discolors it.
• If the battery pack is stored for a long time, it may
discharge and lose its ability to be charged to its full
capacity. If this happens, you can restore its full capacity
by repeating several cycles of discharging the battery to
its rated value then fully charging it.
Compatible SD Cards
Handling during Reading/Writing of Data
Use only an SD card manufactured by Nihon Kohden
(QM-001D or QM-002D). • Only format the SD card and write data to the SD card
with a Nihon Kohden specified device. Otherwise the SD
NOTE: Do not use an SD card other than the card might become unusable.
specified ones. If you do, data may not be
stored or the defibrillator may be damaged. • Never remove the SD card from the device while data is
If you use an SD card that was used with a being written to or read from the card. Otherwise the card
device other than this defibrillator, the data may become damaged.
capacity available with the defibrillator may
decrease.
Use of SD Cards
Be careful of the following when you use an SD card:
WARNING
Do not leave the SD card near the patient or in
reach of children. This may lead to an accident
such as the patient or child swallowing the SD
card.
CAUTION
When using the defibrillator with an ESU, locate Make small
the defibrillator and ESU appropriately and ground
instruments properly. Otherwise noise from the • Set the sync source to “SpO2”
ESU may interfere with the ECG and the heart rate The heart rate may be unstable because of an ESU. Set
and arrhythmia analysis may be incorrect.
the sync source to SpO2 for the stable monitoring.
CAUTION CAUTION
Have another defibrillator ready in case of trouble Before defibrillation, make sure that the patient is
or accident. not in electrical contact with any metal part of a
bed, stretcher, or other equipment via blood or
chemical solution on the patient. Such contact may
cause unwanted pathways for the defibrillator
current and cause insufficient delivery of electrical
shock.
3
(for B)
1
1d Item A is ME The earth conductor of – Additional
EQUIPMENT A B the MULTIPLE SOCKET PROTECTIVE EARTH
and B is non-ME IEC 60601 IEC xxxxx OUTLET is broken or, CONNECTION
EQUIPMENT (for A or B) or,
Due to high TOUCH
powered via
CURRENT of B – Separating transformer
a MULTIPLE MULTIPLE SOCKET-OUTLET
SOCKET-OUTLET
1e Item A is ME Mains Due to high TOUCH – Additional
EQUIPMENT A Plug CURRENT of B PROTECTIVE EARTH
powered from IEC 60601 CONNECTION
specified power B (for B) or,
supply in item B IEC xxxxx
– Separating transformer
1f Item A is ME (for B)
EQUIPMENT Mains
powered from B Plug
A
NON-ME IEC xxxxx
IEC 60601 DC/AC
EQUIPMENT
power supply in B
Power..............................................................................4-2
4
Types of Power...............................................................................4-2
AC Operation............................................................................ 4-2
Battery Operation...................................................................... 4-2
Using AC Power..............................................................4-3
Connecting the Power Cord...........................................................4-3
Inserting an SD Card.....................................................4-10
Changing Settings.........................................................4-10
Administrator Settings..................................................................4-10
4. Preparation
Power
Types of Power
The defibrillator can operate on either battery or AC power.
You can select either AC or an optional battery pack (NKB-301V), according to
where the defibrillator is used.
Combined use of AC power and battery is also possible.
AC Operation
AC power lamp To supply AC power to the defibrillator, use the supplied power cord.
While AC power is being supplied, the AC power lamp is lit. When the
defibrillator is turned ON, a mark “ ” is displayed in an upper right position of
the screen.
Either of the battery charging
or battery operation mark
lights.
WARNING
Only use the specified power cord. When the
specified power cord cannot be used or when
equipotential grounding is doubtful (such as in poor
grounding facility), operate the defibrillator on
AC power is supplied. battery power. Otherwise, the patient and operator
may receive electrical shock or injury.
Battery Operation
Install the optional battery (NKB-301V battery pack) into the defibrillator and
supply power from the battery pack.
If AC power supply is interrupted and a battery pack is installed, the defibrillator
危険
automatically switches to battery power and a mark indicating remaining battery
DAN
GER
power is displayed on the screen.
使用
開始
年月
Using AC Power
NOTE • Connect the defibrillator to the power source corresponds in
frequency and voltage to product specifications, and have
sufficient current capacity.
• Always install the battery pack in case of sudden loss of power
supply, such as a power failure or temporary blackout, in a
hospital even when operating the defibrillator on AC power. This 4
enables continuous operation of the defibrillator.
• If a battery pack is not used in case of sudden loss of power
supply, such as a power failure or temporary blackout, the data
in the defibrillator may be damaged.
In the event of a power failure or temporary blackout in a hospital,
secure power supply by connecting to an emergency power system
while the defibrillator is operating on battery power.
WARNING
Only use the specified power cord. When the
specified power cord cannot be used or when
equipotential grounding is doubtful (such as in poor
grounding facility), operate the defibrillator on
battery power. Otherwise, the patient and operator
may receive electrical shock or injury.
2 Check that the AC power lamp on the front panel of the defibrillator lights
when AC power is supplied.
Either the battery charging lamp “ ” or battery charging completion
lamp “ ” lights, depending on the status of the battery.
AC power lamp
NOTE: If the AC power lamp does not light when the power cord is
connected, check if the power cord is securely connected.
When the defibrillator is turned on, the “ ” mark is displayed at the upper
right of the screen.
Defibrillation
At least 100 discharges at 270 J
(At a frequency of 3 times of charging/discharging per minute then 1-minute
pause)
Monitoring
At least 180 minutes continuous monitoring
Defibrillation
At least 50 discharges at 270 J
(At a frequency of 3 times of charging/discharging per minute then 1-minute
pause)
2 Connect the power cord to the defibrillator and set it to the AC operation
mode.
The AC power lamp and battery charging lamp on the front panel of the
defibrillator light, and charging of the battery starts.
NOTE • Never disconnect the power cord before charging is
completed.
• If the temperature of the battery pack or inside the
defibrillator becomes too high because of long charging
time, etc., the battery charging lamp and battery charging
completion lamp start blinking. In such a case, immediately
stop charging, move the defibrillator to a cooler place,
then resume charging. The defibrillator automatically starts
charging when the temperature of the battery pack or inside
the defibrillator drops.
• During charging, check that the AC power lamp is lit
and that either the battery charging or battery charging
completion lamp is lit.
AC power lamp
AC power lamp
4
Trickle Charging
After charging is completed (the battery charging completion lamp is lit), keep
the power cord connected to the AC outlet regardless of whether the defibrillator
is used or not.
Trickle charge starts in order to keep the battery fully charged.
Trickle Charging
Trickle charge is a method for charging with small current to
compensate for the loss by self-discharge. This prevents the decrease of
battery capacity caused by self-discharge.
CAUTION
To keep the battery fully charged, always keep the
power cord connected to the AC outlet even when
the defibrillator is not used. Otherwise, the battery
may discharge and become unusable.
Mark
Remaining
Remaining Usable Time
Dischages
battery in MONITOR Alarm Action
(at 270 J and
Indication Color power mode 1
20°C (68°F))
1
Usable time for monitoring may be shorter than the above times depending on whether the recorder
is used and which parameters are monitored.
Tabs
Pull the tabs outward to set the
recording paper.
3 Draw out the end of paper toward you from the upper slit.
Close the door until it clicks.
Inserting an SD Card
To store the data (ECG waveform data, defibrillation data, event data, sound,
etc.) to be measured with this defibrillator and waveform reports in an SD card,
insert an SD card specified by Nihon Kohden into the SD card slot on the right
side of the defibrillator, referring to “SD Cards” (p. 10-2-2).
Changing Settings
Various settings can be made using the setup windows.
The details for these settings are described in “DATE AND TIME” (p. 5-9).
Administrator Settings
Some settings on the SYSTEM SETUP screen can only be changed by the
administrator.
The details for these settings are described in the Administrator’s Guide.
Introduction......................................................................5-2
5
GUIDE.............................................................................5-6
Setup Item List...............................................................................5-6
Displaying the GUIDE Window . ....................................................5-6
PADDLE SETUP.............................................................5-7
Setup Item List...............................................................................5-7
SYNC BY PADDLE .......................................................................5-7
HR ALARM.....................................................................................5-8
DEVICE SETUP..............................................................5-9
DATE AND TIME............................................................................5-9
Setup Item List.......................................................................... 5-9
DATE AND TIME....................................................................... 5-9
SELF TEST SETUP.....................................................................5-10
Setup Item List.........................................................................5-10
SELF TEST TIME....................................................................5-10
SELF TEST REPORT AUTO TRANSFER...............................5-10
VOLUME .....................................................................................5-11
Setup Item List.........................................................................5-11
Making Volume Settings for Various Sounds . ........................5-12
MEDICATION SETUP .................................................................5-13
Setup Item List.........................................................................5-13
Naming a Medication Key .......................................................5-13
LARGE NUMERICS SETUP .......................................................5-14
Setup Item List.........................................................................5-14
LARGE NUMERICS ...............................................................5-14
5. Setup Windows
Introduction
Display the SETUP window and make various settings for each operation.
NOTE: The changed settings are immediately applied to the relevant
operations. To return a setting to its previous value, change the
setting again.
Item
Description Page
Setup Menu Submenu
DATE AND YEAR, MONTH, DAY, HOUR,
Change settings for the date and time. p. 5-9
TIME MINUTE
SELF TEST HOUR,
p. 5-10
TIME MINUTE
SELF TEST
SELF TEST Change settings for the self-test.
SETUP
REPORT PAIRING p. 10-2-11
AUTO
FILE
BLUETOOTH DESTINATION
FORMAT,
If an optional QI-832V Bluetooth® module is
5
PIN CODE, p. 10-2-7
DEVICE SETUP SETUP installed, set the destination device.
DESTINATION
SETUP
DEVICE
VOICE INSTRUCTION, ALARM
SOUND, CHARGE SOUND,
VOLUME Change volume settings for various sounds. p. 5-11
SYNC SOUND, KEY SOUND,
OPERATION SOUND
MEDICATION Change settings for naming the medication
MEDICATION 1 to 5 p. 5-13
SETUP keys.
LARGE
Set whether numerics on the monitor screen are
NUMERICS LARGE NUMERICS p. 5-14
to be enlarged or not.
SETUP
Basic Settings
Follow the procedures below for changing the settings.
1 Turn the control dial to the SETUP position to display the SETUP window.
Entering Characters
1) Press the [CHARACTER→] key to select the character position.
2) Press the [↓] key or [↑] key to change the character.
Each time the [ ↓ ] key or [ ↑ ] key is pressed, the next character is 5
selected from 0 to 9, a to z, and A to Z in numerical or alphabetical
order.
If the key is held pressed, the character changes continuously.
GUIDE
Display the GUIDE window for each parameter.
The GUIDE window shows the corrective measures for a technical alarm using
instructions and figures.
?ECG
GUIDE ?SpO2 Displays the GUIDE window for each parameter.
?CO2
PADDLE SETUP
Display the PADDLE SETUP window and change settings for the paddle/pad
lead.
SYNC BY PADDLE
Set whether to enable synchronized cardioversion with the paddle lead or not.
CAUTION
Synchronized cardioversion with the paddle lead
does not provide stable ECG because it is difficult
to hold the paddles steady. Artifact on the ECG
may be misinterpreted as QRS and discharge
might not synchronize with the patient’s QRS.
Settings:
• ON: Enables synchronized cardioversion with the paddle/pad lead.
• OFF (default): Disables synchronized cardioversion with the paddle/
pad lead.
HR ALARM
Set whether to generate heart rate alarms when monitoring ECG with the paddle/
pad lead.
Set to “ON” for monitoring for a long period using disposable pads, or set to
“OFF” for monitoring using the external paddles or internal paddles.
Settings:
• ON: Generates heart rate alarms with the paddle/pad lead.
• OFF (default): Does not generate heart rate alarms with the paddle/
pad lead.
DEVICE SETUP
Change settings for the defibrillator.
• If the date and time are changed while the Enable Transport
setting is set to “On”, the following reports are deleted. Before
changing the date and time, record or save these reports.
-- TRENDGRAPH - PERIODIC LIST - EVENT LIST
Section 10-3 “Transport Function”
3 Set all items, and press the [OK] key to register them.
For MINUTE setting, second is set to “00” when the [OK] key is pressed.
“Setting the Device for Auto-saving the Self-test Report” (p. 10-2-11)
VOLUME
Display the VOLUME window and set the volume.
WARNING
Set the alarm sound volume according to the place
where the defibrillator is used. If the alarm sound is
too quiet, keep the patient under close observation
and periodically check the defibrillator. Otherwise,
the alarm sound might not be heard and critical
changes on the patient or problems in the 5
defibrillator may be overlooked.
VOICE
Select the voice instruction volume. 1, 2, 3, 4
INSTRUCTION
ALARM
Select the alarm sound volume. 1, 2, 3, 4
SOUND
Select the sound volume for charging and end of charging.
CHARGE
• Charging: A continuous beep sounds. 1, 2, 3, 4
SOUND
• End of charging: Beeps sounds intermittently.
DEVICE
VOLUME Select the sync sound volume.
SETUP
Volumes of the optional sounds, such as the sound generated for CO2 0, 1, 2,
SYNC SOUND
calibration, are set linked with SYNC SOUND. However, if SYNC 3, 4
SOUND is set to “0”, the volume of the optional sounds is set to “1”.
Select the volume of the clicking sound generated when a key is 0, 1, 2,
KEY SOUND
pressed. 3, 4
OPERATION
Select the operation sound volume. 1, 2, 3, 4
SOUND
Sound other than SYNC SOUND and KEY SOUND cannot be silenced.
Priority has been set for VOICE, ALARM SOUND, and CHARGE SOUND.
(Priority: high) VOICE INSTRUCTION > ALARM SOUND > CHARGE SOUND
> SYNC SOUND, KEY SOUND, OPERATION SOUND (Priority: low)
When different types of sound are output at the same time, the volume for the
lower-priority sound becomes “1” regardless of the volume setting.
MEDICATION SETUP
Display the MEDICATION SETUP window and change settings for naming the
MEDICATION keys.
The medication keys appear when the Medication setting on the SYSTEM
SETUP screen is “On” and the [EVENT] key is pressed.
• Administrator’s Guide: “System Setup”
• “Event Recording” (p. 10-1-8)
LARGE
DEVICE LARGE Change the setting for whether the numerics on the monitor screen
NUMERICS ON, OFF
SETUP NUMERICS are to be enlarged or not.
SETUP
LARGE NUMERICS
Display the LARGE NUMERICS SETUP window, and change the setting.
Settings:
• ON: Numerics on the monitor screen is displayed large.
• OFF (default): Numerics on the monitor screen is not displayed large.
6-2
Introduction...................................................................6-0-2
6-3
Preparation Before Defibrillation,
Synchronized Cardioversion and AED...............Section 6-1 6-4
Defibrillation........................................................Section 6-2
AED....................................................................Section 6-4
6. Defibrillation, Synchronized Cardioversion and AED
Introduction
With this defibrillator, defibrillation, synchronized cardioversion, and AED can
be performed.
Defibrillation
Defibrillation is a method for delivering electrical shock regardless of patient’s
heart rate conditions, and used for elimination of ventricular fibrillation.
The operator sets the output energy value, charges the defibrillator, then delivers
an electrical shock at any timing.
Synchronized Cardioversion
Synchronized cardioversion is a method for delivering electrical shock with
appropriate timing after detecting a patient’s QRS wave, and it is used for
elimination of atrial fibrillation, etc.
The operator sets the output energy value, charges the defibrillator for any
timing, then holds the shock buttons pressed. The defibrillator will deliver
electrical shock in synchronization with the QRS wave detected first.
AED
The defibrillator analyzes the patient’s ECG then judges whether electrical shock
is needed. If it judges that electrical shock is required, energy will automatically
be charged to the level set beforehand. Electrical shock will be delivered by the
operator, according to the displayed guidance.
Model
Function TEC-5601 TEC-5611 TEC-5621 TEC-5631
1
Option
In this section, necessary preparations and operation procedures for each method
of defibrillation are described.
Flow of Preparation......................................................6-1-2
Defibrillation................................................................................ 6-1-2
Synchronized Cardioversion (TEC-5611, TEC-5621,
TEC-5631).................................................................................. 6-1-2
When Using an ECG from an External Monitor for a
Synchronizing Signal.............................................................. 6-1-2
AED (TEC-5611, TEC-5621, TEC-5631).................................... 6-1-2
Connecting Paddles/Pads............................................6-1-3
Disconnecting Paddles/Pads (TEC-5621, TEC-5631)............... 6-1-3
Connecting External Paddles (TEC-5621, TEC-5631)............... 6-1-4
Changing to the Pediatric Electrode Plate.................................. 6-1-4
Connecting Disposable Pads..................................................... 6-1-5
Connecting the Pad Adapter (TEC-5621, TEC-5631)............ 6-1-6
Attaching the Disposable Pads to the Patient.........................6-1-7
Connecting the Disposable Pads to the Pad Adapter or
Pad Connector....................................................................... 6-1-9
Connecting Internal Paddles (TEC-5621, TEC-5631).............. 6-1-10
Flow of Preparation
After checking the patient’s conditions, perform preparations as shown below,
depending on the defibrillation method.
Defibrillation
1 Connect the paddles/pads. Refer to p.6-1-3.
Connecting Paddles/Pads
Connect paddles/pads to be used, according to the defibrillation method.
Synchronized
Defibrillation AED
Cardioversion
6
External paddles Internal paddles (option) Disposable pads (option)
6-1
Paddle connector 2 By turning the lock of the paddle connector to the unlock position, pull
out the connector toward you while holding the connector, as shown in the
figure.
NOTE: Always hold the connector when pulling it out. Otherwise, the
connector or the cable may be damaged.
Paddle connector
Unlocked position
Paddle
connector
lock
WARNING
Paddle connector When connecting the paddles or pad adapter, firmly
insert the connector into the paddle connector on
Paddle Locked position the defibrillator. Check the connection and confirm
connector that the tab of the paddle connector lock is in the
lock
locked position.
After the paddles or pad adapter is replaced, do a
discharge test and confirm that the defibrillator
operates normally.
Incorrect cable connection may result in troubles
Push the paddle Check that the paddle such as failure to display “CONNECT
connector in. connector lock is in the PADDLES/PAD” message, accidental removal of
locked position.
the cable, or insufficient delivery of electrical shock.
WARNING
Pay careful attention to the energy setting when
using the pediatric electrode plates. Applying high
energy with the pediatric electrode plates can
cause skin burn, because the electrode plates are
small.
The current density on the pediatric electrode plates is higher than the current
density on the adult electrode plates, because the pediatric electrode plates
are smaller than the adult electrode plates 1. This increases the possibility of
electric burn on the electrode plate placement area. Be careful that the minimum
effective energy should be set.
1
he pediatric electrode plates have about 1/3 the surface area of the adult
T
electrode plates.
Adult electrode plate 2 Press the tab of the adult electrode plate to unlock the adult electrode plate.
3 Slide the adult electrode plate forward and off, as shown in the figure.
6
6-1
WARNING WARNING
If the bag containing disposable pads is torn, do • Do not use the disposable pads if the gel has
not use the pads. Dispose of the pads. Failure to become dry.
follow this warning may lead to skin burns or • Do not use the disposable pads if the gel has
insufficient delivery of shock. become abnormal (the gel has become liquified
or is coming out of the edges of the pad, etc.).
Failure to follow these warnings may cause skin
WARNING burn or insufficient delivery of shock.
Do not use the disposable pads if the gel is dark
brown or dark-brown gel is on the protective sheet.
Use of such pads may cause insufficient delivery of WARNING
shock or skin burn where the pads are attached. Do not use the disposable pads if they are past the
expiration date on the package. Failure to follow
this warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Use disposal pads as soon as possible after
opening the package. Failure to follow this warning
WARNING
may lead to skin burn or insufficient delivery of
shock. Do not reuse disposable pads. Failure to follow this
warning may lead to skin burn or insufficient
delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, Do not place heavy objects on the disposable pads
replace them every 24 hours. After 24 hours, the or bend the pads. The pads may become damaged
gel becomes dry and this may reduce performance and deteriorated, resulting in skin burn on the
of the pads. patient.
NOTE: Always have spare disposable pads. Use the spare pads if the gel
of the pads becomes dry, deteriorated or discolored.
Deteriorated means:
• The gel has become liquefied.
• The gel is coming out of the edges of the pad.
Discolored means:
• The color of the gel changes to brownish-red, and brownish gel
is attached to the protection sheet.
Paddle connector 1 Connect the paddle connector of the pad adapter to the
paddle connector on the front panel of the defibrillator as
shown in the figure. Check that the paddle connector lock
is in the locked position.
WARNING
Paddle connector
When connecting the paddles or pad adapter, firmly
insert the connector into the paddle connector on
the defibrillator. Check the connection and confirm
Paddle Locked position that the tab of the paddle connector lock is in the
connector locked position.
lock After the paddles or pad adapter is replaced, do a
discharge test and confirm that the defibrillator
operates normally.
Incorrect cable connection may result in troubles
such as failure to display “CONNECT
PADDLES/PAD” message, accidental removal of
Push the paddle Check that the paddle
the cable, or insufficient delivery of electrical shock.
connector in. connector lock is in the
locked position.
WARNING
Before defibrillation, remove everything including
electrodes and patches from the patient’s chest. If
the defibrillator paddle/pad contacts an object on
the patient’s chest, the discharged energy may be
6
insufficient and cause skin burn.
6-1
CAUTION
Do not attach a disposable pad over another pad.
It may cause skin burn on the patient.
CAUTION
If the patient’s body is wet, thoroughly wipe the
moisture off the skin so that the paddles or pads
will not short-circuit each other. Otherwise, delivery
of shock may be insufficient.
CAUTION
When monitoring ECG with disposable pads,
check the polarity of the pads before attaching
them on the patient. If the pad polarity is incorrect,
the waveform appears upside-down and this may
cause incorrect judgment by the operator and
delay of treatment.
NOTE • To remove the protection sheet, hold the tab at the cable end
and carefully remove it. If gel is accidentally removed together
with the sheet or a metal part becomes exposed, be sure to use
a new disposal pad.
• To attach the disposable pads to the patient, clean the skin, and
if the patient’s body is wet, thoroughly wipe the moisture off the
skin.
• To attach the disposable pads to the patient, thoroughly wipe
the moisture, oil, and dirt off the skin. Also remove any excess
body hair.
• Do not apply any gel or paste when using the disposable pads.
• Firmly attach the disposable pads to the patient’s body. If they
are loosely attached, electrical shock cannot be delivered.
Apex-Anterior Placement
This is a basic attachment method.
Front side
Apex-Posterior Placement
This attachment method is not suitable for monitoring or AED analysis.
Anterior-Posterior Placement
This attachment method is not suitable for AED analysis or monitoring.
To attach the disposable pads to a child’s body, normally attach them by the
apex-anterior placement method, as with an adult patient.
When the patient is a small child and the pads touch each other, attach one pad
on the center of the patient’s chest and the other on the back.
Disposable
pads Disposable pads
6
6-1
2 Turn the control dial to the DISARM position. Check that the error message
“CHECK PADS” or “CHANGE PADS” is not displayed on the screen.
For defibrillation in AED mode, turn the control dial to the AED position
then check that neither of the error messages is displayed on the screen.
CAUTION
Sterilize the internal paddles before use. Failure to
sterilize the paddles may cause serious infection.
Paddle Locked position 1 Connect the paddle connector of the internal paddles to the
connector paddle connector on the front panel of the defibrillator, as
lock shown in the figure. Check that the paddle connector lock
is in the locked position.
WARNING
When connecting the paddles or pad adapter, firmly
Push the paddle Check that the paddle insert the connector into the paddle connector on
connector in. connector lock is in the the defibrillator. Check the connection and confirm
locked position.
that the tab of the paddle connector lock is in the
Paddle connector locked position.
After the paddles or pad adapter is replaced, do a
discharge test and confirm that the defibrillator
operates normally.
Incorrect cable connection may result in troubles
such as failure to display “CONNECT
PADDLES/PAD” message, accidental removal of
the cable, or insufficient delivery of electrical shock.
Paddle connector
Section 8-1
• “Checking the Number of Electrodes and Measuring Leads” (p.8-1-3)
• “Connecting the Electrode Lead to the Defibrillator” (p.8-1-6)
BR-903P
JC-906P
1 Clean the probe sites with absorbent cotton moistened with alcohol.
To dry alcohol completely, rub the probe sites with dry, clean absorbent
cotton.
To obtain a more stable ECG, rub the probe sites with Nihon Kohden
SkinPure.
3 Paste and closely attach the electrode to a probe site. Avoid attaching to an
uneven place or one with many wrinkles.
NOTE: Although an ECG electrode that is in good contact with the
patient skin can be continuously used for about 24 hours,
if the contact becomes poor because the patient sweats or
moves, replace it with a new one.
When using a clip-type electrode lead, attach the Attachment of a
Lightly press the label on the surface electrode to a probe site first then connect the electrode clip-type lead
of the electrode with your finger to
closely attach the electrode to the skin.
lead to the electrode.
NOTE: When connecting a clip-type electrode
lead to an electrode, do not push down
on the clip. The contact terminal of the
electrode lead may become deformed and
prone to be disconnected. Widely open
the clip at the end of the electrode lead
then pinch the electrode element with it.
Surgical tape
4 Fix the electrode lead to the patient’s body with a piece of surgical tape, etc.
Fixing the electrode lead in place reduces the movement of the lead caused
by body motion, which enables more stable ECG measurement.
NOTE: If the electrode lead is kept taut, it may be broken or the
electrode may be peeled off. When connecting the lead to a
monitoring device, keep the lead slack.
Number of
Leads to be displayed
electrodes
3 PADDLE or PAD, I, II, III, AUX, in that order 6
PADDLE or PAD, I, II, III, aVR, aVL, aVF, Ca,1 Cb,1 AUX, in that
6 6-1
order
1
Ca or Cb electrode lead can be set in Ca LEAD or Cb LEAD in ECG SETUP in the
SETUP window.
ECG Lead
WARNING
Before using the defibrillator, check that
synchronized cardioversion occurs within 60 ms of
the peak of the ECG’s R wave with the defibrillator
and an external monitor connected.
NOTE: Check that the external monitor to be used is “in compliance with
the IEC 60601-1 safety standards”.
TEC-5600 series
TEC-5611
6
1 Connect the defibrillator and an external monitor to the AX-103VK
6-1
defibrillator analyzer, as shown in the figure below.
The JJ-202V analyzer connection cable is provided with the AX-103VK
defibrillator analyzer.
External monitor
Example: BSM-6000
series
TEC-5611
AX-103VK defibrillator
analyzer
DELAY button 2 Turn the defibrillator analyzer on then press the DELAY button.
The simulated ECG signal for testing is output from the color-coded
terminals of the defibrillator analyzer to the external monitor.
3 Turn the external monitor on then output a lead I or lead II analog ECG
signal to the defibrillator.
2) Press the [LEAD] key several times until “AUX” is displayed and check
that the ECG waveform from the external monitor is displayed.
5 Turn the control dial of the defibrillator to the 50 J position to set the energy
value of electrical shock to 50 J.
6 Press the SYNC button then check the mode indication and synchronization
points.
• Check that “SYNC MODE” is displayed on the screen.
• Check that the “ ” lines indicating the synchronization positions
are displayed at the rising part (Q–R) of each QRS wave of the ECG
waveform being displayed.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the rising part
of each QRS wave.
The SHOCK When charging is completed, the message “CHARGED” and some guidance
button is displayed on the screen, and a continuous beep sounds. The SHOCK
flashes. button starts flashing at the same time.
CHARGED Energy value for
electrical shock
6
6-1
WARNING
When charging or discharging, do not touch the
pads or connector. If you touch any other part of
the defibrillator during charging or discharging, you
will receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
8 Press the flashing SHOCK button to deliver electrical shock. Hold the
SHOCK button pressed until electrical shock is delivered, because discharge
is performed when the first synchronization point is detected after the
SHOCK button is pressed.
Delay time (ms) 9 Check that the delay time displayed on the display of the defibrillator
Check that the delay time is 60 ms or analyzer is 60 ms or less.
less.
NOTE: If the delay time displayed on the defibrillator analyzer
exceeds 60 ms, the ECG from the connected external monitor
cannot be used as a synchronizing signal.
10 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
TEC-5621, TEC-5631
External monitor
Example: BSM-6000
series
TEC-5621, TEC-5631
JC-831V external
ECG cable
Connect the
electrode leads
from the external
monitor.
DELAY button 2 Turn the defibrillator analyzer on then press the DELAY button.
The simulated ECG signal for testing is output from the color-coded
terminals of the defibrillator analyzer to the external monitor.
3 Turn the external monitor on then output a lead I or lead II analog ECG
signal to the defibrillator.
2) Press the [LEAD] key several times until “AUX” is displayed and check
that the ECG waveform from the external monitor is displayed.
5 Turn the control dial of the defibrillator to the 50 J position to set the energy
value of electrical shock to 50 J.
6 Press the SYNC button then check the mode indication and synchronization
points.
• Check that “SYNC MODE” is displayed on the screen.
• Check that the “ ” lines indicating the synchronization positions are
displayed at the rising part (Q–R) of each QRS wave of the ECG
waveform being displayed.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the
rising part of each QRS wave.
6
6-1
7 Press either the charge button on the external APEX paddle or the CHARGE/
AED button on the front panel of the defibrillator to start charging.
During charging, “CHARGING” is displayed on the screen and beeps sound
intermittently.
CHARGING
The shock buttons flash. When charging is completed, the message “CHARGED” and some guidance
are displayed on the screen, and a continuous beep sounds. At the same time,
the shock buttons on the external paddles start flashing.
CHARGED Energy value for
electrical shock
WARNING
When charging or discharging, do not touch
anything other than the handles of the paddles. If
any other part of the defibrillator is touched during
charging or discharging, the operator receives an
electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
Simultaneously and firmly press 8 With the external paddles connected to the defibrillator analyzer,
the shock buttons on both external simultaneously and firmly press the shock buttons on the external paddles to
paddles.
deliver electrical shock.
Hold the shock buttons pressed until electrical shock is delivered, because
discharge is performed when the first synchronization point is detected after
the shock buttons are pressed.
NOTE: Never deliver electrical shock while the electrodes of the
paddles are in contact with each other. The defibrillator may
be damaged.
10 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
6-2
Introduction...................................................................6-2-2
Flow of Operation....................................................................... 6-2-2
Screen Example......................................................................... 6-2-3
Recording Waveforms................................................................ 6-2-4
Introduction
Defibrillation is a method for delivering electrical shock regardless of a patient’s heart
rate condition and is used for elimination of ventricular fibrillation.
The operator sets the output energy value, charges the defibrillator, then delivers an
electrical shock at any timing.
External paddles, internal paddles, or disposable pads can be used with the defibrillator.
Flow of Operation
Preparation (Refer to Section 6-1.) Defibrillation
or
Set the control dial to DISARM.
Check that no error message is displayed External paddles
on the screen.
The message “CHARGED” and some guidance are displayed
on the screen.
When charging is completed, a continuous beep sounds.
Screen Example
The figure below is a screen example for when the external paddles are used.
Guidance
To be displayed upon
completion of charging
Function keys
• [LEAD]
For selecting the ECG lead being
displayed
For defibrillation, select “PADDLE”
or “PAD”.
Mode indication: MANUAL MODE CHARGING or CHARGED
• [SENSITIVITY]
For selecting the ECG sensitivity
being displayed
• [EVENT]
For event recording, refer to “Event
Recording” (p. 10-1-8).
• [OP SOUND]
Number of discharges Charged energy
For turning the operation (OP) sound
on or off
The number of times of the operation
sound to be generated per minute
can be set in the Operation Sound
(times/min) for adult setting on the
SYSTEM SETUP screen. If it is
set to “Off”, the operation sound is
generated 100 times per minute.
(Administrator’s Guide: “AED
Setup”)
Recording Waveforms
The waveforms indicated below are stored in the internal memory as a waveform
report when electrical shock is delivered and can be recorded, as required.
If the defibrillator is turned off before 22 seconds have passed after a discharge,
the corresponding defibrillation report is not stored.
To record waveforms other than those described above, press the record/stop key
to perform continuous recording.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with external
connected to the patient. Failure to follow this paddles or internal paddles. If ECG is monitored
warning causes serious electrical shock or injury. with paddles, high-frequency energy from the ESU
causes abnormal current to flow in the patient and
unexpected discharge. This may damage the
6
WARNING defibrillator.
Before defibrillation, remove the electrodes for any
other instruments and patches from the positions 6-2
where the paddles will be placed. If a defibrillator WARNING
paddle contacts such an object, the delivery of When performing defibrillation on a child, be
shock may be insufficient and cause a skin burn. careful of the selected energy. High energy may
cause critical damage to the cardiac muscle.
NOTE: Select the appropriate energy and appropriate size of the external
paddles according to the patient. Only use the external paddles
specified by Nihon Kohden.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp
2 Check the mode indication and the ECG lead on the screen.
• Check that “MANUAL MODE” is displayed on the screen.
If “SYNC MODE” is displayed, press If “SYNC MODE” is displayed
the SYNC button to change the mode
indication to “MANUAL MODE”.
3 Pick up the external paddles from the paddle holders then uniformly apply
contact gel (GELAID) to the electrode plate surface of each paddle.
WARNING
Apply contact gel only to the electrode plates of the
external paddles. Otherwise, it may cause electrical
shock to the operator.
WARNING
Do not hold the paddle handles if your hands are
wet or have contact gel on them. This may cause
electrical shock to the operator.
CAUTION
To prevent skin burn on the patient, apply contact
gel evenly to the electrode plates of the external
paddles.
WARNING
Pay careful attention to the energy setting when
using the pediatric electrode plates. Applying high
energy with the pediatric electrode plates can
cause skin burn, because the electrode plates are
small.
STERNUM
paddle 5 Press the paddles on the patient.
1) Place the paddles on the chest of the patient. 6
Place the left (STERNUM) paddle on the right side of the sternum and
below the clavicle, and the right (APEX) paddle at the level of fifth
intercostal space and midaxillary line. 6-2
CAUTION
If the patient’s body is wet, thoroughly wipe the
APEX paddle moisture off the skin so that the paddles or pads
will not short-circuit each other. Otherwise, delivery
of shock may be insufficient.
Placement of the external paddles
NOTE: Do not lean against the paddles when pressing them on the
patient. A paddle may slip and cause injury.
2) Confirm that the patient’s ECG being displayed on the screen has a
shockable rhythm, such as ventricular fibrillation, for defibrillation.
ECG
Confirm that the patient’s ECG has a shockable rhythm, such as
ventricular fibrillation, for defibrillation.
6 Press either the charge button on the external APEX paddle or the CHARGE/
AED button on the front panel of the defibrillator to start charging.
During charging, “CHARGING” is displayed on the screen and beeps sound
intermittently.
CHARGING
WARNING
When charging or discharging, do not touch
anything other than the handles of the paddles. If
any other part of the defibrillator is touched during
charging or discharging, the operator receives an
electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
2) Simultaneously and firmly press the shock buttons on the external paddles
APEX paddle to deliver an electrical shock.
If another defibrillation is required, perform necessary medical treatment
then repeat steps 3 to 8.
Simultaneously and firmly press
the shock buttons on both external
paddles. WARNING
Before discharging, confirm that the paddles or
pads are firmly pressed against the chest wall.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
CAUTION
Do not discharge the energy if the electrodes of
paddles are short-circuited to each other by
contact gel. Failure to follow this warning may
cause skin burn or insufficient delivery of shock to
the heart.
Quick Holders
You can temporarily place the external paddles on the edges (quick holders)
of the paddle holders of the defibrillator while you are performing other CPR
treatments.
Use the gap between the electrode plate and the guard of an external paddle
to put it on the edge of a paddle holder, as shown in the figure below.
With the use of the quick holders, cleanliness is facilitated, because contact
gel (GELAID) on the external paddles does not get on the test-discharge
electrodes of the defibrillator.
NOTE: The quick holders cannot be used when the pediatric
electrode plates are used (when the adult electrode plates are
not attached to the external paddles).
9 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
10 Thoroughly wipe off the contact gel (GELAID) from the electrode plates of
the external paddles then return and gently press the external paddles into the
paddle holders.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with disposable
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high- 6
warning causes serious electrical shock or injury. frequency energy from the ESU causes abnormal
current to flow in the patient and unexpected
discharge. This may damage the defibrillator.
WARNING 6-2
If the bag containing disposable pads is torn, do
not use the pads. Dispose of the pads. Failure to WARNING
follow this warning may lead to skin burns or
• Do not use the disposable pads if the gel has
insufficient delivery of shock.
become dry.
• Do not use the disposable pads if the gel has
become abnormal (the gel has become liquified
WARNING or is coming out of the edges of the pad, etc.).
Do not use the disposable pads if they are past the Failure to follow these warnings may cause skin
expiration date on the package. Failure to follow burn or insufficient delivery of shock.
this warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Do not use the disposable pads if the gel is dark
WARNING brown or dark-brown gel is on the protective sheet.
Use disposal pads as soon as possible after Use of such pads may cause insufficient delivery of
opening the package. Failure to follow this warning shock or skin burn where the pads are attached.
may lead to skin burn or insufficient delivery of
shock.
WARNING
When performing defibrillation on a child, be
WARNING careful of the selected energy. High energy may
Do not reuse disposable pads. Failure to follow this cause critical damage to the cardiac muscle.
warning may lead to skin burn or insufficient
delivery of shock.
CAUTION CAUTION
Do not place heavy objects on the disposable pads When disposable pads are attached to a patient,
or bend the pads. The pads may become damaged replace them every 24 hours. After 24 hours, the
and deteriorated, resulting in skin burn on the gel becomes dry and this may reduce performance
patient. of the pads.
CAUTION
Do not attach a disposable pad over another pad.
It may cause skin burn on the patient.
NOTE • Always have spare disposable pads. Use the spare pads if the
gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
-T he color of the gel changes to brownish-red, and brownish
gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with the
sheet or if a metal part becomes exposed, be sure to use a new
disposal pads.
• Select the appropriate energy and appropriate size of the
disposable pads according to the patient. Only use the
disposable pads specified by Nihon Kohden.
NOTE: Firmly attach the disposable pads to the patient’s body. If they
are loosely attached, electrical shock cannot be delivered.
1) Check the patient’s conditions.
2) Connect the disposable pads.
• Connect the pad adapter (TEC-5621, TEC-5631).
• Attach the disposable pads to the patient.
• Connect the disposable pads to the pad adapter or pad connector.
3) Turn the control dial to the DISARM position. Check that no error
message is displayed on the screen.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp
To use the defibrillator on battery power, check that there is enough remaining
power in the battery pack.
2 Check the mode indication, the ECG lead, and the ECG on the screen.
• Check that “MANUAL MODE” is displayed on the screen.
If “SYNC MODE” is displayed, press
the SYNC button to change the mode If “SYNC MODE” is displayed
indication to “MANUAL MODE”.
WARNING
When charging or discharging, do not touch the
pads or connector. If you touch any other part of
the defibrillator during charging or discharging, you
will receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
6-2
WARNING
Before discharging, confirm that the paddles or
pads are firmly pressed against the chest wall.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
CAUTION
Do not discharge the energy if the electrodes of
paddles are short-circuited to each other by
contact gel. Failure to follow this warning may
cause skin burn or insufficient delivery of shock to
the heart.
6 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
Shock button
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with external
connected to the patient. Failure to follow this paddles or internal paddles. If ECG is monitored
warning causes serious electrical shock or injury. with paddles, high-frequency energy from the ESU
causes abnormal current to flow in the patient and
unexpected discharge. This may damage the
WARNING defibrillator.
When performing defibrillation on a child, be
careful of the selected energy. High energy may
cause critical damage to the cardiac muscle.
CAUTION CAUTION
Sterilize the internal paddles before use. Failure to Pay careful attention to the selected energy when
sterilize the paddles may cause serious infection. using internal paddles. Applying high energy to the
heart may cause cardiac muscle necrosis. Low
energy is recommended.
CAUTION
Do not twist the internal paddle while holding the
electrode or impact strong impact to the paddle.
Doing so can damage or bend the electrode.
NOTE: Select the appropriate energy and appropriate size of the internal
paddles according to the patient. Only use the internal paddles
specified by Nihon Kohden.
2 Check the mode indication and the ECG lead on the screen.
• Check that “MANUAL MODE” is displayed on the screen.
If “SYNC MODE” is displayed, press the SYNC button to change the
mode indication to “MANUAL MODE”.
When the ND-860V Series is Used When the ND-860V series internal paddles are used, the SHOCK button
The SHOCK starts flashing at the same time.
button flashes.
WARNING
When charging or discharging, grip the internal
paddles between the cable and the guard at the
top of the handle. If the internal paddles are
gripped between the electrode and the guard, the
operator may receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
Handles 5 Place the electrodes of the internal paddles on both auricles of the patient’s 6-2
heart as if holding the heart with the paddles. Confirm that the patient’s ECG
has a shockable rhythm, such as ventricular fibrillation, for defibrillation.
For better contact between the electrodes of the internal paddles and heart,
place sterilized gauze moistened with physiological saline solution between
Guard each electrode and the area of the heart.
ECG
Grip each internal paddle between the cable Confirm that the patient’s ECG has a shockable rhythm, such
and the guard at the top of the handle. as ventricular fibrillation, for defibrillation.
WARNING
Before discharging, confirm that the internal
paddles are firmly positioned against the heart.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
WARNING
Do not discharge with the paddles in the air. This
may cause electrical shock or damage the
defibrillator.
7 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
8 Disconnect the internal paddles from the defibrillator. Wash off any blood
from the internal paddles and sterilize them.
• “Disconnecting Paddles/Pads (TEC-5621, TEC-5631)” (p. 6-1-3)
• “Internal Paddles” (p. 12-32)
• Manual of the internal paddles to be used
Introduction...................................................................6-3-2
Flow of Operation....................................................................... 6-3-2 6-3
Screen Example......................................................................... 6-3-3
Recording Waveforms................................................................ 6-3-4
Introduction
Synchronized cardioversion is a method for delivering electrical shock with appropriate
timing after detecting a patient’s QRS wave, and it is used for elimination of atrial
fibrillation, etc.
The operator sets the output energy value, charges the defibrillator for any timing,
then holds the SHOCK button pressed. The defibrillator will deliver electrical shock in
synchronization with the QRS wave detected first.
External paddles, internal paddles, or disposable pads can be used with the defibrillator.
Flow of Operation
Preparation (Refer to Section 6-1.) Cardioversion
Check the patient’s conditions. Select the ECG lead then press the SYNC button.
Connect the paddles/pads. • Check that “SYNC MODE” is displayed on the screen.
Connect the paddles/pads to be used. • Check that the “ ” lines indicating the
External paddles synchronization position are displayed at the
rising part of each QRS wave of the ECG
waveform being displayed.
If the patient is a small child, change
the adult electrode plates to the External paddles: Apply contact gel to the electrode
pediatric electrode plates. plate surface of each paddle.
Disposable pads
Select the energy level.
Connect in the For internal paddles, the selectable energy
following steps: level is 50 J or less.
1) Connect the pad
adapter (TEC-5621, TEC-5631).
2) Attach the disposable pads to the
patient.
3) Connect the disposable pads to the External paddles: Press the paddles on the patient.
pad adapter or pad connector.
Press the CHARGE/AED button.
Internal paddles
Charging starts and beeps will sound intermittently.
or
Set the control dial to DISARM.
Check that no External paddles
error message is
displayed on the The message “CHARGED” and some guidance are
screen. displayed on the screen.
When charging is completed, a continuous beep sounds.
Screen Example
The figure below is a screen example for when the external paddles are used.
ARRHYTHMIA ANALYSIS OFF
When PADDLE is selected as the lead (the external paddles or internal
paddles are used), arrhythmia analysis is always set to “OFF”. For other
leads, arrhythmia analysis is set to “OFF” when the VF/VT alarm is set to
“OFF”.
When the arrhythmia analysis is set to “OFF”, the message
“ARRHYTHMIA ANALYSIS OFF” is displayed on the screen.
Guidance
To be displayed upon
completion of charging
Function keys
• [LEAD]
For selecting the ECG lead being
displayed
• [SENSITIVITY]
For selecting the ECG sensitivity
being displayed Mode indication: SYNC MODE CHARGING or CHARGED
• [EVENT]
For event recording, refer to “Event
Recording” on p. 10-1-8.
• [OP SOUND]
For turning the operation (OP) sound
on or off
Number of discharges Charged energy
The number of times of the operation
sound to be generated per minute
can be set in the Operation Sound
(times/min) for adult setting on the
SYSTEM SETUP screen. If it is
set to “Off”, the operation sound is
generated 100 times per minute.
(Administrator’s Guide: “AED
Setup”)
Recording Waveforms
The waveforms indicated below are stored in the internal memory as a waveform
report when electrical shock is delivered and can be recorded, as required.
If the defibrillator is turned off before 22 seconds have passed after a discharge,
the corresponding defibrillation report is not stored.
To record waveforms other than those described above, press the record/stop key
to perform continuous recording.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with external
connected to the patient. Failure to follow this paddles or internal paddles. If ECG is monitored
warning causes serious electrical shock or injury. with paddles, high-frequency energy from the ESU
6
causes abnormal current to flow in the patient and
unexpected discharge. This may damage the
WARNING defibrillator.
Before defibrillation, remove the electrodes for any
6-3
other instruments and patches from the positions
where the paddles will be placed. If a defibrillator WARNING
paddle contacts such an object, the delivery of Check that the vertical dotted line indicating
shock may be insufficient and cause a skin burn. synchronization position is displayed on the rising
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is
WARNING incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
Confirm that there is no artifact on the ECG.
with the [SENSITIVITY] function key.
Artifact may be misinterpreted as QRS and
• Change the ECG lead with the [LEAD] function
discharge might not synchronize with the patient’s
key.
QRS.
• Change the electrode position.
If the position of the vertical dotted line is incorrect,
synchronized cardioversion may not be performed
WARNING properly and may cause ventricular fibrillation to
When performing defibrillation on a child, be the patient.
careful of the selected energy. High energy may
cause critical damage to the cardiac muscle.
CAUTION
When performing synchronized cardioversion,
confirm that SYNC MODE is displayed on the
defibrillator screen before every discharge.
Depending on the setting made on the SYSTEM
SETUP screen, the defibrillator automatically
returns to the asynchronous defibrillation mode
after synchronized cardioversion.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp
2 Press the [LEAD] key to select the lead of the ECG to be used as the
synchronizing signal.
When the ECG to be used as a synchronizing signal is measured with the
defibrillator, a Lead II signal is usually used so that the highest-amplitude
QRS wave can be obtained.
3 Press the SYNC button then check the mode indication and synchronization
positions.
• Check that “SYNC MODE” is displayed on the screen.
• Check that the “ ” lines indicating the synchronization positions
are displayed at the rising part (Q–R) of each QRS wave of the ECG
6
waveform being displayed.
WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising 6-3
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
key.
• Change the electrode position.
If the position of the vertical dotted line is incorrect,
synchronized cardioversion may not be performed
properly and may cause ventricular fibrillation to
the patient.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the rising part of each QRS
wave.
NOTE • SYNC mode cannot be selected when the control dial is set to
the MONITOR, PACING, or AED position.
• After SYNC mode is selected, if the control dial setting is
changed to MONITOR, PACING, AED, SETUP, or BASIC
CHECK, the defibrillator exits SYNC mode.
4 Pick up the external paddles from the paddle holders then uniformly apply
contact gel (GELAID) to the electrode plate surface of each paddle.
WARNING
Apply contact gel only to the electrode plates of the
external paddles. Otherwise, it may cause electrical
shock to the operator.
WARNING
Do not hold the paddle handles if your hands are
wet or have contact gel on them. This may cause
electrical shock to the operator.
CAUTION
To prevent skin burn on the patient, apply contact
gel evenly to the electrode plates of the external
paddles.
WARNING
Pay careful attention to the energy setting when
using the pediatric electrode plates. Applying high
energy with the pediatric electrode plates can
cause skin burn, because the electrode plates are
small.
STERNUM
paddle
6 Place the paddles on the chest of the patient.
Place the left (STERNUM) paddle on the right side of the sternum and
below the clavicle, and the right (APEX) paddle at the level of fifth
intercostal space and midaxillary line.
CAUTION
If the patient’s body is wet, thoroughly wipe the
moisture off the skin so that the paddles or pads
APEX paddle will not short-circuit each other. Otherwise, delivery
of shock may be insufficient.
Paddle contact
lamp 7 Press the paddles against the paddle placement areas so that the paddle
contact lamp on the STERNUM paddle lights in green.
The paddle contact lamp indicates the status of the transthoracic resistance of
the patient via the external paddle.
The paddle contact lamp might not light in green for some patients, but even
if the lamp is lit in yellow or orange, electrical shock can be delivered.
Section 6-1 “Contact Impedance between Skin and the External
Paddles’ Electrodes” (p. 6-1-21)
8 Press either the charge button on the external APEX paddle or the CHARGE/
AED button on the front panel of the defibrillator to start charging.
6
During charging, “CHARGING” is displayed on the screen and beeps sound
intermittently.
CHARGING
6-3
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
STERNUM 1) Check the patient’s conditions and the charged energy level again.
paddle
NOTE: Before discharge, be sure to check the charged energy
level again.
Energy value for
electrical shock
2) Simultaneously and firmly press the shock buttons on the external paddles
to deliver an electrical shock.
Hold the shock buttons pressed with the external paddles pressed against
the patient’s chest until electrical shock is delivered, because discharge is
APEX paddle performed when the first synchronization point is detected after the shock
buttons are pressed.
If another cardioversion is required, perform necessary medical treatment
Simultaneously and firmly press then repeat steps 5 to 9.
the shock buttons on both external
paddles. If the Sync Mode after CV setting on the SYSTEM SETUP screen is
set to “Defib”, the defibrillation mode changes to “MANUAL MODE”
after an electrical shock is delivered.
Refer to the Administrator’s Guide “System Setup”.
WARNING
Before discharging, confirm that the paddles or
pads are firmly pressed against the chest wall.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
CAUTION
Do not discharge the energy if the electrodes of
paddles are short-circuited to each other by
contact gel. Failure to follow this warning may
cause skin burn or insufficient delivery of shock to
the heart.
Quick Holders
You can temporarily place the external paddles on the edges (quick holders)
of the paddle holders of the defibrillator while you are performing other CPR
treatments.
Use the gap between the electrode plate and the guard of an external paddle
to put it on the edge of a paddle holder, as shown in the figure below.
With the use of the quick holders, cleanliness is facilitated, because contact
gel (GELAID) on the external paddles does not get on the test-discharge
electrodes of the defibrillator.
NOTE: The quick holders cannot be used when the pediatric
electrode plates are used (when the adult electrode plates are
not attached to the external paddles). 6
10 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be 6-3
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
11 Thoroughly wipe off the contact gel (GELAID) from the electrode plates of
the external paddles then return and gently press the external paddles into the
paddle holders.
Dispose of the ECG electrodes used in synchronized cardioversion, referring
to the provided manuals for each item.
Return the paddles to the
“External Paddles” (p. 12-32)
paddle holders.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with disposable
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high-
warning causes serious electrical shock or injury. frequency energy from the ESU causes abnormal
current to flow in the patient and unexpected
discharge. This may damage the defibrillator.
WARNING
If the bag containing disposable pads is torn, do
not use the pads. Dispose of the pads. Failure to WARNING
follow this warning may lead to skin burns or
• Do not use the disposable pads if the gel has
insufficient delivery of shock.
become dry.
• Do not use the disposable pads if the gel has
become abnormal (the gel has become liquified
WARNING or is coming out of the edges of the pad, etc.).
Do not use the disposable pads if they are past the Failure to follow these warnings may cause skin
expiration date on the package. Failure to follow burn or insufficient delivery of shock.
this warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Do not use the disposable pads if the gel is dark
WARNING brown or dark-brown gel is on the protective sheet.
Use disposal pads as soon as possible after Use of such pads may cause insufficient delivery of
opening the package. Failure to follow this warning shock or skin burn where the pads are attached.
may lead to skin burn or insufficient delivery of
shock.
WARNING
When performing defibrillation on a child, be
WARNING careful of the selected energy. High energy may
Do not reuse disposable pads. Failure to follow this cause critical damage to the cardiac muscle.
warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Confirm that there is no artifact on the ECG.
Artifact may be misinterpreted as QRS and
discharge might not synchronize with the patient’s
QRS.
WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
key.
• Change the electrode position.
If the position of the vertical dotted line is incorrect,
synchronized cardioversion may not be performed 6
properly and may cause ventricular fibrillation to
the patient.
NOTE • Always have spare disposable pads. Use the spare pads if
the gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
- The color of the gel changes to brownish-red, and
brownish gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with
the sheet or if a metal part becomes exposed, be sure to
use a new disposal pads.
• Select the appropriate energy and appropriate size of the
disposable pads according to the patient. Only use the
disposable pads specified by Nihon Kohden.
NOTE: Firmly attach the disposable pads to the patient’s body. If they
are loosely attached, electrical shock cannot be delivered.
1) Check the patient’s conditions.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp
2 Press the [LEAD] key to select the lead of the ECG to be used as the
synchronizing signal.
When the ECG to be used as a synchronizing signal is measured with the
defibrillator, a Lead II signal is usually used so that the highest-amplitude
QRS wave can be obtained.
3 Press the SYNC button then check the mode indication and synchronization
positions.
• Check that “SYNC MODE” is displayed on the screen.
• Check that the “ ” lines indicating the synchronization positions
are displayed at the rising part (Q–R) of each QRS wave of the ECG
waveform being displayed.
WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is 6
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
key. 6-3
• Change the electrode position.
If the position of the vertical dotted line is incorrect,
synchronized cardioversion may not be performed
properly and may cause ventricular fibrillation to
the patient.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the rising part of
each QRS wave.
NOTE • SYNC mode cannot be selected when the control dial is set
to the MONITOR, PACING, or AED position.
• After SYNC mode is selected, if the control dial setting is
changed to MONITOR, PACING, AED, SETUP, or BASIC
CHECK, the defibrillator exits SYNC mode.
The SHOCK When charging is completed, the message “CHARGED” and some guidance
button flashes. are displayed on the screen, and a continuous beep sounds. The SHOCK
button starts flashing at the same time.
For safety, the defibrillator automatically internally discharges charged
energy when the charge holding time passes.
The charge holding time can be set in the Charge Holding Time setting
on the SYSTEM SETUP screen. (Default value: 40 seconds)
Refer to the Administrator’s Guide “System Setup”.
Energy value
CHARGED for electrical
shock
WARNING
When charging or discharging, do not touch the
pads or connector. If you touch any other part of
the defibrillator during charging or discharging, you
will receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
WARNING
Before discharging, confirm that the paddles or
pads are firmly pressed against the chest wall.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
CAUTION
Do not discharge the energy if the electrodes of
paddles are short-circuited to each other by
contact gel. Failure to follow this warning may
cause skin burn or insufficient delivery of shock to
the heart.
7 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
6-3
Shock button
WARNING WARNING
When using an ESU, use this defibrillator only in Before defibrillation, make sure that no one is in
MONITOR mode and use the ECG electrodes for contact with either the patient or any metal part of
monitoring. Do not monitor ECG with external any equipment or cables which supports or is
paddles or internal paddles. If ECG is monitored connected to the patient. Failure to follow this
with paddles, high-frequency energy from the ESU warning causes serious electrical shock or injury.
causes abnormal current to flow in the patient and
unexpected discharge. This may damage the
defibrillator. WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising
WARNING slope of every QRS wave (between the Q and R
Confirm that there is no artifact on the ECG. points). If the position of the vertical dotted line is
Artifact may be misinterpreted as QRS and incorrect, adjust the position as follows:
discharge might not synchronize with the patient’s • Change the amplitude of the ECG waveforms
QRS. with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
key.
WARNING • Change the electrode position.
When performing defibrillation on a child, be If the position of the vertical dotted line is incorrect,
careful of the selected energy. High energy may synchronized cardioversion may not be performed
cause critical damage to the cardiac muscle. properly and may cause ventricular fibrillation to
the patient.
CAUTION CAUTION
When performing synchronized cardioversion, Pay careful attention to the selected energy when
confirm that SYNC MODE is displayed on the using internal paddles. Applying high energy to the
defibrillator screen before every discharge. heart may cause cardiac muscle necrosis. Low
Depending on the setting made on the SYSTEM energy is recommended.
SETUP screen, the defibrillator automatically
returns to the asynchronous defibrillation mode
after synchronized cardioversion.
CAUTION CAUTION
Sterilize the internal paddles before use. Failure to Do not twist the internal paddle while holding the
sterilize the paddles may cause serious infection. electrode or impact strong impact to the paddle.
Doing so can damage or bend the electrode.
NOTE: Select the appropriate energy and appropriate size of the internal
paddles according to the patient. Only use the internal paddles
specified by Nihon Kohden.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp
2 Press the [LEAD] key to select the lead of the ECG to be used as the
synchronizing signal.
When the ECG to be used as a synchronizing signal is measured with the
defibrillator, a Lead II signal is usually used so that the highest-amplitude
QRS wave can be obtained.
Lead
3 Press the SYNC button then check the mode indication and synchronization
positions.
• Check that “SYNC MODE” is displayed on the screen. 6-3
• Check that the “ ” lines indicating the synchronization positions
are displayed at the rising part (Q–R) of each QRS wave of the ECG
waveform being displayed.
WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
key.
• Change the electrode position.
If the position of the vertical dotted line is incorrect,
synchronized cardioversion may not be performed
properly and may cause ventricular fibrillation to
the patient.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the rising part of
each QRS wave.
When the ND-860V Series is Used When the ND-860V series internal paddles are used, the SHOCK button starts
The SHOCK flashing at the same time.
button flashes.
WARNING
When charging or discharging, grip the internal
paddles between the cable and the guard at the
top of the handle. If the internal paddles are
gripped between the electrode and the guard, the
operator may receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
Handles
6 Place the electrodes of the internal paddles on both auricles of the patient’s
6-3
heart as if holding the heart with the paddles.
For better contact between the electrodes of the internal paddles and heart,
place sterilized gauze moistened with physiological saline solution between
each electrode and the area of the heart.
Guard
WARNING
Before discharging, confirm that the internal
paddles are firmly positioned against the heart.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
WARNING
Do not discharge with the paddles in the air. This
may cause electrical shock or damage the
defibrillator.
8 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
9 Disconnect the internal paddles from the defibrillator. Wash off any blood
from the internal paddles and sterilize them.
Dispose of the ECG electrodes used for synchronized cardioversion,
referring to the provided manuals for each item.
CAUTION 6
Synchronized cardioversion with the paddle lead
does not provide stable ECG because it is difficult
to hold the paddles steady. Artifact on the ECG
may be misinterpreted as QRS and discharge
might not synchronize with the patient’s QRS. 6-3
Introduction...................................................................6-4-2
Screen Example......................................................................... 6-4-2
AED Flowchart........................................................................... 6-4-3 6-4
AED Procedure............................................................6-4-4
Various Operations.....................................................6-4-15
Pause Function........................................................................ 6-4-15
Timer Operation........................................................................ 6-4-16
Recording Waveforms.............................................................. 6-4-16
6. Defibrillation, Synchronized Cardioversion and AED
Introduction
With the TEC-5611, TEC-5621, TEC-5631, defibrillation in AED mode is
possible.
In AED mode, the defibrillator analyzes the patient’s ECG then judges whether
electrical shock is needed. If it judges that electrical shock is required, energy is
automatically charged to the level set beforehand. Electrical shock is delivered
by the operator, according to the displayed guidance.
In AED mode, only the disposable pads can be used.
NOTE • In AED mode, some alarms may be set to off. Do not monitor
the patient in AED mode for a long time.
• If the attached disposable pads are detached then reattached
3 times or more, AED operation is canceled and the CPR cycle
starts.
Screen Example
The screen example below is for AED for ADULT mode.
Arrhythmia alarm and VF/VT alarm
In AED mode, the arrhythmia alarms, except for the VF/VT alarm, are not
generated, regardless of the alarm setting.
The arrhythmia mark “ ” is displayed only when the optional QS-831V
is installed.
Remaining battery power
ECG mark and AC power mark
Guidance
The operator follows
the guidance to be
displayed.
• [STOP TIMER],
[LAP MEASUREMENT]
For operation of the timer displayed
in the guidance area, refer to p. 6-4-16.
During pause During CPR
• [EVENT]
For event recording, refer to “Event
Recording” on p. 10-1-8.
Remaining time Remaining time CHARGING or
• [PAUSE START/STOP] for pause for CPR CHARGED
Press to enter pause mode during the
periods indicated below. The VF/VT
alarm is suspended during pause
mode.
• From the start of AED operation
until the CHARGE/AED button is
pressed (whether or not pause is
Mode indication: ADULT MODE or Number of Charged
available depends on the setting in
CHILD MODE discharges energy
AED Setup).
• During CPR
To release pause mode, press the key
again. (Refer to p. 6-4-15.)
AED Flowchart
Automatic operation by the defibrillator
The messages shown in quotation marks
(“ ”) are guidance instructions.
Operation by the operator
Check the patient’s conditions then connect the
disposable pads. (Refer to Section 6-1.) Parameters in AED Setup in SYSTEM
SETUP
Charging starts.
“Shock advised. Charging.” Off “It is safe to touch patient. Start
detected
rhythm
Nonshockable
CPR.”
Check the
patient’s condition Continue CPR.
again, then firmly
press the SHOCK Five more chest compressions
button.
“Do 5 more chest compressions.
Do not touch patient.”
“Shock delivered.”
End of
sequence Perform 5 more chest
During a sequence compressions then stop CPR.
AED Procedure
How to perform defibrillation in AED mode is described below.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with disposable
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high-
warning causes serious electrical shock or injury. frequency energy from the ESU causes abnormal
current to flow in the patient and unexpected
discharge. This may damage the defibrillator.
WARNING
If the bag containing disposable pads is torn, do
not use the pads. Dispose of the pads. Failure to WARNING
follow this warning may lead to skin burns or Do not use the disposable pads if they are past the
insufficient delivery of shock. expiration date on the package. Failure to follow
this warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Use disposal pads as soon as possible after
opening the package. Failure to follow this warning WARNING
may lead to skin burn or insufficient delivery of Do not reuse disposable pads. Failure to follow this
shock. warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Do not use the disposable pads if the gel is dark WARNING
brown or dark-brown gel is on the protective sheet. When performing defibrillation on a child, be
Use of such pads may cause insufficient delivery of careful of the selected energy. High energy may
shock or skin burn where the pads are attached. cause critical damage to the cardiac muscle.
WARNING WARNING
• Do not use the disposable pads if the gel has When the patient is a child age 0 to 7, perform
become dry. defibrillation in AED mode (child mode).
• Do not use the disposable pads if the gel has When using the defibrillation pads, make sure that
become abnormal (the gel has become liquified the pads do not touch each other.
or is coming out of the edges of the pad, etc.).
Failure to follow these warnings may cause skin
burn or insufficient delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, When monitoring ECG with disposable pads,
replace them every 24 hours. After 24 hours, the check the polarity of the pads before attaching
gel becomes dry and this may reduce performance them on the patient. If the pad polarity is incorrect,
of the pads. the waveform appears upside-down and this may
cause incorrect judgment by the operator and
delay of treatment.
CAUTION CAUTION
Do not place heavy objects on the disposable pads Do not attach a disposable pad over another pad.
or bend the pads. The pads may become damaged It may cause skin burn on the patient.
and deteriorated, resulting in skin burn on the
patient.
CAUTION
The defibrillator may not be able to correctly
CAUTION analyze an ECG of a patient with an implanted
For some ECG waves, the defibrillator may pacemaker. For such a patient, follow a physician’s
incorrectly judge that defibrillation is not necessary. instructions.
When the defibrillator judges that defibrillation is
not necessary, it provides instructions for
performing CPR. In very rare cases, the 6
defibrillator may incorrectly judge that defibrillation
is necessary.
NOTE • Always have spare disposable pads. Use the spare pads if the
gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means: 6-4
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
- The color of the gel changes to brownish-red, and brownish
gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with the
sheet or if a metal part becomes exposed, be sure to use a new
disposal pads.
• Select the appropriate size of the disposable pads according
to the patient. Only use disposable pads specified by Nihon
Kohden.
• Although a VF or VT alarm is generated in monitor mode, such
an ECG might not be necessarily judged as a shockable rhythm
in AED mode.
1 Confirm that the patient is unconscious and has no respiration and no pulse.
CAUTION
Before ECG analysis or defibrillation, confirm that
the patient is unconscious and has no respiration
and no pulse.
NOTE: Firmly attach the disposable pads to the patient’s body. If they
are loosely attached, electrical shock cannot be delivered.
1) Check the patient’s conditions.
2) Connect the disposable pads.
• Connect the pad adapter (TEC-5621, TEC-5631).
• Attach the disposable pads to the patient.
• Connect the disposable pads to the pad adapter or pad connector.
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp To use the defibrillator on battery power, check that there is enough
remaining power in the battery pack.
To enter AED (ADULT MODE) 3 Turn the control dial to the AED position and check that “ADULT MODE”
is displayed in the mode indication area.
If the patient is a small child, turn the control dial to the AED position while
holding the CHILD MODE button pressed.
• Check that the error message “CHECK PADS” or “CHANGE PADS” is
not displayed on the screen.
• Check that displayed mode indication “ADULT MODE” or “CHILD
MODE” is correctly selected.
Set the control dial to AED.
• Check that “PAD” is displayed as the ECG lead on the screen.
To enter AED (CHILD MODE) NOTE: Only “PAD” is selectable as a lead.
Lead: PAD
WARNING
When the patient is a child age 0 to 7, perform
defibrillation in AED mode (child mode).
When using the defibrillation pads, make sure that
the pads do not touch each other.
NOTE: It may take several seconds for the waveforms to appear after
the control dial is set to the AED position.
Analysis during AED mode
In AED mode, even while the AED analysis is not performed, whether or not
a shockable rhythm appears in the ECG being measured is always analyzed.
6
• A VF/VT alarm can be suspended by pressing the [PAUSE START/
STOP] key for entering pause mode. (Refer to p. 6-4-15.)
• If the Manual Analysis for 1st Discharge in AED Mode setting
in AED Setup is set to “Off”, the message “Press AED button” is
displayed and an AED analysis is automatically performed. For the
Manual Analysis for 2nd or Later Discharge in AED Mode setting in
AED Setup, refer to “AED Flowchart” (p. 6-4-3).
6-4
WARNING
While the defibrillator is analyzing the patient’s
ECG, stop CPR and do not move or shake the
patient’s body. If the patient is in a car, stop the car.
Otherwise, the defibrillator cannot analyze the
patient’s ECG correctly.
WARNING
When charging or discharging, do not touch the
pads or connector. If you touch any other part of
the defibrillator during charging or discharging, you
will receive an electrical shock.
WARNING
Do not move or transport the defibrillator when any
residual charge remains in the defibrillator. If the
defibrillator receives any impact, such as from
falling, it may discharge and can cause electrical
shock.
CAUTION
Asystole is not judged as a shockable rhythm.
To stop delivering electrical shock because, for example, the patient’s pulse,
consciousness, and respiration are restored or a sudden change in patient’s
ECG is recognized, turn the control dial to the DISARM or OFF position.
WARNING WARNING
Before defibrillation, make sure that no one is in Before defibrillation and cardioversion, remove
contact with either the patient or any metal part of from the patient all electrodes, probes and trans-
any equipment or cables which supports or is ducers from connectors that do not have a “ ” or
connected to the patient. Failure to follow this “ ” mark. Otherwise, the operator may receive
warning causes serious electrical shock or injury. electrical shock and the connected instrument may
be damaged.
WARNING
Before defibrillation, remove everything including WARNING
electrodes and patches from the patient’s chest. If Before defibrillation and cardioversion, check that
the defibrillator paddle/pad contacts an object on the cords and cables of the electrodes and trans-
the patient’s chest, the discharged energy may be ducers attached to the patient are properly
insufficient and cause skin burn. connected to the defibrillator. Touching the metal
parts of the disconnected cords and cables may
cause electrical shock or injury by discharged
energy.
WARNING WARNING
Before discharging, confirm that the paddles or When charging or discharging, do not touch the
pads are firmly pressed against the chest wall. pads or connector. If you touch any other part of
Failure to follow this warning may cause skin burn the defibrillator during charging or discharging, you
or insufficient delivery of shock. will receive an electrical shock.
CAUTION CAUTION
Do not discharge the energy if the electrodes of If the patient’s body is wet, thoroughly wipe the
paddles are short-circuited to each other by moisture off the skin so that the paddles or pads
contact gel. Failure to follow this warning may will not short-circuit each other. Otherwise, delivery
cause skin burn or insufficient delivery of shock to of shock may be insufficient. 6
the heart.
Along with the discharge information, the ECG from 10 seconds before to
12 seconds after an electrical shock is automatically stored in the internal
memory of the defibrillator as a defibrillation report.
5) The message “It is safe to touch patient. Start CPR” is displayed in the
guidance area. Perform CPR, as required.
7 Perform CPR.
1) After an electrical shock is delivered or when nonshockable rhythm is
detected, start CPR, following the guidance being displayed.
Each parameter for CPR can be set in AED Setup.
• CPR Cycles per Sequence (for adults/children)
• Operation Sound (times/min) (for adults/children)
• Number of Chest Compressions (for adults/children)
• Number of Rescue Breaths (for adults/children)
During CPR, the message “Continue CPR” and the remaining time for
CPR are displayed.
Remaining time for CPR
8 If electrical shock is required after CPR, repeat step 5 and later steps.
9 To shut the defibrillator off, turn the control dial to the OFF position.
NOTE • Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
6-4
CAUTION
Asystole is not judged as a shockable rhythm.
Various Operations
Pause Function
If the [PAUSE START/STOP] key is pressed in the following cases, the
defibrillator enters pause mode and the [ ] mark and the remaining time for
pause is displayed on the screen:
The pause duration can be set in the Pause Time setting in AED Setup.
Administrator’s Guide: “AED Setup”
6
During AED Operation
In a case where pressing the CHARGE/AED button is required for starting
an AED analysis (whether or not the button must be pressed to start an AED
analysis can be set in AED Setup), if the [PAUSE START/STOP] key is pressed
anywhere from the start of AED operation to pressing of the CHARGE/AED
button, the VF/VT alarm is suspended. 6-4
During CPR
If the [PAUSE START/STOP] key is pressed during CPR, the defibrillator enters
pause mode, regardless of the remaining time for CPR.
When the VF/VT Alarm during CPR setting in AED Setup is set to “Off”, a VF/
VT alarm is suspended.
The CPR cycle is finished when pause mode is canceled during CPR or when the
remaining time for pause becomes zero.
Remaining time for pause
[PAUSE START/STOP]
For starting/canceling pause
Timer Operation
The timer that is displayed in the guidance area is automatically activated when
the defibrillator enters AED mode (for ADULT or CHILD) to indicate the
elapsed time in AED mode. You can use this timer for measuring the duration of
medical treatment.
To operate the timer, use the function keys.
• [STOP TIMER]
For stopping the timer. While
the timer is stopped, the [LAP
MEASUREMENT] key is switched to
[RESET TIMER].
• [LAP MEASUREMENT]
For measuring the lap time.
The number of laps and lap time being
displayed is updated.
Recording Waveforms
In AED mode, the waveforms indicated below are stored in the internal memory
as waveform reports and can be recorded, as required.
A maximum of 2,000 seconds worth of various waveform reports
in total can be stored in the internal memory of the defibrillator. If
the total duration of data exceeds 2,000 seconds, the oldest record is
automatically deleted and a new record is stored.
When the Record “Charging Start” After Discharge setting on the SYSTEM
SETUP screen is set to “On”, the ECG from the beginning of charging after a
discharge is automatically recorded.
To record waveforms other than those described above in AED mode, press the
record/stop key to perform continuous recording.
6-4
Introduction......................................................................7-2
Pacing Procedure...........................................................................7-3
Preparation......................................................................7-4
Connecting the Pad Adapter .........................................................7-4 7
Setting and Checking the Pacing Rate and Current .....................7-5
Measuring the ECG and Selecting the Lead .................................7-6
Connecting Disposable Pads ........................................................7-7
Attaching the Disposable Pads to the Patient . .........................7-8
Connecting the Disposable Pads to the Pad Adapter . .............7-9
Introduction
The TEC-5631 includes a pacing circuit. In cases in which bradycardia is
observed after defibrillation, emergency treatment is enabled with electric
stimulation through the patient’s chest. A single TEC-5631 can cover three roles
of emergency medication: pacing, monitoring and defibrillation.
The disposable pads can be used for pacing so that the ECG waveforms during
pacing can be monitored continuously with the ECG connection cord and
electrodes.
Two pacing modes are provided with the TEC-5631 defibrillators.
• Fixed mode: Pacing current is output at the selected pacing rate, regardless
of spontaneous heart beat.
• Demand mode: When there is no spontaneous heart beat, pacing current
is output at the selected pacing rate. When there is a
spontaneous heart beat and the next heart beat does not occur,
pacing current is output at the selected pacing rate.
WARNING WARNING
Confirm that there is no artifact on the ECG. When using the disposable pads for long term
Artifact may be misinterpreted as QRS and correct pacing, replace them every hour. Failure to follow
pacing cannot be performed. this warning may cause skin burn or insufficient
energy discharge and pacing current to the heart.
WARNING
Do not perform pacing while using an ESU. Before WARNING
using the ESU, turn the defibrillator power off and If any disposable pad or connector gets wet, wipe
remove disposable pads from the patient. Other- off moisture before use. If a wet pad or connector
wise, high frequency energy from the ESU causes is used, it may cause electrical shock.
abnormal current to flow into the patient and
causes electrical burn, shock or other injury. It also
damages the defibrillator.
CAUTION
Check that the pacing pulse is effective, by
observing the ECG on the screen.
NOTE • Always have spare disposable pads. Use the spare pads if the
gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
-T he color of the gel changes to brownish-red, and brownish
gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with the
sheet or if a metal part becomes exposed, be sure to use a new
disposal pads.
Pacing Procedure
Preparation (Refer to p. 7-4.) Pacing
Stop pacing.
Press the START/STOP key or set the pacing
current to “0 mA” to stop pacing.
Preparation
Check the patient’s conditions, and follow the procedures for preparation
described below.
2 Set and check the pacing rate and current. Refer to p. 7-5.
Start pacing.
2 Turn the control dial to the DISARM position and check that the error
message “CONNECT PADDLES/PADS” is not displayed.
For AC power operation, check that the AC power lamp lights.
AC power lamp
Pacing rate
Pacing current: 0 mA
1 Measure the ECG following the procedures below, referring to Sections 8-1
and 6-1.
1) As the measurable lead of ECG depends on the number of electrodes,
check the number of electrodes and the lead.
Section 8-1 “Checking the Number of Electrodes and Measuring
Leads” (p. 8-1-3)
2) Connect the electrode lead to the ECG socket via the ECG connection
cord.
Section 8-1 “Connecting the Electrode Lead to the Defibrillator” (p. 8-1-6)
3) Attach the disposable electrodes to the patient. The placement and lead
depend on the number of electrodes (leads).
ECG lead
WARNING WARNING
If the bag containing disposable pads is torn, do • Do not use the disposable pads if the gel has
not use the pads. Dispose of the pads. Failure to become dry.
follow this warning may lead to skin burns or • Do not use the disposable pads if the gel has
insufficient delivery of shock. become abnormal (the gel has become liquified
or is coming out of the edges of the pad, etc.).
Failure to follow these warnings may cause skin
WARNING burn or insufficient delivery of shock.
Do not use the disposable pads if the gel is dark
brown or dark-brown gel is on the protective sheet.
Use of such pads may cause insufficient delivery of WARNING
shock or skin burn where the pads are attached. Do not use the disposable pads if they are past the
expiration date on the package. Failure to follow
this warning may lead to skin burn or insufficient 7
delivery of shock.
WARNING
Use disposal pads as soon as possible after
opening the package. Failure to follow this warning
may lead to skin burn or insufficient delivery of
WARNING
shock. Do not reuse disposable pads. Failure to follow this
warning may lead to skin burn or insufficient
delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, Do not place heavy objects on the disposable pads
replace them every 24 hours. After 24 hours, the or bend the pads. The pads may become damaged
gel becomes dry and this may reduce performance and deteriorated, resulting in skin burn on the
of the pads. patient.
NOTE • Always have spare disposable pads. Use the spare pads if the
gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
- The color of the gel changes to brownish-red, and brownish
gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with the
protection sheet or if a metal part becomes exposed, be sure to
use a new disposal pads.
Protection
sheet CAUTION
Do not attach a disposable pad over another pad.
It may cause skin burn on the patient.
NOTE • To remove the protection sheet, hold the tab at the cable end
and carefully remove it. If gel is accidentally removed together
with the sheet or a metal part becomes exposed, be sure to use
a new disposal pad.
• To attach the disposable pads to the patient, clean the skin, and
if the patient’s body is wet, thoroughly wipe the moisture off the
skin.
• To attach the disposable pads to the patient, thoroughly wipe
the moisture, oil, and dirt off the skin. Also remove any excess
body hair.
• Do not apply any gel or paste when using the disposable pads.
There are 3 methods for attaching the disposable pads.
Apex-Anterior Placement
This is a basic attachment method.
Front side
Apex-Posterior Placement
This attachment method is not suitable for monitoring or AED analysis.
Anterior-Posterior Placement
This attachment method is not suitable for AED analysis or monitoring.
Screen Example
This is an example of the pacing screen with pacing current of 100 mA and
pacing rate of 80 ppm.
Scale
Pacing mark “ ” Sensitivity
Appears synchronizing with the Lead
pacing pulse output.
Function keys
• [LEAD]
For selecting the ECG lead being
displayed
• [SENSITIVITY]
For selecting the ECG sensitivity
being displayed
• [EVENT] Pacing duration Pacing
For event recording, refer to
“Event Recording” on p. 10-1-8.
2 Start pacing.
1) Press the START/STOP key to start pacing.
“PACING” is displayed on the screen.
NOTE: Pacing is not performed for 3 seconds after the START/
STOP key is pressed.
7
Pacing in progress
Pacing current
Pacing rate
• The step size for pacing current can be set with Pacing Current Steps
on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide “System Setup”.
• Press the PACING RATE key to change the pacing rate.
WARNING
Do not touch the disposable pads or the area
around the pads during pacing. Failure to follow
this warning may cause electrical shock.
CAUTION
Check that the pacing pulse is effective, by
observing the ECG on the screen.
NOTE • The pacing current should be the minimum value for pacing.
• If the pacing current is set to “0 mA”, the PULSE lamp does
not light.
• If the pacing current is set less than “10 mA”, the error
message “Pacing stopped. (pad disconnected)” might not
be displayed. Always check the pacing effect on the screen.
• When the pad-skin contact impedance is high, pacing
may stop and the error message “Pacing stopped. (pad
disconnected)” may appear. To solve this, refer to “Pacing
stopped. (pad disconnected)” (p. 11-7) or “The message
“Pacing stopped (pad disconnected)” appears and pacing
stops before completion.” (p. 11-22).
4 Turn the control dial to the OFF position to turn the defibrillator off.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
Screen Example
This is an example of the pacing screen with pacing current of 100 mA and
pacing rate of 80 ppm.
Heart rate
Function keys
• [LEAD]
For selecting the ECG lead being
displayed
• [SENSITIVITY]
For selecting the ECG sensitivity
being displayed
• [EVENT] Pacing duration Pacing in progress
For event recording, refer to
“Event Recording” on p. 10-1-8.
2 Check that the QRS wave of the spontaneous ECG is detected on the screen.
• Check that the “ ” mark, indicating the detection point of the QRS wave,
is displayed at the rising edge of the QRS wave of spontaneous ECG (the
part corresponding to Q-R) displayed on the screen.
If the position of the “ ” mark is not correct, pacing cannot be performed
correctly. Correct the displayed position of the “ ” mark as follows:
-- Change the amplitude of ECG, using the [SENSITIVITY] key.
-- Change the lead, using the [LEAD] key.
-- Change the attachment site of the ECG electrode.
• Check that the “ ♥ ” mark appears on the screen synchronizing with the
detection of the QRS wave of the spontaneous ECG.
QRS wave detection point “ ”
Check that the mark is displayed at the
QRS sync mark rising edge of every QRS wave.
WARNING
Confirm that there is no artifact on the ECG.
Artifact may be misinterpreted as QRS and correct
pacing cannot be performed.
3 Start pacing.
1) Press the START/STOP key to start pacing.
“PACING” is displayed on the screen.
NOTE: Pacing is not performed for 3 seconds after the START/
STOP key is pressed.
Pacing in progress
Pacing current
Pacing rate
• The step size for pacing current can be set with Pacing Current Steps
on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide “System Setup”.
• Press the PACING RATE key to change the pacing rate.
WARNING
Do not touch the disposable pads or the area
around the pads during pacing. Failure to follow
this warning may cause electrical shock.
WARNING
When performing pacing in a vehicle, such as an
ambulance, confirm that noise due to automobile
vibrations is not misinterpreted as QRS.
CAUTION
Check that the pacing pulse is effective, by
observing the ECG on the screen.
NOTE • The pacing current should be the minimum value for pacing.
• If the pacing current is set to “0 mA”, the PULSE lamp does
not light.
• QRS within 350 ms after pacing pulse output might not be
detected.
• Pacing pulse output stops for 3 seconds if lead or sensitivity
is changed during pacing.
• If the pacing current is set less than “10 mA”, the error
message “Pacing stopped. (pad disconnected)” might not
be displayed. Always check the pacing effect on the screen.
• When the pad-skin contact impedance is high, pacing
may stop and the error message “Pacing stopped. (pad
disconnected)” may appear. To solve this, refer to “Pacing
stopped. (pad disconnected)” (p. 11-7) or “The message
“Pacing stopped (pad disconnected)” appears and pacing
stops before completion.” (p. 11-22).
5 Turn the control dial to the OFF position to turn the defibrillator off.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
Introduction...................................................................8-0-2
Displaying the Monitor Screen .................................................. 8-0-2
Monitor Screen .......................................................................... 8-0-3
Displaying Values Large .......................................................8-0-4
GUIDE Window............................................................8-0-5
8
Displaying the GUIDE Window . ................................................ 8-0-5
Displaying from the SETUP Window ....................................8-0-5 8-1
Displaying when a Technical Alarm is Generated ................8-0-6
8-2
ECG Monitoring .................................................Section 8-1 8-3
Introduction
This defibrillator has various monitoring functions to monitor the patient’s
condition after defibrillation. In addition to ECG measurement (TEC-5611,
TEC-5621, TEC-5631), SpO2 monitoring and CO2 monitoring are also available
when an optional Multi parameter/SpO2 unit is mounted.
Attach the optional ECG electrodes and sensors to the patient, and perform the
ECG monitoring, SpO2 monitoring, CO2 monitoring, and measurements.
When monitoring starts, waveforms and measured values of parameters are
displayed on the monitor screen.
This manual describes measuring procedures and settings for monitoring for each
parameter.
WARNING
Do not diagnose a patient based only on data
acquired by the defibrillator. Overall judgement
must be performed by a physician who
understands the features, limitations and
characteristics of the defibrillator and by reading
the biomedical signals acquired by other
instruments.
WARNING
After attaching electrodes, probes and sensors on
the patient and connecting cables to the
defibrillator, check that there are no error
messages and the waveforms and numeric data
are appropriately displayed on the screen. If there
is an error message, or waveform or numeric data
is not appropriate, check the electrodes, probes
and sensor attachment, patient condition and
settings on the defibrillator and remove the cause.
WARNING
A physician must be within the range where he/she
can hear the alarm sound of the defibrillator while
monitoring a patient on the defibrillator. If the
physician cannot hear the alarm sound, critical
changes on the patient may be overlooked.
Monitor Screen
On the monitor screen, waveforms and measured values for parameters are
displayed.
For details on parameters, refer to the corresponding section.
The measured value for VPC is “---” and the VPC alarm is not generated
if ARRHYTHMIA ANALYSIS in ARRHYTHMIA SETUP in the
SETUP window is set to “OFF”.
Refer to Section 9 “Changing the Settings for Arrhythmia Alarms” (p. 9-15).
NOTE: If the parameter has not been measured correctly, the measured
value is invalid and “---” is displayed. For a parameter whose
measured value is “---”, the upper/lower limit alarms is not
generated.
Value Waveforms (ECG, SpO2, CO2)
Measurement values for Waveforms for parameters are displayed
monitoring and measuring during monitoring.
parameters are displayed.
Remaining battery
Parameter power mark and
AC power mark
8
Sensitivity 8-1
Function keys
• [LEAD]
For selecting the ECG lead being displayed
• [SENSITIVITY]
For selecting the ECG sensitivity being displayed.
• [EVENT]
For event recording (Refer to Section 10-1 “Event Recording” (p. 10-1-8).)
• [FREEZE]
For freezing every waveforms displayed on the monitor screen.
The measured values are not frozen but are updated as usual.
To cancel freezing, perform one of the operations below.
- Press the [UNFREEZE] key.
- Change the lead or sensitivity of the displayed ECG.
- Change the number of traces of the displayed ECG.
- Change the displayed screen.
- Change the parameter to be measured.
• [GUIDE]
The [GUIDE] key is activated if the technical alarm corresponding to
the GUIDE window is generated. Press the [GUIDE] key to display the
GUIDE window. (Refer to p. 8-0-5.)
When the [WAVEFORMS] key is pressed, the normal monitor screen is restored,
and LARGE NUMERICS SETUP is set to “OFF”.
GUIDE Window
The GUIDE window shows the corrective measures for a technical alarm using
instructions and figures.
1 Turn the control dial to the SETUP position to display the SETUP window.
8-3
Introduction
To measure and monitor ECG, attach the disposable electrodes to the patient and
connect them to the ECG socket.
On the monitor screen, ECG from any lead can be displayed. Arrhythmia
analysis can also be performed.
Monitoring using disposable pads instead of disposable electrodes is also
available.
When an optional QS-831V is installed in the defibrillator, the types of
arrhythmia to be detected can be increased.
Refer to “Arrhythmia Analysis” (p. 8-1-27).
Measuring Procedures
Select the electrode lead, ECG connection cord and disposable electrodes.
1 Refer to p. 8-1-5.
8 Check that the dominant QRS is appropriate for the patient. Refer to p. 8-1-10.
Electrode Lead
Symbol Electrode Position
Lead Color Clip Color
L/LA R Red Red-beige
R/RA Right infraclavicular fossa
RA White White-beige
L Yellow Yellow-beige
Left infraclavicular fossa
LA Black Black-beige
F Green Green-beige Lowest rib on the left anterior axillary
LL Red Red-beige line
R/RA L/LA
F/LL
N (RF/RL)
WARNING
Only use Nihon Kohden specified parts and
accessories, such as connection cords, electrodes,
paddles and probes. Otherwise, the defibrillator
may overheat and be damaged, in which case
monitoring will stop or electrical shock may be
caused.
3 electrodes
Type
without
Lead The figure shows the The figure shows the
The figure shows BR-903P. BR-963P.
the Vitrode C.
BR-906P (IEC), BR-906PA (AHA), 0.8 m
BR-916P (IEC),
0.8 m
6 electrodes
BR-926P (IEC),
1.5 m The figure shows the
BR-906P.
Disposable electrodes with DIN-type leads
A DIN type lead has a connector on which no metal part is exposed, for safety. (DIN:
Deutsche Industrie Normenausschuss)
Type
with
Leads
For the type of disposable electrodes, refer to “Paddles and Disposable Pads” (p. 13-4)”.
1
White panels Connect the selected electrode lead to the ECG socket via the
ECG connection cord.
When 3 Electrodes (BR-903P) are Connected 2 Connect the ECG connection cord to the ECG socket on
the left side of the defibrillator.
BR-903P
JC-906P
R F N
L Ca Cb
• For 3 electrodes: R, L, F
• For 6 electrodes: R, L, F, N, Ca, Cb
Vitrode V
JC-906P or JC-916P
WARNING
After attaching the electrode to the patient and
connecting the cable to the defibrillator, check that
electrodes are attached to the patient and check
that the cable is connected to the defibrillator
properly. When the electrodes are removed from
the patient, do not touch the metal part of the
electrode with bare hands or let the metal part of
the electrode contact the metal part of the bed or
any other conductive parts. Failure to follow this
warning may cause electrical shock or injury to the
patient by discharged energy.
CAUTION
When monitoring ECG with disposable pads,
check the polarity of the pads before attaching
them on the patient. If the pad polarity is incorrect,
the waveform appears upside-down and this may
cause incorrect judgment by the operator and
delay of treatment.
CAUTION
When the “Check Electrodes” message is
displayed, ECG is not monitored properly and the
ECG alarm does not function. Check the electrode,
electrode leads and connection cord, and if
necessary, replace with new ones.
CAUTION
When the “Noise” or “Cannot Analyze” message is
displayed, ECG data and alarm are not reliable.
Remove the cause by checking the electrodes,
electrode leads, patient’s body movement, EMG
and peripheral instruments grounding. Also make
sure that an electric blanket is not used.
NOTE: Check that the sync sound is generated when monitoring starts.
If there is no sync sound, check the setting of SYNC SOUND in
VOLUME in the SETUP window and that sync sound is silenced
intentionally.
Screen Example
On the monitor screen, ECG waveforms and values being measured are
displayed.
The sync sound is heard synchronizing with the QRS sync mark.
• Press the [LEAD] or [SENSITIVITY] key to change the setting of the
ECG lead or sensitivity.
• The [GUIDE] key is activated if the technical alarm corresponding to
the GUIDE window is generated. Press the [GUIDE] key to display
the GUIDE window. (Refer to p. 8-0-5.)
VF/VT alarm
If ARRHYTHMIA ANALYSIS is set
Arrhythmia alarm to “OFF” or VF/VT in ARRHYTHMIA
Alarm off mark
Displayed only when an SETUP in the SETUP window is set to
optional QS-831V is installed. “OFF”, the alarm off mark is displayed.
QRS sync
mark If ARRHYTHMIA ANALYSIS
is set to “OFF”, the alarm off QRS detection type
Heart mark is displayed. ECG waveform
Filter setting
rate
Scale
Sensitivity
8
Number of VPCs
The number of VPCs is displayed according to 8-1
Lead
the settings or conditions as described below.
• I f the ECG lead is set to “PAD”, “PADDLE”, or
“AUX”, the number of VPCs is not displayed.
• I f the electrodes are removed or
ARRHYTHMIA ANALYSIS is set to “OFF”,
the measurement value indicating a VPC is
displayed as “---” and the VPC alarm is not
generated.
Function keys
Refer to “Monitor Screen”
(p. 8-0-3).
CAUTION
At the start of ECG monitoring, check that the
dominant QRS is appropriate. Otherwise
arrhythmia monitoring may be inaccurate.
Check that the obtained dominant QRS represents the ECG of the patient
appropriately, following the procedures given below.
NOTE: QRS annotation is printed on delayed recording only. Before
checking the dominant QRS, check that Delayed Recording on
the SYSTEM SETUP screen is set to “On (Default)”.
2 Check that the QRS annotation of ECG is printed correctly on the recording 8
paper.
8-1
If the QRS annotation is not correct, perform ECG learning again.
QRS Annotation
QRS Annotation
Type of QRS annotation and its meaning are as shown below.
QRS
Description
Annotation
Pulse recognized as normal heart rate and the wave with the
N
same waveform
Deformed waveform of pulse recognized as ventricular
V premature contraction (VPC), including ventricular escaped
beat.
P Pulse generated by pacing
Pulse during ECG learning or whose classification is
?
suspended because of noise interference.
- Detected as QRS but recognized as noise but not pulse
CAUTION
If there is any doubt about the arrhythmia analysis,
make the defibrillator relearn the patient’s ECG
and check that the dominant QRS is appropriate.
Otherwise, an important arrhythmia may be
overlooked.
• For ECG learning, keep the patient quiet and check that ECG
with regular rhythm and no noise is observed.
• While the defibrillator is learning an ECG, the message “ECG
LEARNING” is displayed and only the alarms below are
generated.
• ASYSTOLE 1 • VF • BRADYCARDIA 1 • TACHYCARDIA 1
1
Displayed only when an optional QS-831V is installed.
1 Turn the control dial to the SETUP position to display the SETUP window.
2 Learn ECG.
1) Press the [ ] key or [ ] key to select a SETUP menu
item QRS SETUP.
2) Press the [ ] key or [ ] key to select LEARN ECG.
The message is displayed during 3) Press the [OK] key.
learning of an ECG and disappears While the defibrillator is learning an ECG, the message “ECG
when the ECG learning ends.
LEARNING” is displayed in the window and the message disappears
when learning ends.
The monitoring leads setting returns to the default setting 1 minute after the
defibrillator is turned off.
Setting Range
In Monitor Mode
No. of
Lead
Electrodes
3 electrodes Pads or paddles, I, II, III, AUX 1
6 electrodes Pads or Paddles, I, II, III, aVR, aVL, aVF, Ca 2, Cb 2, AUX 1
In Defibrillation Mode
No. of
Lead
Electrodes
3 electrodes Pads or paddles, I, II, III, AUX 1
6 electrodes Pads or Paddles, I, II, III, aVR, aVL, aVF, Ca 2, Cb 2, AUX 1
1
Select the AUX lead if an external monitor is connected, using a JC-831V external ECG
cable.
2
For Ca and Cb, 2 leads among V1 to V6 can be set.
• “Using an ECG from an External Monitor as a Synchronizing
Signal” (p. 6-1-14)
• “Setting the Leads for the Ca and Cb Leads” (p. 8-1-23)
QRS1
P T1 T2
QRS2
Setting Range
The ECG sensitivity setting returns to the default setting 1 minute after the
defibrillator is turned off.
Sensitivity Scale
× 1/4 4 mV
× 1/2 2 mV
×1 1 mV
×2 0.5 mV
×4 0.25 mV
Sensitivity Scale
8
8-1
VPC (/min) Change the upper limit alarm for VPC. 1 to 99, OFF (Default: 10)
4 Turn the control dial to the MONITOR position to display the monitor
screen.
Setting Range
CAUTION
When the alarm limit is set to Off, there will be no
alarm for that limit. Be careful when you set the
alarm limit to Off.
Arrhythmia Alarm
The arrhythmia alarm is set in ARRHYTHMIA SETUP in the SETUP window.
NOTE • Arrhythmia alarms other than VF/VT DETECTED are generated
only when limb leads and chest leads are selected in monitor
mode.
• In pacing mode, the arrhythmia alarm is not generated.
• If VF alarm or VT alarm is generated in monitor mode, it may
not be determined as an ECG that is shockable rhythm in AED
mode.
For details, refer to Section 9 “Alarm Function”.
• “Changing the Settings for Upper/Lower Limit Alarms” (p. 9-13)
• “Changing the Settings for Arrhythmia Alarms” (p. 9-15)
To set the upper or lower limit alarm off, press the [↓] or [↑] key to set a
value outside the setting range. Then the upper limit or lower limit setting
changes to “OFF”.
The cursor is placed on the selected item.
Measurement value
The current measured
value is displayed.
Upper limit
Position
of current
measured
value
Lower limit
Setting Range
In defibrillation mode, AED mode, and pacing mode, the setting for the hum
filter is fixed to “ON”.
Settings:
• ON: Set the hum filter to “ON”.
• OFF: Set the hum filter to “OFF”.
Settings:
• MAXIMUM: D
rift-free filter and high-cut filter. Use this setting when
there is hum noise or ESU is to be used.
• MONITOR: Low-cut filter and high-cut filter.
• DIAGNOSIS: F
or monitoring waveforms similar to the real ECG in
such cases as focusing on the QRS change.
Settings:
• ON: Cascade display
• OFF: No cascade display
Setting Range
Leads set for the Ca and Cb leads are selectable when the lead for monitoring is
to be set.
Setting Range
Settings:
• ON: P
acemaker pulse is detected and distinguished from QRS wave.
It is removed from the heart rate counts.
• OFF: Pacemaker pulse is not detected.
WARNING
Turn the PACING REJECT to On when monitoring 8
a pacemaker patient. Otherwise the pacemaker 8-1
pulse is not rejected. However, even when the
PACING REJECT is set to On, the pacemaker
pulse might not be rejected. When the pacemaker
pulse is not rejected, the pacemaker pulse is
detected as QRS and false heart rate may be
indicated or critical arrhythmia such as asystole
may be overlooked. Keep pacemaker patients
under close observation.
WARNING
Even when the PACING REJECT is set to On, the
pacemaker pulse can be overlooked or detected
as QRS. You cannot confirm the pacemaker
operation only from the detected pacemaker pulse.
CAUTION
At the start of ECG monitoring, check that the
correct patient type is set for [DETECTION TYPE]
on the QRS SETUP window.
If an inappropriate patient type is set, heart rate
cannot be counted accurately and noise or P waves
may be counted as QRS and cardiac arrest may be
overlooked.
The QRS detection type currently set is displayed on the home screen.
Settings:
• ADULT: F
or monitoring an adult.
• CHILD: For monitoring a child.
NOTE • Detection type setting is valid only when the limb/chest lead is
selected in monitor mode. It is not linked with the child mode in
AED mode.
• Even if DETECTION TYPE is set to “CHILD”, a neonate’s QRS
might not be detected correctly.
Arrhythmia Analysis
CAUTION
At the start of ECG monitoring, check that the
dominant QRS is appropriate. Otherwise
arrhythmia monitoring may be inaccurate.
Detection
Message Importance Description Decision Condition
Condition
3 to 10 Longer than 3 to 10 seconds (selectable) with
ASYSTOLE 1 Asystole
seconds no QRS complex.
1
Only when optional arrhythmia analysis software is installed
Introduction
This defibrillator performs CO2 measurement and monitoring with the infrared
absorption method.
The defibrillator supports measurements by sensors of the mainstream method.
Measuring Procedures
Select a CO2 sensor kit.
1 Refer to p. 8-2-3.
2 Refer to p. 8-2-9.
3 Perform zero calibration (single wave spectroscopic method: TG-970P only). Refer to p. 8-2-10.
Connect the CO2 sensor kit to the patient’s respiration circuit or attach it to the patient.
For connecting or attaching the kit, refer to the manual provided with the CO2 sensor kit.
WARNING
When using the airway adapter or nasal adapter
on a patient with low ventilatory volume, the CO2
may mix in the inspiration due to the airway 8
adapter’s dead space, resulting in inaccurate
measured values or difficulty in detecting apnea.
Perform ventilation taking into consideration the 8-2
dead space of the adapters.
CAUTION CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the The CO2 data may be inaccurate when monitoring
measured value may be incorrect when the a patient with an extremely high respiration rate or
operating temperature changes greatly or there is irregular respiration. Read the measured values
excess condensation in the airway adapter or carefully.
nasal adapter.
CAUTION
CAUTION When using an anesthetic instrument with a
Only use Nihon Kohden specified CO2 sensor kit. volatile anesthetic agent, the CO2 measurement
Otherwise, the maximum performance from the may be inaccurate.
defibrillator cannot be guaranteed.
Warning and caution differ depending on the CO2 sensor kit to be used. Refer to
the manual provided with the kit to be used.
NOTE • For tracheal cannulation, attach the CO2 sensor so that it does
not touch the patient.
• Use the TG-970P CO2 sensor kit inside a healthcare facility.
Otherwise, the measurement data may be incorrect by strong
electromagnetic interference.
Dead
When the TG-900 Series CO2 Sensor Tracheal Airway Adapter or Patient Reference
Space
Kit is Attached Cannulation Nasal Adapter (Weight) Page
Volume
YG-120T nasal adapter
Inspiration Zero Balance Adjustment Method (Semi-quantitative Method)
7 kg or
YG-111T airway adapter 4 mL
more
Measurement Method
Straight type
tracheal tube 10 kg or
TG-900P YG-101T airway adapter 5 mL p. 8-2-7
more
Used
Elbow type
tracheal tube
Method (Quantitative Method)
7 kg or
Single Wave Spectroscopic
YG-213T neonatal/infant
TG-970P 2 to 7 kg 0.5 mL p. 8-2-8
airway adapter
YG-214T neonatal/infant
2.5 to 7 kg 1.8 mL
airway adapter
For purchasing the CO2 sensor kit, refer to “For CO2 Monitoring” (p. 13-6)”.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 When measuring CO2 partial pressure of a patient
partial pressure of a patient connected to a with an oxygen mask, set the oxygen supply to
Jackson Rees, Mapleson D or any other 5 L/min or more. If CO2 gas remains in the oxygen
respiration circuit where CO2 gas may be present mask and mixes with the inspired air, the
during inspiration. The semi-quantitative method measured value may be lower than the actual
measures CO2 partial pressure based on the value.
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired CAUTION
air contains CO2 gas, the measured CO2 value
With the TG-900P or TG-920P CO2 sensor kit, the
may be lower than the actual value.
measured value may be incorrect when the
operating temperature changes greatly or there is
8
excess condensation in the airway adapter or
CAUTION nasal adapter.
The TG-900P and TG-920P CO2 sensor kits do not 8-2
adjust the measurement value to compensate for
different atmospheric pressure. Be careful when
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value
may be inaccurate.
Sensor
TG-121T CO2 sensor
Dead
Supply
Type Weight Space
Code
Volume
YG-120T V921
10 kg or
YG-121T 1.2mL V922
more
YG-122T V923
JP-920P CO2 adapter When the patient is intubated: Use the airway adapter.
YG-111T
Dead
Supply
Type Weight Space
Code
Volume
7 kg or
YG-111T 4mL R804
more
WARNING WARNING
The only oxygen cannula that can be used with • When you use YG-122T together with an oxygen
YG-122T is manufactured by HUDSON RCI®. Do cannula, check that the oxygen cannula is
not use any other oxygen cannula. Other oxygen correctly attached on the patient by referring to
cannulas cannot be attached and oxygen cannot other parameters and by observing the patient
be delivered to the patient through the nostrils. periodically.
• If arterial oxygen saturation does not increase,
immediately stop using the oxygen cannula with
WARNING the CO2 sensor kit and select another way to
supply oxygen.
Check that the oxygen cannula tube is not bent,
broken, or blocked by the nasal tube. If the ends of
the oxygen cannula tube turn too far up or down, it
causes insufficient O2 supply or the CO2 value may
be incorrect.
CAUTION
When using the YG-121T or YG-122T nasal
adapter on a patient with bleeding disorder, poor
general medical condition or malnutrition, observe
the patient condition all the time. The mouth guide
touches the mouth and may cause pressure sores.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 With the TG-900P or TG-920P CO2 sensor kit, the
partial pressure of a patient connected to a measured value may be incorrect when the
Jackson Rees, Mapleson D or any other operating temperature changes greatly or there is
respiration circuit where CO2 gas may be present excess condensation in the airway adapter or
during inspiration. The semi-quantitative method nasal adapter.
measures CO2 partial pressure based on the
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired
air contains CO2 gas, the measured CO2 value
may be lower than the actual value.
CAUTION
The TG-900P and TG-920P CO2 sensor kits do not
adjust the measurement value to compensate for
8
different atmospheric pressure. Be careful when
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value 8-2
may be inaccurate.
CAUTION
With the TG-970P CO2 sensor kit, measured value
may be incorrect when the operating temperature
changes greatly. In this case, wait for about 30
minutes to acquire correct measurement.
TG-970P CO2 Sensor Kit When the patient is intubated: Use the airway adapter.
This kit is combined with a sensor for measuring CO2 and Three types of adapters are provided for the weight and
a measurement circuit. ventilation air volume of the patient.
YG-211T YG-214T
YG-213T
Dead
Supply
JG-970P CO2 adapter Type Patient Weight Space
Code
Volume
YG-211T ― 7 kg or more 4 mL R805
TG-221T
CO2 sensor
8-2
Zero Calibration
Zero calibration can be performed in two ways: calibration with air and
calibration with N2 gas.
Zero calibration is performed in CO2 SETUP in the SETUP window.
Calibration method (AIR or N2) can be set in CO2 SETUP in CALIBRATION
METHOD.
Calibration with N2
Flow N2 gas into the airway adapter for zero calibration.
The method for flowing N2 gas into the airway adapter differs depending on the
type of gas cylinder. Refer to the manual provided with the N2 gas cylinder.
Calibrating by Air
Expose the airway adapter to air for zero calibration.
1 Expose the airway adapter mounted to the CO2 sensor kit to air.
2 Turn the control dial to the SETUP position to display the SETUP window.
8-2
4 Turn the control dial to the MONITOR position to display the monitor
screen.
After zero calibration, return the airway adapter to the respiration circuit.
The defibrillator is set to the CO2 measurement mode and starts CO2
monitoring.
1 Connect the airway adapter mounted to the CO2 sensor kit to the N2 gas
cylinder.
2 Turn the control dial to the SETUP position to display the SETUP window.
3) Flow the N2 gas from the N2 gas cylinder to the airway adapter then press
Displayed during calibrating.
the [OK] key.
During calibrating, “ZERO CALIBRATING” is displayed. When
calibration is completed, the message disappears and there is a “BING
bong” sound.
4 Turn the control dial to the MONITOR position to display the monitor
screen.
After zero calibration, return the airway adapter to the respiration circuit.
The defibrillator is set to the CO2 measurement mode and starts CO2
monitoring.
CAUTION
When the “Adapter Failure” or “Sensor Failure”
message is displayed, check the CO2 sensor kit
and replace it if necessary. CO2 cannot be
monitored while the message is displayed.
Notes on Measurement
CAUTION 8
The TG-900P and TG-920P CO2 sensor kits do not
adjust the measurement value to compensate for
different atmospheric pressure. Be careful when 8-2
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for 5.33 kPa
(40 mmHg) CO2 gas when an atmospheric pressure drops 3.3 kPa.
NOTE • The defibrillator automatically calibrates the sensor at periodic
intervals.
• In the following cases, calibration of the sensor is performed
automatically:
- Upon defibrillation power-on and the patient’s first respiration.
- When the airway adapter is removed and connected again.
- When respiration has stopped for 20 seconds.
- When the signal changed rapidly due to temperature change.
• During calibration, the CO2 waveform appears as a stepwise
calibrated waveform, but the respiration rate and measurement
value are not affected.
CAUTION
When using an anesthetic instrument with a
volatile anesthetic agent, the CO2 measurement
may be inaccurate.
Condition: At 1 atmospheric pressure, 5% (38 mmHg, 5.1 kPa) CO2 and N2
mixture dry gas
Screen Example
On the monitor screen, the measurement value (ETCO2 and respiration rate) and
CO2 waveform are displayed.
• The sweep speed of the displayed CO2 waveform can be set with CO2
Sweep Speed on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide: “System Setup”
• The [GUIDE] key is activated if the technical alarm corresponding
to the GUIDE window is generated. To display the GUIDE window,
press the [GUIDE] key. (Refer to p. 8-0-5.)
Ending tidal
CO2 partial
pressure value Alarm off
(ETCO2) mark
Respiration
Rate (RR)
Function keys
Refer to “Monitor Screen”
(p. 8-0-3). CO2 waveform Scale of CO2
waveform
8-2
1
The unit can be set in Pressure Units on the SYSTEM SETUP screen.
4 Turn the control dial to the MONITOR position to display the monitor
screen.
Setting Range
CAUTION
When the alarm limit is set to Off, there will be no
alarm for that limit. Be careful when you set the
alarm limit to Off.
Position of current
measured value
Lower limit
Setting Range
Item Setting Range
1
The units can be set in Pressure Units on the SYSTEM SETUP screen.
Settings:
• AIR: Expose the airway adapter to air for zero calibration.
• N2: Flow N2 gas into the airway adapter for zero calibration.
Settings:
• mmHg display: 0-20, 0-40, 0-80
• kPa display: 0.0-2.5, 0.0-5.5, 0.0-10.5
Measurement Method
The infrared absorption method has two methods (mainstream method and
sidestream method), depending on the expiration sampling method. On this
defibrillator, CO2 is measured with the mainstream method, which measures
CO2 by directly connecting the sensor to the respiration circuit or the patient’s
nasal cavity or mouth.
Infrared Absorption Method
CO2 gas absorbs infrared of 4.3 μm. Using this characteristic, the
infrared absorption method measures CO2 partial pressure.
Principles
The CO2 sensor kit of the mainstream method is classified into the two types as
described below, based on the infrared absorption method.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 When measuring CO2 partial pressure of a patient
partial pressure of a patient connected to a with an oxygen mask, set the oxygen supply to
Jackson Rees, Mapleson D or any other 5 L/min or more. If CO2 gas remains in the oxygen
respiration circuit where CO2 gas may be present mask and mixes with the inspired air, the
during inspiration. The semi-quantitative method measured value may be lower than the actual
measures CO2 partial pressure based on the value.
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired
air contains CO2 gas, the measured CO2 value
may be lower than the actual value. 8
0
Error (mmHg)
10
15
20
25
CO2 mixed in inspiration
1 mmHg
2 mmHg
4 mmHg
8 mmHg
Introduction...................................................................8-3-2
Measuring Procedures .............................................................. 8-3-3
Selecting a Probe.........................................................8-3-4
Types of Probes ........................................................................ 8-3-4
Reusable Probes . .................................................................8-3-4
Disposable Probes ................................................................8-3-5 8
Connecting the Probe to the Defibrillator.....................8-3-6
Attaching the Probe to the Patient................................8-3-6
Starting Measurement (Start of Monitoring).................8-3-7 8-3
Screen Example ........................................................................ 8-3-7
Changing SpO2 Settings...............................................8-3-8
SpO2 Setting Window . ..........................................................8-3-8
Setup Item List .......................................................................... 8-3-8
Displaying the SpO2 Setting Window ........................................ 8-3-9
Changing Alarm Settings............................................8-3-10
Setting Range ..................................................................... 8-3-10
Changing Alarm Settings...........................................................8-3-11
Changing Settings for Monitoring...............................8-3-12
Setting Range ..................................................................... 8-3-12
Changing the Items ................................................................. 8-3-12
Setting the Sync Source to SpO2 ........................................ 8-3-13
Setting the Sync Tone to SpO2 ........................................... 8-3-13
Setting the Pulse Wave Sensitivity ..................................... 8-3-14
Setting the Sensitivity for Measuring the SpO2 Value ......... 8-3-14
8. Monitoring
Introduction
To monitor SpO2, attach a probe to the patient and connect it via the SpO2 socket.
Then measure the pulse wave and SpO2 value.
WARNING WARNING
• When using the TL-201T finger probe, do not SpO2 measurement may be incorrect in the
fasten the probe and cable to the finger by following cases.
wrapping with tape. This may cause burn, • When the patient’s carboxyhemoglobin or
congestion or pressure necrosis from poor blood methemoglobin increases abnormally.
circulation. • When dye is injected in the blood.
• When using probes other than the TL-201T finger • When using an electrosurgical unit.
probe, to avoid poor circulation, do not wrap the • During CPR.
tape too tight. Check the blood circulation • When measuring at a site with venous pulse.
condition by observing the skin color and • When there is body movement.
congestion at the skin peripheral to the probe • When the pulse wave is small (insufficient
attachment site. Even for short-term monitoring, peripheral circulation).
there may be burn or pressure necrosis from
poor blood circulation, especially on neonates or
low birth weight infants whose skin is delicate.
WARNING
Accurate measurement cannot be performed on
When not monitoring SpO2, disconnect the SpO2
a site with poor peripheral circulation.
connection cord from the input unit. Otherwise,
noise from the probe sensor may interfere and
incorrect data is displayed on the screen.
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse WARNING
waveform. Change the measurement site every 8
When monitoring SpO2 of a patient who is
hours for disposable probes and every 4 hours for
receiving photodynamic therapy, the light from the
reusable probes (every 8 hours for TL-630T3 or
finger probe sensor may cause a burn.
TL-631T3 probe). The skin temperature may
Photodynamic therapy uses a photosensitizing
increase at the attached site by 2 or 3°C (4 or 5°F)
agent that has a side effect of photosensitivity.
and cause a burn or pressure necrosis. When
using the probe on the following patients, take
extreme care and change the measurement site The SpO2 probe has two wavelengths with peaks in the range of
650 nm and 950 nm. The maximum light intensity is less than
more frequently according to symptoms and 5.5 mW/sr.
degree.
• Patient with a fever
• Patient with peripheral circulation insufficiency
CAUTION
• Neonate or low birth weight infant with delicate Turn off the power of mobile phones, small
skin wireless devices and other devices which produce
strong electromagnetic interference around a
patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as
CAUTION mobile phones or small wireless devices may be
While a patient is on medication which causes mistaken as pulse waves and the displayed data
vasodilation, the pulse waveform may change and may be incorrect.
in rare cases the SpO2 value might not be
displayed.
CAUTION
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring
site with a blanket.
Measuring Procedures
Select the probe.
1 Refer to p. 8-3-4.
2 Refer to p. 8-3-6.
8
3 Refer to p. 8-3-6.
8-3
Start measurement (start of monitoring).
4 When the procedures above are completed, the defibrillator is set to SpO2 measuring state and
monitoring starts.
Refer to p. 8-3-7.
Selecting a Probe
Select the appropriate probe according to the purpose.
WARNING
Only use Nihon Kohden specified parts and
accessories, such as connection cords, electrodes,
paddles and probes. Otherwise, the defibrillator
may overheat and be damaged, in which case
monitoring will stop or electrical shock may be
caused.
Types of Probes
Reusable Probes
Model Patient (Weight) Attachment Site SpO2 Connection Cord
Finger Probe TL-201T JL-900P
Adults, children
(20 kg or more)
Neonates
Instep and sole
(3 kg or less)
Disposable Probes
Model Patient (Weight) Attachment Site SpO2 Connection Cord
TL-271T (0.8 m), TL-271T3 (1.6 m) JL-900P
Adults
(30 kg or more)
Finger or toe
TL-272T (0.8 m), TL-272T3 (1.6 m)
Children
(from 10 to 50 kg)
Neonates
Instep and sole
(3 kg or less)
Instep Type L
Neonates
and attachment
The attachment tape type S or L depends (3 kg or less)
sole tape
on the patient.
TL-051S (0.8 m), TL-052S (1.6 m)
Adults
Finger
(50 kg or more)
40 mm Neonates
Instep and sole
(3 kg or less)
35 mm Children, infants
Toe
(from 3 to 15 kg)
For purchasing a probe and SpO2 connection cord, refer to “For SpO2
Monitoring” (p. 13-7)”.
Stopper
When the TL-201T Finger Probe is Connected 3 Connect the SpO2 connection cord to the SpO2 socket.
TL-201T
CAUTION CAUTION
When the probe is attached on an appropriate site When a message indicates a faulty probe or faulty
with sufficient circulation and an error message SpO2 connection cord, stop monitoring and replace
about probe attachment repeatedly appears, the the probe or SpO2 connection cord with a new one.
probe may be deteriorated. Replace it with a new
one.
CAUTION
If the attachment site is dirty with blood or bodily
fluids, clean the attachment site before attaching
the probe. If there is nail polish on the attachment
site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
performed.
8
NOTE • Keep the measurement site warm by covering with a blanket
or something similar. Especially for a patient with small pulse
amplitude, warming the site is effective.
• Check that there is a sync sound when starting monitoring. If
there is no sync sound, check the setting of SYNC SOUND in 8-3
VOLUME in the SETUP window and if sync sound is silenced
intentionally.
Section 5 “VOLUME” (p. 5-11)
Screen Example
On the monitor screen, the SpO2 value and pulse waveform are displayed.
• The sweep speed of the displayed SpO2 waveform can be set with ECG Sweep
Speed on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide: “System Setup”
• The [GUIDE] key is activated if the technical alarm corresponding to the
GUIDE window is generated. To display the GUIDE window, press the
[GUIDE] key. (Refer to p. 8-0-5.)
Alarm off
mark
SpO2 value
SENSITIVITY Set the pulse-wave sensitivity. AUTO, ×1/8, ×1/4, ×1/2, ×1, ×2, ×4, ×8
SENSITIVITY MODE Set the sensitivity for measuring the SpO2 value. MAX, NORMAL
8
1) Select a SETUP menu item. 2) Select an item. 3) [OK]
Setting Range
1
The PR (Pulse Rate) alarm can be set when SYNC SOURCE is set to “SpO2”.
The HR/PR alarm can also be set in the setting window shown below.
The settings are linked so that the setting changed in one of the
windows is reflected to other windows.
• ECG SETUP in the SETUP window
CAUTION
When the alarm limit is set to Off, there will be no
alarm for that limit. Be careful when you set the
alarm limit to Off.
To set the upper or lower limit alarm off, press the [↓] or [↑] key to set a
value outside the setting range. Then the upper limit or lower limit setting
changes to “OFF”.
The cursor is placed on the selected item.
8
Measurement value
The current measured
value is displayed.
Upper limit
8-3
Position of
current
measured value
Lower limit
Setting Range
Item Setting Range
SYNC
ECG, SpO2
SOURCE
SYNC TONE FIXED, SpO2
Settings:
• ECG: Synchronized with the QRS.
• SpO2: S
ynchronized with the SpO2 pulse wave. The pulse sync mark
blinks synchronizing with the SpO2 pulse.
NOTE • If noise may be mixed in with the ECG because of the use of
ESU, set SYNC SOURCE to “SpO2”. If it is set to “ECG”, the
measurement for heart rate will be unstable and synchronization
and pulse rate might not be obtained correctly.
• When IABP is used, the SpO2 pulse wave will be irregular. In
8
such a case, set SYNC SOURCE to “ECG”.
• If SpO2 is not measured, it is synchronized with the ECG.
• If the connection cord is disconnected when SpO2 is selected, the sync
source is changed to ECG. When the connection cord is connected
again, the original sync source is restored.
8-3
• When SYNC SOURCE is set to ECG and the defibrillator power is
turned on or the screen is changed to another screen, the sync source
may temporarily change to SpO2 until the heart rate is displayed.
Settings:
• FIXED: The pitch is fixed.
• SpO2: T
he pitch changes in 20 steps from high to low for change in
SpO2 value between 100% SpO2 and 81% SpO2.
• W hen SYNC TONE is set to “SpO2” and the measuring conditions are
as described below, the sound pitch is fixed to the pitch for 81% SpO2.
- When the measurement value is below 81% SpO2.
- W hen SYNC SOURCE is set to “ECG” and the measured value of
SpO2 is not displayed.
• W hen SYNC SOURCE is set to SpO2 and the message “SpO2 CHECK
PROBE” or “DETECTING PULSE” is displayed on the home screen,
the sync sound stops.
Settings:
• NORMAL: Usually set to “NORMAL”.
• MAX: A
small pulse or irregular pulse can easily be measured. When
monitoring a patient with peripheral circulation insufficiency or
when an IABP is used, it is recommended to set to “MAX”.
NOTE: When “MAX” is selected, the SpO2 value may appear even when
When MAX is selected, “SENS the probe is not attached to the patient.
MAX” appears on the left of the
SpO2 value display.
Introduction......................................................................9-2
Types of Alarm................................................................................9-2
Alarm Levels...................................................................................9-3
Defibrillator’s Operation when an Alarm is Generated...................9-4
Priority of Alarms............................................................................9-5
Alarm Sound and Alarm Indicator............................................. 9-5
Messages on the Screen.......................................................... 9-5
Alarm Control Marks.......................................................................9-5
Alarm Recording............................................................9-17
9. Alarm Function
Introduction
Alarms inform you of abnormal measurement data of a parameter (exceeding
upper or lower limits), arrhythmia, or abnormal defibrillator condition. Alarms
are shown by screen message, sound, and blinking or lighting of the alarm
indicator.
WARNING WARNING
Do not diagnose a patient based only on alarm A physician must be within the range where he/she
information of the defibrillator. If the alarm is set to can hear the alarm sound of the defibrillator while
off, critical changes in the patient may be over- monitoring a patient on the defibrillator. If the
looked. physician cannot hear the alarm sound, critical
changes on the patient may be overlooked.
WARNING
If more than one medical equipment is used WARNING
together in the same facility, make sure all Check the alarm settings when you start monitor-
equipments have the same alarm default settings ing a new patient. Check the alarm settings as
(alarm master). If the medical equipments have required during monitoring and change them
different alarm default settings and when initialized, appropriately according to the patient’s condition.
the alarm settings differ with the other equipments The alarm settings return to those specified in
and alarm cannot be managed appropriately in the Alarm Setting on the SYSTEM SETUP screen
facility. If using different alarm default settings about 30 minutes after power-off.
according to areas or wings in the facility, manage
the alarms appropriately.
WARNING
Set the alarm sound volume according to the place
WARNING where the defibrillator is used. If the alarm sound is
When an alarm occurs: too quiet, keep the patient under close observation
• Check the patient first and take necessary and periodically check the defibrillator. Otherwise,
measure to ensure patient’s safety. the alarm sound might not be heard and critical
• Remove the cause of the alarm. changes on the patient or problems in the
• Check the alarm settings on the defibrillator and defibrillator may be overlooked.
change the alarm settings if necessary.
Types of Alarm
Alarms provided with this defibrillator are divided into three categories, as
indicated below.
The places where alarm messages are displayed vary, depending on the type of
alarm.
Apart from the alarms, various informational messages on the
measurement environment and current status of the defibrillator are
also displayed.
Upper/lower limit
alarm
(Measurement value
highlighted)
Arrhythmia alarm
message
Technical alarm
messages/information
regarding measurement
of each parameter
Operation guidance
and technical alarm
messages/information
regarding each mode
Alarm Levels
There are three alarm levels, depending on their urgency.
According to these levels, priorities are set for alarm generation and behavior of
the defibrillator when an alarm is generated.
Level Description
Patient is in critical condition or the defibrillator is in failure
CRISIS and the patient’s life may be at risk without immediate
High
action.
↑
Patient is in critical condition, the defibrillator is in failure,
Priority WARNING or operations are not appropriate. Prompt action should be
taken.
↓
Patient is in abnormal condition, the defibrillator is in
Low
ADVISORY failure, or the conditions for accurate measurement or
treatment cannot be met.
Message displayed
Level Alarm sound Alarm indicator Alarm recording 2
on the screen
Blinking in red
Blinking in yellow
Recording
IEC alarm sound 1 automatically starts
WARNING Highlighted in yellow
“ceg” when an alarm is
generated.
Lit in cyan
IEC alarm sound 1
ADVISORY “ec” (at intervals of Highlighted in cyan
20 seconds)
(IEC).
Automatic recording is performed when the Alarm Recording setting on the
2
Priority of Alarms
If multiple alarms are generated simultaneously, the defibrillator operates as
described below.
9
Alarm
Description Display example
control mark
To be displayed when a current alarm is silenced or when all mark
alarm sounds and blinking/lighting of the alarm indicator are
suspended beforehand.
The remaining suspension time is also displayed.
To be displayed when alarm sounds and blinking/lighting of mark
the alarm indicator for vital alarms and technical alarms other
than those for ECG are suspended during manual defibrillation
or synchronized cardioversion
Alarm sound and the color of the blinking/lit alarm indicator are different,
depending on the level of the generated alarm.
Refer to “Defibrillator’s Operation when an Alarm is Generated” (p. 9-4).
VPC ADVISORY
APNEA WARNING
Arrhythmia Alarms
An arrhythmia alarm is generated when arrhythmia is detected.
If an arrhythmia alarm is generated, the corresponding alarm message is
highlighted in the color corresponding to the level of the alarm.
Alarm sound and the color of the blinking/lit alarm indicator are different
depending on the level of the generated alarm.
Refer to “Defibrillator’s Operation when an Alarm is Generated” (p. 9-4).
Arrhythmia alarms are retained for a given time after arrhythmia disappears. The
alarm retention time varies, depending on the level of the alarm:
• CRISIS: 30 seconds
• WARNING: 20 seconds
• ADVISORY: 10 seconds
WARNING
For arrhythmia monitoring, set [ARRHYTHMIA
ANALYSIS] on the ARRHYTHMIA SETUP to ON.
Otherwise, there is no sound or indication for
arrhythmia alarms (except for Asystole).
VF
CRISIS
VT
VF/VT DETECTED
VPC RUN 1
TACHYCARDIA 1 WARNING
BRADYCARDIA 1
1
To be displayed only when an optional QS-831V is installed.
Technical Alarms
Technical alarms include alarms regarding the measurement environment for the
patient and the defibrillator itself.
If a technical alarm is generated, the corresponding alarm message is highlighted
in the color corresponding to the level of the alarm.
Alarm sound and the color of the blinking/lit alarm indicator vary,
depending on the level of the generated alarm.
Refer to “Defibrillator’s Operation when an Alarm is Generated” (p. 9-4).
Screen Example
Various technical alarm messages are displayed in the upper part of the screen and in the upper part of the measurement value
area of each parameter in the color corresponding to the level of the alarm.
Technical alarm messages
Technical alarm messages regarding the defibrillator regarding the measurement
environment of ECG
Technical alarm
messages regarding
all the parameters
being measured and
ECG measurement
Technical alarm
messages regarding
measurement of each
parameter
Technical alarm
messages
regarding each
mode
Information Display
Apart from the alarms, various informational messages on the measurement
environment and the current status of the defibrillator are also displayed on the
screen of the defibrillator.
• W hen there are technical alarms and two or more information occur at
the same time, the message are displayed alternately.
• No alarm sound nor blinking/lighting of the alarm indicator
acccompanies informational messages.
Screen Example
Various messages are displayed and highlighted in the same place as with technical alarm messages.
Upper/lower limit
Type of alarms Technical
and arrhythmia
Silencing alarms Silent/Unlit Alarm clear
Operation during
(The alarm is silenced for 2 minutes.) (The alarm indicator is unlit and alarm (The alarm is
silencing
sound is silenced.) cleared.)
Alarm sound To be silenced for 2 minutes To be silenced
Alarm indicator To be unlit for 2 minutes To be unlit
Alarm message To remain displayed with highlighted To be deleted
Clearing alarm When the cause of an alarm is removed during silencing, the alarm status is cleared and the
status highlighted message/measurement value disappears.
―
• An alarm other than the silenced alarm is • An alarm other than the silenced alarm is
generated. generated.
Conditions where • The cause of the current alarm has not been • The cause of the current alarm was
an alarm is removed after the suspension time has removed once but is generated again.
generated again elapsed.
• The cause of the current alarm was removed
once but is generated again.
As long as another alarm was not generated,
press the silence alarms key again during
Resuming the
silencing. ―
silenced alarm
Alarm sound and blinking/lighting of the
alarm indicator are resumed.
WARNING
During alarm suspension (“ALL ALARMS
SUSPENDED” or “ALL ALARMS OFF” message
displayed), all alarms are turned off. Be careful
when you suspend the alarm.
When the defibrillator enters defibrillation mode, the message “ VITAL AND
TECHNICAL ALARMS OFF” is displayed in the upper part of the screen.
Message
Arrhythmia Alarms
The arrhythmia alarm settings can be changed for each type of arrhythmias. If an
optional QS-831V is installed, the ON/OFF setting for arrhythmia analysis can
also be changed.
Alarm Setting
on the SYSTEM Alarm settings
SETUP screen
The latest alarm settings are retained, regardless of the elapsed
Latest
time after the defibrillator is turned off.
All alarm settings are reset to the default settings 30 minutes
Default
after the defibrillator is turned off.
All alarm settings return to the user default (alarm master)
settings in “ALARM SETTING LIST” 30 minutes after the
User Settings defibrillator is turned off.
When an optional QS-831V is installed, arrhythmia analysis is
set to “ON”.
NOTE: If the self test is performed less than 30 minutes after the
defibrillator power was turned off, the alarm settings change
according to the Alarm Setting on the SYSTEM SETUP screen 30
minutes after completion of the self test.
CAUTION
When the alarm limit is set to Off, there will be no
alarm for that limit. Be careful when you set the
alarm limit to Off.
Setting Range
Alarm item Upper limit Lower limit Step Unit
HR: bpm
HR/PR 35 to 300, OFF OFF, 30 to 295 1
PR: /min
VPC 1 to 99, OFF ― 1 /min
SpO2 51 to 100, OFF OFF, 50 to 99 1 %SpO2
ALARM SETUP 1
APNEA 5 to 40, OFF ― 5 s
2 to 99, OFF OFF, 1 to 98 1 mmHg2
ETCO2
1.0 to 13.5, OFF OFF, 0.5 to 13.0 0.5 kPa 2
RR 2 to 150, OFF OFF, 0 to 148 2 /min
1
You can also change the upper/lower limit alarm settings in the SETUP
window for each parameter. Any changes in the settings in either of the SETUP
windows will be reflected to the settings in the other window. (The settings in
both SETUP windows are linked to each other.) 9
Section 8 “Monitoring”
The units can be changed in the Pressure Units setting on the SYSTEM SETUP
2
screen.
1 Turn the control dial to the SETUP position to display the SETUP window.
To set the upper/lower limit alarm to “OFF”, press the [↓] key or [↑] key
until a value higher or lower than the setting range is reached. The upper/
lower limit setting changes to “OFF”.
The cursor is placed on the selected item.
WARNING
For arrhythmia monitoring, set [ARRHYTHMIA
ANALYSIS] on the ARRHYTHMIA SETUP to ON.
Otherwise, there is no sound or indication for
arrhythmia alarms (except for Asystole).
CAUTION
When the alarm is turned Off for an arrhythmia,
there will be no alarm for that arrhythmia type.
There is no message or mark to indicate that a
certain arrhythmia alarm is turned off. Therefore,
be careful when you turn off an arrhythmia alarm.
9
Setting Range
1
Available only when an optional QS-831V is installed.
1 Turn the control dial to the SETUP position to display the SETUP window.
Alarm Recording
If the Alarm Recording setting on the SYSTEM SETUP screen is set to “On”,
the measurement value for each parameter and ECG are automatically recorded
when an upper/lower limit alarm or arrhythmia alarm is generated.
Introduction.................................................................10-0-2
10
10-1
10-2
10-3
10. Recording and Data Storing
Introduction
TEC-5611, TEC-5621 and TEC-5631 have a built-in recorder. The defibrillator
can record data and print reports.
TEC-5601 does not have a built-in recorder and cannot print reports,
but can display them in the report window.
If the specified SD card is inserted in the SD card slot on the right side panel
of the defibrillator, data on items being measured (waveform data, various
information, and sound) and waveform reports saved in the internal memory of
the defibrillator can be saved in the SD card.
You can set whether to save sound with Save Audio Together with ECG
on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide: “System Setup”
Introduction
TEC-5611, TEC-5621 and TEC-5631 have a built-in recorder which can print
monitored data and reports.
TEC-5601 does not have a built-in recorder and cannot print reports,
but it can display them in the report window.
NOTE • If the mode is changed with the control dial during recording or
report printng, recording and printing automatically stop. After
changing the mode, perform recording again.
• Long term recording in high temperature may cause lack of
printing. To prevent data loss, insert the SD card to save the
waveforms in the SD card when recording data for a long time.
Recording
The defibrillator has two recording modes: manual and automatic. In manual
recording mode, recording starts when the RECORD key is pressed. In automatic
recording mode, recording starts automatically upon charging or when an alarm
occurs.
Recording Mode Recorded Data Length of Recording Start Recording Stop Recording
Waveform Waveform in the window 1
Continuous from when the
Recording (Real time or delayed) RECORD key is pressed until the
Manual Recording
Recording on ECG waveform before and after From the start of charging to 6 or Charging starts
charging after discharge 12 seconds (set on the SYSTEM
discharge SETUP screen) after discharge
Automatic Recording
1
The waveform to be recorded can be set on RECORDING SETUP in the
SETUP window.
Report Recording
The defibrillator automatically saves reports for measurement parameters and
ECG waveforms (upon defibrillation or alarm generation) into the internal
memory.
Reports can be monitored and recorded in the corresponding report window.
If Pressure Units on the SYSTEM SETUP screen is changed, the reports shown
below are deleted.
• Trendgraph
• Periodic list report
Capacity of
Report Recording
Recorded Data Length of Recording Recorded Start/Stop Recording
Mode
Data 1
Defibrillation ECG waveform at discharge and 22 seconds • Start
Report 3 defibrillation information From 10 seconds before to 12 Press the RECORD
seconds after discharge key.
VF Analysis ECG waveform for VF analysis 15 to 22 seconds
Waveform Report
1
There is a limit to the storage capacity for recorded data. The table above is a
rough guide for the maximum amount of data.
2
A maximum of 2,000 seconds of all waveform reports can be stored in the
internal memory of the defibrillator. If the total duration of data exceeds 2,000
seconds, the oldest record is automatically be deleted.
3
ne report is created for continuous defibrillations within a 2-minute period.
O
But a second report is created from the seventh defibrillations or, if there are
many event informations of the defibrillation report such as VF analysis start in
the 2-minute period.
Recording Setting
You can change the recording setting in RECORDING SETUP in the SETUP
window.
Available Settings
Item Description (Default)
Sets the recording interval for
INTERVAL OFF, FREE, 15 min, 30 min, 60 min, 120 min
periodic recording.
RECORDING
SETUP RECORDING Sets the combination of
ECG, ECG+SPO2, ECG+CO2
WAVES waveforms to be recorded.
Changing Settings
1 Turn the control dial to the SETUP position to display the SETUP window.
Settings:
• OFF (default): Periodic recording is not performed.
• FREE: Periodic recording is performed at the interval set in Periodic
10
Recording Interval on the SYSTEM SETUP screen. (1 to 120
minutes) 10-1
The first periodic recording is based on the time you change the
setting.
For example, if you change the FREE setting to “15 min” at 9:22 in
the morning, the first interval starts at 9:37 (15 minutes later).
Example:
• If you change the INTERVAL setting to “15 min” at 9:22 in the
morning, the first interval starts at 9:30.
9:30 → 9:45 → 10:00.
• If you change the INTERVAL setting to “120 min” at 9:22 in the
morning, the first interval starts at 10:00.
10:00 → 12:00 → 14:00.
Recording Waves
Setting Upper Part of Lower Part of
Recording Paper Recording Paper
ECG Only ECG (lead) is recorded.
ECG+SpO2 SpO2 pulse wave
ECG (lead)
ECG+CO2 CO2 waveform
40 mmHg
10 mm
0 mmHg
5 mm
Displayed scale
Manual Recording
The manual recording functions include the waveform recording and event
recording. To perform either of the functions, press the corresponding key.
Waveform Recording
Waveforms displayed on the screen are recorded continuously.
Besides the waveform, the patient’s ID number, the day, time, lead, and
sensitivity are also printed.
If the [EVENT] key is pressed during recording, the event mark is
printed.
Printing speed can be set with Paper Speed (mm/s) on the SYSTEM SETUP
screen.
If Delayed Recording is set to “On” on the SYSTEM SETUP screen, the
waveform from 4 seconds before the record/stop key is pressed is recorded.
Starting Recording
Press the record/stop key to start recording.
10
If the charge recording function is activated during recording
10-1
The mode is switched to the charge recording mode. (Refer to p. 10-1-9.)
Stopping Recording
Press the record/stop key during recording to stop recording.
Recording Example
Event Recording
Press the [EVENT] key to record the waveforms of 12 seconds (from 4 seconds
before to 8 seconds after the key is pressed).
NOTE: For event recording, set Event Recording on the SYSTEM
SETUP screen to “On”.
Administrator’s Guide: “System Setup”
Starting Recording
Press the [EVENT] key to start recording.
When the [EVENT] key is pressed, the ECG waveform of 20 seconds (from 10
seconds before to 10 second after the key is pressed) is stored in the internal
memory as the event waveform report.
If the charge recording function is activated during recording
The mode is switched to the charge recording mode. (Refer to p. 10-1-9.)
Stopping Recording
Recording automatically stops after 12 seconds.
You can also stop recording anytime by pressing
the record/stop key.
[MEDICATION] keys
Recording Example
Event mark
Displayed at the point where the [EVENT] key has been pressed.
If a [MEDICATION] key is pressed, the assigned medication name is also recorded.
Automatic Recording
Automatic recording includes charge recording, alarm recording, and periodic
recording. Recording starts according to set conditions.
For safety, the defibrillator internally discharges charged energy when the charge
holding time has passed and the charge recording function stops.
The charge holding time is set in Charge Holding Time on the SYSTEM SETUP
screen. (Default value: 40 seconds)
Refer to the Administrator’s Guide: “System Setup”
If the charge recording function is activated during recording
The mode is switched to the charge recording mode.
If discharging is performed again during the auto recording
The ECG waveform of 12 or 6 seconds after the last discharge is recorded.
Stopping Recording
Recording stops automatically 12 or 6 seconds after discharging.
You can also stop recording anytime by 10
pressing the record/stop key.
10-1
Recording Example
Alarm Recording
If an alarm (upper/lower limit alarm or defibrillation alarm) occurs, the
12-second waveform from 4 seconds before to 8 seconds after the alarm is
recorded automatically.
You can print the event on the recording by pressing the [EVENT] key
during recording.
Stopping Recording
Recording automatically stops after 12 seconds.
You can also stop recording anytime by
pressing the record/stop key.
Periodic Recording
12 seconds of waveforms are automatically recorded at the preset interval.
Waveforms are recorded from 4 seconds before to 8 seconds after the recording
start time.
The same items as waveform recording are recorded.
You can print the event on the recording by pressing the [EVENT] key
during recording.
Printing speed can be set with Paper Speed (mm/s) on the SYSTEM SETUP
screen.
Stopping Recording
Recording automatically stops after 12 seconds.
You can also stop recording anytime by
pressing the record/stop key.
10
Recording Example
10-1
Report Settings
You can change settings for reports in REPORT SETUP in the SETUP window.
Available Settings
Item Description (Default)
Sets the measurement interval for the periodic list 1 min, 5 min, 15 min, 30 min,
INTERVAL
report. 60 min
Deletes all report data stored in the internal
DELETE ALL REPORTS NO, YES
memory.
Changing Settings
1 Turn the control dial to the SETUP position to display the SETUP window.
Setting Interval
Set the measurement interval for the periodic list report.
Measured data of the parameter being monitored are stored in internal memory
of the defibrillator at the preset intervals.
1) Press the [↓] key or [↑] key to set DELETE ALL REPORTS to “Yes”.
NOTE: Until all report data are deleted, do not perform any other
operations, such as changing a window. If any operation is
performed before all reports are deleted, new reports may not
be recorded.
Report Recording
Display and check the reports stored in internal memory of the defibrillator then
record them.
The TEC-5601 does not have a built-in recorder and cannot print
reports but can display them in the report window for you to check.
Waveform Report
Display the SAVE REPORT window and check and record the reports.
For Displaying the Window
1) Select REPORT SETUP in the SETUP window.
2) Select SAVE REPORT then press the [OK] key.
“Changing Settings” (p. 10-1-12)
In the SAVE REPORT window, the waveform reports stored in internal memory
of the defibrillator are displayed, as shown below.
Starting Recording
Select a waveform report to be recorded in the SAVE REPORT LIST window or
display the SAVE REPORT WAVEFORMS window and press the record/stop
key.
Stopping Recording
10
Recording stops automatically. 10-1
TRENDGRAPH
Display and check the TRENDGRAPH window and record the reports.
For Displaying the Window
1) Select REPORT SETUP in the SETUP window.
2) Select TRENDGRAPH then press the [OK] key.
“Changing Settings” (p. 10-1-12)
In the TRENDGRAPH window, the graph for the measured value of the
parameter being monitored is displayed (up to 24 hours).
The displayed parameter is highlighted.
Scale
Function keys
• [PARAMETER]
For selecting the parameter to be
displayed.
• [1 HOUR]
For changing the displayed
duration
(1 HOUR, 2 HOURS,
4 HOURS, 8 HOURS,
24 HOURS)
• [←SCROLL], [SCROLL→]
For scrolling the trendgraph
horizontally.
Range of the displayed trendgraph against the time axis
• [MENU]
For returning to the SETUP Time axis: 24 hours
window.
Starting Recording
Display the TRENDGRAPH window and press the record/stop key.
NOTE • During recording, never press the [1 HOUR] key. If the
displayed time axis is changed during recording, the trendgraph
cannot be recorded correctly.
• All parameters are recorded.
Stopping Recording
Recording stops automatically.
Pressing the record/stop key during recording also stops recording.
Maximum
Average
Minimum
In the PERIODIC LIST window, the list of the measured values of the
parameters being monitored is displayed (up to 120 parameters).
The interval to save measured values to the list can be set with INTERVAL in the
SETUP window.
Function keys
• [←SCROLL], [SCROLL→]
For scrolling the list
horizontally.
• [MENU]
For returning to the SETUP
window.
10
Range of the displayed list against the whole list 10-1
Whole list
Starting Recording
Display the measurement date and time to start recording on the left in the
PERIODIC LIST window and press the record/stop key.
The measurement values from the measurement date and time displayed on the
left in the window to the latest are recorded.
Stopping Recording
Recording stops automatically.
Pressing the record/stop key during recording also stops recording.
Recording Example
NOTE: If the report is displayed in ELAPSED LAP, the elapsed time is not
displayed when the elapsed time between events exceeds 1 hour.
Function keys
• [EVENT↓], [EVENT↑]
For selecting an event.
• [SET REF EVENT], [REF
EVENT OFF]
For setting the selected event to
the reference event or clearing the
setting.
• [ELAPSED TIME], [CLOCK
TIME]
For changing the display type of
the list
• [MENU]
For returning to the SETUP [▲], [▼]
window. Displayed when there are more than 6 events.
Press the [EVEMT↓] or [EVENT↑] key to scroll
the list.
Starting Recording
Display the EVENT LIST window then press the record/stop key.
Stopping Recording
Recording stops automatically.
Pressing the record/stop key during recording also stops recording.
Examples of Recording
Event Description
Power On The defibrillator power was turned on.
Power Off The defibrillator power was turned off.
Charging Start Charging started.
Charging Complete Charging was complete.
Discharge XXXJ Discharge in manual mode was performed with XXXJ.
Synchronized Cardioversion XXXJ Discharge in synchronous mode was performed with XXXJ.
Internal Paddles: Over 50J For using the internal paddles, the output energy was set over 70J.
Internal Discharge (cause of internal discharge) Discharge was performed to inside of the defibrillator.
VF/VT Analysis Start An AED analysis started by pressing the CHARGE/AED button.
Shock Needed The ECG that required discharge was detected.
Shock Not Needed The ECG that required discharge was not detected.
Heart Rhythm Changed Heart rhythm was changed.
VF/VT Analysis Canceled VF/VT analysis was canceled. 10
VF/VT Detected VF or VT was detected.
10-1
Alarm HR start *XXX HR alarm started at XXX bpm.
HR alarm stopped (alarm peak: XXX bpm).
Alarm HR Stop Peak *XXX If an alarm was changed to an upper/lower alarm while the alarm is on, the
peak value of the latest alarm is recorded.
ARRHYTHMIA Alarm Arrhythmia Arrhythmia alarm was generated.
VPC Alarm start * XXX VPC alarm started at XXX/min.
VPC Alarm Stop Peak * XXX VPC alarm stopped (alarm peak: XXX/min).
Fixed Pacing Start (XXXppm, XXXmA) Fixed pacing (XXX ppm, XXX mA) was started.
Demand Pacing Start (XXXppm, XXXmA) Demand pacing (XXX ppm, XXX mA) was started.
Pacing Stop (XXXppm, XXXmA) Pacing (XXX ppm, XXX mA) was stopped.
Event Key Pressed The [EVENT] key was pressed.
Medication 1 to 5 Either of [MEDICATION1] to [MEDICATION5] key was pressed.
ECG Electrode Off ECG electrode was disconnected.
ECG Electrode Set ECG electrode was connected.
Disposable Pads Off Disposable pads were removed.
Dispo Pads Attached Disposable pads were attached.
External Paddles Connected External paddles were connected.
Internal Paddles (without SHOCK Button)
Internal paddles were connected.
Connected
Internal Paddles (with SHOCK Button) Connected Internal paddles with the shock button were connected.
Event Description
Paddles/pads Connector Off The paddles/pads connector was disconnected.
Alarm Suspended An alarm was suspended.
CO2 Zero Calibration Zero calibration for parameters was performed.
Parameter Not Available A connection cord for a parameter which cannot be measured was connected.
Timer Start Timer in AED mode was started.
Timer Stop Timer in AED mode was stopped.
Waveform Freeze Waveform was frozen.
ECG Learning Start ECG learning started.
ECG Learning Stop ECG learning stopped.
AED Adult Mode The defibrillator entered the AED mode for adult.
AED Child Mode The defibrillator entered the AED mode for child.
SpO2 Message Alarm messages and information for measurement conditions of parameters
CO2 Message were displayed.
CANNOT ANALYZE HR calculation and arrhythmia analysis were not able to be performed.
ECG NOISE Noise was added to an ECG.
1
These settings can be set on the SYSTEM SETUP screen.
Administrator’s Guide: “System Setup”
2
These settings can be set in the SETUP window.
Section 5 “Setup Windows”
3
hen an alarm is generated, “*” is printed before the measurement value.
W
(Example: HR: * 200)
Introduction.................................................................10-2-2
SD Cards....................................................................10-2-2
Formatting an SD Card ........................................................... 10-2-2
Inserting/Removing an SD Card ............................................. 10-2-3
Inserting an SD Card .......................................................... 10-2-3
Removing an SD Card ........................................................ 10-2-3
Introduction
The TEC-5600 series can save the data on measurements (waveform data,
defibrillation information, event information, sound) and the waveform report in
an SD card (QM-001D or QM-002D SD memory card).
You can set whether to save sound with Save Audio Together with ECG
on the SYSTEM SETUP screen.
Refer to Administrator’s Guide: “System Setup”
SD card QI-832V
(QM-001D or QM-002D SD memory card) Bluetooth® module
For details on installing the QI-832V Bluetooth® module to the defibrillator, refer
to the manual provided with the QI-832V.
SD Cards
NOTE: Also refer to Section 3 “SD Cards”.
Formatting an SD Card
An SD card can be formatted with Format SD Card on the SYSTEM SETUP
screen.
When an SD card is formatted, all data saved in the SD card are deleted.
Inserting/Removing an SD Card
Inserting an SD Card
SD card cover Insert the SD card into the SD card slot on the right side panel of the defibrillator.
NOTE: Do not insert an unspecified SD card into the SD card slot.
1 Open the SD card cover on the right side panel of the defibrillator.
SD card slot SD card 2 Insert the connector side of the SD card into the SC card slot on the right
side panel of the defibrillator until it clicks and is locked.
Face the label side of the card toward the rear panel of the defibrillator.
Removing an SD Card
10
CAUTION
Before removing an SD card, turn the defibrillator
10-2
off. If the SD is removed while the power is on,
data in the SD card may be lost or static electricity
may make it impossible to write data to the card.
1 Turn the control dial to the OFF position to turn the defibrillator off.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
2 Open the SD card cover on the right side panel of the defibrillator.
SD card SD card cover 3 Push the inserted SD card farther inside and withdraw your finger. The
inserted SD card will be ejected.
NOTE: If the inserted SD card is forcibly pulled, the SD card and SD
card slot may be damaged. Be sure to remove the SD card
following the procedures above.
NOTE • If the power is turned off within 30 seconds after turning it on,
any data accumulated during such a period is not saved.
• If the waveform information (measurement parameter, lead,
sensitivity, etc.) is changed, data 30 seconds after the change is
updated.
• If the battery is discharged and the defibrillator is automatically
turned off, the latest measurement data of maximum
30 seconds may not be saved.
Saved Data
Data listed below are saved in an SD card.
1
I f Save Audio Together with ECG on the SYSTEM SETUP screen is set to
“On”, waveforms are saved with sound. The playback sound may be distorted if
the microphone was too close to the sound source.
Administrator’s Guide: “System Setup”
2) The “Do not remove SD card” message is displayed until the SD card
is recognized. Once it is recognized, the free space for the SD card is
displayed in %.
NOTE: Do not remove the SD card while the message is
displayed. If it is removed, the data may be damaged.
10
File name
The file name for the waveform report
saved in the SD card is displayed.
10-2
Message
Sending Data
If the optional QI-832V Bluetooth® module is installed in the defibrillator, you
can set the connection device and send the waveform reports saved in internal
memory via wireless communication.
If Self-test Result Auto-transfer on the SYSTEM SETUP screen is set to “On”,
the test results is automatically sent to the destination device for auto-save after
performing the self-test, via wireless communication.
NOTE: The Self-test Result Auto-transfer function is currently not
available because a compatible device is not available yet.
• Section 12 “Self Tests” (p.12-23)
• Administrator’s Guide: “System Setup”
Make note
of the PIN
CODE.
5) If entry of the PIN CODE is requested on the destination device, enter the
PIN CODE noted in step 1).
10
10-2
The selected item is highlighted.
1) Select an item.
FILE FORMAT
Change settings for the format of the file to be sent.
Press the [←] key or [→] key to change settings.
Settings:
• DAT: For sending the data to a PC.
To reference the data on the destination device, decoding is not
required.
• JPG (Default): For sending the data using a cellular phone.
To reference the data on the destination device, decoding is
required.
6 Press the [MENU] key to close the SELECT DEVICE window and return to
the SETUP window.
1 Turn the control dial to the SETUP position to display the SETUP window.
3 Perform pairing.
10-2
1) Press the [ITEM] key to select PAIRING.
2) Press the [↓] key or [↑] key to select YES to start pairing.
4 Press the [MENU] key to close the SELF TEST SETUP window and return
to the SETUP window.
1 Turn the control dial to the SETUP position to display the SETUP window.
1) [CHANGE DESTINATION]
2) On the destination device, check that the waveform report has been
properly received.
6 Press the [MENU] key to close the SEND REPORT window and return to
the SETUP window.
10
10-2
Introduction.................................................................10-3-2
Transferring Data........................................................10-3-4
10
10-3
10. Recording and Data Storing
Introduction
Waveforms and numerical data measured with the defibrillator can be wirelessly
sent to a bedside monitor which has a QI-670P interface. This is called transport
function.
To send data, install an optional QI-832V Bluetooth® module into the
defibrillator, insert an SD card, and set the Enable Transport setting in the
SYSTEM SETUP items to “On”.
• Administrator’s Guide: “System Setup”
• For installing the QI-832V Bluetooth® module in the defibrillator,
refer to the installation guide of the QI-832V Bluetooth® module.
QI-670P
The data are transferred by
Bluetooth® communication.
Waveform Data
The waveform data extracted from the data on measurements that are saved in an
SD card are sent to the bedside monitor.
10
Trend Data
The defibrillator extracts the maximum, minimum, and average values of every
1 minute of the trendgraphs saved in the defibrillator internal memory and sends
the values to the bedside monitor. 10-3
Each file contains 1 minute of trend data.
Transferring Data
Display the DATA SEND window to transfer the data to the destination monitor.
NOTE • After data is sent to a monitor, the data can only be re-sent to
the same monitor.
• If the date and time of the defibrillator are changed, data from
before the date and time change cannot be transferred.
• A patient’s condition cannot be monitored in the DATA SEND
window. Start monitoring the patient on the destination monitor
before transferring the data.
• Before transferring the data, admit a patient to the destination
monitor. If admitting the patient after data transfer, the
transferred data is deleted.
10
10-3
4 If there are two or more records of turning the power on within 2 hours, the
window for selecting the transfer data appears. Press the [↓] or [↑] key to
select a start time of the data to be transferred and press the [OK] key.
If there is only one record of turning the power on within 2 hours, the
window for selecting transfer data does not appear.
• To change the destination monitor, press the [DESTINATION MONITOR]
key to return to the DESTINATION MONITOR window, wait for
5 seconds, and select a destination monitor.
• If Type of Sent Data on the SYSTEM SETUP screen is set to “Confirm”,
the “Send waveforms?” message is displayed. Press the [Yes] or [No] key
to select the sending data.
- [Yes]: All data including the waveform data are sent.
- [NO]: Only the numerical values are sent.
Refer to Administrator’s Guide: “System Setup”
NOTE • END TIME of DATA RANGE is the time when the DATA
SEND window is displayed.
• The list does not display power-on times from more than
2 hours ago. Power-on times from more than 2 hours ago
are listed as being 2 hours ago.
• To avoid mixing up data, the operator of the defibrillator
should select the data for DATA RANGE.
The selected destination monitor is highlighted.
[▲], [▼]
Displayed when there
are more than
5 records of turning
the power on.
Press the [↓] or [↑]
key to scroll the list.
NOTE: Before sending the data, confirm with the physician that the
transferring data are correct.
6 When the data is sent, the “Sending data complete.” message appears.
If Confirmation to Delete Data after Sent on the SYSTEM SETUP
screen is set to “On”, the “Delete sent waveforms?” message is
displayed. To delete the waveform, press the [Yes] key. Not to delete it,
press the [No] key.
Refer to Administrator’s Guide: “System Setup” 10
10-3
7 Turn the control dial to the “OFF” position to turn the defibrillator off.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
Troubleshooting........................................................... 11-20
General.......................................................................................11-20
Defibrillation................................................................................11-22 11
Pacing........................................................................................11-22
Individual Parameter Measurements..........................................11-23
Electrocardiogram (ECG)....................................................... 11-23
CO2 . ...................................................................................... 11-24
SpO2 ...................................................................................... 11-25
Recording...................................................................................11-26
Battery........................................................................................11-27
SD Card......................................................................................11-27
Transport....................................................................................11-27
11. Messages and Troubleshooting
Screen Messages
The messages displayed on the screen are listed by type in the following tables.
For error messages, the causes and required actions are described. After taking
the required action, confirm that the error message is cleared and the defibrillator
operates properly before further usage.
NOTE: If the message does not disappear after the following actions,
attach a “Repair request” or “Unusable” label to the defibrillator
and contact your Nihon Kohden representative.
The technical alarm messages are highlighted on the screen in the respective
colors correspond to their priority.
Technical alarm
message/information
on all parameters
being measured and
ECG measurement
Technical alarm
message/information
on individual parameter
measurements
Technical alarm
message/
information on
operation modes
Saving data and shutting The power was turned off by setting the
down. Do not touch the control dial to OFF.
AC power cord.
S — —
Saving data. DATA SEND The power was turned off by setting the
screen will appear after control dial to OFF before starting data
restart. transport.
Messages on the Defibrillator The technical alarm messages and information on the defibrillator
are displayed in the area depicted below.
ERROR Axxx Faulty defibrillation circuit Set the control dial to OFF. Then turn on
the defibrillator again and do the same
ERROR Cxxx Communication error
operation that you did when the error
ERROR Dxxx Error in the stored set values or the sum message appeared.
Crisis values in the program If the error message still appears,
Other error immediately turn off the power
ERROR Exxx
and contact your Nihon Kohden
ERROR Kxxx Faulty key unit representative.
E
ERROR Pxxx Faulty pacing circuit “xxx” indicates an error code.
Errors detected in self Defibrillator errors were detected in the Confirm the latest self-test results in the
test. self tests. system setup and take a necessary action.
(Refer to the Administrator’s Guide:
—
“Latest Self-Test”.)
For details on the self tests, refer to “Self
Tests” (p. 12-23).
HV MONITOR ERROR Error inside the defibrillator Set the control dial to OFF. Then turn on
the defibrillator again and do the same
operation that you did when the error
message appeared.
H Crisis
If the error message still appears,
immediately turn off the power
and contact your Nihon Kohden
representative.
INSERT BATTERY PACK No battery when the defibrillator was Install a battery pack.
I Advisory
turned on.
NO REPORT DATA The record key was pressed when there Confirm the report to be recorded.
was no report data.
—
NOW OPERATING ON The defibrillator was switched to AC
N
AC POWER power operation.
—
NOW OPERATING ON The defibrillator was switched to battery
BATTERY power operation.
Advisory Out of recording paper Set the specified recording paper.
OUT OF PAPER
The recorder door is open. Press the recorder door until it clicks.
OVERHEATING Electrical shock is repeated within a short Set the control dial to OFF to turn off the
period. defibrillator and leave it at least for
10 minutes. In an emergency, you can use
O
the defibrillator even when this message
is displayed.
Warning If the error message still appears even
30 minutes have elapsed, immediately
stop using the defibrillator and contact
your Nihon Kohden representative.
RELAY DRIVE ERROR Faulty HV unit Contact your Nihon Kohden
representative.
R
REPLACE BATTERY An error occurred when charging the
Crisis —
PACK battery.
VITAL AND TECHNICAL The alarm sound and alarm indicator
ALARMS OFF blinking/lighting for vital alarms and
V — —
measurement environmental alarms
generated in defibrillation are suspended.
Technical alarm
message/
information of
operation modes
ADULT MODE AED in adult mode is selected. To change to child mode, once set the
control dial to a position other than AED,
Adult mode. Stay calm. —
then set it to AED again while pressing
Follow voice instructions.
the CHILD MODE button.
A
Always check if pacing Pacing is continued for an unusually long Confirm the screen indications and the
Advisory
pulse effective. time. condition of the patient.
Analyzing heart rhythm. The defibrillator started AED analysis
—
Do not touch patient. (VF/VT analysis).
Battery empty. Connect — The battery remaining is 0 in AED mode. Replace the battery with another
B AC power. sufficiently charged battery, or connect
an AC power.
Cannot perform sync A paddle/pad-lead ECG is selected Select an appropriate lead. Refer
cardioversion. Select for the sync signal for synchronized to Section 6-3 “Synchronized
ECG lead. Advisory cardioversion with SYNC BY PADDLE Cardioversion” (p. 6-3-1)).
set to “OFF” in the PADDLE SETUP
window.
CHARGED Charging is complete.
11
CHARGING The defibrillator is now charging energy
for electrical shock.
—
Charging complete Charging is complete.
Charging. The defibrillator is now charging energy
C — for electrical shock.
Check pad cable The defibrillator was set to AED mode If this message appears when the
connection to defibrillator. before attaching the disposable pads to the disposable pads are attached to the
patient. patient, check that the connection
between the pads and the defibrillator. If
the cable is properly connected, replace
the disposable pads or the pad adapter.
CHECK PADS The paddle contact of a disposable pad
Advisory has been in open status for more than the
specified period. —
Check skin contact and Disposable pads became detached during
—
cable connection. AED.
Messages on Operation Modes The technical alarm messages and information on operation modes are
displayed in the area depicted below.
Message
display
area
CHILD MODE AED in child mode is selected. To change to adult mode, once set the
control dial to a position other than AED,
Child mode. Stay calm.
then set it to AED again without pressing
Follow voice instructions.
the CHILD MODE button.
If patient is an adult, set
the control dial to AED
—
without pressing the
CHILD MODE button.
Confirm that patient is The defibrillator was set to AED mode
not responding and is not before attaching the disposable pads to the —
breathing. patient.
CONNECT PADDLES/ No paddle/pad is connected to the paddle Connect the paddles or disposable pads.
PADS connector in defibrillation mode.
C The paddle/pad lead was selected in
monitor mode when paddles or disposable
pads were not connected to the paddle
Advisory connector.
CONNECT PADS The defibrillator was set to pacing or Use the disposable pads in pacing or
AED mode when the external paddles or AED mode.
internal paddles were connected.
No paddle/pad is connected to the paddle Connect the disposable pads.
connector in pacing or AED mode.
Continue CPR. Performing CPR
Could not analyze heart — Noise was detected in AED analysis (VF/ —
rhythm. VT analysis).
Defibrillator error. Use An error defibrillation occurred, Set the control dial to OFF. Then turn
another defibrillator. preventing defibrillation. on the defibrillator and do the same
operation that you did when the error
Crisis message appeared. If the error message
still appears, immediately turn off the
power and contact your Nihon Kohden
representative.
Defibrillator not working. A defibrillator error was detected. Contact your Nihon Kohden
Do not use defibrillator. representative.
Start CPR.
D
DEMAND PACING Demand pacing mode is selected.
Do 5 more chest CPR in AED mode ends after 5 more
compressions. Do not chest compressions.
—
touch patient.
Do not touch patient. Immediately before starting AED analysis —
(VF/VT analysis) in AED mode
Do not touch patient. Defibrillation in AED mode is enabled.
Press the flashing
SHOCK button.
ENERGY WAS NOT There is more than the specified amount
Confirm the status of the paddles or
DELIVERED TO PATIENT Advisory of residual charge remaining in the HV
E disposable pads.
condenser after shock was delivered.
Enter password again. An incorrect password was entered. Enter the correct password.
—
F FIXED PACING Operating in fixed pacing mode. —
Messages on Operation Modes The technical alarm messages and information on operation modes are
displayed in the area depicted below.
Message
display
area
ARRHYTHMIA ANALYSIS The paddle-lead ECG is displayed. Arrhythmia analysis is not performed
OFF for paddle-lead ECG.
The defibrillator is in pacing mode. Arrhythmia analysis is not performed in
pacing mode.
ARRHYTHMIA ANALYSIS Refer to “Changing the Settings for
is set to “OFF” in the ECG Arrhythmia Alarms” (p. 9-15).
A — In SETUP window.
monitor An AUX- or pad-lead ECG is
mode displayed with the VF/VT alarm
set to “OFF”.
—
The defibrillator is in defibrillation mode
with the VF/VT alarm set to “OFF”.
CANNOT ANALYZE Noise interference continues for more Remove noise.
than 30 seconds and heart rate cannot
C Warning
be counted and arrhythmia cannot be
analyzed.
ECG LEARNING ECG LEARN was performed in the ECG Refer to “Relearning ECG (LEARN
SETUP window. ECG)” (p. 8-1-12).
Immediately after power is turned on
The lead for monitoring was changed
(except the paddle/pad and AUX leads).
Recovered from CHECK ELECTRODES
status after continuing for a specified time. 11
ECG NOISE 1
The electrodes are not stable due to Change the electrode sites to reduce
respiration or body movement. movement.
EMG noise is superimposed. Change the electrode sites to where
there is less muscle (e.g. over the ribs).
Warm the patient or reduce tension of
the patient.
E —
The electrode is pulled by the lead. Put some slack into the electrode lead.
The electrode gel is dry. The electrode is Replace the electrode with a new one.
not fitted to the patient.
The contact of an electrode lead clip is poor. Clean the electrode lead clip.
High electrode impedance Rub the skin with “skinPure” skin
preparation gel.
An electric blanket (without a countermeasure Shield the blanket with a cover.
for electromagnetic induction) is used.
Noise due to ESU Refer to “Use with an Electrosurgical
Unit” (p. 3-7).
The defibrillator and/or peripheral devices Ground the devices properly.
are not properly grounded.
FREEZE 1 MIN The [FREEZE] key was pressed and the Press the [UNFREEZE] key to cancel
waveform on the screen is frozen. The frozen status.
F FREEZE 2 MIN — time shows the remaining time of the
FREEZE 3 MIN frozen status.
1
When the message is displayed, the [GUIDE] key is enabled. Press the
[GUIDE] key to display the GUIDE window.
CHANGE ELECTRODES The ECG electrodes are deteriorated. Replace the electrodes with new ones.
CHANGE PADS The disposable pads are deteriorated. Replace the pads with new ones.
CHECK Ca ELECTRODE 1 The electrode referred to became detached Firmly attach the electrode to the
from the patient. patient.
CHECK Cb ELECTRODE 1
CHECK CHEST Multiple electrodes became detached
ELECTRODES 1 from the patient’s chest.
CHECK ELECTRODES 1 An electrode became detached from the
patient.
The ECG connection cord or external Firmly connect the ECG connection
ECG cable was disconnected from the cord or external ECG cable to the
ECG socket. ECG socket.
The electrode lead was disconnected from Firmly connect the electrode lead to
the electrode. the electrode.
C The electrode cannot be attached firmly to Replace the electrode with a new one.
the patient.
The electrode lead was disconnected from Firmly connect the electrode lead to
the ECG connection cord. the ECG connection cord.
Loose connection between the electrode Replace the electrode lead.
Advisory
and the electrode lead clip
Electrode lead discontinuity
CHECK PADS The paddle contact of a disposable pad Firmly attach the disposal pads to the
has been in open status for more than the patient.
specified period.
CONNECT PADDLES/ No paddle/pad is connected to the paddle Connect the paddles or disposable 11
PADS connector in defibrillation mode. pads.
The paddle/pad lead was selected in
monitor mode when no paddle/pad was
connected to the paddle connector.
F (LL) LEAD OFF 1 The electrode referred to became detached Firmly connect the electrode to the
F
from the patient. patient.
L (LA) LEAD OFF 1 The electrode referred to became de
L
tached from the patient.
R (RA) LEAD OFF 1 The electrode referred to became detached
R
from the patient.
USE DISPOSABLE PADS The defibrillator was set to pacing or AED
Use disposable pads in pacing or AED
U mode with the external paddles or internal
mode.
paddles connected.
When the message is displayed, the [GUIDE] key is enabled. Press the
1
CO2
Message Priority Possible Cause/Problem Action
When the message is displayed, the [GUIDE] key is enabled. Press the
1
SpO2
Message Priority Possible Cause/Problem Action
CHECK PROBE 1
The probe became detached from the Check the probe attachment and remove
patient. the cause.
When the The probe was Firmly connect the probe to the SpO2
baseline is disconnected from connection cord.
displayed the SpO2 connection
cord.
Loose contact of the
connector
Probe discontinuity Replace the probe with a new one.
When pulses are The probe is attached Attach the probe to the site specified in
displayed to an inappropriate the operator’s manual of the probe.
site.
Probe deterioration Replace the probe with a new one.
Advisory
CHECK PROBE SITE 1 Probe site not proper. Attach the probe to the site specified in
the operator’s manual of the probe.
Probe deterioration Replace the probe with a new one.
CONNECTOR OFF 1
The SpO2 connection cord was removed The message is cleared by pressing the
from the SpO2 socket. silence alarms key
The SpO2 connection cord was Firmly connect the SpO2 connection
disconnected from the SpO2 socket. cord to the SpO2 socket.
The SpO2 connection cord is damaged. Replace the SpO2 connection cord.
CORD The probe was disconnected from the Firmly connect the probe to the SpO2
DISCONNECTED 1 SpO2 connection cord. connection cord.
Loose contact of the connector
11
Probe discontinuity Replace the probe with a new one.
DETECTING PULSE The defibrillator is searching for correct Wait until the pulse waveform is
pulse waveform. detected.
SpO2 value cannot be measured because Check the probe attachment and remove
D —
of unstable pulse waveform. the cause.
The probe became detached from the
patient.
LIGHT INTERFERENCE 1
The measurement site is affected by light Cover the probe site with a blanket to
such as a surgical light, bilirubin light or block ambient light, preventing noise
fluorescent light. from being superimposed on the pulses.
LOW QUALITY SIGNAL 1 Too poor peripheral circulation to Check the patient condition and remove
measure SpO2 the cause by loosening the probe
attachment or changing the attachment
site.
The probe is attached too tightly and is Reattach the probe.
L Advisory
obstructing the blood circulation.
The probe became detached from the Check the probe attachment.
patient.
One of the following messages is Refer to the respective screen message
displayed for 30 seconds. sections and remove the cause.
• LIGHT INTERFERENCE
• CHECK PROBE SITE
• DETECTING PULSE
“M” mark (unstable Considerable body movement If this message appears frequently,
measurement condition) check the patient and probe attachment
— Unstable probe attachment
condition. Reattach the probe to the
M patient if necessary.
P Warning Faulty SpO2 connection cord Replace the SpO2 connection cord.
Faulty probe Replace the probe. If the error message
still appears after probe replacement,
replace the SpO2 connection cord.
WEAK PULSE 1 Poor peripheral circulation Check the patient condition and change
the attachment site.
W —
The probe is attached too tightly and is Check the probe attachment.
obstructing the blood circulation.
1
When the message is displayed, the [GUIDE] key is enabled. Press the
[GUIDE] key to display the GUIDE window.
Data Storage
The messages displayed when storing a waveform report on the SD card are
listed in the table below.
Data Transmission
When the optional QI-832V Bluetooth® module is installed, the messages listed
below are displayed in the device search window or data send window while you
are setting the destination device or sending data. 11
“Sending Data” (p. 10-2-7)
Bluetooth connection lost. Connection was lost during data Confirm the destination device.
transmission via Bluetooth®.
B Bluetooth device already — Tried to save the device that has been
registered. Rewrite already registered in the BLUETOOTH —
device? SETUP window.
canceled.
Canceling. Destination device search was canceled.
Checking PIN code. The defibrillator started checking the PIN —
code.
Connecting to Bluetooth Connection with the destination device
device. via Bluetooth® is established.
Connection error. An error other than a PIN code error Confirm the destination device.
occurred during service searching via
Bluetooth®.
C Could not access A connection error occurred in data
—
destination. transmission.
Could not find destination. An error occurred for one of the following Confirm the destination device.
reasons during service searching via
Bluetooth®.
• Bluetooth connection is not established
on the destination device.
• PIN code entry was canceled on the
destination device.
• PIN code entered on the destination
device was not correct.
Could not find device. No device was found in device search.
Device search error. The destination device sent back an error
— code during device search.
D
An error occurred during device search
via Bluetooth®.
PIN code error. An incorrect PIN code was entered. Confirm the PIN code.
P Profile unavailable. The profile setting on the defibrillator is Confirm the profile setting available for
not available for the destination device in the destination device.
Bluetooth® communication.
Searching for Bluetooth Searching for the destination device to
device. send data.
Searching. The defibrillator started searching the
destination device to send data via
Bluetooth®. —
S
Sending complete. Sending data via Bluetooth® is complete.
Sending data. Data transmission via Bluetooth® has
been started.
Sending error. Could not A connection error occurred during data Confirm the destination device.
access destination. transmission via Bluetooth®.
The defibrillator is busy. Data transmission was canceled. When you cancel sending a report,
Retry after a minute. the “Retry after a minute” message
is displayed for approx. 30 seconds,
T
disabling resending.
Wait for more than 30 seconds to restart
data transmission.
Transport
When the optional QI-832V Bluetooth® module is installed, the messages listed
below are displayed in the DATA SEND window while sending data to the
bedside monitor.
N
No data to send. There is no report data to send. Confirm the waveform report stored in 11
the SD card.
Profile unavailable. The profile setting on the defibrillator is Confirm the profile setting available for
P not available for the destination device in the destination device.
Bluetooth® communication.
Sending data. Data transport via Bluetooth® has been
started. —
S Sending data complete. Sending data via Bluetooth® is complete.
Sending error. Search and send errors occurred during Confirm the destination monitor.
data transport via Bluetooth®.
Voice Messages
The voice messages listed below are output from the speaker of the defibrillator
according to the operation statuses.
If a voice message is heard, follow the instructions.
Adult mode. Stay calm. Follow voice AED in adult mode is selected.
instructions. The message may vary, depending on the Voice Instruction setting in AED
A Setup. (Refer to the Administrator’s Guide: “AED Setup”)
Analyzing heart rhythm. Do not touch patient. The defibrillator started AED analysis (VF/VT analysis).
B Battery empty. Connect AC power. The battery remaining is 0 in AED mode.
Charging. Energy charging for electrical shocks is in progress.
Check pad cable connection to defibrillator. The defibrillator was set to AED mode before attaching the disposable
pads to the patient.
Check skin contact and cable connection. Disposable pads became detached during AED.
Child mode. Stay calm. Follow voice AED in child mode is selected.
instructions. If patient is adult, set the control The message may vary, depending on the “Voice Instruction” setting in
dial to AED without pressing the CHILD MODE AED Setup. (Refer to the Administrator’s Guide: “AED Setup”)
C button.
Confirm that patient has no response and is not The defibrillator was set to AED mode before attaching the disposable
breathing. pads to the patient.
Continue CPR. Performing CPR.
The message may vary, depending on the “CPR Cycles per Sequence:
adult/child” and “Number of Rescue Breaths: adult/child” settings in AED
Setup. (Refer to the Administrator’s Guide: “AED Setup”)
Could not analyze heart rhythm. Noise was detected in AED analysis (VF/VT analysis).
Defibrillator not working. Do not use A defibrillator error was detected.
defibrillator. Start CPR. The message may vary, depending on the “CPR Cycles per Sequence:
adult/child” and “Number of Rescue Breaths: adult/child” settings in AED
Setup. (Refer to the Administrator Guide: “AED Setup”)
D
Do not touch patient. Immediately before starting AED analysis (VF/VT analysis) in AED mode
Do not touch patient. Press the flashing Defibrillation in AED mode is enabled.
SHOCK button.
Energy was not delivered to the patient. There is more than the specified amount of residual charge remaining in
E
the HV condenser after a shock was delivered.
Five more chest compressions. Do not touch CPR in AED mode ends after 5 more chest compressions.
F
patient.
Heart rhythm changed. Shock canceled. The necessity of electrical shock was once suggested by the result of AED
H
analysis (VF/VT analysis) but was canceled after the subsequent analysis.
It is safe to touch patient. Start CPR. Instruction for starting CPR.
The message may vary, depending on the “CPR Cycles per Sequence:
I
adult/child” and “Number of Rescue Breaths: adult/child” settings in AED
Setup. (Refer to the Administrator’s Guide: “AED Setup”)
No shock advised. The defibrillator detected non-shockable rhythm in AED analysis (VF/VT
N
analysis).
Open package and remove pads. The defibrillator was set to AED mode before attaching the disposable
O
pads to the patient.
Press AED button. An ECG that requires defibrillation was detected in AED mode. Refer to
P
“AED Flowchart” (p. 6-4-3).
Remove all clothing from patient’s chest. The defibrillator was set to AED mode before attaching the disposable
pads to the patient.
Remove pads from liner and apply to patient as The defibrillator was set to AED mode (child mode) before attaching the
R
shown. disposable pads to the patient.
Remove pads from liner and apply to right The defibrillator was set to AED mode (adult mode) before attaching the
upper chest and left side as shown. disposable pads to the patient.
Shock advised. Charging. The defibrillator detected shockable rhythm in AED analysis (VF/VT
analysis).
Shock cancelled. In AED mode:
• The charging hold time elapsed after completion of charging.
S • The defibrillator detected repeated detachment of one or more disposable
pads.
Shock delivered. Defibrillation in AED mode was performed.
Synchronized cardioversion. Charging starts in sync cardioversion mode.
T Testing voice instructions Voice check of the basic checks is in progress.
Use disposable pads. The defibrillator was set to AED mode with the external paddles or
U
internal paddles connected.
11
Troubleshooting
This section lists troubles and their causes and actions.
After the action, check that the problem is solved and the defibrillator operates
properly before using it again.
NOTE: If the following actions do not solve the problem, attach an
“Repair request” or “Unusable” label to the defibrillator and
contact your Nihon Kohden representative.
General
Problem Possible Cause Action
The defibrillator heats up. The defibrillator was being used for There is no abnormality in the defibrillator.
many hours.
Defibrillator abnormality First set the control dial to OFF and disconnect
the power cord, and contact your Nihon Kohden
representative.
The defibrillator does not turn The power cord was disconnected. Firmly connect the power cord to an AC outlet and the
on. defibrillator.
The battery pack is not installed. • Install the specified battery pack (NKB-301V).
Refer to “Replacement” (p. 12-26).
• In an emergency, operate on AC power.
Refer to “Using AC Power” (p. 4-3).
Remaining power of the battery is low. Charge the battery pack. Refer to “Charging the Battery
Pack” (p. 4-5).
The connection of the battery pack or Set the control dial to OFF to turn off the defibrillator,
the AC power cord is loose. firmly connect the battery or the AC power cord then
turn on the defibrillator.
Dirt or foreign substance is on the Set the control dial to OFF to turn off the defibrillator
connector of the battery pack or the and check the connector. Remove any foreign substance
AC power cord. from the connector, install the battery pack or connect
the power cord again, then turn on the defibrillator.
Defibrillator abnormality Contact your Nihon Kohden representative.
Faulty battery pack Replace the NKB-301V battery pack with a new one.
Refer to “Replacement” (p. 12-26).
Faulty LCD unit Stop using the defibrillator and contact your Nihon
Kohden representative.
The status indicator is lit in red Remaining battery power is less than Firmly connect the power cord to an AC outlet and the
while the defibrillator power is 1/3. defibrillator then start the defibrillator.
off.
The battery pack is expired. Replace the NKB-301V battery pack with a new one
and update the battery replacement date. (Refer to the
Administrator’s Guide: “Battery Test Procedure”)
No paddle or pad is connected to the Connect paddles or disposable pads then turn on the
paddle connector. defibrillator.
Faulty CO2 sensor Replace the CO2 sensor then start the defibrillator.
The defibrillator is faulty. Turn on the defibrillator and confirm the latest self-test
results in the system setup to take a necessary action.
(Refer to the Administrator’s Guide: “Latest Self Test”)
If the status indicator remains in red, perform the basic
checks, referring to “Basic Checks” (p. 12-5).
If the basic checks do not solve the problem, contact
your Nihon Kohden representative.
The battery pack is not installed. Install the specified battery pack (NKB-301V).
Refer to “Replacement” (p. 12-26).
Defibrillation
Problem Possible Cause Action
The defibrillator internally The disposable pads became detached Firmly attach the disposable pads to the patient.
discharges the energy while from the patient.
charging. In battery operation, the battery is In an emergency, operate the defibrillator on AC
almost exhausted. power. The battery is automatically charged when the
defibrillator is connected to AC power.
Faulty HV unit (A system error When the system error is displayed, the defibrillator
occurred.) may be faulty. Use another defibrillator and contact
your Nihon Kohden representative.
Cannot switch to SYNC mode. You tried to perform synchronized Set the SYNC BY PADDLE to “ON” in the PADDLE
cardioversion with the paddle or SETUP window and select the paddle or pad lead.
pad lead while setting SYNC BY Refer to “SYNC BY PADDLE” (p. 5-7).
PADDLE to “OFF” in the PADDLE
SETUP window.
Pacing
Problem Possible Cause Action
Although the message Pacing current is set to 0 mA. Set the appropriate pacing current with the PACING
“PACING” is displayed, pacing OUTPUT up/down key.
does not start. In demand pacing mode, the selected Set the pacing rate appropriate for the patient heart rate.
pacing rate is slower than the patient When the patient heart rate is slower than the selected
heart rate. pacing rate, pacing pulse is output automatically.
Faulty pacing function (A system Contact your Nihon Kohden representative.
error “ERROR PXXX”) occurred.)
The message “Pacing stopped Skin-pad contact impedance is high. • Firmly attach the pads to the patient.
(pad disconnected)” appears • Set the pacing current to “0 mA” then increase the
and pacing stops before current gradually to set the lowest effective pacing
completion. current.
If these actions do not solve the problem, clean the skin
and use new disposable pads. Refer to “Attaching the
Disposable Pads to the Patient” (p. 7-8).
Electrocardiogram (ECG)
Problem Possible Cause Action
Dotted lines appear instead of An ECG electrode became detached. Remove the cause. If it does not solve the problem,
the ECG waveforms. change the lead. If changing the lead does not solve the
The clip of the electrode lead was
problem, the defibrillator may be faulty. Contact your
disconnected from the ECG electrode.
Nihon Kohden representative.
The ECG connection cord was
disconnected from the ECG socket.
Discontinuity of the ECG connection
cord or the electrode lead
Baseline drifting Patient body movement. Check the patient.
AC interference on the ECG A 2-prong power cord is used without Use the provided 3-prong power cord.
waveform grounding.
In the ECG SETUP window, HUM • Set HUM FILTER to “ON” in the ECG SETUP
FILTER is set to “OFF”. window.
Refer to Section 8-1 “ECG Monitoring” (p. 8-1-1).
• Check if there is AC interference with other
instruments, and remove the cause.
• Set “AC Line Frequency (Hz)” properly on
the SYSTEM SETUP screen. (Refer to the
Administrator’s Guide: “System Setup”)
ECG waveform cannot Electrode lead discontinuity Replace the electrode lead or the electrode with a new
be recorded even though one.
Dirty electrode
electrodes are connected
properly. New and old or different types of Use the same type of electrodes which are purchased
electrodes are used together. together.
No sync sound Faulty speaker or speaker cable Repair is necessary. Contact your Nihon Kohden
discontinuity representative.
SYNC SOURCE is not set to “ECG” Set SYNC SOURCE to “ECG” in the SpO2 SETUP
in the SpO2 SETUP window. window. Refer to “SpO2 Monitoring” (p. 8-3-1).
The SYNC SOUND volume set to “0” Set the SYNC SOUND volume to “1” or more in the
in the VOLUME SETUP window. VOLUME SETUP window.
Refer to “VOLUME” (p. 5-11).
QRS sync mark is not PACING REJECT is set to “ON” in • Remove the cause of the noise.
displayed. the QRS SETUP window, and large • Set HUM FILTER to “ON” in the ECG SETUP
amplitude AC interference noise is window.
superimposed on the ECG waveform. • Set PACING REJECT to “OFF” in the QRS SETUP
11
window.
Refer to Section 8-1 “ECG Monitoring” (p. 8-1-1).
In the SpO2 SETUP window, SYNC Set SYNC SOURCE to “ECG” in the SpO2 SETUP
SOURCE is not set to “ECG”. window. Refer to “SpO2 Monitoring” (p. 8-3-1).
Sync sound is irregular Noise was misjudged to be QRS. Remove the cause of the noise.
although there is no
arrhythmia.
No alarm is generated. Alarms are silenced or suspended. Press the silence alarms key again.
The alarm function is deactivated. Activate the alarm function. Refer to “Changing Alarm
Settings” (p. 9-12).
Faulty speaker or speaker cable Repair is necessary. Contact your Nihon Kohden
discontinuity representative.
CO2
SpO2
11
Recording
Problem Possible Cause Action
Printing is blurred. The specified paper is not used. Use the specified recording paper.
Dots are missing.
The thermal head is dirty or worn, or • Clean the thermal head with a thermal head cleaning
poor in contact. pen. If it does not solve the problem, the thermal
head must be replaced. Contact your Nihon Kohden
representative.
• Perform RECORDER CHECK in the basic checks and
check the quality of printing. Refer to “Recorder Check
(TEC-5611, TEC-5621, TEC-5631)” (p. 12-20).
Recording paper cannot be The specified paper is not used. Use the specified recording paper.
set correctly.
Nothing is printed. Recording paper is not loaded. Load new recording paper. Refer to “Loading the
Recording Paper (TEC-5611, TEC-5621, TEC-5631)”
(p. 4-9).
The recorder door was not properly Close the door until it clicks.
closed.
Recording paper was set with the wrong Set the recording paper correctly. Refer to “Loading the
side facing up. Recording Paper (TEC-5611, TEC-5621, TEC-5631)”
(p. 4-9).
The recorder unit temperature is too high. Move the defibrillator to a cooler place.
If this does not solve the problem, the recorder unit is
faulty. Contact your Nihon Kohden representative.
Paper skews to one side. Recording paper was not loaded Set the paper straight. Refer to “Loading the Recording
correctly. Paper (TEC-5611, TEC-5621, TEC-5631)” (p. 4-9).
Printout is faint. The recorder unit temperature is too high. Move the defibrillator to a cooler place.
If this does not solve the problem, the recorder unit is
faulty. Contact your Nihon Kohden representative.
Battery
Problem Possible Cause Action
Battery charging lamp is The defibrillator heats up. Move the defibrillator to a cooler place. Battery charging
blinking. is restarted when normal temperature is restored.
Battery charging stops before Faulty battery pack. Replace the battery pack with a new one. Refer to
completion. (Neither the “Replacement” (p. 12-26).
battery charging lamp nor the
Battery charge circuit is not Faulty charging circuit. Contact your Nihon Kohden
battery charging completion
working. representative.
lamp lights.)
The battery pack is deteriorated. Replace the battery pack with a new one. Refer to
“Replacement” (p. 12-26).
Neither the battery charging Faulty battery pack and defibrillator Contact your Nihon Kohden representative.
lamp nor the battery charging
completion lamp is lit.
The defibrillator does not turn Battery connector contact failure. Set the control dial to OFF to turn off the defibrillator and
on when operating on the check the battery pack connector. Remove any foreign
battery. substance from the connector, install the battery pack
again until it locks, then turn on the defibrillator.
SD Card
Problem Possible Cause Action
Data cannot be saved in the No card was set in the defibrillator. Insert a specified card.
SD card.
The card was not inserted properly. Properly insert the card.
A card other than specified card was Insert a specified card.
inserted.
Memory is full. Use a new card, or delete unnecessary data.
The card is write-protected. Release the write protect (LOCK) of the SD card.
The SD card was removed while Turn off the defibrillator then turn it on again.
the defibrillator power was on,
being affected by static electricity.
11
Transport
Problem Possible Cause Action
Data cannot be transported. The destination monitor does not Confirm the destination monitor.
support Bluetooth® communication.
The QI-832V Bluetooth® module is Install the QI-832V Bluetooth® module in the
not installed in the defibrillator. defibrillator.
Daily Check
The defibrillator contains parts which gradually deteriorate with use. Original
performance might not be delivered if any part of the defibrillator is deteriorated.
Perform regular maintenance checks to assure continued safe operation.
If you found any abnormalities, take the appropriate action by referring to
the Service Manual. If the defibrillator is suspected to be faulty, attach an
“Unusable” or “Repair request” label to the defibrillator and contact your Nihon
Kohden representative.
If there are not enough consumables, contact your Nihon Kohden representative.
NOTE • Before use, make sure that the date and time displayed on the
screen are correct. Periodically check them during use. The
date and time printed on recording paper are important parts of 12
the medical records.
• When the status indicator becomes red, restart the defibrillator
in monitor mode and check the message on the screen.
• If any message does not appear, refer to the descriptions for
“The status indicator is lit in red” under “Troubleshooting” in
Section 11 (p. 11-20).
Item Check
Before turning off the The SETUP or SYSTEM SETUP items temporarily changed during
power operation were returned to the original settings.
“0” is displayed on the screen when the control dial is set to DISARM.
Charging is not in progress.
All cords/cables were disconnected.
Abnormality No abnormality was detected during use.
There is no error indication on the screen.
The screen display is normal and clear.
There is no abnormally hot part when you touch the defibrillator.
The setup is in the status you wish.
The status indicator is lit in green (the defibrillator is ready for use) after
the power is turned off.
Appearance The defibrillator is not dirty or damaged.
The test electrode plates and the metal surfaces of the paddles are not
discolored.
The operation panels or labels on the defibrillator are not blurred or lost.
There is no damage or crack on the defibrillator and paddles.
There is no damage on the power cord.
The date to check or replace the battery has not elapsed.
The external paddles were cleaned after use.
The internal paddles were sterilized and disinfected after use.
There is sufficient GELAID left after using the external pads.
The defibrillator was wiped and dried thoroughly if it was in contact with
liquid.
The accessories were well organized after use.
Disposable pads and ECG electrodes were properly disposed of so as not
to cause second infection (TEC-5611, TEC-5621, TEC-5631).
There are sufficient consumables, such as recording paper.
The power cord is connected to an AC power source to charge the battery.
The control dial is set to OFF.
No chemicals and liquid are left around the defibrillator.
Basic Checks
The basic functions and operations of the defibrillator are checked.
Be sure to perform the basic checks on a regular basis.
NOTE: Do not replace the battery pack during the basic checks.
“Check After Turning the Power On and During Operating” (p. 12-3)
WARNING
When performing a basic check, make sure that
the disposable pads are not attached to the
patient. Failure to follow this warning may lead to
unintended electrical shock to the patient.
JJ-202V analyzer
connection cable JJ-202V analyzer
connection cable
The internal paddle adapters are supplied with the AX-103VK defibrillator
analyzer.
AX-103VK defibrillator analyzer
Internal paddle
adapters
Paddle
receptacle
2 Set the control dial to the BASIC CHECK position to open the BASIC
CHECK window.
The maintenance history (such as the date/time of the latest checks) is
displayed in the window when opened.
MAINTENANCE HISTORY
Indicates the historical data, including the date of
execution of the latest checks. 12
• LATEST BASIC CHECKS
If more than two days have elapsed since the
latest basic checks have been performed, the
date is indicated in yellow.
•L ATEST DATE AND TIME SETUP
• LATEST BATTERY TEST
If one month or more has elapsed since the
latest battery test, the date is indicated in
yellow.
• CURRENT TIME
Displays guidance messages.
Pressing the [HISTORY] key opens the basic check history window, permitting
you to confirm the history of the basic checks.
“Confirming the Checking History” (p. 12-22)
3 Press the [START] key to start the basic checks. The checks are started from
the SD card check, and performed in sequence. Proceed with the checks by
pressing the specified keys in accordance with the on-screen guidance.
For details, refer to the corresponding items mentioned on the subsequent
pages.
From “SD Card Check” (p. 12-9) to “Recorder Check (TEC-5611, TEC-5621,
TEC-5631)” (p. 12-20)
Check completed
Result
4 When the basic checks have been completed, the check result window is
displayed and the all results are recorded.
NOTE: Make sure that the date and time printed on the recording
paper are correct. The dates and times on the recording
paper are important parts of the medical records.
SD Card Check
The defibrillator performs writing/reading check to the SD card.
When “Basic Check Type” is set to “Detailed” on the SYSTEM SETUP screen,
the capacity (remaining) of the SD card is also checked.
After confirming that the pads are not attached to a patient, press the [START]
key.
If you use an SD card other than the optional QM-001D or QM-002D,
the “Insert SD card and press NEXT” message is displayed on the
screen. Press the [CANCEL] key to skip the SD card check.
If the out-of-paper check has been completed without problems, recording starts
for the recorder check.
If you press the [CANCEL] key during out-of-paper check, “NOT
CHECKED” is displayed in the result column and the next check is
started.
System Check
The defibrillator checks if there is any system error.
The system check is automatically started and the check result is displayed.
If an error is detected in the system check, the basic checks are canceled.
Paddle Check
The defibrillator checks the type of connected device (paddle or pads) and if they
are properly connected.
Follow the guidance displayed in the BASIC CHECKS window.
If you press the [CANCEL] key during a paddle check, “NOT
CHECKED” is displayed in the result column. The defibrillation check
and pacing check (only for TEC-5631) are skipped and the battery
check is started.
If the paddle check resulted in “ERROR”, the defibrillation check and pacing
check (only for TEC-5631) are skipped and the battery check is started.
Confirm the connected paddles, and press Confirm whether the disposable pads are
[YES] or [NO]. connected, and press [YES] or [NO].
Do not disconnect Check result: ERROR Confirm that pads are not
connection cable until attached to patient. [OK]
check finishes. [OK]
Check result: OK
Defibrillation Check
NOTE: When operating the defibrillator on the battery and the
mark indicating remaining battery power is 1~3 or 0 , the
defibrillation check cannot be performed. Charge the battery
before the defibrillation check.
If you press the [CANCEL] key during a defibrillation check, “NOT
CHECKED” is displayed in the result column and the next check is
started.
1 When the remaining battery power is enough and paddle or pad contact is
good enough for check, the massage “Press the CHARGE/AED button” is
displayed.
If the paddles or pads are not connected properly, an error message is
displayed to indicate that they need to be set to the paddle holders or
defibrillator analyzer. Connect them properly then press the [NEXT] key.
Shock button
1 When the paddles or disposable pads are properly connected, the guidance
“Press START/STOP key” is displayed.
If the paddles or pads are not connected properly, an error message is
displayed to indicate that they need to be set to the paddle holders or
defibrillator analyzer. In this case, connect the paddles or the disposable pads
properly then press the [NEXT] key.
PACING PULSE lamp 2 Press the START/STOP key to start the pacing check.
The check is performed with changing the pacing pulse current.
• Pacing mode: Fixed
• Pacing rate: 180 ppm
• Pacing pulse current: 10 to 200 mA
Each pacing pulse current is checked eight times.
Each time the pacing pulse is detected properly, an “*” mark is displayed on
the screen.
Pacing pulse current Counts of pacing
The pacing check is terminated once pacing has been performed on every
current.
Battery Check
The defibrillator checks the condition of the battery connected to the instrument.
The check is automatically performed and the check result is displayed.
If you press the [CANCEL] key during the battery check, “NOT
CHECKED” is displayed in the result column and the next check is
started.
When a message is displayed on the screen during the battery check, confirm the
content and press the [OK] key.
Message during the check
12
Voice Check
The defibrillator checks that voice instructions are properly output and the
speaker lead is not disconnected.
Follow the guidance displayed on the screen.
If you press the [CANCEL] key during the voice check, “NOT CHECKED”
is displayed in the result column and the next check is started.
Alarm Check
The defibrillator checks alarm sound generation and alarm indicator operation.
In the alarm check, the defibrillator gives the appropriate alarm sound or
indicator light for each instruction.
Alarm indicator
Alarm Check Flow
START
Multi-Parameter Check
If an optional multi parameter/SpO2 unit is mounted, the defibrillator checks that
there is no abnormality in the CO2 module.
The multi-parameter check is performed with a CO2 adapter connected to the
CO2 socket.
The following two items are checked in the multi-parameter check.
CO2 adapter 1) Communication error and start-up check
2) CO2 module check
If no CO2 adapter is connected, pressing the [CANCEL] key cancels the
check without performing “(2) CO2 module check”.
In this case, if “(1) Communication error and start-up check” is
successfully terminated, “OK” is displayed in the result column and the
next check is started.
12
When the recorder check results in “PASSED”, the basic check result window is
displayed and all results are recorded.
NOTE: Make sure that the date and time printed on the recording
paper are correct. The date and time on the recording paper are
important parts of the medical records.
• The item for which the detailed results is displayed can be changed by pressing
the [ ] or [ ] key.
• When you press the [DEFIBRILLATION INFO] key, the defibrillation
information window appears. Pressing the [BACK] key restores the check
result window.
• Press the [PRINT RESULTS] key to print the detailed check result.
The selected item is highlighted. Message
RESULTS
Lists the results of all check
items.
: OK or PASSED
: ERROR or FAILED
DETAILS
Shows the detailed results
of the check item selected
on the list.
DEFIBRILLATION
INFORMATION
Information of the discharged 12
waveform for the
defibrillation check is
displayed.
1 Press the [HISTORY] key on the BASIC CHECKS window to display the
history list window.
HISTORY
Lists the history of the basic
check executions.
Press to store the basic check data from the Press to restore the
selected date/time to the latest ones in an SD card. BASIC CHECKS
window.
The selected item is highlighted.
HISTORY
Lists the results of all check items.
: OK or PASSED
: ERROR or FAILED
DETAILS
Shows the detailed result of the
check item selected on the list.
Self Tests
The defibrillator performs the self-tests every month (the 15th day of each
month), every day, when the defibrillator power is turned on/off, and when the
power cord is connected/disconnected.
The self-tests are automatically performed periodically by the defibrillator itself,
checking the conditions of the battery and internal circuits.
The time to perform the self-tests every day and on the 15th day of each month
can be set under SELF TEST TIME in the SELF TEST SETUP window (default
setting: 12:00).
Indications of the status indicator The status indicator is lit in red during the self-tests. If no problem is found, the
indicator lights in green. It remains red if there is an error.
If the indicator remains in red, restart the defibrillator in monitor mode and check
red (operation green the error message.
disabled) (operation
enabled) If no message is displayed even when the defibrillator is restarted, refer to the
descriptions for “The status indicator is lit in red” under “Troubleshooting” in
Section 11 (p. 11-20).
The test items to be performed depend on the triggers (monthly, daily, power-on,
power-off, or power cord connection/disconnection) as follows:
NOTE: If the power cord is connected and disconnected three or more
times a day, the daily self-test starts after the third connection.
12
Power cord
Power Power
Test Item Description Monthly Daily connect/
on off
disconnect
Paddle Check If no paddle is connected to the paddle connectors,
Yes Yes Yes Yes Yes
the status indicator lights in red.
Remaining Battery If the battery remaining is decreased to 1/3 or less
Power when operating the defibrillator on the battery only, Yes Yes No Yes Yes
the status indicator lights in red.
If the battery is empty when you turn on the
defibrillator to operate it on the battery only, the No No Yes No No
status indicator lights in red.
Battery Voltage If no battery is connected or abnormal voltage is
Yes Yes Yes Yes Yes
detected, the status indicator lights in red
Battery Expire Date If the scheduled battery replacement date is passed,
Yes Yes Yes No Yes
the status indicator lights in red.
Sub Battery Voltage If the sub-battery voltage is below the specified value,
Yes Yes Yes No Yes
the status indicator lights in red.
Power cord
Power Power
Test Item Description Monthly Daily connect/
on off
disconnect
Backup Battery Voltage If an error is detected, the status indicator lights in
Yes Yes Yes No Yes
red.
RTC Alarm If the self test does not start properly, the status
Yes Yes Yes No Yes
indicator lights in red.
HV Test (Energy If an error is detected during charging, the status
Charge) indicator lights in red.
If the paddles or pads are replaced during charge,
a paddle error is generated and the status indicator Yes No No No Yes
lights in red.
When the defibrillation check in the basic checks
resulted in “OK”, the status indicator lights in green.
HV Test (Internal Internal discharge is performed after a charge for
Discharge) measuring the discharge time. If it takes longer than Yes No No No Yes
the specified time, the status indicator lights in red.
Defibrillator
Defibrillator
Disposal
CAUTION
Dispose of Nihon Kohden products according to
your local laws and your facility’s guidelines for
waste disposal. Otherwise, it may affect the
environment. If there is a possibility that the
product may have been contaminated with
infection, dispose of it as medical waste according
12
to your local laws and your facility’s guidelines for
medical waste. Otherwise, it may cause infection.
When an optional NKB-301V battery pack has been installed, remove it before
disposal.
Expiration Date
Replace the battery pack with a new one every 2 years.
If it is used continuously without replacement over 2 years, the defibrillator may
not fully enable its functions and the backup time in battery operation may be
危険
shortened.
DAN
使用
開始
年月
日
Replacement
NOTE • Use only the NKB-301V battery pack.
• Be sure to write the date of replacement on the label of a new
battery before installing it.
• Leave battery replacement to your Nihon Kohden representative
or a person with expertise.
• When replacing the battery in TEC-5611, TEC-5621 or
TEC-5631, be careful not to face the right side panel downward.
This may damage the door release lever, and result in disabling
the recorder.
1
危険
DAN
Before replacement, write the starting date of use on the label of the new
GER
使用
開始
battery.
年月
日
2 Set the control dial to OFF to turn off the power, then disconnect the power
cord from the defibrillator.
Write the date when use of
the battery is started.
CAUTION
When inserting or removing the battery, disconnect
the power cord from the defibrillator. Otherwise, the
operator may receive electrical shock.
NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.
Battery cover
5 Set the new battery pack in the battery case and connect
Black lead the battery cable connector.
NOTE • Insert the battery pack and the battery
cable connector in the correct direction.
• Make sure that the connector clicks and is
securely locked.
Battery pack
Setting direction
12
6 Attach the battery cover with the screw. Make sure the
battery cable is not pinched under the cover.
Disposal
The battery pack uses a nickel-metal hydride (Ni-MH) battery.
Do not dispose of the battery pack with other waste. To dispose of it, contact
your Nihon Kohden representative. The battery pack will be recycled for
environmental protection.
When disposing of the defibrillator, it is necessary to remove the battery pack
from it.
Disposal
To dispose of the JC-865V, contact authorized personnel for medical waste.
WARNING
Do not use the disposable pads if they are past the
expiration date on the package. Failure to follow
this warning may lead to skin burn or insufficient
delivery of shock.
CAUTION
When disposable pads are attached to a patient,
replace them every 24 hours. After 24 hours, the
gel becomes dry and this may reduce performance
of the pads.
Disposal
To dispose of used pads, contact authorized personnel for medical waste.
Other Options
Refer to the documents (including the operator’s manuals) supplied with the
respective products.
Defibrillator
CAUTION
Before maintenance, cleaning or disinfection, turn
the defibrillator power off and disconnect the power
cord from the AC socket. Failure to follow this
instruction may result in electrical shock and
defibrillator malfunction.
Test electrode plates When connecting the external paddles, wipe off any dirt from both paddle
holders (paddle cups) and any contact gel (GELAID) remaining on the test
electrode plates.
NOTE • Do not use organic solvents such as thinners, benzine or
industrial alcohol. These may melt or crack the surface.
• Do not leave saline-soaked gauze on the paddle holders. It
would cause discoloration (rusting) of the metal surfaces of the
test electrode plates or paddles.
CAUTION
Do not touch the thermal head inside the recorder
unit. The thermal head may be damaged by static
electricity or become dirty and cause printing
failure.
3 Clean the paper feed roller with a soft cloth moistened with
disinfecting ethanol (concentration: 76.9 to 81.4 vol% at
15°C or 59°F).
Cleaning
After use, wipe with a non-abrasive cloth moistened with disinfecting ethanol
(concentration: 76.9 to 81.4 vol% at 15°C or 59°F) or neutral detergent diluted
with water, and then wipe dry with a dry cloth.
NOTE: Do not wet the connector.
Disinfecting
Wipe with a non-abrasive cloth moistened with any of the disinfectants listed
below.
Glutaraldehyde solution: 2%
Alkyldiaminoethylglycine hydrochloride: 0.5%
Benzalkonium chloride: 0.2%
Benzethonium chloride solution: 0.2%
Chlorhexidine gluconate solution: 0.5%
NOTE • Do not wet the connector.
• Always use the correct disinfectant concentration.
• Do not disinfect with hypochlorous acid.
• Do not sterilize or disinfect with ultraviolet light or ozone.
Cleaning
After use, wipe with a non-abrasive cloth moistened with neutral detergent 12
diluted with water, and then wipe dry with a dry cloth.
NOTE: Do not wet the connector.
Disinfecting
Wipe with a non-abrasive cloth moistened with any of the disinfectants listed
below.
Glutaraldehyde solution: 2%
Alkyldiaminoethylglycine hydrochloride: 0.5%
Benzalkonium chloride: 0.2%
Benzethonium chloride solution: 0.2%
Chlorhexidine gluconate solution: 0.5%
NOTE • Do not wet the connector.
• Always use the correct disinfectant concentration.
• Do not disinfect with hypochlorous acid.
• Do not sterilize or disinfect with ultraviolet light or ozone.
Operator’s Manual TEC-5600 series 12-31
12. Maintenance
External Paddles
Test electrode
plates
Internal Paddles
Other Options
Refer to the documents (including operator’s manuals) supplied with the
respective products.
Periodic Inspection
The defibrillator is a medical treatment apparatus.
Degradation or loss of defibrillator functions may lead to misdiagnosis.
Service personnel should perform the periodic inspection at least once every
year and make sure that the defibrillator operates properly and replace the
consumables.
If you found abnormalities as a result of inspection and the defibrillator is
suspected to be faulty, attach an “Unusable” or “Repair request” label to the
defibrillator and contact your Nihon Kohden representative.
For inspection, refer to the Service Manual.
12
Standard Accessories....................................................13-2
TEC-5611, TEC-5621, TEC-5631.................................................13-2
13
13. Standard Accessories, Options and Consumables
Standard Accessories
For the standard accessories only use Nihon Kohden specified parts and
accessories to satisfy the safety and performance.
Some accessories may differ depending on the destination country or region.
WARNING
Only use Nihon Kohden specified parts and
accessories, such as connection cords, electrodes,
paddles and probes. Otherwise, the defibrillator
may overheat and be damaged, in which case
monitoring will stop or electrical shock may be
caused.
NOTE: The parts which are marked with * have not been checked for
compliance with the MDD (Medical Device Directive). For EC
member countries, Nihon Kohden recommends the use of parts
that comply with MDD.
Defibrillator
Name Qty Model/Code No. Supply Code
Power cord (For Central and Eastern Europe) 1 547748A –
Power cord (For Brazil) 1 9000-000082 –
Battery pack, NKB-301V 1 YZ-024H9 X065
1 GB 1 QM-001D Y154D
SD memory card
2 GB 1 QM-002D Y154F
Multi parameter/SpO2 unit 1 QI-564V –
Bluetooth® module 1 QI-832V –
Defibrillator report viewer software 1 QP-551VK –
Upgrade kit (For arrhythmia analysis) 1 QS-831V –
Software kit 1 QS-009V –
For Kimberly-Clark Company disposable
1 JC-855V K342A
Pad adapter pads 1
For Nihon Kohden disposable pads 1 JC-865V K342B
Electrode springs
1 6114-927936 –
(test electrode plates in the right and left paddle holders)
GELAID (contact gel) 1 Z-101EA F015
13
1
For purchasing Kimberly-Clark disposable pads, contact Kimberly-Clark or its representative.
Installation
Name Qty Model/Code No. Description Supply Code
Cart 1 KD-561V For TEC-5600 series defibrillators
Basket 1 DI-831V For the KD-561V cart
Wall mount 1 KG-561V For TEC-5600 series defibrillators
–
Paste holder kit 1 YZ-025H0 For holding GELAID (contact gel)
For hooking defibrillator onto a bed
Bed rail hook 1 YZ-047H4
board
Defibrillator Analyzer
Name Qty Model/Code No. Description Supply Code
Defibrillator analyzer 1 AX-103VK For defibrillation check ─
1
The whole dimensions of the external paddle electrodes should be 150 cm2 or more.
2
For both paddles, require 2 adult electrode assies.
3
For infants less than 1 year old, use of the P-713 disposable pads takes priority over use of the P-711 or P-721 disposable pads.
4
For purchasing Kimberly-Clark disposable pads, contact Kimberly-Clark or its representative.
5 Qty 5: P204F
1.6 TL-272T3
Disposable SpO2 Qty 24: P203F
or
probe (BluPRO®) Neonates (less than 3 kg) Instep Qty 5: P204C
0.8 24 TL-273T
Adults (40 kg or more) Finger or toe Qty 24: P203C
Qty 5: P204G
1.6 TL-273T3
Qty 24: P203G
Infants (from 3 to 20 kg) Finger or toe Qty 5: P204D
0.8 TL-274T
Qty 24: P203D
Qty 5: P204H
1.6 TL-274T3
Qty 24: P203H
• Type S attachment tape
Low birth weight infants (1 kg or less) Instep
and sole
Disposable Children, neonates (3 kg or more) Finger or toe 1.6 TL-260T P205A
Multi-site Y probe
• Type L attachment tape
Neonates (3 kg or less) Instep and sole
5
Adults (50 kg or more) Finger 0.8 TL-051S P228A
Neonates (3 kg or less) Instep and sole
Disposable SpO2 1.6 TL-052S P228B
probe Children (from 15 to 50 kg) Finger 0.8 TL-061S P229A
Infants (from 3 to 15 kg) Toe 13
1.6 TL-062S P229B
Attachment tape For BluPRO® finger and multi-site probes
3 × 30 P263
for BluPRO®
Sponge Type S attachment tape P260A
attachment tape Type L attachment tape 24
for TL-260T multi- – P260B
site Y probe
–
Clip adapter For TL-260T multi-site Y probe 1 P256
For TL-051S, TL-052S, TL-061S or TL-062S
Foam tape 4 × 25 P260C
disposable probes
COTTONY tape For attaching probes 20 340703* P259
Probe fastener 30 – P267
14
14. Setting Items and Default Settings
SYSTEM SETUP
Alarm Setting Contents
(Alarm Setting)
The alarm settings are retained regardless of the elapsed time
Latest
after the defibrillator was turned off.
All the alarm settings return to the default settings when 30
Default
minutes elapse after the defibrillator was turned off.
All the alarm settings return to the settings specified with
ALARM SETTING LIST when 30 minutes elapse after the
User Settings defibrillator was turned off.
When the optional QS-831V is installed, ARRHYTHMIA
ANALYSIS is set to “ON”.
GUIDE
Item Settings Backup
?ECG
?SpO2 Displays the GUIDE window for each parameter. No
?CO2
ALARM SETUP
Settings
Item Unit Default Backup
Setting Range Step
Upper Limit HR:bpm 35 to 300, OFF 140
HR/PR 1
Lower Limit PR:/min OFF, 30 to 295 40
VPC Upper Limit /min 1 to 99, OFF 1 10
Upper Limit 51 to 100, OFF OFF
SpO2 %SpO2 1
Lower Limit OFF, 50 to 99 90
APNEA Upper Limit s 5 to 40, OFF 5 OFF Alarm
2 to 99, OFF
Upper Limit OFF
mmHg (1.0 to 13.5, OFF) 1
ETCO2
(kPa) 1 OFF, 1 to 98 (0.5)
Lower Limit OFF
(OFF, 0.5 to 13.0)
Upper Limit 2 to 150, OFF OFF
RR /min 2
Lower Limit OFF, 0 to 148 OFF
1
The unit can be changed in Pressure Units on the SYSTEM SETUP screen.
PADDLE SETUP
Item Settings Default Backup
ECG SETUP
Item Settings Default Backup
The alarm settings and default settings are the same as those in
ECG ALARM HR, PR Alarm
ALARM SETUP. Refer to “ALARM SETUP” (p. 14-3).
HUM FILTER ON, OFF ON
FILTER DIAGNOSIS, MONITOR, MAXIMUM MAXIMUM
Ca LEAD V4 Yes 14
V1 to V6
Cb LEAD V5
CASCADE ON, OFF OFF
QRS SETUP
Item Settings Default Backup
ARRHYTHMIA SETUP
Item Settings Default Backup
1
Available only when the optional QS-831V is installed.
SpO2 SETUP
Item Settings Default Backup
SpO2
The alarm settings and default settings are the same as those in
SpO2 ALARM Alarm
ALARM SETUP. Refer to “ALARM SETUP” (p. 14-3).
HR, PR
CO2 SETUP
Item Settings Default Backup
CALIBRATE (AIR, N2) Press the [OK] key to perform zero calibration. No
ETCO2
The alarm settings and default settings are the same as those in
CO2 ALARM RR Alarm
ALARM SETUP. Refer to “ALARM SETUP” (p. 14-3).
APNEA
CALIBRATION METHOD AIR, N2 AIR
Yes
SCALE mmHg (kPa) 1
0-20, 0-40, 0-80 (0.0-2.5, 0.0-5.5, 0.0-10.5) 0-40 (0.0-5.5)
1
The unit can be changed in Pressure Units on the SYSTEM SETUP screen.
REPORT
Item Settings Default Backup
RECORDING SETUP
Item Settings Default Backup
1
The recording time can be changed in Periodic Recording Interval on the
SYSTEM SETUP screen.
14
DEVICE SETUP
Item Settings Default Backup
VOICE INSTRUCTION 4
ALARM SOUND 1, 2, 3, 4 4
Yes
CHARGE SOUND 4
VOLUME
SYNC SOUND 0, 1, 2, 3, 4 2
KEY SOUND 0, 1, 2, 3, 4 2
OPERATION SOUND 1, 2, 3, 4 4
MEDICATION 1 Adrenalin
MEDICATION 2 Medication2
MEDICATION
MEDICATION 3 Up to 13 characters Medication3
SETUP
MEDICATION 4 Medication4
MEDICATION 5 Medication5
LARGE
NUMERICS LARGE NUMERICS ON, OFF OFF
SETUP
Specifications
Functions
Defibrillator
Manual mode: For charging to a user-specified energy level by using the CHARGE/AED
button
Manual sync mode: For charging to a user-specified energy level by using the CHARGE/AED
button, then discharging in synchronization with the R-wave of an ECG
after the SHOCK button is pressed
AED mode: For charging up to the automatically specified energy level when
defibrillation is required for the ECG. The energy level varies, depending
on the sequence defined in advance
AED mode (child mode): For charging up to the automatically specified energy level for a child
when defibrillation is required for the ECG. The energy level varies,
depending on the sequence defined in advance. This mode is for preschool
children only
Output energy (with loading of 50 Ω)
External paddles: 2, 3, 5, 7, 10, 15, 20, 30, 50, 70, 100, 150, 200, or 270 J selectable
Internal paddles: 2, 3, 5, 7, 10, 15, 20, 30, or 50 J selectable
Disposal pads: 2, 3, 5, 7, 10, 15, 20, 30, 50, 70, 100, 150, 200, or 270 J selectable
AED mode: 1st: 150 J, 2nd: 200 J, 3rd: 200 J (default settings)
(The settings can be selected from among 50, 70, 100, 150, 200, and 270 J.)
AED mode (child mode):
1st: 50 J, 2nd: 70 J, 3rd: 70 J (default settings)
(The settings can be selected from among 50, 70, and 100 J.)
VF/VT analysis: Analysis is performed in the background or when the AED button is
pressed (depending on the setting). In AED mode, the requirement for
defibrillation is determined for ventricular fibrillation waveform of
amplitude more than 0.1 mV and a ventricular tachycardia more than
180 bpm.
Internal discharge: For discharging the charged energy to the internal resistance in the
following cases:
• When power is turned off
• When the control dial is set to DISARM, AED, MONITOR, BASIC
CHECK, PACING, or SETUP
• When 40 seconds or more have elapsed from when a charge completed,
depending on the setting of “Charge Holding Time” (default setting:
40 seconds) in the system setup
• When a paddle is disconnected from the defibrillator
• When a disposal pad is disconnected from the patient
• When discharging with the released external or internal paddles
• When detecting an ECG that requires no defibrillation in AED mode
TTR detection: For measuring the transthoracic electric resistance of a patient
Discharged energy detection:
For measuring the discharged energy
Transcutaneous Pacing
Demand mode: For delivering pacing pulses at the specified pacing output current when
there is no spontaneous QRS within the time calculated from the specified
pacing rate
Fixed mode: For delivering pacing pulses at the specified pacing rate and output
current for a patient having no spontaneous QRS
Monitor
Electrocardiogram (ECG)
Induction
Disposal pads: Pads
External or internal paddles:
Paddles
3 leads: I, II, III
6 leads: I, II, III, aVR, aVL, aVF, Va, Vb
External ECG input: AUX
Indications
Screen Indications
Display: 6.5-inch diagonal, color TFT-LCD
Display area: 132.48 mm × 99.36 mm
Number of pixels: 640(H) × 480(V) pixels
Waveform Indications
Number of waveforms
ECG only: 1 trace of ECG waveform or 2 traces of ECG cascade 1
In SpO2 measurement: Pulse waveform 1
In CO2 waveform measurement:
Respiration waveform 1
1
Selectable by the setup
Waveform sensitivity
ECG: 1/4, 1/2, 1, 2, or 4
Pulse wave: 1/8, 1/4, 1/2, 1, 2, 4, 8, or automatic
CO2: 0 to 20 mmHg, 0 to 40 mmHg, or 0 to 80 mmHg
Sweep rate
ECG, SpO2: 25 or 50 mm/s
CO2: 12.5 or 6.25 mm/s
Numeric Indications
Displayed parameters: HR, SpO2, PR, ETCO2, RR
Defibrillator energy indications (with loading of 50 Ω):
In manual mode, the current energy value at the high-pressure condenser
is displayed during a charge operation and the output energy is displayed
after the charge operation is completed.
Pacing rate indication: The currently set pacing rate is displayed in pacing mode.
Pacing current intensity indication:
The currently set pacing current intensity is displayed in pacing mode.
Pacing duration indication:
The pacing duration time is displayed during pacing.
Clock indication: The current clock setting is displayed.
Timer indication: The time from when pressing the [START TIMER] key to when pressing
the [STOP TIMER] key is displayed in AED mode.
Character, Symbol, and Graphic Symbol Indications
Battery remaining: Indicates the battery remaining.
Recorder operation: Indicates operation statuses of the recorder.
SD card operation: Indicates operation statuses of an SD card.
Bluetooth® indication: Indicates connection statuses of a Bluetooth® module.
Defibrillation mode: Indicates manual mode, synchronized cardioversion mode, AED mode, or
AED mode (child mode) for defibrillation.
Pacing mode: Indicates the selected mode, fixed or demand, with “PACING”.
Analysis/charging/charging complete messages:
Indicate “ANALYZING” in VF analysis, “CHARGING” in energy
charging, or “CHARGING COMPLETE” when charging is complete.
15
Recording
Waveform Recording
Continuous real-time recording:
Pressing the record button initiates continuous waveform recording with
no delay, in accordance with the user setting.
Continuous delayed recording:
Pressing the record button initiates continuous waveform recording with a
delay, in accordance with the user setting.
Event recording: When the [EVENT] key is pressed, data for the certain periods before and
after pressing the key are recorded. The function can be turned on/off by a
user setting.
Alarm recording: Recording is automatically started when a vital alarm is generated. The
function can be turned on/off by a user setting.
Periodic recording: Recording is started at the user-specified time.
Charging start recording: Recording automatically starts when charging begins, and it automatically
stops after defibrillation. The function can be turned on/off by a user
setting.
Report Recording
Defibrillator report: Stores an ECG waveform in the defibrillator when defibrillation is
performed, enabling it to be printed as a discharged waveform when
required. Defibrillator information can also be stored in the defibrillator
when defibrillation is performed, enabling it to be printed as a
defibrillation report when required.
Alarm report: Stores a waveform in the defibrillator when a vital alarm is generated,
enabling it to be printed when required.
Event report: Stores the waveforms before and after your pressing the [EVENT] key in
the defibrillator, enabling them to be printed when required.
VF analysis report: Stores an ECG waveform for which VF analysis is performed in the
defibrillator, enabling it to be printed as an analyzed waveform report.
Trend report: Stores the past vital data in the defibrillator, which can be provided as a
trend graph output.
Periodic list report: Stores HR, SpO2, PR, ETCO2, and RR data measured at the specified
times.
Self-test report: Stores the self-test result as a report.
Basic-check report: Stores the basic-check result as a report.
Event list: Outputs an event report, listing the time and defibrillator status data in
time-series format.
Operation history: Stores a history of defibrillator operations.
Defibrillator history: Stores a history of errors, basic checks and other items related to the
defibrillator.
Recording Information
• Record types can be printed.
• Additional information with respect to recording can be printed.
• Present or delayed vital information can be printed.
• When pacing is performed in pacing mode, information of pacing can
be printed.
• Information regarding the performed defibrillation can be printed.
Sounds
In Normal Operations
Sound when buttons or keys are pressed:
Sounds when a button, switch or key is pressed.
Sound for heart rate or pulse wave synchronization:
Sounds in synchronization with QRS of an ECG or SpO2 pulse waves
when enabled by a user setting.
Sound for heart rate synchronization:
The tone for heat rate synchronization varies, depending on SpO2 values.
The function can be turned on/off by a user setting.
For Defibrillation
Sound during charging: Continuous sound is heard during charging.
Sound at charge completion:
Continuous sound is heard when charging is complete.
Operation sounds: In manual mode, the function can be turned on/off by a user setting. In
AED mode, continuous sound is heard except when analyzing an ECG.
For Alarms
Technical alarm sound: An alarm sound is generated when an error occurs in the defibrillator or in
the measurement environment.
Vital alarm sound: An alarm sound is generated when vital information on any parameter
exceeds the upper/lower limits of the allowable range.
Alarm sound priority: Alarm sounds have priority and vary in tone in accordance with the
priority. 15
Voice
AED mode: Voice instructions are made for the sequence in AED mode.
AED mode (child mode): Voice output is made to announce child mode. Voice instructions for the
sequence are the same as those in AED mode.
Microphone input: Ambient sounds are captured by the microphone and stored with ECG,
SpO2, and CO2 on an SD card.
Sound Volume Adjustment
Volumes of synchronization sounds, charging sounds, operation sounds,
alarm sounds, and voice instructions can be adjusted to the values in
accordance with the user settings in setup mode.
External Interface
Transmission output: Defibrillation, alarm, event or VF analysis reports, SD card data, and data
in internal memory can be output via a Bluetooth® module.
SD card: The measured data can be stored. Recovery of the defibrillator software is
also possible.
External ECG input: Applying 1/1000 to an external ECG enables you to enter it in the lead
ECG, which is displayed on the screen.
Maintenance
Self Tests
The defibrillator automatically performs the self test at power on/off or
power cord connection/disconnection, every day or every month.
Operation when an abnormality is detected:
The status indicator is set to the disabled condition (red).
Basic Checks
This mode enables easy daily inspection.
SD card check: To check whether an SD card can be written and read. The remaining
capacity can also be checked.
System check: To check whether there is an error history.
Paddle check: To check the type of paddles connected to the paddle connector.
Defibrillation check: To check the capacity of the high-pressure condenser. By discharging
to the external paddles or to the test load connected, the supplied
energy, TTR, and charge time are measured for normal or abnormal
determination.
Pacing check: To check a pacing output for normal or abnormal determination
(TEC-5631 only).
Status indicator check: To check whether indications of the status indicator change.
Voice check: To check whether voice instructions can be heard.
Alarm check: To check the alarm indicator and alarm sounds.
ECG check: To check whether communication is properly made with the lead ECG
section (except TEC-5601).
Multi-parameter check: To check whether communication is properly made with the multi
parameter unit (only when QI-564V is connected).
Battery check: To check the battery remaining and expiration date.
Bluetooth® check: To check communication with an external device (only when QI-832V is
connected).
Recorder check: To check whether data can be normally printed on papers (except
TEC-5601).
Maintenance Information
Defibrillator history: When an error occurs, the history is used to store the error generation
status for subsequence investigation.
Time for battery replacement:
A message to prompt battery replacement is displayed upon time for
replacement.
Operations
Control dial: Using this rotary switch, the following modes can be selected.
• Power OFF
• Monitor mode
• AED mode
• Internal discharge
• Energy setting
• Setup
• Basic check
• Transcutaneous pacing fixed mode
• Transcutaneous pacing demand mode
SYNC button: Press for synchronized defibrillation.
CHILD MODE button: To select AED mode for children, turn the control dial to the AED
position while holding this button pressed.
CHARGE/AED button: To start an energy charge in manual mode. VF analysis can also be started
by pressing the button in AED mode.
SHOCK button: Press the SHOCK button to start discharging. It flashes when charging is
complete.
Function keys (1 to 5): The key functions are changed in accordance with the operation screens.
• Initial assignments in monitor mode:
LEAD (to select the ECG lead), SENSITIVITY (to select the ECG
sensitivity), EVENT, FREEZE, and GUIDE
• Major function keys in other statuses:
Start/stop pausing the analysis, start/stop the timer, medication events,
start/stop CPR operation sound, CO2 calibration
Record key: To start/stop recording.
Alarm cancel key: To temporarily stop alarms.
PACING RATE up/down keys:
To increase/decrease the pacing rate.
PACING OUTPUT up/down keys:
To increase/decrease the pacing output current.
PACING START/STOP key:
To start/stop pacing.
Charge button: To start energy charging in manual mode when external paddles are
connected.
Shock buttons (external paddles):
To apply a shock, press the buttons on the left or right of the connected
external paddles. The buttons flash when charge is complete.
Shock buttons (internal paddles):
To apply a shock when you press the buttons on the handles of the 15
connected internal paddles (with switch).
Transportation
Cart: You can carry the defibrillator mounted on a cart.
Bed rail hook: You can hang the defibrillator over the hook.
Wall mount: You can mount the defibrillator in a vehicle, using the wall mount.
Performance
Defibrillator
Output Waveforms
Discharging waveform: Truncated exponential constant power biphasic
Shape of discharging waveform:
Output energy: 50 J
Load resistance
Parameter
25 Ω 50 Ω 75 Ω 100 Ω 125 Ω 150 Ω 175 Ω
First-phase pulse width D1 (ms) 3.86 6.37 8.88 11.4 13.9 16.4 18.9
Second-phase pulse width D2 (ms) 3.62 3.62 3.62 3.62 3.62 3.62 3.62
Second-phase pulse width D3 (ms) < 6.5 < 6.5 < 6.5 < 6.5 < 6.5 < 6.5 < 6.5
Time between the first and second
≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5
phases (ms)
First-phase peak current Ipk1 (A) 29.4 17.9 12.9 10.0 8.20 6.95 6.02
First-phase terminal current It (A) 11.3 6.67 4.73 3.66 2.99 2.53 2.19
Second-phase peak current Ipk2 (A) 6.52 5.45 4.73 4.23 3.86 3.57 3.34
Load resistance of 25 Ω
2 J: (0.85 × Eset)±1 J
3 J: (0.85 × Eset)±2 J
5, 7, 10, 15 J: (0.85 × Eset)±3 J
20 J or more to 270 J or less: (0.85 × Eset)±15%
Load resistance of 75 Ω
2 J: (1.06 × Eset)±1 J
3 J: (1.06 × Eset)±2 J
5, 7, 10, 15 J: (1.06 × Eset)±3 J
20 J or more to 270 J or less: (1.06 × Eset)±15%
Charge time from when power is turned on to when the charge is complete
Manual mode
AC (90% of the rated voltage):
Within 10 seconds for 270 J
Battery (after 15 discharges at 270 J using a fully charged new battery at 20°C, −4°F):
Within 10 seconds for 270 J
AED mode
AC (90% of the rated voltage):
Within 14 to 23 seconds for 270 J
Battery (after 15 discharges at 270 J with a fully charged new battery at 20°C, −4°F):
Within 14 to 23 seconds for 270 J
Sync Mode 1
1
Essential performance in EMC
VF/VT Analysis 15
Analysis time
When “Continuous VF Analysis” in AED Setup is “Off”:
Analysis of shockable rhythm: Minimum 5 seconds
Analysis of non-shockable rhythm: Minimum 8 seconds
When “Continuous VF Analysis” in AED Setup is “On”:
Analysis of shockable rhythm: Minimum 3 seconds
Analysis of non-shockable rhythm: Minimum 5 seconds
Transcutaneous Pacing
Pacing waveform: Modified trapezoidal
Pulse width: 40 ms±10%
Pacing output current (with a load resistance of 250 Ω)
Setting range: 0 mA, 8 mA to 200 mA
Accuracy: ±10% or ±2 mA (whichever greater)
ECG
ECG Inputs
Paddles/pads
Sensitivity: 10 mm/mV±15% (sensitivity ×1)
Input impedance: 100 kΩ or more (when a polarization of ±300 mV is added at 10 Hz,
2 mVp-p)
Hum filter attenuation: –20 dB at 50 and 60 Hz
Transient property: 0.32 seconds or more, 1 second or less
Maximum input voltage: ±5 mV or more
Frequency response: 0.5 to 20 Hz (attenuation of 3 dB or less for 10 Hz)
Heart rate measurement: 0, 15 to 300 bpm ±3% ± 1 bpm
Monitor recovery
Defibrillation output from an external device:
Within 3 seconds
Internal defibrillation output:
Within 3 seconds
VF recognition time: Within 20 seconds
15
Recovery time for disposable pads attached:
Within 10 seconds
VF recognition time for disposable pads attached:
Within 20 seconds
Leads
Sensitivity: Within 10 mm/mV±5% (sensitivity ×1)
Input impedance: 5 MΩ or more (when a polarization of ±600 mV is added at 10 Hz and
2 mVp-p)
Hum filter attenuation
Monitor mode
Power frequency 50 Hz:
–20 dB or more at 50 Hz
Power frequency 60 Hz:
–20 dB or more at 60 Hz
Manual mode/pacing mode
SpO2
SpO2 measurement accuracy (rms1):
±2%SpO2 (80%SpO2 ≤ SpO2 ≤ 100%SpO2)
±3%SpO2 (70%SpO2 ≤ SpO2 ≤ 80%SpO2)
Not specified for SpO2 < 70%SpO2
(Accuracy-guaranteed ambient temperatures: 18ºC to 40ºC, 64.4ºF to
104ºF)
Heart rate measurement accuracy (rms1): ±3% ±1 bpm (30 to 300 bpm)
1
The rms is the difference between measurement value and standard reference values by root-mean square.
CO2
The specifications in this section depend on TG-900-series models.
Measurement range
0 to 13.3 kPa (0 to 99 mmHg)
Measurement accuracy
TG-900P/TG-920P: ±0.40 kPa (0 ≤ CO2 ≤ 1.33 kPa) (±3 mmHg (0 ≤ CO2 ≤ 10 mmHg))
±0.53 kPa (1.33 < CO2 ≤ 5.33 kPa) (±4 mmHg (10 < CO2 ≤ 40 mmHg))
±10% reading (5.33 < CO2 ≤ 13.3 kPa) (40 < CO2 ≤ 99 mmHg)
At 1 atmospheric pressure, air inspiration, no condensation
TG-970P: ±0.27 kPa (0 ≤ CO2 ≤ 5.33 kPa) (±2 mmHg (0 ≤ CO2 ≤ 40 mmHg))
±5% reading (5.33 < CO2 ≤ 9.33 kPa) (40 < CO2 ≤ 70 mmHg)
±7% reading (9.33 < CO2 ≤ 13.3 kPa) (70 < CO2 ≤ 99 mmHg)
No condensation
Screen Displays
Waveform display sensitivity:
10 mm/mV±10% or less (sensitivity ×1, including ECG amplifier)
Waveform sweep speed: 25 mm/s, 50 mm/s±10% or less
Recorder
Recording sensitivity: 10 mm/mV±10% or less
Frequency response: 0.05 to 150 Hz (attenuation 3 dB or less) for a sinusoidal input of
2 mVp-p and 10 Hz as the reference
Recording paper speed: 25 mm/s±10% or less or 50 mm/s±10% or less
15
SD Card Storage
Storage capacity: 1 GB (QM-001D) or 2 GB (QM-002D)
Time for storage: QM-001D: Max. 24 hours of continuous ECG data with audio
Max. 106 hours of continuous ECG data without audio
QM-002D: Max. 50 hours of continuous ECG data with audio
Max. 168 hours of continuous ECG data without audio
Alarm Functions
Alarm Range
Upper or lower limit alarms
Alarm Levels
The alarms of the defibrillator are classified according to the importance, as follows:
Crisis alarm: Generated in an abnormal condition of a patient or of the defibrillator, or
if no proper operation is performed. If no immediate action is taken, the
patient’s life may be at risk.
Warning alarm: Generated in an abnormal condition of a patient or of the defibrillator, or
if no proper operation is performed, requiring prompt action.
Advisory alarm: Generated if the condition is not appropriate for accurate measurement or
proper treatment.
Colors of the Alarm Indicator
Alarms for patients or the defibrillator are indicated.
Crisis: Blinks in red
Warning: Blinks in yellow
Advisory: Lit in cyan
Indications by the Alarm Indicator
Crisis alarm: Blinks in red at a frequency of approx. 1.6 Hz (approx. 640 ms), duty
50%
Warning alarm: Blinks in yellow blinking at a frequency of approx. 0.8 Hz (approx. 1280
ms), duty 50%
Advisory alarm: Lit in cyan
Alarm Sounds
Crisis alarm: Sound conforming to IEC60601-1-8
Warning alarm: Sound conforming to IEC60601-1-8
Advisory alarm: Sound conforming to IEC60601-1-8
Alarm Sound Volume
Volume range: 45 to 85 dB (A)
Alarm Suppression
To temporarily silence an alarm sound:
When an alarm is generated, press the silence alarms key to stop the alarm
sound for a certain time (temporary silence time: 2 minutes).
To suspend all the alarm sounds:
While no alarm is generated, press the silence alarms key to suspend all
alarm sounds for a certain time (suspend time: 2 minutes).
Power Requirements
Alternate Current (AC)
Power-supply voltage range:
100 V to 240 V
Power frequency: 50 Hz or 60 Hz
Power Input
Continuous loading: 150 VA or less
Intermittent loading: 300 VA or less
Battery
Type: Ni-MH battery
Capacity: 2800 mAh
Rated voltage: 12 V (allowable voltage variable range: 9.0 to 18.0 V)
Operation time
Fully charged new battery at 20ºC, 68ºF
Defibrillation (270 J) in manual mode:
100 discharges or more
Monitor mode: 180 minutes or more (defibrillator and external paddles connected, other
parts or accessories not connected)
Pacing: 120 minutes or more (180 ppm, 200 mA)
Fully charged new battery at 0ºC, 32ºF
Defibrillation (270 J) in manual mode:
50 discharges or more
Defibrillation (270 J) in AED mode:
50 discharges or more
Charging request: At least 3 charge/discharge cycles for 270 J are allowed after a request for
charging is instructed
Charge complete indication:
“CHARGING COMPLETE” indicated 15
7 days unattended
7 days unattended (at 20ºC, 68ºF, 65%)
15th 270 J charge time in manual mode:
15 seconds or less
From the 15th VF input to charging completion in AED mode:
30 seconds or less
Applicable Laws
• Medical Device Directive (Classification: Class II b)
• WEEE Directive
• RoHS Directive
Applicable Regulations
• IEC 60601-1: 2005
• IEC 60601-1 Amendment 1: 2012
• IEC 60601-1-2: 2007
• IEC 60601-1-6: 2010
• IEC 60601-1-8: 2006
• IEC 60601-1-8 Amendment 1: 2012
• IEC 60601-1-9: 2007
• IEC 60601-2-4: 2010
• IEC 60601-2-27: 2011 1 2 4
• IEC 60601-2-49: 2011 1 2
• ISO 10993-1: 2009
• ISO 14971: 2007
• EN ISO 14971: 2012
• ISO 80601-2-55: 2011 1 3
• ISO 80601-2-61: 2011 1 3
• EN 1789: 2007
• EN 1789 Amendment 1: 2010
Applicable only for monitor mode (when limb and chest lead ECG selected)
1
This defibrillator complies with clause 201.11.8 when using the battery pack.
2
This defibrillator complies with clause 201.11.8.101 when the battery remaining alarm
3
is not generated.
The hum filter setting of this defibrillator is not displayed. This defibrillator complies
4
Classifications
Type of protection against electrical shock
• When connecting to an AC power (commercial use):
Class I ME equipment
• When not connecting to an AC power (commercial use):
Internally powered ME equipment
Degree of protection against electrical shock
• Type BF applied parts:
External paddles, disposable pads
• Type CF applied parts:
Internal paddles, internal paddles (with switch)
• Defibrillation-proof type CF applied parts:
ECG connection cable, electrode leads, SpO2 probes, CO2 sensor kit
Protection against harmful ingress of water or fine particulates
• IP44: TEC-5621 and TEC-5631 with a pad adapter or internal paddles,
TEC-5611
• IP41: TEC-5621 and TEC-5631 with external paddles, TEC-5601
Applicable when connecting all patient cables (except the recorder)
Sterilization or disinfection methods specified by manufacturers
• Internal paddles, internal paddles with switch:
High-pressure steam sterilization (autoclave sterilization), plasma gas
sterilization, ethylene oxide gas sterilization (EOG sterilization)
• Except internal paddles and internal paddles (with switch):
Not for sterilization
Qualifications for use in a high-oxygen atmosphere
Not qualified
Safety level for use in air and flammable anesthetic gas or oxygen/nitrous oxide and
flammable anesthetic gas
Not applicable
Mode of operation
Continuous operation
Installation conditions
Indoor and in-vehicle uses
Frequency of use (class by IEC 60601-2-4: 2010)
High frequent use 15
Environment Conditions
Storage Environments
Ambient temperature: –25 to +70ºC, –13 to +158ºF
Relative humidity: 10 to 95% (noncondensing)
Atmospheric pressure: 500 to 1060 hPa
Transport Environments
Ambient temperature: –25 to +70ºC, –13 to +158ºF
Relative humidity: 10 to 95% (noncondensing)
Atmospheric pressure: 500 to 1060 hPa
Power Requirements
For both AC and DC
Power voltages
AC operation: 100 V to 240 V (allowable variation range: 80 V to 264 V)
Battery operation: 12 V (allowable variation range: 9 V to 18 V)
Power input: 150 VA or less with continuous loading or 300 VA or less with
intermittent loading
Power frequency: 50 or 60 Hz
Battery rated capacity: 2800 mAh
Battery charging current: 2000 mA
Noise
Less than 48 dB SPL
Cooling System
Natural cooling
Mechanical Strength
Protection against Vibration
• MIL-STD-810F 514.5 Category 4 Restrained Cargo
• Exposure level Annex A 2.2.1C(1)
• MIL-STD-810F 514.5 Category 9 Helicopter
Exposure time: 4 hours for each of XYZ axes
• EN 1789: 2007
• EN 1789 Amendment 1: 2010
Impact
• IEC 60068-2-27: 2008
Impact peak value: 50G
Impact peak value: 10G, repeated times: 1000±10 times
• EN 1789: 2007
• EN 1789 Amendment 1: 2010
Drop
• IEC 60068-2-32: 1975
• IEC 60068-2-32 Amendment 2: 1990
• EN 1789: 2007
• EN 1789 Amendment 1: 2010
Pulse rate
When increasing the pulse rate from 80 to 120 bpm (upper limit: 100 bpm): 15 seconds or less
When decreasing the pulse rate from 80 to 40 bpm (lower limit: 60 bpm): 20 seconds or less
VPC
Approx. 1 second after a measurement value reaches the alarm threshold
Respiration rate
Within 3 seconds after a measurement value reaches the alarm threshold (calculated from intervals
among the previous 4 breaths)
SpO2
Within 3 seconds after a measurement value reaches the alarm threshold
CO2 partial pressure (mainstream method)
Within 3 seconds after a measurement value reaches the alarm threshold (calculated when the next
breath is detected)
Electrocardiogram (ECG)
Electrode disconnection detection
The detecting function is available for each electrode.
Active electrode: Less than 100 mA
Reference electrode: Less than 900 mA
Influence by ESU and defibrillation
Influence on the measurement accuracy:
Use of an ESU or defibrillation may cause a temporary decrease in
measurement accuracy. However, the original operation mode is resumed
within 10 seconds. There is no influence on the security of patients of the
defibrillator, as well as the stored data.
Time to resume normal operations after defibrillation voltage applied
Monitor recovery
Defibrillation output from an external device:
Within 10 seconds
Internal defibrillation output:
Within 3 seconds
Waveform display
Aspect ratio (ECG display sensitivity ratio to the sweep speed)
Standard: 0.4 seconds/mV
Setting range: 0.05 to 6.4 seconds/mV
NOTE: A pulse oximeter tester that generates simulated signals can be used to check the
difference from the design specification, but it cannot be used as a replacement for
human signals for testing accuracy.
Monitor recovery
Defibrillation output from an external device:
Within 3 seconds
Alarm condition delay: Within 12 seconds after a measurement value reaches the alarm threshold
Alarm signal generation delay:
Within 3 seconds after a measurement value reaches the alarm threshold
Measurement accuracy
TG-900P, TG-920P: ±0.40 kPa (0 ≤ CO2 ≤ 1.33 kPa) (±3 mmHg (0 ≤ CO2 ≤ 10 mmHg))
±0.53 kPa (1.33 < CO2 ≤ 5.33 kPa) (±4 mmHg (10 < CO2 ≤ 40 mmHg))
±10% reading (5.33 < CO2 ≤ 13.3 kPa) (40 < CO2 ≤ 99 mmHg)
At 1 atmospheric pressure, air inspiration, no condensation
TG-970P: ±0.27 kPa (0 ≤ CO2 ≤ 5.33 kPa) (±2 mmHg (0 ≤ CO2 ≤ 40 mmHg))
±5% reading (5.33 < CO2 ≤ 9.33 kPa) (40 < CO2 ≤ 70 mmHg)
±7% reading (9.33 < CO2 ≤ 13.3 kPa) (70 < CO2 ≤ 99 mmHg)
No condensation
Monitor recovery
Defibrillation output from an external device:
Within 3 seconds
15
The TEC-5600 series essential performances in EMC standard satisfy the following criteria.
The TEC-5600 series is intended for use in the electromagnetic environment specified below. The
customer or the user of the TEC-5600 series should assure that it is used in such an environment.
Electromagnetic Immunity
The TEC-5600 series essential performances in EMC standard satisfy the following criteria.
The TEC-5600 series is intended for use in the electromagnetic environment specified below. The
customer or the user of the TEC-5600 series should assure that it is used in such an environment.
Electromagnetic environment -
Immunity test IEC 60601 test level Compliance level
guidance
Electrostatic discharge ±6 kV contact ±6 kV contact Floors should be wood, concrete or ceramic
(ESD) tile. If floors are covered with synthetic
±8 kV air ±8 kV air
material, the relative humidity should be at
IEC 61000-4-2
least 30%.
Electrical fast transient/ ±2 kV for power supply ±2 kV for power supply lines Mains power quality should be that of a
burst lines typical commercial or hospital environment.
When there is large noise on the AC power
IEC 61000-4-4 ±1 kV for input/output lines ±1 kV for input/output lines
line, supply the power from the battery pack.
Surge ±1 kV differential mode ±1 kV differential mode Mains power quality should be that of a
typical commercial or hospital environment.
IEC 61000-4-5 ±2 kV common mode ±2 kV common mode
Voltage dips, short < 5% UT < 5% UT Mains power quality should be that of a
interruptions and voltage (> 95 % dip in UT) for (> 95% dip in UT) for typical commercial or hospital environment.
variations on power supply 0.5 cycles 0.5 cycles If the user of the TEC-5600 series requires
input lines continued operation during power mains
interruptions, it is recommended that the
IEC 61000-4-11 40% UT 40% UT
TEC-5600 series be powered from an
(60% dip in UT) for (60 % dip in UT) for
uninterruptible power supply or a battery.
5 cycles 5 cycles
70% UT 70% UT
(30% dip in UT) for (30% dip in UT) for
25 cycles 25 cycles
< 5% UT < 5% UT
(> 95 % dip in UT) for (> 95 % dip in UT) for
5 seconds 5 seconds
Power frequency 3 A/m 3 A/m Power frequency magnetic fields should be at
(50/60 Hz) magnetic field levels characteristic of a typical location in a
typical commercial or hospital environment.
IEC 61000-4-8
NOTE 1: UT is the AC mains voltage prior to application of the test level.
NOTE 2: Noise from the AC power line may generate noise which is superimposed on the ECG waveforms.
15
Immunity test IEC 60601 test level Compliance level Electromagnetic environment - guidance
Portable and mobile RF communications equipment should be
used no closer to any part of the TEC-5600 series, including
cables, than the recommended separation distance calculated
from the equation applicable to the frequency of the transmitter.
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines might not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.
1
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur
radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the
location in which the TEC-5600 series is used exceeds the applicable RF compliance level above, the TEC-5600 series should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting
or relocating the TEC-5600 series.
2
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
• RRD is the abbreviation of Rhythm Recognition Detector.
The TEC-5600 series is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the TEC-5600 series can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the TEC-5600 series as recommended below, according
to the maximum output power of the communications equipment.
Reference
• ANSI/AAMI DF2-1996 Cardiac defibrillator devices
4.3.2 Energy range
A. 4.3.2 Energy range
G N
General Requirements for Connecting Medical Naming a Medication Key..................................... 5-13
Electrical Systems................................................. 3-10 Number of Electrodes and Measuring Leads.......8-1-3
GUIDE..................................................................... 5-6
GUIDE Window....................................................8-0-5
O
Optimum Lead for Monitoring.............................8-1-15
H Options and Consumables.................................... 13-3
HR ALARM.............................................................. 5-8
T
Technical Alarms..................................................... 9-8
Transport..................................................11-17, 11-27
Transport Function
Transfer Data.......................................................... 10-3-3
Transferring Data.................................................... 10-3-4
TRENDGRAPH................................................10-1-16
Trickle Charging...................................................... 4-7
Troubleshooting................................................... 11-20
Types of Alarm......................................................... 9-2
Types of Power........................................................ 4-2
U
Upper/Lower Limit Alarms....................................... 9-6
Using AC Power...................................................... 4-3
Using an ECG from an External Monitor as a
Synchronizing Signal..........................................6-1-14
Using Paddle/Pad-Lead ECG as the
Synchronizing Signal..........................................6-3-25
Using the Battery..................................................... 4-4
V
Voice Messages.................................................. 11-18
VOLUME............................................................... 5-11
W
Warnings and Cautions........................................... 3-4
Waveform Recording..........................................10-1-7
Waveform Report.............................................10-1-14
Contact information is accurate as of Jan 2015. Visit www.nihonkohden.com for the latest information.
The model and serial number of your instrument are identified on the rear or bottom of the unit.
Write the model and serial number in the spaces provided below. Whenever you call your representative concerning
this instrument, mention these two pieces of information for quick and accurate service.
Your Representative
TEC-5600_0614-907188C