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Siemens Axiom Iconos X-Ray System

1. 2 without variable positioning Cassette holder with variable positioning For lateral exposures with a second X ray tube to hold the cassette upright in all table positions including Trendelenburg Maximum cassette format 35 cm in height width is unrestricted e g 35 cm x 43 cm horizontal is possible Minimum cassette formats 13 x 18 cm vertical or 18 cm x 24 cm horizontal AXD3 340 620 13 01 02 29 154 Accessories Optional Accessories Attachment 30 54 Move the patient table to the horizontal position Position the patient Loosen the cap screw 1 Place the cassette holder on the accessory rail and move it to the exposure position Tighten the cap screw 1 Push and pull the cassette holder to ensure that it is seated properly 9 49 2 Lift the tensioning device 4 Place the cassette on the lower holder Slide the tensioning device downward Ensure that the cassette is seated properly in the holder Loosen the cap screw 2 to permit adjustment of the height and the cap screw 3 to permit lateral adjustment With the patient positioned for the examination adjust the height and lateral tilt of the cassette Tighten the cap screws 2 and 3 Ensure that the patient is stabilized and comfortable Have the patient place his her hands on the grip protection strip the grip strip or the handgrip depending on the examination
2. 8 1 Switch rail between tabletop and stand 2 Switch rails in each case at the end of the travel of the spotfilm unit 3 Safety switching sensors on the image intensifier TV device 2 sensors AXD3 340 620 13 01 02 19 44 System Overview Protective Measures On activation of one of the safety devices shutdown devices all system move ments stop and are blocked This means that one cannot move out from the blockage oneself If itis not possible to remove the obstruction causing the problem call in the Sie mens Uptime Services Movements are possible again only after one of the safety devices has be deac tivated Possible collisions of the system with a celling mounted support 1 System movements are possible only if the ceiling mounted support is in its park position or if the bypass switch is activated if necessary 1 Prior to actuating system movements with the bypass switch activated verify that no collision can take place with the ceiling mounted support the X ray tube assembly or the collimator No collision monitoring Warning If system movements are possible even though the ceiling mounted support is not in the park position and the bypass switch is not activated immediately press the emergency shutdown button and notify the SIEMENS Uptime Service 20 144 Measures for avoiding equipment damage Before activating system movements especially tilting the table make sure th
3. o lt q 81 w i 50 mas max value U o 1 2 s E o m C Program 0 hu gt lt 3 4 uGy cm2 Selection Select atomographic program on the unit and an organ program with Plani ION TOMAT and mAs preselection or atomographic program on the unit and actuate the IONTOMAT button Deselection Deselect the tomographic program on the unit or actuate the IONTOMAT button Plani lONTOMAT is selected Exposure data 11 The following exposure data can be set to be set kV value Focal spot Tube load Measuring fields dominants Film screen combination Density compensation 28 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Selection Deselection Exposure data to be set Display of exposure data AXIOM Iconos R200 Select indirect exposure technique Select DR 0 point technique T Setting the kV value from fluoroscopy 1 Exposure cut off by the automatic exposure control Iconos DFR Iconos Cassette Iconos Bed Vertix Info 0 hu gt 3 4 uGy cm2 66 kv O Program Select DR technique on the unit and an organ program with DR 0 point tech nique Select a
4. If there is a fault while actuating one of the following movements tilting the table down up moving the tabletop longitudinally moving the X ray system transversely then these movements are stopped and the fault is displayed as an error in the message line of the integrated generator control console and stored Cancelling the fault Briefly press the exposure release button on the generator ON OFF console up to the 1st pressure point and let go again Don t press more The fault is cancelled as a rule Actuating the same movement again If a fault occurs again when the same movement is actuated then these move ments are once again stopped and the fault is displayed as an error in the mes sage line of the integrated generator control console and stored Cancelling the fault Briefly press the exposure release button on the generator ON OFF console up to the 1st pressure point and let go again Don t press more The fault is cancelled as a rule by this Actuating the same movement again If the same movement is actuated again and there is a fault once again then a warning signal whistle sounds and this movement is blocked The following er ror message is displayed in the message line of the integrated generator control console Severe error please call service A Warning Collision monitoring is inoperable The operator is responsible for avoiding collisions of the system with objects and t
5. No cooldown time required and automatic switching to 80 tube load You may release the preset exposure with 80 tube load 1 X ray tube assembly with heavy load Cooldown time is indicated You may release the preset exposure with 80 tube load only after the indicated cooldown time has elapsed Load data indication The load unit counter stores the load data of the connected X ray tube assem blies Vertix i Iconos DFR Iconos Iconos Bed Cassette Tube load units 1234567 Tube No 1 ACQ on wait 0 ACQ on overloads 0 a E v To 0 3 ma oi min 0 20 mAs mAs 0 hu D 3 3 ms ms 3 4 9 11009 gt E CON el 80 100 Wr Program With the INFO button actuated the load data of the selected X ray tube assembly is indicated in the message line LJ Tube load units BE 1 load unit corresponds to 1 exposure or 1s series 1 ACO on wait Number of exposures released during the indicated cooldown time Li ACO on overloads Number of overloads Tita warning buzzer is to come on at a certain pause time threshold please have it programmed by your customer service AXD3 340 620 13 01 02 11 36 POLYDOROS SX 65 80 Integrated Control Console 12 36 1 hu gt Li INFO button is not active if an information is already present on the message line Indication of the current value of t
6. Open the securing straps on the molded leg supports 9 o Position the patient s lower legs on the molded leg supports AXIOM Iconos R200 AXD3 340 620 13 01 02 15 54 Accessories Optional Accessories 0 Raise the leg supports to the examination position and adjust the position of the legs inward or outward as needed Tighten the cap screws 2 Pull and push on the leg supports and the flanges to ensure they are seated properly Place the leather pads over the center of the patient s lower legs Position the straps around the patient s lower legs Tighten the straps appropriately Removal Move the patient table to the horizontal position Release the straps Lift the patient s legs from the leg supports If necessary remove the leg supports by loosening the cap screws 2 Wrap the straps around the leg supports Loosen the cap screws 1 Remove the flanges from the accessory rails Note on biological compatibility Please place towels between the patient s legs and the knee crutches to avoid direct skin contact with the knee crutches 16 54 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Compression belt Application Used for patient compression during thoracic or abdominal examinations as well as for immobilizing restless or very frail patients Make sure that all traces of contrast medium have been remove
7. System Overview Operating and Display Elements Semitransparent filters SIZ 1 Semitransparent wedge filter e 1 Semitransparent double wedge filter L1 Move semitransparent wedge filter and double wedge filter out from the X beam path LED lights up no filter in the beam path G 1 Coordinate switch for right wedge filter patient related a p projection and double wedge filter 2 a Move in out N Turn to the right left 7 1 Coordinate switch for left wedge filter patient related a p projection and double wedge filter o Move in out o Turn to the right left Radiation release 1 Exposure release button with pre and main contact Stop button LJ Red emergency stop button General operating elements Eg LI Room light on off on site installation required 1 only in operation with DSA filter diaphragm option AXIOM Iconos R200 AXD3 340 620 13 01 02 29 44 System Overview Operating and Display Elements 30 44 000 Cam C O Seceesc Preselection functions a Automatic format collimation for cassette exposures only with cassette spot film device Height and width both LEDs light up Height left LED lights up Width right LED lights up Without automatic format collimation no LED lights up Object setting Oriented to the monitor left LED lights up Oriented to the table right LED lights up Switching over single image series for
8. lt p gt 22 132 Under the following conditions no shadowing of the collimated format will result from the cone arm in the park position T Max 40 cm high on the horizontal unit with orthogonal collimation and 150 cm SID UU Max 35 cm high on the vertical unit with orthogonal collimation or oblique projection in all unit positions from115 cm SID Reading the compression level Read the indication on the display Read the indication at the bottom right on the monitor Tomographic equipment optional TT SEMENS AXIOM Iconos R200 1 2 1 Mirror 2 Scale Setting the fulcrum height The average fulcrum height 120 mm is set automatically when the system is switched on Fulcrum heights of 10 mm approx 300 mm above the tabletop can be set for cassette tomography and digital tomography Press one of the keys Adjustment upwards Adjustment downwards AXD3 340 620 13 01 02 Operator Manual lt gt System remote control console on the system AXIOM Iconos R200 System Operation System Settings Lil Press briefly and the fulcrum height changes by 1 mm Press longer the fulcrum height changes continuously in steps of 1 mm Switching on the fulcrum height light localizer Press one of the keys briefly The light localizer goes out au
9. the shoulder supports must be used The max imum weight of the patient must not exceed 180 kg to 45 Trendelenburg posi tion In Trendelenburg position gt 45 the max patient weight of 150 kg must not be exceeded Move the patient table to the horizontal position Position the patient Loosen the cap screws 1 on both supports Move the supports into position on both accessory rails Pull the shoulder pads out up to the middle of the patient s shoulders Tighten the cap screws 1 Check the shoulder supports Loosen the cap screws 2 for the shoulder pads Adjust the height of the shoulder pads for secure and comfortable positioning 4 Tighten both cap screws 2 A Removal AXIOM Iconos R200 Warning When in Trendelenburg position the patient is protected against slipping only by the shoulder supports Pull on the shoulder supports to be sure that they are securely attached before moving the patient into the Trendelenburg position Move the patient table into the horizontal position Loosen the cap screws 1 on both sides Pull the shoulder supports out of the accessory rails AXD3 340 620 13 01 02 9 154 Accessories Standard Accessories Footboard Attachment Positioning aid for examinations of patients when standing or sitting and for ad ditional use with the foot restraints for recumbent patients in Trendelenburg po sition The maximum permiss
10. System selection bar 1 System selection 1 Button for displaying the load data of the selected X ray tube Message line LI Displays messages warnings and buttons with specific functions Selection field for organ programming 1 1 Indicates O point technique selected deselected lio Cerv spine LI Indicates the selected organ program oblique 1 Switches over to the program menu AXIOM Iconos R200 AXD3 340 620 13 01 02 5 36 POLYDOROS SX 65 80 Integrated Control Console Fluoroscopic data field 0 1 min 0 hu uGy cm2 gt lt Operating mode and IONTOMAT data field no pa z 2 ld i HAR 6 36 1 Fluoroscopic data field symbol 1 Indicates the fluoroscopic kV values 1 Indicates the fluoroscopic mA values 1 Indicates the fluoroscopic time 1 Indicates the tube load d Indicates the dose area product 1 Resets the fluoroscopic data time kV mA and the dose area product cGy cm 1 Symbols indicate that direct radiographic mode is active or indirect radiography is active L1 Indicates that tomographic mode is active LI Selects the IONTOMAT with 3 point technique d Indicates the density compensation 1 Adjusts the density compensation 4 exposure points 1 Selects the film screen combination H high sensitivity U medium sensitivity D low sensitivity high detail resolution 1 Selects the measuring field dominant left center right circular
11. lt A lt gt m or Display of the set compression level only in connection with the compression device optional Additional Cu filter swivelled in Cassette exposures available in film segmentation only with cassette spotfilm device Current position and maximum possible exposure positions in Peristepping optional Fulcrum height axial oblique projection isocenter or tomographic height optional Selected tomographic program angle time Error message Scanning technique DR scanning selected Display of the cassette size System settings a a D Compression device optional decompress compress without function Joystick for table tilt down tilt up Oblique projection cranio caudal caudo cranial AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements 1 Oblique projection 0 orthogonal projection EN b m Joystick for X ray system longitudinal movement Tabletop transverse movement gt 0 1 Coordinate switch for moving tabletop longitudinally transversely A gt y J Fulcrum height for oblique projection isocenter 1 Tomographic height setting above tabletop optional Move cassette into unloading position only with cassette spotfilm device 1 Source image distance with cassette spotfilm device 115 cm 150 cm 1 Source l l distance with l l ima
12. mat collimation AXIOM Iconos R200 Examination Cassette exposures with wall stand Collimation during exposure With the table vertical and 180 rotation of the tube assembly the automatic for mat collimation of the system switches over automatically I to the ACSS Mode with automatic format collimation if using a wall stand with automatic format collimation option LJ to the Manual Mode without automatic format collimation if using a wall stand without automatic format collimation Selecting the exposure technique Select the wall stand system at the integrated generator control console Set the table to a vertical position Set the tube assembly to a source image distance of 115 cm or 150 cm Turn the tube assembly horizontally onto the wall stand Place the cassette in the Bucky Position the patient in front of the wall stand Set the wall stand to the object height o o Adjust the tube assembly to the object using the full field light localizer and positioning laser Collimate in relation to the object The radiation field is automatically set to the cassette format and can then be col limated as small as required in relation to the object There is no limitation of the radiation field and collimation must be performed in relation to the object using the full field light localizer Select measuring field AXD3 340 620 13 01 02 51 152 Examination Cassette exposure
13. Fluoroscopy Fluoro Fluoro Fluoro Fluoro Fluoroscopy with Supervision optional By pressing one of the keys you select Standard fluoroscopy Fluoro or Supervision Fluoro Li You can also switch from one operating mode to another during a fluoroscopic examination Pulsed fluoroscopy optional Press one of the keys briefly to selected Pulsed fluoroscopy with a pulse rate of 3 3 p s 7 5 8 3 p s or 15 12 51 p s or Standard fluoroscopy Increase Fluoro decrease Fluoro the pulse rate A pulse rate of 3 p s is the lowest setting and standard fluoroscopy is the highest setting Li You can also switch over from one operating mode to another during fluorosco py Roadmap Roadmap can be combined with all fluoroscopic modes There is a corresponding Roadmap Fluoro program for every combination Press this key to select deselect Roadmap map 8 52 Li You can select deselect this function only when radiation is not being released Roadmap is automatically deselected when you change to the Pat List menu on changing the exposure system Peri bed side exposure or the organ pro gram selection gt Refer to the FLUOROSPOT Compact Operator Manual for information on the operating sequence 1 Values in brackets apply to VDEOMED DHC 2 only with DSA option AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Fluoroscopy Rel
14. Footswitch for fluoroscopy and radiography Options a D CCOO COO O 6 44 DICOM functions Get Worklist and MPPS Query Retrieve Print Reference image monitor s VERTIX PRO TOP Bucky wall unit 2nd X ray tube assembly on the 3D TOP ceiling mounted support PACS SIENET connection High pressure contrast medium injector Measuring device for area dose product Mobile tableside console AXD3 340 620 13 01 02 Operator Manual System Overview System Description System overview 1 9 1 ICONOS R200 examination unit 2 Generator ON OFF console 3 Monitor trolley optional 4 System remote control console 5 FLUOROSPOT Compact keyboard 6 Foot switch for fluoroscopy and radiography 7 Desk optional for operating consoles 8 Tableside control console with foot switch for fluoroscopy and radiography optional 9 Bucky wall unit optional AXIOM Iconos R200 AXD3 340 620 13 01 02 7144 System Overview System Description Unit overview 9 ie ee 0000 8 O 0000 10 7 5 4 EN 11 AXIOM Iconos R200 12 iw Y 13 14 E sr O08 Saar an Gead 2 15 ES Y
15. Release the brake handle While positioning the patient position the upper body radiation protection out side of the system s swivel range if you do not intend to use it You can clean a slightly soiled lead glass pane with a lukewarm detergent solution and a soft cloth Heavy dirt and grime should be wiped off with a linen cloth moistened with alco hol and then rinsed with clear water Bloodstains are best treated with cold water contrast medium residue with warm water Use disinfectants commercially available for medical use to disinfect the radiation protection device Then wipe it off with clear water Both window designs can be provided with sterile covers sales representative contact your Siemens 1 optional AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Compensating filters Use For absorption compensation in exposures of Thoracic spine and lumbar spine Pelvis Foot Infant skull Skull Shoulder DO CCOO O SIEMENS BWS lateral SIEMENS BWS lateral BWS a p Hy Lo Left thoracic spine lat and right thoracic lumbar spine lat SIEMENS IRI Left pelvis and right foot AXIOM Iconos R200 AXD3 340 620 13 01 02 51 54 Accessories Optional Accessories SIEMENS P diatrie a Q Left infant skull and right skull Shoulder Pleas
16. The compression device moves into park position if present Oblique setting moves into the 0 position Once these positions are reached the flashing LED goes out Select an organ program with serialography according the type of examina tion Moving the system and tabletop into the starting position Position the patient Bring the X ray system and tabletop into the intended starting position The exposure series is generally started in the pelvic region for better exposure control The entire examination area must be scanned without interruption If necessary perform a test run without fluoroscopy and correct the starting position Deflect the joystick for X ray system longitudinal movement in the direction of the head until the entire examination area has been scanned Return to the starting position Check the starting position with fluoroscopy switched on Scanning process The X ray system is in the starting position for the scanning process Lil During the exposure series the patient should take only shallow breaths or not breathe at all Press the exposure release button until the entire examination area has been scanned The X ray system starts moving automatically when the exposure is released End of the scene Let go of the exposure release button The X ray system movement stops automatically i The scene is also ended if the image memory is full and the maximum
17. optional Product description ICONOS R200 universal X ray diagnostic unit with swivelling overtable X ray tube assembly oblique projection and tomography in all table positions and gently starting and braking system movements Two stage setting of the source image distance Table tilt 90 to 17 with soft start and braking Motor driven longitudinally and transversely moving tabletop Fully automatic spotfilm device with extensive subdivision program and 33 cm or 40 cm image intensifier or l l image receptor with 40 cm image intensifier each with a large axial travel range Fluoroscopy and imaging system with ergonomic remote control Integrated system movement control on the spotfilm device AXIOM Iconos R200 AXD3 340 620 13 01 02 5 44 System Overview System Description System configuration The label with MODEL NO 59 02 767 bears the CE 0123 marking for the entire ICONOS R200 system and is attached to the back of the table frame Standard version m a DO CCOO O O ICONOS R200 system Cassette spotfilm device with image intensifier with SIRECON 33 cm or 40 cm image intensifier or l l image receptor with SIRECON 40 cm image inten sifier VIDEOMED DH TV system with DSA or DHC without DSA OPTITOP X ray tube assembly POLYDOROS SX X ray generator Primary collimator Monitor trolley or ceiling suspension system 44 cm or 54 cm monitor s FLUOROSPOT Compact with DICOM Send and Storage Commitment
18. 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Select 2 point technique T Setting the kV and mAs value 1 Exposure cut off by the mAs counter Iconos DFR Iconos Iconos Bed Vertix Info Cassette KO V 4 amp 5w 73 kv 0 3 ma 0 1 min 20 mas mAs 0 ehu U D ms 3 4 5 v ven 00 OO 001 Ol Program Selection 4 Actuate the mAs button With organ program Select an organ program with 2 point technique Deselection Actuate a button for film screen combination 1 point technique is selected or a measuring field dominant button 1 point technique is selected or the ms button 3 point technique is selected With organ program Select an organ program without 2 point technique Exposure data 11 The following exposure data can be set to be set kV value mAs value Focal spot Tube load AXIOM Iconos R200 AXD3 340 620 13 01 02 23 136 POLYDOROS SX 65 80 Integrated Control Console Select 3 point technique Setting the kV mAs and ms value 1 Exposure cut off by the mAs counter Iconos DFR Iconos Iconos Bed Vertix Info Cassette ms KO Y ABR kv Pe 73 kv 0 3 ma A 0 1 min 20 mas ure 0 hu U 25 ms an 3 4 dy mo Edo ml Pro
19. 16 1 8 4 1 Image intensifier TV system with safety shut off device 2 Handgrip at the front adjustable 3 Cassette spotfilm device or l l receptor unit with tableside control panel and removable scattered radiation grid 4 Grip protection strip head end detachable 5 Handgrip strip located on back adjustable secure in all patient positions 6 Compression device optional for inserting a compression cone continuously adjustable compression force 7 Collimator with automatic format collimation and numerical format indication with integrated motor driven additional Cu filters motor driven adjustable semi transparent filters optional 8 X ray tube assembly air cooled partly enclosed can be swivelled 9 Handle for swivelling the tube assembly 10 Tube assembly stand on the longitudinal carriage coupled with the spotfilm device by centering rod axially swivelling tele scopic SID 115cm and 150cm 11 Longitudinal carriage with attached tube assembly stand motorized longitudinal travel precisely controllable speed AXD3 340 620 13 01 02 Operator Manual System Overview System Description 12 Tomographic height display option with laser line light localizer 13 Tabletop with flat accessory rails motor driven longitudinal and transverse travel 14 Footboard adjustable for use as seat with attachment points for foot restraints can be changed over from foot end to
20. 340 620 13 01 02 5 154 Accessories Standard Accessories A Warning The grip protection strip is intended for the safety of the patient in the prone po sition To prevent injury to the hands when moving the tabletop make sure that the patient uses the grip protection strip and not the head end or the side edge of the tabletop Removal Application Attachment 6 54 Move the patient table to the horizontal position Loosen the cap screws Remove the grip protection strip from the accessory rail Handgrip strip Handgrip strip for mounting on the front or back accessory rail to assist in posi tioning the patient Move the patient table to the horizontal position Loosen the right and left cap screws 1 on the handgrip strip Insert the handgrip strip in the accessory rail and push it into position AXD3 340 620 13 01 02 Operator Manual Accessories Standard Accessories We recommend placing the handgrip strip on the far side of the user Tighten both cap screws Make sure that the handgrip strip is secure by pulling and pressing on it A Warning The handgrip strip provides additional safety for the patient To prevent injury to the patient s hands when moving the tabletop make sure that the patient uses the handgrip strip not the cap screw and does not hold onto the head end or the side edge of the patient table Removal Move the
21. AXD3 340 620 13 01 02 Operator Manual Radiographic data field 81 kV i 50 mAs i mAs 280 ms al 100 AXIOM Iconos R200 a a al POLYDOROS SX 65 80 Integrated Control Console Indicates the tube voltage Adjusts the kV value Indicates post indicates the mAs value Adjusts the mAs value Changes the exposure technique Indicates post indicates the ms value Adjusts the ms value Changes the exposure technique Selects 80 100 tube load Selects small large focal spot AXD3 340 620 13 01 02 7 136 POLYDOROS SX 65 80 Integrated Control Console Program menu 1 Iconos DRF Iconos Iconos Bed Vertix Cassette Esophagus Colon Cerv spine 2 Fis 1 F s oblique Abdomen Myelo 1 F s 1 F s Trachea 1F S DSA Carotis NAT Series 7 5 F s 2 F s 2 F s Cerv spine oblique 3 1 System selection bar 2 Message line 3 Program field System selection bar 1 System selection Message line 1 Displays information on operation Program field Cerv spine 1 Selects the organ program oblique Edit name LJ Changes the organ program name Data LI Switches over to the data menu 8 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Explanation of displays and controls Selection of the controls The controls are selected with the PC mouse on the FLUOROSPOT Compa
22. AXIOM Iconos R200 AXD3 340 620 13 01 02 33 54 Accessories Optional Accessories Removal 34 54 Left Releasing fluoroscopy Right Releasing radiography Releasing fluoroscopy Step on the right pedal foot switch for fluoroscopy Continue pressing down on the pedal as long as fluoroscopy should remain active Let go of the pedal LJ Fluoroscopy then ends Releasing radiography Step on the left pedal foot switch for radiography Continue to press down on the pedal until the exposure has ended 1 The exposure has ended when the radiation ON indicator on the remote con trol console goes out Let go of the pedal Depending on the frequency of use you can leave the foot switch attached or disconnect it after the examination Turn the locking ring on the cable plug to the left Remove the plug from the receptacle Roll up the foot switch cable Store the foot switch and cable in an appropriate location AXD3 340 620 13 01 02 Operator Manual Application Attachment AXIOM Iconos R200 Accessories Optional Accessories Armrest For securing the patient s arm for injections IV s or insertion of a catheter 4 Move the patient table to the horizontal position Position the patient Open the clamping lever 1a Sie ANN Place the armrest onto the front or rear accessory rail and slide it into position Clos
23. Ab Gee a a a dans 3 PrOperusSerOrthe ProcUGl 2 y aia sascacsnecetenest bee cceeak sede suse t estas atl Oi Seau estiietevsue steci esadaseusese dah sceanaxthaddcuaay te 3 A a a O 3 AXIOM Iconos R200 AXD3 340 620 13 01 02 3 4 AXIOM Iconos R200 Overall Table of Contents A O O ER 3 Use of several accessory COMPONENTS cc ceceececceceeeeeeeeeeeceeeeeeeeeeeeeeeecccecaaeaeeeeeeeeeeeeeeseeecetaneseeeeeeees 4 Chapter standard ACCES SOM Sia A ER DA A Id 5 GUIP Protec a a id Sis ea ast Th 5 El A A E A 6 AO uri A A os 8 NOU SES UPS a e Bane oe 9 RENON O E SE N EE A A 10 Chapter Optional ACCESS OM a a a aeaa 13 Head SUPPO Eau a e eie A ia EEY 13 AN A E RO 15 COMPLES OM Dl ad ada 17 Footboard Extension cccccececceceeeeeeeeceeeececcne eee eeeeeeeee ce eccaaaaeeeeeeeeeeeeeeecqeccceaeeeeeeeeeeeecseeesccseeeeeeeeeees 21 E O o T 23 CAMA AE A A A o RSME 26 A O ee 27 Lateral cassette Holdet rocio a e ta les ba ae aii 29 Foot switch assemblies for fluoroscopy and radiography oooooooccccccccccccooocnnnnnnnnnnnnncnnnononann nono nnnnnnnnninns 33 A O hn ate art hah luli tae Rats Wall wet bal oe cats 35 Lateral radiation SAE a A td 36 Holdertor BABIX Cradles siii ti rd 38 BABIX cradles Vitis a A A heen aS 40 BABA de e late Ba Mie desta wane 42 Holder for pediatric Cradle manual cccccccccncnccccncncnnnnoneneconnnonononnnnnnnnnnnnnnnnnnnnonnnnnonnnnnnnnnnnnnrnennnnnnninons 43 Patient POSITIONING MALIESS e ha ecscts cach
24. Cu filter is displayed on the control units and pri mary collimator Image reversal Warning It is part of the user s duty to pay attention to the correct orientation of the display on the monitor Use suitable aids for this e g Pb letters Electronically displayed right left markings are not mirrored when the image is reversed A faulty diagnosis is possible due to incorrect position information e g confu sion between right and left with legal consequences and under certain circum stances with severe consequences for the patient 30 32 You can mirror the images on the image monitor horizontally or vertically with these 2 keys If none of the keys is pressed then the image is displayed in the normal position Image mirrored horizontally vertically AXD3 340 620 13 01 02 Operator Manual System Operation Setting the Image Geometry Switching over the image intensifier format You can switch over the format even during a current examination 0 Press one of the keys LED lights up the function is selected e Image intensifier full format o e e Es Es E Zoom level 1 2 3 1 2 3 Regularly control the function of the format switch over gt Refer to the maintenance plan AXIOM Iconos R200 AXD3 340 620 13 01 02 31 732 System Operation Setting the Image Geometry 32 32 AXD3 340 620 13 01 02 Operator Manual Examination Table of Contents Operator Manual Examination Chapter Transferring
25. Mechanical Safety ta sl eine acidos 15 Danger zones with unit in horizontal POSITION occccoccocnnennconnonnnennncnnononennncnnnnnnnnnnnnnoninnnnnons 15 Danger zones with unit in vertical POSITION occoccncocnonnnennnonnnnnnnnnnnononnnonnnnnnnnnnnnnncnnoninnnnnoss 16 Kaa SIGMS aia A E E 16 A Aas et eS ES Ola la a le lal AE Se oes 17 IAM GS ZOMES ara A a A a a a N 17 Patent DOS IN O ake e te seals colla e 18 Patient positioning with unit in vertical POSITION ooccocnnocnccncoonnnnnncnnonnnonnncnnnnnnennnnnnoninnnnnoss 19 Remote compression Optional nerimas td tia dd 19 Salte devices ts bd da e her ade alos Rha eee dealt do 19 Possible collisions of the system with a ceiling mounted SUpport coococcccccnccccnnnonnnccncnnninanconaninnns 20 Measures for avoiding equipment damage ccccocccococnnncnccnnncnnnnconconnnanennnnannnnancnnnnrancinaninaninnss 20 Measures for avoiding unwanted radiation oococcccocnonnnecnnonnnonnnonnnnnonononnnnnnnnnnnnnnnnnoninnnnnnss 21 AXIOM Iconos R200 AXD3 340 620 13 01 02 1 44 System Overview Table of Contents Safety relevant parts subject tOo Wear sioscsniesnsectiacidasetiaiaaadacadanthadnehadeamsdcdbeondecsasdbaravigededides 22 Maintenance Mtervals misi n iio 22 O A O A Sa co ance Soames 22 E AS A Seta i EM A sae at oe 22 Resetting the area dose product ce ccc ccccc ccc eeeeeec eee e eee e eee eeneeee seen esse eee trenn rrr sen eesaeeeneeneeeaes 23 Chapter Operating and Displ
26. Select tomography with PlanilONTOMAT oococccccnnocnncncncnnonnncnnnonononnnnnncnnnnnnncnnnnnnnnnnos 27 Select tomography with Plani lONTOMAT and mAs preselection oocococococococoncncncncncnnooo 28 Select indirect exposure Technique cocccocncocnnoncnnnconnnonnncnnonnnnnnonnnonnnennnonnnnnnnnnnnnnonnnnnnnonnnoos 29 Select DR Op int TECHNIQUE crack ck osas 29 Select DRTPOMETE CANIS a AS AA A AAA 30 Select DR tomography with PlanilONTOMAT ooccccocnncncccnconnncncnnnnnnnnnnnncnnnnnnnncnnnnnannnnns 31 Select DSA CMS A A EEE aE e E SEA EAE ESEE 32 Organ progra S siihna a a aa A ah 32 Selecting an organ Pr gra nsis aiea a ei A A ds 33 Organ progranm data Indica racial A S Ae a EAE AEA 33 Editing Organ PLOT o SRS cM OS MER SMEAR o e en as 33 TEMPOrary CAMISA A E A ida 33 PM OE e e E S EES E E E ETE 33 Editing new organ program NAMES ccooccocnccnnnccnnnnnennncnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnneninnnnnoos 34 2 36 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 POLYDOROS SX 65 80 Integrated Control Console Application POLYDOROS SX 65 80 is a high frequency X ray generator for all procedures in general diagnostic radiology The combination of microprocessor control and high frequency converter tech nology ensures good X ray images due to the high accuracy of the exposure data Configuration Basic version IONTOMAT PN automatic exposure control IONTOMAT PN automatic exposure control for tomography Tomographic
27. can limit the exposure field to the required size with the cor responding operating elements Exposure measurement in digital radio graphy Arrangement of the dominants The following sketch shows the arrangement of the dominants in the monitor in relation to the a p patient position head end at the left looking onto the patient with the table horizontal 2 4 O 1 1 Left dominant 2 Right dominant 3 Middle dominant 4 Central circular dominant AXD3 340 620 13 01 02 23 52 Examination Digital Radiography Selecting the dominants The dominants are filed in the organ programs or can be set on the integrated generator control console Multiple selection of the dominants is possible Exception central circular dominant A Warning Please make sure when changing the selection of the dominants that the cor rect dominant is always selected 24 152 Press one of the keys Left dominant Middle dominant Right dominant Central circular dominant Li If a selected left and or right dominant becomes invalid temporarily e g due to collimation then the central circular dominant is selected and displayed automat ically The originally selected dominant s will be active and displayed again when the collimator is opened again When collimating under fluoroscopy take care that the selected left or right dom inant lies completely in the radiation field Otherwise there
28. cm 17 cm 13 cm RECON 40 4HDR S 4 S 4 image fields 40 cm 30 cm 22 cm 17 cm VIDEOMED DHC High resolution TV camera with maintenance free 1K CCD sensor for digital fluoroscopy and fluororadiography max 66 dB signal to noise ratio Matrix 10242 1 configuration for Japan only AXD3 340 620 13 01 02 Operator Manual TV frame rate Brightness control TV standard Dynamic response TV matrix TV frame rate Brightness control TV standard Monitor Tube assembly Focal spot nominal value ICE 60336 Nominal power IEC 60613 Cold power Nominal voltage IEC 60613 Anode angle Anode heat storage ca pacity Anode rotation frequen cy Mean continuous pow er Total filtration IEC 60601 1 3 AXIOM Iconos R200 Technical Description Technical Data max 25 f s with CAREVISION 12 5 8 3 pulses s Constant image brightness through automatic gain control 72 Hz progressive scan independent of frequency VIDEOMED DH High resolution TV camera with maintenance free 1K CCD sensor for digital fluoroscopy fluororadiography and DSA max 69 dB optimized for DSA Matrix 10242 max 30 f s with CAREVISION 15 7 5 3 pulses s Constant image brightness through automatic gain control 72 Hz progressive scanning independent of frequency SIMOMED HM high line with flicker free display 72 Hz 44 cm or 54 cm screen diagonal SIMOMED HC 1024 lines flicker free di
29. data menu the selected organ program appears inverted Cerv spine oblique Organ program data indication 1 All data stored for the selected organ program are indicated in the data menu Editing organ program data d The exposure data of any organ program can be edited However you have to distinguish between the temporary change and the permanent storage of a program Temporary change Select the organ program Depending on the activated exposure technique the following exposure data can be edited kV value mAs value ms value Focal spot Tube load Measuring fields dominants Film screen combination Density compensation In the data menu the selected organ program is displayed non inverted Li The edited parameters are in effect only until you select another organ program or switch the system off Permanent storage gt For further information refer the FLUOROSPOT Compact operating instruc tions AXIOM Iconos R200 AXD3 340 620 13 01 02 33 36 POLYDOROS SX 65 80 Integrated Control Console 34 36 Editing new organ program names Actuate the desired system selection button Actuate the program button in the data menu The program menu appears Iconos DRF Iconos Iconos Bed Vertix Cassette Store Esophagus Colon Cerv spine 2Fis 1 Fis oblique Abdomen Myelo 1 Fis 1
30. device connection Polymatic incl O point technique Programming unit for organ programs RS 232 printer connection ODOC COC O O O O Tube load computer Options 1 Connection for 3rd tube assembly AXD3 340 620 13 01 02 3 36 POLYDOROS SX 65 80 Integrated Control Console Overview of the controls and displays I Iconos DFR Spotilm Iconos Bed Polydoros SX 80 uolyeulwexy D Control Settings 0 mA one y Z Iconos DFR v SingleShot v 0 00 min OOOO Integrated generator control console on the FLUOROSPOT Compact screen Menu On the basis of the selected program or operating mode the permissible operat ing functions and operating data are indicated in menus on the integrated gener ator control console Various menus are available depending on the program or operating mode 1 Data menu Displays and controls for radiographic parameters LJ Program menu Display of organ programs 4 136 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Data menu 1 Iconos DFR Iconos Iconos Bed Vertix Info Cassette 66 kv 0 20 mas mAs 3 3 ms ms 80 100 m9 Y Cerv spine oblique Program 6 1 System selection bar 2 message line 3 Selection field for organ programming 4 Fluoroscopic data field 5 Operating mode and I ONTOMAT data field
31. during power failures or system mal in an emergency functions proceed as follows Pull out the knob 2 and turn it by 90 until it locks into the deep locking notch lock in position a Lift the cone arm off from the patient until it locks in position at approx 10 Release the cone arm lock again Press the cone arm slightly upwards and hold it Pull out the knob 2 and turn it by 90 until it locks into the flat locking notch lock in position b Let the cone arm move down slowly 46 54 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Radiation protection for tableside examinations Use Additional radiation protection in tableside examinations e g interventional radi ography A Warning Use this radiation protection only with the tabletop practically horizontal up to max 10 At a greater tilt there is a danger that the lead rubber aprons will slip off and drop on the sterile covered patient Fastening Recommendation Set the examination unit horizontal and lower the table to minimum height Push the bar 1 into the upper groove of the accessory rails up to the stop When in position in the stop a spring lever in the left profile rail engages in a notch of the bar Check for the firm seating of the bar on the collimator AXIOM Iconos R200 AXD3 340 620 13 01 02 47 154 Accessories Optional
32. e Ade 22 Chapter Operating and Display ElementsS oociccicinccicicicccccnnonononoronanononnnnononororororononoononononaninanans 25 System remote Gontro Console Ws i sere A ESO 25 GENEratOr On OTE CONSOIE muusa o NS A NO sits 32 Foot switch for fluoroscopy and radiography in the control TOOM oococcccnnncnnncnnnnnnnnncnnnnnnnnnnnonononeconenos 33 Tableside control panel iernare en AAA O AE at 33 LED Mont a o o rd a E NE e E 35 Prima COMA e Ai 36 Part System Operation Chapter On Ol Emergency Stop ssp nl dida 5 SWILCHING the SySte mon Camtasia aod at nd todoo ciel 5 Switchingthe ys Ie molt ie rn di do O ts e Ba e nd cleat 6 Emergency SHUTDOWN button installed on site oooonoooocooocccccccccncnonooonnonononnnnnnnnnnnnonnnnnnnncnnnnnnnnnnns 6 Standby POWErSUPPIY sanio a ld A eae a a et 0 Sige Be NO 6 Red Emergency STO PDutto nis tard added 7 A A Lome sane viene 8 AXIOM Iconos R200 AXD3 340 620 13 01 02 14 AXIOM Iconos R200 Overall Table of Contents Chapter Functional and Safety CHECK ia id A A la 9 Dady LOSES EAA ale teat ee dae ated rele 9 Monthly t6SES iren Gere aad ses la di 10 Legally reg ired TESTS 22 sveovnrs A E A id 10 A o A A 11 General Notes A lee dcs e E eden badd eit A E d ehh tite aah r al 11 Moving the X ray system longitudinally sisri kenes e ea a e a AE EL SE aaen 14 Valid Dae et 15 TUBE assembly Stand cceacc artomntie stare dont snaasaynldauhowtdntsenabeaes a Raid ng ok N IA 17 Tablon A a Pel Rete
33. eee 18 Compression device Optional vetar A a A Dt 21 TOMOgraphic equipMent OPIO iii A A e ba 22 Manual tube assembly rotation s sisri i a a a ade a a i eiaeiiio 24 Moving the grid into out of the beam path ocoooococccocooooooococonononnnnnnnnnnnnnnononononononononononinnnnnnnnininininons 24 Setting The Sourcesimage distance tia 25 Chapter Setting the Image Geometry merrncicatadlica tidad diiniita idad 27 Limiting the radiation field collimation oooooccccccccnononooooooonnnnnnononnnonononnnnnnnnnnnnnnnnnnnnnnnnnononnnnnnnnnns 27 CAREPOSITON Optional ito ero e on Ba e endo dl ol ts bad e A A TA a aS 29 Additional Cu Ma a ita ido 30 IFMAGS FEVETS EE E td dd lt oblea llana dd 30 Switching over the image intensifier format ooooonooooooocccccncnncnonononnononnnonnnonnnnnnnnnnnnnnnnnnnnnnnnnnnnnnonnnnnnennss 31 Part Examination Chapter Transferring and Positioning the Patient 5 E O 5 o chee dons nach r pubs chiolayele sels a E degal aaa aea aiana tease aad Daik deiade rE 5 A PP a ti a e a ait deta a a a gla alba A 7 Fl roscopy operating MOSS x aondar e iia 7 Selecting the fluoroscopy operating Mode ccococococooncccccccncnnnnononoonnnonnnnnnnnnnnnnnnnonnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnos 7 Changing the selection of the fluoroscopy operating mode sssssssssiiiiiisssrsssrrirriiiiiirsrsretrrrirrirrrrrnn 7 Releasing TUOrOSCOPy eni a aaa O 9 oro ol A AA A E A E EET 9 Automatic AUO OSCO C COO A e Se M
34. g com pression belt and shoulder supports these components must be attached and re moved in the correct sequence because most accessory components are attached to the patient table using the accessory rails Example 1 Grip protection strip and footboard are already attached to the patient table 1 You need the shoulder supports in addition because they will be helpful for the examination First you must remove the grip protection strip as described in these instruc tions Then position the patient on the table Next attach the shoulder supports Next push the grip protection strip back into the accessory rails and secure it 9 2 Check that all accessory components are securely attached 1 Exceptions compression belt lateral cassette holder arm rest 4 isa AXD3 340 620 13 01 02 Operator Manual p E z Accessories nT Us Standard Accessories Grip protection strip Application Handgrip and finger protection for patients during examinations in the lateral or prone position Attachment Move the tabletop to the horizontal position Loosen the cap screws 1 on the grip protection strip Insert the grip protection strip up to the stop into the accessory rails at the head end of the patient Tighten 1 the cap screws Check that the grip protection strip is securely attached by pulling and press ing on it AXIOM Iconos R200 AXD3
35. lights up Press this key a The LED in the start key flashes if the conditions for tomography are not fulfilled The possible combinations of tomographic angle tomographic time appear in the display The selected combination is emphasized Qs T a 8 0 8s Y DR 2 20 0 6s 20 71 25 se 40 1 2s 40 2 5s 88 ee a AXIOM Iconos R200 AXD3 340 620 13 01 02 27 152 Examination Digital Radiography Tomographic area 28 152 Press the key again to activate the next possible combination If the LED in the start key flashes press the key The compression device moves into park position if present The tube assembly stand moves into the 0 position A source image intensifier distance of 115 cm is set The image receptor unit moves into the tomographic area Once the positions are reached the flashing LED goes out If you have positioned the image receptor unit outside the tomographic area it is moved automatically when you press the start key so that tomography can be performed with the required tomographic sequence In this case the tabletop is moved automatically synchronously to the image receptor unit Tomographic sequence In the case of low absorption objects with a water value below 10 cm e g pe diatrics upper lower extremities either fluoroscopy must be performed before tomography or a Cu additional filter of at least 0 1 mm must be moved into the beam path Otherwise e
36. of the keys Left dominant Middle dominant Right dominant Li If a selected left or right dominant becomes invalid temporarily e g due to colli mation then the middle dominant is selected and displayed automatically The deselected dominant is displayed crossed through The originally selected dominant is active and displayed again only at the 1st pressure point of the exposure release button precontact or when the collima tor is opened again The position of the measuring field of the measuring field in relation to the object can be checked on the LIH image by means of brief fluoroscopy A diagram with the position and size of the relevant measuring field is displayed briefly on the monitor AXD3 340 620 13 01 02 Operator Manual Examination Cassette Exposures in the Spotfilm Device optional Releasing the exposure UU Release the exposure with the exposure release button in the system remote control console or via the foot switch in the control room or table side op tion The foot switch has no precontact 11 The signal lamps for radiation must light up briefly Q Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot temporarily be seen on the monitor Switch the system off immediately Notify the SIEMENS Uptime Service Discontinue operation of the system Organ programs All parameters necessary for the exposure
37. or closed synchronously and symmetrically to the image receptor center Within the selected image intensifier format the radiation field can be collimated basically as desired and you can switch over from iris to rectangular collimation On selection of a lower ZOOM level larger field or image intensifier full format the rectangular and iris collimation are retained or the larger field is collimated can be configured On selection of a higher ZOOM level smaller field the collimator always switch es to the smaller field iris collimation Cassette exposure The system switches over automatically to rectangular collimation on selection of the spotfilm device or tabletop cassette exposure technique It is not possible to select iris collimation Selection deselection Use the key on the system remote control console for selection deselection ON 0 Press this key tO Rectangular collimation is selected left LED lights up Iris collimation is selected right LED lights up AXIOM Iconos R200 AXD3 340 620 13 01 02 27 132 System Operation Setting the Image Geometry System remote control console Rectangular collimation o t H 4t E Iris collimation Tableside control panel Rectangular collimation gt E Iris collimation i 28 132 Setting Actuate the coordinate switch Push up to the left height width collimator blade pair opens Push dow
38. procedure This will increase the patient s feeling of security during the examination AXD3 340 620 13 01 02 Operator Manual Removal 4 Accessories Optional Accessories Move the patient table to the horizontal position Assist the patient in stepping down from the patient table Hold the rail for height adjustment Loosen the cap screw 2 Lift the rail for height adjustment Tighten the cap screw 2 Loosen the cap screw 1 Remove the cassette holder from the accessory rail Cassette holder without variable positioning Application For lateral exposures with a second X ray tube to hold the cassette upright with the tabletop in the horizontal position For all cassette formats horizontal and vertical Attachment 4 Move the patient table to the horizontal position Warning Use this cassette holder only if the patient table will remain in the horizontal po sition throughout the entire examination procedure The cassette holder will fall if the patient table is tilted Observance of this recommendation will prevent po tential injury to the patient or personnel as well as equipment damage 4 4 AXIOM Iconos R200 Position the patient Ensure that the patient is comfortable and stabilized AXD3 340 620 13 01 02 31 154 Accessories Optional Accessories Slide the cassette into the bracket of the cassette holder Ensure that the cass
39. s head ensure that the stabilizing arms are opened sufficiently and that the cap screws 5 are not tightened too much prior to po sitioning the patient s head in the support Turn the patient s head to the right or left as required for the examination non d The scale indicates the angle in degrees Tighten the cap screw 4 Ensure that the patient is comfortable and properly stabilized Removal Move the patient table to the horizontal position Loosen the cap screw 4 Turn the patient s head to the 0 position Open the stabilizing arms using the cap screws 5 Assist the patient in stepping down from the patient table Assist the patient in removing his her head from the support Loosen the cap screws 1 Remove the head support from the accessory rails 14 154 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Knee crutches Application For facilitating positioning for gynecological and urological examinations Attachment Move the patient table to the horizontal position Loosen both cap screws 1 Slide flanges A onto the accessory rails Insert both molded leg supports B into the holders at the cap screws 2 Position the patient on the patient table Slide the knee crutches along the accessory rails to the examination position Tighten the cap screws 1
40. scene time has been reached independently of the position in which the system is lo cated AXD3 340 620 13 01 02 43 152 Examination Digital Radiography 44 152 al o Start Examination procedure for images of the spine and ortho pedic longleg images Preparation Prepare the digital imaging system Select the DR system at the unit remote control console Position the patient table vertically 909 Have the patient stand in the unit with without footrest and immobilize the patient with the compression belt For reasons relating to the exposure technology the scanning direction for DR scanning Is from bottom to top towards the head end for spinal acquisitions from top to bottom towards the foot end for orthopedic whole leg acquisi tions Set horizontal projection Set the largest possible SID Press this key The LED in the key lights up if the conditions for scanning are not fulfilled DR scanning is selected I I full format is selected The rectangular height diaphragm moves automatically to the configured value approx 10 12 cm The display shows 3 scanning programs with 2 directions each The selected scanning program is highlighted L m 2 Spine gt A on F lt Longleg gt lt Abdomen gt S8 e y By pressing the key again the next possible scanning program with direction be comes active Select a scanning program fo
41. select the required characteristic curve for the automatic dose rate control High contrast fluoroscopy Is a special case of fluoroscopy with automatic control It is selected with the 2nd pressure point of a two stage foot switch The mode is indicated acoustically Fluoroscopic data The fluoroscopic data of kV mA time and dose area product are displayed on the integrated generator control console Display of the kV and mA values 1 During fluoroscopy the current kV and mA values are indicated continuously 1 After the end of fluoroscopy the mean value of kV and mA for the examination Display of the fluoroscopic time Continuous display of cumulative time in minutes during the examination Display of the dose area product Continuous display of the dose area product accumulated in the examination Resetting the fluoroscopic data When the examination is finished record the fluoroscopic data displayed and actuate the Reset button The displays for the fluoroscopic data and for the dose area product are reset to zero 1 depending on the system configuration AXD3 340 620 13 01 02 13 36 POLYDOROS SX 65 80 Integrated Control Console Fluoroscopic characteristic curves For fluoroscopy you can choose between several fluoroscopic curves which you can program depending on the system configuration Characteristic curve examples for normal fluoroscopy kv 110 90 Dose reduced Anti
42. side upwards and insert at least 2 3 of the cassette width into the loading shaft The cassette is drawn in automatically and parked in the spotfilm device At the same time the cassette format is measured and the LED in the cor responding segmentation key lights up The cassette size is shown in the display of the system remote control con sole If a cassette format which is not approved is used the cassette moves automat ically back into the loading position The cassette does not appear in the loading slot Tilt the tabletop into the 45 position Press the unloading key briefly a number of times until the cassette appears in the loading slot In a table position of approx 45 to 90 it can happen that if the cassette is not inserted far enough it drops out from the loading shaft again on automatic center ing depending on its make type The formats 20 x 40 cm 18 x 24 cm and 24 x 30 cm inserted in upright format are especially affected by this In this case insert the cassette with its smooth side upwards and with at least 3 4 of the cassette width in the loading slot hold the ball of your thumb against the cassette until it is securely grasped by the cassette jaws A Caution Under no circumstances may you poke your fingers into the loading slot as this would interrupt the sensing light barrier Otherwise the cassette is rejected 16 52 AXD3 340 620 13 01 02 Operator Manual AXIOM I
43. starting position the entire peripheral examina tion area is scanned The scan movement takes place with increasing movement speed of the X ray system longitudinal displacement with finely graduated con trollable adaptation of the speed to the contrast medium flow The max travel speed of the X ray system is increased to 16 cm s Li You generate an organ program with image series for Periscanning in the Digital Radiography menu Selection Press this key Periscanning is selected the LED lights up i The LEDs in the buttons for Periscanning and DR flash if the prerequisites for Periscanning are not met Select an organ program for Periscanning Deselection Press this key or select another exposure system Periscanning is deselected AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography Releasing the exposure 1 Release the exposure with the exposure release button on the system remote control console or via the foot switch in the control room or table side op tion 1 Radiation is released long as long as you continue to press the exposure re lease button 1 The radiation ON indicators must light up A Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the system off immediately Notify the SIEMENS Uptime Service Discontinue operation of the s
44. the DSA image from the middle of the series is dis played if you let the exposure release button go You start a new DSA exposure series by pressing the exposure release button again The system switches automatically to subtraction after a predetermined number of images e g 2 The point in time at which the contrast medium should be injected must be se lected depending on the examination Organ programs All parameters necessary for the exposure are stored in organ programs gt Refer to the FLUOROSPOT Compact and POLYDOROS SX operating instruc tions for further details on the organ programs and their programming AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography Programs The following programs can be stored Single image organ program Serialography organ program DSA organ program optional Creation of programs gt Refer to the FLUOROSPOT Compact Operator Manual Temporary changes of programs For the following parameters stored in the organ program it is possible to change them temporarily with the corresponding operating elements Film density Switching over from single image serialography Dominants Cu prefilter Automatic level 1 2 3 i The changed parameters apply only until you select another same organ pro gram or switch the system off Tomography optional Selection Press this key Digital radiography is selected the LED
45. the table end in the case of tableside operation You will hear a warning tone if the tabletop is lowered to less than 120 mm above the floor Then control the movement with increased caution Move the table into a vertical position 90 System remote control console A Press the down button until the tabletop stops automatically at 120 mm from the floor lt d Release the button and press it once again y The tabletop moves maximum to 40 mm from the floor an acoustic signal sounds during the tabletop movement Tableside control panel A Press the right button until the tabletop stops automatically at 120 mm from the floor qi gt Release the button and press it once again v The tabletop moves maximum to 40 mm from the floor an acoustic signal sounds during the tabletop movement 1 Display in horizontal table position 16732 AXD3 340 620 13 01 02 Operator Manual lt gt AXIOM Iconos R200 System Operation System Settings Tube assembly stand Setting the projection angle oblique projection The setting range of the projection angle is maximally 40 The center of rotation of the swivel can be adjusted in height by motor drive from 10 mm to 300 mm above the tabletop to adjust it to the position of the object This allows isocentric viewing on the monitor The additional mechanical centering device ensures that the central beam is cen tered onto
46. the tabletop moves transversely y key above below the tabletop moves longitudinally R F Actuate the joystick Deflect to the left right the tabletop moves transversely Sat 4 20 O Tableside control panel A Actuate the coordinate switch lt gt key on the left right the tabletop moves longitudinally Vv key above below the tabletop moves transversely Travel range 1 In order to avoid collisions with the floor the system will retract the tabletop automatically as needed if you tilt the table up or down The X ray system follows this movement synchronously if the available travel range is sufficient The object always remains centered in this case 1 If you have tilted the table more than 30 down or more than 30 up the system continuously calculates the maximum possible travel range of the ta bletop depending upon the room height and the system position You can move the tabletop only within this range 1 Display in horizontal table position AXIOM Iconos R200 AXD3 340 620 13 01 02 15 32 System Operation System Settings Lowering the tabletop completely with the table vertical A Warning If the tabletop is lowered to less than 12 cm above the floor with the table vertical it is possible for feet to be crushed Make sure before remote operation that no one is in the direct vicinity of the system Avoid a location directly at
47. to eR ets a tele ca 42 Moving the system and tabletop into the Starting POSITION eceeeeee eens ee eeeeeeeee teen ees 43 Sanning ProCeSS iii ear oa aaa aaar aaan 43 Ed iOf her a a oo dad E A EA A AEE OEE EAO a 43 Examination procedure for images of the spine and orthopedic longleg images ooococcccccccncnco no 44 A EN 44 Moving the system and tabletop into the Starting POSITION ooooccccccncoccccncccnnnnconccnnnnncnanos 45 Scanning POC a e a e 45 END Ihe SENS a E O OS E ON O ES AT 45 DIG POMO Ut orita a a AAE E A ETE 46 Program suggestions for FLUOROSPOT Compact ccccccccncnnncnncnncncnnnnncnnoncnnnnnnnnnncnnonnnos 46 Peristepping examination sequence for survey IMages cee cece eee eee eee ee eset eee eee tees eaeeteeeaeaeaees 47 Chapter Free Cassette Exposure COMMON ONE IOS UNE asarna ha a aea a a aea a eean 49 Selecting the exposure techniques iii 49 Tabletop cassette exposure or free Mode eee ceee cece eee e nent ee eee eet ee tees tee et teed e ce eeee tae teeeeeeeaees 49 Releasing an EOS a a on a a ee ee 50 Chapter Cassette exposures with wall stand Collimation during OS ES a aia A cal 51 Selecting he exposute TECHN GUS sti dedican 51 Releasing the EXPOSURE dada 52 4 152 AXD3 340 620 13 01 02 Operator Manual Examination Bra Transferring and Positioning the Patient General information 1 Attach all safety accessories especially the grip protection strip handgrip strip handgrip footboa
48. vertebrae a p 73 C15 Thoracic vertebrae lateral 81 C17 1st to 4th lumbar vertebrae a p 77 C16 1st to 4th lumbar vertebrae lateral 90 C19 1st to 4th lumbar vertebrae oblique 81 C17 5th lumbar vertebra a p 77 C16 5th lumbar vertebra lateral 90 C19 Pelvis hip 73 C15 Sacrum coccyx a p 73 C15 Sacrum coccyx lateral 90 C19 Arms Shoulder joint a p 63 C12 Shoulder joint axial 60 C11 Legs Femur upper 70 C14 Femur lower 60 C11 Knee a p 60 C11 Knee lateral 60 C11 20 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Selecting direct exposure technique Select 0 point technique LI Setting the kV value from fluoroscopy 1 Exposure cut off by the automatic exposure control Iconos DFR Iconos Iconos Bed Vertix Info Cassette 40 kv 0 hu M0 m0 Program gt Q 3 4 uGy cm2 Selection Select an organ program with 0 point technique Deselection Actuate the mAs button 2 point technique is selected or the ms button 3 point technique is selected With organ program Select an organ program without 0 point technique Exposure data 11 The following exposure data can be set to be set Focal spot Tube load Measuring fields dominants Film screen combination Density co
49. will be overexposure because of the inappropriate acquisition of the measured exposure values The position of the measuring field of the measuring field in relation to the object can be checked on the LIH image by means of brief fluoroscopy A diagram with the position and size of the relevant measuring field is displayed briefly on the monitor AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography Spotfilming without tomography Selection 0 Press this key Digital radiography is selected the LED lights up At the integrated generator control console select an organ program for Single image or Serialography or DSA Single image serialography Not possible in DSA The display is in the operating area of the live image monitor The image intensifier format cannot be changed during an exposure series Only the collimation is corrected on changing over to a larger zoom level Changing selection If you press this key El the system switches over to single image in the Serialography organ pro gram single image remains selected in the Single image organ program Li A changed organ program for serialography remains retained only until you se lect another same organ program or switch the system off Frame rate Operation is on the infrared control of the FLUOROSPOT Compact mum of 2 stages by pressing the button if the corresponding ruductions have been pro
50. 2 mm Cu prefilter Set the upper lever to the left and the lower lever to the right 1 0 3 mm Cu prefilter Set both levers to the right 1 Not with variant PBL II 4 Only with variant PBL II AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements Changing the bulb of the laser light localizer A wa As soon as the lamp brightness decreases this symbol is shown in the collimator a BULE TC display It recommends to change the bulb Although you can continue working with less brightness we recommend to change the bulb as soon as possible To change the bulb proceed as follows Switch the system off at the generator ON OFF console If necessary turn the collimator to get better access gt Refer to the description in the according system Operator Manual Lamp cover at the backside of the collimator Loosen the 3 screws on the lamp cover using a conventional slotted screw driver Remove the lamp cover Heat shield AXIOM Iconos R200 AXD3 340 620 13 01 02 41 144 System Overview Operating and Display Elements Heat shield might be very hot Please let it cool down before removing it Loosen single turn the two heat shield screws 1 on the lamp Remove the heat shield 2 Remove the defective bulb 2 Do not touch the bulb with your bare fingers it can be very hot Insert the new bulb using a cloth and make sure both contacts 3 are touchin
51. 2CONTHOIS N A AE ASA A ANA 9 Normal inverted display of the Controls c eccceee cece eect ee eee eet ee eee ete eens eee ea eee teeta eteeeaeeeaees 9 RUNCLONSOthles CONMLOIS casey sewn A E A E E EN 9 Changing the fo alspotand tube load sitiar idad a daa 9 Selecting the measuring field dOMINANt Ars e o e a e a aaea aea a Eaa naa adana ai 9 Measuring field dominant display ii A dd 10 Displayiot the expostre datas susana 10 Messages aan A AAA AA AS AA AS 10 General error Messages ccocccocncocnncnnonnnnnnnnnnnnnnnnnnnnn cc 10 TUDE OAC COMPUTS rss 10 A site E N Kaa EA ra E REAO E AEA us EO EE EAS A SE 10 PAUSE tiMeindicai ti aida 11 OAC ata INGiCAtlO Nese e e lol aa tie ee laa le E LEO 11 Funci naland satety Checks dais 12 Daily CAES AA A E A A ADE 12 ATERSWITCHING on a a tn Md e ta ndo to ae Mtn tds tb 12 DU a ek ted 12 MA O AE ETE ES EEI EET S 12 KEQAllY Ee ae CHECKS AE A T E EEEE E E EEE E EEEE EEEE EEEE EE wae 12 Maintenance intervals maien pue o vate a ads 12 A aaa Saa aaa a aa ea aa aa EA a anion 13 Releasing fIlUOrOSCOpY s ssissisieiueiietktit ttet tettet ttnt e utaua ALEAR ne nan nen n nana nanninnn 13 AXIOM Iconos R200 AXD3 340 620 13 01 02 1 736 POLYDOROS SX 65 80 Overall Table of Contents Selecting the fluoroscopic mode cooccocccccnnocnncnncnnononnnnnnnnnncnnnnnnnnnnnnnnnnnnnonnnnnnnnanennnnnnnnnnnnons 13 Fluoroscopy With automatic CONTTO azs a Aaa a a cece cece a pE E A ATNA ar 13 High COntr
52. 620 13 01 02 7 132 System Operation On Off Emergency Stop 8 32 Switching back on Remove the hazardous situation Unlock the red emergency stop button The system is immediately ready for use Ifthe hazardous situation cannot be removed please notify the Siemens Cus tomer Service Patient rescue If the patient has to be rescued in an emergency situation e g power failure proceed as follows Bring accessories into a position which makes rescue possible If the patient is compressed with the cone optional Pull out the knob 1 from the engaged position b and turn it by 90 until it en gages in the deep notch notch position a Lift the cone arm off from the patient until it locks in a position of approx 10 Warning If shoulder supports or foot restraints are loosened in Trendelenburg position then take care that the operating personnel secure the patient sufficiently Obtain the assistance of sufficient personnel for the rescue of the patient AXD3 340 620 13 01 02 Operator Manual System Operation sy Functional and Safety Check Daily tests After switching the system on Perform a visual inspection of all displays and signal lamps on the operating units No errors should be indicated Neither the radiation ON indicator on the operating units nor the radiation warning lamp in the room should light up A Warning If the radiation
53. A EE a Ea a rA aa aa T i 42 Holder for pediatric cradle manual Ni 43 Patient PBISMCNARIMAMES SS 43 CAMPESINA o E a e dd 44 Radiation protection for tableside Examinations cocccnccconnncnnonononanonononinononnnconononononnnnns 47 Radiation protection for the upper body usadas apodaca 49 Compensating ters Ai E A 51 Holding device OA a eEEe 53 TEE Sa RAEN 54 2 154 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Accessories Preliminary Remarks Proper use of the product This Operator Manual describes all the accessories provided by Siemens for the ICONOS R200 system Proper use of the accessories presupposes that the user has read and under stood this Operator Manual in detail In addition the user must be thoroughly familiar with the Operator Manual for the basic system Finally detailed knowledge of the applicable safety regulations for the medical equipment being used is indispensable These regulations are listed in the Safe ty Register of the respective system Operator Manual Explanation of proper use consists of illustrated descriptions of attaching us ing and removing the accessory component Important information will be emphasized and enclosed in a text box Situations involving the use of accessories which could endanger the patient the operator or the equipment will be emphasized with a WARNING Safety For reasons of safety for patients operators and the equipment only original
54. AXIOM Iconos R200 with SIEMENS fixed table height medical Operator Manual AXIOM Iconos R200 with SIEMENS fixed table height medical Operator Manual 3Uckenschild f r Ordner A4 50 mm Ruckenbreite Zuschneiden auf 205 mm x 50 mm AXIOM Iconos R200 with fixed table height Operator Manual SIEMENS medical AXIOM Iconos R200 with fixed table height Operator Manual SIEMENS medical 3Uckenschild f r Ordner A4 30 mm Ruckenbreite Zuschneiden auf 205 mm x 23 mm AXD3 340 620 13 01 02 AXD3 340 620 13 01 02 AXD3 340 620 13 01 02 AXD3 340 620 13 01 02 Jrucknummer zum Aufkleben SIEMENS Operating Manual AXIOM Iconos R200 with fixed table height CE 0123 Siemens AG 2002 All rights reserved Order No AXD3 340 620 13 01 02 Printed in the Federal Republic of Germany AG 12 2007 Contact Information Siemens AG Siemens AG Medical Solutions AX Wittelsbacherplatz 2 Siemensstrasse 1 DE 80333 Muenchen D 91301 Forchheim Germany Germany Phone 49 9191 18 0 Internet www medical siemens com Safety 1 System Overview 2 System Operation 3 Examination 4 Generator 5 Digital Image Processing 6 Interventional Application 7 8 Stands Tube Supports 9 Bucky Wall Unit 10 System Configuration Options 11 Accessories 12 Exposure Table 13 Addendum Current Information 14 Technical Description 15 Important information from the manufacturer This prod
55. Accessories Removal Radiation protection 48 154 value Be sure to set the examination unit horizontal 10 As required hook a lead rubber apron on the front bar of the holder Hook the second lead rubber apron according to the position of the examiner on the left or right bar Do not exceed the maximum permissible additional weight of 70N or 7kg This means that at the most 2 lead rubber aprons may be hooked onto the bar Unhook the lead rubber aprons from the bars after one another and carefully place them on the side do not kink them Pull the bars out from the accessory rails of the collimator Store the accessory in a suitable place The lead rubber elements of this accessory are inserted in welded plastic pock ets These pockets are riveted with the rails The plastic pockets can be cleaned easily with mild dish washing liquid solu tions The lead equivalent of the double layer lead rubber apron is 0 5 mm Pb at 80 kV AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Radiation protection for the upper body General The radiation protection window is used to reduce exposure of the examiner s upper body to scattered radiation It is especially intended to decrease the expo sure of their eyes and thyroid to radiation The radiation protection window is not designed to support additional loads This means it is not suitable to carry any additional weight The radi
56. Fis Trachea 1F S DSA Carotis NAT Series 7 5 F s 2 F s 2 F s Edit name Cerv spine Data oblique ES Actuate the Edit Name button The button appears inverted The program menu for the programming mode appears Iconos DRF Iconos Iconos Bed Vertix Cassette Edit organ name and press button Store to save changes Store Esophagus Colon Cerv spine 2Fis 1 Fis oblique Abdomen Myelo 1 Fis 1 Fis Trachea 1F S DSA Carotis NAT Series 7 5 F s 2 F s 2 F s Data Select a blank field for a new organ program The field appears inverted Type the name of the organ as it is to appear on the button Allowed is a maximum of two lines of 10 characters each Actuate the Store button AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Li Actuating the data or the Edit name button takes you back to the program menu without storing the name of the organ program Now you can edit additional organ programs Following completion of the changes actuate the Edit name button in the pro Edit name gram menu for the programming mode Programming is now terminated and the edited program names are stored AXIOM Iconos R200 AXD3 340 620 13 01 02 35 7 36 POLYDOROS SX 65 80 Integrated Control Console 36 36 AXD3 340 620 13 01 02 Operator Manual Accessorie
57. Gra phys senevacsvascy AA bit 13 B ck mode tt leo el adit ao Des Miata e sei ld Ns 13 Semiautomatic Mod iii cdas 13 Ulli GULOMAALICIMODS maunat a eaaa a a sabe aaa okt Salting a Aa Min tates a aaa aE i 13 Cassette A a a a aT re a a an 14 Cassette formats and segmentation prograM ccococcccocnccocnnocnncnnnnnncnnnnononnnnnncnnnnonnnnnnncncnnnons 14 Selecting the segmentation program s ssisiissisissiktist ttit terrae rrt Lentu nn ron ana nann nro nana nana naa EEE nent 14 IAEE E TATAE EEE AEEA ET 15 Skipping a segmentation s get aiia oit e TT E A E AETA a 15 MiS modestas 15 Loading unloading the spotfilm device curs A ttrt AAA AAA 16 Loading werner tone A eR eee Re 16 Unloading A A A E e 17 Exposure measurement for cassette EXpOSUTES ooccccccccnoncconnccnnonononononaconncnnnancnnnccnnnnonnnns 17 Arrangement Of the dOMINaNiS mii ni iii ias 17 Selection oi thedominants unn da as e a bale E e 18 Releasing MS eXDOSUT aida a 19 Organ progira ri A e a e a 19 SINGIS SxPOSUres seralogra NY all 19 SINOPSIS o a a eb a Gods o a Bally tt 19 Serialography ceinen a e e a A a a 20 Us rt a AEE 20 Spotfilming without da hate tten te asehsatt a tenitten heh neh ach eter ttent Aso teeta tac 20 ona AA A A sea tetas IIA 21 Tomographic SEQUENCE idas A SEAS 22 Chapter Digital Radiography Automatic format collimation in digital radio Qraphy oooococccnnnncncocccocnnnnnonnncccccnnanoncnnn cnn 23 Exposure measurement in digital radiograph
58. M Iconos R200 To avoid unintentional activation of control elements for movements concerning bed exposure please adhere to the following workflow 9 92 Select aquisition mode Bed exposure at the generator control console Tilt the system and move it to the correct SID Rotate the tube assembly accordingly Position the patient Control patient and system Don t let patient stay in system area during absence of operator In vertical table positions do not use the stand column the tube assembly sup port arm the tube assembly cover or the primary collimator as seat or support This unallowed loading can lead to material breakage and damage to bear ings Never put contrast medium cups or open containers with liquid or pasty con tents on the unit on the remote console or on the control cabinets Contrast medium can spill leak or overflow into system parts and lead to operational disturbances of the unit or to misinterpretation of exposures When storing contrast medium in the cup holder on the compression carriage use only cups with a maximum volume of 0 25 liter made of unbreakable ma terials i e under no circumstances glass or porcelain Remove contrast medium traces immediately Measures for avoiding unwanted radiation Before starting system movements make sure that the foot switch for fluo roscopy and radiography optional in the examination room is not in the travel range o
59. ON indicator or a radiation warning lamp lights up or a live fluo roscopic image not LIH appears on the monitor without actuating a switch immediately switch the X ray system off using the emergency shutdown button and notify the SIEMENS Uptime Service Use exclusively foot switches from SIEMENS original parts with approval for ra diation release Prior to the examination Remove unnecessary objects and equipment from the area of action of the system Remove unnecessary accessories from the system accessory rails and the primary collimator Attach the devices required for patient positioning and immobilization secure ly to the system Attach all safety related accessory parts correctly e g footboard grip protec tion strip handgrip handgrip strip and make sure they are properly secured Clean any contrast agent residues from the patient table protective plate and spotfilm device cover Recommendation As a test take a full format exposure using the largest possible format AXIOM Iconos R200 AXD3 340 620 13 01 02 9 32 System Operation Functional and Safety Check 10 32 Run a functional test of the STOP buttons by performing an arbitrary system movement and pressing the STOP button during the movement The movement concerned must stop immediately Then unlock the button turn it clockwise Run a functional test of the proximity switches collision protection by perform
60. Overview Operating and Display Elements A Caution Beam of laser light localizer strikes patient s or user s eye Risk of visual disturbance Eye injury Do not look into laser beam Take care that neither you nor any other person look directly into the light beam Close the laser radiation exit of the Laser light localizer with the sliding cover to protect the eyes of the patient or any other person A Caution Long operating time of light localizer lamp Overheating of housing and danger of burns Take care when touching the collimator housing To switch the laser line light localizer on press the button at the front of the collimator To switch the laser line light localizer off press the button again The laser line light localizer can also be switched off automatically by an internal time switch Crosshairs 1 The crosshairs project the longitudinal and transverse axis of the radiation field onto the cassette or directly onto the patient The full field light localizer for projecting the crosshairs is switched on with the button at the front of the collimator To switch it off press the button again The full field light localizer can also be switched off automatically by an internal time switch 1 The laser line light localizer and the full field light localizer cannot be switched independently of one another Locking spring The locking spring is located on the left guide rail at t
61. Plateau half EP 83 0 kV C48 Plateau half EP 87 5 kV C49 Plateau half EP 93 0 kV C50 Plateau half EP 99 0 kV C51 Plateau half EP 105 0 kV C52 Plateau half EP 113 0 kV C53 Plateau half EP 121 0 kV C54 Plateau half EP 129 0 kV C55 Plateau half EP 137 0 kV C56 Plateau half EP 145 0 kV C57 Plateau 68 0 kV C58 Plateau 68 0 kV C59 Plateau 68 0 kV C60 See graph C61 See graph C62 See graph C63 See graph C64 Plateau 68 0 kV C65 Plateau 68 0 kV C66 Plateau 68 0 kV C67 Plateau 68 0 kV C68 Plateau 68 0 kV C69 Plateau 68 0 kV C70 See graph AXIOM Iconos R200 AXD3 340 620 13 01 02 17 136 POLYDOROS SX 65 80 Integrated Control Console 18 36 No Type of curve Voltage C71 Reserve C72 Plateau 87 5 kV C73 Reserve C74 Reserve C75 Reserve C76 Reserve C77 Plateau 68 0 kV C78 Plateau 68 0 kV C79 Plateau 68 0 kV C80 Plateau 68 0 kV C81 Plateau 68 0 kV C82 Plateau 68 0 kV C83 Plateau 68 0 kV C84 Plateau 68 0 kV C85 Plateau 68 0 kV C86 Plateau 68 0 kV C87 Plateau 68 0 kV C88 Plateau 68 0 kV c89 Plateau 68 0 kV C90 Plateau 68 0 kV C91 Plateau 68 0 kV C92 Plateau 68 0 kV C93 Plateau 68 0 kV C94 Plateau 68 0 kV C95 Plateau 68 0 kV C96 Plateau 68 0 kV C97 Plateau 68 0 kV C98 Plateau 68 0 kV C99 Plateau 68 0 kV C100 Plateau 77 0 kV AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console 102 90 81 73 66 60 0 10 20 30 40 50
62. a dd e aise ede 43 Compression CONES en ek he te ee i A A tds ote Mt ek eae he bait a Ot aes 44 Radiation protection for tableside examinations ccccccccccccccccccccccceeeesseeesesssseeeeseeeeeeeeeeseeseeeeeeeeeeeees 47 Radiation protection for the Upper body cccccccccccncccnccnnnnnnnniononcnnnnnnnnnnnnnnnnnnononononnnnnonnnnnnninrnnennninnnnnnnnoss 49 COrnpensating UHE a A ed ote reos ee 51 Holding device Toreight Titers ra dd 53 Three Held EPS iii A A A A aaa 54 Part Technical Description Chapter Identifying Lale da 3 Position of the labels cota dat rt a ici 3 Chapter Technical Data rin Stalin tila tease ete Tonidinnciess 5 AN 5 MS Tae ce a oa hee Se cere hae kee ie eee O tn a 6 CO O wean Tacs eee 8 O A O 11 4 4 AXD3 340 620 13 01 02 Operator Manual System Overview Table of Contents Operator Manual System Overview Chapter System Description A E 5 PROGUGMUGSOR DELON riada ba barba olmos 5 O 6 Standard MOTION ii AS A E AA A ea cage 6 DP e a nan sath cto Mol 6 SES OVERVIEW a A sia 7 IMEI suc thi a Milde dil Shar aa a a a Rael ich 8 Chapter Protective Measures Emergency Procedur nadia 11 Cleaning and AiSinNfectioN raias dto 11 Radiation protection ZONneS iaa AA EErEE EEEE 12 Position and size of the main operating area ccoccocccnccnncnnccnnncnononinoninonannnannnnn oran nonnnannnananinns 12 Stray radiation in the main operating area according to DIN EN 60601 1 3 sssssssrssrsrsrrsrrereres 14
63. a eee ek 10 FIUOFOSCOPY TIME TINA ee a E susiages danas di oda 11 Fluoroscopy Warning signal ii ias 11 Automatic format collimation in fIUOrOSCOpY ccccccccnnnnnnnnnncnnnnnononononenenonnnnnnnnnnononnnnnnnnnnnnnnnnnnonnninnnnnnnos 11 FIUGFOSCOPY PrOJTAMS Et da E E E TO E 11 Dose reducir ti aae a a Heche amie 12 Chapter Cassette Exposures in the Spotfilm Device optional 13 Automatic format collimation in radiography oooooocincinnccocoooconcccccccnncnonannnnnnnnnnnnnonnn nono ono nnrnnnnnnnninnnnns 13 CESTA 101e VE E ee eet he ete x ea a nate Sheen essa te dete eit feel at ds ase tewcadila cele AusaNed 14 Loading Unloading the spotfilM device ooooocccoccononononoconoconononnnnnnnnnnnnnnnnonononononononnnnnenrennnnnnininininoss 16 214 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Overall Table of Contents Exposure measurement for cassette expOSUTES oocooooccccccooononnnocooonnnnonononnnnnncnonnnnnnononnnonnrnnnonnrarnnnannss 17 Releasing the EXPOSUTE ui da lad les dade esas 19 Organ A A thd Me tA Neca he count aeea deaa laa ea 19 Singleexposur es SenialOgraphy lt Moss e eos Mae ote 19 BUCKY INOGE ess sizotal is lin telde oder ashes doe E de aoe EA 20 SPSL MING WITHOUT TOMOGA ONY lacra dio 20 TLOMOGFAPHY OPTOMA ir A A A eet 21 Chapter Digital AO MA o 23 Automatic format collimation in digital radio Qraphy oooicoccnoccccocccccocococonononnnnnnnnnnnncnnnnnnnann non nnnnncnnnins 23 Exposure measur
64. accessories manufactured and sold by Siemens or Siemens approved accesso ries from another manufacturer may be used Siemens cannot assume any responsibility for accessories not approved by us Orientation When using the accessories and to simplify the description the following direc tional indications shall apply in this Operator Manual with regard to the working position of the user In front of the patient table looking in the direction of the X ray tube left is the head end of the patient table right is the foot end of the patient table Ooc eo frontal means the longitudinal side of the patient table close to the operating panel o in back means the longitudinal side of the patient table away from the oper ating panel AXD3 340 620 13 01 02 3 1 54 Accessories Preliminary Remarks 1 turn toward the right means tighten accessory with knurled screws or levers clockwise 1 turn toward the left means remove accessory with knurled screws or levers or other fastening devices counterclockwise Example Turn both knurled screws toward the left Push the grip protection strip on the head end into both accessory rails Turn both knurled screws toward the right Check that the grip protection strip is seated securely Use of several accessory components This document describes the use of a single accessory component in each chap ter text If you need to work with several components during an examination e
65. adiation release in Vertix bucky wall stand and Iconos Bed free exposure mode All other generator control functions are integrated in the FLUOROSPOT Com pact imaging system gt For more information refer to the FLUOROSPOT Compact Operator Manual AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements Foot switch for fluoroscopy and radiography in the control room 1 Switch for radiography in Iconos DFR and Iconos Cassette mode without precontact 2 Switch for fluoroscopy only with cassette spotfilm device Tableside control panel A A A EE mA 7 VV lt gt lt B gt lt gt pa B am 08 BEBE Displays 4 Table tilt angle 1 Display of a flashing E for an error message MN o A 1 Oblique projection angle max 40 IL or 11 Display of a flashing E for an error message 1 optional in the examination room without mobile tableside control panel AXIOM Iconos R200 AXD3 340 620 13 01 02 33 44 System Overview Operating and Display Elements A gt lt gt dp V 34 44 System settings 1 Oblique projection cranio caudal caudo cranial Oblique projection 0 orthogonal projection Source image distance with cassette spotfilm device 115 cm 150 cm Source l distance with l l image receptor unit 115 cm 150 cm Fulcrum height for oblique projection
66. an be adjusted in height width and lateral tilt Attachment Move the table to the horizontal position Loosen both cap screws 1 for attaching the head support to the accessory rails Insert the head support into the accessory rails at the head end or foot end of the table and move it to the appropriate position Tighten the cap screws 1 Pull the head support to ensure that it is secured properly Turn the following cap screws as indicated to permit adjustment of the 2 position from side to side 3 height 3 4 lateral tilt from 0 to 90 depending on the height setting 5 pads 6 to the width of the patient s head turn to the left Set the position from side to side Tighten the cap screw 2 Tighten the cap screw 3 Turn the cap screws 5 carefully to the right Do o 7H UO OH OH Oo o AXIOM Iconos R200 AXD3 340 620 13 01 02 Raise the stabilizing arms to the height required Push and pull the head support to ensure that it is seated properly Assist the patient in positioning his her head in the head support The patient s head should make contact with the top pad Push and pull on the stabilizing arms to ensure they are seated properly Both padded stabilizing arms will move toward the patient s head 13 154 Accessories Optional Accessories Ensure the patient s head is safely stabilized A Warning To avoid injury to the patient
67. and Positioning the Patient General IMPORMMATOMN tuu dl blvd a tdi dao 5 olas A A a andiQspent seinen ada eg 5 Chapter Fluoroscopy FIUGTOSEODY operating modes st AA 7 Selecting the fluoroscopy operating MOS AAA AA Ree 7 Changing the selection of the fluoroscopy operating mode oooooccccnnnnncccccccccnnninnnnnnnononnnnnos 7 Fluoroscopy with Supervision Optional s nese r a i a aaa aI EEE a aa 8 Pulsed fluoroscopy Optional eesi ea eee sa EES EEEE AATE EE EEE EE EE EE EE EE EEE Enea 8 ROAGMAP ss sbeldce heed htaieds Aita 8 RECIO TIO O can a one huts a e aa do 9 PIUOTOSCOBIS CATA earn o iaa 9 Display orthe kV and MA Vall s ridad A ad ine cds 9 Display OF The HUOFOSCOPIUME 10 A aa 9 Display of the area dose product Optional oooocococococococcconononononcnnnnnonanannononnnnnnnnnanananannannnss 9 Resetting the fluoroscopie data ult dida 10 Automatica FUOLOSCOPIC Control it AAA a 10 Selecting automatic fluoroscopic CONTTO oocccocnncccocnnonnnnnconnnnnnncnnnnononnnononnnnnnnnononnnnnnnnnnnnnos 10 A A O E E EE A EEES 10 FIMOROSCOPICICUIVSS EA E E E EA EE A E E EEA AEE 10 Fluorosc py TIME MIT e ahi atada els 11 ELUOTOSCOPY Wang IRA std A Si 11 Automatic format collimation NUI ados 11 FUOrosco py Droa E 11 Broar eNO EAEE T A E EET 12 AXIOM Iconos R200 AXD3 340 620 13 01 02 1 52 Examination Table of Contents Chapter Cassette Exposures in the Spotfilm Device optional Automatic format collimation in Kacho
68. ant Carry the cradle to the BABIX hanger of suitable shape and length Hook the cradle on the wooden hook with the opening towards the hanger Press the cradle at the two longitudinal sides into the slot of the hanger Check for firm seating of the BABIX cradle in the BABIX hanger Holder for pediatric cradle manual gt See separate Operator Manual This holder is now also available for lconos R200 Patient positioning mattress Mattress for attachment to the grip protection strip for comfortable patient posi tioning 4 Attach grip protection strip to head end Place the mattress on the tabletop and pull loops over the cap screws of the grip protection strip The attenuation equivalent is lt 0 5 mm Al AXD3 340 620 13 01 02 43 154 Accessories Optional Accessories Compression cones Application Examinations of the gastro intestinal tract Three cone shapes are available pyramid optional pointed cone optional A WV flattened cone standard The cones are highly radiotransparent The cone is made of stable aluminum die casting In the uppermost position of the compression carriage the compression cones permit a shadow free field coverage even of the largest cassette formats or l l diameters Radiation protection The attenuation equivalent is lt 0 25 mm AL value 44 154 AXD3 340 620 13 01 02 Operator Manual Changing the cone shape Attachment Removal AXIOM Iconos R200 Accesso
69. are stored in organ programs gt Refer to the POLYDOROS SX register for further details on the organ programs and their programming Single exposures serialography Single exposure S Single exposure selected the LED does not light up Select a suitable segmentation program Possible selection Full format Segmentation 20n1 30n1 40n1 If you now release the exposure you receive one single exposure per exposure release AXIOM Iconos R200 AXD3 340 620 13 01 02 19 152 Examination Cassette Exposures in the Spotfilm Device optional Serialography Serialography selected the LED lights up E Select a segmentation program Segmentation 20n1 30n1 40n1 If you now release the series and keep the exposure release button pressed you obtain an exposure series Lil Serialography in combination with tomography is not possible Bucky mode Use only the light localizer and the operating elements of the primary collimator for collimation Do not release fluoroscopy otherwise Bucky mode is deselected 0 Press this key Bucky mode is selected the LED lights up e Ae Press this key Spotfilm device exposure technique is selected the LED lights up Insert a cassette and select a segmentation program Spotfilming without tomography o A Aad Press this key Spotfilm device exposure technique is selected the LED lights up Select semi or fully automatic mode Inserta cass
70. ast HUOrOSCOPY i iaa 13 FIWOFOSCODIG CALA zeeen A A AN a A 13 Display of the kV and MA values ooccoocnncnncnncccnnnnnennncnnnonnnnnnnnnnnnnnnnnnnnnnnnonnnennnnnnnonnnos 13 Display of the fluoroscopic TIME ooccooccocnncnncccnnnnnennncnnnnnnnnnnonnnnnnnnnnnnnnnnnennnonnnnnnnnnnnos 13 Display of the dose area product oocccoccccnccnncocnnnnnonnnnnnonnnnnnnnnnnnnnonnnnnnnnnnennnnnnnninnnnnons 13 Resetting the fluoroscopic datal ooccooccocnccnncccnonnnennncnnnnnnonnnnnnnnnnonnnnnnnnnnennnnnnoninnnnnoos 13 FluOroscopic charactenistic CURVES a ia des 14 FIUOLOSCOPIG ime IM rd aaa 15 EXPOSURE Rech A a a e a A 15 Exposure release i ex teeta eea E OAE E EE AEEA A a ES AEA 15 Automatic exposure system O point technique oo ce cceeec eee ceeeee eee e ea ee ee eee eset eae eeeeeaeaeeeeeeeeaees 16 General ronan tons thik at Sten tt hohe enh he A not chet ah de ed Ae co Aten teh od 8 16 Programmed characteristic GUNES aia a a a A encoded 16 Selecting direct exposure technique oocoocccocnncncocncocnnnnnnoncncnnnnnonnnonnnenononnncnnnnnnnnnnnnnnnnnonnnoss 21 Sai A Rahal E OREN oS hot Saad MENSA Sa EE 21 Select 1 point A 22 Select point TECH MIQUe icc aha chant datada losa 23 Select 3 pointitechnigue rga A At Natale ATAT 24 Select 3 point technique with IONTOMAT occocccccnnncnncncncncncnnnnnncnnnnnnnnnncnnnnnnnnnoninnnnnnnns 25 Select mAs tomography occoocccocnncnnnnncocnncnnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnninnonnnoss 26
71. at the movement range is free of obstructions Move especially monitor support systems operating consoles gurneys beds and instrument tables out from the tilting range of the table and remove chairs steps stands waste containers and similar objects from the move ment area No collision monitoring Do not place any objects or consumable material on the cover of the table sup port on the spotfilm device and on the longitudinal guides of the stand car riage Considerable forces which can damage these objects in the area of move ment of the systems arise during movements of the spotfilm device or of the tabletop Do not place any loose objects anywhere on the table These objects could fall down when the table is tilted causing injury or damage 1 optional AXD3 340 620 13 01 02 Operator Manual System Overview Protective Measures Do not stand at any place on the spotfilm device or on the covers of the table support outside the marked areas provided for this The covers can be deformed Components located underneath them are damaged and thus lead to oper ating disturbances Place no objects on the operating areas of the control consoles and the table side control A Caution Unintentional activation of control elements for movements Collision with patient operator or equipment Do not load the remote console with any objects accessories folders or documents AXIO
72. ating personnel can be injured If the patient is located in the danger zone it must always be ensured that the operating personnel are in the room and within reach of an emergency stop If the operating personnel leaves the room and or moves out of reach of an emergency stop then the patient has to be moved out of the danger zone Warning signs Special danger zones are marked on the unit with a warning sign This warning sign is a reference to a possible risk of injury by crushing for the pa E 4 E tient and or examiner ecm mha This warning sign shows the position of the patient table in cardiopulmonary re animation CPR with pressure compression up to 500N 50kg 1 Between 90 and 90 depending on the system version 16 44 AXD3 340 620 13 01 02 Operator Manual System Overview Protective Measures Grip locations A AXIOM Iconos R200 Warning When handling the system correctly as well as when positioning the patient operators and patients should use only the grip locations provided for this purpose The following grip locations are provided A 1 handgrip front 1 Grip protection strip head end 1 Handgrip strip back Ensure that the handgrip strip the grip protection strip and the handgrip are always attached If these grip locations cannot be used Pay special attention to the stated
73. ation rectangular diaphragm Semitransparent wedge filters if option is available Cu prefilter preferably filed in the organ program i Position the patient so that the region the vascular filling of which should be im aged first is located in the central ray Press one several keys The dominant preset in the organ program is overwritten Li If a left right dominant or both dominants are selected the system switches over automatically to the central circular dominant if the preselected dominant is covered by the filters since this would inevitably result in a faulty exposure Connect the injector plug to the electronics cabinet only with radiation syn chronous injector release option Set the injection data and switch to ready for injections Test run The X ray system stands in the starting position for the scanning process Start a test run without radiation Switch the light localizer of the collimator on Deflect the joystick up down or the key to the left right until the required examination area has been scanned If necessary correct the starting position AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Digital Radiography Scanning process The X ray system stands in the starting position for the scanning process Press an exposure release button and keep it pressed up to the end of the ex amination i e until the scanning
74. ation protection window can be moved in any direction Components The radiation protection for the upper body comprises the following parts 1 Ceiling rail 1 Carriage with stand 1 Support arm with window pane 1 Brake handle with brake shoe Lead equivalent The lead equivalent value is 0 5 mm according to DIN 6813 Handling The radiation protection window should be positioned so that it protects the examiner s eyes and thyroid Warning Danger of collision There is a risk of collision or damage due to breaking off or falling down espe cially during swivel movements Avoid possible collisions during system movements Positioning If the radiation protection window is mounted on the ceiling rail and can be moved it is positioned using the brake handle on the stand of the carriage Releasing the brakes 9 Pull brake handle 1 The carriage can now be moved freely in the ceiling rail Set it to the required position AXIOM Iconos R200 AXD3 340 620 13 01 02 49 154 Accessories Optional Accessories Engaging the brakes Releasing the brakes permanently Engaging the brakes 50 54 Cleaning and disinfection Sterile cover Release the brake handle Pull the brake handle Insert the brake shoe 2 so that the brake handle remains in the pulled position You can now move the carriage freely in the ceiling rail Pull the brake handle Remove the brake shoe
75. ay Elements System remote control console ad on cl abia 25 Displays Generall ATA a ee a 25 Indicatorsanine CISPlAY asn in Ath AY iter ttl e a a ach Soni aa teak Mi dto de 2 25 System Settings a A A a A i 26 MEC RA 27 Automatic UIC CONTO srren a ste shan a a ei Winn 28 IMAGE revela A A A a it tia 28 Additopalfite r dactilar alo ads 28 GolliMator SENOS sii A A a A A e aes ioe 28 SEMITAN SPA EMS iia 29 RN E EE e A e ad a taal a as alin Sd 29 Ao UttOn rl rs E E E 29 General operating elements siesi siisrciriniritiiiirrai rrtt tiritak crr mirit enirir EE ENDEAN EEAA CETE EEEE Ena 29 Preselectiom f UNGON ys Mea E NE EA SAET A E R A ETS AS 30 Operating nodes a p anaha a aa a aha aaraa a e ae a aaa i 30 Segmentation Propran AI AS AS A AAA S T Beck 31 En A wits test 2 KANEN tnd Saco 32 Foot switch for fluoroscopy and radiography in the Control rOOM eects 33 Tapleside controlpanel variada diria 33 E A AR a a a ME Le a oe Re O a 33 LEE SAANS E EAE E E A EE dt as 34 Image intensifier formats eera a a a E a E a e a o 35 COMA Settings musasi eena ana dap ias 35 LEMA e e o al SD 35 Piman cs AA O aatusarnansaninas ustdinantereedund scaant a eE 36 Control elements and displays at the front oocooccoccnocncocnconnnnnnocnnnonnnnnonononnnnncnnnnnnnnonnnninnnnnnss 36 Control elements at the underside occoocccocnccnconnconnnonenoncnnnnnnnennnonnnnnnnonnnnnnnnnnnnnonnnnnnnonnnons 38 Prefilter Sl CUINA AAA AE A AA AE A CN A 40 M
76. cassette in the spotfilm device Select the required segmentation program by pressing one of the keys The LED in the pressed key lights up The number of free exposures is displayed in the display AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Cassette Exposures in the Spotfilm Device optional Full format no segmentation Segmentation 2 on 1 Segmentation 3 on 1 Segmentation 4 on 1 Li If you have selected a segmentation program which cannot be obtained with the inserted type of cassette then the LEDs in the keys for the selected segmenta tion program flash If 0 is displayed in the display after the exposure the selected program has been completed Further exposures are then blocked Format segmentation Skipping a segmentation segment Press the selected segmentation key once again if you wish to skip a seg ment during exposure Mixed mode It is possible to change the segmentation within a cassette as long as the unex posed part of the cassette permits the newly selected segmentation AXD3 340 620 13 01 02 15 152 Examination Cassette Exposures in the Spotfilm Device optional Loading unloading the spotfilm device A Warning Risk of injury during automatic cassette size sensing Do not reach into the loading shaft of the spotfilm device Loading LED lights up Cassette in unloading position Insert the cassette with the smooth
77. cm Water value WV LJ Recommended characteristic curves for organ programs in 0O point technique These suggestions correspond to the SIEMENS basic exposure table whereby only the part relevant for the O point technique has been listed Organ kV Characteristic curve Cranium Survey of cranium p a a p 70 C14 Cranium lateral 66 C13 Cranium axial 85 C18 Petrosal bones sagittal 70 C15 Petrosal bones Stenvers 70 C14 Paranasal sinuses p a 70 C 14 Optical nerve cavity Rhese 66 C 13 AXIOM Iconos R200 AXD3 340 620 13 01 02 19 36 POLYDOROS SX 65 80 Integrated Control Console Organ kV Characteristic curve Thorax 1st 7th rib p a a p 66 C13 8th 12th rib p a a p 70 C14 Sternum p a 63 C12 Sternum lateral 66 C 13 Clavicle p a 60 C11 Scapula a p 63 C12 Scapula lateral 63 C12 Thorax C61 Lungs heart lateral 125 C24 or C 61 Esophagus oblique 90 C19 or C 60 Esophagus deglutition C 62 Abdomen Kidneys gallbladder a p 66 C 13 or C 63 Kidneys gallbladder lateral 81 C 17 or C 63 Bladder a p 66 C 13 Bladder axial 70 C14 Stomach duodenal bulb GI tract survey 102 C 21 or C60 or C62 Gastrointestinal tract C 60 Colon contrast study C 60 C 62 Spinal column 1st to 3rd cervical vertebrae oral 70 C14 Ath to 7th cervical vertebrae a p 70 C14 1st to 7th cervical vertebrae lateral 70 C14 1st to 7th cervical vertebrae oblique 70 C14 Thoracic vertebrae oblique 81 CAZ Thoracic
78. conos R200 Examination Cassette Exposures in the Spotfilm Device optional Unloading Press the key on the spotfilm device or system remote control console The cassette appears in the loading slot of the spotfilm device The LED lights up Fluoroscopy and radiography are blocked Remove the cassette Possible configurations 1 for cassette unloading Once the selected program has been completed i e 0 is displayed in the dis play the cassette will either automatically appear in the loading slot for removal or will be moved to the parking position can be configured Exposure measurement for cassette expo sures Arrangement of the dominants The following sketch shows the arrangement of the dominants in the spotfilm de vice related to the anterior posterior patient position head end at the left looking onto the patient with the table horizontal 2 O gt 1 Left dominant 2 Right dominant 3 Middle dominant 1 by the SIEMENS Uptime Service AXD3 340 620 13 01 02 17 152 Examination Cassette Exposures in the Spotfilm Device optional A Selection of the dominants The dominants are filed in the organ programs or they can be set on the integrat ed generator control console Multiple selection of the dominants is possible Warning Please make sure when changing the selection of the dominants that the correct dominant is always selected 18 52 Press one
79. ct Normal inverted display of the controls UU Normal display Function deactivated LI Inverted display O 80 Function activated 8 Functions of the controls Brief button actuation Value increases by one step Prolonged button actuation Value increases until the button is released Brief button actuation Value decreases by one step Prolonged button actuation Value decreases until the button is released Changing the focal spot and tube load If the maximum acceptable load of the selected X ray tube is exceeded when switching over 1 from the large to the small focal spot or 1 from 100 to 80 tube load the generator automatically reduces the mAs setting Selecting the measuring field dominant The selection of more than one measuring field dominant is possible Actuate the button Function activated deactivated AXIOM Iconos R200 AXD3 340 620 13 01 02 9 36 POLYDOROS SX 65 80 Integrated Control Console 10 36 Measuring field dominant display If either the left or the right dominant selected becomes invalid e g due to colli mation the measuring field selected is then shown crossed out When the diaphragm is opened again the previously selected dominants are shown normal again Display of the exposure data After the exposure is completed the actual values of kV ms and mAs are dis played Messages General error messages Eac
80. d are generated by the television central control unit 1 Fluoroscopy with pulsed television scanning Supervision option In SUPERVISION only 15 12 5 frames per second are generated In this case fluoroscopy is applied at half the radiation dose with half the temporal resolution or 1 Primary pulsed fluoroscopy CAREVISION option In pulsed fluoroscopy the radiation is pulsed at 15 12 5 or 7 5 8 3 or 3 3 pulses per second In this way a corresponding dose saving with a lower temporal resolution is possible 1 Roadmap only with DSA option with standard fluoroscopy with Supervision optional or pulsed fluoroscopy optional Roadmap is a special fluoroscopic mode with subtraction display Selecting the fluoroscopy operating mode All parameters necessary for fluoroscopy are stored in organ programs Select a corresponding organ program on the integrated generator control console Changing the selection of the fluoroscopy operating mode It is possible to change the selection of the operating modes in connection with the Supervision or CAREVISION options The current operating mode is displayed in the operating menu of the live moni tor Use the FLUOROSPOT Compact infrared control for operation If your system is equipped only with standard fluoroscopy the Fluoro and Fluo ro keys have no function 1 Values in brackets apply to VDEOMED DHC AXD3 340 620 13 01 02 7 152 Examination
81. d from the com pression belt Otherwise the X ray image will show artifacts The compression belt is made of transparent plastic and can be cleaned with a damp cloth Attachment Move the patient table to the horizontal position Position the patient on the table Push the tensioning part of the compression belt into the required position over the front accessory rail AXIOM Iconos R200 AXD3 340 620 13 01 02 17 154 Accessories Optional Accessories Press both tension levers 2 outward Check that the tensioning roller is firmly seated by pulling on it Press the ratchet handle 1 downward LI The belt is released For very obese patients the belt holder is easier to secure if you are standing at the back of the patient table In this case and for very restless or frail patients we recommend that someone assist you in attaching the compression belt Lift the holder with the belt across the patient Push the holder over the back accessory rail Make sure that the compression belt attaches straight across the tabletop and not at an angle 18 54 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Press the tension lever 4 outward Check that the holder is seated firmly by pulling on it Turn the cap screws 3 on the tensioning roller toward the right The belt will tighten Push and pull back on th
82. dentifying Labels Position tinca Sa a e detailed 3 Primary CO llIMatOr Ahstt nad ite cial Shad decido sedal kel Soh adh ed ride aut td eden dad bel Roh sed al As 4 BE Ted lt esha etch iste eat nA SRA AUN Mr thct ah Hoh ts etd Ba hatin Uns MN deed kt atch aU NA 4 POULIN os AO A A Seale Oa teat Ata aN eo 4 Chapter Technical Data A A A A fats AAO TE STT 5 A eee are eer Sie lc ere Sor rt ace boa tl st wna EE ald Tepe 6 CA A A aes 8 A A im Svacauaatialy sae 11 AXIOM Iconos R200 AXD3 340 620 13 01 02 1 712 Technical Description Table of Contents Operator Manual 2 of 12 AXD3 340 620 13 01 02 Technical Description a Identifying Labels Position of the labels BS O o Oo Oj e ae gt 32 oa lt A ae o IF Ss J 3 a gt P00 Daa oe Sebo 4 SS gt gt SS 2 Es gt 1 1 Image intensifier 2 Primary collimator 3 X ray tube assembly 4 Table AXIOM Iconos R200 AXD3 340 620 13 01 02 3 12 Technical Description Identifying Labels Primary collimator Backside Mot No 10092604 Rev00 01 02 03 04 05 O 07 08 09 10 11 12 13 1 SIEMENS E e a TT UT Serial Na Shaman At pen Vache 011 iadshacer Pirts PADOT Memeo Cn Mad jade In German This product complies with DHHS regulations 21 eh Subchapter J appl leable at date of manufacture Vo
83. digital radiography with seriolography LED lights up series Selection of fast series for exposure technique with cassette and cassette segmentation only with cassette spotfilm device LED lights up fast series Operating modes a D D D Bucky mode with temporary automatic format collimation DR exposure technique digital fluororadiography with image intensifier Periscanning exposure technique native angiographic bolus tracking Peristepping exposure technique optional native pelvis leg angiography Exposure technique of spotfilm device with cassette Exposure technique of tabletop cassette exposure free exposure Scanning technique with DR for displaying long objects optional 1 only with cassette spotfilm device AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements Q gt A Selection of tomographic program for DR or cassette optional iN 1 Exposure technique with without scattered radiation grid LED lights up grid in the beam path E i Segmentation program J Full format 1 Format segmented 2 on 1 1 Format segmented 3 on 1 1 Format segmented 4 on 1 1 only with cassette spotfilm device AXIOM Iconos R200 AXD3 340 620 13 01 02 31 144 System Overview Operating and Display Elements 32 44 Generator on off console 1 System OFF button 2 System ON button 3 Radiation indicator 4 R
84. e be very careful with the compensating filters and three field templates They are thin sensitive to scratching and can become useless if handled carelessly 52 54 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Holding device for eight filters AY Use For storing a maximum of eight compensating filters Attaching the 4 wall holder Equipping the 4 wall holder with compensating filters Using the compensating filters AXIOM Iconos R200 Fasten the holder to the wall at working height in a suitable place with the en closed wall plugs and screws Remove the compensating filters from the packaging Turn the filters so that the designation on the filters can normally be read from above Place the filters in the upward inclined compartments Remove the required compensating filter from the wall holder Push the locking lever on the left collimator accessory rail to the left Slide the filter into the collimator accesssory rails in the correct direction for the examination The locking lever on the accessory rail springs back to the right Check that the compensating filter sits firmly in the collimator AXD3 340 620 13 01 02 53 154 Accessories Optional Accessories Storing the compensating filter in the wall holder Use Using the three field templates Storing the three field templates 54 54 Push the locking lever on the left accessory rail to the
85. e injector to avoid unnecessary contrast medium injections Press the fluoroscopy release switch briefly for at least 2 s The exposure parameters are calculated and taken over from the fluoro scopic values 0 point technique Press the exposure release button and keep it pressed up to the end of the examination i e until the filling run is ended Trigger the injection automatically or manually Observe the contrast medium filling on the live image monitor Li If the injector is not connected the first exposure series is started immediately With the injector connected firstly the injection is triggered or the exposure se ries released depending upon the set triggering Release 1st step and further steps Deflect the joystick briefly up down or press the key to the left right once Mn the optimum contrast medium filling is reached d A t The X ray system moves in each case into the next position The position is displayed on the display in the remote control console e g 2 4 up to max 4 4 a gt Sier End of scene Letthe exposure release button go once the required contrast medium filling is reached in the last exposure position i The exposure series is also ended if the image memory is full and the maximum scene time has been reached independently of the position in which the system is located AXIOM Iconos R200 AXD3 340 620 13 01 02 39 752 Examinatio
86. e ratchet handle 1 until the belt tension is optimal 60 DL 2 Check the belt tension on the patient once again Loosening the compression belt Move the patient table to the horizontal position Press the ratchet handle 1 back Turn the cap screw 3 on the tensioning roller toward the left The compression belt will loosen DO 9 Using the ratchet handle set a lower belt tension Removal Move the patient table to the horizontal position 0 Press the ratchet handle 1 back Turn the cap screw 3 on the tensioning roller toward the left m The compression belt will loosen AXIOM Iconos R200 AXD3 340 620 13 01 02 19 54 Accessories Optional Accessories Radiation protection value 20 54 Press both tension levers 4 on the belt holder inward Pull the belt holder backward off the accessory rail Lift the belt holder over the patient Roll up the compression belt halfway using the cap screw 9 4 2 Place the belt holder next to the tensioning roller A T gt o 0 Press both levers 2 inward on the tensioning roller Pull the tensioning roller from the front accessory rail Assist the patient in stepping down from the patient table Using the cap screw 3 roll up the belt on the tensioning roller The attenuation equivalent of the compression belt is lt 0 8 mm Al AXD3 340 620 13 01 02 Operator Manual Accessories Optio
87. e shoulder supports Make sure that patients standing on the footboard hold onto the handgrip and the handgrip strip For additional safety use the compression belt for frail or very unsteady patients Press the spring loaded handgrip strips in the handgrips the two red buttons must be visible Move the footboard to the desired position lock in position Release the handgrip strips and shift the footboard slightly back and forth until it locks in the two red buttons must be flush with the handgrip A Removal Maintenance note AXIOM Iconos R200 Warning The footboard may only be unlocked adjusted or removed when the table is in the horizontal position In all other system positions the footboard could fall off and present a high risk of accidents Move the patient table to the horizontal position Press the spring loaded handgrip strips in the handgrips the two red buttons must be visibible Lift the footboard first on one side and remove from the accessory rail Remove other side of the footboard from the accessory rail In order to prevent influx of contrast medium into the sockets the pedal must be covered with absorbent fleece material AXD3 340 620 13 01 02 11 154 Accessories Standard Accessories 12 54 AXD3 340 620 13 01 02 Operator Manual p E z Accessories nT E Optional Accessories Head support LAN Application Holder for cranial examinations C
88. e the clamping lever 1b Push and pull on the armrest to ensure it is seated properly Loosen the cap screw 2 Move the padded armrest to a comfortable position Tighten the cap screw 2 Ensure that the armrest is seated properly Place the patient s arm on the armrest AXD3 340 620 13 01 02 35 154 Accessories Optional Accessories 36 54 Removal Application Attachment Place the strap over the patient s arm and under the pin Press down on the clamp 3 Ensure that the patient s arm is stabilized and comfortable Move the patient table to the horizontal position Pull the clamp upward and loosen the strap Raise the patient s arm from the armrest Open the clamping lever 1a 9 494 2 Remove the armrest from the accessory rail Lateral radiation shield For additional radiation protection during tableside operation of exposures Move the patient table to the horizontal position Position the patient Loosen the right and left cap screws on the lateral radiation shield AXD3 340 620 13 01 02 Operator Manual Removal AXIOM Iconos R200 Accessories Optional Accessories Insert the radiation shield in the front accessory rail and slide it to the appro priate work position Tighten both cap screws Push and pull on the radiation shield to ensure that it is seated properly Tilt the radiation shield into a protect
89. easing fluoroscopy 1 Use the foot switch to release fluoroscopy 1 Radiation is released as long as you continue to press the footswitch for fluo roscopy After you let the switch go the last image is retained and displayed on the monitor LIH 1 With the red emergency STOP button actuated fluoroscopy can be switched back on consciously after letting the fluoroscopy switch go and pressing it again 1 A patient folder must be created and selected in the FLUOROSPOT Compact 11 No processing functions apart from storing the image are possible during flu oroscopy 1 The radiation ON indicators must light up Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the system off immediately Notify the SIEMENS Uptime Service Discontinue use of the system Fluoroscopic data The fluoroscopic data of kV mA time and area dose product optional are dis played on the integrated generator control console Display of the kV and mA values 1 During fluoroscopy Running display of the momentary kV and mA values UU After the end of fluoroscopy kV and mA mean value of the examination Display of the fluoroscopic time Continuous display of the time accumulating in the examination in minutes Display of the area dose product optional Continuous display of the area dose product accumulating in the
90. eau whole EP 40 0 kV C2 Plateau whole EP 41 0 kV C3 Plateau whole EP 42 0 kV C4 Plateau whole EP 44 0 kV C5 Plateau whole EP 46 0 kV C6 Plateau whole EP 48 0 kV C7 Plateau whole EP 50 0 kV C8 Plateau whole EP 52 0 kV C9 Plateau whole EP 55 0 kV C10 Plateau whole EP 57 0 kV C11 Plateau whole EP 60 0 kV C12 Plateau whole EP 63 0 kV C13 Plateau whole EP 66 0 kV C14 Plateau whole EP 70 0 kV C15 Plateau whole EP 73 0 kV C16 Plateau whole EP 77 0 kV C17 Plateau whole EP 81 0 kV C18 Plateau whole EP 85 0 kV C19 Plateau whole EP 90 0 kV C20 Plateau whole EP 96 0 kV C21 Plateau whole EP 102 0 kV C22 Plateau whole EP 109 0 kV C23 Plateau whole EP 117 0 kV C24 Plateau whole EP 125 0 kV C25 Plateau whole EP 133 0 kV AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console No Type of curve Voltage C26 Plateau whole EP 141 0kV C27 Plateau whole EP 150 0 kV C28 Plateau 68 0 kV C29 Calibration curve C30 Plateau 68 0 kV C31 Plateau half EP 40 5 kV C32 Plateau half EP 51 5 kV C33 Plateau half EP 43 0 kV C34 Plateau half EP 45 0 kV C35 Plateau half EP 47 0 kV C36 Plateau half EP 49 0 kV C37 Plateau half EP 51 0 kV C38 Plateau half EP 53 5 kV C39 Plateau half EP 56 0 kV C40 Plateau half EP 58 5 kV C41 Plateau half EP 61 5 kV C42 Plateau half EP 64 5 kV C43 Plateau half EP 68 0 kV C44 Plateau half EP 71 5 kV C45 Plateau half EP 75 0 kV C46 Plateau half EP 79 0 kV C47
91. ected With organ program Select an organ program without 3 point technique with IONTOMAT Exposure data 1 The following exposure data can be set to be set kV value mAs value ms value Focal spot Tube load Measuring fields dominants Film screen combination Film density compensation Display of exposure U After the end of the exposure the mAs and ms values in the display are flash data ing AXIOM Iconos R200 AXD3 340 620 13 01 02 25 136 POLYDOROS SX 65 80 Integrated Control Console Select mAs tomography T Setting the kV mAs values and the tomographic time 1 Exposure cut off by the mAs counter Iconos DFR Iconos Iconos Bed Vertix Info Cassette Gy 45 jo S lr 70 w 0 3 ma 0 1 min 50 mAs vana u D 800 ms Del ym 000 001 100 Program Selection Select a tomographic program on the unit Deselection Deselect the tomographic program on the unit or Actuate a button for film screen combination Plani I ONTOMAT is selected or a measuring field dominant button Plani lONTOMAT is selected or the IONTOMAT button Plani IONTOMAT with mAs preselection is selected Exposure data 11 The following exposure data can be set to be set kV value mAs value Focal spot Tube l
92. een distance Distance from central beam to end of table Attenuation of the useful radiation AXIOM Iconos R200 Technical Description Technical Data Front loading for cassettes standardized according to IEC ANSI and DIN metal or plastic of the formats 18 cm x 24 cm 8 x 10 up to 35 cm x 43 cm 14 x 17 For permissible sizes and segmentations refer to cassette program automatic loading centering and format sensing Can be selected separately according to format height width for cassette spot filming automatic formatting for Bucky exposures object related collimation pos sible after 1 to 2 seconds Max 4 on 1 secondary width diaphragms Park to exposure position max 1s 24 cm x 30 cm cassette without lead inlay Fluoroscopy radiographt 1s 15 without filter positioning grid movement 1 35 s 15 with oscillating grid With multiple segmentation and DFR 7 8 cm minimum 11 8 cm minimum Stationary 17 1 70 lines cm fo 125 cm Oscillation for CR cassettes configurable by Uptime Service Motorized grid movement in or out of beam path in 4 s Max 105 cm remote controlled fine adjustable up to max 8 cm s routine or 16 cm s Periscanning PERISTEPPING option stepping with max 5 steps of 18 cm each 1 1 40 77 cm to 182 cm with table tilted up 90 7 8 cm minimum l l image receptor only minimum 42 cm head end Attenuation factor without cone m 2 48 Attenuation facto
93. eina 32 SCANMIMG DFOCOSS T EE EE racecar has daria 33 End of THe SCONE E A E E E E EE 33 Organ Progam Sen ae eee E drena O Aa ES a A E E E S Ahad 33 CHEAT OM OF PLOGTANIS A AA AA O A chi ado T E E T 33 Temporary changes Of programMS ocoocccocnncnncnncncnnnnnennnncnnnnnnnnnnnnnnnnnnnnnnnnonnnnnnnnnnnnnnnnnoss 33 Peristepping optional atintntetuct deci tradinad tha aatanudeienntvngiiedetemaebuadsmcnieledutanedd aentnadiied ole rner En 34 A Fach Mea Paes ated Poa ta eae re eA A A 34 PROQMAMARAING FUE E EEA E daw ede ad id aa da 35 A SO RO OA 35 Select e E a aa E del liada dla ade 35 Desclscion a a Att Re ant Git tensa tales tan tenn ah ahaa ihc e hs ak ton Re oA Rh 35 Releasing AN EXPOSURE a A A dd 36 EX mination Procedures 36 Preparation toas ras Ch elated ea o ea e cats bea a dai e as 36 Proa MMINO TIO a A A A A ade 38 ANNE K SUE SERESTA ASTA ena ee T e A E 39 EMO SCONE innri a a A a leg LA a 39 Orgami progran s sN ca ello e 40 CreatiOnOFPrOGranns ali lt a ae eel eee 40 Temporary changesio Programs emir tipa Di bil 40 AXIOM Iconos R200 AXD3 340 620 13 01 02 3 52 Examination Table of Contents Brescia a a a r ara 40 General mo ON 40 Selecion en eaea a a a a E aa de 41 Deselection clar ad dd ea dalle Micdeiies 41 MAGS transtornos 41 REC SA A In a eee a Nn ae 41 Examination procedure for abdominal Survey IMages oocccccccncnccnnccncnnnennnnonanananconcnnnnenenananinnss 42 O estan hota Mi a onli fan Eck A ah oh Lon
94. ement in digital radiography ooooooiinnccocococcccccccccccccnnoon nono nnnnnnnnonnnnnnnnnnn cnn nn nnnnnnnins 23 Spottilming WITHOUT OMITA o esoe eens eaa ae aa a a R EA VE 25 Tomography opuonalh e aeta a a te a e e ea a ea Wet ok na de e eke o 27 PEFISCAMMIAG ii A iv 30 Rensteppina optional aoe te aenea a A e e Ma sa 34 Breed a eraai aa al a a aa a aean 40 Chapter Free Cassette EXPO dt 49 Collimatioh On PXpOsule aida teca ai aaa atadas 49 Selecting the exposure technique nsan A aer ad 49 Releasing IN exposure orrtha iaie a e a e e ataia aada S ATEA EE 50 Chapter Cassette exposures with wall stand oooconcocidcinicinicnononnconnononononororororonononnonononrnanoconos 51 CollimationGuring SXPOSULE oeio aaraa enn e aiana aa Ra aa hanaan AEE aandaa abian BEd daaa iaa 51 S lecting the exposure technique 2d A tt daa 51 MElEASING EE d SOE a AEE con A T A E NS 52 Part POLYDOROS SX 65 80 Chapter Integrated Control CORSA Ai id 3 ADPlCatION nitro e e e e a eaa AEA a A Ne a ARA Orea ES AEE 3 GOMMGUFATI OM e ON 3 Ovetvi w ofthe controls and displays siots esidan diis a aiit iiae ea e a a aA aaae 4 Explanation of displays and GOntrOlS iii ed i adi T EA 9 Messages darane aiae aa e ea naa a a a a rE e aide aa aE EET nut 10 TUDEIOIA COMPULS ri AN E E AA E E 10 Fu unctionaland safety CHECKS iia 12 ANA AAA E E E A E T O E E REN 13 DAE E S E E E E E E E 15 OIM do dde 0 EAE 32 Part Accessories Chapter Preliminary Remarks scsi did a a had
95. ererrerrnrrsrrsrerrnrrere 18 Reading off the projection angle occocccccccocnnononnnconnnnnnennnonnnonnnonnnnnnnnnnnnnonnnnnnnonnnnnnnnnnnnnnns 18 Tabletops AAA es So Tal Ca ae Me RATES 18 OS position On Ihe tableta caldo sea amandarsiakeasneonnsace ma inatind e a a eaaa 19 Tilt ts tale UAM ria A A A lt dt 19 Reading the Ape lt cas e lo et 20 Compressi n device Opina ares ost 21 Usina tth compressi n device aida 21 Reading the compression level ooccocccocccocnnonoonnconnnonnnnnnonnnonnnonnnnnnnnnnnnnonnnnnnnonnnnnnnnnnnnnnns 22 Tomographic equipment A a ai a e e 22 Setting the fulcrum height ooccocccnccnnccnncnnncnncnnncnoronnnnn nono rn nr nnn none nan n rn EEEE REEERE EEEE EE EEE EEEE 22 Switching on the fulcrum height light localizer ococccocncocnonncocncnonenoconnnonnnonononnnnnnonnnncnnnnnos 23 Readi g iheTulcrum HEIGHT isa load sli ia 23 Manual tube assembly rotation dsd aditd 24 Moving the grid into out of the beam path tn tadas 24 Setting the source image distance a Ses dines 25 Chapter Setting the Image Geometry Limiting the radiation field COMMON A 27 Rectangular and or iris collimation oooonnccnnnnccnncannra nana ettn ttt atuta tentea ELEA EELEE EREEREER EEEE EEEE 27 Selection deselecton RT A AAA a 27 SIn le EEA E EN EEEE AEEA 28 Semitransparent wedge filters optional cooccoccconnnocnonncoonnnononenenononnnnncnnnnnnnnnnnnnnnnnnnonnnoss 28 Selection deselection rissin uie ira a 28 M
96. es Optional Accessories Move the patient table to the horizontal or vertical position as needed 0 If the table is not in the horizontal position insert the BABIX holder into the accessory rail position it and secure it Push and pull on the BABIX holder to ensure that it is seated properly Bring the BABIX cradle with the secured infant into the examination room Hang the BABIX U cradle on the hook of the holder and position it for the ex amination Place the BABIX Flat cradle on the horizontal patient table in the examination position Remove the BABIX U from the holder Take the BABIX cradle with the infant out of the examination room and attend to the infant Hang the BABIX cradle on the corresponding BABIX rack and store appropri ately The attenuation equivalent of the BABIX cradle is lt 1 6 mm Al Size 600 mm 6 kg Size 700 800 mm 10 kg Size 1000 mm 15 kg AXD3 340 620 13 01 02 41 154 Accessories Optional Accessories Information on the In addition to Accessories please note the following information concerning possibility of wear the possibility of wear on BABIX cradles and their immobilizing straps 1 After prolonged use cracks may form in the PVC plastic material 1 The immobilizing straps may show wear Following a visual check the defective parts have to be replaced if necessary or the entire BABIX cradle has to be disp
97. est Press the handle towards the rear and allow it to engage Check for lock in by turning the tube assembly slightly to the left and right Moving the grid into out of the beam path Moving the grid into the beam path Press this key LED lights up the grid is in the beam path Moving the grid out of the beam path Press this key again LED dark the grid is moved out of the beam path AXD3 340 620 13 01 02 Operator Manual System Operation System Settings Setting the source image distance If a SID is set between the two SID positions of 115 cm and 150 cm then only free exposure technique is possible 0 Press a key Once the selected SID is reached the LED in the key lights up If you release the key before the end position the LEDs in both keys flash SID 115 cm 150 cm 2 y AXIOM Iconos R200 AXD3 340 620 13 01 02 25 32 System Operation System Settings 26 32 AXD3 340 620 13 01 02 Operator Manual E E m System Operation nT a Setting the Image Geometry Limiting the radiation field collimation Rectangular and or iris collimation Fluoroscopy and You can view the collimation on the monitor under fluoroscopy The default is iris Digital Radiography DR collimation optional The maximum possible collimator aperture is never greater than the selected im age intensifier format The edge of the diaphragm must be visible in the fluoroscopic image The collimator is opened
98. ette and select a segmentation program Select single exposure or serialography 20 52 AXD3 340 620 13 01 02 Operator Manual Tomographic area AXIOM Iconos R200 Examination Cassette Exposures in the Spotfilm Device optional Tomography optional The tomographic exposures are taken as linear planigraphy with 3 different blur ring angles Press this key Spotfilm device exposure technique is selected the LED lights up Press this key The LED in the start key flashes if the conditions for tomography are not fulfilled The possible combinations for tomographic angle tomographic time appear in the display The selected combination is emphasized Dx o Es 8 0 8s f DR 20 0 6s 201 285 Eos 40 1 2s 40 2 55 SR SE Press the key again and the next possible combination becomes active Select Bucky or semiautomatic mode Inserta cassette and select the cassette program If the LED in the start key flashes press this key The compression device moves into its park position if present The tube assembly stand moves into the 0 position A source image distance of 115 cm is set The image receptor unit moves into the tomographic area Once the positions are reached the flashing LED goes out If you have positioned the image receptor unit outside the tomographic area it is moved automatically when you press the start key so that tomography can be per
99. ette is seated properly in the holder Position the cassette holder on the tabletop at the patient in the location ap propriate for the examination Ensure that the cassette holder is stable Have the patient place his her hands on the grip protection strip the grip strip or the handgrip depending on the examination procedure This will increase the patient s feeling of security during the examination Removal Remove the cassette from the bracket of the cassette holder Remove the cassette holder from the tabletop Assist the patient in stepping down from the tabletop 32 154 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Foot switch assemblies for fluoroscopy and radiography Application For releasing radiographic or fluoroscopic exposures during tableside examina tions Attachment Insert the foot switch plug into the receptacle in the electronics cabinet Turn the locking ring of the plug to the right until the connector is seated prop erly Route the cable along the floor appropriately Position the patient A Caution Route the cable carefully to avoid safety hazards e g tripping Do not permit the wheels of transport devices such as carts and wheelchairs to run over the pedals of the foot switch assembly since this could cause inadvertent radiation release The following steps require radiation release Ensure proper radiation protection
100. examination AXD3 340 620 13 01 02 9 152 Examination Fluoroscopy 10 52 Resetting the fluoroscopic data Once the examination is ended then please note the displayed fluoroscopic data and 0 Press the reset key The displays for the fluoroscopic data and the area dose product are reset to zero Automatic fluoroscopic control Selecting automatic fluoroscopic control The fluoroscopic curves and dose levels preset in the organ program can be changed with the automatic program keys on the system remote control console You can select different fluoroscopic curves with the automatic programs You select automatic programs 1 2 or 3 with one of the keys Stop function If the fluoroscopic values kV mA set by the system should remain constant 0 Press the stop key during fluoroscopy If you want to cancel the stop function Select one of the 3 automatic programs by a key or an organ program Fluoroscopic curves Depending upon the system configuration the following fluoroscopic curves are assigned to the automatic programs Automatic Configured with Configured with Configured with program standard Fluoro standard Fluoro standard Fluoro and SUPERVI and CAREVISION SION 1 Dose reduced curve Antiisowatt curve 2 Antiisowatt curve 3 Contrast curve 60 to 80 kV AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Fluoroscopy Fluoroscopy time limit F
101. extension Release the locking lever 22 154 AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Foot restraint Application Safety device for patients in Trendelenburg examinations to relieve the pressure on the spinal column Ata Trendelenburg position gt 40 the foot restraints must be used in addition to the shoulder supports The maximum patient weight must not exceed 180 kg The maximum patient weight must not exceed 150 kg at a Trendelenburg posi tion gt 45 Attachment Move the patient table to the horizontal position Push the footboard into the working position Check that the footboard is locked by pulling on it Position the patient in the prone or supine position with his her feet on the footboard Attach the foot restraint snugly around the ankles Tighten the straps Warning A If you are using only the foot restraint to secure the patient on the patient table the locking metal clip is the only device preventing the patient from slipping or falling For this reason you must check that the metal clip of the foot restraint is securely locked into the footboard Have the patient hold onto the handgrips during this examination procedure AXIOM Iconos R200 AXD3 340 620 13 01 02 23 54 Accessories Optional Accessories Move locking handle 1 on the rear of the footboard in arrow direction and hold fast Insert the
102. f the image intensifier light distribution system AXD3 340 620 13 01 02 21 144 System Overview Protective Measures 22 144 Safety relevant parts subject to wear This system contains no safety relevant parts subject to wear Maintenance intervals Maintenance must be performed annually in order to ensure the safety and func tioning ability of the system If you have not concluded a maintenance contract please notify the Siemens Up time Service on time CAREWATCH Display data At the start of fluoroscopy acquisition the following system parameters are dis played in the lower right area of the live monitor 1st line Display of the prefilter in fluoroscopy 2nd line Display of the prefilter in radiography With the area dose product meter optional 3rd line Area dose product in cGycm Ath line During fluoroscopy Display of the patient entrance dose in mGy min In the radiation pauses the percentage of the patient entrance dose reached related to a config urable limit of 0 5 to 5 Gy or the accumulated patient entrance dose in mGy is displayed The measuring device must be calibrated at regular intervals This is done within the scope of a maintenance contract If no maintenance contract have been con cluded the measuring device can be calibrated by the Siemens Uptime Service of the manufacturer 1 can be configured by the SIEMENS Uptime Service 2 standardized to 30 cm abo
103. ff immediately Notify the SIEMENS Uptime Service Discontinue operation of the system If you let go of the exposure release button during radiation the exposure is in terrupted immediately and the tomographic movement is stopped Letting go of the exposure release button or elapsing of the tomographic time ends the exposure Organ programs All parameters necessary for the exposure are stored in organ programs gt Refer to the FLUOROSPOT Compact and POLYDOROS SX operating instruc tions for further details on the organ programs and their programming Programs The following programs can be stored Tomography organ programs Creation of programs gt Refer to the FLUOROSPOT Compact operating instructions Temporary changes of programs For the following parameters stored in the organ program it is possible to change them temporarily with the corresponding operating elements Film density Cu prefilter i The changed parameters apply only until you select another same organ pro gram or switch the system off AXD3 340 620 13 01 02 29 152 Examination Digital Radiography 30 52 DR Periscanning Serial exposures of the contrast bolus during aortoarteriography with the patient at rest General Periscanning is selected after the patient has been positioned the catheter has been placed and the system settings for aorto arteriography have been per formed Proceeding from the abdomen
104. footboard AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 System Overview Protective Measures Patient positioning with unit in vertical position During examinations with the unit in the upright position there is a risk of crush injuries to the patient if the X ray system stand with tube unit receptor unit with image intensifier is moved in the longitudinal direction Position the X ray system approximately in the acquisition position Move the patient into the acquisition position 4 Set the X ray system to object height Always watch the patient when initiat ing this movement Remote compression optional 1 The motor driven compression device requires special care on the part of the examiner for the applied compression forces especially in the case of frail e g infants sick and elderly patients 1 Observe especially that both an increased risk of crushing for the patient with consequential injury and considerable mechanical shearing forces with risk of damage can occur between the compression cone and attached accessories e g shoulder supports lateral support optional or motor driven infant cradle holder optional by collision during the motor driven tabletop movement d When moving the compression carriage into the lowest position the carriage may collide with the patient s hand on the grip protection strip Use extreme caution when actuating the cone movement Safety devices
105. formed with the required tomographic sequence In this case the tabletop is moved automatically synchronously to the image receptor unit so that the initial object centering is reset AXD3 340 620 13 01 02 21 152 Examination Cassette Exposures in the Spotfilm Device optional Tomographic sequence 0 Press the exposure release button up to the first pressure point The tube assembly stand moves to the head end tomography starting posi tion at the left with the unit horizontal Give the breathing command to the patient Press the exposure release down fully and keep it pressed until the tube as sembly stand stops in the foot end position During the exposure the tube assembly stand moves towards the foot end and automatically remains there following the exposure Li With the exposure release button pressed the tube assembly stand moves back into the starting position Prepare the next tomographic exposure Set anew tomographic height Press the exposure release button up to the first pressure point The tube assembly stand moves from the foot end position towards the head end tomography starting position at the left with the unit horizontal 22 152 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Digital Radiography Automatic format collimation in digital radio graphy The exposure field is never larger than the selected image intensifier format Within this area you
106. ft LED lights up Object setting oriented to the monitor is selected 1 Right LED lights up Object setting oriented to the system is selected Only possible from the system remote control console for the following move ments Moving the X ray system longitudinally Moving the tabletop longitudinally transversely Start positions Automatically determined system settings are performed with the Start button depending upon the selected operating mode tomography Periscanning Peristepping scanning technique LED flashes the approved system settings are not yet concluded LED does not light up the approved system settings are concluded General notes on error messages The system is constantly monitored internally during operation When a fault is detected the system is blocked and the fault is displayed as error in the message line of the integrated generator control console and stored Cancelling blocking Briefly press the exposure release button on the generator ON OFF console up to the 1st pressure point and let go again Don t press more The fault message is cancelled as a rule Further operation of the system may be only under increased attention of the user However if an error message is still displayed there is an error Call the Siemens Uptime Service AXD3 340 620 13 01 02 Operator Manual System Operation System Settings Behavior of the system settings in the case of a fault
107. g the frame stop position Do not touch the bulb with your bare fingers Insert the heat shield to the stop position and tighten the screws 1 Attach the lamp cover A Caution Lamp breaks Patient and or user injured by glass splinters Use only OEM Siemens spare parts 42 144 AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements Testing the fit of the new bulb An incorrect position of the new bulb is visible by a mismatch of crosshairs and laser line Correct position Incorrect position Accessories and auxiliary devices The maximum permissible weight of accessories and auxiliary devices attached to the collimator must not exceed 7 kg AXIOM Iconos R200 AXD3 340 620 13 01 02 43 144 System Overview Operating and Display Elements 44 144 AXD3 340 620 13 01 02 Operator Manual Operator Manual System Operation Chapter On Off Emergency Stop Switching the system Oda diia eii Switching the system off etica Emergency SHUTDOWN button installed on site Standby power Supply scada Standby power supply inside the hospital oocococcccccccccccnnononnnos Battery supported standby power supply optional o o Red Emergency STOP DUO e Patent rescue nren a aa a a ea Chapter Functional and Safety Check De NESTS aca aires After switching the system on cccccccncnnoncononconconcncnncnncnnnncnncnnnns Prior to the examination
108. g LED goes out Select an organ program for Peristepping Set the following parameters with the corresponding operating elements Primary rectangular collimators Cu prefilter Semitransparent wedge filters i Zoom formats cannot be selected The l l full format of 40 cm is always select ed The primary collimation is not set automatically to the full format but must be adapted according to the object Adapting the dominant Press one several keys 100 i itt The dominant preset in the organ program is overwritten If a left right dominant or both dominants are selected the system switches over automatically to the central circular dominant if the preselected dominant is covered by the filters since this would inevitably result in a faulty exposure Prepare the injector Connect the injector plug to the electronics cabinet only with radiation syn chronous injector release option Set the injection data and switch to ready for injections AXIOM Iconos R200 AXD3 340 620 13 01 02 37 152 Examination Digital Radiography Release 1st step AP a Release 2nd step and further steps dy lt r g gt Move the X ray sys tem into the starting position AP i 38 52 Programming run The X ray system stands in the starting position position 1 for the programming run abdomen 0 Deflect the
109. ge Automatic system mAs integrator Switching time Tube assembly connection Number of workstations Automatic exposure control Tolerances 12 112 Working range Normal fluoroscopy from 40kV 0 2mA to 110kV 4 1mA High contrast fluoroscopy from 40kV 0 2mA to 110kV 18mA maximum of 4 FLUO curves can be configured 53 values from 40 to 150 kV In steps of half Siemens exposure points EP or 1 EP configurable 0 1 point technique with continuously falling load 2 3 point technique with constant load 3 point technique with IONTOMAT PL with constant load 65 values from 0 5 mAs to 800 mAs In steps of half Siemens exposure points EP or 1 EP configurable 1 point technique 1 ms to 5 s with mAs and time postindication 2 point technique 2 ms to 5 s depending upon kW mAs and kV 3 point technique 20 ms to 5 s depending upon kW mAs and kV in 49 steps In steps of half Siemens exposure points 2 Siemens double focus tube assemblies max 5 IONTOMAT PN with 6 measuring inputs for measuring chambers as well as mul tiplier connection option or photodiode array PDA kV accuracy 5 mAs accuracy 5 or 0 5 mAs depending on which value is higher mA accuracy 5 or 0 1 mA in fluoroscopy depending on which value is higher mA accuracy 10 in radiography AXD3 340 620 13 01 02 Operator Manual
110. ge receptor unit 115 cm 150 cm 1 Automatic stop for tilt 0 on off dP E lt i gt Move to automatic position of all system movements for patient transfer LY Start position for various system settings in the operating modes Tomography optional Periscanning Scanning technique optional Peristepping optional E p O Image intensifier formats Oo d Image intensifier full format e Oo Oo x zpk LI Image intensifier zoom formats zoom stages 1 2 3 1 2 3 AXIOM Iconos R200 AXD3 340 620 13 01 02 27 144 System Overview Operating and Display Elements 28 144 S EEE E E Automatic fluoroscopy control Automatic fluoroscopy program 1 Automatic fluoroscopy program 2 L1 Automatic fluoroscopy program 3 1 Automatic fluoroscopy stop Image reversal 1 Right left image reversal vertically mirrored 1 Top bottom image reversal horizontally mirrored Additional filter d Select additional Cu filter 0 1 mm 0 2 mm 0 3 mm Collimator settings 1 Coordinate switch for adjusting the primary collimator by motor drive open close Rectangular collimation Iris octagonal collimation in fluoroscopy and DR 1 Select rectangular or iris octagonal primary collimator for manual collimation Switch light localizer of the primary collimator on off Display of graphics for CAREPROFILE option AXD3 340 620 13 01 02 Operator Manual
111. gram Selection 4 Actuate the ms button With organ program Select an organ program with 3 point technique Deselection Actuate a button for film screen combination 1 point technique is selected or a measuring field dominant button 1 point technique is selected or a button for mAs setting 2 point technique is selected or the IONTOMAT button 3 point technique with IONTOMAT is selected With organ program Select an organ program without 3 point technique Exposure data 1 The following exposure data can be set to be set kV value mAs value ms value Focal spot Tube load 24 136 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Select 3 point technique with IONTOMAT T Setting the kV value and the maximum mAs and ms values 1 Exposure cut off by the automatic exposure control Iconos DFR Iconos Iconos Bed Vertix Info Cassette Y 45 wv 73 w 0 3 ma 01 min ae ls a IES 0 hu D 25 ms max value 010 001 80 100 mu O gt lt 3 4 uGy cm2 Program Selection Actuate the IONTOMAT button With organ program Select an organ program for 3 point technique with IONTOMAT Deselection Actuate the IONTOMAT button 1 point technique is sel
112. grammed in the relevant organ program see FLUOROSPOT Com pact Fis During a native series the programmed frrame rate can be rduced in a maxi y AXIOM Iconos R200 AXD3 340 620 13 01 02 25 152 Examination Digital Radiography Releasing the exposure 1 Release the exposure with the exposure release button in the system remote control console or via the foot switch in the control room or table side op tion 1 The radiation ON indicators must light up briefly during the exposure A Radiation interruption Exposure end In DSA exposures 26 52 Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the generator off immediately Notify the SIEMENS Uptime Service Discontinue operation of the system If you let go of the exposure release button during radiation the exposure is in terrupted immediately in single exposure in serialography the last exposure is still exposed correctly If a DSA series is interrupted before exposing the mask then the first image is used as mask The series is then displayed native In single exposure only one image is exposed even if the exposure release but ton continues to be pressed In serialography letting the exposure release button go a full image memory or reaching the programmed maximum scene time ends the exposure series The DSA series is ended and
113. h the system off and back on within 10s The system again starts with the automatic safety test program As a rule the fault is rectified by this If this is not the case switch the system off After the image system has auto matically switched off monitor dark wait 30 s and then switch it on again In this case the image system is run down and restarted A possible error will be dis played on the monitor Please notify the SIEMENS Uptime Service if this is the case gt Refer to the FLUOROSPOT Compact Operator Manual for further information Perform a functional and safety check according to the Functional and Safety Check chapter 1 If a local hardcopy camera connection is present the associated camera and network components should be switched on first AXD3 340 620 13 01 02 5 132 System Operation On Off Emergency Stop 6 32 Switching the system off Press the button on the generator ON OFF console The entire system and all further connected devices are immediately switched off All started operating sequences will be interrupted and the selected programs will be deselected gt Refer to the FLUOROSPOT Compact Operator Manual for further information Emergency SHUTDOWN button installed on site Use this shutdown method only in an extreme emergency because it is an un controlled process Data could be lost e g unsaved images exporting and filming jobs etc The tube cooling system is also disc
114. h time the system is switched on an automatic check of all important func tions is made test routine When a fault is detected the generator is blocked and the fault is displayed as er ror in the message line and a window with the error message appears on the right side of the monitor screen You can cancel the disable status as follows Acknowledge error message If the error message is still displayed then there is an error in the system Please call the SIEMENS Uptime Service Tube load computer General The tube load computer protects the connected X ray tube assembly from over loading in radiographic mode From the selected exposure factors and from the physical and geometrical prop erties of the tube assembly it computes the length of the cooldown time that may be necessary Furthermore the tube load computer stores all important operating data of the respective X ray tube assembly The current load Y hu is constantly displayed AXD3 340 620 13 01 02 Operator Manual INFO AXIOM Iconos R200 POLYDOROS SX 65 80 Integrated Control Console Pause time indication The cooldown time indicated in the message line must be observed to prevent overloading the tube assembly The next exposure must not be released before this time has elapsed 1 X ray tube assembly with no load No cooldown time required You may release the preset exposure up to 100 tube load 1 X ray tube assembly with little load
115. he floor Actuate system movements only with direct visual control All other movements are possible only step by step A warning signal whistle sounds on actuating and during the movement Rescue the patient Call the Siemens Uptime Service AXIOM Iconos R200 AXD3 340 620 13 01 02 13 32 System Operation System Settings Moving the X ray system longitudinally The X ray system consists of Stand with tube assembly and primary collimator Image receptor unit with image intensifier and spotfilm device System remote control console L Actuate the joystick gt Deflect up down X ray system moves headwards footwards Use this operating element primarily during fluoroscopy i The speed of the movement increases the further you deflect the joystick Tableside control panel Press a key ka The X ray system moves headwards footwards The movement takes place at constant speed 14 132 AXD3 340 620 13 01 02 Operator Manual System Operation System Settings Tabletop Moving the tabletop longitudinally transversely 0000 System remote control console Actuate the coordinate switch lt f gt key on the left right
116. he movement is stopped when a collision zone is reached 1 If the 3D support optional is not in its park position then the system move ments are disabled This system movement is enabled by simultaneously actuating the bypass key and an operating element Press and hold this key Start the system movement after 2s Operating elements for system positions AXIOM Iconos R200 Warning Immediately press the nearest STOP button in the case of danger to the patient All system movements are stopped After removing the cause of the danger unlock the STOP button by turning it to the right 1 Operating elements with deadman functions All operating elements for the system settings are designed as deadman func tion i e system settings are active only as long as the operating element is actu ated 1 Operating elements with LEDs LED lights up function is selected LED does not light up function is deselected LED flashes selected function is not yet concluded or message about a particular status see relevant chapter for description AXD3 340 620 13 01 02 11 732 System Operation System Settings 12 32 c Object dependent system settings The agreement of the actuation direction of the operating element with the movement of the X ray system stand with tube assembly and primary collimator image receptor unit with image intensifier and spotfilm device depends upon the selected object setting 1 Le
117. he tube load in relation to the maximum heat storage capacity in per cent Functional and safety checks Daily checks After switching on Please make a visual inspection of the displays and signals on the integrated generator control console No error message may appear The radiation warning lights in the room must not light up If a radiation warning light lights up without actuating a switch immediately switch off the X ray system through emergency off and notify the SIEMENS Uptime Service During the examination Check the radiation indicator It may light up only during the duration of the X ray exposure Monthly checks Perform a functional check of the automatic exposure control as described in Register Safety Legally required checks Obtain information in Register Safety Maintenance intervals Maintenance must be performed annually to maintain the safety and functioning of the generator If you have not concluded a maintenance contract please notify the SIEMENS Uptime Service in good time AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 POLYDOROS SX 65 80 Integrated Control Console Fluoroscopy gt For further information refer the FLUOROSOT Compact Operator Manual Releasing fluoroscopy Fluoroscopy is released via the fluoroscopy foot switch Selecting the fluoroscopic mode Fluoroscopy with automatic control With the automatic stage buttons on the unit
118. he underside of the collimator The locking spring locks the compensating filters templates etc inserted in the accessory rails of the collimator thus securing them against falling out To remove the accessories press the locking spring to the left until the com pensating filter template etc can be removed from the collimator AXIOM Iconos R200 AXD3 340 620 13 01 02 39 144 System Overview Operating and Display Elements Prefilter selection A Caution Malfunctioning of prefilter Incorrect radiation dose Take care of correct filter setting on manual prefilter 40 144 Motorized prefilter selection 0 To select a prefilter press the prefilter selection button The Cu prefilter changes to the next value each time the button is pressed Possible settings are 0 0 mm Cu no prefilter 0 1 mm Cu prefilter 0 2 mm Cu prefilter 0 3 mm Cu prefilter The currently selected prefilter is shown in the display Manual prefilter selection O ere 0 0 0 2 anes F 00 1 Manual prefilter selection is performed using two levers 1 on the left side of the multileaf collimator Four combinations of lever positions are possible 1 0 0 mm Cu no prefilter Set both levers to the left A 0 1 mm Cu prefilter Set the upper lever to the right and the lower lever to the left 1 0
119. head end 15 Table frame motor driven adjustable in height can be tilted 90 17 16 Unit base with tilting drive on installation plate AXIOM Iconos R200 AXD3 340 620 13 01 02 9 144 System Overview System Description 10 744 AXD3 340 620 13 01 02 Operator Manual la System Overview SE E Protective Measures E Emergency Procedures Warning Due to the complexity of the system the loss of X ray imaging or other system functions during an examination or procedure can not be completely excluded Risk of failure during interventions Consider therefore the need to establish emergency procedures in such cas es Cleaning and disinfection Caution Use of harsh cleaning agents liquids or sprays Risk of electrical hazard or damage to the system Use only substances for cleaning and disinfection which are recommended Do not let cleaning liquids seep into the openings of the system e g air openings gaps between covers Observe the following cleaning and disinfection instructions AXIOM Iconos R200 AXD3 340 620 13 01 02 11 144 System Overview Protective Measures Radiation protection zones Position and size of the main operating area Horizontal patient table NN INT 107 200 SSI lt lt SSA ARA AK AZAD d Main operating area Dimensions in cm 12 144 AXD3 340 620 13 01 02 Ope
120. ible patient weight on the footboard is 180 kg The footboard can also be attached to the head end of the patient table if the patient has to be turned for positioning right head ena 3 lock in positions each at the head end and foot end ata distance of 20 cm each are available Attachment 4 10 54 Move the patient table to the horizontal position Hold footboard laterally on the handgrips and press the spring loaded handgrip strips in the handgrips the two red buttons 1 must be visible Insert the footboard anywhere in the acccessory rail at any place of the table top in the head foot range first on one side and then on the other Move the footboard to the desired position lock in position Release the handgrip strips and shift the footboard slightly back and forth until it locks in the two red buttons must be flush with the handgrip Check that the footboard is locked by pulling on it Position the patient AXD3 340 620 13 01 02 Operator Manual A Adjustment Accessories Standard Accessories Warning Be sure to check that the footboard has locked into position before allowing pa tients to sit or stand on it If you want to tilt the patient table from the horizontal position to the Trendelenburg position you must secure the patient with the shoulder supports or the foot restraints at 15 In case of a Trendelenburg posi tion gt 40 the foot restraints must be used in addition to th
121. in this time then the imaging system is shut down in a controlled manner and subsequently restarted After restoration of the power supply The green and red lamps on the control unit of the UPS light up Switch the system off The imaging system remains switched on The generator and table are switched off Press the red button on the control unit Press To toggle Power Supply The red lamp on the control unit goes out Switch the system on within the next 6 s If the system is not switched back on within this time then the imaging system is shut down in a controlled manner and subsequently restarted Red Emergency STOP button pio A 7 E ececee A 2 OO e E Ba y y AA lt gt VY EH A l H c e 1 0 o y 9 1 F e 8 E E STOP button on the unit STOP button on the system remote control console If there is an emergency situation that is potentially hazardous to the patient the operator or the system All system movements are stopped The generator and the imaging system still remain switched on and ready Radiation is interrupted fluoroscopy can be switched on again consciously after letting the foot switch go and actuating it again Injection with the synchronized injector is interrupted Press one of the red stop buttons on your system AXIOM Iconos R200 AXD3 340
122. ing an arbitrary system movement and pressing a proximity switch during the movement The movement concerned must stop immediately After releasing the proximity switch all system movements are possible again During the examination Check the radiation ON indicator It should light up only if one of the fluoroscopy switches has been pressed or for the duration of an X ray exposure Warning If radiation fluoroscopy digital radiography is released and the radiation ON in dicator lights up but no fluoroscopic image appears on the monitor error in the television chain immediately switch the system off using the emergency shutdown button and notify the SIEMENS Uptime Service Check the patient positioning devices e g use of the grip protection strip and handgrip Switch system movements on only if there is no danger of injury to the patient or third parties there are no objects blocking the path of system movements Monthly tests Runa functional test of the automatic dose rate control and automatic format collimation as described in the Safety operating instructions Legally required tests gt Inform yourself in the Safety operating instructions AXD3 340 620 13 01 02 Operator Manual 3D support System Operation System Settings General notes Collision protection Safety areas 1 All system movements stop when a collision protection device is activated d T
123. iography 42 152 Examination procedure for abdominal survey images Preparation Prepare the digital imaging system Select the DR system at the unit remote control console Move the patient table into the 0 position horizontal Position the patient head on the left For reasons relating to the exposure technology the scanning direction for DR scanning should be from the pelvis headwards Set vertical projection Set the largest possible SID Perform the examination e g colon double contrast as usual Press this key The LED in the start key lights up if the conditions for scanning are not ful filled DR scanning is selected I I full format is selected The rectangular height diaphragm moves automatically to the configured value approx 10 12 cm The display shows 3 scanning programs with 2 directions each The selected scanning program is highlighted y A PS EE m BE Spine gt DR lt Longleg gt lt Abdomen gt Q gt By pressing the key again the next possible scanning program with direction be comes active Select the scanning program for abdomen left arrow scanning from right to left right arrow scanning from left to right AXD3 340 620 13 01 02 Operator Manual Oo Start AXIOM Iconos R200 Examination Digital Radiography If the LED in the start key flashes press the key
124. ional General Peristepping comprises the following phases UU Programming run A Filling run native Peristepping is selected after the patient has been positioned the catheter has been placed and the system settings for aorto arteriography have been per formed With this selection the X ray system can be moved only longitudinally in steps and the transverse movement is automatically blocked Peristepping is possible in all unit positions and in the axial direction both to wards the head end and towards the foot end The step length per step is 18 cm with 1 1 40 Starting position End position X ray system X ray system 1 2 3 4 5 6 Position Programming run Move X ray system into starting position Injector triggering Filling run 34 152 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 DR Examination Digital Radiography Programming run Proceeding from the abdomen starting position the primary collimators semi transparent wedge filters and dominant if required are set step by step up to the last position You must deflect the joystick or press the key for X ray system longitudinal movement in the movement direction for each step as long as the next step po sition is reached Once the next step position is reached the X ray system stops automatically and the corresponding position number appears on the remote con trol console The last set collimato
125. isocenter Tomographic height setting above tabletop optional without function Tilt table up down Coordinate switch for moving tabletop longitudinally transversely Move X ray system longitudinally Move cassette into the unloading position only with cassette spotfilm device Move to automatic position of all system movements for patient transfer Bypass key for actuating system movements if the ceiling mounted support optional is not in park position AXD3 340 620 13 01 02 Operator Manual System Overview Operating and Display Elements Image intensifier formats e U Image intensifier full format LI Image intensifier zoom formats zoom stages 1 2 3 1 2 3 Collimator settings al F 1 Coordinate switch for open close Rectangular primary collimator Iris primary collimator N 1 1 Switch light localizer of the primary collimator on off LCD Monitor Operating elements The buttons for adjusting the LCD monitor are located in the housing The necessary settings are made at start up No operation is required during op eration Power on off The unit has a power switch on the bottom which you must operate only if the LCD monitor is not switched through a system AXIOM Iconos R200 AXD3 340 620 13 01 02 35 44 System Overview Operating and Display Elements Operating indicator 36 44 The unit has a green LED operating indicator on the right side above the adjusting elemen
126. isowatt 77 66 57 50 44 40 0 1 0 2 0 5 1 0 2 0 5 0 10 mA Characteristic curve examples for high contrast fluoroscopy kv 110 T 90 77 sE High Contr PS L 66 57 50 44 0 1 0 2 0 5 1 0 2 0 5 0 10 20 mA 14 136 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 POLYDOROS SX 65 80 Integrated Control Console Fluoroscopic time limit After a fluoroscopic time of 10 minutes fluoroscopy switches off automatically and cannot be switched on again To continue working let go of the fluoroscopy switch and actuate it again Exposure Exposure release You can release an exposure either with the release button on the generator ON OFF console on the system control console or with the exposure release foot switch in controlroom Check the selected exposure data on the integrated generator control console before every radiation release You can release an exposure if LJ no error message appears and LJ none of the displays kV mAs ms flashes The radiation indicator lights up and a signal sounds during the exposure release 1 Observe the following to increase the life of the tube assembly If possible always select 80 tube load at the generator It is essential that you program 80 tube load in the programs with small focal spot and a tube voltage less than 70 kV Work with the
127. ive position The radiation shield can be tilted inward on the accessory rail as well as out ward and all the way down Move the patient table to the horizontal position Tilt the radiation shield to the vertical position Loosen both cap screws Remove the lateral radiation shield from the front accessory rail AXD3 340 620 13 01 02 37 154 Accessories Optional Accessories 38 54 Application Attachment A Holder for BABIX cradles For pediatric examinations using BABIX cradles with the patient table tilted or in the vertical position Move the patient table to the horizontal position Slide the BABIX holder with the hook along the front or rear accessory rail to the center of the patient table and move it to the exposure position Tighten the cap screw Pull and push the holder to ensure that it is seated properly Warning Tighten the cap screw and ensure that it is secure Remember that the BABIX holder is the sole means of support for the hanging BABIX cradle Securing the cap screw properly ensures that the BABIX holder will not slide down the ac cessory rail thereby avoiding injury to the patient and equipment damage AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories Place the hanger of the BABIX cradle on the hook of the BABIX holder The maximum permissible load of the BABIX holder is 15 kg Re
128. joystick above below or press the key to the left right The X ray system moves into the next position The position is displayed on the display in the remote control console e g 2 4 The settings of the starting position are stored Adapt the following parameters with the corresponding operating elements Primary rectangular collimator Cu prefilter Dominant Semitransparent wedge filters if option present Deflect the joystick above below or press the key to the left right The X ray system moves into the next position The position is displayed on the display in the remote control console e g 3 4 up to max 4 4 The settings of the positions are stored Move to each position one after the other and adapt the radiation field and dominant as far as required Li A maximum of 5 steps and thus 6 positions are possible Deflect the joystick up down or press the key to the left right until the X ray system has reached the starting position again The position is displayed on the display in the remote control console e g 4 4 The stored parameters are set automatically AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography Filling run The X ray system stands in the starting position for the filling run abdomen 1 4 for instance is displayed on the display in the remote control console Lil Check the correct programming of th
129. l 1 Drive grid out for slender patients 2 Use 0 0 mm copper filter for obese patients 3 When a white display is required for the survey images on the LEONARDO workstation acquire the images with black display in the imaging system Compose these on the workstation and then invert them from black to white at the workstation This also applies for one sided leg displays 4 When a white display is required for the survey images on the LEONARDO workstation acquire the images with black display in the imaging system Compose these on the workstation and then invert them from black to white at the workstation Peristepping examination sequence for survey images 1 Take Peristepping exposures as described under Peristepping 1 Select an exposure for each exposure position e g a max opac image of this series and send it from the imaging system to the LEONARDO worksta tion using the DICOM Send function AXIOM Iconos R200 AXD3 340 620 13 01 02 47 152 Examination Digital Radiography 48 52 AXD3 340 620 13 01 02 Operator Manual p E z Examination a Free Cassette Exposure Collimation on exposure 1 The automatic format collimation of the system is not effective if you have se lected tabletop cassette exposure or free mode or if you have turned the tube assembly into a position outside 0 You can set the exposure format freely The limits of the maximum radiation field are determined by the mecha nism of
130. large focal spot below 70 kV tube voltage if possible Keep the prep time short and possibly push through to keep this time short Let go of the exposure release button immediately after the exposure i The above instructions should be observed especially at workstations with high patient throughput accident stations to counteract premature wear of the X ray tube assembly 1 At the wish of the customer this parameter can be changed by SIEMENS Uptime Service in accor dance with country specific regulations 2 Not possible in DFR and Cassette mode in Vertix mode with ACSS only when tube unit is rotated 180 3 Not possible in Bed mode and Vertix mode AXD3 340 620 13 01 02 15 36 POLYDOROS SX 65 80 Integrated Control Console 16 36 Automatic exposure system 0 point technique General d 0 point technique presupposes fluoroscopy it is therefore expedient only for spotfilming 11 The following exposure parameters are determined and set automatically for direct and indirect technique Direct technique Exposure kV Exposure mA Indirect technique Exposure kV Exposure mA Focal spot Programmed characteristic curves 1 Several characteristic curves which you can program depending on the sys tem configuration are available to you for the exposure 1 Programmed characteristic curves in the curve stock No Type of curve Voltage C1 Plat
131. left The locking lever on the accessory rail springs back to the right Place the filter in a free compartment of the wall holder turning the filter so that the designation can normally be read from above Three field templates For exposing the IONTOMAT ionization chambers on the object to be exposed The three tield templates are available as a complete set or individually for the fol lowing SIDs SID 90 cm 110 cm SID 110cm 130cm SID 130cm 175cm SID 175cm 220cm td ta FFA90 110cm 36 42 ins SID tdi FFA 110 130cm 42 50 ins SID ts ta J FFA 130 175cm 50 70 ins SID nor FFA 175 220cm 70 90 ins SID Push the locking lever on the left accessory rail to the left Slide the template into the collimator accessory rail in the correct direction for exposing the ionization chamber The locking lever on the accessory rail springs to the right Check that the template sits firmly in the collimator Expose the ionization chambers To do so switch on the light of the collima tor Push the locking lever on the left accessory rail to the left Pull the template out of the accessory rails The locking lever on the accessory rail springs to the right Store the three field templates in a suitable location AXD3 340 620 13 01 02 Operator Manual Technical Description Table of Contents Operator Manual Technical Description Chapter I
132. luoroscopy is switched off automatically and can no longer be switched on after a fluoroscopy time of 10 minutes To continue working let the fluoroscopy switch go and press it once again Fluoroscopy warning signal An acoustic signal sounds after a fluoroscopy time of maximum 5 minutes The signal disappears when you press the key on the Fluorospot Compact The time for the acoustic signal can be reset to zero at any time Automatic format collimation in fluoroscopy Automatic format collimation is also switched on automatically when fluoroscopy is released l e the fluoroscopic field is never larger than the selected image intensifier for mat You can limit the fluoroscopic field to the required size with the corresponding operating elements within this area Fluoroscopy programs All parameters necessary for fluoroscopy are stored in programs The following programs can be stored Standard fluoroscopy Supervision Pulsed fluoroscopy Carevision Roadmap standard fluoroscopy Roadmap Supervision Roadmap pulsed fluoroscopy gt Refer to the Fluorospot Compact Operator Manual 1 Can be changed on request by SIEMENS Uptime Service under compliance with the national regulations 2 Can be configured from 1 to 5 minutes by the SIEMENS Uptime Service AXD3 340 620 13 01 02 11 152 Examination Fluoroscopy 12 152 Dose reduction In fluoroscopy with CAREVISION pulsed fluoroscop
133. ly at the system with your legs knees un der the head foot end crossbeam The system monitors the safety distance only with regard to the floor Collisions can occur with other room equipment and mobile objects such as foot switch es steps refuse bins etc Make sure before you actuate movements that no obstructions are present Then control the system with increased caution If you have set the footboard in an exceptional case on the head end of the tabletop the safety distances which your system maintains automatically are impaired Actuate movements then only with direct visual control 18 732 AXD3 340 620 13 01 02 Operator Manual System remote control console System Operation System Settings 0 position of the table You switch the automatic stop position of the table in the 0 position on or off with this key LED lights up the table moves through the 0 position when tilting up down LED does not light up the table stops in the 0 position when tilting up down With the Stop in 0 position function switched on the movement stops even if the tilting down tilting up operating elements are operated in the 0 position You can continue the movement beyond the 0 position by letting go the operat ing element and activating it again Tilting the table up down lt 0 Deflect the joystick to the left right 14 nO The tabletop tilts down up Tableside cont
134. metal clip of the foot restraint 2 into the hole on the footboard pro vided for this purpose 1 When positioned correctly the patient s heels or toes should touch the pa tient table slightly Release the locking handle Check that the device is locked by pulling on the foot restraint Warning To avoid spinal compression or in cases where the patient must be turned the shoulder supports cannot be used The patient is held secure by the foot re straint only 24 154 AXD3 340 620 13 01 02 Operator Manual Removal Control care note AXIOM Iconos R200 Accessories Optional Accessories Move the patient table to the horizontal position Move locking handle on the rear of the footboard in arrow direction and hold fast Pull the metal clip of the foot restraint out of the hole in the footboard Loosen the straps Lift the patient s feet out of the foot restraint Check the foot restraints for correct condition at regular intervals of approx 2 months Check especially the firm seating of the fastening rivets of supporting belts and closing belts as well as the completeness of their seams and the condition of the leather for cracks and porous places Before using the foot restraint always check that the safety device 3 is present If this safety device is not present then the foot restraint must not be used any more In case of defects to the foot restraint take this out of service and
135. moval Remove the BABIX cradle from the BABIX holder Take the BABIX cradle with the infant out of the examination room and attend to the infant Loosen the cap screw Remove the BABIX holder from the accessory rail AXIOM Iconos R200 AXD3 340 620 13 01 02 39 154 Accessories Optional Accessories Application BABIX cradles For pediatric examinations with the patient table in the vertical or horizontal posi tion The BABIX cradles are made of transparent radiolucent plastic They are available in 2 shapes BABIX U Is suitable for examinations on the tilted to vertical tabletop in which the body of the infant must be firmly enclosed in a straight posture Only in connection with the holder for BABIX cradles A Warning There is a danger of rolling away when placed down on the horizontal table 40 54 BABIX Flat This shape is suitable for pelvic and spinal examinations The flat cradle can be placed safely on the table in the horizontal position The infant can be secured above and below the knees through the slit in the back of the cradle The infant can be secured in the abdominal region through slits at the sides Use the rubber or Velcro tapes provided for immobilizing infants AXD3 340 620 13 01 02 Operator Manual Attachment Removal Radiation protection value Permissible load of the BABIX cradle AXIOM Iconos R200 Accessori
136. mpact approx 80 kg mobile tableside control console approx 40 kg Without ceiling mounted support at least 3 20 m with ceiling mounted support 3 30 m without restrictions of the system move ment from 2 50 m to 3 20 m with automatic movement restrictions by collision computer 1 Pretransformer required for 440 480 V AXD3 340 620 13 01 02 5 112 Technical Description Technical Data Table and patient tabletop Table tilt Table height Tabletop Patient weight Longitudinal travel Transverse travel Tube assembly stand SID Oblique projection Tube assembly swivel 6 112 Unit Motor driven 90 to 17 Tilting speed approx 4 5 s min tilting time 90 to 0 21 s incl soft start and braking automatic stop in horizontal position 0 can be switched on off In horizontal position 89 cm with 1 1 33 or I 1 40 Dimensions outside 210 cm x 80 cm radiotransparent 193 cm x 55 cm attenuation equivalent lt 0 6 mm Al at 100kV 2 7mm Al HVL lt 0 65 mm Al at 100kV 3 7mm Al HVL Maximum of 200 kg with the following restrictions 181 kg to 200 kg patient lying centrally on the horizontal not projecting tabletop no table longitudinal and transverse movements permitted 151 kg to 180 kg patient lying centrally on the tabletop restriction of the movement speeds max 20 and of the table longitudinal movement 40 cm and transverse movement to the front 7 5 cm Trendele
137. mpensation Display of the UU After the end of the exposure the mAs and ms values in the display are flash exposure data ing AXIOM Iconos R200 AXD3 340 620 13 01 02 21 136 POLYDOROS SX 65 80 Integrated Control Console Selection Deselection Exposure data to be set Display of exposure data 22 136 Select 1 point technique 1 Setting the kV value 1 Exposure cut off by automatic exposure control Iconos DFR Iconos Iconos Bed Vertix Info Cassette xy 45 Ww al 40 w 0 3 ma 0 1 min me 0 hu An JE is oii 100 E O Program gt Q 3 4 uGy cm2 Actuate a button for film screen combination or ameasuring field dominant button With organ program Select an organ program with 1 point technique Actuate the mAs button 2 point technique is selected or the ms button 3 point technique is selected or the IONTOMAT button 3 point technique with IONTOMAT is selected With organ program Select an organ program without 1 point technique 11 The following exposure data can be set kV value Focal spot Tube load Measuring fields dominants Film screen combination Film density compensation LJ After the end of the exposure the mAs and ms values in the display are flash ing AXD3 340 620 13 01
138. mpensation tobeset y Measuring fields dominants AXIOM Iconos R200 AXD3 340 620 13 01 02 31 7 36 POLYDOROS SX 65 80 Integrated Control Console Select DSA constant time T Setting a constant exposure time LI Exposure cut off by the timer Iconos DFR Iconos Iconos Bed Vertix Info Cassette 40 kv Djam Program Selection Select DR technique on the unit and an organ program with DSA constant time technique Deselection Select an organ program without DSA constant time technique Exposure data 1 Density compensation tobeset y Measuring fields dominants Organ programs 1 A certain number of organ programs has been stored during the initial start up of your system 1 As a maximum 50 organ programs can be generated and stored d For DR tomography tomography and Peristepping Perivision 25 organ pro grams can additionally be generated and stored in each case d At any time you can tailor these organ programs to your personal needs or generate and store new organ program If desired this can also be done by the SIEMENS Uptime Service 32 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Selecting an organ program Actuate the program button in the data menu Program the program menu appears Select an organ program after the selection the system returns to the
139. n to the right height width collimator blade pair closes Push diagonally both collimator blade pairs open close simultaneously Actuate the coordinate switch Push diagonally to the left above collimator opens Push diagonally to the right below collimator closes Press the keys Key above on the left width height collimator blade pair opens Key below on the right width height collimator blade pair closes Press the keys Key on the left or above collimator opens Key below or on the right collimator closes Semitransparent wedge filters optional Operation is exclusively at the system remote control console or the optional mo bile tableside console Selection deselection You select deselect the wedge filters with one of the keys LED lights up the wedge filter is selected and can now be moved with the coordinate switch LED does not light up the wedge filter is deselected and remains standing in the current position Left right wedge filter Double wedge filter AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 System Operation Setting the Image Geometry By pressing this key you move all semitransparent wedge filters out of the beam path e g for resetting the wedge filters LED lights up no wedge filter in the beam path Moving the semitransparent wedge filters The movements refer to the display on the monitor and always behave the same even
140. n Digital Radiography 40 52 Organ programs All parameters necessary for the exposure are stored in organ programs gt Refer to the FLUOROSPOT Compact Operator Manual and the POLYDOROS SX register for further details on the organ programs and their programming Creation of programs gt Refer to the FLUOROSPOT Compact Operator Manual Temporary changes of programs For the following parameters stored in the organ program it is possible to change them temporarily with the corresponding operating elements Dominants i The changed parameters apply only until you select another same organ pro gram or switch the system off DR Scanning optional General To display large objects a series of displayed images is combined to give a large format image in the image processor of the workstation The entire exposure area is moved over continuously with the image receptor proceeding from the starting position not in Peristepping After the acquisition the images are sent from the imaging system to the LE ONARDO workstation for processing e g image reconstruction Depending on the examination there are 2 types of acquisition d DR scanning for images of the spine orthopedic longleg images abdominal survey images 1 Peristepping for survey images of the peripheral vessels Li Generate an organ program for the scanning technique in the series image menu AXD3 340 620 13 01 02 Operator Man
141. n organ program without DR 0 point technique Ll Density compensation 1 Measuring fields dominants LJ After the end of the exposure the mAs and ms values in the display are flash ing AXD3 340 620 13 01 02 29 136 POLYDOROS SX 65 80 Integrated Control Console Select DR 1 point technique T Setting the kV value 1 Exposure cut off by the automatic exposure control Iconos DFR Iconos Iconos Bed Cassette Vertix Info 40 kv 0 hu 3 4 ole Selection Select DR technique on the unit and an organ program with DR 1 point tech nique Deselection Select an organ program without DR 1 point technique Exposure data d Density compensation tobeset 4 Measuring fields dominants Display of exposure UU After the end of the exposure the mAs and ms values in the display are flash data ing 30 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Select DR tomography with Plani lLONTOMAT T Setting the kV value and the tomographic time d Exposure cut off by the timer Iconos DFR Iconos Iconos Bed Vertix Info Cassette 77 kv mO Program Selection Select DR technique and a tomographic program on the unit Deselection Deselect the tomographic program on the unit Exposure data d Density co
142. nal Accessories Footboard Extension 0 00 Use Extension board for enlarging the surface of the footboard especially for lateral patient positions The maximum permissible patient weight on the footboard extension is 180 kg The footboard extension is not monitored by the collision computer Therefore proceed with care when tilting the tabletop with the footboard and extension attached towards the ceiling With the footboard extension the foot restraints cannot be used Attachment Move the tabletop with the footboard attached to approximately the 80 posi tion Move the tabletop headwards Place the footboard extension on the rear end of the footboard Push the locking lever 1 on the rear of the footboard in the direction of the arrow While exerting pressure on the extension board fit the metal pegs of the ex tension into the holes of the footboard AXIOM Iconos R200 AXD3 340 620 13 01 02 21 154 Accessories Optional Accessories Push the locking lever 1 on the rear of the footboard all the way to the stop in the direction of the arrow Make sure the footboard is attached firmly by pushing and pulling it Removal Move the tabletop to approximately the 80 position Move the tabletop headwards Push the locking lever 1 on the rear of the footboard in the direction of the arrow and hold it Remove the footboard
143. nburg position max 45 with patient secured with shoulder supports and foot restraints 0 kg to 150 kg no restrictions of the table longitudinal and transverse movement In addition 50 kg for cardiac massage CPR in the table mid position The permitted nominal patient weights were defined with 4 times the test load according to IEC 601 160 cm motor driven 80 cm each to the head and foot end speed 6 cm s 50 Hz or 7 2 cm s 60 Hz 35 cm motor driven 17 5 cm each to the left and right speed 5 cm s 115 cm 150 cm can be set by motor drive adjustment at approx 5 cm s Max 40 SID 115 cm or 35 SID 150 cm at max 8 s fulcrum height adjustable by motor drive 10 to 300 mm above tabletop parallax correction of the object automatic parallax compensation between cassette and image intensifier input screen in the central ray only with cassette spotfilm device Manually in the range of 90 to 90 with stops every 10 and 90 to 180 with stops every 30 AXD3 340 620 13 01 02 Operator Manual Cassette spotfilm de vice optional Cassettes Automatic format collimation Film segmentation Inward movement time Transition time Series technique Tabletop film distance Tabletop l l distance l l image receptor cas sette spotfilm device optional Scattered radiation grid Spotfilm device travel Central ray height above the floor Tabletop image intensi fier scr
144. nufactured Sierens Akiiengese schoft Wittelebocherplatz 2 0 8 333 Nienchen Coman Filtration 1 0mm AL 70KV Locallzer Light 24 150 W Osram Xenophot ri ive Siemens Part 83 75 545 G2107 taser rapation LASER a APERTURE EL 4 12 AXD3 340 620 13 01 02 Operator Manual Power connection Nominal voltage Nominal frequency Nominal rating Ambient conditions Operation Storage and transport Radio interference suppression EMC Protection type Degree of a protection A Floor space required Weight Room height AXIOM Iconos R200 Technical Description Technical Data All technical data represent typical values unless specific tolerances are stated System The entire system is connected to the power supply via the generator 3 N PE 400 V 10 50 60 Hz 1 Hz Internal fuse 3 x 50 A slow blow 10 C to 35 C 20 to 75 relative humidity non condensing 700 hPa to 1060 hPa 20 C to 70 C 10 to 95 relative humidity non condensing 500 hPa to 1060 hPa EN 60 601 1 2 Protection class according to IEC 601 1 Type B max 3 80 m x 2 32 m without restrictions to movement traffic area and safety distances min 2 80 m x 2 32 m with restrictions to movement max SID 1 15 m at 90 without traffic area and safety distances Unit approx 1300 kg system remote control console approx 12 kg generator cabinet approx 290 kg FLUOROSPOT Co
145. oad 26 36 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Integrated Control Console Select tomography with Plani lONTOMAT T Setting the kV value and the tomographic time d Exposure cut off by the timer Iconos DFR Iconos Iconos Bed Vertix Info Cassette ms Vay 45 kw lio Z Pe 70 w ood mAs U D 800 ms uon A oon m O Program 0 hu 3 4 co Selection Select atomographic program on the unit and an organ program with PlaniIONTOMAT or atomographic program on the unit and actuate a button for film screen combination or a measuring field dominant button Deselection Deselect the tomographic program on the unit or actuate the mAs button mAs tomography is selected or the IONTOMAT button Plani IONTOMAT with mAs preselection is selected Exposure data 11 The following exposure data can be set to be set kV value Focal spot Tube load Measuring fields dominants Film screen combination Density compensation AXIOM Iconos R200 AXD3 340 620 13 01 02 27 136 POLYDOROS SX 65 80 Integrated Control Console Select tomography with Plani lONTOMAT and mAs preselection T Setting the kV and mAs value and the tomographic time 1 Exposure cut off by the timer Iconos DFR Iconos Iconos Bed Vertix Info
146. obtain a re placement through the Siemens Uptime Service We recommend using a commercially available impregnating pump spray for cleaning and care AXD3 340 620 13 01 02 25 154 Accessories Optional Accessories Application Inserting the cup Removing the cup 26 154 Cup holder Available only with the Compression option Radiographic examinations of the gastro intestinal tract for patients drinking con trast medium fluids The following requirements apply to the cup and contents Diameter 5 5 cm to 7 0 cm Maximum fill quantity 250 ccm 0 25 liter Maximum fill height 8 5 cm Material Rigid plastic or similar material no porcelain or glass 1 The cup holder is permanently mounted on the left side of the compression carriage It can swing in and out Fill the cup with contrast medium fluid Insert the cup in the holder Remove the cup from the cup holder Dispose of the contrast medium fluid and the cup according to the manufacturer s instructions AXD3 340 620 13 01 02 Operator Manual Accessories Optional Accessories IV holder Application For intravenous therapy or administration of a contrast agent during the radiolog ical examinations Attachment Move the patient table to the horizontal position Loosen the cap screw 1 Position the IV holder at the treatment position and clip it
147. onnected from the power supply and the tube can overheat Standby power supply Only continuous fluoroscopy is possible in standby operation Pulsed fluoroscopy and all radiography modes are not possible Standby power supply active appears on the integrated generator control con sole in the message line Standby power supply inside the hospital A standby power supply inside the hospital switches on if the line voltage fails However this is not as a rule without interruption and can take some time The system is switched off and must be switched on anew Battery supported standby power supply optional UPS Uninterrupted Power Supply An uninterrupted power supply is a battery supported system for the standby power supply in the case of mains power supply failures If an UPS is installed for your system then this UPS switches automatically to standby operation if the mains voltage fails or is too low To prevent loss of data images the imaging system remains switched on The generator and table are switched off AXD3 340 620 13 01 02 Operator Manual System Operation On Off Emergency Stop In the case of a power failure The imaging system remains switched on The generator and table are switched off The green lamp on the control unit of the UPS goes out The red lamp on the control unit lights up after approx 4 s Now switch the system on within the next 6 s If the system is not switched back on with
148. onto the accessory rail or slide it onto the accessory rail Tighten the cap screw Push and pull on the IV holder to ensure it is seated properly AXIOM Iconos R200 AXD3 340 620 13 01 02 27 154 Accessories Optional Accessories To set the height of the IV holder push the fixing ring 2 at the removable upper section of the IV holder upward as shown above and move the upper section to the desired height To fix the height just release the fixing ring 2 Ensure that the height adjustable rod is seated properly and secure Hang one or more IV s on the loops The IV holder can be used in system positions up to 20 Removal Move the patient table to the horizontal position Remove the IV s Push the fixing ring 2 at the removable upper section of the IV holder upward and move the upper section downward Release the fixing ring 2 Ensure that the upper section and extension rod are secured Loosen the cap screw 1 9 2 Lift the base of the IV holder from the accessory rail or slide it off the acces sory rail 28 154 AXD3 340 620 13 01 02 Operator Manual Application Application AXIOM Iconos R200 Accessories Optional Accessories Lateral cassette holder For lateral exposures using a second X ray tube to hold the cassette upright There are two different versions of the cassette holder 1 with variable positioning
149. ooccccocncnccnnncnnnccnnnnnnnanononccnanicnnos During the examination ccc ccc ce cece ec eeceeeee eee eeeeeeeeeneeeeeeeneenens Monthy TESTS Josienne e a idiin Legally required tests aii Chapter System Settings General NOES rinde ne aa a a nea neatly Collision protection Safety areas ooooococcococononononononcnnnnnnnnonononos Operating elements for system POSITIONS oocococccccnccconcnnnnnnonnnos Object dependent system SettinQS oocococccncnnononcnonnnnncnnnnnnononos SAPOS 3 sie wes e a a General notes on error MESSAGES cccococccncnnonnncnnnnnnnonanannnnnnnnnnos Behavior of the system settings in the case of a fault o o o o AXIOM Iconos R200 AXD3 340 620 13 01 02 System Operation Table of Contents 1 32 System Operation Table of Contents Moving the X ray system longitudinally sc csctsetadadeciagadsveestherdendel dhes wpheadadbbockegndasdobendieddaabans 14 VIEL Dad AA Aoi 15 Moving the tabletop longitudinally transverSely oocococcccccccccncncconccncnnnonncnonananccnanonannoncnananicnss 15 Lowering the tabletop completely with the table vertical ooooonocnnccncccccnccccnnnononccncnaninnnconanannns 16 TUI stand Lenape tort ae meer ieee erate een Reo ce ae Nees eer er 17 Setting the projection angle oblique projection ccc cece cece eee eec eect ecee ease teen see ee eet esenesenene ease 17 Setting orthogonal projection oblique projection 0 sssssssrssrsrrsrerrsrr
150. osed of U The tensile shear strength of the welded chains brackets and fittings has been designed so as to ensure a safety factor of 20 If any external damage can be seen on these parts they must be replaced Cleaning 1 The BABIX cradles can be cleaned using commercially available detergents and disinfectants Caution Do not use chemical based solvents BABIX hanger Use Storing and tensioning the BABIX cradle There are BABIX hangers for every BABIX cradle shape and every cradle length 42 154 AXD3 340 620 13 01 02 Operator Manual Mounting the BABIX hanger Removing the BABIX cradles Keeping BABIX cra dles Application Attachment Radiation protection value AXIOM Iconos R200 5 100 500 9 4 2 Accessories Optional Accessories Have the wooden holder fastened to the wall with the enclosed wall plugs and screws at a suitable place in working height Pull the BABIX cradle carefully out from the slot of the BABIX hanger Hold the cradle tight Lift the cradle off from the wooden hook of the hanger Place the BABIX cradle on a secure base Position the infant carefully and comfortably in the BABIX cradle Immobilize the infant securely in the cradle Check for the safe position of the infant in the BABIX cradle Bring the infant into the already prepared X ray room for the examination Remove the infant from the cradle and attend to the inf
151. otorized prefilter selection 2 0 0c cece cece ccc eccc seen eee e cece eeneeee cece eeee eee seseeeen een sesaeeeneeneeeaes 40 Manual prefilter selection occoccoccccocnnononnncocnncnnonnnonnnonnnnnnnnnnnnnnnnnonnnnnnnnnnnnnnnnnnnnnnns 40 2 144 AXD3 340 620 13 01 02 Operator Manual System Overview Table of Contents Changing the bulb of the laser light lOCalizer ooocoocncocincccnccnncnnccnnncnoronornnccn oran cnnnncnoranocinons 41 Testing the titof thennew bulb ad dd A 43 43 Accessories and auxiliary devices nse netar ni aaa ai a Nat gea aaia EA aT E a n Ae ETa Naia AXIOM Iconos R200 AXD3 340 620 13 01 02 3 44 System Overview Table of Contents 4 144 AXD3 340 620 13 01 02 Operator Manual E E m System Overview a System Description Application The ICONOS R200 is an X ray system for universal use and is suitable both as intensively used universal workstation and as a highly loaded special workstation You can perform examinations with the following techniques 1 Fluoroscopy through image intensifier and television system 1 Cassette exposures with spotfilm device optional Spotfilms Bucky exposures Tomography optional U Digital radiography DR Spotfilms Tomography optional Periscanning Peristepping optional DR scanning optional Digital subtraction angiography optional 1 Tabletop cassette exposures 1 Bed side exposures 1 Exposures onto the wall stand
152. ould take only shallow breaths or not breathe at all Actuate the exposure release button until the entire examination area has been scanned The X ray system moves automatically when the exposure is released End of the scene Let go of the exposure release button The X ray system movement stops automatically i The scene is also ended if the image memory is full and the maximum scene time has been reached independently of the position in which the system is lo cated AXD3 340 620 13 01 02 45 152 Examination Digital Radiography Organ programs All parameters necessary for the exposure are stored in organ programs gt gt For further details on the organ programs and their programming refer to the FLUOROSPOT Compact Operator Manual and the POLYDOROS SX register The programs are intended for the following examinations 1 Program A Survey images of the urinary tract kidney and bladder with scanning program Abdomen and direction of scanning headwards 8 cm sec scanning speed 1 Program B Orthopedic longleg images with scanning program Longleg and direction of scanning footwards 4 cm sec scanning speed 1 Program C a p and lateral images of the spine with scanning program Spine and direction of scanning headwards 4 cm sec scanning speed 1 Program D Survey image of the colon with scanning program Abdomen and direction of scanning headwards 8 cm
153. oving the semitransparent wedge filters oc occcocnocncoonnonnncnncnnnnnnnonnonanennnonnnncnnnnnnos 29 CAREPROFILE collimation without radiation optional coccoccoccncconincnnncnnnncnnnnnnonannnnnccncnnnos 29 CARES dE 29 AN a e e eto 30 2 132 AXD3 340 620 13 01 02 Operator Manual System Operation Table of Contents Image reversal Switching over the image intensifier format AXIOM Iconos R200 AXD3 340 620 13 01 02 3 32 System Operation Table of Contents 4 132 AXD3 340 620 13 01 02 Operator Manual at the integrated generator control console on the live monitor on the system remote control console on the tableside con trol panel Emergency stop AXIOM Iconos R200 System Operation On Off Emergency Stop Switching the system on Press the button on the generator ON OFF console The entire system and all further connected devices are switched on A safety test program runs automatically from this time The welcome menu appears on the monitor The system is ready after initialization and the end of the safety test program if 1 no error message appears in the message line of the data menu LJ none of the kV mAs or ms displays flashes a system selection is active 1 the patient menu appears 1 no displays flash 1 no error message appears 1 no displays flash 1 no red emergency stop button is activated In the case of a fault of the safety test program switc
154. patient table to the horizontal position Loosen both cap screws on the handgrip strip Pull the handgrip strip out of the accessory rail Li If required an additional handgrip strip for the front accessory rail can be ordered via the Siemens Uptime Service against payment AXIOM Iconos R200 AXD3 340 620 13 01 02 7 154 Accessories Standard Accessories Application Attachment A Handgrip The handgrip can be mounted in the front or back accessory rail for stable and secure patient positioning Move the patient table to the horizontal position Holding the base of the handgrip loosen the handgrip 1 Slide the handgrip onto the edge of the accessory rail and move it into posi tion Tighten the handgrip Check that the handgrip is secure by pulling on it Warning The handgrip provides additional safety for the patient To prevent injury to the patient s hands when moving the tabletop make sure that the patient is using the handgrip and not the head end or the side edge of the patient table Removal 8 154 Move the patient table into the horizontal position Loosen the handgrip Pull the handgrip out of the accessory rail AXD3 340 620 13 01 02 Operator Manual Application Attachment Accessories Standard Accessories Shoulder supports To support the patient during examinations in Trendelenburg position e g myelography Ata Trendelenburg position gt 15
155. possibilities of crushing between moving parts and their guide openings Ensure during the examination that the patient under no circumstances holds on to the edges of the patient table Not intended as gripping point The handle for turning the tube assembly must not be used as grip location or hold for the patient Danger zones The dotted areas mark the danger zone where no objects must be located during tilting Danger zone Movement range of the positioning table Prior to activating any movements of the unit especially tilting of the unit make sure that there are no objects such as stairs steps stands waste con tainers instrument tables beds gurneys monitor support systems operat ing consoles or the like in its movement range AXD3 340 620 13 01 02 17 144 System Overview Protective Measures These objects are not detected by the collision monitoring of the unit Avoiding collisions of the unit with these objects is subject to the operator s duty to take care If a collision of the unit with a rigid obstacle e g step has occurred press one of the red emergency stop buttons rescue the patient 18 44 Warning Under no circumstances must the unit be tilted down further or tilted up since ex
156. process is ended Trigger the injection automatically or manually Deflect the joystick up down or press the key to the left right until the entire examination area has been scanned 0 If necessary reduce the frame rate in a maximum of 2 steps as filed in the organ program saving dose and storage capacity Lil Follow the contrast medium flow on the monitor Adapt the movement speed of the X ray system to the contrast medium flow End of the scene Let the exposure release button go i The exposure series is also ended if the image memory is full and the maximum scene time has been reached independently of the position in which the system is located Organ programs All parameters necessary for the exposure are stored in organ programs gt Refer to the FLUOROSPOT Compact Operator Manual and the POLYDOROS SX register for further details on the organ programs and their programming Creation of programs gt Refer to the FLUOROSPOT Compact Operator Manual Temporary changes of programs For the following parameters stored in the organ program it is possible to change them temporarily with the corresponding operating elements Film density Dominants Cu prefilter Automatic level 1 2 3 i The changed parameters apply only until you select another same organ pro gram or switch the system off AXD3 340 620 13 01 02 33 152 Examination Digital Radiography Peristepping opt
157. r positions filter positions and dominants are stored auto matically assigned to each step position A maximum of 6 positions 5 steps is possible After the programming run is completed the X ray system must be moved back to the starting position abdomen automatic stop Filling run Initiate the individual steps of the X ray system using the joystick or the key for X ray system longitudinal movement corresponding to the contrast medium flow with monitoring on the live image monitor Selection 0 Press this key Peristepping is selected the LED lights up Deselection i There is no automatic deselection of Peristepping after the end of the scene Press this key or select another exposure system Peristepping is deselected AXD3 340 620 13 01 02 35 152 Examination Digital Radiography Releasing an exposure UU Release the exposure with the exposure release button on the system remote control console or via the foot switch in the control room or table side op tion 1 Radiation is released as long as you continue to press the exposure release button 1 The radiation ON indicators must light up A Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the system off immediately Notify the SIEMENS Uptime Service Discontinue operation of the system Radiation inte
158. r spine or orthopedic longleg images left arrow scanning direction from bottom to top right arrow scanning direction from top to bottom If the LED in the start key flashes press the key The compression device moves into park position if present Oblique setting moves into the 0 position Once these positions are reached the flashing LED goes out AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Digital Radiography Select an organ program with serialography according to the type of examina tion Select the measuring fields dominants center dominant for images of the spine lateral dominants for orthopedic longleg images Moving the system and tabletop into the starting position Position the patient Bring the X ray system and tabletop into the intended starting position The exposure series is generally started in the pelvic region for better exposure control The entire examination area must be scanned without interruptions If necessary perform a test run without fluoroscopy and correct the starting position Deflect the joystick for X ray system longitudinal movement up down until the entire examination area has been scanned Return to the start position Check the starting position during fluoroscopy Scanning process The X ray system is in the starting position for the scanning process Li During the exposure series the patient sh
159. r with cone m 2 50 AXD3 340 620 13 01 02 7 112 Technical Description Technical Data Compression device optional Compression force Speed Force indication Cone tabletop distance Park position Projection angle Tomographic device optional Tomographic angle tomographic time combinations SID Fulcrum height Image intensifier TV system Dynamic response TV matrix 8 12 Can be remotely controlled cone radiotransparent detachable and replaceable 3 shapes 5 to max 155 N or 80 N movement blockage starting from 50 N compression force Compression decompression approx 7 5 cm s Digital LCD in steps of 1 through 15 or 8 at the system remote control console 2 cm to 50 cm standard cone Cone in max decompression position 30 to 30 Linear tomography in all table positions with cassette only with cassette spotfilm device and digital I 1 automatic positioning of object and image receptor in the working area 8 with 0 4 s 0 8 s working area 57 5 cm 20 with 0 6 s 1 2 s working area 42 5 cm 40 with 1 2 s 2 5 s working area 11 0 cm Tomographic angle at 300 mm fulcrum height 115 cm 10 to 300 mm above tabletop adjustable millimeter by millimeter at 0 5 cm s Laser line light localizer optional for fulcrum height on the patient Operation on the system remote control console and table side Components RECON 33 4HDR image fields 33 cm 22
160. rator Manual System Overview Protective Measures Vertical patient table XX SS OREA 200 s a SN SS Fr 140 RSS SN Main operating area Dimensions in cm AXIOM Iconos R200 AXD3 340 620 13 01 02 13 44 System Overview Protective Measures Stray radiation in the main operating area according to DIN EN 60601 1 3 Tolerance of the air kerma measurements 5 Characteristic A and C continuous fluoroscopy 63kV 0 8mA antiisowatt Characteristic B and D continuous fluoroscopy 110kV 3mA Patient table horizontal Height above floor cm 200 150 P i 100 50 Air kerma mGy h Y 6 SO 10 wo A al Patient table vertical Height above floor cm 200 150 O 100 50 Air kerma 0 mGy h o _ N 14 144 AXD3 340 620 13 01 02 Operator Manual System Overview Protective Measures Mechanical safety Danger zones with unit in horizontal position The places marked in the illustrations show possible danger zones at which the patient or operator can be injured v E AXIOM Iconos R200 AXD3 340 620 13 01 02 15 44 System Overview Protective Measures Danger zones with unit in vertical position The places marked in the illustration indicate possible danger points where the patient or oper
161. rd and shoulder supports 1 Use only positioning aids expressly approved by Siemens Contact your local Siemens representative if you have any questions 1 Refer to the Accessories Register for all accessories available for position ing Attaching the accessories is also described there 1 Ensure that these devices and positioning aids are secured correctly and are functioning properly 1 Make sure that the body parts of the patient especially arms and legs do not extend over the edge of the tabletop 1 Ensure that the patient uses the grip locations provided Positioning the patient So that you can position the patient comfortably i Press this key the system moves into a position favorable for patient transfer gt Now transfer the patient Immobilize the patient with the corresponding accessory parts Move the radiographic system into the required position A Warning The collision protection system does not recognize accessory parts which project beyond the system contours The system and the accessories can be damaged and possibly the patient can also be injured AXIOM Iconos R200 AXD3 340 620 13 01 02 5 52 Examination Transferring and Positioning the Patient 6 52 AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Fluoroscopy Fluoroscopy operating modes 1 Standard fluoroscopy continuous fluoroscopy In continuous fluoroscopy 30 25 frames per secon
162. ries Optional Accessories Removing Hold the cone arm with one hand Grasp the cone with your other hand and push it out to the side from the hold er Inserting Place the cone arm with the opening upwards on a firm surface Insert the cone laterally and press it in until it snaps into place Move the patient table to the horizontal position The compression carriage should be in the uppermost position Hold the compression cone so that it is horizontal N eq JK Insert the pins of the cone arm into the opening in the compression carriage up to the stop The locking lever 1 locks into place Pull on the cone arm and check for firm seating of the cone arm Position the patient Move the cone into the compression position For safety reasons the maximum compression cannot be exceeded The com pression drive is automatically shut off when it reaches the maximum compres sion force Move the patient table to the horizontal position Move the compression carriage one notch upward The cone must no longer touch the patient Press the locking lever 1 and hold it until the lock is released Pull the cone arm out completely Move the compression carriage into the upper end position AXD3 340 620 13 01 02 45 154 Accessories Optional Accessories Patient assistance If decompression cannot be controlled e g
163. rol panel A Press one of the keys pa The tabletop tilts down up AXIOM Iconos R200 AXD3 340 620 13 01 02 19 732 System Operation System Settings Limitations when tilting in Trendelenburg position Tabletop tilting stops when the distance table Image Intensifier to floor is less than 40 mm To further tilt the table Release the joystick button and press it once again Spotfilm device and tabletop move footwards until table tilting is possible again an acoustic signal sounds during tilting i The movement always stop automatically in the 0 position of the tabletop if the Stop in 0 position function is switched on When tilting the table down to a Trendelenburg position gt 15 the shoulder sup ports supplied or the foot restraints available as optional accessory must be used to secure the patient The weight of the patient must not exceed 180 kg In the case of a Trendelenburg position gt 45 the foot restraints available as op tional accessory must be used in addition to the shoulder supports The weight of the patient must not exceed 180 kg In the case of a Trendelenburg position gt 45 the weight of the patient must not exceed 150 kg Reading the table tilt System remote control console A Read the tilt in degrees on the display Tableside control panel mr 7 o y a non E E Read the display in degrees 20 32 AXD3 340 620 13 01 02 Opera
164. rruption 36 52 Exposure end DR If you let go of the exposure release button during radiation the exposureis inter rupted immediately Letting the exposure release button go a full image memory or reaching the max imum scene time ends the exposure series including contrast medium injection The scene time refers to the set maximum frame rate A reduction of the frame rate leads to a corresponding lengthening of the scene time Examination procedure Preparation Prepare the digital imaging system Move the tube assembly into the 0 position Transfer and position the patient 4 Move the X ray system and tabletop into the intended starting position Press this key Peristepping is selected the LED lights up The starting position is now defined The display of the current position and the maximum exposure positions e g 1 4 appears on the display in the remote control console I I full format is selected Transverse table travel is blocked AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography i The LEDs in the Peristepping and start keys flash if the conditions for exposure are not fulfilled If the LED in the start key flashes press the key The compression device moves into park position if present Oblique setting moves into 0 position A source image intensifier distance of 115 cm is set Once these positions are reached the flashin
165. s Table of Contents Operator Manual Accessories Chapter Preliminary Remarks POPE USO the a ad 3 A neuuaintatet ea a e an Aaah Dadad ecw aubetasaen uh le auleditt i heat adsasaaa tute emcees 3 So A E a O EA STAEN 3 Use of several accessory COMPONENiES errar ctrl 4 Chapter Standard Accessories ANP ld EE 5 TA 6 A O A 8 shoulder SUID DONS sn id toda deidad 9 A EO E A ea N E wale 10 Chapter Optional Accessories Read SUDO sere E En A A a E E A T ei aoue menses 13 A A EEE ET 15 Note on biological compatibility wise sores enie a a aa ues aaa niana aatia 16 Compression Delt dio 17 Footboard EXIeEnNSIONn rata iio E A N E EEEE A AEEA 21 FOOL TOS Hal orita E a a a E die ae A AAS 23 CUP ROGET sane aa E dee auhestannden 26 AXIOM Iconos R200 AXD3 340 620 13 01 02 1 154 Accessories Table of Contents o O tolduandiobennsnehtaendadeblebasaadetddetdacendtunertanietiae 27 Lateral Casse ite holder suse aida 29 Cassette holder with variable positioning oocooccoccnocncocncoonenncocnnnononononnnonnnnnnnnnnnnnncnnnninnnnnnos 29 Cassette holder without variable POSITIONING ococccocncocnonccocnnonnnnonenonononononnnnnnnnnnnnonnnnnnonnnoss 31 Foot switch assemblies for fluoroscopy and radiography coooooooocooccooccoccccoccccnnnnnnnnnnnnnnnnnos 33 RE 35 Lateral radiata SAIC serra ida 36 Moen TOR BABA Cradles esas lid 38 BABIX cradle Sarei siden ottedweiabeisheidda ide enganhds a reptiles dnd 40 BABIES rt iiNet Oa aa a A a
166. s with wall stand Releasing the exposure d To release the exposure actuate the exposure release button on the genera tor ON OFF console For safety reasons radiation cannot be released from the system control con sole or the footswitch in this mode LJ Before each exposure release check the collimation with the aid of the light localizer on the multileaf collimator the set SID with the tape measure on the multileaf collimator that if the dominants are changed the correct dominant is always selected the central ray onto the cassette center with the aid of the laser line light localizer on the multileaf collimator 1 The signal lamps for radiation ON must light up A Warning If these radiation indicators light up although no switch has been actuated Switch the system off immediately Notify SIEMENS Uptime Service Do not start the system up again 52 152 AXD3 340 620 13 01 02 Operator Manual POLYDOROS SX 65 80 Overall Table of Contents Operator Manual POLYDOROS SX 65 80 Chapter Integrated Control Console A RAN 3 A A O duh baat easton 3 Basi VeriMed id 3 Opos naa aa dota dni oia casada bdon 3 Overview of the controls and displays iss cics ciecedecpteanciaieandedtdaapshedesestestacsdoubagageiduniedenssonuiale 4 A RNT E EEE E TE A E E E AA 4 Data Men N A TEETE T EET E EEA AEE NES 5 Programi Meni eo ON 8 Explanation of displays and controls susrcd iaa iaa diiiiia 9 SCISCUONZOF THE
167. sec scanning speed Program suggestions for FLUOROSPOT Compact Organ program A B C D Program name Kidneys Legs Spine ap lat Colon Fluoroscopic Fluoro 1 Fluoro 1 Fluoro 1 Fluoro 1 mode Supervision SV 3 P s SV 3 P s SV 3 P s SV 3 P s Carevision SDM dominant lr lr c c Dose level 100 100 100 100 Acquisition data Yes Yes Yes Yes from fluoro kV auto auto auto auto Characteristic C16 C16 C18 C 21 curve C kV dose reduc 133 133 133 133 tion kV Focus Large Large Large Large Regulation stop Yes No No Yes Max pulse width 30 30 30 30 ms Film density cor 0 0 0 0 0 0 0 0 rection Grid In In No In Acquisition filter No No No No auto 46 152 AXD3 340 620 13 01 02 Operator Manual Examination Digital Radiography Organ program A B Cc D Filter type 0 0 0 2 0 2 0 0 Culmm Acquisition mode Native series Native series Native series Native series Mark image Yes Yes Yes Yes Auto collimator Yes Yes Yes Yes Bones White Black White Black White Black White Black Contrast C 700 700 700 700 700 700 700 700 Brightness B 306 450 276 480 276 480 316 440 Scene length s 10 30 30 10 Frame rate 1 3 2 2 3 Frame rate 2 3 2 2 3 Frame rate 3 3 2 2 3 Edge filter 15 15 15 15 Kernel size 5 5 5 5 Harmonization 30 60 60 30 Harmonization 127 127 127 127 kerne
168. splay 72 Hz 44 cm screen diagonal LCD monitor 18 46 cm screen diagonal OPTITOP 150 40 80HC 100 cover with fan 0 6 1 0 40 kW 80 kW 52 kW 103 kW 150 kV 12 580 000 J 783 000 HU Radiography 150 Hz 180 Hz Fluoroscopy 20 to 30 Hz max 450 W 2 5 mm Al at 80 kV AXD3 340 620 13 01 02 9 12 Technical Description Technical Data Inherent filtration Leakage radiation IEC 60601 1 3 Load curves Primary collimator Max field size Min field size Angle of rotation Halogen lamp Inherent filtration Additional filters Radiation protection Brightness of full field light localizer Dimensions height x width x depth Max weight without accessories Max weight of the accessories Connected load Aperture angle 10 12 1 5 mm Al at 80 kV lt 0 8 mSv h at 150 kV 450 W in 1 m distance Refer to the X ray tube assembly operating instructions 35 cm x 35 cm at 0 7 m SID 43 cm x 43 cm at 1 0 m SID 42 5 cm x 42 5 cm at 1 0 m SID for collimator with DSA module lt 3 0 cm x 3 0 cm at 1 0 m SID 50 about the central beam axis Only original Siemens replacement lamps may be used 24 V 150 W part no 8375545 G2107 1 0 mm Al at 70 kV 0 1 mm 0 2 mm 0 3 mm Cu manual filter selection depending on regulations up to max tube voltage of 150 kV gt 160 lux measured at a distance of 1m if original Siemens three field templates and dose measurement chambers are
169. ternally invisible but safety relevant damage to the tilting drive may occur Severe consequential damage including personal damage cannot be excluded in this case immediately notify the SIEMENS Uptime Service 11 Avoid standing or sitting immediately adjacent to the system and especially do not sit next to the system with your legs or knees under the cross beam at the head or foot end of the table 1 Take care that during system movements no one is in the area between the unit base and table 1 Take care that with the footboard attached there is a risk of collision with the extended cone optional when the tabletop and or the longitudinal carriage are moving 1 Do not grasp in the loading shaft of the spotfilm device because of the risk of crushing Patient positioning 1 All safety related equipment must be installed and operable In particular the handgrip strips head end and lateral handgrip footboard foot restraints compression belt and shoulder supports LJ The patient s hands arms legs head and hair must not extend unsecured be yond the edge of the tabletop 1 Observe the patient while moving the tabletop and in system movements and take care that any catheter is correctly located 1 In examinations with the table tilted up vertically the footboard serves as an adjustable step or seat Ensure that the footboard is locked together with the tabletop on both sides Check the firm location of the
170. th automatic format collimation Manual without automatic format collimation 3 Ready system ready for exposure 4 Display of the selected prefilter in mmCu if prefilter is selected using a button or via remote control Nothing is displayed in this field if the collimator is equipped with a manual filter unit 5 Format display height x width in cm or inches 6 7 8 Display of SID in cm or inches Display Collimator centered on image receptor We A a Display Collimator rotated 1 can be configured in cm or inch by Siemens Uptime Service 2 Display function not available with all systems AXD3 340 620 13 01 02 37 144 System Overview Operating and Display Elements Control elements at the underside 1 Button for full field light localizer and laser line light localizer switches off automatically after 10 90 s configurable 2 Laser line light localizer with slider to cover the outlet opening 3 Crosshairs in the light localizer window 4 Locking spring for accessories Laser line light The laser line light localizer projects the axis mark for longitudinal centering localizer 2 which is aligned with the centering mark on the receptor If necessary the laser radiation exit of the laser line light localizer can be closed with the slider 2a 38 44 AXD3 340 620 13 01 02 Operator Manual System
171. the cassette or segmentation format If the rectangular diaphragms are opened less than the cassette or segmentation format then they are opened up to the selected cassette or segmentation format during the preparation Automatic format collimation can also be selected separately for height and width diaphragms The diaphragms not selected then behave in the same way as with semiautomatic mode Fully automatic mode width and height is active both LEDs light up Fully automatic mode width is active right LED lights up left LED is dark Fully automatic mode height is active right LED is dark left LED lights up AXD3 340 620 13 01 02 13 152 Examination Cassette Exposures in the Spotfilm Device optional Cassette program Cassette formats and segmentation program The following cassettes standardized according to IEC ANSI or DIN are permit ted 14 52 18 cm x 24 cm 8 x10 20 cm x 40 cm 24 cm x 24 cm 9 5 x 9 5 24 cm x 30 cm 10 x 12 30 cm x 35 cm 11 x 14 30 cm x 40 cm 35 cm x 35 cm 14 x 14 35 cm x 43 cm 14 x 17 40 cm x 40 cm Selecting the segmentation program console Select the spotfilm device exposure technique at the system remote control Insert an approved
172. the image receptor for each projection angle Press a key cranio caudal projection right key caudo cranial projection left key If the tube assembly stand or the image receptor unit reach the end of their re spective travel range the movement will stop To perform further oblique projections Press the key for oblique projection again The tube assembly stand or receptor unit moves to a position for additional projections The object centering is lost Reposition the object by moving the tabletop longitudinally provided the range of travel allows this Lil For fluoroscopy position the isocenter for oblique projection at the object height The object centering on the monitor will remain the same without shift if you se lect oblique projection AXD3 340 620 13 01 02 17 132 System Operation System Settings Setting orthogonal projection oblique projection 0 0 Press this key If the central beam is orthogonal to the receptor unit the LED lights up The display for oblique projection indicates 0 i SS Ss Reading off the projection angle System remote control console non wy Read the angle in degrees on the display Tableside control panel gt 7 Read the display in degrees 3 E play grees Tabletop A Warning Avoid a seated working position direct
173. the primary collimator The collimator does not react to a change of the SID The digital display field of the primary collimator shows Manual Selecting the exposure technique Tabletop cassette exposure or free mode Press this key a The LED lights up With tabletop cassette exposure or the tube assembly swivelled out the sys tem automatically switches over to Free mode tabletop exposure The au tomatic format collimation system is disabled AXIOM Iconos R200 AXD3 340 620 13 01 02 49 152 Examination Free Cassette Exposure Releasing an exposure d To release the exposure actuate the exposure release button on the genera tor ON OFF console For safety reasons radiation cannot be released from the system control con sole or the footswitch in this mode LJ Before every exposure release check the format limitation with the aid of the light localizer on the collimator the set SID with the tape measure on the collimator the central ray on cassette center with the aid of the laser line light localizer on the collimator 1 The radiation ON indicators must light up A Warning If these radiation indicators light up although no switch has been actuated Switch the system off immediately Notify the SIEMENS Uptime Service Discontinue operation of the system 50 52 AXD3 340 620 13 01 02 Operator Manual with automatic format collimation option without automatic for
174. tomatically after approx 20s Reading the fulcrum height The fulcrum height display on the system remote control console is decisive for all examinations Read the display display in mm Switch the fulcrum height light localizer on You have 2 possibilities of reading the fulcrum height Direct method light line on the object Look from the right side in the mirror on the system You will see the projection of a red laser light line directly on the patient This light line indicates the set fulcrum height directly on the patient Indirect method on scale Look at the scale next to the mirror on the system You will see a red light mark there Read the scale value indicated by the light mark One division corresponds to 0 5 cm AXD3 340 620 13 01 02 23 132 System Operation System Settings 24 132 Manual tube assembly rotation 1 During the rotational movement radiation release is not blocked 1 Outside the 0 rotation position the automatic format collimation system switches over to the Manual mode free radiation field setting 1 Tube assembly rotation is possible from 90 to 90 with stop positions every 10 and from 90 to 180 with stop positions every 30 Remove the compression cone if present Pull the handle 1 to the front and hold it firmly Turn the X ray tube assembly to the required position and hold it firmly at r
175. tor Manual lt i gt AXIOM Iconos R200 System Operation System Settings Compression device optional 1 Compression device with cone Using the compression device D Insert the cone arm Refer to the Accessories chapter Set an oblique projection angle of less than 30 Press a key key above decompression key below compression The motor driven compression device is subject to the examiner s special duty to take due care regarding the applied compression forces especially in the case of frail sick and elderly patients For further information refer to Patient positioning im Register System Overview Protective Measures chapter For information about patient rescue in case of a power failure see the chapter On Off Emergency Stop You can apply a maximum compression force of 155 N or 80 N1 adjustable in 15 or 8 steps Movements are no longer possible at a compression force of 50 N and higher The cone carriage moves automatically into the park position topmost decom pression position in tomography in Peristepping Periscanning scanning technique when setting a swivel angle greater than 30 l configuration for Japan only AXD3 340 620 13 01 02 21 132 System Operation System Settings Cone arm in park position System remote control console F Monitor
176. ts Errors 1 If the LCD monitor displays no image or a blurred image vertical lines or other defects please contact the SIEMENS Service 1 If no input signal is present the No Signal message appears Primary collimator Control elements and displays at the front 7 6 5 4 8 3 2 9 1 Accessory rails 2 Button for full field light localizer and laser light localizer switches off automatically after 10 90 s configurable 3 Manual setting of width and height of the radiation field Turning to the right opens the collimator Turning to the left closes the collimator 4 Motorized prefilter selection button 5 Display field 6 Selection of the collimated radiation field of the last exposure 7 Stop lever for 45 rotation of the collimator about the vertical axis stop position 0 l configurable by SIEMENS Uptime Service AXD3 340 620 13 01 02 Operator Manual Display field System Overview Operating and Display Elements 8 Buttons for entering the SID for free setting 9 Tape measure for SID setting cm and inch 10 Slide for covering the laser line light localizer 11 Integrated measuring chamber for dose area product optional 12 Manual prefilter levers at the left side not shown sleljelehleja bad melss le 3 3 3 AXIOM Iconos R200 1 Selected tube assembly selected 2 Operating mode ACSS PBL wi
177. ual ado Examination Digital Radiography Selection Press this key Press this key DR scanning is selected The display shows 3 scanning programs with 2 directions each Select an organ program for DR scanning at the integrated generator console Deselection Press this key or select a different exposure system DR scanning is deselected Image transfer Send the images from the imaging system to the LEONARDO workstation us ing the DICOM Send function Releasing an exposure 1 Release the exposure with the exposure release button in the system remote control console or via the footswitch in the control room or table side option d Radiation is released as long as you continue to press the exposure release button 1 The signal lamps for radiation must light up A Radiation interruption Exposure end AXIOM Iconos R200 Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the system off immediately Notify SIEMENS Uptime Service Discontinue operation of the system If you let go of the exposure release button during radiation the exposure is in terrupted immediately Letting go of the exposure release button a full image memory or reaching the maximum scene time ends the exposure series AXD3 340 620 13 01 02 41 152 Examination Digital Rad
178. uct is provided with a CE marking in accordance with the regulations stated in Appendix II of the Directive 93 42 EEC of June 14th 1993 concerning medical devices In accordance with Appendix IX of the Directive 93 42 EEC this device is assigned to class ll b The CE marking applies only to medical devices which have been put on the market according to the above mentioned EC Directive Unauthorized changes to this product invalidate this declaration Please observe the Safety Operator Manual Important information is given there The original version of this manual was written in English AXIOM Iconos R200 Overall Table of Contents Operator Manual Overall Table of Contents Part Lists Chapter Overall Table of COntents batida lalo 1 Part System Overview Chapter System Descriptio sissie a a a a a 5 AD PLICATIONS a E A E AE A E T vei eG T E ESTE 5 PRODUCE GESCHDLIOM sreinge padan T tad 5 System CON IU a a A E St O AE N 6 SYSTEMS a td ida ice 7 TEO VEIS Wa EA An se A eee 8 Chapter Protective Measuls Sneen ni aena lc danna ideo lina 11 Emergency POCO US A a a Ai liado 11 CleaninG and GiSimfSCtO visitan o cipal dia ladle 11 Radiation Protection ZONE it A AAA EA A IEA 12 Mechanical Sat esti o ta ed deal lin aeann 15 Safety relevant parts subject tO Wear oocconooocccccooonnnncnonnnnnnonoonnnonnnnonn non nnnnonnnnnnnnnonnnnnnnononnnnnnnnnnnnnncinoos 22 Maintenance teva a e e e na a toe ce eo e 0 22 CARE WATE Hra o A A e
179. used 183 mm x 232 mm x 352 mm without DSA module 262 mm x 233 mm x 380 mm with DSA module 10 5 kg to 15 5 kg with DSA module lt 7kg 30 40 V AC 50 60 Hz 8A 28 28 AXD3 340 620 13 01 02 Operator Manual Line connection Nominal voltage line frequency Internal line resistance Nominal load Radio interference suppression EMC Type of protection Degree of protection Ambient conditions operation Temperature range Relative humidity Atmospheric pressure Weight High voltage wave form Output AXIOM Iconos R200 Technical Description Technical Data X ray generator 400 V 10 50 60 Hz three phase 440 480 V 10 50 60 Hz three phase via internal line matching transformer expansion POLYDOROS SX 65 0 15 ohms 400 V 0 18 ohms 440 V 0 22 ohms 480 V POLYDOROS SX 80 0 10 ohms 400 V 0 14 ohms 440 V 0 16 ohms 480 V at 400 V 34 6 kVA at 440 V 38 0 kVA at 480 V 41 5 kVA EN 60 601 1 2 Protective class according to IEC 601 1 IP 20 according to IEC 529 10 C to 40 C 20 to 75 not condensing 70 kPa to 106 kPa Maximum expansion 290 kg Multipulse POLYDOROS SX 65 800 mA at 81 kV 650 mA at 100 kV according to IEC 601 430 mA at 150 kV POLYDOROS SX 80 980 mA at 81 kV 800 mA at 100 kV according to IEC 601 530 mA at 150 kV AXD3 340 620 13 01 02 11 712 Technical Description Technical Data Fluoroscopy Tube volta
180. ve the tabletop AXD3 340 620 13 01 02 Operator Manual System Overview Protective Measures Resetting the area dose product Once the examination is finished actuate the reset button at the integrated generator control console gt lt The displays for the area dose product and the patient entrance dose are reset to zero gt Refer to the Operator Manual of Fluorospot Compact AXIOM Iconos R200 AXD3 340 620 13 01 02 23 144 System Overview Protective Measures 24 44 AXD3 340 620 13 01 02 Operator Manual System Overview Bl Operating and Display Elements System remote control console 3 S 0000090 A A Onn o AB y y SD AA E lt p VT E A X a 7 7 lt gt ae no o e a o y A F o o Displays general I Radiation ON indicator Symbol lights up orange wS 1 Generator is busy indicator Symbol lights up orange Id Indicators in the display YD 15 E471 2 AQ 10 3 5 DR 8 125mm 3 0 1mm 40 1 2s amp y Ea lt Longleg wey I Oblique projection angle O LI Table tilt angle NX 9 1 User interface is identical for the optional mobile tableside control console 2 depending on the operating mode AXIOM Iconos R200 AXD3 340 620 13 01 02 25 44 System Overview Operating and Display Elements 26 144 P E474 lt Longleg 30 cm 24 cm gt lt i gt
181. with image reversal Coordinate switch for moving turning left wedge filter moving turning double wedge filter 1 Coordinate switch for moving turning right wedge filter moving turning double wedge filter CAREPROFILE collimation without radiation optional The collimation of the rectangular iris collimators and of the semitransparent fil ters option can be displayed on the LIH image without radiation The collimator position is displayed by a contour line as soon as the position of the collimator is changed gt Refer to the FLUOROSPOT Compact operating instructions for further details CAREPOSITION optional The CAREPOSITION function enables you to position the patient anew without further fluoroscopy with the aid of the last fluoroscopic image LIH gt Refer to the FLUOROSPOT Compact operating instructions for further details 1 in relation to monitor image edge AXD3 340 620 13 01 02 29 132 System Operation Setting the Image Geometry Additional Cu filter The organ programs determine which additional Cu filter is moved into the beam path on selection of the program A temporary change of the automatic additional Cu filter selection with organ pro gram is possible by manual switchover The manually selected additional Cu filter is maintained until renewed switchover or selection of an organ program with configured additional Cu filter The currently selected additional
182. xposures may be overexposed or interrupted and there fore useless Press the exposure release button up to the first pressure point The tube assembly stand moves to the head end tomography starting posi tion at the left with the unit horizontal Give the breathing command to the patient Press the exposure release button all the way down and hold pressed until the tube assembly stand stops During the exposure the tube assembly stand moves towards the foot end and automatically remains there following the exposure Li With the exposure release button pressed the tube assembly stand moves back into the starting position Prepare the next tomographic exposure Set anew tomographic height Press the exposure release button up to the first pressure point The tube assembly stand moves from the foot end position towards the head end tomography starting position at the left with the unit horizontal AXD3 340 620 13 01 02 Operator Manual A Radiation interruption Exposure end AXIOM Iconos R200 Examination Digital Radiography Releasing the exposure d To release the exposure actuate the exposure release button in the unit re mote control console 1 The radiation ON indicators must light up during the exposure Warning If these radiation ON indicators light up although no switch has been actuated and the current fluoroscopic image cannot be seen on the monitor Switch the generator o
183. y ccoccnnnccnnnococonoconaconononoccnnnonnnancnnncnnnnnns 23 Arrangement of the dominants oocccocnccncocnnocnnnnnnnnnnnnnonnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnninnnonns 23 Selecting the dom NantsS ocococccncnnccnncnnncnnncnnnnnnnn corno ron nn n non nn nn nene nan n ran nene n arena rre nana nnnanncinins 24 2 152 AXD3 340 620 13 01 02 Operator Manual Examination Table of Contents Spotfilming without tomography ricota als inomislaiollciadc nd 25 SEIBCTON AA AAA A A AA 25 Single image Sena grapa ld A aida 25 Changlind SSlecuon ta ada et e AAE a ala dann ane 25 FIAMIG RATE sida vances 25 Releasing TheSxDOSUTE E 26 Organ PTAS sus Meck AAA A A A A A eta aR 26 PLOMO A a e Lt e e o e th do Ahn acted 27 Creation Or programs da ada dois 27 Temporary changes of programs bastado leo rollo labial delicia 27 komography Optional castrado e end i 27 A SN 27 Tomographic Sequence sms tradi iia 28 RECAE AM el era e es ae Ba ed alta 29 Organ Programs A la E T 29 Prod MS tala a eE a aiaa 29 Creatim ot Progra rns rr A E a al calcined a ade dali 29 Temporary changes Of prograMS ocoocccocnncnnconcncnnnnnennnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnoss 29 PEMSCANUNGS mirada iii E aA 30 General earme e o o e o ee CI 30 Sl A ii a E 30 DES cION e et AISA te tae NS AT Na NIE AE A Nae DSS i AMF Ate PS ee teed 30 Releasing the eXpOSUre ccc 31 EXAMIMALION NR 31 Preparation cd ii T A ieee 31 Mestra eeit aa e a i a aa e e aa ei a
184. y or SUPERVISION the fol lowing dose reductions configured in the factory result related to standard fluor oscopy Automatik CAREVISION CAREVISION CAREVISION SUPER programm 15 P s 7 5 P s 3 P s VISION 1 50 75 90 50 2 33 55 75 50 3 30 50 65 50 Deviating factory setting for USA 1 for image receptor input dose rate AXD3 340 620 13 01 02 Operator Manual AXIOM Iconos R200 Examination Cassette Exposures in the Spotfilm Device optional Automatic format collimation in radiography Bucky mode In the Bucky mode the rectangular diaphragms move to the format of the insert ed cassette or to the selected segmentation format The light localizer is switched on automatically on selection The radiation field can then be collimated smaller as desired The collimation is retained during the exposure Bucky mode is active LED lights up Semiautomatic mode In the semiautomatic mode the rectangular diaphragms are limited automatically to the cassette or segmentation format It is possible to collimate arbitrarily within the cassette or segmentation format The collimation is retained during the expo sure Semiautomatic mode is active no LED lights up Fully automatic mode In the fully automatic mode the rectangular diaphragms are limited automatically to the cassette or segmentation format It is possible to collimate arbitrarily within
185. ystem Radiation interruption Exposure end AXIOM Iconos R200 If you let go of the exposure release button during radiation the exposure is in terrupted immediately Letting go of the exposure release button a full image memory or reaching the programmed maximum scene time ends the exposure series Examination procedure Preparation Prepare the digital imaging system Move the tube assembly into the 0 position Position the patient Seta nominal source image intensifier distance of 115 cm or 150 cm Bring the X ray system and tabletop into the intended starting position You must ensure that the travel range for the X ray system is sufficient Press this key The LED lights up Periscanning is selected Serialography is selected i The LEDs in the Periscanning and start keys flash if the conditions for exposure are not fulfilled AXD3 340 620 13 01 02 31 152 Examination Digital Radiography Adapting the dominant Prepare the injector lt q 32 152 gt KOH If the LED in the start key flashes press the key The compression device moves into park position if present Oblique setting moves into the 0 position Once these positions are reached the flashing LED goes out Select an organ program for Periscanning Position the patient and set the following parameters with the corresponding operating elements Primary collim

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