Using the Ear Wash System - Eickemeyer Veterinary Equipment Inc.
Contents
1. The water splash is making a mess or splashing onto adjacent electrical units Excess water pres sure from the water line Ensure that the chamber aer ator is attached to the bot tom of the chamber The water pressure from the eartip seems too high or too low Installation of eartip has caused a prob lem Apply a new eartip with the tab side pointing upwards There is leakage from the chamber aerator and or adapter The return water exit port is clogged on the bottom of the chamber Tighten the aerator and or adapter with a pair of pliers Remove the chamber from the faucet and dislodge any foreign materials from the exit port Proceed with the normal cleaning procedure There is an internal malfunction With an eartip attached spray water from the handle into a graduated cylinder or measuring cup for exactly 20 seconds If there was less than 90 mL or more than 110mL of measured water contact your Welch Allyn Technical Service Depart ment 12 Types of Cerumen Cerumen is the natural by product of the ear canal It lubricates the skin lining in the ear canal acts as a water repellent and entraps dust hair fol licles and foreign bodies Cerumen can take many different forms which affect the process and time to remove There are generally two different types of cerumen found in the ear canal dry and wet The following are subtypes of cerumen that you will c2. 46 28536 Always inspect the ear before attempting any irrigation The AN presence of a perforated or damaged tympanic membrane indi cates it is unsafe to irrigate the ear Do not use this device if the patient has a current or prior history with chronic middle ear infections diabetes PE tubes or immune compromised If the water is too cold the patient may become dizzy or experi ence vertigo Please verify that the thermal indicator is white before proceeding with the irrigation Reimbursement Information Ear Cleanings using the Welch Allyn Ear Wash System are reimbursable under CPT Code 69210 Removal of Impacted Cerumen in one or both ears Getting Started Unpacking and Verifying Contents Inspect the packaging for any damage incurred during shipping If you find any damage notify the carrier Complete and return the warranty reg istration card It validates the warranty and allows Welch Allyn to send announcements of product enhancements When you unpack your new Welch Allyn Ear Wash System verify that the following items are included Water chamber Handle Tubing assembly One snap aerator Three different faucet adapters Chamber Aerator One box of eartips 25 ct Storage Tray User s Manual Quick Reference Guide If you believe any items are missing contact your Welch Allyn distributor Use the figure on page 4 to familiarize yourself with the features of the Welch Allyn Ear Wash System Diagram of the
3. Pe WelchAllyn Ear Wash System 29300 Operating Instruction Manual Table of Contents Getting Started naaa neue 3 Unpacking and Verifying Contents 3 Using the Ear Wash SysteM 6 Steps for Irrigation Aedes tk Sa ds Veen 6 Disassembly acs oases anions ee 8 Maintenance 00 nenn nn 9 Cleaning and Disinfecting the System 9 Troubleshooting woran wer 11 Types of Cerumen 1000 ira kn Nak Wara 13 Anatomy And Physiology u 2 da ada 14 Cerumenolytic Agents 14 Warranty and Service Information 15 AA GA AA AA AA 15 Technical Service Department 16 Replacement Parts and Accessories 17 Ordering Information sa 224845 17 Specifications e amd aaa 18 General Specifications ase sk a dee 18 Patente daa Er ME 18 TM Sy rh teak Oe ee BAGA AA 18 Introduction Thank you for purchasing the Welch Allyn Ear Wash System The Welch Allyn Ear Wash System provides a safe and effective way to remove cerumen from patients of all ages This method of irrigation is much cleaner and safer than other irrigation methods currently on the market Since it is easy to use with built in safety and simplicity any healthcare worker at your facility can use this device The Welch Allyn Ear Wash System provides the following features e Patient Comfort Hydrovac action e Patient Safety High temperature water shut off valve W
4. Welch Allyn Ear Wash System A F Mr BE aps CT AG bok NS A u AA NG N Bo y NANA NAA 9 ZN Ns 5 SK 7 NU N 1 Faucet Interface 9 Water Flow Actuator 2 Faucet Adapter Optional 10 Water Temperature Sensor 3 Snap Aerator 11 Cerumen Trapping Screen in Eartip 4 Snap Connector with white 12 Water Jet Output ring 5 Handle Rest Grip Ring 13 Water Suction Input 6 Irrigation Port Irrigation water 14 Disposable Eartip to ear blue 7 Return Port Return water from 15 Eartip Removal Tab ear black 8 Return Water Exit Port 16 Chamber Aerator Faucet Aerator Installation 1 Remove your current aerator from your faucet including any original washers You may need to use a pair of pliers to remove your aerator If you still have difficulty in removing it soak your current aerator in distilled vinegar for about twenty minutes and try again 2 Try attaching the snap aerator to your faucet by turning it counter clockwise If it does not fit try using one of the adapters that is included with the unit Attempt to match the adapter to your faucet and then attach the snap aerator Verify the rubber washer on the snap aerator and adapter matches to the old washer on your faucet If you need to use the threadless universal adapter only available in certain regions you may need to remove the inner rubber o ring if it is too small for your faucet 3 Once th
5. any Phone 011 49 7477 927173 Fax 011 49 7477 927193 Welch Allyn China Service Center Room 708 227 Huang Pi Road North Central Plaza Shanghai 200003 China Phone 011 86 21 6327 9631 Fax 011 86 21 6327 9632 Welch Allyn France 814 rue Charles de Gaulle 77100 Mareuil les Meaux France Phone 011 33 1 60 06 33 66 Fax 011 33 1 60 09 67 97 Welch Allyn LTD Singapore 300 Beach Road 25 08 The Concourse Singapore 199589 Phone 011 65 291 0882 Fax 011 65 291 5780 Welch Allyn Ltd Australia Metro Center Unit 5 38 South Street Rydalmere NSW 2116 Australia Phone 011 612 9638 3000 Fax 011 612 9638 3500 For service in Latin America and the Caribbean region contact MD International 11300 N W 41st Street Miami FL 33178 USA Phone 1 305 669 9003 Fax 1 305 669 1971 Replacement Parts and Accessories Ordering Information To order replacement parts or accessories contact your Welch Allyn Ser vice Representative or call the Welch Allyn Customer Service Depart ment in Skaneateles Falls NY USA directly at 1 800 535 6663 Monday through Friday 8 00AM to 8 00 PM EST Part Part Number Eartips Case of Eartips 29360 Tubing Hose Assembly 29330 Snap Aerator 29370 Aerator Adapter Kit Domestic 29371 International 29355 17 Specifications General Specifications The specifications common to all of the major components of Welch Allyn Ear Wash System are listed the fo
6. ater pressure regulation inside chamber e User Friendly Visual temperature feedback sensor e Superior Engineering Fully functional at variable water pressures as well as different faucets This manual describes how to operate and maintain the Welch Allyn Ear Wash System Please follow these instructions to ensure many years of accurate and reliable service For additional information on cerumen types and the irrigation process see the Types of Cerumen section About this Manual This manual serves as guide for ear irrigation using the Welch Allyn Ear Wash System The Welch Allyn Ear Wash System is intended for use by Healthcare Professionals Any use other than the intended use invalidates the manufacturer s warranty Warnings and Symbols This manual uses the icons and symbols described below ATTENTION Refer to the operating instructions This symbol is intended to advise the user of the presence of important operating or maintenance instructions in the documents accompanying the instrument 6 Performance specifications verified by ETL Laboratories C iste us 74227 The CE mark on this device indicates that it has been C tested and conforms to the provisions noted within the 93 42 EEC Medical Device Directive Authorized European Representative Address European Regulatory Manager Welch Allyn Ltd Kells Road Navan County Meath Republic of Ireland FDA Requirements Telephone 353 46 28122 Fax 353
7. e snap aerator is attached to the faucet the ear cleaning chamber is easily attached or removed from the snap aerator You can still use your sink normally when the Ear Wash System is not attached to the snap aerator Chamber Aerator Installation The chamber aerator is an optional attachment that is necessary if you are experiencing a significant amount of water splash around your sink When the chamber aerator is attached replace the chamber normally into the storage tray 1 Find the notch located on the top of the chamber aerator and line it up with the blue irrigation port on the chamber 2 Gently press the chamber aerator against the chamber until it is snug NOTE The chamber aerator is only capable of attaching to the chamber if it is aligned correctly It should go on relatively smoothly and there is no need to force it onto the chamber Using the Ear Wash System Steps for Irrigation The presence of a perforated or damaged tympanic membrane indicates it is unsafe to irrigate the ear Do not use this device if the patient has a current or prior history with chronic middle ear infections diabetes PE tubes or immune compromised i Always inspect the ear before attempting any irrigation Attaching the Tubing and Chamber 1 Connect the tubing to the chamber Match the black connector to the black return port on the side of the chamber Match the blue connec tor to the blue irrigation port on the lower side
8. ermal indicator is white before proceeding with the irrigation i If the water is too cold the patient may become dizzy or To irrigate the ear grasp the patient s pinna Pull gently back to straighten a child s ear canal or up and back for an adult While main taining tension on the pinna insert the tip of the handle into the ear to create a seal Squeeze the actuator on the handle By adjusting how much force you push on the actuator some control over the flow rate is attained Aim the stream of water toward the ear canal walls by rotating the handle during the irrigation Flood the ear with water The suction return system will return the discharge away from the ear See the quick reference guide for a diagram of correct water flow During the irrigation conversation regarding patient status will pro vide confidence to the patient If the temperature of the irrigating water becomes too hot the unit will restrict the flow to the handle while continuing to dis charge out the bottom of the unit For the unit to reset bring the water temperature down to a safe level by adjusting the knobs on the faucet until the water cools sufficiently Release the actuator and keep the eartip in the canal for 5 to 10 sec onds to vacuum any residual irrigating water NOTE The procedure typically takes 30 seconds to 5 minutes depending on the type of cerumen and whether or not a wax softening agent is used In severe cases the process co
9. f shipping This warranty does not cover breakage or failure due to tampering mis use neglect accidents modification or shipping and is void if the instru ment is not used in accordance with manufacturer s recommendations or if repaired or serviced by other than Welch Allyn or a Welch Allyn autho rized representative NOTE Return of the instrument registration card is required for proof of purchase and warranty validation 15 Technical Service Department For customers in North America please return instruments requiring ser vice to Welch Allyn or an authorized Welch Allyn Service Representative Please call the Technical Service Department for a Return Authorization Number prior to shipping the Ear Wash System back to Welch Allyn for repair United States Welch Allyn Inc Attn Technical Service Department 4341 State Street Road Skaneateles Falls NY 1314 0220 Telephone 1 800 535 6663 1 315 685 4560 Fax 1 315 685 3361 Canada Welch Allyn Ltd Canada 160 Matheson Blvd E Unit 2 Mississauga Canada LAZ 1V4 Phone 905 890 0004 Fax 905 890 0008 For customers outside of North America return your unit to a local authorized Welch Allyn distributor or to your nearest Welch Allyn service center Welch Allyn Ltd UK Cublington Road Aston Abbots Buckinghamshire England HP22 4ND Phone 011 44 1296 689905 Fax 011 44 1296 682104 Welch Allyn GmbH PSC Zollerstrasse 2 4 72417 Juningen Germ
10. hysicians ability to visualize the tympanic mem brane Less frequently cerumen can accumulate and harden in the canal causing occlusion of the ear canal In the most severe cases cerumen can become impacted in the deep bony canal causing pain and temporary loss of hearing Cerumenolytic Agents Cerumenolytic agents are those agents designed specifically to dissolve or soften cerumen Most softening agents particularly overthe counter products contain carbamide peroxide which is the only agent the FDA con siders safe for loosening or softening cerumen In some instances it is necessary to soften cerumen prior to removal or instead of removal 14 Warranty and Service Information Warranty Welch Allyn Inc warrants the Ear Wash System to be free of original defects in material and workmanship and to perform in accordance with manufacturer s specifications for a period of one year from the date of purchase If this instrument or any other component thereof is found to be defective or at variance from the manufacturer s specifications during the warranty period Welch Allyn will repair or replace the Ear Wash Sys tem or component s at no cost to the purchaser This warranty only applies to products purchased new from Welch Allyn or its authorized distributors or representatives The purchaser must return the product directly to Welch Allyn or an authorized Ear Wash Sys tem distributor or representative and bear the cost o
11. leach 90 water solution to eliminate most bacteria and fungi growth It is recom mended that alcohol is used since it will help to evaporate any remaining water in the tubing Place handle into 3 cup of cleaning solution 1 Remove the eartip and discard 2 Clean the outside of the chamber handle and hose with a soft cloth saturated with a mild solution of soap and water 3 To clean the unit prepare a 4 cup solution of soap and water To disin fect the unit prepare a 2 cup solution of Isopropyl Rubbing Alcohol or 10 bleach 90 water solution 4 Detach the chamber from the faucet Leave hoses attached to the unit Pour Y cup of the solution into the top opening of the coupler Save the remainder of the solution later steps of this procedure 5 Replace the chamber on the faucet head and submerge the exposed handle interface surface where the tip attaches into the remainder of the solution 6a To clean the unit turn on the water Squeeze the actuator to allow the solution to flow from the handle into the container The suction line will remove the solution Continue this process for 5 minutes 6b 10 Remember to keep the exposed tip of the handle submerged in the solution To disinfect the unit turn on the water Do not squeeze the actuator After half of the solution is removed turn the water off at the faucet Remove handle from solution and rest in the handle rest grip ring This will trap solutio
12. llowing table Operating Temperature 50 104 F 10 40 C Storage Temperature 40 120 F 40 49 C Flow Rate from Eartip 100 mL 0 0264 gal of water per 20 seconds at operating pressure Source faucet Water Pressure Range 40 110 Psi 275KPa 758 Kpa Minimum Source Water Flow Rate 7 5 l min 2 gal min Water Pressure from Eartip 10 Psi 69kPa Patents U S Patent Number 5 685 851 other patents pending Eartips e Bio compatible latex free insert type e One size fit patients from pediatric to adult e Single use only e Fits most round ear canals 18 WelchAllyn Printed in the U S A Welch Allyn Inc 4341 State Street Road PO Box 220 Skaneateles Falls NY 13153 0220 Tel 315 685 4560 1 800 535 6663 Part No 293044 Rev B
13. n in the return line and allow effective disinfec tion If unit is used on a patient with compromised skin substitute a solution of 55 Ortho Phthalaldehyde Welch Allyn recommends use of Cidex OPA Follow manufacturers recommendations on soak times for maximum benefit Repeat the cleaning procedure above to remove any residual disinfecting solutions Turn the water off and remove both tubes from the chamber To remove any stagnant solution in the tubing disconnect the hoses from the chamber and place the open end in the sink Hold the han dle higher than the tube and squeeze the actuator The water will run out of the open end into the sink basin Remove the chamber from the faucet Allow the chamber to drip dry Replace the unit in its holding container To facilitate a recommended thorough flush and faster drying pour Isopropyl rubbing alcohol inside the chamber and hoses If hard water calcium buildup is a concern a solution of 100 vinegar can be substituted Allow the vinegar to soak in the chamber for no more than 2 3 minutes A final flush of isopropyl alcohol is required 10 Troubleshooting If your Welch Allyn Ear Wash System is experiencing problems consult the following table to find the symptom and the likely cause and the solu tion If the information in this table does not describe or solve the prob lem you are having contact the Welch Allyn Technical Service Department or an authorized Welch Allyn Dist
14. of the chamber To attach the chamber to the faucet pull down the white plastic ring on the top of the chamber and then insert the chamber over the snap aerator on the faucet When the chamber is positioned release the white plastic ring The chamber is now secure Attaching an Eartip 1 Line up the grooves on the side of the eartip with the corresponding indentations on the handle interface Verify that you are attaching the eartip with the tab facing upwards 2 Press firmly on the eartip until it is flush against the handle interface You will feel a slight snap when the eartip is in place Irrigation 1 Initially you may cover the patient with a cloth drape to eliminate splashing onto his or her clothes Once the technique of sealing the ear canal is mastered this is not necessary 2 Begin to run water through the unit by first turning the cold water on completely Then gradually turn on the hot water until the water exit ing the bottom of the chamber feels close to body temperature 6 Check the temperature of the irrigating water by looking at the ther mal sensor while depressing the water flow actuator If the thermal sensor is blue the irrigating water is not warm enough If the thermal sensor white the water temperature is at least 90 F and the proce dure may begin You must depress the actuator on the handle for the temperature sensor to function correctly experience vertigo Please verify that the th
15. ommonly encounter and how they may affect the irrigation procedure White Flaky Cerumen This form of cerumen will easily dissolve in the irrigation water The irriga tion procedure is relatively short and a cerumenolytic agent is not always necessary Often you will not see solids trapped in the eartip with this form of cerumen rather you will see some of the dissolved cerumen trapped in the eartip screen The rest of the dissolved cerumen will leave through the exit port of the chamber Light Brown Jelly Like Cerumen This cerumen resembles the consistency of petroleum jelly and does not completely dissolve in the irrigation water Some solids may be present in the eartip and the procedure time is slightly longer than for the white flaky variety A cerumenolytic agent is recommended to speed the time of irrigation Dark Hard Cerumen This cerumen is often found lining the walls of the canal and forms a plug in the patient that can cause significant hearing loss Large solids of ceru men are seen trapped in the eartip and the procedure time is often longer than the wet jelly like cerumen A cerumenolytic agent is often neces sary to speed the time of irrigation 13 Anatomy And Physiology Cerumen is produced in the outer third of the ear canal and natu rally moves to the outer ear as new tissue grows from the area around the tympanic membrane Normal cerumen routinely becomes a medical issue when it impedes the p
16. ributor to help you See Service and Warranty Information Card for more information Problem Possible Cause Solution No water is coming out of the handle even though am pulling the actuator The temperature shut off safety fea ture has activated due to the hot water temperature There is a kink in the tubing The tubing on the INSIDE of the handle is restricting water flow Run COLD water through the system for 10 30 sec onds This will reset the tem perature shut off safety feature and allow water to flow again Make sure there are no bends in the tubing restrict ing the flow of water Prime the actuator 25 50 times until water begins to flow normally Excessive water leaking from the ear The water is not turned on high enough Turn the cold water on full in order for the suction system to work properly but still within the right temperature range Eartip attachment problem Replace the eartip with the tab side pointing upwards Tubing connection problem Ensure that both tube fit tings are fit snugly into the chamber Incorrect technique Check the Quick Reference Guide to verify you are aim ing the water correctly 11 Problem Possible Cause Solution Lack of a clean water stream com ing from eartip Installation of eartip has caused a prob lem Apply a new eartip with the tab side pointing upwards
17. uld take longer When the irrigation is complete grasp the tab located on the eartip of the device and pull the eartip off of the handle with a downward motion This eartip is disposable Please place in an appropriate receptacle If there is no water flow out of the eartip and the actuator is depressed check to see if the hot water shut off has tripped by running cold water through the unit This should restore water A flow to the handle Eartips are intended for single use only Discard after use Disassembly 1 2 Turn off the faucet and disconnect the tubing from the chamber Detach the chamber from the faucet Press down the white ring on top of the chamber and then pull the chamber from the snap aerator The chamber will drain through the open hose ports at the front and bottom To remove any stagnant water from the tubing place the open end of the tubing over the sink Hold the handle higher than the tubing and squeeze the actuator Roll the tubing up into a coil holding the handle higher than the tubing The water should run out of the open end into the sink basin Maintenance Cleaning and Disinfecting the System Clean the Ear Wash System after every use and disinfect at N i en ni the user s discretion Y chamber Cleaning the unit with soap A and water will eliminate any debris and reduce the number of microorganisms in the tub ing Disinfect the unit with 70 isopropyl alcohol or 10 b
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