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        REMstar Pro M Series Domestic
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1.           _er   RESPIRONICS    1001 Murry Ridge Lane  Murrysville  PA 15668  www respironics com                EC   REP       Respironics Deutschland  Gewerbestrasse 17  82211 Herrsching  Germany    1050656  JR 1 22 08  EN DOM    RESPIRONICS       REMstar   Pro    M Series  USER MANUAL    IMPORTANT  Fill in the information below when you receive the REMstar  Pro M Series system     Serial No    located on the bottom of the device           System Prescribed for     Date of Purchase or Rental        Pressure Setting  cm H O  Mask Type   Mask Size           If you have any questions concerning the system  contact     e Home Care Company        Telephone Number   e Health Care Professional           Telephone Number        e Respironics  Inc   1001 Murry Ridge Lane  Murrysville  Pennsylvania  15668 8550 USA  Customer Service    Telephone Number  1 800 345 6443  US and Canada  or 1 724 387 4000    The REMstar   Pro M Series with C Flex    system is covered by one or more of the following patents   5 148 802  5 313 937  5 433 193  5 632 269  5 803 065  6 029 664  6 305 374  6 539 940  5 535 738   5 794 615  6 105 575  6 609 517  6 629 527  6 622 724  6 564 797  6 427 689  and 6 932 084  Other  patents pending  REMstar  Whisper Swivel  Encore Pro  and Encore Pro SmartCard are trademarks of  Respironics  Inc  NOTE  The C Flex trademark is used under license       2008 Respironics  Inc  and its affiliates  All rights reserved     TABLE OF CONTENTS                Chapter 1T Introduct
2.   hard  flat surface so the feet on the bottom of  the device can adhere to the surface  make sure  there is no fabric under the device   The device   and humidifier  if using  must be level for  proper operation     Also  place the device away from the edge of  the nightstand or table  so it doesn   t acciden   tally get knocked off the table     If you are using a humidifier with the device   make sure that the device and humidifier are  placed below your head and mask  so that any  condensation in the tubing drains back into the  water chamber     If the device and humidifier fall and water gets  into the device  drain all water out of the device  and make sure it is completely dry before reap     plying power     If the placement of the tubing causes the de   vice to fall  make sure that you use proper hose  management when setting up your device   Route the tubing behind the bed s headboard   as shown in Chapter 3  Setup     If the device falls or water gets into the device  upon falling  let the device dry completely be   fore restarting it  If the device does not operate  correctly after falling  contact your home care  provider        REMstar Pro M Series User MANUAL    PROBLEM Why It HAPPENED    You are having problems   You have lost the   connecting the tubing   air outlet port or   to the device  are traveling and  forgot to bring the  port with you     You are experiencing The air outlet port  excessive air leaks where   is not installed cor   the tubing connects
3.  cycle   40  U     60  dip in U   for   5 cycles   70  U   30  dip in   U   for 25 cycles    lt 5  U    gt 95  dip in U   for  5 sec    COMPLIANCE LEVEL    V contact    V air    V for supply mains    V for input output lines    V differential mode       V for common mode    SAU      gt 95  dip in U   for   0 5 cycle   40  U     60  dip in U   for 5 cycles  70  U   30  dip in U   for 25  cycles    lt 5  U    gt 95  dip in U   for  5 sec    NOTE  U  is the a c  mains voltage prior to application of the test level     REMstar Pro M Series User MANUAL    ELECTROMAGNETIC ENVIRONMENT    GUIDANCE    Floors should be wood  concrete or ceramic  tile  If floors are covered with synthetic  material  the relative humidity should be at  least 30      Mains power quality should be that of a typi   cal home or hospital environment     Mains power quality should be that of a typi   cal home or hospital environment     Mains power quality should be that of a  typical home or hospital environment  If the  user of the device requires continued opera   tion during power mains interruptions  it is  recommended that the device be powered  from an uninterruptible power supply or a  battery     Power frequency magnetic fields should be  at levels characteristic of a typical location in  a typical hospital or home environment        GUIDANCE AND MANUFACTURER   S DECLARATION   ELECTROMAGNETIC IMMUNITY     This device is intended for use in the  electromagnetic environment specified below  The user of 
4.  if enabled by your home care provider    e Ramp starting pressure  if enabled by your home care provider   e Mask alert  enable disable    e Auto off  enable disable     4 3 1 NAVIGATING THE DISPLAY SCREENS    Use the     button to navigate to the next screen and the button to navigate to the previous  screen     Use the   and     buttons to adjust the settings on the Patient Setup screens     REMstar Pro M Series User MANUAL    4 3 1 1 Viewing DATA ON THE PATIENT DATA SCREENS    Figure 4 6 shows how to navigate the Patient Data screens                                                                             e   4  Press 3 Press  gt   RESPIRONICS  ue   FOSQ   Setup            gt   Summary Data     Therapy Usage nd  Therapy Hours  0 12 Hrs Night  Blower Hours  0 12 7 Day Avg  5 00  Total Sessions  0 30 Day Avg  8 00     gt       gt   Compliance Check Sessions  gt  4  7 Days  5 Sessions  3467 30 Days  8 Sessions   lt  lt       gt   Apn Hyp Index    System Leak          7 Day Avg AHI   0 0 U min      7 Day Avg  00  30 Day Avg  AHI   0 0 Pirati 2    az o o o o a    Figure 4 6 NAVIGATING THE PATIENT DATA SCREENS                      Press the   gt  button to scroll forward through the data screens  or press the  lt   button to scroll  through the screens in the reverse order     The Patient Data screens are described below        1  Standby Screen   The Standby screen appears when you first apply power to the  RESPIRONICS device  You can access the Patient Data menu from this 
5.  the setting     To change the C Flex setting  press the C Flex button  The screen shown in Figure 4 4 appears   with an arrow above the current C Flex setting        C FLEX i                123       Figure 4 4 C FLex SETTING SCREEN    The setting of 1 provides a small amount of pressure relief  with higher numbers providing ad   ditional relief  To change the pressure relief  press the   or     buttons to increase or decrease the  setting     Note  You can also view and change the C Flex setting by navigating to the C Flex Set   ting screen from the Patient Setup menu  see Section 4 3      REMstar Pro M Series User MANUAL 4 3    4 4    4 2 2 2 C Fiex DISABLED   If C Flex has not been prescribed for you and your provider has disabled the C Flex feature  the  following screen appears when you press the C Flex button  and you cannot enable or adjust the  setting        C Flex Setting N    FLEX comfort has been  disabled on this unit                 Figure 4 5 C FLex DISABLED SCREEN    4 3 CHANGING THE Device SETTINGS    You can view the set pressure on the Active Display screen  as well as the following information  on the Patient Data screens     e Therapy usage hours   e Number of sessions greater than 4 hours   e System leak  if enabled by your home care provider    e  Apnea Hypopnea Index  if enabled by your home care provider   e Compliance check value   e Summary data   Additionally  you can view and modify the following settings on the Patient Setup screens   e  C Flex 
6.  with you to help security personnel  understand the REMstar Pro M Series device     If you typically use a humidifier with your device  but leave the humidifier home when traveling  make  sure you attach the air outlet port to your device when you remove the humidifier from the device   You need the port to connect the tubing directly to your device  Figure 7   3 illustrates how to attach  the air outlet port     Attach Air Outlet Port  to the Device       Figure 7 3 ATTACHING THE AiR OUTLET Port TO THE Device    7 5 1 INTERNATIONAL TRAVEL    If you are traveling to a country with a line voltage different than the one you are currently using  a dif   ferent power cord or an international plug adaptor may be required to make your power cord compat   ible with the power outlets of the country to which you are traveling  Contact your home care provider  for additional information     REMstar Pro M Series User MANUAL    CHAPTER 8  SPECIFICATIONS    ENVIRONMENTAL    OPERATING STORAGE                            TEMPERATURE 5   C  41   F  to 35   C  95   F   20   C   4   F  to 60   C  140   F   Revative Humipity 15 to 95   non condensing  15 to 95   non condensing   ATMOSPHERIC PRESSURE 77 to 101kPa  0   7500 ft  N A  PHYSICAL  Dimensions  75    Lx 5 0    W x 3 125    H  19 x 12 7 x 7 9 cm   Weight  Approximately 2 2 lbs   without a humidifier     STANDARDS COMPLIANCE    This device is designed to conform to the following standards       IEC 60601 1 General Requirements for Safety 
7. TOR    System Error Backlights  The device enters the   Device failure Press any of the display  00 00 00    Safe state    in which screen buttons to silence  the device power the alert  Remove the  Screen displays the   remains on  but the power supply cord from  following symbol  airflow is disabled  the device to remove  indicating that power  Plug the cord back  service is required  into the device s power  inlet to restore power  If the  A alert continues to occur   contact your home care  provider     SmartCard Backlights  The device continues   A problem exists   Remove the SmartCard  Error 00  to operate and with the Smart  to clear the alert  Confirm  provide therapy  but   Card inserted in that the card is properly    data logging is un  the accessory oriented  with the arrow   available and FOSQ   slot  The card may   pointing towards the de    is deactivated  be improperly in    vice  as shown below  and  serted or the data   reinsert the SmartCard     may be corrupt     Screen displays the  following flashing  error symbol     If the alert continues to  occur  remove the Smart   Card from the device and  contact your home care  provider  The card may be  corrupt and need to be  replaced        5 2 REMstar Pro M Series User MANUAL    ALERT           AUDIBLE  INDICATOR    Patient  Reminder    VISUAL  INDICATOR    Backlights   999    The words Mask  Leak flash on the  Active Display  screen     The words Auto  Off flash on the  Standby screen   indicating that a  ma
8. a low     resistance  main flow bacteria filter should be installed in line between  the device and the circuit tubing to prevent contamination     To connect your breathing circuit to the device  complete the following steps     1  Connect the flexible tubing to the air outlet on the back of the device  as shown in Figure  3 2        FIGURE 3 2 CONNECTING THE FLEXIBLE TUBING    Note  If required  connect a bacteria filter to the device air outlet  and then connect  the flexible tubing to the outlet of the bacteria filter     REMstar Pro M Series User MANUAL    2  Connect the tubing to the mask     a  Ifyou are using a mask with a built in exhalation port  connect the mask   s connector to  the flexible tubing  as shown in Figure 3 3                    Exhalation Port     4                Mask s  Connector             Flexible  Tubing  Connector    Figure 3 3 CONNECTING A Mask witH BuILT IN EXHALATION PORT    b  Ifyou are using a mask with a separate exhalation device  connect the open end of the  flexible tubing to the exhalation device as shown in Figure 3 4  Position the exhalation  device so that the vented air is blowing away from your face  Connect the mask   s connec   tor to the exhalation device                   Exhalation    Device  ET                   Flexible  Tubing  Connector    FIGURE 3 4 CONNECTING A MASK WITH A SEPARATE EXHALATION DEVICE    Warning  The exhalation device  e g   Whisper Swivel II  or exhalation port  on  masks with an integrated exhalation p
9. ate the warranty  or result in costly  damage     e Periodically inspect electrical cords  cables  and the power supply for damage or signs of wear   Discontinue use and replace if damaged     e To avoid electric shock  unplug the device before cleaning it  DO NOT immerse the device  in any fluids     e Pins of connectors identified with the ESD warning symbol  2 should not be touched   Connections should not be made to these connectors unless ESD precautionary procedures  are used  Precautionary procedures include methods to prevent build up of electrostatic  discharge  e g   air conditioning  humidification  conductive floor coverings  non synthetic  clothing   discharging one   s body to the frame of the equipment or system or to earth or a  large metal object  and bonding oneself by means of a wrist strap to the equipment or system  or to earth     REMstar Pro M Series User MANUAL 1 3    1 3 2 CAUTIONS    A Caution indicates the possibility of damage to the device   The device may only be operated at temperatures between 41   F  5   C  and 95   F  35   C      If this device has been exposed to either very hot or very cold temperatures  allow it to adjust  to room temperature before starting therapy  Condensation may damage the device     Do not immerse the device or allow any liquid to enter the enclosure or the inlet filter   A properly installed  undamaged reusable foam inlet filter is required for proper operation     Tobacco smoke may cause tar build up within the dev
10. com    REMstar Pro M Series User MANUAL    CHAP    TER 2  Device CONTROLS AND DISPLAYS    This chapter describes the device s control buttons and displays  patient circuit connections  and  rear panel connections     2 1 CONTROLS AND DisPLays       Figure 2 1 Primary Controt BUTTONS    These buttons are described below     BUTTON DEscRIPTION       Ramp  When the airflow is on  this button allows you to activate or restart the ramp function  Ramp  lowers the airflow pressure and then gradually increases it  allowing you to fall asleep more easily        Start Stop   This button starts the device s airflow and places the device in the Active state  or stops the  airflow  and places the device in Standby  You can also press this button to exit any setting screen        C Flex          C Flex   This button adjusts the C Flex comfort setting        If you do not want to modify the settings that your home care provider has set for you  you only  need these three buttons to start and stop therapy and do not need to use the display buttons located  under the device cover door     Figure 2 2 shows the device display and navigation buttons that are under the cover door     A  RESPIRONICS    FOSQ   Setup      Figure 2 2 Display Buttons  The display buttons are described below                    BUTTON DESCRIPTION                   Allows you to access the Data screens  Also allows you to navigate to the previous screen when in  the Data or Setup menu     gt   Allows you to access the Da
11. ctions  and error messages     Filter Area A reusable  gray foam filter must be placed in the filter area to  screen out normal household dust and pollens  An optional  white  ultra fine filter can also be used for more complete filtration of  very fine particles     Medical Equipment Note   For ease at airport security stations  there is a note on the bottom  of the device stating that it is medical equipment  It may help if  you also take this manual with you when you travel     Power Inlet Connect the power cord here   Ramp Button This button starts or restarts the ramp cycle   Start Stop Button This button starts or stops the airflow        1 4 1 BREATHING CiRCUIT OVERVIEW    The patient breathing circuit  shown in Figure 1 4  consists of the following    e Circuit tubing to deliver air from the device to your interface  e g   mask    e A mask or other patient interface device to deliver the prescribed pressure to your nose or  nose and mouth  depending on which interface has been prescribed for you    e An exhalation device to vent exhaled air from the circuit    Patient Interface   Typical        H R A   Exhalation Exhalation    Device Port       Mask s  Connector    Ee  Circuit L  gt  Flexible  Tubing Tubing  Connector                                           Circuit with Separate Circuit with Mask with  Exhalation Device Integrated Exhalation Port    Figure 1 4 TypicAt BREATHING CIRCUITS    REMstar Pro M Series User MANUAL    Note  The exhalation port may be part of 
12. e  The instructions in this manual are not intended to super   sede the health care professional   s instructions regarding the use of the device     e The operator should read and understand this entire manual before using the device   e This device is not intended for life support     e The device should be used only with masks and connectors recommended by Respironics  or with those recommended by the health care professional or respiratory therapist  A mask  should not be used unless the device is turned on and operating properly  The exhalation  port s  associated with the mask should never be blocked   Explanation of the Warning  The device is intended to be used with special masks or con   nectors that have exhalation ports to allow continuous flow of air out of the mask  When the  device is turned on and functioning properly  new air from the device flushes the exhaled air  out through the mask exhalation port  However  when the device is not operating  enough  fresh air will not be provided through the mask  and exhaled air may be rebreathed  Re   breathing of exhaled air for longer than several minutes can in some circumstances lead to  suffocation     e     If oxygen is used with the device  the oxygen flow must be turned off when the device is not  in use   Explanation of the Warning  When the device is not in operation and the oxygen flow is  left on  oxygen delivered into the tubing may accumulate within the device   s enclosure  Oxy   gen accumulated in the dev
13. e symbols indicating when certain conditions are turned on or detected will also appear  on the Active Display screen or on the Standby screen  These symbols are described below     SYMBOL DESCRIPTION    I Ramp   You can initiate the ramp feature by pressing the Ramp button   Theramp symbol displays on the Active Display screen when the ramp  function is active                       Mask Mask Leak Alert   This flashing text displays on the Active Display screen  Leak ifthe Mask Alert setting is enabled and the device detects an excessive  mask leak   Auto Auto Off   This flashing text displays on the Standby screen if the Auto   Off Off setting is enabled and the device detects a mask disconnect     SmartCard  This symbol displays if a SmartCard is inserted in the device    lt   ws          If the Smartcard is inserted incorrectly  the symbol will flash intermit   tently   Eai Modem  This symbol displays if a modem is connected to the device      Note  This symbol will vary in appearance depending on the type of  c   modem being used         4  Put on your mask assembly when the air starts to flow     5  Make sure that no air is leaking from your mask into your eyes  If it is  adjust the mask and  headgear until the air leak stops  See the instructions provided with your mask for more  information     Note  A small amount of mask leak is normal and acceptable  Correct large mask  leaks or eye irritation from an air leak as soon as possible     6  If you are using the device w
14. ed or replaced  If the problem  persists  check the DC cord   s fuse following the  instructions supplied with your DC cord  The  fuse may need to be replaced  If the problem    still occurs  contact your home care provider     If you are using a humidifier  make sure you fol   low the instructions for applying power that are  provided with your humidifier     Make sure the device is powered correctly  fol   lowing the instructions on the previous page   If the audible indicator sounds and the button  backlights turn on when you apply power  but  the airflow does not turn on  there may bea  problem with your device  Contact your home  care provider for assistance     Note  When the device is functioning cor   rectly  after you press the d button   the device beeps and the airflow turns  on after a slight delay  This brief delay    is normal        REMstar Pro M Series User MANUAL    PROBLEM Why It HAPPENED WHart to Do    The device s display is The device or Unplug the device and the power supply   erratic  power supply has   Reapply power to the device  If the problem  been dropped continues  relocate the device to an area with  or mishandled  lower EMI emissions  e g   away from electronic  or the device or equipment such as cellular phones  cordless  power supply isin   phones  computers  TVs  electronic games  hair  an area with high   dryers  etc     Electromagnetic  Interference  EMI    If the problem still occurs  contact your home  emissions  care provider for assista
15. em overview   Glossary and symbol key    How to contact Respironics    SYSTEM CONTENTS           User Manual    7    B Reusable Gray Foam  Filter  Disposable Ultra fine    Filter    Figure 1 1 System CONTENTS    Note  If your system includes a humidifier  you will receive additional items with your    package  See the instructions included with your humidifier for more informa   tion     Note  If any of the above items are missing  contact your home care provider     REMstar Pro M Series User MANUAL 1 1    1 2    1 2 INTENDED Use    The Respironics REMstar Pro M Series system is a CPAP  Continuous Positive Airway Pressure   device designed for the treatment of Obstructive Sleep Apnea only in spontaneously breathing    patients weighing  gt  66 lbs  30 kg      The device is to be used only on the instruction of a licensed physician  Your home care provider  will make the correct pressure settings according to your health care professional s prescription     Several accessories are available to make your OSA treatment with the REMstar Pro M Series  system as convenient and comfortable as possible  To ensure that you receive the safe   effective therapy prescribed for you  use only Respironics accessories     1 3 _WARNINGS  CAUTIONS  AND CONTRAINDICATIONS    Caution  U S  federal law restricts this device to sale by or on the order of a physician     1 3 1 WARNINGS    A warning indicates the possibility of injury to the user or the operator     e This manual serves as a referenc
16. evel of pres   sure throughout the breathing cycle     When prescribed for you  the device provides several special features to help make your therapy  more comfortable  The ramp function allows you to lower the pressure when you are trying to fall  asleep  The air pressure will gradually increase until your prescription pressure is reached  You also  have the option of not using the ramp feature at all     Additionally  the C Flex comfort feature provides you with pressure relief during the expiratory  phase of breathing     Several accessories are also available for use with your REMstar Pro M Series device  Contact your  home care provider to purchase any accessories not included with your system        Figure 1 2 REMstar Pro M Series Device    Figure 1 3 illustrates many of the device features  described in the table below     Start Stop  Ramp Button Butt  MEER Flex  Button    4             Power Inlet       Display Screen   under door     Air Outlet       ical   Equipment Note   on bottom  Accessory   Module    Filter Area    Figure 1 3 REMstar Pro M Series System OVERVIEW    REMstar Pro M Series User MANUAL 1 5    Device FEATURE DESCRIPTION    Accessory Module If applicable  insert the optional accessory card here   Connect the flexible tubing here     C Flex Button This button allows you to change the C Flex comfort setting  if  C Flex is prescribed for you  See Chapter 4 for more information  about C Flex     Display Screen Shows therapy settings  patient data  instru
17. filter  insert it into the filter area first  mesh   side facing in  towards the device     2  Insert the gray foam filter into the filter area as shown in Figure 3 1     Note  If you are not using the white disposable filter  simply insert the gray foam filter  into the filter area        Fi N  Disposable Ultra Fine Reusable Gray  Filter  optional  Foam Filter   required     FIGURE 3 1 INSTALLING THE Air FILTER    REMstar Pro M Series User MANUAL 3 1    Note  See Chapter 7  Cleaning and Maintenance  for information on how to clean or  replace the air filters     3 2 WHERE TO PLACE THE Device    Place the device on a firm  flat surface somewhere within easy reach of where you will use it  Make  sure the filter area on the back of the device is not blocked by bedding  curtains  or other items   Air must flow freely around the device for the system to work properly  Make sure the device is  away from any heating or cooling equipment  e g   forced air vents  radiators  air conditioners      3 3 CONNECTING THE BREATHING CIRCUIT    To use the system  you will need the following accessories in order to assemble the recommended  circuit     e  Respironics interface  e g  nasal mask  with integrated exhalation port  or Respironics inter   face with a separate exhalation device such as the Whisper Swivel  II     e  Respironics 6 ft   1 83 m  flexible tubing  e  Respironics headgear  for the patient interface   Warning  If the device is used by multiple persons  e g   rental devices   
18. formation     e A filter area where the filter s  supplied with your device should be inserted    e ADC power inlet where the power cord is connected  see Chapter 3  Setup  for complete  information on supplying power to the device     e The air outlet port where the breathing circuit   s flexible tubing is attached     REMstar Pro M Series User MANUAL    CHAPTER 3  SETUP    This chapter provides instructions on how to   e Install the air filters   e Position the device   e Connect the breathing circuit    e Supply power to the device    3 1  INSTALLING THE AIR FILTERS    Caution  A properly installed  undamaged foam filter is required for proper operation     The device uses a gray foam filter that is washable and reusable  and an optional white ultra fine  filter that is disposable  The reusable filter screens out normal household dust and pollens  while  the optional ultra fine filter provides more complete filtration of very fine particles  The gray reus   able filter must be in place at all times when the device is operating  The ultra fine filter is recom   mended for people who are sensitive to tobacco smoke or other small particles     Two reusable gray foam filters and one disposable ultra fine filter are supplied with the device     If your filters are not already installed when you receive your device  you must at least install the  reusable gray foam filter before using the device     To install the filter s      1  Ifyou are using the white disposable ultra fine 
19. gt   Au You can enable this feature if you want the device to automati           cally turn the airflow off whenever you remove the interface  e g      Feature  ON i  mask  from your airway           Press the   or   buttons to select OFF or ON  If this feature is en   abled  then the words Auto Off appear on the Standby screen if  the device detects that you have removed your mask  The airflow  shuts off  and the Auto Off message continues to appear on the  Standby screen until the condition is corrected     After you have finished modifying the Patient Setup screens  press the d  button to return to the  Standby screen     Note  The Setup menu automatically times out and returns to the Standby screen  after one minute of inactivity     REMstar Pro M Series User MANUAL    4 4 COMPLETING THE FOSQ QUESTIONNAIRE  Note  The FOSQ option only appears on the Standby screen if you have a SmartCard  inserted or amodem connected to the device     From the Standby screen  you can access the FOSQ questionnaire by pressing the     button  The  FOSQ test is a    quality of life    questionnaire designed specifically for people with sleep disorders   The results allow health care professionals to see how therapy has improved the quality of your  life  By completing the questionnaire periodically  you can provide valuable information about  the effectiveness of your treatment  The device can record your answers on the SmartCard or via a  wired or wireless modem for later review by the healt
20. h care professional  Contact your home care  provider for further instructions     Note  If your health care professional or home care provider instructs you to com   plete the questionnaire  he or she will provide you with the questions  and you  can enter your answers into the device  Make sure a SmartCard or modem is  installed before answering the questions  The FOSQ screens will not display if a  SmartCard or modem is not present and able to store data     To answer the FOSQ questionnaire  complete the following steps     1  Make sure that the SmartCard or modem is properly installed  Answers to the questionnaire  are saved onto the SmartCard or sent to the health care professional via a wired or wireless                modem  when available   If you are using a SmartCard  a SmartCard symbol     appears  in the upper right corner of the Active Display screen  If the SmartCard is inserted incor   rectly  this symbol flashes to indicate that the card is incorrectly installed  and the FOSQ  questionnaire will not be available     2  From the Standby screen  press the     button to access the first FOSQ screen  shown in Figure  4 8        FOSQ 1 30             4  012 3 4       Figure 4 8 FOSQ Screen 1 oF 30    Press the   or     button to select your answer to the first question  and an arrow appears over  your answer         0 indicates that you choose 0 as the answer to the question       1 indicates that you choose 1 as the answer to the question       2 indicates that yo
21. hile sleeping  try placing the tubing from the device over your  headboard  This may reduce tension on the mask     Note  Ifyou are having trouble with your mask  refer to the instructions included with  the mask     4 2 REMstar Pro M Series User MANUAL    4 2 Using THE Ramp AND C FLex FEATURES    You can press the      Ramp  button to activate the Ramp feature  or the C Flex button to  change the C Flex setting  if your provider has enabled these features     4 2 1 Ramp FEATURE    The device is equipped with an optional ramp feature that your home care provider can enable or  disable  This feature reduces the air pressure when you are trying to fall asleep and then gradually   increases  ramps  the pressure until your prescription setting is reached  allowing you to fall asleep  more comfortably     If ramp is enabled on your device  after you turn on the airflow  press the J button on the top  of the device  You can use the Ramp button as often as you wish during the night     Note  If the ramp feature is disabled  nothing will happen when you press the  lt   but   ton     4 2 2 C F Lex Comrort FEATURE    The C Flex comfort feature allows you to adjust the level of air pressure relief that you feel when  you exhale during therapy  Your home care provider can enable or disable this feature     4 2 2 1 C FLex ENABLED    When your provider enables C Flex  a C Flex level will already be set for you on the device  If this  is not comfortable for you  you can increase or decrease
22. ice  which may result in the device  malfunctioning     Note  Additional warnings  cautions  and notes are located throughout this manual     1 3 3 CONTRAINDICATIONS    When assessing the relative risks and benefits of using this equipment  the clinician should  understand that this device can deliver pressures up to 20 cm H O  In the event of certain fault  conditions  a maximum pressure of 30 cm H O is possible  Studies have shown that the following  pre existing conditions may contraindicate the use of CPAP therapy for some patients     Bullous Lung Disease  Pathologically Low Blood Pressure  Bypassed Upper Airway  Pneumothorax    Pneumocephalus has been reported in a patient using nasal Continuous Positive Airway Pres   sure  Caution should be used when prescribing CPAP for susceptible patients such as those  with  cerebral spinal fluid  CSF  leaks  abnormalities of the cribriform plate  prior history of  head trauma  and or pneumocephalus   Chest 1989  96 1425 1426     The use of positive airway pressure therapy may be temporarily contraindicated if you exhibit    signs of a sinus or middle ear infection  Not for use with patients whose upper airways are by     passed  Contact your physician if you have any questions concerning your therapy     1 4    REMstar Pro M Series User MANUAL    1 4 System OVERVIEW   The REMstar Pro M Series device  shown in Figure 1 2  is a sleep apnea system that   delivers Continuous Positive Airway Pressure  CPAP   CPAP maintains a constant l
23. ice enclosure will create a risk of fire     REMstar Pro M Series User MANUAL    e Oxygen supports combustion  Oxygen should not be used while smoking or in the presence  of an open flame     e When using oxygen with this system  a Respironics Pressure Valve must be placed in line  with the patient circuit  Failure to use the pressure valve could result in a fire hazard     e Do not use the device in the presence of a flammable anaesthetic mixture in combination  with oxygen or air  or in the presence of nitrous oxide     e Do not use this device if the room temperature is warmer than 95   F  35   C   If the device is  used at room temperatures warmer than 95   F  35   C   the temperature of the airflow may  exceed 106   F  41   C   This could cause irritation or injury to your airway     e Do not operate the device in direct sunlight or near a heating appliance because these condi   tions can increase the temperature of the air coming out of the device     e Contact your health care professional if symptoms of sleep apnea recur     e Ifyou notice any unexplained changes in the performance of this device  if it is making un   usual or harsh sounds  if the device or the power supply are dropped or mishandled  if water  is spilled into the enclosure  or if the enclosure is broken  discontinue use and contact your  home care provider     e Repairs and adjustments must be performed by Respironics authorized service personnel  only  Unauthorized service could cause injury  invalid
24. io sszssssesiecisstacteistuciassiticder san aaa A Aa 1 1  1 1 SYStOMCOMECIES sis ccisscectcistecactsschcsatesscusodssescsstaoszessnessayi  aasteancistaisusscessiesusdseboepibsbetes  V2 MAEMO SOUS AAE A AE  1 3 Warnings  Cautions  and Contraindications  1 3 1 Wa M  N gS sssssisccsscssscisssscccssssesscsssasansagsteascasessagsdatacssesactsantaaacusscvastsansdatesosesuctosesaas  N32 Caut ON Sn n A A N ERR  1 3 3 Contraindicatii ON Saninten a ai ai 1 4  TA SyStEMOVENVIEW seriesas ieena esii nasais i iaire asr asais 1 5  1 4 1 Breathing Circuit Overview     uneossseonssssenssenonsssnenusssennessnonesseennssennnnsene 1 6  T5 GOS AAI ap aa a E ENA IRSD  1 6 Symbol Key  1 7 How to Contact Respironics        eesssesssescsecnsecsecnseessecnsccssecsscesuccnsecssecsseesueenseesneess 1 8  Chapter 2  Device Controls and Displays          ssssssccssscssescssscsssecssscessscesseeessecssneceseecesseesneeeste 2 1  2 1 Controls and Displays        usnesssennsennnsseennnseennensennnnnennnnnsennnnnennnnnennnnnnennnnnennnnnnennn 2 1  2 1 1 Control Panel Inactivity un  en 2 2  22 Rear  Panels nennen an a R  Chapter 3  Setup  a susaseiskniekiiieguninaibspeniibinen nimm A ARa  3 1 Installing the Air Filters  3 2 Where to Place the DeViCe      esssssssssssssssccsssesssessnsccsnscesseesssccsssecsseeeeseecsneessneeesneees 3 2  3 3 Connecting the Breathing Circuit     u   seseennseennnsennnnsennnnsennnnnsennnnnennnnnnennn 3 2  3 4 Supplying Power to the Device        usnsnsennsennnsseensssennnssennnnsenn
25. line  with the patient circuit  Failure to use the pressure valve could result in a fire hazard     Oxygen accelerates fires  Keep the device and the oxygen container away from heat  open  flames  any oily substance  or other sources of ignition  Do not smoke in the area near the  device or the oxygen     When using oxygen with this system  turn the device on before turning on the oxygen  Turn  the oxygen off before turning the device off  This will prevent oxygen accumulation in the  device     If administering fixed flow supplemental oxygen  the oxygen concentration may not be con   stant  The inspired oxygen concentration will vary  depending on the CPAP setting  patient  breathing pattern  and leak rate  Substantial leaks around the mask may reduce the inspired  oxygen concentration to less than the expected concentrations  Appropriate patient monitor   ing should be implemented     REMstar Pro M Series User MANUAL    CHAPTER 7  CLEANING AND MAINTENANCE    This chapter describes how to clean the device and its filters and provides tips on traveling with your  REMstar Pro M Series system     7 1 CLEANING THE DEVICE    Warning  To avoid electrical shock  always unplug the power cord from the wall  outlet or DC power source before cleaning the device   Caution  Do not immerse the device in liquid or allow any liquid to enter the enclo     sure  inlet filter  or any opening   1  Unplug the device  and wipe the outside of the device with a cloth slightly dampened with water  a
26. maximum output power rating of the transmitter in watts  W  according  to the transmitter manufacturer    Note 1  At 80 MHz and 800 MHz  the separation distance for the higher frequency range applies    Note 2  These guidelines may not apply in all situations  Electromagnetic propagation is affected by absorption and reflection from structures   objects  and people        A 2 REMstar Pro M Series User MANUAL    LimitED WARRANTY    Respironics  Inc  warrants that the system shall be free from defects of workmanship and materials  and will perform in accordance with the product specifications for a period of two  2  years from  the date of sale by Respironics  Inc  to the dealer  If the product fails to perform in accordance  with the product specifications  Respironics  Inc  will repair or replace     at its option     the  defective material or part  Respironics  Inc  will pay customary freight charges from Respironics   Inc  to the dealer location only  This warranty does not cover damage caused by accident  misuse   abuse  alteration  and other defects not related to material or workmanship     Respironics  Inc  disclaims all liability for economic loss  loss of profits  overhead  or  consequential damages which may be claimed to arise from any sale or use of this product  Some  states do not allow the exclusion or limitation of incidental or consequential damages  so the  above limitation or exclusion may not apply to you     This warranty is given in lieu of all other exp
27. n in Figure 3 6        Figure 3 6 CONNECTING THE Power SUPPLY CoRD TO THE DEVICE    3 4 REMstar Pro M Series User MANUAL    4  Ensure that all connections are secure     Important  To remove AC power  disconnect the power supply cord from the elec   trical outlet     Warning  Inspect the power cord often for any signs of damage  Replace a dam   aged power cord immediately     3 4 2 Usinc DC Power    The Respironics DC Power Cord can be used to operate this device in a stationary recreational  vehicle  boat  or motor home  The Respironics DC Battery Adapter Cable when used with the  DC Power Cord  enables the device to be operated from a 12 VDC free standing battery     Caution  When DC power is obtained from a vehicle battery  the device should not  be used while the vehicle s engine is running  Damage to the vehicle or the  device may occur     Caution  Only use a Respironics DC Power Cord and Battery Adapter Cable  Use of  any other system may cause damage to the device or vehicle     Refer to the instructions supplied with the DC Power Cord and adapter cable for information on  how to operate the device using DC power     REMstar Pro M Series User MANUAL 3 5    3 5 Comp ete ASSEMBLY EXAMPLE    Figure 3 7 shows an example of how a complete assembly will look  with breathing circuit con   nected and power applied to the device                    Figure 3 7 Finat AssemBLy EXAMPLE  SHOWN WITH OPTIONAL Accessory MoDuLeE     Figure 3 8 shows an example of how you should route yo
28. nce     Device Resets Reboots    The device comes   Such a reset poses no danger to the patient  installed with and assures that the patient receives prescribed   The device shuts down   troubleshooting therapy throughout the night  If there is a pos    and restarts automati  software that sibility of damage to the device  the device will    cally during therapy  automatically shut down permanently  The product will then   This is unlikely to occur     monitors perfor    display the following system error alert symbol  mance  to indicate that the device be returned to the  home care provider for service     A    The Ramp feature does   Your home care If Ramp has not been prescribed for you  dis   not work when you provider did not cuss this feature with your home care provider  press the Ramp button   prescribe Ramp for   to see if they will change your prescription    I  you  or your CPAP  pressure is already   If your provider has enabled Ramp  but the  set to the mini  feature still does not work  check the CPAP set   mum setting  ting on your Active Display screen  If CPAP is set  to the minimum setting  4 0 cm H O   theRamp  feature will not work        REMstar Pro M Series User MANUAL 5 5    PROBLEM    The device has fallen off  your table or nightstand     Why It HAPPENED    The device may  not have been  properly seated  on the nightstand   or the placement  of the tubing may  have caused the  device to fall     Whar to Do    Always make sure your device is placed ona
29. nd a mild detergent  Let the device dry completely before plugging in the power cord     2  Inspect the device and all circuit parts for damage after cleaning  Replace any damaged parts     7 2 CLEANING OR REPLACING THE FILTERS  Caution  Operating the device with a dirty filter may keep the system from working prop   erly and may damage the device     Under normal usage  you should clean the gray foam filter at least once every two weeks and replace it  with a new one every six months  The white ultra fine filter is disposable and should be replaced after  30 nights of use or sooner if it appears dirty  DO NOT clean the ultra fine filter     Caution  Dirty inlet filters may cause high operating temperatures that may affect device perfor   mance  Regularly examine the inlet filters as needed for integrity and cleanliness     1  If the device is operating  stop the airflow by pressing the d  button   Disconnect the device from the power source      2  Remove the filter s  from the enclosure by gently squeezing the filter      in the center and pulling it away from the device  as shown in Figure  7 1    3  Examine the filter s  for cleanliness and integrity      4  Wash the gray foam filter in warm water with a mild detergent  Rinse Figure 7 1 REMOVING THE  thoroughly to remove all detergent residue  Allow the filter to air dry FILTERS       completely before reinstalling it  If the foam filter is torn  replace it    Only Respironics supplied filters should be used as replacemen
30. nd the setting is not comfortable for you   you can increase or decrease the setting by pressing the   or    buttons  The setting of 1 provides a small amount of pres   sure relief  with higher numbers providing additional relief   Press the   or     buttons to increase or decrease the setting      gt    C Flex Setting             Ne    1              gt    _ If your provider has disabled C Flex  you cannot enable or ad   C Flex Setting g   h   ae  just the setting  The screen shown at left displays to indicate  eat neuen al that C Flex is disabled   isabled on this unit              REMstar Pro M Series User MANUAL 4 7       3  Ramp Starting Pressure Screen   You can increase or decrease the ramp starting pressure in 0 5 cm  4 0 cmH20 H O increments by pressing the   or   buttons  The default setting  is 4 cm H O  You can adjust the setting from 4 cm H O to the CPAP  pressure setting        gt   Ramp Start Pres                Note  This screen will not display if your provider has not en   abled Ramp on your device           Mask Alert  gt  4  Mask Alert Screen  You can enable or disable the mask alert setting by pressing the    Feature  ON or     buttons to select OFF or ON  If this feature is enabled  then the             words Mask Leak appear on the Active display screen if a signifi   cant mask leak is detected  and an audible alert sounds     Note  Ifyour physician indicates that the Mask Alert is neces   sary for you  do not disable it        5  Auto Off Screen       
31. nnssennnnsennnnnsennn 3 4  SATTUSIN AC ROWE seisein a a TAR 3 4  34 2  USING DG POW E E A renden 3 5  3 5 Complete Assembly Example          sssssssscsseessssssecssscesseecssecssscsseeceseecsneessneeesseees 3 6  Chapter 4  Device Operation  4 2 Using the Ramp and C Flex Features    csscsssssccsssecsseessssnssessseesesseesesuneeesnsees 4 3  4 2 1 Ramp Feature sissscssssseacssnssessesesesceescsansesssstoazsansans  attsssassivenndeassndessssnedtesctesieensesd 4 3  4 2 2 C Flex Comfort Feature       csesssssecsssecssesesseecsncesseeecstecsssesseeceseecsneessneeesneees 4 3  42 21 G Flex Ema led ssscsscsessssssscecseactasastasvssiaesweaaciisidisshecesnatscde a 4 3  4 2 2 2 C Flex Disabled oe sesssssscssssscsscccsseessteccseccssccsseeceseecsneecsneeesneeesseees 4 4    REMstar Pro M Series User MANUAL i    4 3 Changing the Device Settings           nenseenennnnssennnssennnnennnnesennnnssnennnsennnnsenunne             4 3 1 Navigating the Display Screens      uunnesseeneeennsseennsseennssseennnssennnssennnnee  4 3 1 1 Viewing Data on the Patient Data Screens  4 3 1 2 Viewing and Modifying Patient Setup Screens    4 7  4 4 Completing the FOSQ Questionnaire         unsensensseeenneonnnnseennnnennnnssennnnsennnnn 4 9  4 5 Patient Reminder Screen         sssssssssscesssccssssecssssscessssecseseecesstecessssesssnsesesaseesseseeees 4 10  Chapter 5  Device Alerts and Troubleshooting            uasessenseennsseonnsseennsssennnnsennnnseennnnee 5 1  5 1 Device Alei sesisccssvescecsisectizscctss
32. nt Reminder       Check your mask  a new one  may be available  Call your  provider              Figure 4 9 Patient REMINDER SCREEN    REMstar Pro M Series User MANUAL    CHAPTER 5  Device ALERTS AND TROUBLESHOOTING    This chapter describes the device alerts and also provides troubleshooting information for issues  you may run into when using the device     5 1 Device ALERTS    The device provides two alert levels  high and medium priority     e High Priority     These alerts require immediate operator response  The alert signal consists  of a high priority sound  which is a continuous two beep pattern  indicated in the following  table as  e e e e   Additionally  the backlights on the buttons will provide a high priority  flashing pattern consisting of a continuous  bright to off  two flash pattern  indicated in the  following table as  00 00 00      e Medium Priority     These alerts require prompt operator response  The alert signal consists  of a medium priority sound  which is a continuous one beep pattern  indicated in the fol   lowing table as    e   Additionally  the backlights on the buttons will provide a medium  priority flashing pattern consisting of a continuous  bright to dim  one flash pattern  indi   cated in the following table as  9 0 9      REMstar Pro M Series User MANUAL 5 1    ALERT SUMMARY TABLE    The following table summarizes the high and medium priority alerts     ALERT AUDIBLE VISUAL Device ACTION PossiBL   E CAUSE Patient ACTION  INDICATOR INDICA
33. of Medical Electrical Equipment      ENISO 17510 1 Sleep Apnea Breathing Therapy Devices    ELECTRICAL  AC Power Consumption  100     240 VAC  50 60 Hz  1 0 A max   DC Power Consumption  12 VDC  3 0 A max     Type of Protection Against Electric Shock  Class II Equipment  Degree of Protection Against Electric Shock  Type BF Applied Part  Degree of Protection against Ingress of Water  Device  Drip Proof  IPX1  AC Power Supply  Drip Proof  IPX1  Mode of Operation  Continuous    Electromagnetic Compatibility  The device meets the requirements of EN 60601   1 2  2nd edition     Fuses  There are no user replaceable fuses     REMstar Pro M Series User MANUAL 8 1    8 2    PRESSURE    Pressure Increments  4 0 to 20 0 cm H O  in 0 5 cm H O increments     Pressure Stability     lt 10 0 cm H O  40 5 cm H O    210 0 to 20 0 cm H O   1 0 cm H O    Measured in accordance with EN ISO 17510 1   1 3  2 3  and Pmax with BPM set to 10  15   and 20 BPM   20   C    5   C   50  RH   5    and an atmospheric pressure of 101 54 kPascals     Maximum Flow  35 LPM    Measured in accordance with EN ISO 17510 1   1 3  2 3  and Pmax with BPM set to 10  15   and 20 BPM   23   C   2   C   50  RH   5    and an atmospheric pressure of 101 54 kPascals     DISPOSAL    Dispose of the device in accordance with local regulations     REMstar Pro M Series User MANUAL    Arpenod  x A  EMC INFORMATION    GUIDANCE AND MANUFACTURER S DECLARATION   ELECTROMAGNETIC EMISSIONS     This device is intended for use in the  elec
34. ort  is designed to exhaust CO   from the patient circuit  Do not block or seal the ports on the exhala   tion device     Warning  If you are using a full face mask  i e   a mask covering both your mouth  and your nose   the mask must be equipped with a safety  entrain   ment  valve     3  Attach the headgear to the mask  See the instructions that came with your headgear     REMstar Pro M Series User MANUAL 3 3    3 4 SuppLyinc Power To THE DEVICE    You can power the device using AC or DC power     Caution  If this device has been exposed to either very hot or very cold tempera   tures  allow it to adjust to room temperature before beginning the  following setup procedures     Warning  Route the wires to avoid tripping     Warning  This device is activated when the power cord is connected  Pressing  the  ly button turns the airflow on or off     Important  Ifyou are using your device with a humidifier  refer to the instructions  included with your humidifier for details on how to power the device  and humidifier     3 4 1 Usinc AC Power    Complete the following steps to operate the device using AC power     1  Plug the socket end of the AC power cord into the power supply  as shown in Figure 3 5        Figure 3 5 CONNECTING THE POWER CorD To THE Power SUPPLY    2  Plug the pronged end of the AC power cord into an electrical outlet that is not controlled by  a wall switch     3  Plug the power supply cord   s connector into the power inlet on the back of the device  as  show
35. provider    may periodically ask you for this information     System Leak Screen   This screen displays a 7 day and 30 day average of the leak history  for the device in liters per minute  LPM   System leak is a combina   tion of intentional and unintentional air leak  Intentional leak is the  expected leak at the exhalation port  Some leak is required to mini   mize CO  rebreathing  Unintentional leak occurs around the patient  interface  If you see a large increase in the amount of leak indicated  here  contact your home care provider for assistance     Note  This screen only displays if your home care provider has  enabled it  It is only for reference  Your home care provider    may periodically ask you for this information     Apnea Hypopnea Index Screen  This screen displays your Apnea Hypopnea index  AHI  for the last 7  and 30 days     Note  This screen only displays if your home care provider has  enabled it  It is only for reference  Your home care provider    may periodically ask you for this information     Compliance Check Value Screen   This screen displays a number used by your home care provider to  validate that the data provided by you is the data taken from the  Summary Data Screen  This is a    read only    screen and you cannot  change the number on the screen     Note  This screen is only for reference  Your home care provider    may periodically ask you for this information     Summary Data Screen   This screen displays the total therapy hours for the de
36. r mask  fitting  etc     This is caused by  a nasal reaction to  the airflow     The air is too dry     You may have a  sinus or middle ear  infection     Wuat to Do    Clean or replace the air filters as described in  Chapter 7     The temperature of the air may vary somewhat  based on your room temperature  Make sure  that the device is properly ventilated  Keep   the device away from bedding or curtains that  could block the flow of air around the device   Make sure the device is away from direct sun   light and heating equipment     If the problem continues  contact your home  care provider     If you experience any issues with your mask   refer to your mask instructions for information  on proper fitting  etc  If the problem continues   contact your home care provider     Call your health care professional     Increase the room humidity  Consult with your  health care professional about using a Respi   ronics humidifier with the device  If you have  a humidifier  refer to the instructions included  with your humidifier to make sure it is working  properly    Stop using the device and contact your health  care professional        REMstar Pro M Series User MANUAL    CHAPTER 6  ACCESSORIES    Contact your home care provider for additional information on the accessories available for your  REMstar Pro M Series system  When using optional accessories  always follow the instructions  enclosed with the accessories     6 1 ADDING A HUMIDIFIER    You can use the M Series Heated h
37. ress warranties  In addition  any implied warranties      including any warranty of merchantability or fitness for the particular purpose     are limited   to two years  Some states do not allow limitations on how long an implied warranty lasts  so the  above limitation may not apply to you  This warranty gives you specific legal rights  and you may  also have other rights which vary from state to state     To exercise your rights under this warranty  contact your local authorized Respironics  Inc  dealer  or contact Respironics  Inc  at     1001 Murry Ridge Lane  Murrysville  Pennsylvania 15668 8550  1 724 387 4000    
38. retically with accuracy  To assess the electromagnetic environment due to  fixed RF transmitters  an electromagnetic site survey should be considered  If the measured field strength in the location in which the device is  used exceeds the applicable RF compliance level above  the device should be observed to verify normal operation  If abnormal performance  is observed  additional measures may be necessary  such as re orienting or relocating the device    Over the frequency range 150 kHz to 80 MHz  the field strengths should be less than 3 V m        RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND Mo    LE RF Communications EQUIPMENT AND This Device   The device is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled  The customer or  the user of this device can help prevent electromagnetic interference by maintaining a minimum distance between portable and mo   bile RF communications equipment  transmitters  and this device as recommended below  according to the maximum output power  of the communications equipment     Raten Maximum Power SEPARATION DISTANCE ACCORDING TO FREQUENCY OF TRANSMITTER  OUTPUT oF TRANSMITTER    Ww  150 KHz To 80 MHz 80 MHz to 800 MHz 800 MHz To 2 5 GHz    d 1 2 P d 1 2 P d 2 3 P    For transmitters rated at a maximum output power not listed above  the recommended separation distance din meters  m  can be estimated using  the equation applicable to the frequency of the transmitter  where P is the 
39. screen by     FOSQ   Setup   pressing the   gt  or buttons                 Note  You can access the Patient Setup screens by pressing the    button  and the FOSQ questionnaire by pressing the     but   ton  as described later in this chapter     Note  The FOSQ option only appears if a SmartCard is inserted or  a modem is connected to the device          th erapy Usage  gt  2  Therapy Usage Screen l l  INK This screen displays the number of hours that the device provided  Teana  z0 therapy  as 7 day and 30 day averages  The maximum value that can    i be displayed for both averages is 24 hours                 Note  This screen is only for reference  Your home care provider  may periodically ask you for this information     REMstar Pro M Series User MANUAL 4 5       a Sessions  gt  4 id       5 Sessions  8 Sessions    7 Days   30 Days                 System Leak       L min  7 Day Avg  0 0  30 Day Avg  0 0                       Apn Hyp Index        AHI   0 0  AHI   0 0    7 Day Avg   30 Day Avg                                   gt   Compliance Check  3467     gt     Summary Data          Therapy Hours  0 12  Blower Hours  0 12  Total Sessions  0          Sessions Greater than 4 Hours Screen   This screen displays the number of device therapy sessions that  exceeded 4 hours in 7 day and 30 day periods  The maximum value  for the 7 day period is 35 sessions  while the maximum value for the  30 day period is 150 sessions     Note  This screen is only for reference  Your home care 
40. sk disconnect  has been detected     Backlights   9 9 9    Screen displays   a customized  reminder message  whenever the de     vice transitions from    the Active state to  the Standby state     REMstar Pro M Series User MANUAL    Device ACTION    The device continues  to operate     The airflow shuts  off and the device  enters the Standby  state approximately  45 60 seconds after  detection     The device continues  to operate     PossiBL   E CAUSE    The breathing  circuit is discon   nected or there is  a large air leak     The mask has  been removed     Your home care  provider may   set a patient  reminder sched   uled to pop up at  a particular time  to remind you   to replace your  mask  change  your filters  etc        PATIENT ACTION    Check your breathing  circuit connections and re   connect the tubing if it has  come loose  Press any of  the display buttons to clear  the alarm  Make sure your  mask is on properly before  you press the d button to  restart the airflow     If the alert continues to  occur  disable the mask  alert setting following the  instructions in Chapter 4   and continue your therapy  overnight  Contact your  home care provider the  next morning to have your  mask checked  You may  need a mask refitting     Put your mask back on    and press the    button  to turn the airflow on and  resume therapy     Press any of the display  buttons to acknowledge  the message and clear it  If  you do not acknowledge  the reminder  it will disap   pear af
41. t filters   p ieee  5  Ifthe white ultra fine filter is dirty or torn  replace it      6  Reinstall the filters  inserting the white ultra fine filter first if applicable  as      shown in Figure 7 2        Caution  Never install a wet filter into the device  It is recommended  that you clean the filter in the morning and alternate using rn nn eat  the two foam filters provided with the system to ensure ee  sufficient drying time for the cleaned filter  FIGURE 7 2 REINSTALLING    THE FILTERS    REMstar Pro M Series User MANUAL 7 1    7 2    7 3 CLEANING THE TUBING    Clean the tubing daily  Disconnect the flexible tubing from the device  Gently wash the tubing in a  solution of warm water and a mild detergent  Rinse thoroughly  Air dry     7 4 SERVICE       The REMstar Pro M Series device does not require routine servicing     Warning  If you notice unexplained changes in the performance of this device  if it is  making unusual or harsh sounds  if the device or power supply have been  dropped or mishandled  if the enclosure is broken  or if water has entered the  device  discontinue use  and contact your home care provider     7 5 TRAVELING WITH THE SYSTEM    When traveling  the carrying case is for carry on luggage only  The carrying case will not protect the  system if it is put through checked baggage     For your convenience at security stations  there is a note on the bottom of the device stating that it is  medical equipment  It may be helpful to bring this manual along
42. ta screens  Also allows you to navigate to the next screen when in the  Data or Setup menu     Allows you to enter the FOSQ screens  and also allows you to decrease the settings on the setup screens      Allows you to enter the Setup screens  Also allows you to increase the settings on the setup screens              REMstar Pro M Series User MANUAL 2 1    The device s display screen shows the set pressure  patient data  instructions  and error messages   See Chapter 4 for instructions on navigating the display screens     Figure 2   3 provides a view of the entire device control panel  with the cover door open                   Oo   Placement Area  p    y for Optional Quick  i i Reference Label  Cover Door A pok  ff bo  Previous Next  Screen      gt        Screen      amp  Bee  Button       Button         Decrease        Increase  Button N   Button   OA         S IN  Ramp  Button a C Flex  Button    Button    Figure 2 3 Device ContROL PANEL    2 1 1 ControL PANEL INACTIVITY    Some screens have time out periods  The screen   s timer starts when the screen is initially displayed  and is restarted whenever a button is pressed  The screen times out after one minute if there is no  activity and returns to the Standby screen     2 2 Rear PANEL       Accessory Slot Filter Area    F  sure 2 4 REMstar Pro M Series REAR PANEL    The rear panel contains the following    e An accessory slot for optional accessories such as the SmartCard or modem  see Chapter 6   Accessories  for more in
43. ter 6 minutes  and  then reappear for three  consecutive days whenever  the device transitions from  the Active state to the  Standby state  If you still do  not acknowledge the mes   sage  the reminder period  will reset and the message  will not reappear until   the next time the Patient  Reminder setting expires     5 3    5 2 TROUBLESHOOTING    The table below lists some of the problems you may experience with your device or mask and pos   sible solutions to those problems     PROBLEM    Nothing happens when  you apply power to the  device  The audible in   dicator does not sound  and the backlights on    the buttons do not light     The device does not  operate when you press  the d button  The air   flow does not turn on     Why It HAPPENED    There s no power  at the outlet or  the device is un     plugged     There may be a  problem with the  blower     Wuat to Do    If you are using AC power  check the outlet  power and verify that the device is properly  plugged in  Make sure the AC power cord is  connected correctly to the power supply and  the power supply cord is securely connected to  the device s power inlet  If the problem contin   ues to occur  contact your home care provider   Return both the device and power supply to  your provider  so they can determine if the  problem is with the device or power supply     If you are using DC power  make sure your DC  power cord and battery adaptor cable con   nections are secure  Check your battery  It may  need recharg
44. the interface or may be part of a separate  exhalation device  but is required to minimize the potential for CO  rebreathing     1 5 GLOSSARY    The following terms and acronyms appear throughout this manual     Term AcRONYM DEFINITION    Active State The state of the device when power is applied  the airflow is on  and the  device is providing therapy                    Apnea A condition marked by the cessation of spontaneous breathing    Auto Off When this feature is enabled  the device automatically discontinues  therapy whenever the mask is removed    Auto On With this feature  the device automatically initiates therapy when you  begin breathing on the device  This feature is always enabled    BPM Breaths Per Minute   C Flex A therapy feature that provides pressure relief during exhalation  if    enabled by your home care provider        Compliance Check   Represents a code used by the home care provider to determine the          Value accuracy of reported data   CPAP Continuous Positive Airway Pressure  FOSQ Functional Outcomes of Sleep Questionnaire   A   quality of life    ques     tionnaire designed specifically for people with sleep disorders  The  results allow health care professionals to assess how CPAP therapy has  improved the quality of their patients    lives     LPM Liters Per Minute  OSA Obstructive Sleep Apnea    Patient Data Menu   The display mode in which you can view certain stored information   such as therapy usage hours              Patient Setup Men
45. this device should make sure it is used in such an environment     Immunity Test IEC 60601 Test LeveL Comptiance LeveL ELECTROMAGNETIC ENVIRONMENT  GUIDANCE    Portable and mobile RF communications equipment should be  used no closer to any part of the device  including cables  than the  recommended separation distance calculated from the equation  applicable to the frequency of the transmitter     Recommended separation distance   Conducted RF 3 Vrms d 1 2 P   IEC 61000 4 6 150 kHz to 80 MHz  d 1 2JP _80MHzto 800 MHz   Radiated RF 3V m d 23 P   800 MHzto 2 5 GHz   IEC 61000 4 3 80 MHz to 2 5 GHz  where P is the maximum output power rating of the transmitter in  watts  W  according to the transmitter manufacturer and d is the  recommended separation distance in meters  m      Field strengths from fixed RF transmitters  as determined by an  electromagnetic site survey     should be less than the compliance  level in each frequency range        Interference may occur in the vicinity of equipment marked with  the following symbol   u     NOTE 1 At 80 MHz and 800 MHz  the higher frequency range applies    NOTE 2 These guidelines may not apply in all situations  Electromagnetic propagation is affected by absorption and reflection from structures    objects  and people    a Field strengths from fixed transmitters  such as base stations for radio  cellular cordless  telephones and land mobile radios  amateur radio  AM  and FM radio broadcast and TV broadcast cannot be predicted theo
46. to   rectly and doesn t  the device  seal properly     REMstar Pro M Series User MANUAL    Wuat to Do    If you are not using a humidifier  you cannot  connect your tubing to the device without the  detachable air outlet port  shown below     You must have the port attached properly  before connecting your tubing     Remove the port and reattach it to make sure  it s properly installed     To remove the port    a  Put your thumb underneath the port and  insert your index finger into the port open   ing    Pivoting from the bottom  unsnap the port  and pull it away from the device     To properly reattach the port    a  Make sure it is correctly oriented  with the  port opening at the top   and insert the  two latches at the bottom of the port into  the openings on the bottom of the device   Push the top of the port down to snap it  into place     Reattach your tubing  turn on the airflow  and  check to make sure you do not still feel air com   ing out of the port area        PROBLEM    The air out ofthe mask  is much warmer than  usual     The mask feels uncom   fortable to wear  there    is significant air leakage  around the mask  or you  experience other mask   related issues     You have a runny nose     You have throat or nose  dryness     You experience nasal   sinus  or ear pain     Why It HAPPENED    The air filters may  be dirty     The device may be  operating in direct  sunlight or near a  heater     This could be due  to improper head   gear adjustment  or imprope
47. tromagnetic environment specified below  The user of this device should make sure it is used in such an environment     COMPLIANCE    Emissions TEST    RF emissions  CISPR 11    Group 1    ment     ELECTROMAGNETIC ENVIRONMENT   GUIDANCE    The device uses RF energy only for its internal function  Therefore  its RF emissions  are very low and are not likely to cause any interference in nearby electronic equip     RF emissions Class B The device is suitable for use in all establishments  including domestic establish   CISPR 11 ments and those directly connected to the public low voltage power supply    z ag network   Harmonic emissions Class A  IEC 61000 3 2  Voltage fluctuations Flicker emissions Complies  IEC 61000 3 3       GUIDANCE AND MANUFACTURER   S DECLARATION   ELECTROMAGNETIC IMMUNITY     This device is intended for use in the    electromagnetic environment specified below  The user of this device should make sure it is used in such an environment     IMMUNITY TEST    Electrostatic  Discharge  ESD     IEC 61000 4 2    Electrical fast  Transient burst    IEC 61000 4 4    Surge  IEC 61000 4 5    Voltage dips  short interrup   tions and voltage variations on  power supply input lines    IEC 61000 4 11    Power frequency  50 60 Hz   magnetic field    IEC 61000 4 8    IEC 60601 Test  LEVEL     6 kV contact     8 kV air     2 kV for power supply lines     1 kV for input output lines     1 kV differential mode     2 kV common mode     lt 5  U      gt 95  dip in U   for   0 5
48. u   The display mode in which you can change patient adjustable device  settings  such as the ramp starting pressure        Ramp A feature that may increase patient comfort when therapy is started  The  ramp feature reduces pressure and then gradually increases the pres   sure to the prescription setting so you can fall asleep more comfortably           Safe State The state in which the device does not provide therapy  The device  enters this state if an error is detected    Standby State The state of the device when power is applied but the airflow is turned  off                 REMstar Pro M Series User MANUAL 1 7    1 8    1 6 Symeot Key    The following symbols appear on the device and power supply         SYMBOL DEFINITION     2  Consult accompanying instructions for use     me DC Power    e  Type BF Applied Part   Oo  Class II  Double Insulated                       IPX1 Drip Proof Equipment  A Electrostatic Discharge  Arad  Q  Canadian US Safety Certification  Cc US       TUV Safety Standard Compliance          AA US UL Recognized for Canada and the United States    No User Serviceable Parts                To have your device serviced  contact your home care provider  If you need to contact Respironics  directly  call the Respironics Customer Service department at 1 800 345 6443 or  1 724 387 4000  You can also use the following address     Respironics  1001 Murry Ridge Lane  Murrysville  Pennsylvania    15668 8550 USA    Visit Respironics web site at  www respironics 
49. u choose 2 as the answer       3 indicates that you choose 3 as the answer         4 indicates that you choose 4 as the answer     REMstar Pro M Series User MANUAL 4 9    3  After you answer the first question  press the  gt  button to access the next FOSQ screen and  continue answering each question  If you need to go back to a previous screen  press the  amp   button     4  There are 30 FOSQ questions  Once you have reached the last question  press the  gt  button  to save your answers and exit the questionnaire     4 5 Patient REMINDER SCREEN   Your home care provider may set a patient reminder that will appear periodically to alert you  to take certain actions  such as replacing your mask  A message will appear whenever the device  transitions from the Active Display to the Standby state if the period of time specified by your  provider has expired     You can acknowledge the message by pressing any of the display buttons           gt  or     If you  do not acknowledge the message within six minutes of it appearing on the screen  it will time  out and disappear  The message will continue to display for three consecutive days whenever the  device transitions from Active to Standby until it is acknowledged  If  after three days  you still  have not acknowledged the message  then the reminder period will reset and no more reminders  will display until the next time the patient reminder setting expires     Figure 4 9 shows an example of a patient reminder message        Patie
50. umidifier or the M Series Pass over humidifier with your de   vice  They are available from your home care provider  A humidifier may reduce nasal dryness and  irritation by adding moisture  and heat  if applicable  to the airflow     Caution  For safe operation  the humidifier must always be positioned below the  breathing circuit connection at the mask and the air outlet on the device   The humidifier must be level for proper operation     Refer to the humidifier   s instructions for complete setup information     6 2 USING THE SMARTCARD    Some REMstar Pro M Series systems come with a SmartCard accessory module installed in the  accessory slot on the back of the device to record information for the home care provider  Your  home care provider may ask you to periodically remove the SmartCard and send it to him her for  evaluation     Note  The SmartCard does not need to be installed for the device to work properly   The SmartCard records device usage information for use by your home care  provider  Contact your provider if you have any questions about the SmartCard     REMstar Pro M Series User MANUAL 6 1    6 2    6 3 ADDING SUPPLEMENTAL OXYGEN    Oxygen may be added at the mask connection  Please note the warnings listed below when using    oxygen with the device     WARNINGS    When using oxygen with this system  the oxygen supply must comply with local regulations  for medical oxygen     When using oxygen with this system  a Respironics Pressure Valve must be placed in 
51. ur tubing and situate your device on  your nightstand for the best setup possible  This will help prevent the device from falling off your  nightstand or table        Figure 3 8 RECOMMENDED DEVICE AND TUBING PLACEMENT    3 6 REMstar Pro M Series User MANUAL    CHAPTER 4  Device OPERATION    This chapter explains how to start the device and change the settings     4 1 STARTING THE DEVICE    1  Plug the device in to an AC or DC power source  The three primary buttons light up and the  Software Version screen momentarily appears  shown in Figure 4 1             RESPIRONICS  V 1 0                FIGURE 4 1 SOFTWARE VERSION SCREEN    Note  Version 1 0 shown in Figure 4 1 is an example  Your device may have a different  software version installed     2  The next screen to appear is the Standby  or Inactive  screen  shown in Figure 4 2  You can  access the FOSQ questionnaire or patient settings and data from this screen  See Section 4 3  for instructions on how to navigate the display screens     2   RESPIRONICS    FOSQ   Setup                     FIGURE 4 2 STANDBY SCREEN    Note  The FOSQ option will only appear on the Standby screen if a SmartCard is  inserted in the device or if a modem is connected     REMstar Pro M Series User MANUAL 4 1    3  Press the d button to turn on the airflow  The Active Display screen appears  shown in  Figure 4 3         lt     15 0 emo    Figure 4 3 Active Dispcay  WiTH SmartCarb              The Active Display screen shows the set pressure     Som
52. vice  the total  blower hours  and the total number of sessions greater than 4 hours  since the device was last reset by the home care provider  This is  a   read only    screen and you cannot change the numbers on the  screen     Note  This screen is only for reference  Your home care provider    may periodically ask you for this information     REMstar Pro M Series User MANUAL    4 3 1 2 Viewing AND Mobpiryine PATIENT SETUP SCREENS  Figure 4 7 shows how to navigate the Patient Setup screens        RESPIRONICS    FOSQ   Setup               Press         Press  lt   C Flex Setting  gt   Press  gt   Fr    z  123 N       autoof                        K  gt   Ramp Start Pres                      Feature  ON 4 0 cmH20    ev      MaskAler     J    Feature  ON                      F  sure 4 7 NAVIGATING THE PATIENT SETUP SCREENS    The Patient Setup screens are described below              1  Standby Screen  The Standby screen appears when you first apply power to the  RESPIRONICS device  You can access the Patient Setup menu from this screen by    FOSQ   Setup   pressing the   button  Once inside the Setup menu  press the  gt        or   buttons to cycle through the screens        2  C Flex Setting Screen  This screen displays the C Flex level set by your home care   3 provider  This setting allows you to adjust the level of air pressure   relief that you feel when you exhale during therapy  Your home   care provider will either enable or disable C Flex      If C Flex is enabled a
53. vvesstxicctevisecss sect vecse  sdensssechsvdens  isectar  cone  itensszcetaies   5 1  5 2 1ro  ubleshooting  uu eekseieee lea 5 4  Chapter 6  Accessories  6 1 Adding a Humidifier ccs sscossdsexsasdecsnsssarsassctonasecossas niet eanaeekennn anderen ner mas en 6 1  6 2  Using the SmartCard cocisccacissciesssecoodsesiess Stosvesdonsssitans estoayeettous iteaveedaasi ideas ssteaverddent 6 2  6 3 Adding Supplemental Oxygen          sssccsssccsssscsseecssscecessecsssnseessnsescesseessnseesease 6 2  Chapter 7  Cleaning and Maintenance         sescsnssscssssssessseeesnssecesueessnseeeesuseessnseessnaseeesueessnssees 7 1  2 1 Cle  ning the Device    here nie in when pa 7 1  7 2 Cleaning or Replacing the Filters           usnennseennssennnnseennnneennnrsennnnreennnntenn 7 1  7 3 Cleaning the Tubing  TAP SOUN S E A EE EE E A OSE E  7 5 Traveling with the System        ssssssssccssssecssseecessseecsnseecesseccessssecsnsescessneecsnsecenseeeess 7 2  7 5 1 International Travel         sssssscsssssccssssecssseecessecsssseecsssecessseessnseceessseeesnseessees 7 2  Chapter  8  Specifications visctssssiaiciscisessiastessdadeartieast an na iaa ENa 8 1  Appendix A  EMC Information      csssscssssccssesssssscssecssssesssecsnseessesesssecsssccenecesscessneessueeesneeesseeeseeesses A 1    REMstar Pro M Series User MANUAL    CHAPTER 1  INTRODUCTION    This chapter provides information on     1 1    REMstar Pro M Series system contents  Intended Use   Warnings  cautions  and contraindications  Syst
    
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