Ambulatory Blood Pressure Monitor
Contents
1. Hem Part Number Description rr o 650 0399 00 672 0171 01 211 0087 01 211 0051 00 176 5072 00 176 5073 00 166 0007 00 337 0176 00 348 0196 00 2x MANIFOLD ASSY 90217 ASSEMBLY ECB 90217 CASE BOTTOM REAR CASE DOOR BATTERY COVER CASE TOP FRONT CONTACT BATTERY SINGLE INSULATOR BATTERY PUMP ASSY 3V 3700 RPM TBG PLSTC S RBA 104 ID 192 SCREW MAC 2 56 FLAT 82 STL WIRE STRND 24 PVC BLACK 7 WIRE STRND 424 PVC RED 7 TUBING SILICONE 078 ID 125 O SHIELD ESD 90217 GASKET SEAL 90217 ABP Monitor Drawing 1 Main Assembly P N 650 0398 00 Sheet 1 of 2 070 0502 00 Rev E 90217 ABP Monitor 9 MORF EN DETAIL B SCALE 2 1 VIEW 3 90217 ABP Monitor Drawing 1 Main Assembly P N 650 0398 00 Sheet 2 of 2 070 0502 00 Rev E 90217 ABP Monitor 8 2x DIODE PHOTO OP293A 16MW 60DEG D1 D2 SWITCH REED AXIAL LEAD SW1 DISPLAY LCD 4 DIGIT 7 SEG DIS1 SPRING GROUNDING ABP WSHA PLAIN CLUTCH SPINDAL ACET STANDOFF HEX 2 56X 095F 2 56X STANDOFF 3 16 HEX 2 56 1 8 L A 90217 ABP Monitor Drawing 2 ECB Assembly P N 672 0171 01 Sheet 2 of 2 070 0502 00 Rev E2. Make certain that all folds in the bladder are removed prior to inserting it back inside the cuff e The bladder may be installed with the hose exiting the second cuff opening However the bladder must be positioned with its long side toward the center of the cuff e 4 1 Ambulatory Blood Pressure Monitor Air Bladder Removal second cuff opening self applied cuffs long side of bladder o ee m oe ow oe oe oe non patient contact side outside second cuff opening Air Bladder Reinstallation 4 2 Maintenance Calibration Check To verify calibration of the 90217 ABP Monitor 1 Obtain a full size mercury sphygmomanometer manometer or aneroid gauge 2 Disconnect the cuff hose from the monitor 3 Connect the T tube P N 016 0040 00 to the monitor luer connector and the manometer cuff wrapped around cylinder 4 Wrap and fasten the cuff around a rigid cylinder such as a bottle that is approximately 6 inches long 15 3 cm and 3 5 inches 8 9 in diameter 5 Press the START STOP button on the front of the monitor After the pump has stopped the monitor display should read approximately 165 mmHg only if the START STOP button has been operated since the last measurement otherwise it should read 35 mmHg above the average of the last five readings Compare the readings on the monitor and the manometer while the pressure bleeds down The monitor reading should be within th
3. STAND BY Key xi All batteries should be disposed of properly to protect the environment Lithium batteries should be fully discharged before disposal Batteries such as lead acid Pb and nickel cadmium Ni Cd must be recycled Please follow your internal procedures and or local provincial laws regarding disposal or recycling gt Caution hazardous voltages To reduce risk of electric shock do not remove the cover or back Refer servicing to a qualified service personnel U S A DANGER High Voltage International PAUSE or INTERRUPT Slow Run Replace Fuse Only as Marked Fuse Power supply jack polarity Signs May be Reversed Equipotentiality Terminal Battery Replace only with the appropriate battery Replace only with the appropriate battery Signs May be Reversed Alternating Current Direct Current lt gt A DE Screen Indicators Both Direct and Alternating Current y AC DC Input Amperes H Z Hertz Volts W Watts KA A Temporary Shut Off of Alarm Tone or A Alan 7 2 Description ENTER Key Symbols Description PRINT REPORT Key Attention Consult Operations or Service Manual for Description Risk of Explosion if Used in the Presence of Flammable Anesthetics gt tf Indicator Remote control Indicator Local Control ma w Return Unit to Monitor Mode Indicato
4. VSW is provided by the main batteries via the unit power switch With this switch ON VSW is applied to the power converter the air pump and to the various circuits which must remain active during the processor idle down mode VBB The backup battery supply VBB is always a diode drop 0 3 volts down from the main battery voltage VSW the 5 or the lithium battery voltage whichever is the highest e If the power switch is OFF and there are charged main batteries in the unit the main batteries supply the voltage through a diode VBB will be approximately 3 3 to 4 5 V e If the power switch is ON and the 5V supply is higher than VSW the power comes from the 5V supply through a diode VBB is approximately 4 6 to 4 8 V e lf the main batteries are removed the voltage is developed from the lithium backup battery through a diode VBB is approximately 3 0 V Power Converter The power converter is a MAXIM MAX655 step up converter It develops the 5 V supply from the main battery voltage which ranges from 2 5 to 4 8 VDC Low and High Current Modes When the power converter is in its low current mode it draws 40 lt amps of quiescent current The power converter goes into a high current mode upon receiving an interrupt from any of its three wake up sources cable connect clock or START STOP button A 5 msec delay following a wake up signal keeps the power converter in high current mode while the processor wakes up
5. N 012 0097 xx greater than 02 e Setup for air leaks see Air Leak Test for illustration e Analog manometer optional e Stop watch or equivalent e Battery spring insertion tool P N 003 0084 00 Visual Inspection 1 Check the display window and ensure that it is clear free from scratches contamination etc with the words SYS DIA appearing on the left side 2 Verify that the front panel START STOP button responds with a clear snap when depressed 3 Inspect inside the battery compartment to ensure that the battery springs are clean and provide a good electrical contact with the batteries 4 Install the three AA batteries and verify that the battery door closes and latches properly Air Leak Test 1 Connect the test setup illustrated below e This figure shows the use of both an analog and digital manometer Both or either can be used in these tests If only one manometer is used block off the unused hose 2 7 Ambulatory Blood Pressure Monitor Setup for Air Leaks analog digital manometer manometer plastic tee 90217 luer fitting tubing sealed pint can with 2 squeeze bulb fittings soldered into lid 2 Close the squeeze bulb valve 3 Turn the 90217 ON and press the START STOP button 4 Verify the following monitor response e Two beeps are sounded e The display counts down 5555 4444 3333 2222 1111 e Pumping begins and _ _ _ _ is displayed could displa
6. and asserts the PWR_HI line The power convertor develops the 5 V supply the 5 VA supply and the converter reference voltage ONNV_VREF 5 V Supply The 5 V supply is developed directly from the VSW main batteries and is regulated to 4 75 to 5 25 volts The maximum current available is 60 ma typical draw is approximately 20 ma 5 VA Supply 5 VA is a secondary power source for the analog circuitry lt can be disconnected to reduce power consumption when the analog circuits are not being used by asserting the PWR_DWN line 3 6 Theory CONV VREF The converter reference CONV VREF is created by a band gap reference about 1 25 volts to produce 5 volts adjusted to 5 volts at the 5 VA supply Backup Battery Circuit A 3 0 V rechargeable lithium cell provides backup power to the clock and RAM circuits when the main batteries are removed or exhausted This lithium battery receives its charge from the three AA batteries and has a 20 35 ma hrs capacity with sufficient charge to last approximately 4 months without the main batteries installed Main Battery The main battery voltage is monitored by reading the BAT VOLTS line with the A D converter The voltage at this point is a divided down sample of the VSW voltage Wake up Interrupt The power converter is activated when one of its three wake up sources generate an interrupt and trips the 5 msec one shot The microprocessor must assert the PWR_HI line duri
7. and whether the tone is ON or OFF For multiple cycle time specify each cycle interval and whether the tone is ON or OFF for each cycle Any other information the base station operator may request 3 The base station operator enters the patient information in the computer 4 Prepare the monitor to receive the patient data from the base station 2 4 Switch the modem ON When instructed by the base station operator switch the ABP monitor ON The modem link must be established within 45 seconds for the 90217 If this does not happen switch the monitor OFF and return to step 1 5 Setup When the information transfer is complete the ABP monitor beeps and voice communication is restored e Switch the monitor OFF and disconnect it from the modem e If there is a direct connection between the monitor and the base station switch the monitor OFF and disconnect it from the ABP data interface unit To transfer readings from the monitor to the base station 1 2 5 e Contact the base station by telephone for remote operation only Ask the base station operator to read the monitor Give the following information to the operator e Patient s name e Patient ID number e Any other information that the base station operator may request The base station operator enters the patient information into the computer If the monitor is in a remote location the operator must turn power to the base station modem O
8. inflated because of a software crash There are two watch dog timers in the Model 90217 one resides inside the processor the other inside the real time clock Each counts 180 seconds before timing out Both timers start at converter power up The real time clock watch dog timer triggers the hold off that disables the pump opens the bleed valve and informs the CPU of its action In 16 seconds after the hold off is asserted if the software does not end the reading fault shutdown resets the system The hold off is also asserted at the end of every reading The hold off always stays active for 32 seconds or until a manual reading is started Fault Shutdown The fault shutdown circuitry resets the system because of two conditions There is an over pressure condition not detected by software e Pressure reading takes longer than 180 seconds this indicates a software crash since a software time out should have already stopped the reading Over Pressure Detector In addition to software over pressure detection there is also a hardware over pressure detector that activates at approximately lt 295 mmHg A one half second delay in initiating an over pressure response prevents motion artifacts from causing a false over pressure detection 3 3 Ambulatory Blood Pressure Monitor 90217 Block Diagram 32 KHz LCD Display NES 30 seconds seconds SCL START STOP 7 Push Button 49 COLON and Back Plane
9. s sni pea as eua van da e a nn tent rennene ene 1 Base Station Report Event Codes 0 cee ttn eee ne 3 Problem Solving Checklist oooooococoocococrar etna 5 If monitor problems develop use the information provided in this chapter as a problem solving guide Monitor Event Codes The Model 90217 ABP Monitor displays a two digit event code whenever it is unable to successfully complete a blood pressure measurement This event code appears as the last digits on the monitor display and is preceded by the letters EC for example in the displayed event code EC01 01 is the event code The following list contains a brief description of event codes which can appear EC03 Patient cancel EC04 Out of time for measurement NO time to collect additional data but enough time to evaluate data already collected Evaluation did not produce a valid reading EC05 Individual result corrupted EC10 Hung 20 seconds at a bleed step EC11 Did not pump high enough Failed to inflate cuff above systole EC13 Reset of Office Check mode EC15 Bad checksum in ROM EC16 Low battery detected before cuff measurement EC18 Too few entries in table to perform analysis EC20 Pulse pressure too small Diastole is greater than historical diastole 20 and there are large oscillometric entries at cuff pressures below diastole which indicate that diastole might be lower EC25 Bad checksum in RAM containing code Initialize monitor to download corre
10. show dashes Put up time and go into idle mode If pinched hose or open hose abort and show event code on LCD On any other abnormal condition abort and show event code IR cable connected Adjust pump speed to match cuff volume Communications will allow input output with a host Used for downloading soft ware program initialization of monitor retrieving pa tient readings diagnostic control Stop pumping when at target pressure 165 mmHg initially then setto 30 mmHg over last systolic pressure Look for moderate size pulses If pulses are big pump higher 3 8 Otherwise collect 2 osc pulse peaks If too long at bleed step time out If the reading is too long time out If pressure changes readjust Look for lt 80 mmHg If detected bleed one more step and if below diastolic purge pressure If not bleed by 8 mmHg and repeat If the SHOW READING bit is set or if it is first five read ings show readings on dis play Show 3 times systolic diastolic heart rate Showing first five can be canceled by pressing START STOP button Show time go to Idle mode update time every minute repeat Maintenance Contents CEN mr tet AEE tha oi NE A TEE EE Wee swear Neha 1 Calibration Check ic a on ae anal aide mat Got adie ora Lisa Sian 3 Calibration Procedures 22 0 sic 3 Sea acess eS os erd ee tee 4 Operational Verification ssr iesma ere e A AP d
11. to indicate that it has detected a cable connect and has gone into the communication mode The monitor periodically attempts to contact a modem The left two digits on the monitor display indicate the steps in the communication process For more information refer to Base Station via Modem on page 2 3 Programming Options These monitor options are user programmed Day or Night Modes Day mode beeper ON inflation time approximately 15 seconds Night mode beeper OFF inflation time approximately 20 seconds Measurement Intervals and Periods Measurement intervals are selectable from 6 to 120 minutes in one minute increments for each period It is also possible to not have readings taken during a specified period Up to 12 periods may be defined Clinical Verification Mode When set to this mode the monitor is forced to bleed to 40 mmHg or to one step below diastole whichever is lower for each reading Office Check Mode This mode verifies monitor operation and allows a user to view cuff pressure and blood pressure results regardless of any previous disabling of the display During Office Check Mode the monitor bleeds an additional pressure step below diastole 1 3 Ambulatory Blood Pressure Monitor This mode is enabled for the first five successful blood pressure readings or attempted readings following monitor initialization Office Check can be disabled by a patient cancel and can be re enabled after turning the power sw
12. 0 mmHg min retighten all external hose connections and repeat the test If the system continues to fail isolate each length of tubing to locate and repair the source of the leak Press the Esc key to return to the main menu Maintenance 90217 Test Preparation 1 2 3 4 Setup the ABP monitor by connecting it to the CuffLink Refer to the table below for a list of systolic diastolic heart rate settings to be performed on the 90217 monitor Pressure Setting Range Systolic 60 52 60 Diastolic 30 26 33 Heart Rate 40 Systolic 100 91 103 Diastolic 65 60 70 Heart Rate 60 Systolic 120 111 124 Diastolic 80 74 88 Heart Rate 80 Systolic 150 143 161 Diastolic 100 92 108 Heart Rate 120 Systolic 200 196 218 Diastolic 150 142 158 Heart Rate 120 Systolic 255 253 277 Diastolic 195 185 205 Heart Rate 120 Connect the 90217 to the simulator Adult Cuff 1 8 ID x 6 a CuffLink Model 90217 Simulator ABP Monitor 1 8 ID x 12 1 8 ID x 108 Move the CuffLink cursor to SelectBp and press the ENT key to select ADAMS Adult Ambulatory Blood Pressure Monitor 6 7 8 9 10 11 12 f 13 14 Press the F2 key AdjEnv and verify that the gain is at 100 If it is not adjust it using the arrow keys At the same time verify that OFFSET and or SHIFT are at 0 Press the ENT key Press the
13. 0829 00 6 2 Drawings Title Part Number Drawing 90217 Assembly 650 0398 00 1 90217 ECB Assembly 672 0171 01 2 Parts 6 3 Symbols The following list of international and safety symbols describes all symbols used on Spacelabs Medical products No one product contains every symbol Symbol Description Symbol Description UCW or Ultraview 1700 HELP Key SETUP UCW or Ultraview 1700 MONITOR SETUP Key El jet B p SPECIAL FUNCTIONS UCW or Ultraview 1700 SPECIAL FUNCTIONS Key UCW or Ultraview 1700 ALARMS Key UCW or Ultraview 1700 RECORD Key PREVIOUS MENU UCW or Ultraview 1700 PREVIOUS MENU Key UCW or Ultraview 1700 NORMAL SCREEN Key UCW or Ultraview 1700 mouse connection UCW or Ultraview 1700 Keyboard Connection ON Power Connection to Mains OFF Power Disconnection from Mains On Position for Push button Power Switch Off Position for Push button Power Switch STOP or CANCEL Key CONTINUE Key START STOP Key START STOP START NIBP Key On Direction ON OFF Television Video Display Recycle Protective Earth Ground K OS 90 mM E Functional Earth Ground 7 1 Ambulatory Blood Pressure Monitor Symbol Description Symbol ON Part of the Instrument Only Description OFF Part of the Instrument Only TO Partial ON OFF G
14. 4 1 Calibration Check ugras ak S raa Sr fre eek eee ae 4 3 Calibration Procedures gt 2 at avse ane ork bd base PAG Ate fager dea ee re 4 4 Operational Verificati0ON oooooocococooroorr renn rann nen 4 10 Manifold Kit P N O050 0110 00 ooococcccocccn narr n na nakne 4 13 Disassembly Procedures 000 eee ee eee ann 4 14 Troubleshooting Monitor Event Codes einas e rart ska eee Ma ded eid bo ae 5 1 Base Station Report Event Codes 0 0 0 cece renn eee 5 3 Problem Solving Checklist 0 20 00 00 00 cece ett etna 5 5 Parts 90217 Field Replaceable Parts Lists 2 0 0 c eee tees 6 1 Drawings 509 f l epe serer oie he he bale Dee GA ne 6 3 Symbols Introduction Contents A ja bisettelse ae ek aa AG 1 User COMMONS ai cle Sud od a a a do odo am E E ETT 2 Displayer i e eaa A A A a ad 2 Programming Options ss 8 sexe A A A A cio 3 Overview The Model 90217 is a small lightweight battery powered Ambulatory Blood Pressure ABP monitor that uses the non invasive Oscillometric method to measure blood pressure and heart rate This data is then stored into memory for later transfer to an ABP Analysis System FT1000A FT2000A or equivalent a PC Interface a Base Station or a Report Generator for data analysis report printing and archiving The 90217 monitor is housed in a plastic case with a removable battery cover that provides access to its three AA cells Inside the monitor ar
15. Esc key to return to the main menu Move the cursor to AUTO using the arrow keys and select Execute using the ENT key Press the F1 key to select ADULT readings Zero the pressure by pressing the F5 key Press the Esc key until the first pressure simulation reading is displayed on the CuffLink Press the START STOP button on the ABP monitor to start the reading e The CuffLink simulator may automatically change to the next blood pressure setting when the current reading is complete If you must repeat a reading press the Esc key repeatedly until the ADULT INFANT menu is shown at the bottom of the screen Press the F1 key to select ADULT readings and then use the Esc key to increment to the reading desired Repeatedly press the START STOP button on the 90217 to sequence through the list of blood pressures simulated by the CuffLink At the end of the readings verify that the systolic and diastolic readings are within given ranges provided in step 2 e Ifthe readings are out of range retest the ABP monitor at the same setting If it still fails check all hose connections perform the leak test as described in the beginning of these procedures and check the gain settings on the simulator If all this fails refer to Troubleshooting on page 5 1 CuffLink Manual Operation The following steps outline the manual selection of simulated blood pressures and heart rates These may be used to repeat a reading which was out of range or produced no
16. N Prepare the monitor to transfer data to the base station e Switch the modem ON e When instructed by the base station operator switch the ABP monitor ON for remote operation only e The modem link must be established within 45 seconds for the 90217 If this does not happen switch the monitor OFF and return to step 1 When the information transfer is complete the ABP monitor beeps and voice communication is restored e Switch the monitor OFF and disconnect it from the modem Modem Indicator Lights When the monitor is switched ON the modem s RD receive data and SD send data lights flash for several seconds The OH on hook indicator is lit when the monitor starts communicating with the remote modem When both modems connect the CD carrier detect is lit The SD and RD lights flash as data is being transferred After the transmission is complete and the monitor is turned OFF the HS TR and MR indicators will always remain lit at the local modem 2 5 Ambulatory Blood Pressure Monitor 90217 Modem Connection Status Indications The left most digit of the 90217 display shows the various stages of the modem connection process 1 Sending modem identify query 2 Waiting for response to identify query 3 Sending modem reset commands 4 Sending modem setup commands 5 Send off hook command 6 Waiting for contact 7 Contact established 9 Not attempting to contact modem Once contact has been established the se
17. Real Time Display Clock Circuit Driver SCL Backup Battery Address Logic Auxiliary IR Serial O Communication IR Xmitter Receiver Drivers RAM 128K x 8 Port 80C198 SCL Microprocessor aam TE BAT_VOLTS Pressure Shutdown and Hold off Watch Dog Timer Pressure Cuff Air Air Pump Valve Over Pressure Manifold Detector Oscillator OSC Assembly Amplifier Xducer Pressure Pressure Amplifier FAFA zu Transducer Driver Gain Offset Power Supply Adjust Adjust PWR_DWN ADR 5VA Adjust Adjust Theory Digital Circuitry Display Board Information is sent from the processor to the LCD controller via a serial bus CBUS The LCD controller activates the necessary segments to display information on the 4 segment LCD Each of the segments can be controlled separately The processor determines which segments must be turned ON and sends this information to the controller An exclusive OR gate blinks the colons once per second when in the clock mode and also changes drive polarity Real Time Clock The real time clock sends and receives data via a bidirectional serial bus that goes to the processor The clock is backed up by the 3 volt lithium cell when the main batteries are removed The clock uses an adjustable 32 KHz crystal RAM A 128K x 8 RAM stores patient collected information programmed information and RAM code software execution RAM is backe
18. SIS Electrosurgical Interference EXT External Suppression FHR1 Fetal Heart Rate Channel 1 EGG Fetal Electro ardiogram FHR2 Fetal Heart Rate Channel 2 OND Patient Isolated Ground HLO High Level Output gnd hlo LE Inspiration Expiration Ratio Multiview Multi Lead Electrocardiogram NIBP nibp Non Invasive Blood Pressure N20 Nitrous Oxide O Oxygen PEEP Positive End Expiratory Pressure PRESS press Pressure Pmin Minimum Inspiratory Pressure PRS 7 8 Symbols Symbol Description Symbol Description Ppeak Peak Inspiratory Pressure Ad Respiration SPO2 Sp02 Arterial Oxygen Saturation SDLC Synchronous Data Link Control SpO as Measured by Pulse Oximetry SaO SVO2 SYS SvO2 Mixed Venous Oxygen Saturation Systolic sys SvO T1 Temperature 1 T2 Temperature 2 he Pr 13 Temperature 3 UA Uterine Activity or Umbilical Artery T4 Temperature 4 VAC Vacuum connection BirthNet CVScan Data Shuttle FT1000 FT3000 Flexchart Flexform Flexport Flextable Flextools Flexview Global Participant Index Intesys Multiview Neoscan PCIS PCMS PrintMaster Quicknet Sensorwaich Spaceview TRU CAP TRU CUFF TRU LINK UCW Ultralite Ultraview Ultraview Clinical Messenger Uni Pouch Universal Flexport Varitrend Web Source and WinDNA are trademarks of Datex Ohmeda Inc Other brands and product names are trademarks of their respective owners 7 9 90217 ABP Monitor AIR INTAKE
19. Spacelabs A Division of Instrumentarium Ambulatory Blood Pressure Monitor 90217 Service Manual 070 0502 00 Rev E Copyright 2003 Datex Ohmeda Inc All rights reserved Contents of this publication may not be reproduced in any form without the written permission of Datex Ohmeda Inc Products of Spacelabs Medical a Division of Instrumentarium Datex Ohmeda Inc Spacelabs Medical are covered by U S and foreign patents and or pending patents Printed in U S A Specifications and price change privileges are reserved Spacelabs Medical considers itself responsible for the effects on safety reliability and performance of the equipment only if G assembly operations re adjustments modifications or repairs are carried out by persons authorized by Spacelabs Medical and the electrical installation of the relevant room complies with the requirements of the standard in force and the equipment is used in accordance with the operations manual Spacelabs Medical will make available on request such circuit diagrams component part lists descriptions calibration instructions or other information which will assist appropriately qualified technical personnel to repair those parts of the equipment which are classified by Spacelabs Medical as field repairable Spacelabs Medical is committed to providing comprehensive customer support beginning with your initial inquiry through purchase training and service for the life of y
20. Telephone 39 02 216 931 Fax 39 02 2692 6226 SPAIN Datex Ohmeda SL Manuel Tovar 26 28034 Madrid Telephone 34 91 3342600 Fax 34 91 3581284 TAIWAN Datex Ohmeda Pte Ltd Taiwan Representative Office 2 FI No 85 Sec 2 Chien Kuo N RD Telephone 8862 2515 0457 Fax 8862 2501 9136 THE NETHERLANDS Datex Ohmeda B V De Wel 18 3871 MV Hoevelaken Telephone 31 33 25 41 222 Fax 31 33 25 41 223 Authorized EC Representative UNITED KINGDOM Datex Ohmeda Ltd 71 Great North Road Hatfield Herts AL9 5EN Telephone 44 1707 263 570 Fax 44 1707 260 065 e US Federal law restricts the devices documented herein to sale by or on the order of a physician Contents Chapter Page Introduction Overview oia ee ra St el 1 1 User Controls us ste ve soso de argeste trade sanse lid 1 2 BIE JOSE EEE SEE ola 1 2 Programming Options 2 2 5 s 24 Gee sos ad 1 3 Setup Installing the Batteries 0 0 5 5 ts a sl kake Re ee det 2 1 Initializing the Monitor 0 00 00 eae ie eee eee 2 2 Operational Tests soos eras eres ew dradd a cal oe eat 2 7 Theory Pressure Amplifier s s vs vate Ve A PE ee ee E 3 1 Oscillometric Amplifier 0 0 0 0 6 cece eee eee 3 2 90217 Block Diagram 44 dvd ee leah ikek me baie de oe ae E ir 3 4 Digital Circuitry as sd aient a tad bedad side id 3 5 Unit POWER arar et and deca ae STK Pir eek aaron ae 3 6 Software Flow Chart 20 ta nie aed A RAN Re 3 8 Maintenance Cleaning iranere enda et
21. a 10 Manifold Kit P N 050 0110 00 1 1 varar venner eneren renn eee 13 Disassembly Procedures a auunvrvanv rv n ravn eee revner era 14 Periodic maintenance consists of cleaning the unit replacing or recharging the batteries testing the unit for accurate operation and calibrating when necessary Cleaning Use a soft damp cloth and mild detergent mixed with water to wipe the exterior of the monitor Clean the carrying pouch and air hose with isopropyl alcohol The cuff wrap may be sterilized only with ethylene oxide ETO sterilization methods using standard hospital procedures Use standard aeration techniques after sterilization Small soiled or stained areas may be cleaned by gentle scrubbing with a sponge or cloth soaked in a mild soap and water solution The cuff wrap with the air bladder removed is machine washable on delicate cycle only Do not wash with bed linens gowns or in large commercial type washers To remove the bladder for cleaning refer to the figures below and follow these steps 1 Using your fingers only fold or roll up the bladder inside the cuff Do not use pencils pens or other hard objects as damage to the bladder could easily occur 2 Remove the bladder through the hose exit opening Once the bladder has been removed be sure to attach the hook and loop surfaces on the cuff before washing 3 After washing and drying the cuff reinstall the bladder in the reverse order of its removal
22. abel Front Panels draumana o al a co a daa 334 0830 00 Label Communications 00 000 ccc ee ees 334 0828 00 Label Operating Instructions 2 000 e eee eee ee 334 0829 00 Label ID Serial Number 0 00 momo 334 0922 00 International English Label Front Panel vuitton tasa 334 1098 00 Label CommunicationS 00000 ee eens 334 0828 00 Label Operating Instructions 0 000 c eee eee 334 0829 00 French Label Front Panel i sss cacti cade ae ook esa ie GS nasa eee 334 1098 00 Label Communications 00000 334 1112 00 Label Operating Instructions 0 000 e eee eee 334 1107 00 German Label Front Panel 0 0 ccc cee es 334 1098 00 Label CommunicationS 0 0 0 000 ccc eee eee 334 1111 00 Label Operating Instructions 000 e eee eee eee 334 1106 00 Spanish Label Front Paneluussastsmeed itte a Abe 334 1098 00 Label Communications oooooooooooooooooooooo 334 1109 00 Label Operating Instructions 0 000 e eee eee eee 334 1104 00 Italian Label Front Panel nananana cee ce ee 334 1098 00 Label CommunicationS 00 0000 cece eee eee eens 334 1110 00 Label Operating Instructions 0 00 e eee eee eee 334 1105 00 Japan Label Front Panel 0 0 0 cc eee ee es 334 1098 00 Label CommunicationS 0 0000 ccc eee eens 334 0828 00 Label Operating Instructions 0 00 e eee eee eee 334
23. ate and time are correct and that the event code EC18 appears Press the ESC key Initialize the 90217 by typing 1 initialize ABP Press the END key and use the up arrow key until PATIENT NAME is selected Type TEST and press the Enter key 1234567890 and press the Enter key NONE and press the END key Verify that the display reads MONITOR INITIALIZED Press Space Bar ESC key ESC key ESC key Y key yes Remove the 90217 from the system and switch power OFF Remove one AA battery Wait one minute and reinstall the battery Switch 90217 power ON and verify that the time remained correct 2 9 Contents Pressure Amplifi r oca a ads gh khanen kekd 1 Oscillometric Amplifier sa stats spas she meet o bike eng Sees fyken 2 90217 Bl ck Diagram ai or ase sa Geert tkd ude kes benene een ne a ag akt 4 Digital Circuitry AA bee rane Ga AA ease 5 Unit POWER ut sorte O aids Le io 6 Software Flow Charts icon aba ad eee 8 Pressure Amplifier The pressure amplifier monitors the voltage produced across the pressure transducer This voltage is proportional to the pressure in the arm cuff The pressure transducer circuits require temperature compensation to account for changes in sensitivity This is accomplished by using a reference current to provide a constant current source into the bridge Any change in bridge resistance due to temperature will change the bridge voltage in an amount that compensates f
24. c Diastolic Pressure and Heart Rate Patient information appears on the display sequentially with systolic first diastolic next and then heart rate Each parameter appears for approximately one second The screen is blanked for one second and the sequence of readings is re displayed two more times A bar indicator at the left of the display identifies which parameter is currently being displayed It appears next to the sys for systolic next to dia for diastolic pressure and next to the heart symbol for heart rate Time of Day A real time clock provides the time of day which appears between measurement cycles and can be programmed in either a 12 or 24 hour mode 1 2 Introduction Cuff Pressure This pressure can be shown while the monitor is taking a measurement If cuff pressure is not selected appears Cuff pressure can be enabled or disabled in software Event Code Event codes are 4 digit LCD messages that begin with EC or in some cases show specific codes such as LLL for a low battery If enabled a beep sounds during an event code and the code is displayed on the monitor Refer Troubleshooting on page 5 1 for event code information Count Down Sequence Whenever the monitor begins a measurement cycle it turns its tone ON if beep is enabled and counts down from 5555 to 1111 on the display IR Communications During IR communications the monitor first displays 9999 on the LCD
25. cal Report Generator For a direct connection to a Local Report Generator place the monitor into the chute on the Report Generator Model 90239A or equivalent Local Report Generator Direct Connect Configuration Ensure that the monitor lines up against the side to align IR ports Local Report Generator 90239A 2 2 Setup PC Interface For a direct connection to an IBM XT AT PS2 or equivalent via a Model 90219 02 90219 03 or equivalent 1 Connect the ABP monitor to the 90219 Analysis System 2 Connect the 90219 Analysis System cable from the monitor to the serial port on the PC PC Interface Direct Connect Configuration Model 90219 Analysis System ve 90217 cable to serial port ABP Monitor 3 Refer to the 90219 Ambulatory Blood Pressure PC Interface Base Station Operations Manual P N 070 0238 xx for instructions for operating the Analysis System Base Station via Modem For a modem connection to a remote IBM XT AT PS2 or equivalent base station Modem Connection Configuration cable to TO PUBLIC serial port BASE TELEPHONE ABP STATION NETWORK Monitor MODEM Ls e The initialization procedure is provided in the 90219 Ambulatory Blood Pressure PC Direct Base Station Operations Manual P N 070 0238 xx 1 The 90217 can use one of the following modems for communication e Hayes Smartmodem 1200 e Hayes Optima 9600 or equ
26. charge gt 1 25 V minimum Alkaline 1 56 V full charge gt 1 50 V minimum Maintenance Pre calibration Checks 1 Remove the back cover on the 90217 monitor 2 Measure the 4 608 volt reference TP7 on the Main Board Place a magnet near the IR port on the monitor or connect the IR cable to the port Switch monitor power ON c Connect a DC voltmeter positive lead to TP7 4 608 and the negative lead to TP9 ground Refer to the figures below for test point locations r ig C44 Bes 0000000000000 A od mm RJ R38 pi R39 un an 28 688 S cn fra g ES H a Sir in TE am cg R79 1 OP U42 u41 u38 us m ur me 5 voted A uta u39 UM Vig m am on RI an mn R12 UDE I II 2 8 Eg O E tn cp C16 iti mi Ya7 22 00000000000 Main Board Bottom 4 5 Ambulatory Blood Pressure Monitor d Verify that TP7 is between 4 605 and 4 611 volts If not readjust R22 to obtain 4 608 0 002 V 3 Measure the 5 V supply TP6 on the Main Board a Connect a DC voltmeter with the positive test lead on TP6 5 volts and the negative on TP9 ground b Verify that TP6 measures between 5 05 and 4 95 volts If not adjust R78 on the power board until TP6 measures 5 0 0 01 volts 4 Replace the back cover of the 90217 case removed in step 1 Calibration Setup 1 Verify that the IR cable is connected to t
27. collapse This same circuit provides a start up processor reset signal at power up Reset time is a product of the reset R C time constant and the hold off time necessary for the power convertor to reach 5 volts the reset time constant is 350 msec A D Voltage References The A D reference ADR is generated from a LM4041 1 2 band gap reference lts reference output of 1 2 volts is amplified to 4 608V by a gain adjustable amplifier ADR 4 608 volts adjustable 30 Second Pulse The real time clock produces a pulse every minute with a 30 second duration This pulse s leading and trailing edges are conditioned into separate pulses and applied through a diode to the processor s WAKE_UP line to awaken it every 30 seconds Second Pulse The SECONDS line goes to the LCD where it blinks the colon and changes the LCD polarity Cable Connected If a cable is connected to the RS 232 communications connector with the power switch ON the power converter activates and awakens the processor A cable connected condition prevents the power converter from going down as a result of a shutdown fault generated by the watch dog timer but cannot prevent an over pressure shutdown Once a cable has been connected the processor goes into a listening mode awaiting instructions from the RS 232 port These instructions adhere to the ABP communications protocol 3 2 Theory Watch Dog Timers The watch dog timers ensure that the cuff cannot remain
28. cond digit from the left on the 90217 display indicates the baud rate of the connection On high speed modems the indicated speed refers to the connection between the ABP monitor and the modem The two modems may be communicating at some speed other than that at which the modem is communicating with the monitor The baud rate codes are as follows 0 1200 1 not used 2 2400 3 4800 4 9600 519 2k 6 38 4 k Setup Test e Verify that all cable connections are installed correctly and are connected securely Oo Switch the ABP monitor ON It initially displays 9999 When the monitor is being read or initialized these digits change to indicate that communication is taking place between the monitor and the analysis system When communication is complete the digits stop changing The right most digit indicates that a message has been sent from the monitor to the base station The second digit from the right indicates that a non garbled message has been received by the monitor A common failure mode is with only the right digit spinning This indicates garbled messages are being received and an I don t understand response is being transmitted by the monitor 2 6 Setup Operational Tests Conduct the following procedures to verify proper operation of the Model 90217 ABP Monitor Equipment Required e 90219 02 system e 90219 03 ABP Base Station software e Type AA alkaline batteries 3 e Cable 90217 to PC P
29. ct code EC28 Diastole greater than 200 mmHg EC30 Software could not track changes in oscillometric activity EC32 Software overpressure EC38 Pulse pressure equals 16 mmHg or less EC39 Oscillometric input queue overflow Ambulatory Blood Pressure Monitor EC40 EC42 EC45 EC48 EC50 EC52 EC55 EC58 EC62 EC69 EC70 EC79 EC80 EC85 EC90 EC95 EC99 No non discarded entries at lower cuff pressures but within 16mmHg of systole No cuff attached Illegal bleed size Not between 4 and 8 mm Pulse pressure is less than historical pulse pressure minus 20 and many pulses failed either screen or failed match No non discarded entries at higher cuff pressures but within 16mmHg of diastole Kinked hose Unexpected loss of power User may have turned power switch OFF during a reading Diastole is less than historical diastole minus 15 and many pulses failed either screen or failed match Loose cuff Reached 25 mmHg but not target pressure Cuff may not be attached Too few entries to calculate heart rate Excessive motion at highest cuff pressures Partially clogged bleed line All blood pressure attempts are inhibited Attempts can be enabled by turning power switch OFF then ON again Pulse pressure too small Many pulses failed either the screening or the matching criteria and one of the following a there is an oscillometric entry at a cuff pressure higher than systole whose amplitude is above the level defi
30. d up by the 3 volt lithium cell during main battery removal Addressing and Control Addressing and control are accomplished using a combination of processor ports latches and gates Communications RS 232 Connector The communications connector is a modified RS 232 interface When the communications cable IR cable is connected to the back of the unit a reed relay activates the monitor if the power switch is turned ON At this point the processor checks and determines that the C CON cable connected line is asserted and goes into the communication mode The processor determines whether the cable is communicating with a modem or a report generator and responds accordingly Communications are done using two lines transmit and receive Data is converted into IR signals in the cable and ABP monitor Processor The processor type is an 80C198 with a 7 37 MHz crystal It contains on board RAM ROM A D converter data ports addressing control serial bus lines and modulator ports that control motor speed and speaker outputs The on board ROM contains routines for communication and start up The majority of the ABP monitor s program is loaded into RAM using the infrared RS 232 port 3 5 Ambulatory Blood Pressure Monitor Unit Power All power for the Model 90217 ABP Monitor comes from the main batteries 3 AA cells and the rechargeable 3 volt lithium battery Unregulated Power Supplies VSW The switched battery voltage
31. e three printed circuit boards the Main Power and Display boards Programming resides in an internal 128k RAM and Microprocessor ROM Most of the code exists in the RAM and can be updated via an infrared IR serial port located at the rear of the unit The internal ROM contains a boot code and other codes for downloading and completing special tasks The IR serial port transfers collected data to a report generator and sends setup changes to the ABP monitor A rechargeable lithium battery keeps the RAM and real time clock backed up during periods when the AA batteries are removed 1 1 Ambulatory Blood Pressure Monitor User Controls The 90217 ABP monitor provides two user controls a START STOP button and Power ON OFF switch power ON OFF switch battery door START STOP button 4 digit Liquid Crystal Display LCD Power ON OFF Switch When turned ON this switch activates the monitor and begins executing the timed blood pressure program START STOP Button This front panel control manually starts a blood pressure measurement stops a measurement already in progress or sets special modes of operation refer to the 90207 90217 Ambulatory Blood Pressure Monitors Operations Manual P N 070 0137 xx Display The monitor display is a 4 digit LCD that presents the following information refer to the 90217 Ambulatory Blood Pressure Monitors Operations Manual P N 070 0137 xx for instructions on use Systoli
32. he pressure will increase until it opens the over pressure relief valve When the pressure increase levels off at a rate of 3 sec mmHg check the pressure displayed on the manometer and verify that it falls between 300 and 325 mmHg Remove the jumper between TP8 and TP9 Power the 90217 OFF Press the Esc key 10 Power the 90217 ON Hardware Safety Timers Check 1 oa FO N From the main menu select 2 MAKE CONTACT WITH MONITOR When the main menu appears select 11 MANOMETER MODE Manually pump up the system pressure to 165 mmHg 10 Remove the IR cable and start the timer Exit the X program and return to DOS by pressing Esc two times When the valve opens pressure decreases rapidly verify that the elapsed time is between 178 and 182 seconds fault holdoff timer When the 90217 display changes from showing pressure to showing the software version verify that the elapsed time falls between 194 and 198 seconds watch dog timer Remove the test setup and restore any 90217 screws previously removed 4 9 Ambulatory Blood Pressure Monitor Operational Verification These procedures verify that the 90217 ABP monitor s blood pressure readings are consistent with design standards e These procedures use the DynaTech Nevada CuffLink Blood Pressure Simulator If you are using a different simulator refer to ts operator s manual and determine equivalent tests Refer to the end of this Maintenance chapter for instructio
33. he serial port on the computer system and to the IR port on the back of the 90217 when communicating correctly the monitor will display 9999 and occasionally 2999 2 Start the X program by changing to the subdirectory where the file XMAIN exe is located and typing X and pressing the Enter key 3 When the computer establishes contact with the monitor the Test Utility Main Menu appears 1 SYSTEM CONFIGURATION 2 MAKE CONTACT WITH MONITOR ENTER SELECTION _ From this menu select MAKE CONTACT WITH MONITOR by typing the item number appearing to the left of this menu item 2 and pressing Enter Verify that the screen clears and momentarily displays SPEED 4 IS ENGAGED and other miscellaneous information If the RAM code is corrupted the program downloads code 4 6 Maintenance 4 Atthe conclusion of the above process the Manufacturing Test Utility Main Menu reappears with additional menu items and the monitors RAM and ROM code version numbers SYSTEM CONFIGURATION INITIALIZE MONITOR DOWNLOAD 90217 RAM CODE EXHAUSTIVE MEMORY TEST SET 90217 GAIN AND OFFSET SPEAKER TEST PUMP TEST HARDWARE OVERPRESSURE TEST 10 COMMUNICATIONS TEST 11 MANOMETER MODE 12 RESET FOR ANOTHER MONITOR ENTER SELECTION __ Oo 0 N oO AH WwW PD ROM ID 90217 V 03 02 xx RAM ID 90217 V 03 02 xx 5 Select 2 INITIALIZE MONITOR 6 Verify that the screen disp
34. ic procedures including the use of an ESD wrist band and mat An electrostatic discharge from your fingers can permanently damage electronic components e All static sensitive electronic components are packaged in static shielding bags Retain this bag for repackaging the component should you need to store it or return it to Spacelabs Medical for any reason To open the monitor and access its internal components 1 Remove the Communications label from the back of the unit refer to the Parts section of this manual for replacement part number and remove the two screws that are exposed see below 2 Remove the identify label on top of the unit see illustration below and remove the two exposed screws to separate the top and bottom case pieces Remove these two screws from back requires removal of the communications Remove these two screws to separate label top and bottom case requires removal of the identity label Remove these two screws to separate ECB assembly from bottom case requires removal of front panel label To separate the ECB assembly from the bottom case half 1 Remove the front panel label from the unit refer to the Parts section of this manual for replacement part number and expose the two screws holding the ECB assembly 2 Remove these two screws see previous illustration and separate the ECB assembly from the lower half of the case 4 14 Troubleshooting Contents Monitor Event Codes
35. itch ON and holding the START STOP button in while the last digit of the software version number is being displayed Blood Pressure Heart Rate Measurements Displayed These measurements can be selected to appear or not to appear at the end of a measurement Cuff Pressure Displayed This measurement can be selected to appear or not to appear during the measurement cycle 1 4 Contents Installing the Batteries icon arar AR 1 Initializing the Monitor asavunv vann nr vnv eens 2 7 Operational Tests lt oecon acarana tenn a eees Installing the Batteries Two types of batteries are used in the 90217 ABP Monitor three standard AA batteries Spacelabs Medical P N 146 5011 xx to power the cuff air pump and one rechargeable lithium battery to backup the clock and RAM circuits when the AA batteries are removed or are exhausted This lithium battery receives its charge from the AA batteries and does not normally require replacement lts expected life is at least nine years If alkaline batteries are used as the AA batteries they must be replaced after each patient use Nickel cadmium batteries require a full charge before each use AA Batteries To replace the three AA batteries 1 Switch the monitor s power switch to OFF 2 Remove the battery compartment cover plate by sliding it to the right until it can be pulled free slide battery cover off to access 3 AA cells Model 90217 Ambulatory Blood Press
36. ivalent e Most 2400 baud modems If the remote site also has 90202 or 90207 monitors a Hayes Smartmodem 1200 must be used with those monitors 2 3 Ambulatory Blood Pressure Monitor High Speed modems are setup via software commands The Hayes Smartmodem 1200 which attaches to the monitor must be setup as follows Switch Setting at Monitor Site down up down down down up up down up 10 up O NX O COI BAB O0O N 2 Connect the serial port cable P N 012 0096 00 between the monitor and the modem e If call waiting or call forwarding are options on the telephone used to transfer data ensure that both are deactivated or modem communications may be interrupted In addition telephone systems such as CBX or PBX can cause interference with the modem or the modem can cause interference with the switching system To initialize the monitor for a remote connection 1 Contact the base station by telephone for remote operation only 2 Ask the base station operator to initialize the monitor Give the following information to the operator Patient s name Patient ID number If the monitor display is to be active or inactive Time of day 12 or 24 hour format If measurements are to be displayed systolic diastolic and heart rate Multiple or single cycle times If using a single cycle for the 24 hour monitoring period indicate the cycle interval
37. lays ABP RESET SUCCESSFUL and CLOCK SUCCESSFULLY SET and that the Main Menu screen again appears Pressure Offset and Gain Adjustment 1 Adjust the pressure offset a From the Main Menu select 5 SET 90217 GAIN AND OFFSET b Verify that the following screen appears 90217 GAIN AND OFFSET ADJUSTMENT 1 Adjust offset pot for 00 with hose disconnected 2 Adjust gain to match manometer at about 200 mmHg 3 Due to interaction repeat 1 and 2 as needed 0 1 mmHg 20 counts c Verify that the mmHg value appearing at the bottom of the screen reads 0 0 0 3 If not readjust R49 pressure offset adjustment until the mmHg value at the bottom of the screen reads 0 0 0 1 4 7 Ambulatory Blood Pressure Monitor 2 Adjust the pressure gain a Connect the sphygmomanometer test configuration to the 90217 monitor analog manometer optional digital manometer L 90217 ABP Monitor EN av squeeze bulb pint can with two fittings soldered in lid Calibration Test Setup b Manually pump system pressure to 195 mmHg c Verify that the mmHg value appearing at the bottom of the screen reads 195 1 0 If not adjust R42 pressure gain adjustment until the mmHg value reads 195 3 Repeat the offset and gain adjustments until no further adjustments are required to produce the correct values Pressure Leakage 1 Inthe sphygmomanometer test configuration use a hemo
38. ng this 5 msec period to place the power converter in its high power mode Three sources can place the power converter into high power mode An RS 232 serial cable is connected This cable connect is detected when the reed switch is activated by an external magnet When the reed switch closes it causes an interrupt to the processor on the WAKE UP line A clock wake up The real time clock produces an output that changes state every 30 seconds These transitional states are shaped into pulses that create interrupts to the processor e The START STOP button is pressed When the START STOP button is pressed the WAKE UP line is asserted Once an interrupt request has gone to the processor by asserting the WAKE UP line the processor looks to see which of the three sources asserted the WAKE UP line Power Switch When the power switch is ON closed the VSW supply comes up and provides power to all the circuitry in the ABP unit The VBB supply receives power directly from the main batteries to ensure that the lithium battery will not be drained when main batteries are available 3 7 Ambulatory Blood Pressure Monitor Software Flow Chart Power switch turned ON START STOP button pressed Display Software Version Shut Valve and Start Pump Count Down Displayed Look for communications cable If present go to communications routine If the Show Pressure bit is set show pressure If not set
39. ning systole suggesting that systole might be higher b there is an oscillometric entry at cuff pressure below diastole whose amplitude is above the level defining diastole suggesting that diastole might be lower Bad clock Excessive motion throughout the measurement Three out of five entries were rejected Cuff pressure baseline out of bounds Initializing the monitor resets the cuff pressure Unexpected or Contradictory Data The following codes may also appear on the monitor display 5 2 LLL FULL Main batteries 3 AA cells are low and do not have sufficient power to operate the pump and complete a measurement No retry attempt is made following an LLL message The monitor contains 240 readings and cannot store any more Troubleshooting Base Station Report Event Codes The following list contains the extended event codes which may appear in a blood pressure report The extended event code digit appears in the first tens digit position for example 11 The list is grouped according to the monitor event code if applicable which would be displayed at the time of the event The codes are printed as a numeric value in the systolic column with all other columns printing zero Monitor displays EC00 Base Station report prints 10 Measurement aborted as the result of excess movement artifact Frequent 10 messages may indicate an air leak 20 A A very large number of movement artifacts 30 A Mo
40. ns on using the CuffLink simulator in the automatic or the manual mode Equipment Required DynaTech Nevada CuffLink Non invasive Blood Pressure Analyzer and equivalent and associated tubing manuals luer fittings software version 2 0 or higher is required 1 8 1 D tubing P N 162 0019 00 or equivalent Adult cuff P N 016 0264 00 or equivalent Luer connector P N 103 0008 00 Blood Pressure Simulator Preparation 4 10 No a PF w amp Turn the CuffLink simulator ON and allow it to warm up for a minimum of 15 minutes Verify that the calibration sticker is current If it is not the simulator will need to be calibrated by the manufacturer or its authorized service facility Check the zero pressure by selecting ADAMS Adult from SelectBp in the main menu Press ENT Press F5 to zero the pressure Press Esc to return to the main menu Perform a leak rate check on the blood pressure simulator and associated tubing as follows a While in the main menu move the cursor to Press and select Leak Test by pressing ENT Connect a squeeze bulb to the hose which will connect directly to the unit under test Pump up the system pressure to approximately 170 mmHg Wait 10 seconds for the pressure to stabilize Press the START F1 key on the CuffLink simulator and wait one minute while the leak rate is measured At the end of the minute the leak rate will appear on the CuffLink display If the leak rate is greater than 1
41. olated floating patient applied part providing a high degree of protection against electric shock and is defibrillator proof ETL Laboratory Approved IEC 601 1 Type B equipment The unit displaying this symbol contains an R adequate degree of protection against electric shock Canadian Standards Association Approved ooo ad Keypad ooo Enlarge Zoom Menu Keys Delete Waveform Parameter Keys PCMCIA Card Fragile handle with care Foot Switch E 3 gt This Way Up me Environmental Shipping Storage ne Temperature Limitations Environmental Shipping Storage Humidity Limitations 7 4 Symbol Description Symbol Open Padlock Symbols Description Closed Padlock Down Arrow Up Arrow Event TEME Temperature temp Antenna Environmental Shipping Storage Altitude Limitations E y F Y BE Network Connection Audio Output Speaker N Remote Alarm Nurse Alert Nurse Call AG AH gt 1 Serial Port 1 gt 2 Serial Port 2 gt External marker push button connection t SDLC SDLC Port gt Microphone Mermaid Connector 7 5 Ambulatory Blood Pressure Monitor Symbol Description Note Description Video Output Warning About Potential Danger to Human Beings Caution About Potential Danger to Equipment Non Inva
42. or any change in sensitivity Voltage across the transducer is amplified differentially and turned into a single ended voltage that is amplified offset and sent to the processor s A D converter the oscillometric amplifier and the overpressure detector Offset Adjust Both transducer offset and operational amplifier offset are nulled out using a pressure offset adjustment Minor variations in the offset are tracked and compensated for in software Gain Adjust Changes in gain are compensated for with a gain adjustment The voltage gain to the A D converter is 15 mv mmHg and the voltage is offset by approximately 0 09 volts This 0 09 volts is inserted to prevent the A D converter signal from going negative during drifts in the offsets The 0 09 volt offset is subtracted in software Ambulatory Blood Pressure Monitor Oscillometric Amplifier Gain Offset and Filtering The oscillometric amplifier is DC coupled A D A convertor provides large amounts of DC offset to the amplifier to prevent the large static pressure component of the waveform from over driving the amplifier It provides gain x64 DC offset and high frequency filtering 3dB point approximately 80 Hz The oscillometric filtering that was present in earlier designs is now done by software RAM Protect and Reset Circuit When the 5 volt power supply begins to drop the RAM protect circuit asserts a reset signal to the processor that protects RAM data during power
43. our Spacelabs Medical equipment U S A Spacelabs Medical 5150 220th Ave SE Issaquah WA 98029 Telephone 425 657 7200 Telephone 800 345 2700 Fax 425 657 7212 AUSTRALIA Datex Ohmeda Pty Ltd Unit 1 149 Arthur Street Locked Bag 356 Homebush NSW 2140 Telephone 61 2 9735 7222 Fax 61 2 9764 2354 AUSTRIA amp BELGIUM Meda n v Oeyvaersbosch 12 B 2630 Aartselaar Belgium Telephone 32 3 870 1111 Fax 32 3 870 1112 CANADA Datex Ohmeda Inc 1093 Meyerside Drive Unit 2 Mississauga Ontario L5T 1J6 Telephone 905 565 8572 Fax 905 565 8592 CAUTION CORPORATE OFFICES CHINA Datex Ohmeda Pte Ltd Shanghai Representative Office Room 2509 Lippo Plaza No 222 Huaihai Road M Shanghai 200021 Telephone 86 21 5382 5657 Fax 86 21 5382 1691 FRANCE Spacelabs Medical ZAC de Sans Souci 1211 Chemin de la Bruy re 69760 Limonest Telephone 33 4 78 666 210 Fax 33 4 78 432 658 GERMANY Datex Ohmeda GmbH Dr Alfred Herrhausen Allee 24 D 47228 Duisburg Telephone 49 2065 691 0 Fax 49 2065 691 236 HONG KONG Spacelabs Medical Limited Suite 901 Tower 1 China Hong Kong City 33 Canton Road Tsimshatsui Kowloon Telephone 852 2376 1370 Fax 852 2376 2502 INDIA Datex Ohmeda India Pvt Ltd International Trade Tower S 3 Level Block E Nehru Place New Delhi 110019 Telephone 91 11 621 6060 Fax 91 11 621 3003 ITALY Datex Ohmeda S p A Via Cassanese 100 20090 Segrate MI
44. pressure was too high B Measurement aborted because measurement has taken longer than two minutes to complete 65 Equipment malfunction Return unit for service 75 Equipment malfunction Return unit for service 85 Equipment malfunction Return unit for service 95 Cuff pressure baseline out of bounds Monitor displays LLL Base Station report prints 16 Low battery prior to start of measurement 26 Low main battery after measurement started Monitor displays EC08 Base Station report prints 18 Too few data entries to accurately determine blood pressure 28 Diastole above 200 mmHg 38 Pulse pressure less than 16 mmHg Monitor displays EC09 Base Station report prints 19 Hardware fault valve open with pump turned ON 29 Diastolic pressure value cannot be obtained from the data available 39 Systolic pressure value cannot be obtained from the data available 49 Mean arterial pressure value cannot be obtained from the data available 59 Heart rate value cannot be obtained from the data available 69 Heart rate value cannot be obtained from the data available 5 4 Problem Solving Checklist Use this table to diagnose a monitor problem Troubleshooting Problem Modem indicators are incorrect Possible Cause Modem switch settings are incorrect Solution Monitor display is incorrect No data was transferred Check modem cable for tight connection Only the last digit to the righ
45. r Out of Paper w ii Activate Recorder for Graphics Recorder Paper Indoor Use Only Auto Mode NIBP Output No Output Terminated Data Input Output gt e aM sap HELP Explain Prior Screen Key Clock Time Setting Key Input Output ona Monitor Setup Select Program Options ona Set Initial Conditions Menu ona Access Special Function Menu Normal Screen Return to Prior Menu TREND TIMER Key gt Ill I OS QR Gas Exhaust 7 O lll a Electrocardiograph or Defibrillator Synchronization 7 3 Ambulatory Blood Pressure Monitor Symbol Description A Arterial Pulse Description IEC 601 1 Type BF equipment The unit displaying this symbol contains an F type isolated floating patient applied part providing an adequate degree of protection against electric shock IEC 601 1 Type BF equipment which is defibrillator proof The unit displaying this symbol contains an F type isolated q K floating patient applied part which contains an adequate degree of protection against electric shock and is defibrillator proof IEC 601 1 Type CF equipment The unit displaying this symbol contains an F type isolated floating patient applied part providing a high degree of protection against electric shock IEC 601 1 Type CF equipment The unit displaying this symbol contains an F type is
46. reading f 4 12 When the CuffLink is warmed up move the cursor to the SelectBp option of the main menu and ADAMS Adult Press the ENT key to make a selection Press the F2 key and verify that the gain is set to 100 At the same time verify that the SHIFT and or OFFSET are at 0 Press the ENT key Press the F1 key to move to the heart rate menu Use the arrow keys to move the cursor to the desired heart rate Press the ENT key to make a selection Use the arrow keys to move the cursor to the desired blood pressure and press the ENT key The CuffLink is ready to simulate the selected heart rate and pressure Press the START STOP button on the monitor to begin Maintenance CuffLink Automatic Operation Use the following procedure to set or change the automatic sequences stored in the CuffLink 1 Move the cursor to the Auto option of the main menu and select Utility by pressing the ENT key Use the arrow keys to move the cursor to the EDIT box Select sequences to edit and press the appropriate button F1 F2 F3 etc F1 is assigned to ADULT In the first screen answer YES to the Pop Off test and NO for the rest The second and third screens list the sequence of blood pressures and heart rates Use the arrow keys to move around the list and use the F4 and F5 keys to change the settings Set CYCLES for each blood pressure reading When finished making changes press F3 STORE to end the edit session Use the arrow key
47. ree millimeters of the manometer reading or 2 of the reading whichever is greater the accuracy of the manometer At the end of this procedure the monitor will display an event code 6 Disconnect the T tube from the monitor Disconnect the air hose and sphygmomanometer from the T tube Re connect the cuff to the monitor 4 3 Ambulatory Blood Pressure Monitor Calibration Procedures The following procedures allow field testing and calibration of the Model 90217 ABP Monitor Equipment Required Computer system 90219 02 compatible with appropriate software DC voltmeter 4 5 digits Fluke 8060A or equivalent Diskette 90217 Production Test Aids P N 063 0609 xx Diskette 90217 RAM code current version AA type batteries 3 ea Cable IR communications 90217 90207 P N 012 0097 02 or later Calibration test setup see page 4 5 Screwdriver 0 05 flat blade insulated handle Screwdriver Phillips 0 tip Screwdriver Phillips 1 tip Hemostats Magnet Preparation 4 4 Carefully read through these procedures Connect the communications cable to the IR port on the 90217 Load the Production Test Aids software Xmain exe onto the hard disk of the computer system Copy the 90217 RAM code into same directory as Xmain exe program Production Test Aids software Ensure that charged batteries 3 are installed into the 90217 monitor e A voltmeter may be used to check battery condition NiCads 1 30 V full
48. s 90217 Field Replaceable Parts Lists 0 0000 cece eee 1 DraWINGS EE deed dba Awaba Hid eae Peek e deed Gadd 3 90217 Field Replaceable Parts Lists Assemblies Description Part Number Manifold Assembly 0 0000 cence eee eee 650 0399 xx ECB PCBA utvirket Bae eyes 672 0171 xx Pump Assembly 0 0 0 e eee eee eee 119 0060 xx Standard Accessories Description Part Number Standard Adult Pressure Cuff Assembly 0 5 015 0068 xx Carrying Pouch iiai eu aa aia ye ce bed ea sien 016 0340 xx Strapuat Lu nb o Aah be dade nokta es hatter 016 0262 xx Belt at Xe ran ata 016 0080 xx Calibration Kit vis os 2 sv ebay eed ead ee a va 016 0040 xx Garment Clip m edits Lada Meds pee nek Bebe y 344 0008 00A Battery Set 3 AA alkaline CellS o ooooooooooooo 146 501 1 xx Patent Di ryusrarutditaietd alder sie Bhd ee ad 000 0027 xx Operations Manual 1 0 0 0 00 cece ete ee 070 0137 xx Binder for Manual oooooccococoo ee 006 0075 xx Ambulatory Blood Pressure Monitor Optional Accessories Description Part Number Child s Cuff 220 4420 ig rss ewes datet sti 015 01 18 xx Small CU ee A et 015 0067 xx Large Culiacan acordada mena Te alanis 016 0077 xx Extra Large Adult CUff o oooococococccooo 016 0109 xx Cuff Support Harness 0 000 e eee rennene 015 0070 xx Service Manual 0 00 en E eE aa R EA RARES 070 0502 xx Labels Description Part Number Domestic L
49. s to move the cursor to the NAME box Select the sequence to be named and press the appropriate button F1 F2 F3 etc Use the arrow keys to move to each character and use the UP and DOWN arrow keys to change the character When complete press ENT to end the edit Manifold Kit P N 050 0110 00 To replace the manifold in the 90217 monitor 1 Disassemble the 90217 ABP Monitor and remove the 672 0171 xx assembly Separate the manifold from the rest of the assembly by cutting through the 176 0279 00 four conductor flexstrip cable Refer to Disassembly Procedures on page 4 14 Unsolder the remaining section of flexstrip from the 672 0171 xx assembly and clear the holes of solder From the back non display side of the display board insert the leads from the new flexstrip They are pre attached to the manifold and should fit into the cleared holes in the old assembly Do not bend or stress the new flexstrip any more than necessary during replacement Ensure that the flexstrip is squarely aligned with the display board and fully seated Solder the four leads in place and trim excess lead length Install the 672 0171 xx assembly back into the case Perform a full monitor calibration Refer to Calibration Procedures on page 4 4 Reassemble the 90217 monitor 4 13 Ambulatory Blood Pressure Monitor Disassembly Procedures WARNING e Never touch electrostatic sensitive electronic components without following proper anti stat
50. sive Blood Pressure NIBP Neonate Fetal Monitor Connection Analog Fetal Monitor Connection RS232 Digital Physiological Monitor Connection RS232 Digital Input gt Reset N Y Hard Drive Power Indicator LED ra N Activate Telemetry Recorder Omnidirectional Microphone Battery Status Universal Serial Bus c o 83 ar s Stand by Low Battery Gas Sampling Port Gas Return Port 7 6 Symbols Symbol Description Symbol Description Operates on Non Harmonized Radio aa Serice Message Frequencies in Europe 9 Happy Face E Sad Face Reset Power Indicator LED kort Magnifying Glass Compression File Cabinet List of Rooms Printer 4 Arrows 7 7 Ambulatory Blood Pressure Monitor Abbreviations used as symbols are shown below Symbol Description Symbol Access Codes Description ree 1 Through 32 ne A ANT 1 Diversity Antenna System 1 Arr1 Arrhythmia Net 1 ANT 2 Diversity Antenna System 2 ArrNet2 Arrhythmia Net 2 CH EEG EMG or ECG Channel ch EEG Channels CH1 CH2 CH3 CH4 cmH20 Centimeters of Water EMG Channel CH5 C O CMV Controlled Mechanical Ventilation CO Cardiac Output co DIA Diastolic FCG Electrocardiogram dia ecg EEG Electroencephalogram EMG Electromyogram eeg emg E
51. stat to clamp the hose going to the 90217 and pump the pressure to 280 mmHg 4 2 Clamp the hose going to the squeeze bulb with a hemostat and measure the leakage rate system leakage 3 Unclamp the hoses going to the 90217 and squeeze bulb 4 Repump the system to 280 mmHg reclamp the hose to the bulb and measure the leakage rate 90217 system leakage 5 Subtract the first leakage rate system leakage from the second leakage rate 90217 system leakage 4 8 Maintenance Verify that the pressure drop due to 90217 leakage is lt 6 mmHg per minute or lt 4 mmHg per 4 minutes for 90217 41 Japan and lt 4 mmHg per 2 minutes for 90217 32 units German Release the system pressure Over Pressure Checks 1 2 Press the Esc key the main menu should return From the Main Menu select 9 HARDWARE OVERPRESSURE TEST Verify that the pump starts and continues to run building pressure until the hardware over pressure limit is achieved Verify that the pressure value appearing at the bottom of the screen falls between 285 and 295 mmHg Press the Esc key Over Pressure Relief Valve Check Do 91 RR 8 9 Power the 90217 OFF Disable the hardware over pressure circuit by connecting TP8 over pressure test point to TP9 ground using a small patch cable Power the 90217 ON From the initial menu select 2 MAKE CONTACT WITH MONITOR When the Main Menu appears select 9 HARDWARE OVERPRESSURE TEST T
52. t changes when attempting to communicate Data being received fails the CRC test and is declared corrupt Check communications cable for tight connections If it is loose and a bright external light is present the light may be corrupting the data Data is not retained Replace backup battery Power is low or not there Check the batteries for correct polarity and a full charge If needed replace or recharge the batteries Can be one of the following time out no reading due to air leak in the system improper cuff size or cuff not properly attached to the monitor Isolate cause and correct If using a modem phone line is bad Have phone company check out line If using a modem phone system is incorrectly configured Verify modem configuration with the phone company and with Spacelabs Medical Technical Support Department Monitor displays LLL and alarm sounds Main battery is low Turn OFF monitor immediately Replace batteries to continue monitoring Cuff is too tight Cuff placed on the patient too tightly Reposition the cuff The air pump stayed ON too long Return the unit to Spacelabs Medical for service Cuff is too loose when inflated Cuff is placed on the patient too loosely Reposition the cuff Air pump is not staying ON long enough Return the unit to Spacelabs Medical for service 5 5 Parts Content
53. ure Monitor 3 3 If present remove the old AA batteries from the monitor and replace each with a fresh alkaline battery or fully charged nickel cadmium being careful to match polarities where indicated or e The monitor will not operate if batteries are incorrectly installed Oo e Ifthe monitor is going to be stored longer than two weeks remove the AA batteries to prevent the possibility of leakage or discharge Spacelabs Medical is not responsible for product damage caused by battery leakage If your unit has been damaged by a leaky battery contact the battery manufacturer for any recoverable repair costs 4 After correctly inserting the batteries gently slide the battery cover back into place 5 Switch the monitor ON and verify that the display appears If there is no display switch the monitor OFF and refer to the Troubleshooting chapter in this manual When power is first switched ON the first four digits of the RAM code revision are displayed for about 1 second followed by a blanked display followed by the last two digits of the revision number Initializing the Monitor The ABP monitor must be initialized prior to use Initialization specifies the monitoring period patient information time format measurement interval monitor tone ON OFF during selected periods event code display and whether or not to display pressure values To initialize the monitor connect itto one of the following analysis systems Lo
54. vement artifact at mean arterial pressure B Heart rate arrhythmia 40 A Movement artifact at systole B Heart rate arrhythmia 50 A Movement artifact at diastole B Heart rate arrhythmia Monitor displays EC01 Base Station report prints 11 Did not pump above the mean arterial pressure 21 Did not pump above the systolic pressure Monitor displays EC02 Base station report prints 12 Did not reach initial cuff pressure The cuff may have been improperly applied or there may be an air leak 22 Overpressure 32 Overpressure 42 No cuff attached 52 Kinked hose 62 Cuff applied too loosely 72 Kinked hose 82 Kinked hose Monitor displays EC03 Base station report prints 03 Patient canceled measurement by pressing monitors START STOP button Monitor displays EC04 Base Station report prints 04 Measurement not completed within 110 seconds Occasional EC04 messages may result from excessive patient movement Frequent EC04 messages would either indicate an improperly placed cuff or a monitor malfunction which requires service 5 3 Ambulatory Blood Pressure Monitor Monitor displays EC05 Base Station report prints 15 Equipment malfunction Return it to Spacelabs Medical for service 25 Unit failed to initialize Please re initialize 35 At least one of the blood pressure or time readings obtained before the event code is erroneous Interpret all readings with caution 55 A Measurement aborted because cuff
55. y the pump pressure depending upon how the monitor was initialized 5 Verify that the system pumps up to 165 mmHg 8 mmHg before the pressure begins to drop in 7 to 9 mmHg steps Ensure that the pressure does not drift down e It may take 3 or 4 steps before the cuff size is learned by the monitor and the steps fall within this range 6 Verify that the display reads EC18 7 Open the bulb valve and remove the monitor from the manometer setup PC Interface Test Connect the system as illustrated Power ON all devices Start the 90219 03 Base Station software loaded on hard drive AB oO N Type ABP or ABPPCI and press the Enter key on the base station e Ifthe file name has been changed from ABP type DIR and press Return to determine the new name 2 8 10 11 12 13 14 15 16 17 18 19 20 21 Setup Switch the 90217 power switch ON Press in this order Space Bar 1 ABP communication 3 direct connect skip this step if a PC Interface data key is attached instead of a base station data key 2 read ABP unit Press any key wait Type 8 Enter key and Y yes e 8 is the name of a dummy file which should be setup on the computer already Press the END key Verify that the clinical data appears on the computer screen The last reading on this screen is the results of the test done earlier in these procedures Verify that the d
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