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SERVICE MANUAL - ERS Biomedical

Contents

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3. 95 Ultrasound RBEPTEXCOPUNTU TROC 96 Applicator Movement 5 5 gd ett atas HE edet uf ates E a A Ee tiene Cle 96 Patient Susceptibility 2cacie he oet uda nodu gods 96 Potential for BUrns aie gea emer aos igni ep v du Ho Eo SERE e 96 Output Power n tira ets ess el Hed e ae eto en Re ddr eH etes 97 Penetration of Ultrasound Waves ss 97 Couplings instant aline e eid ede tecta 97 Section V Ultrasound Technical Information Ultrasound 100 Beam Prol eie RIRE DP SERRE 101 Enter Soundhead Parameters oerte uses Den srl ns DARE NEN rt ee ni it UR Conon n 104 New SmartHeads1M i cri es oes pie eene ge et edere tette dett ares 104 Using Older Model Soundheads With the 50 Series Plus eee 104 Calibration Procedure NE nn Perret 106 Problem Solving 109 Soundhead Temperature Too Hot sise 109 Cooling the Soundhead 109 Whirlpool Treatments t et ee e e a tet Re edd 109 Soundhead Temperature Too Cold sise 110 No Soundh ead ee eret tee eene tete etr cele dle eletto er ete eee peter 110 Other Error Messages in the Display ss 110 Section VI Technical Information General SpecifiCatiOns ee 114 Dynatron 850plus and 550plus Specifications ss 114 Stimi Spe
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6. O 5 RAMP 1 5 RAMP 2 0 RAMP Dynatron 550plus Control Panel key while you press the Stop key or by reducing that channel s treatment time to zero 3 PAUSE FUNCTION This key is used in combination with other key presses for accessing unique features including select polarity high volt and microcurrent audio volume control microcurrent and to stop one treatment only Specific instructions for using this key are provided later in this manual For Dynatron 850plus only This key is also used to pause an ultrasound treatment First press the channel toggle CH to select SOUND then press PAUSE FUNCTION the ultrasound output is stopped the treatment time is paused and the light on the Pause key is on When this key is pressed again the ultrasound treatment resumes and the light on the Pause key is off The PAUSE option is not available with the Dynatron 550plus since that model does not offer ultrasound NOTE During a Combo treatment only the ultrasound output and the treatment timer are stopped when you press Pause the stim output continues 4 TIME ARROW KEYS These UP DOWN arrow keys are used to increase decrease the treatment time or other parameter that is displayed in the Time display 5 TIME DISPLAY This display is used to show the treatment time for one treatment at a time the display shows treatment time for the selected channel the selected channel is indicated by the green LED all other
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8. O1 e uv TIME O2 OMICRO FREQ CH SOUND RATE WIDTH IFC HIGH PREMOD Low TARGET SWEEP O 10 O 20 O 50 CONT PAUSE FUNCTION BIPHASIC 28 NORMAL O CO CONT O RECIP 1 0 RAMP 1 5 RAMP 2 0 RAMP MICRO O 10 10 x O CONT 5 RAMP mens Use these arrow keys to change the upper limit of the range SOUND 1 MHz O 2MHz COMBO y 3 MHz CH1 CH 2 HV Press this toggle key to select RATE The Time and Intensity displays then show the lower and upper settings for the PULSE RATE range you have selected High or Low In the example above 80 Hz is the lower limit for the range and 120 Hz is the higher limit for the range Use the arrow keys beside each display to change either or both of these frequencies if desired NOTE By setting both displays to the same value you can deliver a treatment at a single PULSE RATE rather than sweep through a range For example set both the upper and the lower limits at 100 for a 100 Hz treatment When you are finished setting the pulse rate range press the Time toggle key to return to the Time display After 10 seconds with no key presses the Time display automatically returns 6 Change the treatment TIME if desired If the Time LED is not lighted press the Time toggle key to select Time The default time is displayed Use the Time arrow keys to increa
9. The FDA has issued a Public Health Advisory regarding Unsafe Electrode Lead Wires and Patient Cables Used With Medical Devices This warning pertains specifically to lead wires with unprotected pins that is leads with one end connected to the patient and the other end having pins that can be inserted directly to a power source such as a wall AC outlet The diagrams on this page illustrate the compliance of configurations using Dynatronics electrodes and lead wires Neither the Poly electrodes with snap adapters nor carbon electrodes have lead wires or pins that could allow direct connection to a power source Polys electrodes with wire connector have a short pigtail 3 to 5 inches in length the pigtails have female connectors Since all Dynatronics electrodes have either no lead wire at all or very short pigtail lead wires it is impossible to connect an electrode directly to an improper power source when the electrode alone is attached to the patient Lead Wire From Patient to Device Electrode attached to patient Lead wire from patient only when an electrode is attached Stereo connector to device requires a stereo jack Cannot be inserted into a wall outlet N p Tip not connected to patient General amp Technical Information 120 Dynatrone 850plus amp 550plus When the electrode is connected to a patient lead wire as shown in the diagram above the stereo jack at the opposite end of t
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11. 76 High Volt Therapy with Electrodes ss 76 High Volt with Optional Probes ette ee Ee un PNR Rte eet 76 Hish Volt WavV ons ses Meter tiefe a eee heres be He ge b He Een eate oie dte 76 on me efte t ee eter ue ded adi 76 Dynatrone 850plus amp 550plus Microc rrent THEPAPY M A 78 Microcurrent Therapy with Electrodes ss 78 Microcurrent Therapy with Probes seen 78 Microcurrent Waveforms dne need der der decedere Ede ani 78 Macrocurrent Settings uae Ete ge E Re e Re E ERU Re En eae oue Ee eta 78 Ultrasound Therapy EP 79 About Ultrasound ei e egere tre denm cep ree o Pie eri eie at 79 SmattHeads EET RE Ree NACER nts 79 Patient Coupling ene mte ale oL i ER e Ee Coe ete 79 Soundhead Temperature aded are e dte e ire iHe rede pee dete 80 Section IV Contraindications Warnings and Precautions Contraindications Warnings amp Precautions for Interferential Premodulated Russian Biphasic and High Voltage Pulsed Stimulation 4 e eres eese esee ee ee eene eene ense sten ta seta setas etas 82 CornttattidicatioDs ea ote leet Ht ete i dee EA ite 82 Warnings en GRE RU I e e eed tens 82 Prec utions n SIR Rr ME oo al go de a DEM Eye on UE EYE de Li 83 Treatmen
12. Continue to ensure the soundhead is making contact with the patient s skin 1 Press START If you fail to set the intensity or ultrasound power before pressing START the Power Intensity display will begin flashing and you will be unable to start the treatment until you set the intensity Remember that you must set both the intensity for the stim treatment and the power for the sound treatment NOTE SAVE DEFAULTS The default combination treatment includes ultrasound with premodulated treatment for five minutes The stim treatment parameters are derived from the defaults for that modality You may change the default stim modality for COMBO treatments to any of the stim modalities available with COMBO You may also set a new default treatment time 1f desired To save new default settings after setting up the treatment press and hold the START key for two seconds At the end of two seconds you will hear a beep indicating the treatment parameters have been saved If you changed any parameters for the stim modalities during this treatment setup those parameters will also be saved as the new default settings for that modality Any ultrasound parameters that are saved will apply only to combo treatments separate ultrasound treatments may have separate default settings Press STOP if it is necessary to stop a treatment before time has expired When the treatment time has elapsed the current to the patient stops and a tone sounds not
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14. 1 1 19 2 3 9 4 1 0 9 1 1 1 9 2 1 3 9 4 1 3 MHz 0 9 1 1 1 9 2 1 3 9 4 1 1 Watt 1 0 1 5 Watts 1 5 2 Watts 2 0 2 MHz 0 9 1 1 19 2 1 0 9 1 1 14 1 6 XXXXXXX Ground Fault Chassis leakage not to be greater than 75 uA and on leads 20 uA Leakage no ground chassis leads chassis leads Leakage grounded chassis leads chassis leads Hot Return reversed chassis leads chassis leads ACCEPTANCE Schematics and QC Check Lists DS005C REV 6 10 25 02 129 Dynatrone 850plus amp 550plus DYNATRON 650 550 PLUS and PLUS E FINAL QUALITY CHECK Unit S N Software Ver Repair RS Production Verify all LED s light all key presses function and have 1 2 Date good tactile feel INTERFERENTIAL 42 55 Vpp a Static High Low all channels 4Vpp b Target Sweep all channels c Modify Features mode time function cancel d Verify current limit 50 mA maximum PREMODULATED 42 55 Vpp a High Low all channels b High Low alternate all channels c Modify Features mode time cancel d Verify current limit 50 mA maximum RUSSIAN STIM 42 55 Vpp a One Channel Normal all channels b Two Channel Reciprocal channel pairs c Two Channel Co contraction channel pairs d Verify current limit 50 mA maximum BI PHASIC 42 55 Vpp a One Channel Normal all channels b Two Channel Reciprocal channel pairs c Two Channel Co contraction channel pairs d Verify current li
15. COMBO 3 MHz CH1 CH2 HV Press this toggle key to select FREQ The Time and Intensity displays then show the lower and upper settings for the range you have selected High or Low In the example above 80 Hz is the lower limit for the range and 150 Hz is the higher limit for the range Use the arrow keys beside each display to change either or both of these frequencies if desired NOTE By setting both displays to the same value you can deliver a treatment at a single frequency rather than sweep through a range of frequencies For example set both the upper and the lower limits at 100 for a 100 Hz treatment Modify frequency ranges in Interferential or Premodulated treatments 4 Choose HIGH LOW HIGH LOW alternating or HIGH LOW consecutive Press the HIGH LOW toggle key one or more times to select the high frequency range the low frequency range or both The lights next to the toggle key show what you have selected Select from the following options a b High only Toggle until only the High light is on Low only Toggle until only the Low light is on High Low Alternating Toggle until both High and Low lights are on only one of these is flashing When the treatment has started the device alternates between the two modes at intervals of approximately 30 seconds each beginning with Low High Low Consecutive Toggle again both High and Low are flashing During the first half of the treatme
16. Plug a lead into Channel 1 no other channel is used for the lead test Remove snap adapters if applicable from the leads and hold the tips pins together UNDER NO CIRCUMSTANCES SHOULD THE LEADS BE CONNECTED TO A PATIENT DURING THIS TEST Press START A tone will sound until good contact with lead pins is achieved Hold the pin ends of the lead together The tone will sound when the connection is bad for any reason Hold the pins securely together move the leads around wiggle the cord especially at the jack end of the cord If the tone sounds even for a short time check to be sure you are holding the pins together If the tone continues to sound and you are certain the pins are touching the leads are probably bad and should be replaced After the test remove the lead from Channel 1 Plug in the next lead to be tested and continue testing all leads in this way To exit the Lead Test function press STOP The device then shows the normal treatment displays and you may proceed with treatment setup NOTE The lead Test should be used for testing patient lead wires only This is not an accurate means of testing carbon electrodes Contact Dynatronics Customer Service to arrange for free testing of carbon electrodes or for instructions for testing these electrodes Current Limit The Dynatron 850plus and 550plus continuously measure the actual current output during a treatment and limit the output current to the level indicated in Te
17. This feature for models having software greater than Rev 1 01 only see Page 2 This added safety feature warns you if the device detects an open or incomplete circuit during setup of an interferential treatment An open can be due to a lead that is not plugged in an electrode that has fallen off or otherwise is not making contact with the patient or another reason that would cause an incomplete circuit When this occurs current is not being delivered to the patient and the condition must be corrected before continuing with treatment setup LEAD ERROR No Patient Current A TIME BEN aT A LOC y No Patient Current During an interferential treatment setup if an open is detected the Lead warning is displayed along with the channel number that triggered the error When the device detects this condition during the treatment setup it will beep and display LEAD in the Time display and will indicate in the Intensity display the number of the channel that has triggered the error for example CH1 and you will be unable to increase the intensity setting If this error occurs reduce the intensity for the channel indicated correct the condition then return the intensity to the desired treatment level In adjusting Operation amp Treatment Instructions 22 Dynatrone 850plus amp 550plus intensity always observe the warnings and precautions provi
18. Treatment Instructions ULTRASOUND 53 Dynatrone 850plus amp 550plus When the temperature is again satisfactory press the START key to resume the treatment output power resumes the displays return to its normal state and the timer resumes While the soundhead is still too hot the device will not allow you to resume the treatment To prevent overheating of the soundhead maintain good coupling throughout the treatment For direct coupling you may need to apply more conductive gel or lotion during the treatment to achieve better coupling You can reduce the power during the treatment if you are treating an area where it is difficult to obtain good coupling Head Temperature Bar Graph During an ultrasound treatment you can view a graph showing the relative soundhead temperature by pressing SOUND and the HI LO keys simultaneously As shown in the illustration below the Time display shows the letter followed by a bar graph with from 1 to 6 segments lighted The more segments displayed the hotter the soundhead This display does not provide an actual temperature reading but does give a visual indication when the soundhead is becoming too hot To return to the treatment time display press the TIME key Head Temperature Bar Graph TIME POWER INTENSITY START A STOP I PAUSE FUNCTION Press the SOUND and the HI LO keys simultaneously during an ultrasound treatment to view a graph showing relative head temp
19. c Verify that polarity changes FAILURES Step No Reason Repaired ACCEPTANCE Technician Date TECH initials QC Inspector Date Technician Date Schematics and QC Check Lists DS005C REV 6 10 25 02 128 Dynatrone 850plus amp 550plus DYNATRON 950 850 Plus FINAL QUALITY CHECK QC CHECKOFF SHEET Unit S N Software Version Date Repair RS Production Head SN 5 10cm 2cm lem Refer to Test equipment operation manual and unit operating instructions manuals TECH QC initials e Verify all keys work all keys have good tactile feel e Verify all LED s light up e Verify output turns off when STOP is pressed e Verify head temperature bar graph works e Verify coupling bar graph works with 5cm smart soundhead e Verify unit and soundhead serial number e Verify stim jack is tight e Combo with stim Verify stim output through soundhead using combo cable e Verify ultrasound output power for each head per table below 2 5 Watts 0 5 5 Watts 1 0 10 Watts 2 0 2 4 2 6 4 9 5 1 9 8 10 2 2 4 2 6 4 9 5 9 8 10 2 2 4 2 6 49 5 9 8 10 2 5 Watts 0 5 10 Watts 1 0 20 Watts 2 0 4 9 5 1 9 8 10 2 19 0 20 4 4 9 5 1 9 8 10 2 19 0 20 4 4 9 5 1 9 8 10 2 XXXXXXX 1 Watt 0 5 2 Watts 1 0 4 Watts 2 0 0 9
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21. parameters have been saved The next time you select the MICRO modality these parameters are selected automatically Separate default parameters may be saved for both treatments with electrodes and with probes See Setting Defaults in this manual for further instructions 8 Turn AUDIBLE TONE on off and or adjust volume The audible tone allows you to monitor conductance if desired As conductance increases as resistance is decreased the tone becomes higher in pitch The audible tone is defaulted to ON for probes treatments and OFF for electrodes treatments but may be changed After the microcurrent treatment has started the MICRO key acts as a toggle key to turn the tone on and off Press MICRO to turn the tone on or off You may also adjust the tone volume after the treatment has started To adjust the volume PRESS and HOLD the FUNCTION key and at the same time use the Power Intensity arrow keys to raise or lower the volume until a comfortable volume setting is found The Power Intensity display will temporarily show an MICROCURRENT Treatment Instructions 44 Dynatrone 850plus amp 550plus incremental value representing the volume selection You must continue holding the FUNCTION key down while adjusting the volume When you release the FUNCTION key the Power Intensity display returns to its normal display 9 MODIFY a treatment in progress While the treatment is in progress you can modify the treatment paramet
22. 2 MHz 3 MHz 0 10 watts 0 2 0 w cm 10 10cm2 head 1 MHz 2 MHz 0 20 watts 0 2 0 w cm 10 10cm2 head 3 MHz 0 10 watts 0 1 0 w cm 10 Environmental Conditions Transport and Storage This equipment is capable while packed for transport or storage of being exposed to environmental conditions not outside the following ranges a an ambient temperature range of 40 C to 70 C b a relative humidity range of 10 to 100 including condensation c an atmospheric pressure range of 500 hPa to 1060 hPa Operation This equipment complies with requirements for operation in normal use under the least favorable combination of the following environment conditions a an ambient temperature range of 10 C to 40 C b a relative humidity range of 30 to 75 including condensation c an atmospheric pressure range of 700 hPa to 1060 hPa Safety Features of the Dynatron 850plus and 550plus e Double redundancy protection on output amplifiers e Current sensing If current reaches the current limit for the device intensity is automatically reduced Service 115 Dynatrone 850plus amp 550plus intensity levels are automatically set to zero at the end of treatment ensures proper setting of intensity levels for the next patient Internal surge protection protects against line noise machine switching operation and any other type of interference that could cause patient discomfort Soundhead temperature monitoring prev
23. 2 cm Head Near Field Ultrasound Technical Information 103 Dynatrone 850plus amp 550plus Enter Soundhead Parameters For Dynatron 850plus users only New SmartHeads The Dynatron 850plus features Dynatronics new SmartHead soundhead that has all calibration information self contained With the new SmartHead it is not necessary to enter soundhead parameters as with earlier Dynatron devices The new SmartHeads can be used with the Dynatron 125 or the 50 Series PLUS models Do not use SmartHeads with former Dynatron devices including Dynatron 150 850 950 800 or 300 Using Older Model Soundheads With the 50 Series Plus Soundheads that were designed for use with the Dynatron 50 Series products may be used with the Dynatron 850plus However these earlier models do not have the calibration information self contained and it will be necessary for you to enter the unique parameters for that soundhead into the Dynatron 850plus before using the soundhead The following instructions are provided only in the event you need to enter soundhead parameters Be sure to follow these steps carefully to ensure you have entered all parameters correctly The procedure utilizes keys and displays on the key pad that are normally used for other purposes but which have specialized applications in the Head Parameters Mode If you have any questions about the following instructions contact Dynatronics Customer Service Department before pro
24. Power Meter These values are automatically entered and stored in the Head Parameters for the Head Size Power Meter Value device this operation is automatic and 1 2 1 watt invisible to the user Record these values 2cm2 2 watts on the calibration sheet for future 5cm2 5 watts reference 10cm2 10 watts 7 Press the frequency toggle key to select 2 Target value is 1 0 w cm for the MHz The 2 MHz LED will light soundhead size used indicating the soundhead is now ready to be calibrated at this frequency Repeat steps 3 through 5 above 8 Press the frequency toggle key to select 3 MHz The 3 MHz LED will light indicating the soundhead is now ready to be calibrated at this frequency Repeat steps 3 through 5 above 9 f you wish to cancel the calibration procedure without storing any new calculations press the PAUSE key 10 This completes the calibration of one soundhead For devices that use more than one soundhead you must calibrate each of those soundheads individually To calibrate the next soundhead turn the machine off and repeat steps 1 through 10 above CAUTION Avoid unnecessary ultrasound exposure Ultrasound Technical Information 108 Dynatrone 850plus amp 550plus Problem Solving Soundhead Temperature Too Hot If poor coupling occurs during a treatment the temperature of the soundhead rises and the patient does not receive the full ultrasonic output This device continuously measures the temperature o
25. RAMP 2 0 RAMP Dynatron 850plus Control Panel Dynatron 850plus and Dynatron 550plus Physical Features Before operating the Dynatron 850plus or Dynatron 550plus acquaint yourself with the control panel by reviewing the illustrations and descriptions on this and the following pages The numbered features in the diagrams correspond to the numbered descriptions Before administering treatment to a patient read the sections later in this manual that provide specific instructions for performing treatments discussions of each modality definitions of the available options along with contraindications warnings and precautions for all modalities Note that some options use toggle keys for making selections More specific instructions for using toggle keys are provided later in this section General Selections 1 START Pressing this key starts the treatment timer and treatment proceeds as set up 2 STOP Pressing this key during a treatment IMMEDIATELY stops the output and sets the treatment time to zero for all modalities Treatments may also be stopped by pressing the button on the patient REMOTE STOP cable You can also stop a treatment for one treatment only by pressing and holding the Function Installation amp Features Dynatrone 850plus amp 550plus 11111 II LILI O O CO CONT O RECIP O 10 10 10 30 10 50 CONT
26. SWEEP or STATIC for Interferential treatments only 6 Increase INTENSITY patient will feel the current 7 Press START 8 Press STOP if you need to stop a treatment before its time has expired stops all current treatments IFC amp PREMOD Treatment Instructions 24 Dynatrone 850plus amp 550plus NOTE Prior to increasing intensity electrodes must be placed on the patient and the lead s attached to the device Plug the lead s into the channel s the device selects for this treatment Give the remote stop cable to the patient Consult published sources for electrode placements treatment settings and treatment times Make sure electrodes make good contact with the patient s skin over the entire surface area of the electrode Improper electrode contact may result in patient injury Detailed Interferential Premodulated Setup 1 Press PREMOD key once to choose interferential or press this key twice to choose PREMOD premodulated When you choose IFC channels 1 and 2 are automatically selected When you choose PREMOD the first available channel is selected make sure the patient lead is plugged into the correct jack for the channel selected The default settings for the modality are automatically selected too and if you wish to use the default settings you can now increase the intensity to the desired level then press START If you wish to change the treatment settings do the following
27. TARGET Press the toggle key to select this option if it is not already selected The patented Target feature allows you to pinpoint the treatment site to deliver the full interferential current where it is needed NOTE You must set the intensity before using the Target Pad so the patient will be able to tell you when the treatment site is found Also remember an injured area will often be more sensitive to the current delivered Therefore an intensity setting that is comfortable to the patient at first may feel uncomfortable when the treatment site is found using the Target pad If necessary reduce the intensity to the patient s comfort level SWEEP Press the toggle key one or more times to select this option This option uses Dynatronics patented Target feature to automatically move the point of interference in a somewhat spiral fashion covering 75 to 80 percent of the area within the electrodes This allows you to bathe a more general area with the interferential current while retaining the full interferential beat STATIC This option is applied when neither Target nor Sweep are selected Press the toggle key one or more times to unselect those options the LEDs will both be off The treatment becomes a STATIC treatment In other words it simply allows the two currents to take a path of least resistance and intersect at a natural point within the electrodes Press START When you press start the treatment timer begins counting down and
28. Ultrasound Instructions are for DYNATRON 850plus USERS ONLY The Dynatron 550plus model does not offer the ultrasound feature WARNING ALWAYS keep the applicator soundhead in constant motion ALWAYS keep the soundhead properly coupled to the patient s skin or submerged under water when intensity is turned on Use ample conductive gel to ensure good coupling throughout the treatment If needed apply additional gel during the treatment See the section of this manual entitled Contraindications Warnings and Precautions for ultrasound treatments Be alert for any sign of periosteal bone pain Be sure to read all instructions for operation before treating a patient Do not drop the soundhead on hard surfaces do not cool the soundhead with ice water or ice packs do not allow the soundhead to overheat repeatedly and do not hold the soundhead in the air while a treatment is running All of these conditions are likely to damage the soundhead crystal and or to stress electronic components in the device CAUTION Use of controls or adjustments or performance of procedures other than those specified herein may result in hazardous exposure to ultrasonic energy Make sure a soundhead is firmly plugged into the device before turning the device on When changing to a different size soundhead turn the machine off first remove the soundhead plug in the desired soundhead then turn the machine on again NOTE The patient Remote Stop ca
29. With this modality you can deliver muscle stimulation treatments selecting from an array of options including normal co contraction and reciprocal contraction selectable on off cycle times and ramp times and customizable pulse rate and pulse width High Voltage Pulsed Stimulation This traditional electrotherapy modality offers a pulsed monopolar current with pulse widths in the microsecond range and pulse rates ranging from 1 to 200 Hz utilizing a twin peak monophasic waveform Polarity on off cycle time and ramp time are selectable and pulse rate may be customized for each treatment Treatment may be delivered using either electrodes or optional probes Microcurrent Therapy Microcurrent treatment may be delivered using two electrodes for unattended therapy or the optional hand held probes for manual treatment You may select the desired polarity and customize the frequency and intensity An audible tone allows you to monitor conductance The following additional modalities are provided with the Dynatron 850plus not included with the Dynatron 550plus Ultrasound Therapy The Dynatron 850plus includes Dynatronics patented multi frequency ultrasound capability Soundheads are available in 1 cm 2 cm 5 cm and 10 cm sizes Each soundhead offers 1 2 and 3 MHz The 1 cm soundhead offers 2 and 3 MHz Duty cycle options are 10 20 or 50 percent or a continuous duty cycle Combination Therapy Comboplus Dynatronics new
30. area with the spiral pattern as shown in the illustration to the right interferential current bathing about 80 percent of the area within the electrodes with the interferential current Interferential Electrode Placement When performing interferential therapy with a two channel four electrode setup it is important to arrange the electrodes in a criss cross manner so the current from one channel will intersect with the current from the second channel at the point where treatment is to be delivered Consult published literature for electrode placements for specific sites and conditions Interferential Electrode Placement IFC amp PREMOD General Information 72 Dynatrone 850plus amp 550plus Russian Biphasic Therapy Russian Stimulation With the Dynatron 850plus and 550plus Russian stimulation mode the output of the device is a 2500 Hz sinusoidal wave Russian stimulation currents produce strong muscle contractions The Dynatron 850plus and 550plus allow you complete control over all the parameters of the Russian Stimulation treatment Three treatment modes include Normal for firing one muscle Reciprocal for firing two different muscles at different times and Co contraction for firing two different muscles simultaneously The Dynatron 850plus and 550plus allow you to choose a muscle contraction relaxation cycle from options of 10 10 ten seconds on
31. as this Dynatron device e Do not use the same power outlet or line with a whirlpool and certain traction machines In areas which are carpeted and static electricity is present it may be necessary to use a conductive mat to remove any static charge from the operator Adverse Reactions Skin irritation and burns beneath the electrodes may occur with microcurrent treatment NOTE When using microcurrent frequencies and intensities it is extremely unlikely that a burn may occur However this possibility exists under certain circumstances for example if a high current setting is combined with poor electrode quality and or high current density small current delivery area Monitor the patient s comfort throughout the treatment and change treatment settings if the patient finds the treatment intolerable Ultrasound Technical Information 86 Dynatrone 850plus amp 550plus Contraindications Warnings amp Precautions for Ultrasound Treatment Contraindications The Dynatron 850plus ultrasound should not be applied in the following conditions Pregnancy Acute and sub acute thrombosis and thrombophlebitis Potentially malignant lesions tumors malignant or benign Areas or lumps that may be suspected as cancerous or precancerous Third degree musculo tendonous lesions Cardiac pacemaker Implants of any electrical nature Skin diseases Multiple sclerosis Osteomyelitis Disturbances in cardiac rhythm Tissue or bone with acute
32. at the factory and do not require calibration before initial use However new soundheads purchased separately to add to an existing device may require re calibration before use Also soundheads must be calibrated with the device every six months to a year to ensure proper operation The calibration procedure is provided for use when recalibration is required With the exception of calibration all service on the Dynatron 850plus device should be performed by a Dynatronics service technician If your Dynatron 850plus requires service contact Dynatronics Customer Service at 800 874 6251 The calibration procedure MUST be performed by a qualified ultrasound technician using the proper equipment Calibration may be performed either by Dynatronics or by an ultrasound technician in your local area When to Calibrate Dynatronics recommends that the Dynatron 850plus be calibrated at least annually to ensure the unit is working at its peak performance What to Calibrate You must calibrate all soundheads used with this device at 1 2 and 3 MHz frequencies except the 1 cm soundhead which is calibrated at 2 and 3 MHz only Equipment Required You will require an ultrasound power meter capable of accurately measuring outputs up to 3 MHz Check the manufacturer s specifications to confirm your power meter meets this qualification Ohmic Instrument UPM DT1 or UPM DT 10 are Ultrasound Technical Information 106 Dynatrone 850plus amp 550plus re
33. beat which is between 1 and 150 Hz utilized with four electrodes placed in a criss cross fashion bracketing the treatment site as shown in the illustration to the left The output from Channel 1 is the constant 4000 Hz wave while the output of Channel 2 is the variable 4000 to 4150 sine wave Premodulated Bipolar Therapy Premodulated therapy utilizes one output jack and two electrodes The current delivered is a composite wave form In order to produce this composite current two frequencies are mixed within the device prior to output One frequency is 4000 Hz while the second frequency covers a range between 4000 to 4150 Hz With the Dynatron 850plus and 550plus either of the two channels may be used simultaneously to deliver two separate independent premodulated treatments A criss cross electrode setup pattern should not be used when setting up multiple premodulated treatments Note that a premodulated treatment usually requires a lower intensity setting than an interferential treatment since current is dispersed to only two electrodes rather than four a smaller total dispersement area means greater current density at the treatment site IFC amp PREMOD General Information 70 Dynatrone 850plus amp 550plus Target The Dynatron 850plus and 550plus feature Dynatronics patented TARGET feature available for interferential treatments only simplifies electrode placement for an interferential treatment Int
34. cared for these electrodes can fail to deliver the desired treatment and can present the possibility for injury to a patient To ensure greatest safety and effectiveness with your treatments follow these rules when using carbon electrodes 1 Carbon electrodes must be well moistened prior to treatment setup Dry carbon electrodes are very poor conductors of current and should NEVER be used They may be moistened with either water or an electrolyte spray Water is adequate for short treatments but will evaporate too quickly for longer treatments If water is used for longer treatments you may need to interrupt the treatment and remoisten the electrodes A special sponge fabric available with some carbon electrodes may be moistened well and used as a conductive medium do not use ordinary sponges for this purpose Do not use ultrasound gel as a conductive agent with carbon electrodes Ultrasound Technical Information 90 Dynatrone 850plus amp 550plus If you use an electrolyte spray this liquid may be diluted with equal amounts of distilled water if desired This reduces the amount of build up on the electrodes yet usually provides adequate moistening of the electrodes NOTE As you increase the intensity to higher levels during setup if your patient feels a biting sensation or if the patient feels nothing this indicates you are not getting adequate conductivity the electrode may be too dry or is not moistened evenly across its
35. default stim treatment for combo Stim parameters for this setup are saved and become the default settings for that stim modality both during combo and during separate treatments e Ultrasound parameters for this setup are saved and become the default ultrasound settings for combination treatments only non combination ultrasound treatments may have different default settings treatment time is saved as the default treatment time for combination treatments Treatment Instructions COMBINATION 61 Dynatrone 850plus amp 550plus Simultaneous Treatments The Dynatron 850plus and 550plus allow several combinations of simultaneous treatments to be delivered at once using available channels Simultaneous treatments are not the same as combo treatments A combo treatment combines ultrasound with a stim therapy into a single treatment A combo treatment is always delivered to one patient Simultaneous treatments are independent treatments that are set up separately that have separate treatment timers and which may be delivered to one or more patients at the same time You can set up any number of separate treatments as described below with the exceptions noted Channels 1 and 2 may be used for one interferential two premodulated one premodulated and one Russian or one premodulated and one biphasic treatment For treatments using one channel the device will select the next available channel For treatments usi
36. device These options are explained in detail where they apply in the treatment instructions later in this manual NOTE Where two keys are required ie FUNCTION STOP you must press both keys simultaneously to achieve the result KEY PRESS RESULT DESCRIPTION FUNCTION STOP STOP TREATMENT Stop one treatment FUNCTION HI VOLT CHANGE HIGH VOLT POLARITY Change high volt polarity Repeat to change again FUNCTION TIME CONDUCTANCE BAR GRAPH Press during IFC premod or mcrocurrent treatment to view conductance bar graph Press TIME to return to normal display FUNCTION SOUND HEAD WARMING ON OFF Set head warming feature to on HD 1 or off HD SOUND TARGET ULTRASOUND COUPLING BAR GRAPH During an ultrasound treatment only press to view the ultrasound coupling bar graph Press TIME to return to normal display SOUND HI LO keys SOUNDHEAD TEMPERATURE BAR GRAPH During an ultrasound treatment press to view the ultrasound head temperature bar graph Press TIME to return to normal display FUNCTION DISPLAY WATTS or W cm2 During ultrasound treatment hold for 2 seconds to change ultrasound power display from w cm to Watts or reverse FUNCTION TARGET SWEEP key TEST LEADS Enter the Lead Test Function Then press START to begin lead test and press STOP to exit the lead test function NEVER DO THIS WHILE ELECTRODES ARE ATTACHED TO PATIENT FUNCTION MICRO CHANGE
37. in an Autoclave Daily cleaning is recommended Self Adhesive Electrodes Dynatronics Polys self adhesive electrodes are intended for multiple usage when used appropriately Improper use of the electrodes can decrease the life of the electrode and could even result in harm to your patient The following instructions will help you achieve maximum usage from your electrodes while ensuring patient safety and comfort during treatment 1 Make sure the electrode is adhering and making contact with the skin across the entire surface of the electrode Electrodes will lose their adhesive quality when exposed to air dust dry skin etc To retain adhesiveness electrodes should be stored in a tightly sealed pouch until used The patient s skin should be clean and free from oils or flakiness Ultrasound Technical Information 91 Dynatrone 850plus amp 550plus To Restore Adhesiveness e Before a Treatment Before placing the electrode on patient moisten the patient s skin with a damp cloth using plain water then apply the electrode to the skin e After a Treatment Spray the adhesive side of the electrode with plain water rub it lightly with fingertips then reapply the electrode to its plastic backing and seal it tightly in its storage pouch Do not use an electrolyte spray to remoisten self adhesive electrodes as this substance can destroy the adhesive With this method of rehydration after a couple of hours electrodes can
38. intensity may be displayed at a time Flashing green or flashing yellow indicate the off segment of a biphasic Russian or high volt treatment cycle The channel s intensity and other treatment parameters may only be modified when it has a green indicator light Press the Channel Toggle key CH to select a channel to be viewed TIME TOGGLE KEY Press this key to display various treatment parameters in the Time display including Time treatment time Freq frequency Rate pulse rate and Width pulse width Available options during a given treatment or treatment setup depend on the modality selected TIME GROUP SELECTIONS These lights indicate the parameters that are displayed one at a time in the Time display The default selection is the treatment time Press the Time toggle key to select the desired option available options depend on the modality selected When a parameter is selected its indicator light is green its value is displayed in the Time display above and the time arrow keys may be used to change the value The device returns to the Time display after 10 seconds with no key presses POWER INTENSITY DISPLAY This display is used to display the treatment power for ultrasound or intensity for all other modalities for the currently selected channel the selected channel is indicated by the green LED all other channels in use at the time will have yellow LEDs Press the channel toggle key to select the desired channel
39. or dirt and grime Cleaning with an alcohol wipe should be adequate Allow the alcohol to fully evaporate before applying the electrodes Iontophoresis occurs with all electronic therapies and can drive any of the above surface contaminants below the epidural layer where an allergic reaction may occur 3 Make sure the electrodes being used are in good condition The polyadhesive electrodes should have good adhesion over the entire surface area of the electrode The area where the leads attach to the electrode either through a lead or a snap should not be damaged such that the connection to the foil backing behind the adhesive is broken Carbon electrodes should be deep black and should be free of cracks in the electrode surface Any electrode which is suspect should be discarded it s not worth the price of an electrode to risk harming a patient 4 Some patients tend to be much more sensitive to electrotherapy treatments On patients with this tendency treat with reduced intensity and or shorter treatment times with possibly more frequent treatments if required Most reactions are localized and very short lived so limiting the exposure should minimize any potential for adverse reactions Carbon Electrodes Carbon electrodes provide an economical means of delivering electrotherapy to patients not for use with microcurrent This type of electrode lasts a long time and can be used again and again However if they are not properly
40. selected and either the HIGH or LOW range selected you may use the up down arrow keys to change the upper and lower limits of the range chosen If you set both displays to the same value the treatment will be delivered at that single frequency rather than sweep through a frequency range When you are finished setting the frequencies press the Time toggle key to return to the Time display After 10 seconds with no key presses the Time display automatically returns Treatment Instructions IFC amp PREMOD 25 Dynatrone 850plus amp 550plus Use these arrow keys to change the lower limit of the range or LOW range Use this toggle key to select the HIGH The lower limit in the sweep range is shown here In this example this is the lower limit of the default HIGH frequency range The upper limit of the range is shown here In this example this is the upper limit of the default HIGH frequency range POWER INTENSITY L START Use these arrow keys to change the upper limit of the range PAUSE FUNCTION uic TIME NORMAL D CH S souno sE BIPHASIC WIDTH O RECIP RUSSIAN La O 10 10 HIGH TARGET 10 30 PREM O Low O SWEEP 10 50 HI VOLT O CONT O 10 m O 5 RAMP 20 O 1 0 RAMP 50 TAHGET dS RAMP MICRO CONT 2 0 RAMP 9 SOUND 1 MHz O 2 MHz
41. sepsis Arteriosclerosis or weakened blood vessels Hemophilia Where sensory nerve damage is present with a loss of normal skin sensation The Dynatron 850plus ultrasound should not be applied to the following areas Transcerebrally To the eye To the ear Over a carotid sinus To the heart To major subcutaneous nerves and blood vessels To the spinal cord Around the bulbar area of the spinal cord To reproductive organs Over viscera stomach spleen liver Over epiphyseal areas of the bones in growing children Over stellate ganglion and subcutaneous major nerves To tissues previously treated by deep x ray or other radiation Over the joint capsule in acute or sub acute arthritic conditions Over ischemic tissue in patients with vascular disease Over a laminectomy site Over total joint replacements the effect of ultrasound on the new plastics is unknown The Dynatron 850plus ultrasound should not be used over healing fractures INTENSITY POWER SHOULD BE REDUCED IF PATIENT COMPLAINS OF PERIOSTEAL BONE PAIN BONE ACHE Ultrasound Technical Information 87 Dynatrone 850plus amp 550plus Precautions The Dynatron 850plus must be used cautiously in the presence of any of the following conditions e When there is a tendency to hemorrhage following acute trauma or fracture Acute bursitis Do not use in continuous duty cycle mode Warnings e Do not use in general area where high powered high frequency tra
42. source before using the battery to supply power to this device An optional battery is available for the Dynatron 850plus and 550plus allowing you to deliver up to hours of battery powered treatments wherever power may be unavailable or unreliable To use the optional battery do the following 1 Before use ensure the battery has been adequately charged DISCONNECT the battery charging cable from the battery while it is in use for treatment 2 Plug the battery adapter into the jack labeled BATT on the back of the Dynatron 850plus or the 550plus device Turn the battery pack on 4 Setup and deliver treatments as you normally do 5 When available battery power is reduced to a certain level the device will flash a message BATT LO to indicate low battery power The treatment can continue but you will probably be unable to set up and deliver another treatment when the current treatment has ended 6 When the available battery power becomes too low to continue operating the device the BATT LO message is again displayed the treatment intensity is ramped down and the machine is then shut off Before you can continue with battery operation of the device you must recharge the battery If battery power is fully depleted the message BATT BAD is displayed to indicate either a bad battery or to indicate the battery must be recharged Any treatments that were running at that time will stop NOTE Use the ON OFF switch on the battery pack to c
43. steps Set TIME The default treatment time is displayed Use the Time arrow keys to increase or decrease the treatment time Customize the FREQUENCY settings optional The default High and Low frequency settings are The HIGH range is 80 to 150 Hz The LOW range is 0 to 10 Hz These ranges may be changed for a single treatment if desired or new default settings may also be saved to apply to all future treatment setups The same default setting applies to both interferential and premodulated treatments You may change the frequency settings for the range you plan to select for this treatment if desired see illustration next page Each premodulated treatment may have its own frequency settings After you press START to begin the treatment frequency settings will remain in effect for the duration of the treatment If you save defaults during this treatment the new frequency settings you have entered become the defaults for this modality However if you do not save the new settings the unit will return to the current default settings for the next treatment To modify the frequency during setup first press the toggle key and select either the HIGH or the LOW frequency range Next press the TIME toggle key to select FREQ The FREQ light under the TIME display becomes green and you will see the current frequency range settings displayed in the Time and the Intensity displays as shown in the diagram on the following page With FREQ
44. the High Volt treatment is in progress you can modify the following treatment parameters e Use the toggle keys to select a different contraction rest cycle e Use the toggle keys to select a different ramp time e Use the Function Hi Volt keys to change the polarity Use the Time arrow keys to increase or decrease the treatment time e Use the Power Intensity arrow keys to increase or decrease the intensity You can not change from High to Low or the reverse once a treatment has started 10 Press STOP if it is necessary to end the treatment before the treatment time has expired When the treatment time has elapsed current to the patient is stopped and a tone sounds notifying you of the treatment end Treatments in progress may be stopped at any time using one of the following methods STOP Press this key to stop treatment at all channels You may prefer to stop treatment at one channel only see explanation below REMOTE STOP During unattended therapy a patient stop button is provided to allow the patient to stop treatment The remote cord should be plugged into the machine prior to starting the treatment When the remote stop button is pressed all output from the device is stopped time is set to zero and a tone sounds briefly STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the chan
45. the device then displays the parameters for the next treatment that remains in progress if any Biphasic Russian Default Settings The following default settings are set by the manufacturer and are selected when you select Biphasic or Russian You may change these defaults to your own preferred settings See Setting Defaults in this manual Normal mode e 10 30 contraction rest times e Treatment time 10 minutes e Ramp up and down time 5 sec Treatment Instructions RUSSIAN amp BIPHASIC 33 Dynatrone 850plus amp 550plus Biphasic Stimulation Default Setting Pulse Rate 50 Pulses per second Pulse Width 200 uSec Russian Stimulation Default Setting Pulse Rate 50 Pulses per second Pulse Width 10 mSec Valid Range 1 to 500 50 to 400 uSec Valid Range to 500 depends on Pulse Width 4 to 50 mSec RUSSIAN amp BIPHASIC Treatment Instructions 34 Dynatrone 850plus amp 550plus High Volt Instructions WARNING NEVER turn the power on or off while the unit is connected to the patient Always give the Remote Stop device to the patient prior to the treatment Always STOP a treatment before removing or attaching electrodes or leads Leads and electrodes must only be applied to the patient before a treatment is started Never use worn or damaged leads or electrodes as these may result in injury to the patient See Contraindications Warnings and Precautions in this manual before
46. the treatment proceeds If you fail to set the intensity before pressing START the intensity display will begin flashing and you will be unable to start the treatment until you set the intensity SAVE DEFAULTS If the treatment you have just set up is a common treatment setup you use you can save the treatment parameters as new defaults for your own machine After setting up the treatment simply press and hold the START key for two seconds At the end of two seconds you will hear a beep indicating the treatment parameters have been saved The next time you select that modality these parameters are selected automatically MODIFY settings While the treatment is in progress you can modify any of the treatment parameters if desired Note If you change the treatment time during a consecutive High Low treatment the treatment will revert to alternating High Low Treatment Instructions IFC amp PREMOD 27 Dynatrone 850plus amp 550plus e Use the High Low toggle key to select a different frequency option High Low or High Low alternating only High Low consecutive is only available during treatment setup e Use the Target Sweep toggle key to change this option IFC only e Use the Time arrow keys to increase or decrease the treatment time e Use the Intensity arrow keys to increase or decrease the intensity e Relocate the treatment site by touching the Target pad at any time during the treatment only when Target is sele
47. this channel s parameters The channel is not delivering current while the light is flashing YELLOW Solid You CANNOT see or modify this channel s parameters at this time The channel is delivering current YELLOW Flashing You CANNOT see or modify this channel s parameters at this time The channel is not delivering current while the light is flashing Stop One Treatment STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches zero The output at the selected channel is stopped and the device then displays the parameters for the next treatment that remains in progress if any Pressing the STOP key or the Patient Remote Stop button will stop all treatments at once REMOTE STOP During unattended therapy a patient stop button is provided to allow the patient to stop treatment The remote cord should be plugged into the machine prior to starting the treatment When the remote stop button is pressed all output from the device is stopped time is set to zero and a tone sounds briefly Simultaneous Treatments 63 Dynatrone 850plus a
48. to be viewed POWER INTENSITY ARROW KEYS The arrow keys are used to increase decrease the intensity or power of one treatment Changes made to power and intensity affect only the currently selected channel the selected channel is indicated by the green LED all other channels in use at the time will have yellow LEDs Press the channel toggle key to select the desired output channel The arrow keys may then be used to change the intensity or power for that channel Installation amp Features Dynatrone 850plus amp 550plus IFC Premod Selections 12 IFC PREMOD Press this key once to begin setup of an interferential treatment the IFC LED is lighted press this key twice to begin setup of a premodulated treatment the Premod LED is lighted When you select IFC both channels 1 and 2 are automatically selected and the green LED lights for those two channels will be on Connect two leads to the output jacks for the channels that are selected When you select PREMOD a single channel or 2 is automatically selected and that channel s green LED will be on Connect one lead to the output jack that corresponds to the channel indicated by the green LED 13 HIGH LOW TOGGLE used with interferential premodulated and high volt Press this key one or more times to select the desired frequency range for interferential and premodulated treatments or the pulse rate range for high volt treatments The green LED indicates the opti
49. treatment until the treatment time expires or press STOP to stop all treatments in progress at any time Each of the therapies you can deliver with the Dynatron 850plus and 550plus offers its own default settings To make your treatment setup even more convenient the Dynatron 850plus and 550plus allow you to change the defaults for each modality to your own most common treatment selections See Setting Defaults later in this manual The following pages provide more detailed setup instructions for each individual modality Before administering a treatment to a patient be sure to read all treatment instructions as well as contraindications warnings and precautions for that modality provided later in this manual Also consult published literature for recommended application of these modalities Conductance Bar Graph This feature for models having software greater than Rev 1 01 only see Page 2 During setup of an interferential or premodulated treatment a conductance graph is automatically displayed in the Time display while you set the treatment intensity The graph allows you to see whether conductance is good for that treatment setup and if current is being delivered efficiently through the electrodes The display reverts to the Time display when you press any other key after setting the intensity You may again view this conductance graph at any time during an interferential premodulated or microcurrent treatment by pressing FUNCTION
50. two active electrodes However the area of the dispersive electrode is recommended to be at least double the combined total area of the active electrodes High Volt with Optional Probes High volt therapy with probes accommodates hands on treatment This therapy utilizes a high volt probe and a dispersive electrode The high volt probe is an optional accessory and is not included in the standard accessory package for the Dynatron 850plus and 550plus High Volt Waveform The high volt waveform is a twin peak monophasic Limited to less than 500 V open load decaying waveform with either positive or negative polarity At one half amplitude pulse width is 25 5 High Volt Settings High and Low Sweep Pulse Rate The user may 1 select High 80 120 Hz or Low 1 10 Hz frequency idols s lg ranges During a treatment the device scans through interval spacing the range of frequencies selected The settings for these pulse rate ranges may be modified and saved by the user The available range is 1 to 200 Hz Single Pulse Rate The pulse rate may be set to a High Volt Waveform for positive polarity HIGH VOLT General Information 76 Dynatrone 850plus amp 550plus single pulse rate instead of a range The pulse rate is selected from a range of 1 to 200 Hz Selectable Polarity Positive or Negative monophasic current may be selected You may also select both positive and negative and the current deliv
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52. 0 150 Hz Default Low Range 0 10 Hz Available Range 0 150 Hz NOTE The default frequency ranges and the High Low option you set will be the default settings for both Interferential and Premodulated treatments However every treatment may be modified to have unique settings regardless of the defaults you set Russian Biphasic Default Settings Normal mode 10 30 contraction rest times Treatment time 10 minutes Ramp up and down time 5 sec Russian Stimulation Default Setting Valid Range Pulse Rate 50 Pulses per second 1 to 500 depends on Pulse Width Pulse Width 10 mSec 4 to 50 mSec Biphasic Stimulation Default Setting Valid Range Pulse Rate 50 Pulses per second 1 to 500 Pulse Width 200 uSec 50 to 400 uSec Setting Defaults 65 Dynatrone 850plus amp 550plus High Volt Default Settings Continuous on time Treatment time 10 minutes Ramp up and down time 5 sec Polarity Negative Pulse Rate Default High Range 80 120 Hz Default Low Range 1 10 Hz Available Range 1 200 Hz Microcurrent Default Settings The Microcurrent treatment setup with electrodes is the default and the following defaults are selected e Bipolar wave 3 Hz frequency 50 uA intensity Time 20 minutes counts down Audible Tone Off If Probe treatment is selected the following defaults are automatically selected Negative unipolar wave 4 Hz frequency 300 uA intensity Time zero counts up Audible Tone On Available Rang
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57. A non blinking decimal Power displayed in Watt cm A blinking decimal Power displayed in Watts START STOP POWER INTENSITY DAS Press and hold the PAUSE FUNCTION key for two seconds The machine will beep once to indicate you have changed the display Dynatron 850plus Power Display You can view power in either W cm or WATTS A steadily lighted decimal means the power is displayed in W cm A blinking decimal means the power is displayed in WATTS 55 Treatment Instructions ULTRASOUND Dynatrone 850plus amp 550plus Combination Therapy Instructions The following combination therapy instructions are for DYNATRON 850plus USERS ONLY The Dynatron 550plus does not offer the ultrasound feature WARNING DO NOT use combination therapy for underwater treatment Placing active electrodes under water poses a serious hazard to the patient Use VERY LOW STIM INTENSITY for combo treatments Remember to observe all contraindications warnings precautions and usage cautions for BOTH ultrasound and electrical stimulation therapy when performing combination therapy Since electrical current travels between the electrode and the soundhead during combo treatment the electrode should be placed in proximity with the treatment area Do not place the electrode and soundhead in positions that will cause current to pass through contraindicated areas Avoid removing the soundhead from the skin
58. Bar Graph nette detenti Ne ee entend Head Tenmperatu re Hot i i aeos Ea Head Temperature Bar Graphiste ati eter hoisted ie engi oti Aline Display Watts or W eim2s 5i ou ono tee ea eoa a a E ERO Pe ROGER Combination Therapy Instructions eee eere eee eee ee eene seen eee to seta aset enses een see seen Sees ense eate teens seen aee Comboplus M o sito ud a e Stim Through the Soundh d 52 tannins nt ep e EU Eee Hee e iere ep eet Combination Therapy Setup iar eerde ae hee e e E rd oer ie E Modify Treatment s ite e epe etae Gd eter tete Hl ER ttes de Combination Default Settings 2 Ia e eee detinet e a iE Dynatrone 850plus amp 550plus Simultaneous Tr CALI CIS RU 62 Set UPA Second Treatment 2e cda e ed e ode dene edes 62 Modify Simultaneous Treatments ss 63 Stop One Treatment e eeu RR IR LER iH erg ni tan dee eee t 63 Setting amp 64 Save New Defaults iE oda ete ea eei umen 64 Restore Factory Detaults ssh nu panne deer ios HERR Een espe RAE LEER DELE 65 Interferential Default Settings ss 65 Premodulated Default Settings eie Lee menant 65 Russian Biphasic Default Settings 2 65 High Volt Default Settings Ete e eet eee nee een 66 Microcurrent Detault Settings ie
59. Comboplus feature gives you almost unlimited options in setting up a combination treatment with the Dynatron 850plus Now you can combine an ultrasound treatment with any single channel electrotherapy modality provided by this device including Premodulated Biphasic Russian High Volt or Microcurrent In addition combination therapy is Dynatrone 850plus amp 550plus no longer restricted to just one channel any channel may be used This means you may set up a combination treatment using any of the three electrotherapy output jacks Combination therapy offers simultaneous treatment time and allows you to select from all the available options for both modalities used in the combined treatment Simplified Setup The unique design of the Dynatron 850plus and 550plus front panels means treatment setup has never been easier A few simple key presses are all you need to fully set up a treatment The careful grouping of available options for each modality ensures that you can easily see and select from the appropriate options for that modality Each modality offers default settings which are automatically selected when the modality is selected saving time in the treatment setup You can change these defaults to match your own most common treatment setups to reduce setup time to a matter of seconds Before You Treat a Patient Before administering a treatment to a patient with the Dynatron 850plus or 550plus you should familiarize yours
60. MICROCURRENT POLARITY Change microcurrent polarity Repeat to change again During a microcurrent treatment turn audio tone on and off MICRO AUDIO TONE ON OFF FUNCTION INTENSITY UP amp DOWN ARROW CHANGE VOLUME Change loudness of tone during microcurrent treatment only KEYS START SAVE NEW DEFAULT SETTINGS Hold for 2 seconds to save defaults for current treatment The following key presses are applied only when powering up the device AT POWER ON HOLD DOWN THE FOLLOWING KEYS WHILE THE DEVICE STARTS UP Press and hold on power up to enter Lead Test feature TARGET SWEEP LEAD TEST MODE Press and hold on power up and wait for beep to restore factory START RESTORE FACTORY SETTINGS default settings Press and hold on power up to enter soundhead calibration mode FUNCTION ENTER CALIBRATION MODE for technicians only ULTRASOUND DUTY CYCLE KEY ENTER SOUNDHEAD PARAMETERS Press and hold on power up to enter soundhead parameter entry mode for technicians only FUNCTION TIME MODE KEY Rev 1 02 and later DISABLE CONDUCTANCE BAR GRAPH Press and hold these keys at the same timeto disable the conductance bar graph for treatment setup the graph will still be available for viewing after a treatment has started After the device starts up select 1 in the intensity screen to turn the option on and 0 to turn the option off FUNCTION INTENSITY DOWN ARROW Rev 1 02 an
61. REMOD 2 Press the HIGH LOW toggle key one or more times until both the High and the Low indicator lights are on 3 Use the TIME arrow keys to change the time to 15 minutes 5 PRESS and HOLD the START key for two full seconds NOTE You can save defaults at any time during treatment setup or while a treatment is in progress Select the desired channel then press and hold the START key for two seconds A beep confirms that the new settings have been saved Only defaults for the selected channel are saved Setting Defaults 64 Dynatrone 850plus amp 550plus Restore Factory Defaults If you have saved your own defaults but would like to return ALL your default settings to those that were set at the factory do the following 1 Turn the machine off 2 Press and hold the START key while turning the machine on Continue holding the Start key down until you hear machine beep briefly and you see the display message RST FP which indicates the parameters have been reset You may now proceed with treatment setup Interferential Default Settings High Target Channels 1 and 2 Time 10 minutes Frequency Ranges for both Interferential and Premodulated Default High Range 80 150 Hz Default Low Range 0 10 Hz Available Range 0 150 Hz Premodulated Default Settings High The first available channel 1 or 2 Time 10 minutes Frequency Ranges for both Interferential and Premodulated Default High Range 8
62. SERVICE MANUAL Dynatron 850plus amp Dynatrone 550plus Dynatrone 850plus amp 550plus CAUTION Federal law restricts this device to sale by or on the order of a physician chiropractor physical therapist or dentist licensed by the law of the state in which said person practices to use or order the use of the device IMPORTANT Before treating a patient with the Dynatron 850plus or the Dynatron 550plus see the Contraindications Warnings and Precautions in this manual INDICATIONS FOR USE Muscle stimulation therapy delivered by the Dynatron 850plus and 550plus is indicated for the following uses relaxation of muscle spasm prevention or retardation of disuse atrophy increasing local blood circulation muscle re education immediate postsurgical stimulation of calf muscles to prevent venous thrombosis and maintaining or increasing range of motion Interferential premodulated high volt and microcurrent therapy are indicated for providing temporary relief of chronic intractable pain INDICATIONS FOR ULTRASOUND USE Ultrasound therapy is intended to generate deep heat within body tissues for the treatment of selected medical conditions such as relief of pain muscle spasms and joint contractures but not for the treatment of malignancies 21 CFR 890 5300 Dynatron 850plus and Dynatron 550plus Service Manual Revised June 2004 Copyright 1997 Dynatronics Corporation 7030 Park Centre Drive Sal
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64. TIME The conductance bar graph is not available for combination treatments The bar graph uses the eight segments in the top half of the display with eight lighted segments indicating best conductance and one lighted segment indicating poorest conductance In the illustration below eight of the eight segments are lighted indicating good conductance Conductance Bar Graph Eight lighted segments indicate conductance is good If only two or three segments are lighted conductance is poor TIME POWER INTENSITY START X STOP J PAUSE FUNCTION During an IFC Premodulated or Microcurrent treatment press the FUNCTION and the TIME keys simultaneously to see the conductance graph Press TIME to return to the treatment time display 4 The graph is automatically displayed when the intensity is increased during treatment setup for IFC and Premod Conductance Bar Graph Operation amp Treatment Instructions 21 Dynatrone 850plus amp 550plus If the graph indicates poor conductance check to be sure leads and electrodes are in good condition that leads are fully plugged in and the entire surface of the electrode is making contact with patient s skin Extremely dry skin can also be a cause of poor conductance If leads or electrodes are found to be worn they should be replaced Leads may be tested using the Lead Test function described in the operat
65. TRACTION REST CYCLE TOGGLE for Russian biphasic and high volt treatments Press this key one or more times to select the desired contraction rest on off cycle Available cycles include 10 10 10 30 10 50 and Continuous The first value indicates the on time in seconds and the second value indicates the off time For example 10 30 indicates the current is on muscle is contracting for 10 seconds and current is off muscle is relaxed for 30 seconds With Continuous mode current is applied continuously with no off cycle The continuous duty cycle is not recommended for electrical muscle stimulation but may be used for settings that are intended to effect other results than a muscle contraction RAMP TIME TOGGLE for Russian biphasic and high volt treatments This key is pressed to select the ramp time The ramp time is applied before and after the On segment of the cycle it provides both a ramp up and a ramp down Available ramp times are 5 1 1 5 and 2 seconds NOTE The High Low option described previously under the Interferential Premod options is also used for High Volt treatments see item 13 above Installation amp Features 11 Dynatrone 850plus amp 550plus Microcurrent Selections 24 MICRO Press this key to begin setup of a microcurrent treatment This key is also used to turn the conductance tone off and on after a microcurrent treatment is started When MICRO is selected Channel 1 is automatic
66. Volt Selections 19 20 21 22 23 BIPHASIC RUSSIAN Press this key once to begin setup of a biphasic treatment the Biphasic LED is lighted press this key twice to begin setup of a Russian treatment the Russian LED is lighted Biphasic and Russian treatments use a single channel 1 or 2 when the Normal mode is selected and a channel pair 1 and 2 when the Reciprocal or Co contraction mode is selected HIGH VOLT Press this key to begin setup of a High Volt treatment the Hi Volt LED is lighted The HV output channel is automatically selected the LED for the channel selected is GREEN Connect the patient lead wire to the HV output jack HIGH VOLT POLARITY To select or change the polarity of a high volt treatment use the HI VOLT key together with the FUNCTION key Press and continue holding the FUNCTION key while pressing the Hi Volt key one or more times to select positive only the LED is lighted negative polarity only the LED is lighted or both both LEDs are lighted TREATMENT MODE TOGGLE for biphasic and Russian treatments Press this key one or more times to select Normal Co Contraction or Reciprocal contraction The output channel is automatically selected When Normal is selected one output jack only is selected 1 or 2 When Co contraction or Reciprocal is selected channels 1 and 2 are selected Connect the patient lead wire s to the output jack s for the channel s selected CON
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68. You may set up either the ultrasound or the stim treatment first The Channel Toggle key allows you to switch between channels to select the treatment type to be set up first When the Sound indicator light is green you can set up ultrasound parameters When the stim channel light is green you can set up the electrotherapy parameters The treatment timer does not begin until you press Start after both modalities have been set up 1 Press the SOUND COMBO key twice to select COMBO If desired you may now set up the Sound portion of the treatment Then toggle to the stim channel by pressing START or the channel toggle key or press the appropriate key to select the desired electrotherapy modality Premod Biphasic Russian High Volt or Microcurrent The front panel of the device shows the following default selections The COMBO LED is lit e selected modality key is lit e The first available channel for the stim therapy chosen is indicated by a GREEN light The SOUND channel light is YELLOW e The TIME display shows 5 minutes or other time if you have changed this default 2 Attach the lead wire to channel jack that corresponds with the channel light for the modality chosen Apply the stim electrode to the patient now Apply conductive gel to the ultrasound treatment site now Set up Biphasic Russian Premod High Volt or Microcurrent 1 The stim channel light must be green before setting up the stim treatment Press the Ch
69. a cloverleaf shaped area Using the Target pad the point of interference in easily moved to the desired treatment area Why Is Target Better Channel 2 The Dynatron 850plus and 550plus employ a unique patented method which actually moves the center of interference With Target the voltage output from both channels remains equal at all times so wherever the treatment is applied a full deep interferential beat occurs Other devices attempt to achieve this effect by increasing the current from one channel while decreasing the current from the other channel This method only rotates the cloverleaf shaped area but the center of interference does not move In addition the depth of the beat is reduced Other devices increase current at one channel while decreasing it at the other This merely rotates the treatment The center of interference does not move General Information IFC amp PREMOD 71 Dynatrone 850plus amp 550plus Sweep Channel Channel 1 2 You can use the Sweep Target Sweep feature to bathe a wider area with the interferential current up to 80 percent of the area within the electrodes may be covered The Sweep feature utilizes the patented Target feature and moves the point of interference to cover a wider treatment area while still retaining the full interferential beat The Sweep option literally moves the point of interference inward and outward in a somewhat Sweep bathes a larger
70. ach the active electrode to the positive output of the lead wire to ensure you are getting the selected polarity Set Up High Volt Treatment with Optional Probe Intensity is controlled at the front panel of the device Be sure the applicator surface is making full contact with the patient s skin before setting intensity DISPERSIVE ELECTRODE Should be at least twice the size in area of the paddle attachment used with the probe Plug this cable into the HV channel High Volt Probe Setup This attended form of high volt therapy is delivered using a hand held probe optional accessory in conjunction with a dispersive electrode The hand held probe is connected to the selected High Volt output jack on the front of the machine With a probes treatment intensity is controlled on the front panel of the device keep the device nearby so you can change the intensity as needed If you select an on off cycle rather than continuous you can watch the channel display when the HV LED begins blinking this indicates the treatment is in the off or rest portion of the cycle and you can position the probe at the next treatment site By repositioning the probe only during the rest portion of the cycle you ensure that the ramp is applied when the current again comes on the ramp provides greater patient comfort as the current resumes The continuous duty cycle may be uncomfortable to the patient as it provides no r
71. administering a treatment to a patient High volt electrical stimulation is a pulsed DC current with pulse widths in the microsecond range and pulse rates ranging from 1 to 200 Hz with a peak amplitude of up to 1 0 amp The Dynatron 850plus and 550plus deliver high volt utilizing a twin peak monophasic waveform High volt treatments with the Dynatron 550plus and 850plus may be delivered using electrodes or an optional hand held probe The device provides a dedicated channel for high volt treatment HV This channel is used to deliver high volt treatments only The device s other output channels CH1 2 Dispersive slectrode remain available for other stim treatments Attach to NEGATIVE Active electrode simultaneously with the high volt treatment 5 Mic POSITIVE Set Up High Volt Treatment with OUTPUT LEAD Connect to HV Electrodes channel This treatment setup utilizes a double output High Volt Electrode Setup lead with two electrodes an active and a dispersive electrode The size of the dispersive electrode is recommended to be double the area of the active electrode If desired the active output of the lead may be bifurcated to attach additional active electrodes however the combined total area of the active electrodes should be no more than half the area of the single passive electrode These setups are illustrated on this page and the following page Treatment Instructions HIGH VOLT 35 Dynatrone 850p
72. air When a service call is received by Dynatronics the following information must be supplied before an RA number can be issued User name and address User phone number Serial number of the unit A description of the problem with the unit Se coat as ae This information is important so we may identify the problem before the unit is shipped and ensure proper handling of the repair or disposition of the unit The user or dealer name and address and the serial number of the unit is required before Dynatronics will issue an RA number When the unit is received at Dynatronics it is unpacked and inspected for shipping damage An inventory of the parts that were sent with the unit is taken at that time and recorded on the RA sheet Any observed damage is also noted on the sheet The unit is then examined by a repair technician who evaluates the problems with the unit and writes observations on the RA form The technician completes the repair again writing the steps taken to repair the unit listing the parts used and recording the time taken in the repair The technician dates and signs the form The unit then receives a final quality assurance QA inspection by quality control staff member who signs the RA form indicating the QA is complete One copy of the RA form is returned to the user with the unit to tell the dealer and the user what was done to the unit while it was in for repair Why the Information is Necessary Dynatronics is requir
73. alibration should be performed by a qualified technician Check the output voltages and currents on all outputs Inspect soundhead connectors on unit and on soundhead Verify dac calibration and current limits General amp Technical Information 116 Dynatrone 850plus amp 550plus MAINTENANCE PERFORMED BY USER 1 Inspect accessories daily for wear and damage Examine cables and connectors on the cables for any visible sign of wear or damage Replace accessories as needed Replace lead wires and carbon electrodes at least every six months Replace self adhesive electrodes after not more than 15 uses Examine ultrasound heads periodically for cracks which may allow ingress of conductive fluid If a machine or soundhead is dropped or if it sustains damage due to lightning severe power surge submersion in water or other incident that could cause damage to electronic components the device must be examined by a Dynatronics technician before being returned to clinical use For older devices contact Dynatronics or your Dynatronics dealer for information and pricing for current upgrades to your device Even if the machine is functioning properly you can send it to Dynatronics for preventative maintenance service for a nominal charge call for pricing Inspect device air vents periodically to ensure air flow is not blocked An ordinary household vacuum hose may be used to clean dust from air vents externally Immediat
74. ally selected for the default electrodes treatment and the LED for that channel is lighted For a microcurrent treatment setup with electrodes connect a patient lead wire to Channel 1 output jack For a microcurrent probes treatment press the channel toggle key CH to select the MICRO channel selection Channel 1 LED will become yellow and MICRO will become green to indicate the probes option is selected Connect the microcurrent probe to the microcurrent output jack on the left side panel of the device NOTE Channel 1 is committed to the microcurrent output during a probes treatment as well as during a treatment with electrodes and is not available for use by any other modality while any microcurrent treatment is in progress MICROCURRENT POLARITY To select or change the polarity of a microcurrent treatment use the MICRO key together with the FUNCTION key Press and continue holding the FUNCTION key while pressing the MICRO key one or more times to select positive only the LED is lighted negative polarity only the LED is lighted or dual polarity both LEDs are lighted 25 OUTPUT JACK CHANNELS 1 and 2 These are the output jacks for delivering interferential premodulated Russian biphasic and microcurrent treatments Consult treatment instructions later in this manual for appropriate channels and treatment setup for each modality 26 HIGH VOLT OUTPUT JACK HV This is the output jack for delivering high volt treat
75. amping of current when the probe is repositioned HIGH VOLT Treatment Instructions 36 Dynatrone 850plus amp 550plus When setting intensity the probe must be making contact with the patient s skin Ensure that the patient can feel the current as you increase the intensity Do not increase intensity for probe treatments if the patient is unable to report feeling the current Basic High Volt Setup 1 Press HI VOLT Attach lead wire or probe cable to the high volt jack Attach electrodes to patient at this time Give the remote stop cable to the patient Choose the POLARITY hold down FUNCTION key and press HI VOLT key Choose the CONTRACTION REST times for electrodes treatment only Choose the RAMP setting Select or set up a PULSE RATE RANGE High Low or set a single pulse rate Change the treatment TIME if desired Raise the INTENSITY to the desired level for probe treatment make sure probe is in contact with patient skin when raising intensity Press START Press STOP if you need to stop a treatment before its time has expired Detailed High Volt Setup 1 Press the HI VOLT key When you press HI VOLT the high volt channel and the default settings for high voltage pulsed stimulation are automatically selected If you have not already done so attach leads and place electrodes on the patient now and plug the lead wire or probe cable into the HV jack See instructions at the start of this sectio
76. and ten seconds off 10 30 10 50 or continuous cycle The continuous duty cycle is not recommended for electrical muscle stimulation but may be used for settings that are intended to effect other results than a muscle contraction In addition you can modify the pulse rate the pulse width and the ramp time The Normal mode requires use of just one output jack Channel 1 or 2 The Reciprocal and Co Contraction modes utilize both channels 1 and 2 Biphasic Stimulation The biphasic stimulation feature is similar to Russian stimulation in the parameters that are selected and in the available options It differs from Russian stimulation in the pulse width and rate ranges Additionally the biphasic pulse includes just one cycle including one positive phase and one negative phase per pulse Biphasic Russian Parameters The Dynatron 850plus and 550plus offer even greater control over the Russian and biphasic stimulation treatments through customization of the pulse rate and the pulse width The default settings and the available ranges for each of these are as follows Biphasic Stimulation Default Setting Valid Range Pulse Rate 50 Pulses per second 1 to 500 Pulse Width 200 uSec 50 to 400 uSec Russian Stimulation Default Setting Valid Range Pulse Rate 50 Pulses per second 1 to 500 Pulse Width 10 mSec 4 to 50 mSec depends on Pulse Rate The pulse rate and width should not be confused with the contraction rest times in the treatm
77. annel Toggle key if needed to select the stim channel NOTE Combination with microcurrent requires Channel 1 to be used 2 Ifthe modality you wish to use is not already selected Premod Russian Biphasic High Volt or Microcurrent press that modality key now When a modality key is pressed the LED on that key is lighted while the COMBO LED remains lighted as well Again make COMBINATION Treatment Instructions 58 Dynatrone 850plus amp 550plus sure the combo lead is plugged into the correct output jack for the stim modality you have selected Enter treatment parameters for the selected modality as instructed earlier in this manual Place the soundhead at the treatment site making good contact with the skin be sure you have applied conductive gel first Raise the stim intensity to the desired level If the soundhead is in proper position and coupling is good the patient will feel the current If the patient does not feel the current check to be sure coupling is good and make sure you have used ample conductive gel KEEP THE STIM INTENSITY LOW Set up Sound Continue to keep the soundhead in contact with patient skin during ultrasound setup l The Sound indicator light must be green before setting up ultrasound parameters Press the Channel Toggle key if needed to select SOUND Enter ultrasound parameters as described in Ultrasound Instructions earlier in this manual After both modalities are set up
78. ation When this occurs the machine will not allow a treatment to be set up or delivered and will display an error message in the LED displays An error message can consist of any combination of alpha numeric characters which are not normally expected at any given point in treatment setup or delivery Some errors are easily resolved by the following methods e Press STOP to stop the treatment if any and turn the machine off then on again Check to be sure the soundhead has not become disconnected from the machine The soundhead should be firmly plugged into its port Only Dynatronics soundheads may be used with this device If the soundhead has been dropped it may be damaged If the device operates normally with one soundhead but not with another the problem may be a damaged soundhead and you must contact Dynatronics Customer Service sure the soundhead is not too hot For hot soundheads follow the instructions provided earlier in this section Ultrasound Technical Information 110 Dynatrone 850plus amp 550plus Check to see if conditions may have caused extreme moisture condensation in the device This could occur when the machine has become very cold then is brought indoors to a warm humid environment Condensation is a not a serious condition Allow the machine to sit in a dry environment until the condensation dries The machine will operate normally once the condensation is gone ERROR 13 The Error 13 m
79. atment Read the operating instructions in this manual before proceeding with a treatment Standard Accessories The following accessories are included with the Dynatron 850plus or 550plus units Qty Part No Description 1 D851 D551 Dynatron 850plus or Dynatron 550plus unit 1 9B0031 Power Cord 1 8A0061 Patient Remote Stop Cable 1 8H0006 Operator s manual 2 7B0230 7B0231 72 double leads 1 red 1 black 1 7B0234 Special lead wire for combination treatments with Dynatron 850plus only 1 7B0204 POLYS self adhesive electrodes 1 75 x 3 75 w pin connector pkg of 4 4 7B0063 7B0065 3 round carbon electrodes 2 red 2 gray 4 7B0191 Sponge fabric for use with carbon electrodes 2 DW248 2 x 48 straps 1 7 0191 5 x 8 dispersive electrode for high volt w sponge fabric 1 7B0202 Applications manual 1 7 0217 Ultrasound gel sample with Dynatron 850plus only Installation amp Features Dynatrone 850plus amp 550plus Soundheads and Probes The Dynatron 850plus may be purchased with one or more applicator soundheads in the following sizes Part No Size Frequencies SHOICM 1 cm Operates at 2 and 3 MHz CMO2SH 2 cm Operates at 1 2 and 3 MHz CMOSSH 5 cm Operates at 1 2 and 3 MHz CM10SH 10 cm Operates at 1 2 and 3 MHz An optional high volt probe or microcurrent probe may also be purchased for use with this device Contact your Dynatronics dealer to order optional accessories Accessories The follo
80. aused 9 Press STOP if you need to stop a treatment before its time has expired When the treatment time for a treatment has elapsed the output to the soundhead is stopped and a tone sounds notifying you of the treatment end STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output at the selected channel is stopped and the device then displays the parameters for the next treatment that remains in progress if any Ultrasound Default Settings The following default settings are set by the manufacturer and are selected when you press the Sound key You may change these defaults to your own preferred settings See Setting Defaults in this manual e 1 MHz for 2 5 and 10cm soundheads and 2 MHz for the 1cm soundhead e Continuous Time 5 minutes Patient Coupling The Dynatron 850plus provides the feature of patient coupling detection which senses the coupling between the soundhead and the patient to ensure proper delivery of the ultrasonic therapy The coupling bar graph described on the following page provides a grap
81. be replaced Service 125 Dynatrone 850plus amp 550plus Installing Software Updates Features and function of this device may be updated from time to time by the manufacturer Such updates are installed via the port on the device using a handheld download device which is available from Dynatronics It is recommended that a Dynatronics dealer perform the software update for you This will ensure the software update is installed successfully and will save you the expense of purchasing the separate download device If you have registered your product warranty with the manufacturer you will be notified of any software updates that may become available in the future Installing Replacement Parts Since software updates for the Dynatron 950 plus and 650 plus are provided from an external connection it is not necessary to replace the EPROM in the device This device is not generally serviceable in the field If you wish to perform any service on the device or replace any internal parts you must first contact Dynatronics Customer Service for guidance Keep in mind that if the device is serviced or altered by anyone except authorized Dynatronics service personnel the warranty on the device is invalidated For service assistance contact Dynatronics Service Department at 1 800 874 6251 126 Dynatrone 850plus amp 550plus Section VIII Schematics and QC Check Lists Schematics and QC Check Lists 127 Dy
82. being calibrated The output power display is set to a value of zero The LED for 1 MHz should be illuminated indicating the soundhead is now ready to be calibrated for this frequency If it is not press the toggle key to select 1 MHz now 3 Press STOP and the TIME UP ARROW simultaneously to enter the Temperature Mode The temperature of the soundhead is displayed in the Time display window The soundhead must be at a temperature between 72 and 75 degrees If the sound head is not within this range warm the water and or the head before continuing Press STOP to get out of the temperature mode At this point there is zero output from the device Zero the scale on your ultrasound power meter now When the scale is at zero on your power meter press the START key to begin 4 Press the UP DOWN arrow keys located next to the Power display window on the Dynatron 850plus until the power meter shows the target value for the specific soundhead size consult the table Target Value Power Meter for target power meter readings 5 When the watts reading on the meter is at target value for the soundhead and the reading is stable press the Duty Cycle toggle key this is the key that selects 1096 2096 5096 or Continuous Ultrasound Technical Information 107 Dynatrone 850plus amp 550plus 6 The Dynatron 850plus performs the calculation internally for the 7 impedance value and the coupling value Target Value
83. ble is not necessary during ultrasound treatments since this is always an attended therapy However if for any reason this might be preferred the Remote Stop cable may be given to the patient for use during Combo treatments If the Remote Stop button is pressed during a Combo treatment both the stim and the ultrasound outputs are stopped and the timer is set to zero Soundhead Warming When the device is powered on it automatically enters a default head warming mode During this mode the soundhead should remain in its holder as a small amount of ultrasound output is emitted from the soundhead 1 Wcm The warming feature turns on and off automatically as needed to maintain a comfortable soundhead temperature The soundhead warming mode is automatically stopped during a treatment and resumes automatically as needed after a treatment has ended ULTRASOUND Treatment Instructions 48 Dynatrone 850plus amp 550plus Turn Soundhead Warming Off On If you do not wish to use the head warming feature you can turn the feature off with the following key press The head warming setting is saved and will apply to the device whenever it is used until you change the setting again These key presses are only necessary if you want to change the current state of head warming e Press and hold the FUNCTION while pressing the SOUND key to turn soundhead warming off or to turn it on again The device will beep and the Time display will show the s
84. body structure or ii relieve unanticipated temporary impairment of a body function or unanticipated temporary damage to a body structure Reference Food and Drug Administration HHS 21 CFR Ch 1 4 1 90 Edition 803 9 h Reporting any Incident of Patient Discomfort Dynatronics recommends that if discomfort of any level is reported by the patient the treatment be stopped immediately The device and all accessories in use during that treatment should be isolated and held for inspection Make a note of treatment parameters that were in use during the treatment including intensity settings Also note environmental factors that were observed during the treatment office lights flickering static electricity discharge other devices in use on the same power source or in the same room etc The incident should be reported immediately to Dynatronics Customer Service at 1 800 874 6251 The customer service representative will inform you if it is necessary to send the device and or accessories to Dynatronics for inspection Service 121 Dynatrone 850plus amp 550plus General amp Technical Information 122 Dynatrone 850plus amp 550plus Section VII Service Service 123 Dynatrone 850plus amp 550plus Processor Interaction Processor Interaction with the Keyboard and Displays The keyboard is controlled by a microcontroller which scans the keys for key presses keeps the displays updated and reads any p
85. bout 60 degrees F in order for the machine to recognize that the soundhead is present and to proceed with setting up a treatment You can accomplish this with any of the following methods 1 Press the flat face of the soundhead against the palm of your hand for 30 to 60 seconds to warm it slightly This usually provides adequate warmth to the crystal to raise the temperature to the minimum acceptable level Once the crystal reaches this level you can proceed with treatment 2 Youcan also place the soundhead in room temperature water to warm the crystal However do not place the soundhead in very hot water when the crystal is this cold as it could damage the crystal HEAD ERROR No Soundhead No Soundhead TIME stant For devices having software greater than Rev 1 01 If the device cannot detect a soundhead during setup or ae delivery of an ultrasound treatment the error message FUNCTION HEAD is displayed in the Time display If this error HEAD Error This error message indicates the occurs check to be sure the soundhead is firmly plugged into its connector If you are unable to clear the message soundhead is not plugged in or for some reason is Ne not being detected by the device by reconnecting the soundhead contact Dynatronics customer service department at 1 800 874 6251 for assistance Other Error Messages in the Display Certain conditions can cause an error in oper
86. ceeding NOTE The following procedure IS NOT REQUIRED if you are using new SmartHeads 1 Head Calibration Printout Earlier soundhead models are shipped with a Head Calibration Printout sheet The following is an example of this sheet The sheet contains unique calibration numbers for a specific soundhead The soundhead serial number appears on the sheet to assist you in matching the correct soundhead with the printed parameters HEAD CALIBRATION PRINTOUT HEAD SERIAL 105000 SIZE 5 CM2 MHZ 2 MHZ 3 MHZ I TEMP Ultrasound Technical Information 104 Dynatrone 850plus amp 550plus NOTE THE ABOVE NUMBERS ARE PROVIDED FOR ILLUSTRATION ONLY AND SHOULD NOT BE ENTERED INTO YOUR DYNATRON DEVICE USE ONLY THE ACTUAL NUMBERS PROVIDED WITH YOUR OWN SOUNDHEAD 2 Plugin Soundhead Turn the Dynatron 850plus off then plug in the new soundhead 3 Enter Head Parameters Mode To enter the Head Parameters Mode press and hold the Duty Cycle toggle key 1096 2096 5096 Cont key while turning the machine ON Continue holding down the Duty Cycle toggle key until the device finishes its startup sequence The unit senses and displays the head size in the Power Intensity display For example if 5 is displayed it means the device senses a 5 cm head is plugged in 4 Enter 1 MHz Values You will begin by entering the 1 MHz values from the Head Calibration Printout Make sure that the 1 MHz LED is
87. change these defaults to your own preferred settings See Setting Defaults in this manual Interferential High frequency range Target Time 10 minutes Premodulated e High frequency range e Time 10 minutes IFC amp PREMOD Treatment Instructions 28 Dynatrone 850plus amp 550plus Biphasic Russian Instructions WARNING NEVER turn the power on or off while the unit is connected to the patient Always give the Remote Stop device to the patient prior to the treatment Always STOP a treatment before removing or attaching electrodes or leads Leads and electrodes must only be applied to the patient before a treatment is started Never use worn or damaged leads or electrodes as these may result in injury to the patient See Contraindications Warnings and Precautions in this manual before administering a treatment to a patient In the Russian and Biphasic Stimulation modes the output of the device is a pulsed sinusoidal wave The Dynatron 850plus and 550plus allow the operator to choose a muscle contraction relaxation cycle that is most suited for the individual patient and for the desired treatment When the cycle required is chosen each muscle stimulating burst is followed by a relaxation rest cycle See Russian Biphasic Parameters in this manual for further discussion of pulse rate and width and illustrations showing the segments of the Russian Stimulation cycle and the Biphasic Stimulation cycle T
88. channels in use at the Installation amp Features Dynatrone 850plus amp 550plus 10 11 time will have yellow LEDs The Time display can also display the pulse rate and width for Russian and biphasic treatments as well as the frequencies for interferential premodulated and microcurrent treatments and pulse rate for high volt The treatment parameters for any treatment in progress may be displayed at any time by first using the channel toggle key to choose the desired channel then using the Time toggle key to select the desired parameter Time Freq Rate Width CHANNEL TOGGLE KEY CH When a treatment is in progress you can press this key to choose an output channel and display the parameters for the treatment being delivered by that channel When a channel light is GREEN the displays show the settings for that channel The available options depend on the modality selected When two or more treatments are in progress simultaneously the toggle key is used to select the channel you wish to view CHANNEL SELECTIONS These lights indicate which output channels are currently in use solid GREEN light indicates current is being delivered to that channel the time intensity and other treatment parameters for that channel are also displayed A solid YELLOW light indicates a channel is in use and delivering current but the time intensity and treatment parameters are not displayed at this time only one channel s time and
89. ching electrodes or leads Leads and electrodes must only be applied to the patient before a treatment is started Never use worn or damaged leads or electrodes as these may result in injury to the patient See the contraindications warnings and precautions for interferential and premodulated treatments in this manual before administering a treatment to a patient Additional warning from the Canadian Health and Welfare Department Health Protection Branch WARNING Thoracic applications are contraindicated Cardiac fibrillation may occur if output current is 50 mA RMS or greater for any output circuit For use in Canada and Japan this device is limited to 50mA output An interferential treatment uses both channels 1 and 2 and four electrodes The device will automatically select these channels when you select IFC A premodulated treatment uses one channel and two electrodes The device will automatically select the first available channel 1 or 2 when you select PREMOD If desired you may set up two premod treatments using available channels Basic Interferential Premod Setup 1 Choose IFC or PREMOD Plug the patient lead s into the output jack s for the channel s selected Attach electrodes to patient at treatment site Give the remote stop cable to the patient 2 Setthe treatment TIME 3 Optional CUSTOMIZE FREQUENCIES now 4 Choose HIGH LOW or HIGH LOW alternating or HIGH LOW consecutive 5 Choose TARGET
90. chnical Information in this manual As you increase the intensity of a treatment you also increase current output If you reach the maximum current limit the device issues a warning described below This warning is to alert you to the fact that you may have set the treatment intensity too high and to prevent the possibility of patient discomfort caused by too high current output Ultrasound Technical Information 93 Dynatrone 850plus amp 550plus Current Limit Warning When you reach the maximum output current limit the device will e Immediately stop increasing the intensity and automatically reduce the intensity a few increments several times e Flash the intensity display You should rarely if ever encounter the current limit warning during a patient treatment as reaching the current limit would often require an intensity setting that is uncomfortable and intolerable to most patients For patient safety and comfort you must address this warning before continuing with the treatment Consider the following possible causes for example e The patient is unable to adequately feel the current and is unable therefore to report discomfort at the high intensity level e When using four very large electrodes for a treatment current is dispersed over a larger electrode surface area permitting a higher intensity setting without discomfort to the patient As you increase the intensity ensure that the patient feels th
91. cifICations s 114 Microcurr nt Specifications on e eni Mte te e Ee deri RUE ee s le ee dtes 114 Hish Volt Specifications iei enne eg ede i e eee epe eme ia 115 Ultrasound Specifications Dynatron 850plus only 115 vii Dynatrone 850plus amp 550plus Environmental Condit 0ns SP ke dig Safety Features of the Dynatron 850plus and 550plus ss Care and Cleaning Instructions irt ep e ote orent Lg e HERE HEU UTER EEE PO LEE ah inet Suggested Maintenance Schedule sise Routine Ultrasound Calibration Inspections Dynatron 850plus only Software Updates ito ie egt grece eet nr PL mnt Returmng Unit for Reparto uer er Re euet teni iet D finition Of Symbols eerte te Mies eter hin dene ate ated tee tel ra tee deett en Equipment Classification sise ee ho eb e a n E Seal anes Disposal of Equipment and Accessories see Additional Technical Information Available for Technicians Only FDA Compliant Electrodes and Lead Wires Medical Device Reporting Requirements ecce eee e ee eee ee setate aee enses etas testen aseo Reporting any Incident of Patient Discomfort ss Section VII Service Processor MCSF ACE OM Una cerei SRE EEE Pre ike vitu ELI DURAS INE Processor Interaction with th
92. commended for use refer to the operation manual for these devices for instructions on their use Water Quality Water used in the testing procedure must be degassed water with an oxygen content of four parts per million 4ppm or less The following steps are provided to assist the technician with the calibration procedure A calibration program is built into the software for the device The procedure utilizes keys and displays on the key pad that are normally used for other purposes but which have specialized applications in the Calibration Mode If you have any questions about the following instructions contact Dynatronics Customer Service Department before proceeding STEPS 1 Begin with the machine turned off Plug Soundhead Types Table the soundhead to be calibrated into the S tHeads Dynatron 850plus ultrasound output jack _ Time Display HS and center the soundhead over the cone in Power Display the ultrasound power meter 2cm2 2 Enter the Dynatron 850plus Calibration rue 2 E Mode by pressing and holding the PAUSE RCM key while turning the machine on The display windows first show the soundhead type that is plugged into the machine see oes ay i Soundhead Types Table below dem H2 The soundhead type is displayed for about es 2 a one second Next the display shows the stored frequency values for soundhead Soundhead Types that is
93. cted 9 Press STOP if it is necessary to stop a treatment before time has expired When the treatment time has elapsed the current to the patient stops and a tone sounds notifying you of the treatment end Treatments in progress may be stopped at any time using one of the following methods STOP Press this key to stop all treatments at all channels REMOTE STOP During unattended therapy a patient stop button is provided to allow the patient to stop treatment The remote cord should be plugged into the machine prior to starting the treatment When the remote stop button is pressed all output from the device is stopped time is set to zero and a tone sounds briefly STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output at the selected channel is stopped and the device then displays the parameters for the next treatment that remains in progress if any Interferential Premodulated Default Settings The following default settings are set by the manufacturer and are selected when you select IFC or PREMOD You may
94. d later DISABLE ULTRASOUND COUPLING DETECTION Press and hold these keys to disable the ultrasound coupling detection feature The Time display will show the current setting briefly CP1 feature on CPO feature off Repeat this step to revert to the prior setting Installation amp Features 18 Dynatrone 850plus amp 550plus Section Il Operation and Treatment Instructions Operation amp Treatment Instructions Dynatrone 850plus amp 550plus General Operating Instructions Power On Off Press the power switch located on the rear panel of the unit The self diagnostic and calibration function automatically occurs each time the unit is turned on It is recommended that the unit remain on throughout the day if it is used on a regular basis CAUTION Never turn power on or off while the unit is connected to the patient Set intensity to minimum power before pressing START Basic Treatment Setup Treatment setup is simple and fast with the Dynatron 850plus and 550plus Each modality has default settings that are automatically selected when you press a modality key The basic steps for setting up any treatment are l Press a modality key once or twice to choose the desired modality IFC Premod Russian Biphasic High Volt Micro Sound or Combo The lighted LED on the key indicates the modality chosen The first available output channel s and default settings for that modality are au
95. d of going into the skin distributed evenly throughout the entire electrode surface This has the effect of increasing the current density since the current is being delivered through a smaller area Patient Susceptibility Some patients skin is more sensitive to electrotherapy currents This can cause a reaction similar to a heat rash Electrotherapy treatment can result in a rash burn or blister The tendency to do this is dependent upon the factors listed above and can be minimized by applying the following guidelines 1 Use only moderate current It is not always necessary to raise the treatment intensity to just short of the patient s pain threshold to achieve adequate results Suggested maximum treatment levels for different electrode sizes are given below for interferential or premodulated therapy These values are not intended to be inflexible but they should be a guideline If your treatment goes beyond these intensities you should examine the treatment to discover why such a high intensity setting is required Use as large an electrode as is practical for the application Note that the current density in a 1 25 square electrode is FIVE TIMES the current density in a 1 75 by 3 75 electrode for the same intensity setting Using larger electrodes allows current to be delivered over a larger area of the body keeping the current density to be as low as possible and minimizing the possibility for adverse reactions Interferent
96. ded in the operator s manual for this device This error will not occur if the intensity is set below 11 The error condition can also be detected during setup of premodulated treatments at the High frequency settings The error warning will also occur while a treatment is in progress under the same conditions described above but will only be displayed if the affected channel is currently selected for display Disable the Lead Warning If you find the lead warning feature is too sensitive for your treatment setup and is detecting conditions that are not truly open you can adjust the sensitivity To do this press and hold the IFC key while powering the device on NEVER TURN THE DEVICE ON OR OFF WHILE LEADS ARE CONNECTED TO A PATIENT The word OPEN is displayed in the Time display and the default setting of 24 is displayed in the Intensity display A lower number provides reduced sensitivity At a Zero setting no error will be displayed Use the up down arrow keys to change the setting then press Start to exit this mode The setting you select will remain as the default for the device until you change it Operation amp Treatment Instructions 23 Dynatrone 850plus amp 550plus Interferential Premodulated Instructions WARNING NEVER turn the power on or off while the unit is connected to the patient Always give the Remote Stop cable to the patient prior to the treatment Always STOP a treatment before removing or atta
97. delivered using either electrodes or optional probes If you are not familiar with the operation of the probes see How to Use Microcurrent Probes later in this section For treatment with electrodes plug one lead into the Channel 1 jack and place the two electrodes on the patient before setting up the treatment For treatment with probes plug the microcurrent probe into its own output jack on the left side of the device During the microcurrent treatment the current is delivered to both Channel 1 and to the probe outputs simultaneously Therefore Channel 1 is unavailable for any other treatment while any microcurrent treatment is in progress including during probes treatments Basic Microcurrent Setup 1 Press the MICRO key 2 Choose treatment channel CH 1 for electrodes or MICRO for probes and attach the lead and electrodes or the probe cable to the selected output channel Choose the POLARITY press FUNCTION MICRO For electrode treatments only change the TIME if desired Change the FREQUENCY if desired Change the INTENSITY setting if desired Press START Press MICRO again to turn AUDIBLE TONE on off as desired Press STOP if you need to stop a treatment before its time has expired MICROCURRENT Treatment Instructions 42 Dynatrone 850plus amp 550plus Microcurrent Treatment Time probe treatments are manual and a treatment time is not set During the probe treatment the timer will start a
98. device Installation amp Features 15 Dynatrone 850plus amp 550plus Soundheads for the Dynatron 850plus come in 1 cm 2 cm 5 cm and 10 cm sizes The 2 cm 5 cm and 10 cm soundhead operate at 1 2 and 3 MHz while the 1 cm soundhead operates at 2 and 3 MHz The soundheads are waterproof allowing ultrasound not combination therapy to be administered in water if desired Do not drop the soundhead nor allow it to strike a hard surface Do not place soundheads into ice water Do not allow soundheads to repeatedly reach maximum head temperature of these conditions can cause damage to the crystal Any such damage is not covered by the warranty For new or replacement soundheads contact Dynatronics or your authorized Dynatronics representative Microcurrent Probes optional accessory The Dynatron 850plus and Dynatron 550plus devices offer optional probes for delivering hands on microcurrent treatment The microcurrent probes can only be used for microcurrent therapy It is not possible to select the probe output nor to use the microcurrent probe to deliver a probe treatment for interferential premodulated Russian biphasic or high volt modes The setup includes an active probe along with either a ground probe or a ground electrode Use the end of a cotton swab such as a Q Tip inserted into the ends of both the active probe and the ground probes Cut the end of the swab to a short length the cotton must touc
99. does not affect Continuous treatments Press the toggle key one or more times to select the desired ramp time Available options include 5 1 0 1 5 and 2 0 seconds The ramp time is applied to both the start and to the end of the contraction time and the ramp time is in addition to the contraction time itself Change the treatment TIME if desired The default time is displayed Use the Time arrow keys to increase or decrease the treatment time Change the PULSE WIDTH and or PULSE RATE if desired Two Normal treatments will share whatever frequencies you set for the first channel Keep this in mind if you plan to set up two biphasic or Russian treatments Also note that the pulse width and pulse rate may only be changed when setting up the first channel in a two channel treatment Press the Time toggle key to select either pulse width or pulse rate The indicator lights next to the Time toggle key show you which option is currently selected When either pulse width or pulse rate is selected the current setting for that option is displayed in the Time display only You can change the setting by using the Time up down arrow keys You can press the toggle key again to return to the Time display if desired However if you make no key presses for 10 seconds the display automatically returns to the Time display The ranges and default settings for pulse width and pulse rate are listed later in this section See Biphasic Russian Defau
100. e ss Basic High Volt Setup 1 no RARE RE RR RG CR d Detailed High Volt Set p uer te peo a i Re ere be euge High Volt Default Settings ade tre e e ee lesa dan eine Mieroc rrent Instructions Ea ee ele sen ERE QR S RURE ont Basic Microcurrent Setup eed UR ew de te ie eR re RS Microcurrent Treatment Time uie eene Eten tete R ee eee comes eee Detailed Microcurrent Setup idee rete deerit eee eee de eed rene Audio eee Dee us Microcurrent Default Settings se toi Cete one dant Peg ete edere tees ire oo Gos e Qutb gen How To Use Microcurrent Probes cccccccssssssssscscccecccsssevcscccescacssssescscsceeenssssvcsccesscessesssevcscessenes Ultrasound Instructions Soundhead e ede e de re mette ent Turn Soundhead Warming Off On tenete nennen tne Basic Ultrasound Set p aired qe trib oe go tco LL Fete eR ED nent tege ot ede Detailed Ultrasound Setup ze Lore eae te e e eee et eoe duos Ultrasound Default Set ngs eie et eL eet ee P i HP e et e o p tel Lea Patient Coupling etti E et e oec ier E ee ne teeth pe eer as Poor Coupling ue aes uae dene Ultrasound Coupling
101. e 20 LED lighted enter the value for Temp 2 MHz Ultrasound Technical Information 105 Dynatrone 850plus amp 550plus d Select 10 Duty Cycle With the 10 LED lighted enter 0 zero as the value for Coupling The coupling detection feature is not available with old style soundheads 6 Enter 3 MHz Values Press the FREQ key to select 3 MHz Make sure the 3 MHz LED is lighted Locate the 3 MHz column on the printout and enter those numbers as follows a Select CONT Duty Cycle The CONT and 3 MHz LEDs are lighted Enter the value for F1 3 MHz by pressing the time selection keys until the desired value is displayed in the Time display b Select 50 Duty Cycle With the 50 LED lighted enter the value for Z 3 MHz c Select 20 Duty Cycle With the 20 LED lighted enter the value for Temp 3 MHz d Select 10 Duty Cycle With the 10 LED lighted enter 0 zero as the value for Coupling The coupling detection feature is not available with old style soundheads 7 Store New Parameters After you have entered all parameters press START to store them in the device s memory Then press STOP to exit this mode The above procedure must be performed for each separate soundhead for the device Turn the device off before attaching the next soundhead then turn the device on again with the soundhead firmly plugged in Calibration Procedure New soundheads that accompany a new device are calibrated
102. e Keyboard and Displays eene ene Processor Interaction with Oscillators ss Processor Interaction with the Output Jacks s S rennen Processor Control of Output Waveforms ses Basic Trouble Shooting Techniques eee ee eere e eee seen sesto set ao e ep e seen ete ao s seas essa sese eos eaae e esae eoe Hands On Testing Pads and Eeads 2 te e e ebbe e eee peccet Installing Software Updates e Installing Replacement Part iciscccccsecccssdssscovscsccseoscessdecsdsoseceoceeteossesedesssbeseuaseessdessseteckncvesdessesessevscevedessss Section VIII Schematics and QC Check Lists viii Dynatrone 850plus amp 550plus Section Introduction Dynatrone 850plus amp 550plus Introduction to the Dynatron 850plus and 550plus The Dynatron 850plus and Dynatron 550plus offer the practitioner a wide range of treatment options in a single device Both devices provide interferential and premodulated therapy high voltage pulsed stimulation Russian and biphasic stimulation and microcurrent The 850plus also includes ultrasound and combination therapy The devices include the advantages of earlier Dynatronics models such as customizable treatments with convenient setup In addition these units are smaller and lighter in weight than earlier models and now offer the option of battery operat
103. e current as expected If the patient is unable to feel the current you could unintentionally raise the current to a level much too high and risk causing unnecessary possibly severe discomfort to the patient Keep the intensity very low if the patient has little or no feeling in the treatment area see Contraindications Warnings and Precautions in this manual Keep in mind a wide range of factors can cause the patient to lack sufficient feeling in the treatment area including but not limited to pain control drugs use of ice packs neurological damage etc Always consider these and other factors when delivering an electrotherapy treatment and determine intensity settings based upon your medical expertise and judgment If you encounter the Current Limit warning it could indicate that the patient cannot adequately feel the current Ensure that the patient can feel the current If you are treating an area that may be desensitized for any reason reduce the intensity immediately Read all the warnings regarding treatment of desensitized areas provided in this manual under Contraindications Warnings and Precautions Ultrasound Technical Information 94 Dynatrone 850plus amp 550plus Microcurrent Usage Cautions Microcurrent uses only very low frequencies and the current generally is not felt by the patient However microcurrent at high intensity settings especially when using probes can sometimes be felt by the patien
104. e time The Time display will very briefly display the new setting as follows CP 1 CP 0 Coupling on Coupling off ULTRASOUND Treatment Instructions 52 Dynatrone 850plus amp 550plus After a second the display returns to the treatment time display Repeat this key sequence to change the default setting again if desired NOTE In changing the coupling setting you may inadvertently PAUSE the treatment the PAUSE LED will be lighted Just press PAUSE again to resume the treatment NOTE The coupling sensing bar graph may be viewed both during sound treatments and during combo treatments Changes to the treatment settings including frequency duty cycle and size of soundhead will cause some variance in the graph This bar graph is not available for 1 cm soundheads Head Temperature Hot If poor coupling is allowed to continue the temperature of the soundhead rises and the patient does not receive the full ultrasonic output The Dynatron 850plus continuously measures the temperature of the soundhead to ensure both that the patient is receiving the optimal treatment and that the soundhead crystal is protected from overheating If the soundhead temperature approaches the maximum level the POWER display will begin flashing For devices having software Rev prior to 1 02 If the temperature reaches the maximum level allowed the treatment is automatically PAUSED the output power is stopped the treatment time stops counti
105. ed by the FDA to keep records on all units sold consisting of 1 the date the unit was sold 2 to whom it was sold 3 any problems the customer has with that unit in General amp Technical Information 118 Dynatrone 850plus amp 550plus the field and 4 any information on repairs performed on the unit The information collected also helps us improve the unit s performance It helps us to identify trends and allows us to pinpoint a manufacturing or engineering change that will make the unit function more reliably Packaging and Shipping of Replacement Parts defective or broken parts should be shipped back to Dynatronics in the original shipping container These containers are designed to withstand the punishment of shipping If the original containers are not usable find containers that are similar in protection so damage in shipping will be prevented The person or company sending the unit to Dynatronics is responsible for any shipping damage resulting from a poorly packaged part or unit Definition of Symbols Some or all of the following symbols are included in the labeling for this device The meanings of the symbols are described here Alternating Current Attention consult accompanying documents Off power disconnection from the mains On power connection to the mains gt O amp Type BF patient applied part Equipment Classification This device is classified as follows Protection a
106. ed only under the continued supervision of a physician TENS devices have no curative value TENS is a symptomatic treatment and as such suppresses the sensation of pain which would otherwise serve as a protective mechanism Electronic monitoring equipment such as ECG monitors and ECG alarms may not operate properly when TENS stimulation is in use This device should be kept out of the reach of children Ultrasound Technical Information 85 Dynatrone 850plus amp 550plus Precautions 1 Isolated cases of skin irritation may occur at the site of electrode placement following long term application 2 Effectiveness is dependent upon patient selection 3 Some patients may experience skin irritation or hypersensitivity due to the electrical stimulation or electrical conductive medium The irritation can usually be reduced by use of an alternate conductive medium or alternate electrode placement This therapy must be used cautiously in the presence of any of the following conditions e When there is a tendency to hemorrhage following acute trauma or fracture e Over the menstruating uterus e Where sensory nerve damage is present or in any case where there is a loss of normal skin sensation this includes areas desensitized by medication Do not use in general area where high powered high frequency transmitting surgical units are being operated Short wave diathermy should not be turned on or used at the same time
107. effect of the current is on the platelets and would tend to spread any clot with perhaps fatal results in a patient with coronary thrombosis If a patient has a history of deep vein thrombosis even many years past the treatment may increase rather than decrease swelling Pacemakers Patients with pacemakers should avoid all high and medium frequency generators Cardiac Conditions The electrodes should be placed to avoid the stellate ganglion and the heart itself If there is a potential for heart problems the clinician must exercise professional judgment and use adequate precautions The clinician should not expose the patient to risk if possible heart problems are suspected Bacterial Infections The effect on bacteria is uncertain and it is advisable that bacterial infections should not be treated Malignancy The use of Interferential Premodulated High Volt Biphasic or Russian Stim treatment is contraindicated in patients with clinically diagnosed cancer Additional warning from the Canadian Health and Welfare Department Health Protection Branch WARNING Thoracic applications are contraindicated Cardiac fibrillation may occur if output current is 50 mA RMS or greater for any output circuit 1 Adequate precautions should be taken in the case of persons with suspected or diagnosed epilepsy 2 Severe spasm of the laryngeal and pharyngeal muscles may occur when the electrodes are positioned over the neck or mouth The contracti
108. election made as follows HD 1 Head warming on HD 0 Head warming off e Press STOP after selecting the desired setting Basic Ultrasound Setup Press the SOUND COMBO key once to select SOUND 2 Choose the FREQUENCY Choose the DUTY CYCLE Change the treatment TIME if desired Raise POWER 6 Press START 7 Press STOP if you need to stop a treatment before its time has expired Detailed Ultrasound Setup 1 Press the SOUND COMBO key once When you press the SOUND COMBO key once the SOUND LED is lighted and the ultrasound treatment default settings are automatically selected If you wish to use the default settings increase the power then press START If you wish to use other settings do the following 2 Choose the FREQUENCY Press the frequency toggle key one or more times to choose 1 2 or 3 MHz Any one of the three frequencies may be selected with the 2 cm 5 cm and the 10 cm soundheads The 1 cm soundhead offers 2 and 3 MHz 3 Choose the DUTY CYCLE Press the duty cycle toggle key one or more times to select the desired duty cycle Available options include 10 percent 20 percent 50 percent and Continuous duty cycle Treatment Instructions ULTRASOUND 49 Dynatrone 850plus amp 550plus 4 Change the treatment TIME if desired Use the Time up down arrow keys to change the treatment time if needed 5 Raise POWER Use the Power Intensity up down arrow keys to increase the power
109. elf with all the operating instructions for the modality used as well as the contraindications warnings and precautions for that modality You should also read in this manual general information about each of the modalities In addition to the information provided in this manual consult other published sources for additional application and safety instructions regarding use of each type of therapy How to Use This Manual This manual is organized to help you learn how to use your Dynatron 850plus and 550plus device and to provide easy reference for looking up specific instructions or information The information in the manual is grouped as listed below Note that all treatment instructions for all modalities are in one section and that all contraindications warnings and precautions for all modalities are provided together in another section This grouping of information makes it easy for you to find what you are looking for To assist you further descriptive titles appear at the foot of each page to help to identify immediately what section you are in Familiarize yourself with the organization and presentation of this manual to make best use of the information provided Section I Introduction Installation and Features Section II Operation and Treatment Instructions Section III General Modality Information Section IV Contraindications Warnings and Precautions Section V Ultrasound Technical Information Section VI General Techn
110. ely for each channel e Use the Time toggle key to select the Pulse Rate or Width then use the Time up down arrow keys to change the pulse rate not available for Reciprocal treatments nor when two Normal treatments are running simultaneously 11 Press STOP if it is necessary to end the treatment before the treatment time has expired When the treatment time has elapsed current to the patient is stopped and a tone sounds notifying you of the treatment end Treatments in progress may be stopped at any time using one of the following methods STOP Press this key to stop treatment at all channels REMOTE STOP During unattended therapy a patient stop button is provided to allow the patient to stop treatment The remote cord should be plugged into the machine prior to starting the treatment When the remote stop button is pressed all output from the device is stopped time is set to zero and a tone sounds briefly STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output at the selected channel is stopped and
111. ely report any device malfunction to Dynatronics Customer Service Department NOTE BEFORE sending a device to Dynatronics for service you must FIRST obtain a return authorization number Call Dynatronics Customer Service Department at 1 800 874 6251 and discuss any problems or required service to save time and ensure the machine is returned to you as quickly as possible Routine Ultrasound Calibration Inspections Dynatron 850plus only Government agencies regulate the frequency at which ultrasound units must have their calibration checked The device must still be examined at the periodic intervals specified by the governing agency for the country in which the device is used To have the inspection performed by Dynatronics contact Dynatronics Customer Service Department The device will need to be shipped to Dynatronics for the inspection As an alternative these periodic checks may be performed in your own locale by an independent contractor who is expert in checking the calibration of ultrasound equipment The calibration procedure MUST be performed by a qualified ultrasound technician using the proper equipment and is recommended every 6 to 12 months Calibration instructions are included in this manual Service 117 Dynatrone 850plus amp 550plus Software Updates Software updates may possibly be made available by the manufacturer for this device in the future A software update is installed in the the Dynatron 850p
112. en the current treatment parameters for that channel displayed Any changes you make to the parameters will affect the channel with the green light only e When achannel s light is yellow the channel is still active but its parameters are not being displayed and it may not be modified until it is selected You must first press the toggle key to select the channel its light will then become green and modifications are allowed e When a light is solid any color this indicates the channel is in the CONTRACTION segment of the cycle and current is being delivered to that channel When a light is flashing this indicates the channel is in the REST segment of the cycle and current is not being delivered at this time If you select a channel for modification while its light is flashing the device will ramp the current up on that channel before allowing you to make modifications When the light changes from flashing green to solid green you will be able to modify the settings for the channel RUSSIAN amp BIPHASIC Treatment Instructions 32 Dynatrone 850plus amp 550plus During a Biphasic or Russian treatment you may make the following modifications e Use the toggle keys to select a different contraction rest cycle e Use the toggle keys to select a different ramp time e Use the Time arrow keys to increase or decrease the treatment time se the Intensity arrow keys to increase or decrease the intensity separat
113. en the button on the remote stop cable is pressed output for all stim modalities is stopped and the tone sounds briefly During Combo treatments both sound and stim outputs are stopped Right side of device D850plus only Left side of device Micro Probe e 31 Ultrasound Ouput Jack 32 Ouput Jack for Microcurrent Probe Side Panels Dynatron 850 and 550plus Side Panels 31 ULTRASOUND OUTPUT JACK DYNATRON 850plus ONLY not available on the Dynatron 550plus The applicator soundhead plugs into this jack for ultrasound therapy 32 MICROCURRENT OUTPUT JACK The microcurrent probe plugs into this jack for microcurrent probe therapy Instructions for Using Toggle Keys Toggle keys are used to make selections from two or more options in a given area Toggle keys are pressed one or more times to make a desired selection A GREEN light LED next to the toggle key shows the option that has been selected Pressing the toggle key one or more times allows you to scan through the available options Each toggle key has unique capabilities Most toggle keys allow only one selection For example the Ramp toggle key requires you to select just one of the four ramp times available However some toggle keys allow you to select two options For example in interferential you can press the High Low toggle key once to select High press again to select Low and press again to select both High and Low The following is a list of al
114. ent as these are different parameters the pulse occurs only during the contraction time The diagrams below illustrate the relationship of each of these parameters General Information BIPHASIC amp RUSSIAN 73 Dynatrone 850plus amp 550plus The pulse width indicates the duration in milliseconds or microseconds of the output cycle of the pulse and the pulse rate is measured in number of pulse occurrences per second Between pulses current is at zero A 50 percent duty cycle or less is the usual duty cycle for Russian stimulation the duty cycle includes one output cycle period and one zero current period 50 percent duty cycle means that the length of the pulse width must be equal to or less than the zero current period The number of pulses per second affects the allowable range of pulse widths A greater number of pulses per second means a shorter pulse width is allowed The Dynatron 850plus and 550plus will not allow you to circumvent this rule Width gt Ramp i 1 1 Y 1 1 t 1 1 T 1 1 1 Lan WMA heen pay r ses E i Contraction Rest lec Sea eS Sane Se a ge ee tee gt Russian Stimulation If a given Russian stimulation treatment has a 50 percent duty cycle this means the output cycle is continuously repeating for half of the pulse duration see Rate in the diagram above followed by a zero curren
115. entire surface Stop the setup and correct the problem 2 Carbon electrodes must be free from any build up If electrodes have a build up from body oils or a moistening agent such as an electrolyte spray conductivity is greatly impaired If treatment is allowed to continue intensity could be inhibited When using carbon electrodes with any electrotherapy device you must make sure conductivity 15 not impaired due to any type of build up on the electrodes 3 Carbon electrodes eventually wear out Do not assume you can safely use carbon electrodes indefinitely Over time these electrodes will wear and when worn the amount of current delivered through the electrode will decrease and will be inconsistent over the surface of the electrode As a general rule carbon electrodes that are used regularly should be replaced at least every six months Do not take chances with patient safety Discard worn carbon electrodes If you think your carbon electrodes are showing wear you can send them to Dynatronics to be tested with an ohm meter Good carbon electrodes should test at between 40 and 200 ohms Unfortunately practitioners frequently send us electrodes having resistance measuring in the thousands of ohms Overused electrodes such as this present a potential hazard to the patient How to Clean Carbon Electrodes Carbon electrodes from Dynatronics may be cleaned using a mild soap and a small brush such as a nail brush They may also be sterilized
116. ents the soundhead from becoming too hot both to protect the soundhead crystal from damage and to ensure patient comfort Care and Cleaning Instructions Clean the outer surface of the Dynatron 850plus or 550plus with a slightly damp or lightly moistened cloth Mild household cleaners work well Do not spray the solution directly on the unit First moisten the cloth and then wipe the unit off Solvents caustic solutions and harsh or abrasive cleaners must never be used Avoid stretching cords to full length bending cords sharply or wrapping cords tightly Undue stress on cords can damage connections Keep all food and soft drinks away from the machine and its accessories spills can cause costly damage to the machine and repairs for this type of damage are not covered by the warranty Do not drop the unit or the soundheads as severe damage will occur Ultrasound heads should be cleaned with warm water Always keep the head free from gel buildup Do not use ice water for cooling soundheads Do not allow soundheads to overheat repeatedly This could result in thermal shock to the crystal Damage of this type is not covered by the warranty Suggested Maintenance Schedule SERVICE TO BE PERFORMED BY A TECHNICIAN Every 6 Months Test leads and carbon electrodes Lead resistance should be less than 10 above the mean cable resistance Greater values indicate strand breakage and lead should be replaced Annually Annual ultrasound c
117. er zeer zeer zeer zeer 9 1 coer EGEF eeer EEr onemy 9 Z voer veEr S veEf 9 vOEr S tax b Bx 4 ei LBA 8 9 tax 18x Z tex 18x 91 LEZ IIa LBA leer amp voer 145
118. erature Press Time to return to the treatment time display CONT Temperature Bar Graph During an ultrasound treatment press SOUND and the HI LO keys simultaneously to view a bar graph representing the soundhead temperature Display Watts or W cm2 Power for the Dynatron 850plus may be displayed as WATTS or W cm The default setting for power is W cm but you may select the display you prefer at any time before or during treatment To change the power display press the PAUSE FUNCTION key and hold it down for two seconds To change back again press and hold the PAUSE FUNCTION key for two seconds The device will beep to indicate you have changed the display Note that if you are in a treatment when you press and hold the Pause key the treatment may be paused the Pause LED is on and you should press Pause briefly again to turn off the Pause LED and resume the treatment ULTRASOUND Treatment Instructions 54 Dynatrone 850plus amp 550plus The default power display is W cm If you change the display to WATTS during use the machine reverts to the W cm display when the machine is turned off and on again However if you save ultrasound default settings while using the WATTS display the WATTS display will become the default display for your machine You can tell when you have selected WATTS display by the decimal in the display window
119. ered alternates between the two polarities Selectable Duty Cycle Continuous or on off duty cycles may be selected The Dynatron 850plus and 550plus allow you to choose a muscle contraction relaxation cycle from options of 10 10 ten seconds on and ten seconds off 10 30 10 50 or continuous cycle Selectable Ramp Speed You can choose a ramp speed of 1 2 to 2 1 2 seconds in half second increments For patient comfort the ramp occurs both before and after the segment of the pulse Pulse Width The pulse width is fixed at 25 us Pulse Pair Interval The interval between the two pulses in the wave form is fixed at 100 us Intensity Display in Volts The intensity display is shown in volts peak voltage with no load with a range of 1 to 500 General Information HIGH VOLT 77 Dynatrone 850plus amp 550plus Microcurrent Therapy Microcurrent is low volt pulsed microamp stimulation which has been used for symptomatic relief of chronic intractable and post surgical pain With the Dynatron 850plus or 550plus you can provide attended or unattended microcurrent therapy Unattended therapy is delivered using electrodes Attended therapy is delivered using an optional hand held probe Microcurrent Therapy with Electrodes Microcurrent treatment setup with electrodes is provided using Channel 1 and two electrodes Electrodes are placed on opposite sides of the affected area so current is directed through the affected a
120. erferential treatment is performed using four electrodes with two channels The channels produce two currents which intersect producing the interferential beat Without Target it is often difficult to place the electrodes in the right position to produce the beat at the desired treatment area This is because different types of human tissue skin muscle bone etc conduct current differently making it impossible to guess the course of the two currents Target helps eliminate the need to move the electrodes to get the desired result Ea Channel Channel With Dynatronics 4 patented Target feature you can move the center of interference where the two currents cross simply by moving your finger across the Target um aaa touch pad Patient feedback will let you Normal Interferential currents cross at a point between electrodes It is know when you have difficult to guess where they will cross as shown in the left diagram With positioned the treatment Target you move the point of interference without moving electrodes as at the desired spot shown in the diagram on the right just press the touch pad In the diagram here the electrodes are placed in a position to treat a point directly in the center of the electrodes But the center of interference actually occurs at another point In these illustrations the point of interference is shown in a cloverleaf shape as interferential treatment affects
121. ers e Press the FUNCTION MICRO key to select a different polarity e Use the Time toggle key to select TIME then use the Time arrow keys to increase or decrease the treatment time e Use the Time toggle key to select FREQ then use the Time arrow keys to increase or decrease the frequency e Use the Power Intensity arrow keys to increase or decrease the intensity 10 Press STOP if it is necessary to end the treatment before the treatment time has expired When the treatment time has elapsed current to the patient is stopped and a tone sounds notifying you of the treatment end Treatments in progress may be stopped at any time using one of the following methods STOP Press this key to stop treatment at all channels You may prefer to stop treatment at one channel only see explanation below STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output at the selected channel is stopped and the device then displays the parameters for the next treatment that remains in progress if any Remote Stop Cable With Microcur
122. es for both Electrodes and Probes e Frequency Between 1 and 500 Hz e Intensity Between 10 and 990 microamps in increments of 10uA NOTE For Microcurrent treatments you may save separate default settings for a probe treatment and for a treatment with electrodes You may also indicate the most preferred option between probes and electrodes The last default setting saved probes or electrodes becomes the primary default when Microcurrent is selected Ultrasound Default Settings e MHz for 2 5 and 10cm soundheads and 2 MHz for 1cm soundhead e Continuous Time 5 minutes Combination Default Settings In Combo mode you can save new default treatment time and the preferred stim modality The stim settings in a Combo treatment are determined by the defaults of the that modality Separate ultrasound default settings may be saved for the combo treatment which will not affect ultrasound only treatments Setting Defaults 66 Dynatrone 850plus amp 550plus Battery Operation Use ONLY a Dynatronics Approved Battery Contact Dynatronics or your Dynatronics dealer to purchase the optional battery or to obtain specifications for an acceptable battery that may be used not substitute another battery without first confirming with Dynatronics that the battery you are purchasing may be used with this device Only use a battery that CANNOT be recharged while it is in use Disconnect the battery charger from the AC power
123. essage can occur if you plug in a soundhead while the device is on If you get this error make sure the soundhead is firmly plugged in then turn the device off and on again The message should be cleared If you have tried all of these suggestions and the error is still displayed on the LEDs the device may require service by the manufacturer Make a note of the error message and the sequence of events that cause the error and contact Dynatronics Customer Service at 1 800 874 6251 for further assistance Do not send the device to Dynatronics without first contacting the Customer Service Department Ultrasound Technical Information 111 Dynatrone 850plus amp 550plus Ultrasound Technical Information 112 Dynatrone 850plus amp 550plus Section VI Technical Information Service Dynatrone 850plus amp 550plus General Specifications Other ranges accuracy and precision values that are not provided here may be obtained from Dynatronics upon request Dynatron 850plus and 550plus Specifications Power requirements 100 240 V 50 60 Hz Power consumption 150 watts maximum Fuse 250 V T1 6 AL slow blow Dimensions 9 5 W x 3 75 H x10 D Weight 4 6 pounds Stim Specifications Interferential Premodulated Therapy 4000 Hz sine wave frequency modulated by a 4000 to 4150 Hz variable frequency sine wave of equal amplitude Russian Stimulation 2500 Hz sine wave amplitude modulated at 50 Hz Biphasic Stimulat
124. f the soundhead to ensure both that the patient is receiving the optimal treatment and that the soundhead crystal is protected from overheating If the soundhead temperature approaches the maximum level the POWER display will begin flashing For devices having software Rev prior to 1 02 If the temperature reaches the maximum level allowed the treatment is automatically PAUSED the output power is stopped the treatment time stops counting down both the Time and Power displays flash continuously The soundhead must then be cooled down before the treatment can resume For devices having software greater than Rev 1 01 With software revisions greater than Rev 1 01 the Time and Power displays do not flash but the Time display shows the error message HOT see Page 2 of this manual for instructions on determining the revision level of your device When this condition occurs the treatment timer is paused output is stopped and the soundhead must be cooled down before the treatment can resume Once the soundhead is cooled press Pause or Start to resume the treatment See Ultrasound Instructions in this manual for more information regarding warnings for a hot soundhead and the new soundhead temperature graph available for software revisiong 1 02 1 03 or later as well as more complete information for cooling the soundhead before resuming treatment Cooling the Soundhead The temperature alert not only ensures good coupling
125. gainst electric shock Class I protectively earthed enclosure Protection against electric shock Type BF floating patient applied part Protection against harmful ingress of water none e Equipment not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide Mode of operation Continuous operation Disposal of Equipment and Accessories There is no risk posed in disposal of this equipment or its accessories These items contain no hazardous materials Service 119 Dynatrone 850plus amp 550plus Additional Technical Information Available for Technicians Only Dynatronics will make available on request circuit block diagrams component part lists descriptions calibration instructions or other information which will assist the user s appropriately qualified technical personnel to repair those parts of the equipment which are designated by Dynatronics as repairable and which will not violate protection of Dynatronics proprietary information FDA Compliant Electrodes and Lead Wires Poly Electrode with Wire Connector Carbon Electrode Inset Connector Female connector no pin Female connector no pin N bw Pa Patient cable PA Patient cable from device from device x Pigtail lead wire from patient about 3 5 inches in length Poly Electrode with Snap Connector Electrode from patient N Patient cable from device 5 Female connector no
126. h the probe s metal ring Use water or a conductive electrolyte spray to wet the cotton swab before treating Active Probe To deliver the current to the patient through the active probe press and release the button on the probe Press and release the button again to stop the current The active probe should touch the patient s skin at the treatment site and the ground probe should touch the patient s skin elsewhere This completes the circuit and delivers current to the patient You do not need to hold the button down Once you have pressed and released the button the current is delivered until you press and release the button again to stop the current While you are delivering current the treatment timer counts up in seconds from zero When the current is stopped the timer returns to zero Press the button again to commence the next time sequence Continue in this way until treatment is completed Ground Probe The ground probe is attached directly to the banana pin connector on the probe Press and release button to start and to stop current delivery during treatment N Cut the end off a cotton swab and insert it into the tip of the cone Saturate the cotton with water or an electrolyte spray before treating Microcurrent Active Probe optional accessory cable This probe is used to complete the circuit to allow flow of current through patient tissue The ground probe should touch
127. hat channels LED is selected green You may only modify the parameters for the channel that is currently selected indicated by the green LED A green flashing LED indicates that the selected channel is in the rest segment of its cycle If the light is green and flashing when you begin to modify intensity pulse rate or pulse width current is ramped up to treatment level for that channel so those parameters may be modified 9 Press START When you press start the treatment timer begins counting down If you fail to set the intensity before pressing START the intensity display will begin flashing and you will be unable to start the treatment until you set the intensity For Reciprocal and Co contraction treatments you must set the intensity for each channel separately SAVE DEFAULTS If the treatment you have just set up is the most common Biphasic or Russian treatment setup you use you can save the treatment parameters as new defaults for your own machine After setting up the treatment simply press and hold the START key for two seconds At the end of two seconds you will hear a beep indicating the treatment parameters have been saved The next time you select this modality these parameters are selected automatically 10 MODIFY settings While the treatment is in progress you can modify the treatment parameters You will need to observe the channel indicator lights when modifying a treatment e When achannel s light is gre
128. he Dynatron 850plus and 550plus provide three modes of treatment in Russian and Biphasic Stimulation Normal Reciprocal and Co Contraction You will need to decide which mode is to be used and attach the appropriate number of leads needed when setting up the treatment You may set up two Biphasic or two Russian treatments with Normal mode You may not set up one Russian and one Biphasic at the same time as both channels share frequency settings during these treatments NORMAL Use one channel with one lead wire two electrodes place the electrodes so as to treat through the muscle The contraction relaxation cycle is selected from an option list of 10 10 10 30 10 50 and Continuous there is no rest cycle with Continuous Each time period is indicated in seconds For example 10 30 indicates 10 seconds of stimulation with 30 seconds of relaxation The continuous duty cycle is not recommended for electrical muscle stimulation but may be used for settings that are intended to effect results other than a muscle contraction CO CONTRACTION Use two channels and two lead wires four electrodes for this treatment Each pair of electrodes is placed over a different muscle group This treatment fires the two muscle groups simultaneously contraction and rest cycles for both treatment areas occur at the same time Two channels are required 1 and 2 RECIPROCAL Use two channels and two lead wires four electrodes for this treatment The reciprocal mu
129. he LED for the channel Sy becomes GREEN and the The SIEEN and yellow cha nnel lights LEDs for all other active channels become YELLOW each will also appear solid non flashing or flashing A solid light Channel Toggle Key means current is being delivered to the channel at this time for example during the ON cycle of the Russian stimulation treatment A flashing light means current is not being delivered to the channel at this time for example during the OFF cycle of the Russian stimulation treatment CHANNEL OUTPUT INDICATOR LIGHTS GREEN Solid You CAN see this channel s parameters displayed on Time and Power Intensity displays The channel IS delivering current GREEN Flashing You CAN see this channel s parameters displayed on Time and Power Intensity displays The channel IS NOT delivering current YELLOW Solid You CANNOT see this channel s parameters displayed on Time and Power Intensity displays The channel IS delivering current YELLOW Flashing You CANNOT see this channel s parameters displayed on Time and Power Intensity displays The channel IS NOT delivering current Ultrasound Heads Dynatron 850plus only The Dynatron 850plus features the new Dynatronics SmartHead ultrasound applicator soundhead that has all calibration information self contained SmartHeads may be used interchangeably with any 50 Series Plus model or the Dynatron 125 model with no need for entering calibration numbers into the
130. he lead wire prevents connection of the cable to any power source other than a stereo jack as found on Dynatronics devices The stereo connector is 1 4 in diameter and cannot be inserted directly into an AC power source NOTE As of May 9 2000 new FDA compliant lead wires are available from Dynatronics and are included with all new devices Medical Device Reporting Requirements Under the Safe Medical Devices Act SMDA of November 1990 the manufacturer and distributor are required to report specific incidents to the FDA In the event of any applicable incident you should report details of the incident to the Dynatronics Service Department at 1 800 874 6251 Reports should be submitted to the manufacturer immediately to allow the manufacturer to report to the FDA within 10 working days e If you receive information that reasonably suggests a probability that a device caused or contributed to a death serious injury or serious illness e If you receive information that reasonably suggests a device malfunction and a recurrence will probably cause death serious injury or serious illness Definition of serious injury A serious injury is an injury that 1 is life threatening 2 results in permanent impairment of a body function or permanent damage to body structure or 3 necessitates medical or surgical intervention by a health care professional to 1 preclude permanent impairment of a body function or permanent damage to
131. hical representation of coupling status during a treatment Coupling contact between the soundhead and the treatment site may be provided either via a coupling agent such as a gel or lotion or in water as with underwater treatments Any material used as a coupling agent must be highly conductive of ultrasonic waves Airisa very poor conductor of ultrasonic waves Therefore avoid allowing any air between the soundhead and the treatment area During the treatment the soundhead should be moved continuously covering an area approximately twice the size of the soundhead in area The full surface of the soundhead should maintain contact with the patient s skin except with underwater treatments Treatment Instructions ULTRASOUND 51 Dynatrone 850plus amp 550plus Poor Coupling If all or part of the soundhead is not touching the patient coupling may not be adequate and the patient will not receive the intended dosage of the ultrasonic wave Poor coupling if allowed to continue can also result in increased temperature of the soundhead Do not hold the soundhead in the air while a treatment is running as this may damage the soundhead crystal and or stress electronic components in the device Ultrasound Coupling Bar Graph This feature for models having software greater than Rev 1 01 only see Page 2 During an ultrasound treatment you can press SOUND TARGET press both keys at once to display a bar graph to indicate coupling C
132. ial Premodulated Electrode Size Maximum Recommended Intensity Carbon Electrodes 3 round 25 30 3 x5 30 40 Self adhesive Electrodes 1 75 square 10 15 1 75 x 3 75 25 30 1 25 round 10 12 2 round 10 20 3 round 25 30 Ultrasound Technical Information 89 Dynatrone 850plus amp 550plus NOTE The above intensity settings should be considered maximum and not target intensities These suggested settings apply to interferential and premodulated treatments For high voltage pulsed stimulation the intensity is displayed in volts therefore these suggested settings do not apply For biphasic or Russian stimulation treatments intended to effect a muscle contraction it may sometimes be necessary to exceed these recommended limits to achieve the desired results However use caution when doing so to ensure that the patient can feel and can comfortably tolerate the electrical current Also observe all other precautions in this section concerning leads and electrodes to ensure the higher intensity setting is not necessary as a result of defective accessories In any case do not exceed patient tolerance in setting the intensity Consult published medical literature for more information about treatment protocols using each of these electrotherapy modalities 2 Ensure that the area on the patient s skin where the electrode is to be placed is clean and free of all foreign matter This includes powders perfumes and the like as well as body oils
133. ical Information Section VII Patient Information Introduction Dynatrone 850plus amp 550plus Installation and Features Unpacking When you receive the unit immediately unpack it and all accessories and check for possible damage obvious or concealed In case of damage immediately notify the carrier and take any steps necessary to file a claim for the damage sustained Do not destroy the shipping carton The carton should be reused if the device must be shipped for any reason The carton is specially designed to protect the unit from shipping damage Improper packaging of the unit during transport can result in damage and invalidate the warranty Complete the warranty registration form and return it to Dynatronics within 10 days of purchase This is essential to insure you are not billed for services that are covered by the warranty policy Warranty registration should include serial numbers for both the device and soundheads Connect the AC power cord which is equipped with a hospital grade UL listed plug to a properly grounded 110 120V 60 Hz AC outlet the device will automatically switch to 220 240V 50 Hz when connected to a power source with that voltage The power cord must also be firmly plugged into the device itself When the cord is properly connected it can not be easily pulled out Do not place the cord or the device in a place where the cord could be tripped over or accidentally pulled out of its socket during a tre
134. ick Reference of Special Key Presses e eee ee ee ee ee esee eren eene eet ense to seta ases 18 Section Il Operation and Treatment Instructions General Operating InStructioris 42 rh aoi onere o Lea ra nao ine eo ria cen seen vio ore enn 20 Power uin esee ug t Hagrid ees Foie e tees Pede ee mn cae EE EE TED RR dut 20 Basic Treatment Setup tete etre de tee E ee Deo ben tere frere Es aes 20 Conductance Bar Graph iin et heec e era e en a ere 21 LEAD Warning No Patient Current pee eene tot tdem 22 Interferential Premodulated Instructions 24 Basic Interterential Premod Set p ipee HE ROLL n eee 24 Detailed Interferential Premodulated Setup ss 25 Interferential Premodulated Default Settings 28 iii Dynatrone 850plus amp 550plus Biphasic Russian Instructions Lecce esee esee esee ee ette seen setas setae ettet te ette seta seta seta tease Basic Biphasic Russian Setup doa eate adl dte Detailed Biphasic Russian Setup sise Biphasic Russian Default Settings ss High Volt Instructions epe rete Ro eoa ooro eo eo ee EE ME sosegoesesevasssducesessnessecesessogsssseedensedetesoese Set Up High Volt Treatment with Electrodes ss Set Up High Volt Treatment with Optional Prob
135. ide of the jack and touch the patient lead as it is inserted into the jack The connector that touches the TIP of the patient lead and the connector that touches the small RING on the patient lead need to be soldered together there is no connection to the ground contact To measure the continuity of the leads turn the meter from OFF to the setting shown to 0000 figure this is the continuity checker of the meter Then plug the red and black leads of the DVM into the matching alligator clips so that the meter lead fits into the round hole of the alligator clip Plug the lead that is being tested into a test jack Clip the test leads of the meter with the alligator clips onto the free ends of the patient lead The meter should beep continuously Flex the lead at both ends and at the strain reliefs Flex the main body of the lead to make sure that there are no opens or shorts in the lead If the meter stops beeping at any time during the flexing there is an open in the lead and it should be replaced Test Lead and Pads The carbon pads and poly electrodes can also be checked with the DVM This is done with the resistance setting of the meter Set the meter to OO OO After removing the alligator clips from the test leads of the meter plug one of the test leads into the pin receptacle of the pad Touch the other lead to the surface of the pad If a resistance of more than 100 Ohms is seen the pad is beginning to break down and should
136. ifying you of the treatment end Treatments in progress may be stopped at any time using one of the following methods STOP Press this key to stop all treatments at all channels Treatment Instructions COMBINATION 59 Dynatrone 850plus amp 550plus REMOTE STOP During unattended therapy a patient stop button is provided to allow the patient to stop treatment The remote cord should be plugged into the machine prior to starting the treatment When the remote stop button is pressed all output from the device is stopped time is set to zero and a tone sounds briefly STOP ONE TREATMENT ONLY If you have more than one treatment in progress you can stop one treatment by either of the following methods First press the channel toggle key to select the channel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output for the channel s selected is stopped during a combo treatment this includes both stim and sound channels and the device then displays the parameters for the next treatment that remains in progress if any NOTE Pausing a Combo Treatment In Combo mode if a treatment is paused by any means either by pressing the PAUSE key or as a result of a soundhead that has become too hot the ultra
137. in this manual The determine the software revision level for the Dynatron device power the device on and observe the number shown in the Time display at the end of the device s startup routine Introduction Dynatrone 850plus amp 550plus Treatment Options The following modalities are provided by both the Dynatron 850plus and the Dynatron 550plus Interferential Therapy This traditional therapy delivered with two channels and four electrodes also includes Dynatronics patented Target feature for easy location of the treatment site and delivery of the full interferential beat where it is needed You can select the high frequency range the low frequency range or both along with Target Or select Sweep when you want to deliver the current over a more general area You can also customize the frequency settings for individual treatments or save a unique default setting Premodulated Therapy Ideal for treating areas where four electrode placement is not practical this modality extends the versatility of the device by offering a premodulated interferential current using one channel and two electrodes Biphasic Stimulation This option provides muscle stimulation using a sinusoidal biphasic waveform with pulse widths ranging from 50 to 400 microseconds It offers normal co contraction and reciprocal contraction modes selectable on off cycle times and ramp times and customizable pulse rate and pulse width Russian Stimulation
138. ing refers to the ability to deliver ultrasonic waves from the soundhead to the skin surface with as little impedance or dissipation of power as possible The best coupling is achieved when the ultrasound head has full direct contact over the treatment site or when the treatment site and soundhead are separated only by a substance that provides excellent conductance For example water is an excellent conductor of ultrasonic waves Therefore ultrasound treatment in water provides excellent coupling Air is a poor conductor of ultrasonic waves If any part of the soundhead is exposed to air during the treatment coupling is decreased When treating a patient outside of water the soundhead must maintain good contact with the patient skin at all times In addition a good conductive gel or lotion should be used to ensure the best possible coupling Many such products are commercially available specifically for ultrasound therapy Since air is a poor conductor of ultrasound it is not advisable to introduce air into the water during an ultrasound treatment The air bubbles in a whirlpool for example can decrease the effective ultrasound therapy to the patient Ultrasound Technical Information 97 Dynatrone 850plus amp 550plus Ultrasound Technical Information 98 Dynatrone 850plus amp 550plus Section V Ultrasound Technical Information For the Dynatron 850plus Only Ultrasound Technical Information Dynatrone 850plus a
139. inking in the wire Never use worn or damaged leads to treat a patient Using faulty leads may result in injury to a patient Test Leads Daily Lead wires should be tested regularly to ensure they are functioning properly and safely A simple test performed with the Dynatron 850plus and 550plus makes daily lead testing convenient Damaged or worn leads should be discarded and replaced Under normal use leads should be replaced about every 6 months Instructions for testing are provided below Remove Corrosion From Lead Tips Lead tips will build up corrosion through use The lead tips must be cleaned and kept free of this corrosion in order to function correctly To Ultrasound Technical Information 92 Dynatrone 850plus amp 550plus remove corrosion from lead tips use steel wool to gently scrape off the corrosion Take care not to scratch the metal plating of the tip during cleaning If the tip s metal surface becomes pitted or uneven the lead must be replaced Test Leads To test leads perform the following steps daily Begin with the machine turned off 1 Press and hold the TARGET SWEEP toggle key while turning the device on After initial power up the Lead Test function is launched If the device is already powered on you can enter the Lead Test function by pressing and holding the FUNCTION key while pressing the TARGET SWEEP toggle key When the device is in the Lead Test mode the Time display will read LEAd
140. ion 50 to 400 us pulse duration Pulse Width 1 200 Hz 50 levels see diagram Power output O to 100 milliamps into a 500 ohm load each channel NOTE Devices for Canada and Japan have a 0 to 50 A milliamps range Devices with the 50 mA limit are Vmin 2 available for any user specifying this limit Vmin Biphasic Stimulation pulse Microcurrent Specifications Width curation Output Waveform Two different waveforms are provided 1 a monophasic pulse with equal on and off times and 2 a biphasic wave 50 duty cycle The polarity of each waveform is selectable by the user With the biphasic waveform pulse equal charge of both polarities is applied to the patient during each cycle of the treatment waveform a Monophasic Square Wave Biphasic Waveform Pulse Frequency Range 1 to 500 Hz Maximum open circuit Voltage 50V General amp Technical Information 114 Dynatrone 850plus amp 550plus Microcurrent Pulse Output Current Range 10 to 990 microamps into 500 ohm load constant current High Volt Specifications Waveform Twin peak monophasic Pulse Width 25 us Pulse Rate Range 1 to 200 Hz Pulse Interval 100 us Maximum Power Output Limited to less than 500 V open load Ultrasound Specifications Dynatron 850plus only Ultrasound Power output 1cm head 2 MHz 3 MHz 0 2 watts 0 1 5 w cm 10 2cm head 1 MHz 2 MHz 3 MHz 0 4 watts 0 2 0 w cm 10 5cm head 1 MHz
141. ion making the devices truly portable One additional channel is now dedicated to high volt therapy allowing a greater variety of simultaneous treatments The manufacturer s warranty for these devices is now two years see full warranty details at the back of this manual This manual provides operator information and instructions for both of these models The sections that discuss ultrasound and combination treatments apply only to the Dynatron 850plus model other sections of this manual apply to both devices Sections of this manual that apply only to the Dynatron 850plus are clearly marked New Features For models having software greater than Rev 1 01 or later the following new features have been added effective January 1998 e Conductance Bar Graph A graphical representation of conductivity during and interferential premodulated or microcurrent treatment e Ultrasound Coupling Bar Graph Shows soundhead coupling during an ultrasound treatment e Soundhead Temperature Bar Graph Indicates when soundhead temperature is too hot during a treatment e Lead warning A new warning displayed if the device detects an open circuit indicating no patient current is being delivered and the treatment setup must be inspected e New warnings notifying the user when the soundhead is too hot or when the soundhead is not detected by the device These new features are described in greater detail in the treatment instructions later
142. is displayed in micro amperes in the Power Intensity display Use the up down arrow keys to change the intensity For Electrodes treatments the CHANNEL 1 indicator light is green For probes treatments the MICRO channel light is green and the Channel 1 light is yellow Changes you make will affect output to both the probe and Channel 1 7 Press START For electrode treatments when you press START the treatment timer begins counting down and stim is delivered through Channel 1 For probe treatments after pressing Start you must press and release the button on the probe to activate current through the probe the device beeps once to signal that current delivery has started it is not necessary to hold the button down while treating The treatment timer begins counting up in seconds from zero to provide a convenient means of timing the delivery of current at a given point Press and release the button again to stop the current through the probe the treatment timer returns to zero and the device beeps twice to signal that current delivery has stopped Continue starting and stopping current delivery in this way NOTE SAVE DEFAULTS If the treatment you have just set up is the most common microcurrent setup you use you can save the treatment parameters as new defaults for your own machine After setting up the treatment simply press and hold the START key for two seconds At the end of two seconds you will hear a beep indicating the treatment
143. l the toggle keys available with each modality Installation amp Features 13 Dynatrone 850plus amp 550plus IFC and Premod e Target Sweep IFC only e High Low Frequency Ranges Russian and Biphasic Stim e Treatment mode e Contraction Rest cycle Ramp Time High Volt Stim e Contraction Rest cycle Ramp Time Polarity e High Low Pulse Rate Ranges Microcurrent e Microcurrent Polarity e Channel toggle to select Micro or Channel 1 during setup only Modalities e Time Frequency Rate Width e Channel Toggle to view individual channels one at a time while treatments are in progress Ultrasound Dynatron 850plus only e Ultrasound Frequency e Ultrasound Duty Cycle Stim Intensity Display The intensity display is intended as an incremental value only for the convenience of the practitioner POWER INTENSITY Increasing the intensity does increase current delivery However intensity and current are not a 1 1 comparison Actual current delivered to the patient depends upon the intensity setting and the current density affected by the size and condition of the electrodes Ultrasound Power Display Ultrasound power is displayed with the value shown either in WATTS or W cm2 POWER INTENSITY A blinking decimal indicates the power is displayed as WATTS A steady non blinking decimal indicates WATTS cm2 Pressing and holding the PAUSE key changes the disp
144. lay from WATTS to W cm2 or reverse Microcurrent Intensity Display Microcurrent intensity is displayed in microamperes POWER INTENSITY High Volt Intensity Display High volt intensity is displayed in volts CA IL Examples of Power Intensity displays for the Dynatron 850p us and 550plus Installation amp Features 14 Dynatrone 850plus amp 550plus Time and Power Displays The Time display and the Power Intensity display can show the settings for only one channel at a time The Time and Power Intensity settings displayed are for the channel with the GREEN light only Any other channel in use at that time will have a YELLOW light to show it is active but its parameters are not currently displayed To view the settings for another When a channel is selected its parameters displayed in channel or output press the channel the Time and Power Intensity displays and treatment toggle key one or more times until parameters for that treatment may be modified 88 y the light for the desired channel becomes GREEN The GREEN TIME light appears next to a different de 9 channel or output each time you key to select any press the toggle key and the Time channel that is and Power Intensity displays change currently in use to show the parameters currently in PC MICRO EG e SOUND RATE effect for that channel x WIDTH T
145. lighted before entering these values Locate the 1 MHz column on the printout You will enter the values shown for F1 Z and TEMP Enter those numbers as follows a Select CONT Duty Cycle The CONT and 1 MHz LEDs are lighted Enter the value for F1 1 MHz by pressing the time selection keys until the desired value is displayed in the Time display Use the Time Selection up down keys to enter the desired number The value you enter is displayed in the TIME display Press and hold the up or down key to move more quickly to the desired number or press and release the key to step up or down one digit at a time b Select 50 Duty Cycle With the 5096 LED lighted enter the value for Z 1 MHz c Select 20 Duty Cycle With the 20 LED lighted enter the value for Temp 1 MHz d Select 10 Duty Cycle With the 10 LED lighted enter 0 zero as the value for Coupling The coupling detection feature is not available with old style soundheads 5 Enter 2 MHz Values Press the FREQ key to select 2 MHz Make sure the 2 MHz LED is lighted Locate the 2 MHz column on the printout and enter those numbers as follows a Select CONT Duty Cycle The CONT and 3 MHz LEDs are lighted Enter the value for F1 2 MHz by pressing the time selection keys until the desired value is displayed in the Time display b Select 50 Duty Cycle With the 50 LED lighted enter the value for Z 2 MHz c Select 20 Duty Cycle With th
146. lt Settings Raise the INTENSITY to the desired level Set the intensity by pressing the Intensity UP arrow key When you increase intensity current to the patient begins Intensity can be decreased by pressing the down arrow key Before selecting the intensity setting for an individual patient see Electrotherapy Usage Cautions for recommended intensity settings later in this manual Also see the section of this manual entitled Contraindications Warnings and Precautions for specific precautions when treating any conditions contributing to loss of sensation or any time the patient cannot feel the electrical stimulation The intensity pulse rate and pulse width must all be considered together when setting up the treatment as all three factors affect patient comfort It may be necessary to adjust one or more of these parameters somewhat after the initial settings are selected to find the best settings for a given treatment and patient Treatment Instructions RUSSIAN amp BIPHASIC 31 Dynatrone 850plus amp 550plus 8 Forco contraction or reciprocal treatments select the SECOND CHANNEL and set the INTENSITY for this channel Intensity is set for each channel separately Press the Channel Toggle key to select the second channel When you are setting intensity only the channel with the solid green light is affected If you wish to select a channel which has a YELLOW colored light press the Channel Toggle key until t
147. lus 550plus using a separate device known as a Dynatronics Download Box Should updated software become available the update may only be installed by Dynatronics or by a representative or technician under the supervision of Dynatronics CAUTION Following software installation with the Dynatronics Download Box factory default settings for the Dynatron 850plus 550plus must be restored before using the device To restore factory defaults begin with the the Dynatron 850plus 550plus powered off Then press and hold the START key while turning power on to the device Continue holding the Start key down until a beep is heard indicating the factory defaults have been restored You may then reset customized default settings if desired Complete instructions for using the Dynatronics Download Box for installing software accompany the Download Box NOTE This software update information is provided for information only and is not intended to imply that software updates will in fact become available for this device Returning a Unit for Repair Return Authorization To send a unit to Dynatronics for repair you MUST first receive authorization from Dynatronics This authorization is represented by a Return Authorization RA number An RA form is used internally at Dynatronics to help identify who is sending the unit in for repair and why It shows customer complaint or problem information and has the address where the unit should be shipped after rep
148. lus amp 550plus Press the HI VOLT key the device automatically selects the high volt channel HV Connect one lead with two output connections to the HV channel It is best to use a lead that is marked to show polarity The active electrode is connected to the positive output The dispersive electrode is connected to the output end that is marked negative Ensure electrodes are attached correctly to ensure the polarity selected on the front panel of the device is delivered If desired a bifurcated lead extension may be attached to the positive active Dispersive electrode Active electrodes A bifurcated extension may be attached to the lead to allow TWO active electrodes if desired However the dispersive electrode should still be twice the combined size in area of the two active electrodes High volt electrodes with bifurcated active lead end of the lead wire allowing two active electrodes to be used In this case be in area of the combined sizes of the sure the dispersive electrode is at least twice the size active electrodes The bifurcated lead wire extension is an optional accessory available through your Dynatronics dealer During the treatment current flows in one direction between the active and dispersive electrodes Changing the polarity in the treatment parameters has the effect of reversing the direction of the current flow between electrodes It is important to att
149. ment or when treating in water make sure that the applicator head is completely under water For direct coupling you may need to apply more conductive gel or lotion during the treatment to achieve better coupling You can also reduce the power during the treatment if you are treating an area where it is difficult to obtain good coupling Do not drop the soundhead on hard surfaces do not cool the soundhead with ice water or ice packs do not allow the soundhead to reach maximum temperatures repeatedly and do not hold the soundhead in the air while it is delivering ultrasonic waves All of these conditions are likely to damage the soundhead crystal and or cause stress to electronic parts Damage resulting from these conditions is not covered under the warranty ULTRASOUND General Information 80 Dynatrone 850plus amp 550plus Section IV Contraindications Warnings and Precautions Ultrasound Technical Information Dynatrone 850plus amp 550plus Contraindications Warnings amp Precautions for Interferential Premodulated Russian Biphasic and High Voltage Pulsed Stimulation Contraindications Warnings Thrombosis It is possible that the current produces chemical changes in the blood leading to alterations in the clotting time At present there is no hard evidence to support this Nevertheless treatment must not be given to any patient who is taking anticoagulants as it may render these ineffective The
150. ments Consult treatment instructions later in this manual for high volt treatment setup Dynatron 850plus and 28 Electrical Stim to Ultrasound 550plus Back Panel Input Jack only on D850plus 29 Jack for Optional Battery Pack 27 POWER ON OFF SWITCH Located on the back of the unit this switch is labeled 1 and 0 Set the switch to 1 for set the switch to 0 for OFF 28 STIM INPUT JACK FOR COMBINATION 30 Patient Remote Stop Jack TREATMENTS The special Switch lead wire for combination treatments is plugged into this jack for a combination treatment setup providing stim output through the ultrasound head The special lead wire is also plugged into the jack on the front of the device which has been selected for the specific combo treatment See combination treatment instructions later in this manual for detailed information regarding combination treatment setup Dynatron 550plus and 850plus Back Panel Installation amp Features 12 Dynatrone 850plus amp 550plus 9 BATTERY This jack may be used to supply power to the device using an optional battery pack More information about the optional battery operation is provided later in this manual 30 REMOTE STOP A cord with a remote stop button is inserted in this jack The remote stop is controlled by the patient during unattended therapy to allow the patient to stop the treatment at any time Wh
151. mit 50 mA maximum CHECK labels screws chime jacks remote stop micro probe conductance FUSE check rating 1 6 0 8 Amp slow blow 250v VERIFY Custom Presets b Check Lead Test target sweep upon power up or function target after power up Check lead warning d Conductance bar graph Labels Microcurrent a Verify 10uA 10 and 990uA 1 b Conductance changes with and without a load notice audible tone change c Verify the polarity changes d Verify microcurrent conductance bar graph 10 High volt 650 2 ch s 550 1 ch a Without load verify 500 volts 10 b Conductance c Verify the polarity changes Ground Fault Chassis Leakage not be greater than 200uA and on leads 20uA 11 Leakage no ground chassis leads 12 Leakage grounded chassis leads 13 Hot Return reversed chassis leads FAILURES Step No chassis chassis chassis Reason ACCEPTANCE Technician TECH QC Initials I leads leads leads Date QC Inspector Date Schematics and QC Check Lists DS005C REV 6 10 25 02 130 Lower am sas BREL SIRET DA IOBINOOJO Z s swasa auon 12na3 ash eano g JNI SOINOBHLVNACG m EM ze 524 z Qu w 25m ASHA 1S0H B A82 Se ZAY De ZEZ1S0 7 isu S
152. mp 550plus Setting Defaults Each of the modalities has default settings that are automatically selected when you press that modality key The default setting feature allows you to set up a treatment with common treatment parameters in just seconds For guidance in selecting the appropriate settings for each modality consult published medical literature Save New Defaults If your most common treatment settings are different than the ones already set for this device you can change the defaults to suit your own preferences Setting new defaults is simple And defaults may be changed again and again whenever needed 1 Press the modality key desired IFC Premod Russian Biphasic High Volt Micro or Sound 2 Set up a treatment using your preferred settings 3 Ifthis is an actual treatment you may increase the intensity now intensity is not saved with the default settings This step is optional 4 PRESS and HOLD the START key for two full seconds to SAVE the new settings You will hear a beep to signal that the new settings have been saved If the intensity was set before you pressed the START key the treatment will begin upon pressing START You may proceed with delivering the treatment now or you may stop the treatment Example If for example your most common premodulated treatment uses the alternating High Low frequency setting and you prefer to treat for 15 minutes Set the new defaults as follows Press P
153. mp 550plus Ultrasound Regulation The Dynatron 850plus complies with the following IEC 601 2 5 1984 Medical Electrical Equipment Part 2 Particular requirements for the safety of ultrasonic therapy equipment FDA 21CFR 1050 1 1 The error in indication of the temporal average ultrasonic power shall not exceed 20 percent for all emissions greater than 10 percent of the maximum emission FDA 21CFR 1050 c 1 1 The sum of the errors in the indications of temporal maximum ultrasonic power and the ratio of the temporal maximum effective intensity to the temporal average effective intensity shall not exceed 20 percent for all emissions greater than 10 percent of the maximum emission FDA 21CFR 1050 10 c 2 The treatment timer must be accurate to within 0 5 minute of the preset duration of emission for settings less than 5 minutes to within 10 percent of the preset duration of emission for settings of from 5 minutes to 10 minutes and to within 1 minute of the preset duration of emission for settings greater than 10 minutes NOTE The Dynatron 850plus is accurate to within 1 of any treatment time Pursuant to FDA 21CFR 1050 10 f 1 the uncertainties in magnitude expressed in percentage error of the ultrasonic frequency effective radiating area and the ratio of the temporal maximum to temporal average effective intensity pulse duration and pulse repetition rate for the Dynatron 850plus are as follows 1 X Ultraso
154. n 10 and 990 microamps in increments of 10uA The ranges of 1 to 500 Hz frequency and between 10 and 990 micro amperes intensity are available for setting up both electrodes and probes treatments For guidance in selecting the appropriate frequency and intensity for a given probes or electrodes treatment consult published medical literature How To Use Microcurrent Probes The microcurrent active and ground probes are optional accessories available from Dynatronics For both the active and ground probe use the end of a cotton swab such as a Q Tip inserted into the end of the probe Cut the end of the swab to a short length The cotton must touch the metal ring at the tip of the probe Use a conductive electrolyte spray or water to wet the cotton swab before treating If the cotton dries out during treatment conductance may become erratic Rewet the cotton if needed Active Probe To deliver the current to the patient through the active probe first set up the probe treatment and press Start Then hold the probe as you would hold a pencil and press the button near the tip of the probe to start delivery of current The active probe should touch the patient s skin at the treatment site and the ground probe should touch the patient s skin elsewhere near the treatment site This completes the circuit and delivers current to the MICROCURRENT Treatment Instructions 46 Dynatrone 850plus amp 550plus patient You do not need to h
155. n for setting up electrodes or probes treatments If you wish to use the default settings you can now increase intensity to the desired level then press START If you wish to use other settings do the following 2 Choose the POLARITY Polarity is selected by holding down the FUNCTION key and pressing the HI VOLT key at the same time Continue pressing FUNCTION HI VOLT to select either positive or negative polarity or dual polarity both and LEDs on When both are selected the device alternates between the two delivering each polarity for approximately 30 seconds NOTE Some discomfort may be felt by the patient when the polarities change If the patient finds this Treatment Instructions HIGH VOLT 37 Dynatrone 850plus amp 550plus setup too uncomfortable you may consider selecting a monopolar treatment and or reducing the intensity 3 Choose the CONTRACTION REST cycle times Press the toggle key one or more times to select contraction rest cycle times Available options include 10 10 10 30 10 50 and Continuous The setting of 10 30 for example means a 10 second contraction time followed by a 30 second rest time The continuous duty cycle is not recommended for electrical muscle stimulation but may be used for settings that are intended to effect other results than a muscle contraction NOTE For probe treatments a NON CONTINUOUS duty cycle is recommended The high volt probe doe
156. natrone 850plus amp 550plus DYNATRON 950 850 Plus STIM FINAL QUALITY CHECK Q C CHECKOFF SHEET 1 INTERFERENTIAL 42 55 Vpp a Static High Low all channels 4 Vpp b Target Sweep all channels c Modify Features mode time function cancel d Verify current limit 50mA maximum 2 PREMODULATED 42 55 Vpp a High Low all channels b High Low alternating all channels c Modify Features mode time cancel d Verify current limit 50mA maximum 3 RUSSIAN STIM 42 55 Vpp a One Channel Normal all channels b Two Channel Reciprocal channel pairs Two Channel Co contraction channel pairs d Verify current limit 5 0mA maximum 4 BI PHASIC 42 55 Vpp a One Channel Normal all channels b Two Channel Reciprocal channel pairs Two Channel Co contraction channel pairs d Verify current limit 5 0mA maximum 5 CHECK labels screws chime jacks remote stop micro probe conductance 6 FUSE verify rating 1 6 Amp slow blow 250v 7 VERIFY a Custom Presets b Check Lead Test target sweep upon power up or function target after power up c Check lead warning d Conductance bar graph 8 Microcurrent a Verify at 10 uA 10 and at 990 uA 1 b Conductance changes with and without a load notice audible tone change c Verify the polarity changes d Verify microcurrent conductance bar graph 9 High volt 950 2 ch s 850 1 ch a Without load verify 500 volts 10 b Conductance
157. natronics new SmartHead ultrasound applicator These soundheads have calibration numbers programmed into them allowing the soundheads to be freely exchanged with other Dynatron 850plus units or with the Dynatron 950plus the Dynatron 150plus and the Dynatron 125 models There is no need to enter calibration numbers into the device when a new SmartHead soundhead is added Patient Coupling Coupling acoustic contact between the soundhead and the treatment site may be provided either via a coupling agent such as a gel or lotion or in water as with underwater treatments Any material used as a coupling agent must be highly conductive of ultrasonic waves Airis a very poor conductor of ultrasonic waves Therefore avoid allowing any air between the soundhead and the treatment area During an ultrasound treatment the device measures coupling a flashing TIME display indicates that coupling is poor and should be corrected However a treatment is not automatically paused due to poor coupling unless the soundhead temperature also becomes too high ULTRASOUND General Information 79 Dynatrone 850plus amp 550plus Soundhead Temperature When coupling is poor the temperature of the soundhead rises and the patient does not receive the full ultrasonic output The Dynatron 850plus continuously measures the temperature of the soundhead to ensure both that the patient is receiving the optimal treatment and that the soundhead crystal is pro
158. nd grime Cleaning with an alcohol wipe should be adequate Allow the alcohol to fully evaporate before applying the electrodes Iontophoresis occurs with all electronic therapies and can drive any above surface contaminants below the epidural layer where an allergic reaction may occur 4 Make sure the electrodes being used are in good condition The polyadhesive electrodes should have good adhesion over the entire surface area of the electrode The area where the leads attach to the electrode either the pin connector or a snap should not be damaged such that the connection to the backing behind the adhesive is broken Carbon electrodes should be deep black and should be free of cracks in the electrode surface 5 Some patients tend to be much more sensitive to microcurrent treatments On patients with this tendency treat with reduced intensity and or shorter treatment times with possibly more frequent treatments if required 6 Ifelectrodes are placed on an uneven skin surface such as over a raised mole the electrode may not adhere evenly over its entire surface and current could be intensified at the raised area causing discomfort to the patient Ultrasound Technical Information 95 Dynatrone 850plus amp 550plus Ultrasound Usage Cautions For Dynatron 850plus users only The Dynatron 550plus does not offer the ultrasound feature Ultrasound by its very nature has the ability to irritate the patient s skin While the be
159. nd increase intensity to the periosteum Desensitized areas can be overheated or burned without the patient realizing it so extreme care must be taken with these patients e g patients having desensitized areas due to diabetes neural damage medication use of ice packs etc Ultrasound Technical Information 96 Dynatrone 850plus amp 550plus Burns can be avoided as long as the treatment causes no pain tingling excess heat or aching for patients with normal skin sensation Use sufficient coupling agent and make sure there are no bubbles in the gel When treating in water clear the bubbles off the soundhead and off the patient s skin An uncalibrated or faulty ultrasound unit can cause shear waves and standing waves that can also cause burns Output Power Higher output levels have a greater potential for patient discomfort Output power may be reduced by simply choosing a lower watt setting Output power is also effectively reduced by selecting a pulsed duty cycle Penetration of Ultrasound Waves Coupling The correct frequency should be selected for the depth of penetration desired 1 MHz provides deeper penetration 2 MHz provides moderate penetration and 3 MHz provides more shallow penetration The amount of penetration needed is determined by the density of tissue and the depth of the site to be treated Care should be taken to select a penetration level that does not cause periosteal bone pain The term coupl
160. nds you will hear a beep indicating the treatment parameters have been saved The next time you select the SOUND modality these parameters are selected automatically 7 MODIFY a treatment in progress if desired While the treatment is in progress you can modify the following treatment parameters e Use the frequency toggle key to select a different frequency e Use the duty cycle toggle key to select a different duty cycle e Use the Time arrow keys to increase or decrease the treatment time e Use the Power Intensity arrow keys to increase or decrease the power e Press and hold the PAUSE FUNCTION key for two seconds to change display from w cm to Watts or reverse 8 Temporarily PAUSE a treatment if necessary while the treatment is in progress To temporarily pause the treatment press the PAUSE key This stops the ultrasound output from the soundhead and pauses the treatment timer without ending the treatment While a treatment is paused the light on the Pause key is lighted and the ultrasound output to the soundhead is stopped resume the treatment either press START or press PAUSE again Output then resumes and the treatment timer starts from where it was paused ULTRASOUND Treatment Instructions 50 Dynatrone 850plus amp 550plus NOTE During a combo treatment THE STIM OUTPUT OF THE TREATMENT IS NOT PAUSED when the PAUSE key is pressed although the ultrasound output is stopped and the treatment timer is p
161. nefits of ultrasound far outweigh any disadvantages certain precautions should be observed to assure maximum safety and comfort for your patients A patient s tendency to have adverse reactions to ultrasound is dependent upon several factors Some of these factors are discussed below In addition to cautions listed below read the section in this manual entitled Contraindications Warnings and Precautions Applicator Movement The rate of speed at which the applicator moves across the skin is very important in determining how much ultrasonic energy is delivered to an area If the rate is too slow the patient may feel periosteal pain bone ache pain If the rate is too fast or if the applicator head becomes uncoupled with the skin the amount of energy delivered is reduced and the soundhead can overheat Patient Susceptibility Some patients skin is more sensitive to ultrasound output This can cause a reaction similar to a heat rash Potential for Burns It is possible for a patient to suffer a burn from ultrasound therapy if the therapy is not administered properly Burns can occur for the following reasons e high intensity power e low a frequency e Holding the soundhead in one place on the patient s skin e Moving the soundhead too slowly e Treating an area where sensory nerve damage is present with a loss of normal skin sensation Bony prominences are especially susceptible as they reflect sound waves a
162. nel to be stopped that channel s light is green when selected FUNCTION STOP Press and hold the FUNCTION key and press STOP REDUCE THE TREATMENT TIME TO ZERO Press the Time down arrow until the Time display reaches zero The device beeps when the time reaches Zero The output at the selected channel is stopped and the device then displays the parameters for the next treatment that remains in progress if any HIGH VOLT Treatment Instructions 40 Dynatrone 850plus amp 550plus High Volt Default Settings The following default settings are set by the manufacturer and are selected when you select High Volt You may change these defaults to your own preferred settings See Setting Defaults in this manual Continuous on cycle Treatment time 10 minutes Ramp up and down time 5 sec Polarity Negative Pulse Rate High Range Default High Range 80 120 Hz Default Low Range 1 10 Hz Available Range 1 200 Hz Treatment Instructions HIGH VOLT 41 Dynatrone 850plus amp 550plus Microcurrent Instructions WARNING NEVER turn the power on or off while the unit is connected to the patient Always STOP a treatment before removing or attaching electrodes or leads Never use worn or damaged leads or electrodes as these may result in injury to the patient See Contraindications Warnings and Precautions in this manual before administering a treatment to a patient Microcurrent treatments may be
163. ng intensity for the treatment COMBINATION Treatment Instructions 56 Dynatrone 850plus amp 550plus When you select COMBO and select the Plug the banana end of the combo lead wire into stim modality to be combined with stim input jack on the back panel of the D850plus ultrasound the device automatically chooses an ouput jack for the treatment Plug the special combo lead wire into stim jack selected The soundhead should be firmly plugged into this jack before the device is turned on Connect an electrode to the pin end of the special COMBO lead wire Attach the electrode to the patient Special Combo Lead Wire Stereo jack attaches to any of the channels Banana end plugs into the stim input on the back of the device The pin end of the lead wire attaches to an electrode Stim Through the Soundhead With combination therapy the soundhead is used in place of one electrode for a stim treatment and electrotherapy current is delivered through the soundhead This means that for a normal 2 electrode stim treatment therapy you would place one electrode on the patient and use the soundhead as the second electrode site to complete the setup patient lead wire designed to accommodate this setup is included in the Dynatron 850plus standard accessory package During the treatment the stim current passes between the soundhead and the other electrode At the same time ultrasonic waves are introd
164. ng down both the Time and Power displays flash continuously The soundhead must then be cooled down before the treatment can resume For devices having software greater than Rev 1 01 HOT ERROR Soundhead Too Hot With software revisions iris uid greater than Rev 1 01 the 1 1 L Time and Power displays do r1 L v not flash but the Time display shows the error message see Page 2 of this manual for instructions Error During an ultrasound treatment if the on determining the revision soundhead becomes too hot the HOT error message is displayed and the treatment is paused for the soundhead to be cooled level of your device When this condition occurs the treatment timer is paused output is stopped and the soundhead must be cooled down before the treatment can resume Once the soundhead is cooled press Pause or Start to resume the treatment The soundhead will cool slowly if placed in the soundhead holder or if held exposed to the air Larger soundheads take longer to cool than smaller heads To resume the treatment right away you can place the soundhead in cool room temperature water to cool the head more quickly NEVER USE ICE OR ICE PACKS TO COOL THE SOUNDHEADS as this is likely to cause thermal shock to the electronic components of the soundhead and may necessitate a costly repair Heads damaged by thermal shock are not covered by the warranty
165. ng two channels the device will select both channels 1 and 2 e Russian or biphasic parameters selected will apply to both channels in a channels 1 and 2 at once Therefore you cannot have both a Russian and a biphasic treatment simultaneously You may deliver two biphasic or two Russian treatments e separate High Volt treatments may be set up regardless of any other treatments that may be currently running e separate Ultrasound treatment may be set up or a combination treatment using ultrasound and a single channel modality with any available channel The device allows only ONE attended therapy to be delivered at one time Attended therapies include ultrasound microcurrent probe and high volt probe treatments While the attended therapy is in progress other available channels may be used for unattended treatments subject to availability of the channel needed Microcurrent therapy is delivered only through Channel 1 and through the Microcurrent Probes output jack at the same time Whenever any microcurrent treatment is in progress probes or electrodes Channel 1 is unavailable for any other use However Channel 2 may be used for other stim treatments Set Up A Second Treatment To set up the second or third treatment after you have set up and started the first modality press the modality key for the second treatment to be set up The device automatically selects the treatment channel s to be used The green cha
166. nic frequency x1596 2 Effective Radiating 50 3 Ratio of the temporal maximum to temporal average effective intensity 20 4 Pulse duration i aeree 10 5 Pulse repetition rate 10 Ultrasound Technical Information 100 Dynatrone 850plus amp 550plus Beam Profile For Dynatron 850plus users only The Dynatron 550plus does not offer ultrasound The following diagrams show the typical spatial distribution of the radiated field for each size of Dynatron 850plus sound head This applies to the radiation emitted into the equivalent of an infinite medium of distilled degassed water at 30 C and with line voltage variations in the range of x10 percent of the rated value 1 MHz 2 MHz MY ME N M A TY SEES ARAM UST UR RR DATE ccn AS s Av OU Sa ed ANIM at ica Ki Raster ae Sar th MANUS TEE EQUUM na REC mA st aes gt AL Aa 3 MHz 10 cm Head Near Field Ultrasound Technical Information 101 Dynatrone 850plus amp 550plus 1 MHz y Ay CR XA n or cA XX QU REOR HIN 2 MHz REPRE mM a i mie tee 4 Id x li ei E e aeu E E dde Der 3 MHz 5 cn Head Near Field Ultrasound Technical Information 102 Dynatrone 850plus amp 550plus N T 2 MHz 3 MHz
167. nnel light shows you the channel s selected for this treatment Plug the lead or cable into the corresponding output jack s before you proceed with setting up the treatment Select the treatment parameters for the second treatment following the setup instructions for that modality provided in this manual When parameters have been entered press START Simultaneous Treatments 62 Dynatrone 850plus amp 550plus Modify Simultaneous Treatments You may VIEW and MODIFY parameters for the channel with the GREEN light While two or more treatments may be in progress at once the Time display and the Power Intensity displays can show the settings for only one channel at a time The settings displayed are for the channel with the GREEN light only Any other channel in use at that time will have a YELLOW light to show it is active delivering current but its parameters are not currently displayed To change the settings for a channel or output that has a YELLOW light press the channel toggle key one or more times until the light for the desired channel becomes GREEN You hear a beep each time you press the channel toggle key The Time and Power Intensity displays also change to show the parameters currently in effect for the channel indicated by the green light CHANNEL OUTPUT INDICATOR LIGHTS GREEN Solid You CAN see and modify this channel s parameters The channel is delivering current GREEN Flashing You CAN see and modify
168. nsmitting surgical units are being operated Short wave diathermy should not be turned on or used at the same time as this Dynatron device e Do not use the same power outlet or line with a whirlpool and certain traction machines e In areas which are carpeted and static electricity is present it may be necessary to use a conductive mat to remove any static charge from the operator e Use a surge suppresser if power problems are encountered e Avoid unnecessary exposure to ultrasound patient and therapist Ultrasound Technical Information 88 Dynatrone 850plus amp 550plus Electrotherapy Usage Cautions The following are general cautions to be observed during interferential premodulated Russian biphasic and high voltage pulsed stimulation For microcurrent electrotherapy see separate Microcurrent Usage Cautions following this section Electrical stimulation by its very nature has the ability to irritate the patient s skin Certain precautions should be observed to assure maximum safety and comfort for patients A patient s tendency to have adverse reactions is dependent upon several factors These factors are Current Density This is the amount of current being delivered to the patient divided by the area through which the current is being delivered the surface area of the electrodes being used Electrode Condition Worn or dried out electrodes cause the current to concentrate in small areas of the electrode instea
169. nt time the High frequency range is delivered During the second half of the treatment time the Low frequency range is delivered NOTE Make any desired changes to the treatment time before selecting Consecutive Treatment time changes made after selecting Consecutive will cause the treatment to revert to an alternating treatment option c above Once the treatment has started the frequency range High or Low being delivered at a given time is indicated by the flashing High or Low light 5 Increase INTENSITY Set the intensity by pressing the Intensity UP arrow key When you increase intensity current to the patient begins Intensity can be decreased by pressing the Down arrow key NOTE For devices having software greater than Rev 1 01 the conductance bar graph is IFC amp PREMOD Treatment Instructions 26 Dynatrone 850plus amp 550plus displayed while intensity is being set or changed See page 21 for a complete explanation of the conductance bar graph Before selecting the intensity setting for an individual patient see Electrotherapy Usage Cautions in this manual for recommended intensity settings Also see the section of this manual entitled Contraindications Warnings and Precautions for specific precautions when treating any conditions contributing to loss of sensation or any time the patient cannot feel the electrical stimulation Choose TARGET SWEEP or STATIC for interferential only
170. ocurrent Pulse Output Current Range 10 to 990 microamps MICROCURRENT General Information 78 Dynatrone 850plus amp 550plus Ultrasound Therapy For Dynatron 850plus users only The Dynatron 550plus does not offer the ultrasound feature About Ultrasound Ultrasound therapy channels sound waves through muscle nerve bone and connective tissue to aid in reducing pain muscle spasms and joint contractures The physiological effect of ultrasound therapy depends upon the frequency of the ultrasound signal The lower frequency 1 MHz penetrates deeper than a higher frequency such as 2 MHz or 3 MHz thus the practitioner can decide which frequency to use according to the condition and depth to be treated A section in this manual entitled Ultrasound Usage Cautions provides some general guidelines for ultrasound treatment to help ensure you deliver safe and effective treatments to your patients Further information about ultrasound application may be obtained from published medical literature With the Dynatron 850plus four different soundhead sizes are available 1 cm 2 cm 5 cm and 10 cm And you can select three different frequencies without changing the soundhead The 2 cm 5 cm and 10 cm soundheads each operate at 1 2 and 3 MHz The 1 cm soundhead operates at 2 and 3 MHz The desired frequency is easily selected both before and during treatment setup SmartHeads The Dynatron 850plus includes Dy
171. old the button down Once you have pressed and released the button the current is delivered until you press and release the button again to stop the current The unit beeps once when you press the button to start the current and beeps twice when you press the button to stop the current While you are delivering current the treatment timer counts up in seconds from zero When the current is stopped the timer returns to zero Press the button again to commence the next time sequence Continue in this way until treatment is completed Ground Probe The ground probe is used to complete the circuit to allow flow of current through patient tissue The ground probe should touch the patient s skin at any location away from the treatment point As an alternative you may also use a dispersive electrode as explained below With the ground electrode you do not need to hold the ground probe in your hand during treatment This is particularly convenient when treating in several different places around one point Ground Electrode You can use an electrode in place of the ground probe Just unplug the ground probe from its cable attach a banana to pin adapter to the cable this optional adapter is available from your Dynatronics dealer then attach an electrode to the pin Place the electrode on the patient at a site where it will not interfere with placement of the active probe during treatment TREAT Press and release the button on the active p
172. on selected For example press the High Low toggle key once to select High press again to select Low press again to select High Low Alternating and press again to select High Low Consecutive For high volt treatments you can select High or Low only but not both During a treatment the current sweeps through the range s selected For interferential and premodulated the HIGH frequency range is initially set at 80 to 150 Hz and the LOW frequency range is 0 to 10 Hz For high volt the HIGH pulse rate range is initially set at 80 to 120 Hz and the LOW pulse rate range is 1 to 10 Hz These frequency ranges may be modified for every treatment if desired and new default settings for the device may also be saved See treatment setup instructions later in this manual for a complete description of the options that may be selected 14 TARGET SWEEP TOGGLE This key is pressed to select either Target Target Sweep or static treatment for an interferential treatment The Target pad is used to locate the exact treatment site if the Target option is selected during an interferential treatment 15 TARGET PAD For use during interferential treatments when Target is selected Touch the TARGET pad at different points on the pad to reach the precise treatment site When you lift your finger from the Target pad the selected point is locked until you change it again This patented feature is used to locate the specific treatment site in an interferential
173. ons may be strong enough to close the airway or cause difficulty in breathing 3 Caution should be used in the transthoracic application of EMS devices in that the introduction of electrical current into the heart may cause arrhythmia 4 This device should be kept out of the reach of children The Dynatron device should not be used in the following conditions e Pregnancy e Acute and sub acute thrombophlebitis e Potentially malignant lesions Ultrasound Technical Information 82 Dynatrone 850plus amp 550plus Precautions 1 Implants of any electrical nature Do not use over a carotid sinus e Transcerebrally e Disturbances in cardiac rhythm The long term effects of chronic electrical stimulation are unknown This device should not be used to relieve pain syndromes until etiology has been established Precautions should be observed following recent surgical procedures when muscle contractions may disrupt the healing process Some patients may experience skin irritation or hypersensitivity due to the electrical stimulation or electrical conductive medium The irritation can usually be reduced by use of an alternate conductive medium or alternate electrode placement Interferential premodulated biphasic Russian and high volt therapy must be used cautiously in the presence of any of the following conditions When there is a tendency to hemorrhage following acute trauma or fracture Over the menstruating uteru
174. ontrol power to the device during battery operation While the battery is attached to the Dynatron 850plus or 550plus device the battery s ON OFF switch controls power to the device overriding the device s own ON OFF switch General Modality Information 67 Dynatrone 850plus amp 550plus Battery Requirements 12 volt and at least 5 amps peak current 1 5 ampere hours minimum e Battery adapter cord Cigarette lighter plug on one end to attach to the battery pack and a barrel plug on the other end to fit a 325 barrel jack The cord needs to be a high quality gauge wire Radio Shack carries a high quality cord that is recommended Cat No 270 1534D This cord comes with a 2 amp fuse This needs to be replaced with a 5 amp fast blow fuse Note If a low quality gauge cord is used you can get the BATT LO error when the battery is not low Battery Life The length of time that a unit can be used with a battery pack is dependent on several factors amperage of the battery pack A larger amperage will provide longer use The modality used Ultrasound requires more power than stim modalities e The intensity of the treatments The higher the intensity the higher the consumption of power e use of multiple treatments The more channels used the more power is consumed e The amount of charge remaining on the battery As a general rule the unit may be run continuously for 30 minutes to several hou
175. or s manual for this device Guidelines for replacing leads and electrodes are also provided in the operator s manual When you no longer wish to view the conductance graph press the TIME key to redisplay the treatment time NOTE The treatment time counter does not stop but continues counting down when the graph is displayed Disable the Conductance Bar Graph If you do not wish to see the conductance bar graph automatically during the treatment setup you can disable this function Press and hold the FUNCTION and TIME mode keys while powering the device on NEVER TURN THE DEVICE ON OR OFF WHILE LEADS ARE CONNECTED TO A PATIENT When the device completes starting up the word bar appears in the TIME display and 1 appears in the Power Intensity display Use the intensity up down arrow keys to change from 1 to 0 select 1 to turn this option on select 0 to turn the option off Press START after making your selection Once you have disabled the automatic portion of this option the device will default to the disabled mode each time the device is powered on However you may still view the conductance graph at any time after the treatment has started as described above If you wish to reset the default to re enable the bar graph to appear automatically during treatment setup again press and hold the FUNCTION and TIME mode keys while powering the device on and select the desired setting LEAD Warning No Patient Current
176. orms The output waveforms are generated by a Digital Signal Processor on command from the main processor Since the signals are digitally created the accuracy of the waveform is derived from the crystal clock of the processor whose accuracy is typically 001 or better Both the output intensity as well as the frequency are digitally controlled through communication between the main and the Digital Signal processors 124 Dynatrone 850plus amp 550plus Basic Trouble Shooting Techniques Hands On Testing Pads and Leads NOTE The following examples use the Beckman Circuitmate DM78 to show proper DVM use and safety precautions Leads may easily be tested without any special equipment by using the Lead Test function as discussed in the Electrotherapy Usage Cautions section of this manual The DVM can also be used to see if the pads and leads are in good working condition Electricity will always choose the path of least resistance to ground If it does not have a good path or a complete circuit it cannot flow and no stimulation will be felt This is why good leads and pads are so important in the operation of the Dynatron electrotherapy device Prior to testing the leads a test jack must be made Any standard 1 4 stereo jack will work well Call the service department at Dynatronics if you are unsure of what is needed The test jack is made by shorting the connections for the patient lead together These connections are ins
177. osition from the XY pad Periodically several times per second the main processor polls the keyboard processor receiving status of any keys pressed or XY position and updating the displays as required Processor Interaction with Oscillators The processor controls the internal oscillators that generate the therapy wave forms It initially calibrates the proper output frequencies during the test cycle and then keeps track of the frequency the rest of the time the unit is on If the oscillator happens to drift too far out of range for the processor to calibrate it the processor will give an error message During the treatment the processor causes the sweep frequency oscillator to change its frequency at a controlled rate It chooses the rate and frequency from what is selected on the keyboard when the treatment is set up or when changes are made during the treatment It tracks and keeps the fixed frequency where it should be during the treatment It also keeps track of the 2500 Hz signal that creates the Russian therapy turns it on and off at a 50 Hz rate OSCILLATORS 4 KHz fixed 4000 4010 Hz Interferential Low option 4080 4150 Interferential High option 2500 Hz Russian Processor Interaction with the Output Jacks The processor board controls the proper channeling of the output signals to the output jacks The processor also activates and senses the relay that allows output from the unit Processor Control of Output Wavef
178. oupling sensing indicates whether adequate contact is being maintained between the soundhead and the patient s skin The bar graph uses the eight segments in the top half of the display with eight lighted segments indicating best conductance and one lighted segment indicating poorest conductance In the illustration below eight of the eight segments are lighted indicating good coupling Ultrasound Coupling Bar Graph C TIME POWER INTENSITY A caa IDA BIS fs GE FUNCTION SOUND C ERE WIDTH irc O HIGH O TA Press the SOUND and the TARGET keys PREMOD SWEEP simultaneously during an ultrasound treatment to D view a graph showing soundhead coupling Press C O 10 Time to return to the treatment time display CONT Coupling Bar Graph Eight lighted segments indicate good coupling between patient and soundhead To correct poor coupling ensure you are using an adequate amount of ultrasound conductive gel and the face of the soundhead is making full contact with the patient s skin Press TIME to redisplay the treatment time Treatment time continues counting down while the bar graph is displayed unless the treatment is paused for any reason Disable the Coupling Sensing You can disable the coupling sensing capability of the device if desired While the treatment is running press the FUNCTION and the Power Intensity DOWN ARROW keys at the sam
179. r use with the electrotherapies provided by this device Contact Dynatronics Customer Service if you have questions about appropriate electrodes for use with this device Caution Any electrical stimulation has the potential to burn or irritate a patient s skin The tendency towards burning is dependent upon several factors the most important being patient susceptibility and current density The practitioner has little control over patient susceptibility other than to observe first time patients carefully However current density is totally controllable It is important to note that the intensity displayed is not a measurement of the current delivered For interferential premodulated and biphasic stim this is a relative reading only Current delivered at a given intensity setting is dependent upon the current setting the size and type of electrodes used and conductance Current density is the amount of current delivered divided by the area through which the current is being delivered Higher current density increases the tendency to burn or irritate The current density can be reduced by decreasing the amount of current or increasing the area through which the current is being delivered The area can be increased by using larger electrodes and or making sure that the total area of the electrode is actually delivering current Current density is also reduced when more electrodes are used four instead of two Electrodes which are worn or ha
180. rea Microcurrent Therapy with Probes Microcurrent therapy with probes accommodates hands on treatment for a variety of applications With the Dynatron 850plus and 550plus you can use the optional treatment probes to measure tissue conductance both before as well as during the treatment The probes are used to treat very small areas or to easily deliver treatment to a number of different areas in succession This therapy utilizes the active probe and the ground probe If desired a dispersive electrode may be substituted for the ground probe The active and ground probe are optional accessories for this device Microcurrent Waveforms Three different output Negative Unipolar Square Wave waveforms polarity may be selected with the Dynatron Positive Unipolar Square Wave 850plus and 550plus The first two are unipolar square waves For a bipolar square wave press the toggle key until having monophasic pulse ata both negative and positive waveforms are selected 50 percent duty cycle equal on and off times In the Microcurrent Waveform illustration above the first unipolar waveform has negative polarity only and the second has positive polarity only The third waveform is a bipolar negative and positive square wave with a 50 percent duty cycle Microcurrent Settings The Dynatron 850plus and 550plus offer the following ranges of microcurrent settings Pulse Frequency Range 1 to 500 Hz e Micr
181. regain up to 90 per cent of their original adhesive quality 2 NEVER use a self adhesive electrode for more than 15 treatments maximum 3 NEVER use STRAPS weights or other devices to attach self adhesive electrodes to the skin If an electrode has lost its adhesive quality you can use one of the methods given above to rehydrate the adhesive or you should discard the electrode Using straps and weights with self adhesive electrodes could have an unpredictable effect on the electrodes and could cause injury Combination Treatment Usage Cautions When delivering combination ultrasound and stim treatments delivering stim current through the soundhead the following are the recommended maximum stim intensities refers to premodulated biphasic or Russian stimulation only Maximum Recommended Intensity Head Size for Electrotherapy 1cm head 3 6 2cm head 4 7 5cm head 10 15 10cm head 15 20 Lead Wires Even with good care lead wires will eventually develop breaks open connections simply from normal usage and they must be replaced Lead wires have a limited lifetime and must be replaced about every six months Lead wires can be damaged due to jerking or pulling on the wires excessive bending or tight wrapping of the wires or running over the wire with a device cart When setting up treatments keep lead wires out of areas where a person could trip on them When storing lead wires should be loosely wrapped to prevent any k
182. rent Even though microcurrent is a very low voltage therapy you may allow the patient to hold the Remote Stop cable during an unattended treatment if desired If the button on the Remote Stop cable is pressed during any microcurrent treatment the treatment time and output are stopped and the timer returns to zero Treatment Instructions MICROCURRENT 45 Dynatrone 850plus amp 550plus Audio Tone The audio tone allows monitoring of conductivity throughout the microcurrent treatment to ensure adequate contact between the patient s skin and the probe or electrodes for purposes of patient safety and comfort The unit senses conductivity of the connection as soon as current is applied and continues throughout the treatment Microcurrent Default Settings The following default settings are set by the manufacturer and are selected when you press Micro You may change these defaults to your own preferred settings See Setting Defaults in this manual The Microcurrent treatment setup with electrodes is the default and the following defaults are also selected Bipolar wave e 3Hzfrequency e 50 uA intensity e Time 20 minutes counts down e Audible Tone Off If Probe treatment is selected the following defaults are automatically selected e Negative unipolar wave e 4Hz frequency e 300 uA intensity e Time zero counts up e Audible Tone On Available Ranges e Frequency Between 1 and 500 Hz e Intensity Betwee
183. robe to start current Press and release button deli Th itb t to start and to stop Deeps ONCE TO current delivery during indicate current delivery has started treatment When the active probe and a ground probe touch the patient s skin the current is delivered to the patient Observe conductance by listening to the 7 Cut the end off a cotton swab insert it into audio tone the tip of the cone Saturate the cotton with water or an electrolyte spray before treating TEST Mode Press and release the button again to stop delivery of current The unit beeps twice to let you know current delivery has stopped The probe is now in Test mode allowing you to continue monitoring conductance at any point desired When the probe touches the patient s skin conductance continues to be measured and the audio tone is produced Press and release the button when you wish to return to the Treat mode NOTE In Test mode during a microcurrent treatment a small amount of current is delivered to allow an impedance reading to be taken in order to show conductance The current delivered during Test mode is either 25 micro amperes or the micro amperage setting for the treatment itself whichever is less For purposes of this measurement current is delivered in pulses of approximately 20 ms Treatment Instructions MICROCURRENT 47 Dynatrone 850plus amp 550plus Ultrasound Instructions The following
184. rs depending on these factors General Modality Information 68 Dynatrone 850plus amp 550plus Section Ill General Modality Information General Modality Information Dynatrone 850plus amp 550plus Interferential and Premodulated Therapy Interferential Quadpolar Therapy Interferential therapy uses four electrodes to deliver two currents one current with a constant frequency of 4000 Hz and the other current with a variable frequency of 4 001 to 4150 Hz The paths of these two currents cross resulting in a beat that produces the therapeutic frequency at the treatment site The resulting frequency is between 1 and 150 Hz An example of wave forms representing these currents is illustrated here CHANNEL 1 CHANNEL 2 4000 Hz 4001 4150 Hz Direction of stimulation Area of low Stimulation High stimulation intensit where currents cross Electrode Skin Surface Stimulation produced by 4 electrodes In the interferential The beat phenomenon Two waves of mode two output jacks different frequencies over 4000 Hz combine to Channels 1 and 2 are produce a
185. s Use extreme caution when administering a treatment where sensory nerve damage is present or in any case where there is a loss of normal skin sensation this includes areas desensitized by medication When treating an area where there is loss of feeling there is an increased danger of injuring the patient Do not treat such areas unless you have sufficient training and experience in applying this therapy for such cases and you are confident you can deliver the treatment safely without injuring the patient When treating any conditions contributing to loss of sensation or any time the patient cannot feel the electrical stimulation do not exceed an intensity setting of 12 15 when using large electrodes 3 3 4 x 1 3 4 or an intensity setting of 8 10 when using small electrodes 1 3 4 x 1 3 4 and select short treatment times approximately 8 minutes Be alert for any irregularities in the skin following the treatment Never use high volt therapy to treat an area where there is a loss of normal skin sensation Do not use in general area where high powered high frequency transmitting surgical units are being operated Short wave diathermy should not be turned on or used at the same time as this Dynatron device Do not use the same power outlet or line with a whirlpool and certain traction machines In areas which are carpeted and static electricity is present it may be necessary to use a conductive mat or anti static carpet trea
186. s not have a manual on off control you simply lift the probe off the skin during the rest cycle and reapply it at the next treatment site before the next contraction cycle begins 4 Choose the RAMP setting Press the toggle key one or more times to select the ramp time Options include 5 1 0 1 5 and 2 0 seconds The ramp time is applied to both the start and to the end of the contraction and the ramp time is in addition to the contraction time itself A ramp setting is not applied to the Continuous duty cycle 5 Choose HIGH or LOW pulse rate range Press the HIGH LOW toggle key one or more times to select the high range only or the low range only this toggle key is found next to the IFC PREMOD key The lights next to the toggle key show you what you have selected In a high volt treatment High or Low only must be selected the combined High Low option is not available for High Volt Default High and Low pulse rate ranges for High Volt The HIGH range is 80 to 120 Hz The LOW range is 1 to 10 Hz These ranges may be changed for a single treatment if desired or new default settings may also be saved to apply to all future treatment setups Change the PULSE RATE RANGE optional You may change the pulse rate settings for the High or Low range if desired You may only change the pulse rate range before pressing START to begin the treatment When you modify the settings they will remain in effect for the duration of the trea
187. s selected Press once to select positive press again to select negative and press again to select dual polarity both and LEDs are lighted When both positive and negative are selected the resulting bipolar waveform includes both a positive and a negative phase For electrode treatments only change the TIME if desired To change the time use the Time up down arrow keys to change the treatment time Be sure that Time is selected when you make this change the indicator light shows which option is selected The toggle key allows you to choose the desired option For probes treatment the Time display shows zero until you begin treating When you press the button on the probe the device beeps once and the timer then counts up from Zero in seconds allowing you to time the delivery of current to each treatment site When you press the button on the probe to stop the current the device beeps twice and the timer returns to zero Treatment Instructions MICROCURRENT 43 Dynatrone 850plus amp 550plus 5 Change FREQUENCY if desired To change the frequency use the Time toggle key to select FREQ then use the Time up down arrow keys to change the frequency You can press the Time toggle key again to return to the Time display if desired However if you make no key presses for 10 seconds the display automatically returns to the Time display 6 Change the INTENSITY setting This setting
188. scle stimulation fires two muscle groups such as reciprocal flexors extensors one after the other For example with a duty cycle of 10 30 the device Treatment Instructions RUSSIAN amp BIPHASIC 29 Dynatrone 850plus amp 550plus would deliver stimulation for 10 seconds to the first muscle followed by 10 seconds of stimulation to the reciprocal muscle The 30 second rest time follows each stimulation The timing of the two cycles will overlap the first muscle group is stimulated after a 30 second rest even though the second muscle group is 20 seconds into its rest cycle The Continuous contraction cycle is not available for Reciprocal treatments Two channels are required 1 and 2 Basic Biphasic Russian Setup 1 Choose BIPHASIC or RUSSIAN 2 Choose the TREATMENT MODE Normal Co contraction Reciprocal Plug the patient lead s into the output jack s for the channel s selected Give the remote stop cable to the patient Choose the CONTRACTION REST times Choose the RAMP setting Change the treatment TIME if desired Change the PULSE WIDTH and or PULSE RATE if desired Raise the INTENSITY to the desired level For co contraction or reciprocal treatments toggle to the SECOND CHANNEL and set the INTENSITY for this channel Press START Press STOP if you need to stop a treatment before its time has expired stops all current treatments Detailed Biphasic Russian Setup If you do not understand the
189. se or decrease the treatment time The Time toggle key may also be used to select RATE if you wish to modify the pulse rate settings as explained in step 5 above 7 Raise the INTENSITY to the desired level Remember when you increase intensity current to the patient begins Therefore you should proceed to press START immediately after setting the intensity to begin the treatment timer Never use High Volt to treat any conditions which contribute to loss of sensation and never use High Volt to treat an area where the patient cannot feel the electrical stimulation 8 Press START Be sure to press Start to begin both electrodes or probes treatments When you press start the treatment timer begins counting down If you fail to set the Treatment Instructions HIGH VOLT 39 Dynatrone 850plus amp 550plus intensity before pressing START the intensity display will begin flashing and you will be unable to start the treatment until you set the intensity NOTE SAVE DEFAULTS If the treatment you have just set up is the most common High Volt setup you use you can save the treatment parameters as new defaults for your own machine After setting up the treatment simply press and hold the START key for two seconds At the end of two seconds you will hear a beep indicating the treatment parameters have been saved The next time you select this modality these parameters are selected automatically 9 MODIFY settings While
190. sound output is stopped and the treatment timer is paused However the stim current continues to be delivered Therefore the pause condition should be corrected as quickly as possible and the treatment resumed or the treatment should be stopped completely by pressing the STOP button If the button on the REMOTE STOP cable is pressed during a Combo treatment both the sound and the stim portions of the treatment are stopped at once Modify Treatment e Modifications to a treatment in progress may be made to both modalities used See the instructions earlier in this manual for specific modification instructions for each modality Keep in mind that since the stim and the ultrasound modalities share the Time and Power Intensity displays you will need to select the desired output channel with the channel toggle key before making changes to the ultrasound or the stim portion of the treatment e Treatment time for both treatments is simultaneous Changing the treatment time affects both therapies COMBINATION Treatment Instructions 60 Dynatrone 850plus amp 550plus Combination Default Settings The factory default for a combination treatment is an ultrasound treatment with a premodulated treatment and the respective default settings for those two modalities If you save defaults during a Combo treatment the following settings are saved stim modality that is selected for the current combo treatment is saved as the
191. surface during Stim Through Soundhead treatments as this may cause increased current density momentarily which may be uncomfortable to the patient The soundhead should remain in full contact of the skin until current output is stopped Be alert for any sign of periosteal bone pain Comboplus Dynatronics new Comboplus feature means you have almost unlimited options in setting up a combination treatment with the Dynatron 850p us Now you can e Combine an ultrasound treatment with any electrotherapy modality provided by this device single channel options only Premodulated Biphasic Russian High Volt or Microcurrent Set up a combination treatment using any of the three electrotherapy output jacks This means combination therapy is no longer restricted to just one channel any channel may be used A special combo lead wire is provided in the standard accessories for this device to accommodate the Comboplus feature This lead wire is plugged into the selected stim jack then the banana end of the lead is connected to the stim input jack on the back of the device and the pin end of the lead is connected to an electrode to be placed on the patient The following illustration shows one example of a combination therapy setup Since any of the channels may be used with combination therapy it is important to note the channel selected by the device during setup and connect the lead wire to the correct channel before setti
192. t and may even be uncomfortable for the patient This is a result of current being concentrated at a very small area As with all forms of electrotherapy current density is dependent upon the current setting the intensity setting the size and type of electrodes used and conductance Higher current density increases the possibility for patient discomfort The current density can be reduced by decreasing the amount of current intensity or increasing the area through which the current is being delivered The area can be increased by using larger electrodes and or making sure that the total area of the electrode is actually delivering current Read more about current density in Electrotherapy Usage Cautions earlier in this section When delivering microcurrent therapy observe the following guidelines 1 Use only moderate current Consult published literature for recommended settings for microcurrent treatment 2 When using microcurrent probes keep in mind that all of the current is delivered through the tip of the probe resulting in much higher current density than when using electrodes Therefore low to moderate intensity settings will be much more comfortable for the patient especially when treating sensitive areas 3 When using electrodes ensure that the area on the patient s skin where the electrode is to be placed is clean and free of all foreign matter This includes powders perfumes and the like as well as body oils or dirt a
193. t Lake City UT 84121 801 568 7000 800 874 6251 ALL RIGHTS RESERVED Dynatrone 850plus amp 550plus Table of Contents Section I Introduction I Introduction to the Dynatron 850plus and 550plus M Lee ecce esee eere ee eee eee en seta 2 NewEedtures diete vaste tera tete diet det uy wheel mee e 2 Treatment Optioris He donet ae e oto eet eee pP a tate He ede pese te poo Le Lin fe kon iota 3 simplified Setup t eee Meteo e d Ner MR ee e PR e P eae Me 4 Before You Treat Patient ueste eee eter dese ret eat t ined 4 How to Us This Mantal 21 ette e Pre deett ete re ea te ete e dea 4 Installation and rai pcne SRE OS RE RE 5 UrnpackIBg rrt tete etm t t eet 5 Standard ACCeSSORIGS c6 nte rere eet ren eee ete Pte tete ere TT eee 5 soundheads and Probe Sr rente ann fe alerte le re 6 INC CESSOTIES den eee at etant tee en Rem ete seen a Re nl 6 Dynatron 850plus and Dynatron 550plus Physical Features 7 Instructions for Using Toggle Keys ses 13 Time and Power Displays ore o te du ep er CE EU EDU He FUE seit ened E eee 15 Ultrasound Heads Dynatron 850plus on y ss 15 Microcurrent Probes optional accessory siennes 16 High Volt Probe optional accessory sisi 17 Qu
194. t S tup Warhlngs on Re RU e RE Hose e eR CR p odia 84 Adverse o ep ere iu ae 84 Use Only Dynatronics Accessories With This Device ss 84 Contraindications Warnings amp Precautions for Microcurrent Treatment 85 Indications Tor Use ie e ON He p oo 85 OP LESE LOT TENEAT inte ete H EU 85 85 Pr cautions nio ice P e E LEE REL ER EG 86 Adverse Reactions ete Dp ee 86 Contraindications Warnings amp Precautions for Ultrasound Treatment ss 87 Contradictions un des da Saeed 87 Preca UO eite tice i T EE CRGA opa 88 Donius T P M an nee 88 Electrotherapy Usage Cautions 4 eere reete eese esee seen essen sten snae ta atentos 89 Carbon Electrodes er e t e 90 Selt Adhesive Electrodes canine 5 2 n int time Hn e io t e HR E GR HR Le ade ea Lind 9 Combination Treatment Usage Cautions ss 92 IE n B n ECCE 92 Test Ledds zc ecce rh Maced mh doe M 93 vi Dynatrone 850plus amp 550plus Current Eit e Ere IRR Rr PURA E Re E ESTEE e N ae E EA Ee PUO A e Te E ee 93 Current Limit WarhIng o ohne dad e ce e oot 94 Microcurrent Usage
195. t period for the other half of the pulse duration Biphasic stimulation differs from Russian stimulation in the pulse width and rate ranges as explained above In addition the biphasic pulse includes just ONE output cycle per pulse As shown in the diagram below one pulse cycle including one positive phase and one negative phase occurs followed by a zero current period Width Duration T 1 1 55 gt I i d ie di I poi 1 iol ho iz d A D Ik j 1 1 I T 1 T i Rate gt b Contraction Rest decem Eee cese co EA St Biphasic Stimulation BIPHASIC amp RUSSIAN General Information 74 Dynatrone 850plus amp 550plus The pulse rate and width may be modified during setup of a Russian or Biphasic Stimulation treatment or may be modified while a treatment is in progress Since a channel pair shares pulse parameters during a Russian or biphasic treatment you cannot deliver both a Russian and a biphasic treatments at the same time with this device You can deliver two Russian or two biphasic treatments at once NOTE If a biphasic or Russian stimulation treatment is in progress on one channel you may not customize the pulse rate and width for the second channel When you customize the pulse rate and width it affects all simultaneous biphasic or Russian stimulation treatments for both channels 1 and 2 If
196. t tet eee Leine Ea ete ee tpe iate AAE 66 Ultrasound Default SGttngs uii t terea tente E Hte ee phe Hep sages iid ep Robe pe bee Hv 66 Combination Default Settings ete ete ett dete ote ee e te eve deem 66 Battery Operation e 67 Battery Requitemienits ii etre eei e Eee eu see ege woes 68 Battery Lie i e pete eee enia eee ope eec p De pe ith He Bes e 68 Section Ill General Modality Information Interferential and Premodulated Therapy 4 eee eee ee ee ee eese e eee ee eee ete seen sese an sesta setae stas e sena 70 Interferential Quadpolar Therapy ss 70 Premodulated Bipolar Therapy top Late nm menti 70 Target eee iode depen ete ee tete ed ed voee etate 71 Whys Target Better rendi tert pee ives oL Eee er egt ester tasse 71 SWEEP rara Ae ane EA Cha gadis Pe citet eft teat e ede xut ie be ea medo n eL 72 Interferential Electrode Placement sn 72 Russian Biphasic EE 73 Russian Stimulation Hr C ento pr eti ns inf Rule nero Herc thin 73 Biphasic Stimulation edi Le ete e Ee pete Cite ete bas eet dent 73 Biphasic Russian Parameters seen 73 Hi h Volt THERAPY inst
197. t zero and count UP in SECONDS when current is on and will return to zero when current is stopped You must press START to begin the treatment then press the button on the probe to start and stop delivery of current Press STOP or Function Stop at the end of a probe treatment Electrode treatments are timed and a treatment time in MINUTES is entered at the start of the treatment The timer counts DOWN for electrode treatments Detailed Microcurrent Setup Before setting up a microcurrent treatment with electrodes attach a lead wire with two electrodes to Channel 1 or for a probes treatment connect the optional probe to the MICRO PROBE output on the left side of the device During a microcurrent treatment the microcurrent is delivered to both probes and Channel 1 outputs simultaneously 1 Press the MICRO key When you press the MICRO key the default settings are automatically selected If you wish to use the default settings you can now simply press START If you wish to use other settings do the following Choose the output desired CHI for electrodes treatment or MICRO for probes treatment The default for this option is treatment with electrodes Press the channel toggle key to select MICRO for treatment using the optional probe if desired Choose POLARITY Press and hold the FUNCTION key and press the MICRO key at the same time to select the desired polarity Repeat this one or more times until the desired polarity i
198. tected from overheating If the soundhead temperature approaches the maximum level the POWER display will begin flashing Treatment can continue beyond this warning level but the user should ensure coupling is corrected Under normal circumstances improved coupling will reduce the soundhead temperature and allow the treatment to continue If the temperature reaches the maximum level the treatment is automatically paused the output power is stopped a tone sounds and both the TIME and the POWER displays flash The soundhead must then be cooled down before the treatment can resume The soundhead will cool slowly if placed in the soundhead holder or if held exposed to the air Larger soundheads take longer to cool than smaller heads To resume the treatment right away you can place the soundhead in cool room temperature water to cool the head more quickly NEVER USE ICE OR ICE PACKS TO COOL THE SOUNDHEADS as this is likely to cause thermal shock to the electronic components of the soundhead and may necessitate a costly repair Heads damaged by thermal shock are not covered by the warranty When the temperature is again satisfactory press the START key to resume the treatment output power resumes the displays return to constant and the timer resumes As long as the soundhead is too hot the device will not allow you to resume the treatment To prevent soundhead overheating check to be sure proper contact is being made throughout the treat
199. terms contraction rest ramp time pulse width or pulse rate consult the diagrams in the section of this manual entitled Biphasic Russian Parameters 1 Press the BIPHASIC RUSSIAN key once to choose BIPHASIC or press this key twice to choose RUSSIAN When you select this modality the default settings are automatically selected If you wish to use the default settings you can now increase intensity to the desired level then press START If you wish to change the treatment settings do the following 2 Choose the TREATMENT MODE Normal Co contraction Reciprocal Press the toggle key one or more times to select Normal Co contraction or Reciprocal contractions these options are explained at the start of this section Connect the patient lead wire s to the channel s selected RUSSIAN amp BIPHASIC Treatment Instructions 30 Dynatrone 850plus amp 550plus Choose the CONTRACTION REST cycle times Press the toggle key one or more times to select contraction rest cycle times Available options include 10 10 10 30 10 50 and Continuous The setting of 10 30 for example means a 10 second contraction time followed by a 30 second rest time Note that you may not select Continuous cycle for a Reciprocal treatment The Continuous duty cycle is not recommended for electrical muscle stimulation but may be used for settings that are intended to effect results other than a muscle contraction Choose the RAMP setting
200. the patient s skin at any location away from the treatment point As an alternative you may also use a ground electrode as explained below Installation amp Features 16 Dynatrone 850plus amp 550plus in place of the ground probe This is particularly convenient when treating in several different places around one point Ground Electrode You can use an electrode in place of the ground probe Just unplug the ground probe from its cable attach a banana to pin adapter to the cable then attach an electrode to the pin Place the electrode on the patient at a site where it will not interfere with placement of the active probe during treatment The banana to pin adapter is an optional accessory available from Dynatronics High Volt Probe optional accessory An optional probe may be purchased which allows you to deliver an attended high volt treatment The high volt probe is connected to the dedicated high volt jack HV on the front of the machine The probe is used in conjunction with a large dispersive electrode The high volt probe is used only for delivering high volt therapy Complete setup and use instructions are provided in this manual under the treatment setup instructions for high volt High Volt Probe optional accessory Installation amp Features 17 Dynatrone 850plus amp 550plus Quick Reference of Special Key Presses The following is a brief list of special key presses available with this
201. throughout the treatment it helps avoid damage to the soundhead crystal If the soundhead becomes too hot it must be allowed to cool down before resuming the treatment The head will cool slowly if allowed to sit at room temperature To cool the soundhead quickly you can place it in room temperature water Sometimes just applying more conductive gel will adequately cool the head Larger soundheads will take longer to cool down DO NOT USE ICE to cool the soundhead as this can cause thermal shock to the crystal and may necessitate a costly repair Damage caused by thermal shock is not covered under the warranty Whirlpool Treatments If you are treating in a whirlpool you may find the temperature reaches a high enough temperature to cause the display to flash 115 This is a warning only to let you know you are approaching the temperature limit You may however continue with the treatment at this Ultrasound Technical Information 109 Dynatrone 850plus amp 550plus level If your whirlpool temperature is hot enough to cause the treatment to stop you may need to adjust the temperature of the whirlpool Soundhead Temperature Too Cold If the soundhead has been sitting in a very cold room or vehicle it could be too cold to operate when you turn the device on The keypad may not respond to key presses and you will be unable to use the device until the soundhead is sufficiently warmed You must raise the temperature of the soundhead to a
202. tment If you save defaults during this treatment the new settings you have entered become the defaults for high volt However if you do not save the new settings the unit will return to the current default settings for the next treatment First press the TIME toggle key to select RATE The RATE light under the TIME display becomes green and you will see the current pulse rate range settings displayed in the Time and the Power Intensity displays as shown in the diagram below Next press the toggle key to select either the HIGH or the LOW range this is found next to the IFC PREMOD key With RATE selected and either the HIGH or LOW range selected you may use the up down arrow keys to HIGH VOLT Treatment Instructions 38 Dynatrone 850plus amp 550plus change the upper and lower limits of the range chosen If you set both displays to the same value the treatment will be delivered at that single pulse rate rather than sweep through a range Use these arrow keys to change the lower limit of the range Use this toggle key to select the HIGH or LOW range The lower limit in the sweep range is shown here In this example this is the lower limit of the default HIGH range for the PULSE RATE The upper limit of the range is shown here In this example this is the upper limit of the default HIGH range for PULSE RATE v 4 START STOP POWER INTENSITY
203. tment to remove any static charge from the operator before touching the device To avoid causing possible interference with the operation of the Dynatron device it should not be connected to anyone who is wearing or holding an RF transmission device two way radio cell phone beeper etc Ultrasound Technical Information 83 Dynatrone 850plus amp 550plus Treatment Setup Warnings 1 NEVER turn the power on or off while the unit is connected to the patient 2 Always STOP a treatment before removing or attaching electrodes or leads to the patient Leads and electrodes must only be applied to the patient before a treatment is started 3 Never use worn or damaged leads or electrodes as these may result in injury to the patient Check leads using the Lead Test function provided by this device Adverse Effects Skin irritation and burns beneath the electrodes have been reported with the use of electrical muscle stimulators Use Only Dynatronics Accessories With This Device The leads and electrodes provided by Dynatronics have been tested with Dynatronics devices and are appropriate for use with these devices Dynatronics cannot guarantee the safety or performance of leads and electrodes purchased from other vendors Only use electrodes which are designed for use with this device NEVER use monitoring electrodes such as ECG EKG or EMG NEVER use electrodes specified only for TENS devices as those electrodes may not be adequate fo
204. to the desired setting For patient safety and comfort it is recommended that you start with 1 w cm then increase power to the desired level after the treatment begins Valid ranges are from 1 to 2 0 w cm exceptions valid ranges when using a 10 cm head at 3 MHz are from 1 to 1 0 w cm valid ranges when using a 1 cm head are from 1 to 1 5 w cm NOTE You may view the power display in either WATTS or W cm The default setting for the device is W cm This option is explained in detail later in this section 6 Press START When you press START the treatment timer begins counting down and output is delivered to the soundhead If you fail to set the power before pressing START the intensity display will begin flashing and you will be unable to start the treatment until you set the power Be sure to use a coupling agent such as gel or lotion and maintain good coupling throughout the treatment see Ultrasound Usage Cautions in this manual Do not hold the soundhead in the air as this will cause the soundhead to overheat The device provides coupling sensing to help you know when coupling is not adequate This feature is discussed later in this section SAVE DEFAULTS If the treatment you have just set up is the most common ultrasound setup you use you can save the treatment parameters as new defaults for your own machine After setting up the treatment simply press and hold the START key for two seconds At the end of two seco
205. tomatically selected For ultrasound and combination treatments the soundhead must be connected to the device before selecting Sound or Combo Plug lead wires or probe cable into the appropriate jack s on the device for the modality to be delivered Observe which channels the device selected for this treatment channels are selected automatically by the device Attach the electrodes to the leads and affix the electrodes to the patient For unattended stim treatments attach the Remote Stop cable and give the cable to the patient Change any options desired using the toggle keys available for that modality Increase power or intensity Current delivery to the patient starts when you increase intensity Only do this when you are ready to proceed with the treatment For Target treatments only locate the treatment site using the Target pad For Russian biphasic two channel treatments press Start or the channel toggle key after setting the intensity for the first channel then set the intensity for the second channel For Combo treatments set the parameters for the stim modality or ultrasound press Start then set parameters for ultrasound or stim then press Start again You can select the desired stim modality in this step by pressing the desired modality key after pressing Combo Press Start The treatment timer begins Operation amp Treatment Instructions 20 Dynatrone 850plus amp 550plus 7 Administer
206. treatment and to place the point of interference at that point Ultrasound Selections DYNATRON 850plus ONLY the ultrasound feature is not available on the Dynatron 550plus 16 SOUND COMBO Press this key once to begin setup of an ultrasound treatment the Sound LED on this key is lighted as well as the Sound LED in the channel indicator area press this key twice to begin setup of a combination treatment the Combo LED is lighted as well as the Sound LED and a single Channel LED in the channel indicator area When either of these options is chosen the soundhead should first be plugged into the ultrasound output jack on the side panel For combination treatments the special combo lead wire should be attached to the output jack selected see full instructions for setting up a combination treatment later in this manual In the COMBO mode the electrotherapy treatment is delivered through the soundhead and through a single electrode which is placed on the patient Only single channel electrotherapy options are available in the COMBO mode Installation amp Features 10 Dynatrone 850plus amp 550plus 17 18 SOUND FREQUENCY TOGGLE This key is pressed one or more times to select the desired ultrasound frequency 1 MHz 2 MHz or 3 MHz DUTY CYCLE TOGGLE This key is pressed one or more times to select the desired duty cycle for ultrasound treatment Options are 10 20 or 50 percent or Continuous Russian Biphasic High
207. uced into patient tissue through the soundhead Avoid touching the electrode with the soundhead during the treatment keep the soundhead in contact with the patient s skin at all time and keep the intensity low for the stim current When setting up a combination treatment observe all contraindications warnings and precautions for both therapies to be used REMEMBER Use a very low stim intensity for all combo treatments Treatment Instructions COMBINATION 57 Dynatrone 850plus amp 550plus Combination Therapy Setup In order to set up a combo treatment you must be familiar with setup instructions for both the electrotherapy modality to be used and ultrasound as explained earlier in this manual Also remember e When a channel s LED is green the treatment parameters for that output are displayed Any changes you make to the parameters will affect that channel only e When an indicator light is yellow the channel is active but its parameters are not being displayed and may not be modified at this time You must first press the channel toggle key CH to select the channel its light will then become green and modifications are allowed Since ultrasound and stim share the Time and Power Intensity displays during a combination treatment you will need to observe the indicator lights when setting up or changing treatment parameters You may toggle between the stim and sound channel using the channel toggle key
208. ve lost their adhesiveness or carbon electrodes which are corroded and are not securely fastened fail to deliver current evenly as required These kinds of electrodes may have hot spots where higher than normal current density will be delivered If the patient complains of pin prick sensations the electrode may be delivering current through only a small portion of its area and the electrode should be replaced Also see Electrotherapy Usage Cautions in this manual for further discussion regarding safe use of leads and electrodes Ultrasound Technical Information 84 Dynatrone 850plus amp 550plus Contraindications Warnings amp Precautions for Microcurrent Treatment Indications for Use This device is used to provide symptomatic relief of chronic intractable pain Contraindications Warnings The following treatment conditions are specifically contraindicated and must be excluded 1 2 Any electrode placement that applies current to the carotid sinus neck region Any use of TENS on patients who have a demand type cardiac pacemaker Any electrode placement that causes current to flow transcerebrally through the head The use of TENS whenever pain syndromes are undiagnosed until etiology is established The safety of TENS devices for use during pregnancy or delivery has not been established TENS is not effective for pain of central origin This includes headache TENS devices should be us
209. wing optional and replacement accessories may be purchased from Dynatronics or from your Dynatronics dealer Part No 8E0026 8E0017 8E0018 8E0019 8D0007 8D0027 7B0208 7B0209 7B0063 7B0065 7B0059 7B0061 7B0067 7B0069 7B0003 7B0203 7B0005 7B0204 7B0205 7B0206 7B0207 7B0139 7B0141 7B0077 7B0081 7B0001 7B0161 SLTRGEL Description High volt probe requires one or more applicators High volt applicator 2 round High volt applicator 5 8 round High volt applicator 2 x1 1 2 Microcurrent active probe Microcurrent ground probe 2 diameter carbon electrodes red and gray 3 diameter carbon electrodes red and gray 3 x 5 carbon electrodes red and gray 1 5 x 2 0 carbon electrodes red and gray 1 75 x 3 75 adhesive electrodes with snap or pin connector 1 75 square adhesive electrodes with snap or pin connector 1 25 round adhesive electrodes with pin connector 2 round adhesive electrodes with pin connector 3 round adhesive electrodes with pin connector 120 lead black 120 lead red Bifurcated extension lead wire Banana to pin adapter Snap adapter Ultrasound coupling gel 8 oz bottle or 5 liter container Installation amp Features Dynatrone 850plus amp 550plus 11111 II LILI O O CO CONT O RECIP 10 10 10 30 10 50 O CONT 5 RAMP 1 5
210. you are modifying the pulse rate and width for a treatment in progress you should also modify the intensity as all three of these parameters will affect delivered energy and patient comfort General Information BIPHASIC amp RUSSIAN 75 Dynatrone 850plus amp 550plus High Volt Therapy High voltage pulsed stimulation is a pulsed DC current with pulse widths in the microsecond range and pulse rates ranging from 1 to 200 Hz with a peak amplitude of up to 1 0 A utilizing a twin peak monophasic waveform The Dynatron 850plus and Dynatron 550plus provide the option of one high volt treatment using the dedicated channel labeled HV The treatment utilizes one channel with one or more active electrodes and a large dispersive electrode Electrodes are placed on opposite sides of the affected area so treatment is through the affected area An optional probe is available to accommodate hands on treatment delivery High Volt Therapy with Electrodes High volt therapy may be delivered as an unattended treatment using electrodes This treatment setup uses one channel with two or more electrodes for unattended treatment One electrode acts as the dispersive electrode and one electrode is the active electrode The active electrode is placed over the treatment site It is recommended that the dispersive electrode be at least double the size in area of the active electrode The lead for the active electrode may be bifurcated allowing placement of

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