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PIC Service Manual - Frank`s Hospital Workshop

1. ES NOTE 12 Lead shown REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Memory Card Board Item 26 if option installed 3 Disconnect the Preamp Protection Cable Item 32 or 81 from the Paddle Preamp Board Item 27 or 83 4 Disconnect Pacer Panel Cable Item 30 from Motherboard Item 46 at J211 by lifting retaining clip with fingernails or small instrument Carefully remove cable 5 Disconnect Pacer Panel Cable Item 30 from Top Enclosure Assembly Item 22 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable ial NOTE If unit is 12 Lead PIC the Pacer Panel Cable 30 1 will have a length of Shrink Tubing Item 125 which should remain on the cable unless damaged REPLACE 1 Connect Pacer Panel Cable Item 30 to Top Enclosure Assembly Item 22 by lifting retaining clip with fingernails or small instrument placing cable into the connector checking that cable is seated straight and pushing down on the retaining clip the insulated side of the cable should face the back of the retaining clip Check that the Shrink Tubing Item 125 is in place PORTABLE INTENSIVE CARE SYSTEM SERVICE MANU
2. Set Up NIBP Suprvsr Date Time Shifts Back Setup Menu Recorder Grid Log Review Voice Trends Back t Time 1 sec gt gt Next Exit 2 f Respiration ECG Trend Back ttt tt tt Trend Setup Speed Reset Back Setup Size Speed Response Reset Back ECG Resp Setup Size Speed Response Back gt SPO Size Back gt Alarm IBP HR SPO Resp Temp Back t Display Traces Freq Filter Pt Cable Brightness Contrast Back t t T Available only if purchased T t f Available only 5 Lead PICs t Available only 12 Lead PICs tttt Visible only if memory card is in place PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 7 MENUS E i User Menus Display Trace Menu Waveform 2 Off Y Waveform 3 Off Cancel Save 3 8 The Display menu options allow users to configure the PIC Display area to show multiple traces choose frequencies patient cable and filter options and adjust the brightness and contrast if the display type supports variable brightness and contrast The Display options are accessed from the Treatment Configuration menus Treatment Intubate IV EPI Lido Bret Sample Clear Next Configuration a Display Alarms SPO NIBP Resp Recorder Set Up Back Display Traces Freq Filter Pt Cable Brightness Co
3. 2 PIC System Controls and Indicators 2 5 PIC System Modes Initial Installation Evaluation Equipment 2 11 Summary of Operations Part Numbering System Options and 2 22 Technical Specifications 2 24 CAUTION Federal law restricts this device to use by or on the order of a physician NOTE Seethe PIC User Instruction Manual for more detailed operation procedures when using this system on a patient LT NOTE The disassembly performance verification and adjustment LT procedures described in this manual are intended to be performed by qualified service technicians using the recommended tools and equipment PORTABLE INTENSIVE CARE SERVICE MANUAL 2 1 GENERAL INFORMATION 8 h Product Overview The MRL PIC System is an extremely flexible device that incorporates an ECG monitor defibrillator manual or semi automated external pacer pulse oximeter and a non invasive blood pressure respiration monitor The PIC System s small and lightweight design makes it ideal for transport situations or for use in and out of the hospital General Description MRL PIC System AN MRL Monitor 2 2 Refer to the following User s Manuals for instructions on the operation of th
4. REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Mono LCD Inverter Cable Item 34 from LCD Display Adapter Board Item 49 at J4 by pulling wires out of connector 3 Disconnect Mono LCD Inverter Cable Item 34 from Backlight Inverter Item 43 at by pulling wires out of connector REPLACE 1 Connect Mono LCD Inverter Cable Item 34 to LCD Display Adapter Board Item 49 at J4 by pushing the cable into the connector the ridged side of the cable should face out 2 Connect Mono LCD Inverter Cable Item 34 to Backlight Inverter Item 43 at by pushing the cable into the connector down the ridged side of the cable should face out 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 35 Mono LCD Cable ROUTE CABLE THROUGH FERRITE REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Mono LCD Cable Item 35 from LCD Display Adapter Board Item 49 at J5 by very carefully lifting retaining clip with fingernail or small instrument and carefully pulling out cable Connector is fragile 3 Disconnect Mono LCD Cable Item 35 from Top Enclosure Assembly Item 22 by very carefully lifting retaining clip with fi
5. 4 10 Supervisor een 4 12 Supervisor Defibrillator 4 13 Supervisor Pacer Menu optional 4 15 Supervisor Diag Menu see 4 16 Supervisor Setup 4 17 Supervisor Upgrade 4 19 Performance Test Procedures 5 1 Inspection 2 5 2 Recommended Test Equipment 54 Safety Testing ee ette et n eee 5 6 ECG Monitor 5 7 ECG Amplitude Calibration 5 9 Heart Rate Display Accuracy 5 10 Defibrillator RIDGE IU RSS 5 11 Synchronized Discharge 5 13 Transthoracic Pacemaker if equipped 5 14 Advisory Option if equipped 5 15 Battery Charger Test 5 16 3 Volt Lithium Battery Check 5 17 Battery Capacity Test and Reconditioning ProCedute iie et p ether octets 5 18 Guidelines for Maintaining Peak Battery Pertorm nGe enin etre 5 20 12 Lead ECG Data Acquisition and Fax Modem Test epe ettet ete 5 21 Non In
6. 3 3 Quick Access Buttons and 5 3 5 Quick Access Buttons and Pop up Menus 3 6 User Mens RR RE eR Una 3 7 User Menus 3 8 User Menus 3 11 User Menus Non Invasive Blood Pressure 3 12 User Menus Respiration ECG 3 13 User Menus Respiration 3 15 User Menus Respiration 3 17 User Menus Recorder User Menus 3 20 Supervisor Menus 3 22 Supervisor Menus 3 23 Supervisor Menus 3 25 Supervisor Menus SAED 3 26 Supervisor Menus 12 lead 3 28 Supervisor Menus 3 30 Supervisor Menus 3 35 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 1 MENUS 8 5 User Menu Overview Configuration Factory Menu Submenu Choices Choice Range Default Display Traces Waveform2 Off Resp Pleth IBP1 IBP2 Off Waveform3 Off Resp Pleth IBP2 IBP1 Off Freq Limited 2 20 Hz Monitor Monitor 1 40 Hz Diagnostic
7. Filter Pt Cable Back Frequency Filter Menu Patient Menu Menu Cable Menu Enter passcode S Supervisor Defib Pacer Setup Diag Back Supr Defib Pacer Setup Diag Menu Menu Menu Menu PORTABLE INTENSIVE CARE SERVICE MANUAL 4 3 MRL LITE PROGRAM MENU SETUP MRL Lite Menus Alarm Menu 4 4 The MRL Lite Menu options are available to all users Supervisor menus can only be accessed after entering the supervisor passcode MRL Lite zu On Upper Limit Off 120 Lower Limit Off 35 Exit Alarm Setup Log Sample gt Alarm Setup Log Menu Menu Menu Sample Bright X Contrast Use the Alarm menu to set the heart rate HR alarm The alarm options are Off On or Auto Press the Alarm menu button to display the HR Alarm menu Press a Quick Access button to change a setting In this example the alarm is off the upper limit setting is 120 and the lower Heart Rate Window HR 60 BPM a appear in the Heart Rate window of the display The icon indicates the current alarm settings The alarm will activate when the patient s heart rate exceeds the upper and or lower limit set in this menu option limit setting is 35 Auto Lower limit set upper limit disabled Upper limit set lower limit disabled If the alarm
8. VOLUME Adjusts the overall volume on PIC System A GLOBAL ALARMS Enables and disables global alarms 1 QRS BEEPER Enables and disables the QRS Beeper CALIBRATION Calibrates the display Set we SET HEART RATE Sets the value to be use in automatic HR alarm settings NEXT Open another Quick Access window if advanced options 12 lead CO2 IBP etc are available A ADVISORY optional Analyzes current ECG as shockable or non shockable 12 12 LEAD optional Allows the operator to acquire a 12 lead analysis L Er LOG Displays the items stored in the log file IBP optional Allows the operator to measure pressure invasively CO optional Allows the operator to measure end tidal carbon dioxide levels BACK Return to the previous quick access window PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 5 MENUS eee Quick Access Buttons and Pop Up Menus The Quick Access buttons are also used to select pop up menu options including the User and Supervisor menu options 1 HR Bpm 5002 Il Rec x 7 98 AUTO D aa x1 Signal OK F Log Menu Print Log 2 Lio 96 Clear Log Exit D ul 12 7 8 986 socra energy m Ea 200 e Sample E Next 57 DEFIBRILLATOR 3 Start Stoy ae palis
9. PORTABLE INTENSIVE CARE SERVICE MANUAL Use the Rate menu to set the default pacer rate setting The range is from 30 to 180 PPM Press the UP DOWN arrow buttons to increase decrease the pulse per minute PPM selection Press EXIT to close the Pacer Rate menu Use the Mode Menu to set the default pacing mode The options are Demand or Async Press the corresponding option button A bold outlined box indicates the selected option Press EXIT to close the Pacer Mode menu 4 15 MRL LITE PRoGRAM MENU SETUP 85 LL Supervisor Diagnostic Menu Defib Pacer Setup Diag Back pr lt q SW Rev Back Menu Software Rev SW Rev Menu Motherboard XXXX Preamp 5 XXXX Defib XXXX 4 16 Use the Software Version menu to display system information including the current software version for the microprocessor in the MRL Lite PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 85 8 Supervisor Setup Menu tena Defib Pacer Setup Diag Back Line Freq Date Upgrade Language Code Printer Back Line Freq Date Language Code Printer Menu Format Menu Menu Menu Enter supervisor password Upgrade Menu Line Frequency Menu Use the Line Frequency menu to set the line frequency The frequ
10. 1 5 Monitoring Precautions Defibrillator Precautions External Pacing Pulse Oximeter Precautions 1 Non Invasive Blood Pressure Precautions 1 Battery Precautions Charger Precautions 1 SAED Precautioris 2 oe dade dde tao duca 1 IBP 1 Precautions 1 PORTABLE INTENSIVE CARE SERVICE MANUAL 1 1 SAFETY INFORMATION Symbols and Icons Symbols Graphical symbols letter symbols and signs listed below may be found on the PIC System and accessories distributed by MRL Please note the use of these symbols for safe and proper use of the equipment 1 Alternating current Attention consult accompanying documents Auxiliary power operation Caution high voltage Dangerous voltage Defibrillator protected type BF patient connection Defibrillator protected type CF patient connection Earth ground e Bm E For indoor use only on battery charger only Negative input terminal Positive input terminal Power off Power on Recycle battery Protective earth ground Defibrillator discharge button Release The symbols listed below may by found throughout this manual Warning Hazards or unsafe practices tha
11. Software Version The Software Version menu provides Menu information about the software installed for PERUE E the motherboard preamp defibrillator oximeter and blood pressure board Defib E Oximeter BP Modem Self Test The Modem Self Test menu allows the Runseftest Supervisor to run a modem self test Note Test will take approx 8 sec to finish PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 35 MENUS eee Card Menu NIBP Cal Menu SPO Cal Menu Mod Out Cal Menu 3 36 Card Info Card Erase Program PIC The NIBP Calibration menu is used by authorized service personnel to calibrate the PIC blood pressure measurement capabilities WARNING This menu should be used only by authorized service personnel DO NOT attempt to calibrate the blood pressure when the PIC System is being used on a person From the Card menu the supervisor can get information about the memory card size type contents format count and format date erase the memory card and program the MRL PIC from a programmable card From the SPO Cal menu the supervisor can test the DC output gain For every 1 mV on the ECG there should be one volt of DC output Press the up down arrow buttons to select a bias calibration T
12. DefibCommFail Defib cable faulty or Check Main Defib Cable Item disconnected 19 550721 Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 ApexFire Faulty or damaged paddle Check paddle set ButnFail set Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 SternemFire Faulty or damaged paddle Check paddle set ButnFail set Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PdlCharge Faulty or damaged paddle Check paddle set ButnFail set Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PdlEnergyUp Faulty or damaged paddle Check paddle set ButnFail set Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE 8 8 PdlEnergyDn Faulty or
13. Disarm Manual mode SAED Basic If the PIC has been configured to power up in the SAED Basic Mode mode the voice memo supervisor configurable chart recorder hold blood pressure SpO treatment summary and disarm controls will be active Below is an example of the active controls and display Blood Pressure Voice Memo SP02 ETT Hold Chart Recorder A ANALYZING ECG STAND BACK SAED BASIC MODE Disarm Manual mode PORTABLE INTENSIVE CARE SERVICE MANUAL 2 7 GENERAL INFORMATION Manual Mode If the PIC has been configured to power up in the Manual Defibrillation mode all the controls will be active Below is an example of the display er JE 2 8 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION Initial Installation Evaluation To determine the initial installation condition of the MRL PIC System after shipment follow the simple steps below Unpacking Visually inspect the carton and the equipment for any signs of Instructions damage or mishandling carton perforations cuts or dents bent or collapsed corners or broken carton seal If damaged contact MRL immediately BEFORE PROCEEDING FOLLOW STEPS 1 2 3 1 2 Power
14. PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 25 MENUS eee Supervisor Menus SAED The supervisor can use the SAED Menu to change the SAED configuration settings This menu is accessible through the Treatment Configuration Set Up menus Set Up Suprvsr Date Time Shifts Back Enter Passcode here 3 Supervisor UNLOCKED Defib Pacer SAED 12Lead SetUp Diag Exit gt Supr SAED ALSCode E Prot Audio StartUp Back Y Y Y Set ALS SAED SAED SAED Code Protocol Audio Start Up Menu Menu Menu Menu The supervisor may use this menu to setup a separate pass code that allows ALS personnel to enter the Manual Defib mode from the SAED mode Set ALS Code Menu Required Save Use the SAED Protocol menu to select an energy protocol Press a corresponding button to select an option then press EXIT to save the setting SAED Protocol Menu 200 200 360 200 300 360 3 26 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS SAED Audio Menu Use the SAED Audio menu to select a Voice Memo option Memo User must press and hold the Memo Memo button to record audio Start Stop Recording will end when button is Continuous released Start Stop User must press the Memo button to record audio Recording will
15. Recorder Grid Log Review Voice Trends Back Print Log Review Voice Trend Grid Menu Notice Memo Interval Menu Menu Menu Menu Recorder 1 sec gt gt Next Exit Print Grid Menu In the Print Grid menu users can choose to print or not print a grid on the chart paper Press the ON button to print a grid on plain white paper Select OFF and a grid will not be printed A bold outlined box indicates the selected option Press EXIT to return to the Recorder Configuration menu Log Menu The Log menu allows the user to print review or clear the internal log Print Log See chapter 12 in the PIC System User Stop Print Instruction Manual for specific instructions on how to use this function Clear Log Press EXIT to return to the Recorder Exi Configuration menu 3 18 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Voice Memo Menu Voice Memo menu allows the user to select play skip forward skip Play backward and stop options for voice Skip Forward memo recordings stored in the PIC See chapter 12 in the PIC System User Instruction Manual for information on how to use this function Skip Backward Stop Press EXIT to return to the Recorder Configuration menu NOTE This menu is not visible if the speech card
16. SOOM oes mae gt J Sample Menu Recorder Grid On Log Review Voice Trends Back When you select an item on a menu located along the bottom of the PIC window a pop up menu will display next to the Quick Access buttons along the left side of the display Sample Pop Up Menu pem Print Log Print Trend Stop Print Clear Log Exit To select a pop up menu option or enter information press the Quick Access A button located next to your selection 3 6 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS User Menus User menus can be accessed by all operators and do not require a supervisor pass code Operators can configure a variety of PIC system options including some of the display features The User menus are shown in the following diagram This section also provides an explanation of how to access and set User menu options Treatment Intubate IV EPI Lido Bret Sample Clear Next Treatment Configuration Menus Configuration Display Alarms SPO NIBP Resp Recorder Set Up Back
17. Supervisor Menus MRL Lite Alarm Setup Log Sample gt Supr EcgConf Grid Date Time Back Enter passcode Defib Pacer Setup Diag Back gt SuprDefib ExtEng Int Eng Mode Back Supr Pacer 4 Rate Mode Back NEETETAM Line Freq Date Upgrade Language Code Printer Back 5 Adv Pacer Back Supr Diagnostics 4 SW Rev Back 4 12 PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 85 h Supervisor Defibrillator Menu Optional Defib Pacer Setup Diag Back Supr Defib ExtEng Int Eng Mode Back Ext Energy Int Energy CV Mode Menu Menu Menu External Energy Use the External Energy menu to select the default energy setting that will be active when the MRL Lite is first turned on with external paddles connected The default selected energy setting is displayed in this menu The options are 2 5 7 10 20 30 50 70 100 150 200 300 or 360 Joules To change the default energy setting press the UP arrow to increase and the DOWN arrow to decrease the energy selection Press EXIT to return to the Supervisor menu Internal Energy Use the Internal Energy menu to select the default inter
18. run time is short be sure that the correct PIC and battery type have been selected on the comparison chart e Verify that the battery is fully charged prior to the capacity test Consider the age of the battery and the frequency of its use The recommended replacement interval in this critical application is every 2 years as indicated on the battery label PORTABLE INTENSIVE CARE SERVICE MANUAL 5 19 PERFORMANCE TEST PROCEDURES 85 Guidelines for Maintaining Peak Battery Performance 1 Each battery should be identified with a number or letter An identification mark will be useful in tracking battery performance 2 Keep extra batteries in the MRL charger where their status can be quickly determined A blinking indicator is the most positive indication of a fully charged battery 3 Always carry at least one fully charged spare battery If no other source of back up power is available two spare batteries are advisable 4 Rotate spare batteries routinely The charge level gradually diminishes in a battery after it is removed from the charger 5 Whenever possible recharge a partially depleted battery This can be accomplished following any incident that involves patient monitoring It will ensure maximum operating time for each use without reliance on spares The need for a spare can then serve as an alert when an aging battery fails to provide normal operating time 5 20 PORTABLE INTENSIVE CARE SERVIC
19. Improper probe incompatible non MRL Use MRL temperature probes only Failure to obtain Patient cable not Check patient cable respiration connected measurement Damaged patient cable Check replace patient cable Damaged hands free cable Check replace hands free cable ECG preamp circuit failure 5 Lead Check Pre Amp Board Item 51 590328 Paddle Pre Amp Board Item 27 590343 ECG preamp circuit failure 12 Lead Check Pre Amp Board Item 84 590377 Paddle Pre Amp Board Item 83 591379 ECG preamp Motherboard Check Preamp Motherboard cable damaged or Cable disconnected 5 Lead Item 52 550720 12 Lead Item 82 550751 Inaccurate Poor quality electrodes Check expiration date on respiration patient motion corrupts electrodes measurement signal Incorrect electrodes incompatible non MRL Use MRL electrodes only PORTABLE INTENSIVE CARE SERVICE MANUAL 7 7 TROUBLESHOOTING GUIDE EN 7 8 Motion artifact Take steps to eliminate source of motion Incorrect ECG frequency response ECG preamp circuit failure Check Preamp Board 5 Lead Item 51 590328 12 Lead Item 84 590377 Improper lead fault indication ECG preamp Motherboard communication failure faulty or disconnected cable Check Preamp Motherboard Cable 5 Lead Item 52 550720 12 Lead Item 82 550751 ECG preamp circuit failure Check Preamp Board 5 Lead Item 51
20. 9 I33HS L 3385 WS 22 83d ANY Old N33AL38 3015 z iy Wau I349vs8 991 TO OL GsdVL QV3H 3llHe3d 491 ONOW NOLLO3NNOO E NOLLO3NNOO ns 33XV3dS 6 Re 5 xi py sti i ansaid Ove 4 L JH 31 Z NOILO3NNO2 013195 LNOHLIM EN NI 4 4 IMS T3NVd 1NO3J ps Zum 11 2220 mm mE 2 ZZ P 61 99 NZ 8 3unS019N3 PT LA d nonoa 340338 VEG aa NOILD3NNOS mE SAJGONVLS 3 0 Q3NOILISOd 993 AM3dOMd 38 LSNW 5 31000N A430 LON 61 WS NOILO3NNO2 9 vlad 335 j a EC P MM EE N mE T NOLL23NNO2 ov NS 9 I33HS NIVA BH30 SN NOLLO3NNOO vs 2 WvHOVId 33s NOILOJNNOO NOLL23NNO2 6 NIVA 81433G NOLLO3NNO2 HOLIMS 8 amp 3MOd QMVOH ANSLLVE NOILO3NNOO HH30 NO 1SIX3 AVW MIA 3415 NOlInVO 8 4 6 01 6 JL n BIN 9 6 40 8 5 CLOLOO OU 3OlAddS Old 59110 9219459 uoaJuDesaJ DO p9UuJ Lb WALI I3x0v38 421 OL d3dVL QV3H dilHHid NOILO3NNOJ a31 ONON IAC 2TOT66N6NCVIVNSIN IMVACN 3 1
21. Internal hose crimped or otherwise obstructed Check Internal Hoses Item 74 800123 Check for possible Air Block message Failure of power supply Check Power Supply Board Item 44 590337 Inaccurate BP measurement Use of improper cuff and or hose incompatible non MRL Use proper size cuff for patient s arm size Make sure cuff is not too loose or too tight See PIC User Instruction Manual Motion artifact Eliminate source of motion BP module circuit failure out of calibration Check Blood Pressure Board Item 92 590346 Failure to obtain Probe failure Check replace probe oximeter measurement Failure of internal cable Check Temperature OX Interface Board Item 75 590372 Oximeter Motherboard Check Main Oximeter Cable cable faulty or Item 91 550722 disconnected Failure of oximeter board Check Oximeter Board Item 90 590340 Faulty or damaged probe Check replace probe Oximeter probe oximeter Check Input Panel and board cable failure Connectors Item 24 See Chapter 10 Failure of power supply Check Power Supply Board Item 44 590337 Inaccurate Probe failure Check replace probe oximeter measurement Oximeter circuit failure Check Oximeter Board Item 90 590340 Failure to Failure of power supply Check Power Supply Board respond to Item 44 590337 controls device turned on Front panel motherboard cable damaged or disconnected C
22. 8 64 Item 71 EL Display 8 66 Item 73 Blood Pressure Coupling 8 67 Item 74 Blood Pressure Tube 8 68 Item 81 12 Lead Preamp Protection Cable 8 69 Item 82 12 Lead Motherboard Cable 8 70 Item 83 12 Lead Paddle Preamp Board 8 72 Item 84 12 Lead Preamp Board 8 74 Item 85 Color Display Adapter Board 8 76 Item 89 EL Display Adapter Board 8 78 Item 90 Oximeter Board without CO 8 80 Item 91 Main Oximeter 8 82 Item 92 Blood Pressure 8 83 Item 93 Main Blood Pressure Cable 8 85 Item 94 Speech 8 86 Item 96 Dual Backlight Inverter 8 87 Item 97 Paddle Pickup Cable 8 89 Item 100 Color Display Shield and EL Display 5 8 90 Item 103 Oximeter Board with 8 92 Item 105 Modem 8 94 Item 106 12 Lead Paddle Barrier 8 96 Item 109 Color Inverter Ca
23. Display Cable 8 66 Item 73 Blood Pressure Coupling 8 67 e Item 74 Blood Pressure 8 68 tem 81 12 Lead Preamp Protection Cable 8 69 e tem 82 12 Lead Motherboard Cable 8 70 e Item 83 12 Lead Paddle Preamp Board 8 72 e tem 84 12 Lead Preamp Board 8 74 e Item 85 Color Display Adapter Board 8 76 tem 89 EL Display Adapter Board 8 78 Item 90 Oximeter Board without 8 80 tem 91 Main Oximeter Cable 8 82 e Item 92 Blood Pressure Board 8 83 e Item 93 Main Blood Pressure Cable 8 85 e Item 94 Speech 8 86 e Item 96 Dual Backlight Inverter 8 87 e Item 97 Paddle Pickup Cable 8 89 tem 100 Color Display Shield and EL Display Shi ld eee Rel 8 90 103 Oximeter Board with 8 92 e tem 105 Modem Board 8 94 e Item 106 12 Lead Paddle Barrier 8 96 e tem 109 Color Inverter Cable 8 97 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 3 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 15 Main Memory Card Cable 8 4 1V OUT CONNECTOR FRONT PANEL CABLE RECORDER CABLE REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Memory
24. NOTE To disable the upper limit option Disabled will display instead of a number If the upper limit option is set the lower limit option must be disabled If the lower limit option is selected the upper limit option must be disabled 4 Press the LOWER LIMIT button to activate this option and highlight it with a bold box 5 Press the UP DOWN buttons to increase or decrease the Lower Limit setting button a second time The word Disabled will display NOTE To disable the upper limit option press the Upper Limit instead of a number If the upper and lower limits are set the Alarm On icon will appear in the HR window and the global alarms will be enabled 6 Press EXIT to enable the settings and return to the the MRL Lite Menu PORTABLE INTENSIVE CARE SERVICE MANUAL 4 5 MRL LITE PRoGRAM MENU SETUP Heart Rate Window a 60 BPM Setup Menu 4 6 TURN ON AND SET THE AUTO HH ALARM 1 Press the OFF ON AUTO button until Auto is highlighted The auto alarm icon will appear in the HR window and the global alarms will be pud On NOTE The upper and lower limits will be Y undetermined if a valid ECG is not ib present Exit 2 Press EXIT to save the setting and leave the HR Alarm menu 3 Press the quick access AUTO button next ur to the set icon to set the automatic HR Alarm limits The patient s heart rate at the moment the button was presse
25. V Frequency Response User selectable 2to 20 Hz Limited mode 1 to 40 Hz Monitor mode 0 05 to 150 Hz Diagnostic mode automatically sets chart recorder response Common Mode Rejection Complies with AAMI EC13 1992 section 3 2 9 10 Tall T Wave Rejection Meets AAMI EC13 1992 section 3 1 2 1c for 1 2 mV T wave 1 0 mV with diagnostic response and 1mV QRS Diagnostic Signals Applied to Patient Connections Leads off active noise suppression sensing circuit is 0 1mA DC The impedance respiration detector signal frequency is 45 4kHz at 78mA RMS 117mV RMS into an impedance of 1 5k pseudo sinewave Heart Rate Meter 20 to 300 BPM Heart Rate Alarms User selectable Size 0 125 0 25 0 5 1 2 4 cm mv and auto ranging Aspect Ratio 0 05 0 1 0 4 0 8 1 6 respectively ECG Output 1 V mV PORTABLE INTENSIVE CARE SERVICE MANUAL 2 25 GENERAL INFORMATION Alarms 2 26 Heart Rate Meter Response Time Responds to a 40 BPM step increase in heart rate in 2 to 4 5 seconds per AAMI EC 13 1992 section 3 1 2 1 f Responds to a 40 BPM step decrease in 1 4 to 3 9 seconds per AAMI EC 13 1992 section 3 1 2 1 f Response times include a 2 5 second display update interval Heart Rate Response to Irregular Rhythm AAMI EC13 1992 section 4 1 2 1 e Ventricular Bigeminy 80 BPM expected Slow Alternating Ventricular Bigeminy 60 BPM expected Rapid Alternating Ventricular Bigeminy 120 BPM
26. Equipment Required Procedure Acceptable Results Corrective Action Cardiac Demonstrator 015 0622 00 or ECG simulator with Arrhythmias including ventricular fibrillation Connect the patient cable to the Cardiac Demonstrator and to the PIC Set the Cardiac Demonstrator to VFIB and turn the power ON Press the A button on the PIC The PIC should display a SHOCK ADVISED message within 12 to 16 seconds Set the Cardiac Demonstrator to NSR 120 Press the A button The PIC should display a NO SHOCK ADVISED message within 4 to 16 seconds Repeat steps 4 and 5 with the Cardiac Demonstrator set to Asystole and verify a NO SHOCK ADVISED result See steps 3 and 5 Refer to the Artifact on ECG listing in Chapter 7 Troubleshooting Guide PORTABLE INTENSIVE CARE SERVICE MANUAL 5 15 PERFORMANCE TEST PROCEDURES 8 LL Battery Charger Test Procedure Equipment Required Procedure 5 16 Use this procedure to test either type of charger option the attached Paddle Tray Power Supply or the separate Quick Charger Stopwatch or clock to measure elapsed time Defibrillator and a battery that has successfully passed the capacity test but has not yet been recharged 1 Connect AC power and verify that the green POWER indicator is on If the separate Quick Charger is being tested connect its Auxiliary Power cable to provide power to the PIC Do not insert a battery into the PIC 2 Press Power Switch to o
27. NIBP Item 24 MRL Nellcor Temp IBP Part Number N N N N 570618 G or Y x N 570611 G or Y Y Y 570613 G or Y Y N Y N 570618 G2 or Y2 Y Y 570618 G5 or Y5 Item 46 Mother Board 10 4 Product Item 46 Number Re order Number Lite 971039 591329 599329 PIC PIC Monitor 590329 598329 NOTE For a replacement Mother Board order 598329 or PIC PIC 2 PIC 2H and PIC Monitor Order 599329 for MRL Lite The new Mother Board will come pre programmed with a unique serial number Contact MRL Service Department 800 462 0777 for the option and upgrade codes for the new board PORTABLE INTENSIVE CARE SERVICE MANUAL SERVICE PART NUMBERS Item 65 Label Kit Product Item 65 Number Lite 971039 800974 PIC PIC Monitor 800972 Item 105 Fax Modem Board The Fax Modem board part number is based on the Language Option in the product part number Language Option Item 105 Part Number EorM 590384 A 593384 All Others 595384 PORTABLE INTENSIVE CARE SERVICE MANUAL 10 5 SERVICE PART NUMBERS 10 6 PORTABLE INTENSIVE CARE SERVICE MANUAL
28. Supervisors may change this code in the Supervisor Menus Press a button to increment the corresponding digit A When all four digits are entered press ENTER B to access the Supervisor menu To reset the code press the RESET TO 0 button The Lock icon on the Supervisor menu title block will open Qp when the correct code is entered If the wrong code is entered the will remain locked NOTE If the code is lost contact your MRL authorized service representative Set Date Menu To select the month option press the corresponding button A A bold outlined box indicates the selected option Press the UP or DOWN arrow buttons B to select a specific month Follow the same procedure to set the day and year When finished press SAVE C 3 20 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Set Time Menu To select the hour option press the corresponding button A A bold outlined box indicates the selected option Press the UP or DOWN arrow buttons B to select the hour Follow the same procedure to set the minute When finished press SAVE C Active Shift Menu The Active Shift menu allows the user to select predetermined shift settings options established by the supervisor This option enables the user to save the user Shift 1 configurable m
29. transmit 12 lead data Once selected a 847 520 030 telephone specific menu located along IX the bottom of the display area is Receiver Type EAX available Fax Menu The Fax menu controls the output of the fax display for the 12 lead data Grid Full grid default setting provides Audio Output grid masks every 0 2 cm Partial grid BaudRate alternative setting provides grid masks 9600 Baud every 1 0 cm and reduces fax transmission Enabled time by as much as 30 seconds XI Audio Output If hardware is installed On default enables and Off disables Fax audio output during dialing and negotiating phases 3 28 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Baud Rate Affects the fax transmission time Select a rate that will work with your cellular service 2400 4800 7200 and 9600 default available Fast Fax Disabled is the default When enabled only 1 lead of the real time ECG trace displays and transmission time decreases Freq Menu Freq menu controls the Rolloff Filter Fitbag used when acquiring a 12 lead snapshot 0 05 40 Hz The Freq Menu only affects the real time display and the acquired signal Diagnostic 0 05 150 Hz Analysis Setup Menu The Analysis Setup menu is used to select TETEE the Automatic or Manual modes for Manual condu
30. zezsu Al av oid 12 Wall 50 14 vao 38ni 901008 sze NiHS 01008 921 A x lt x jeje jy JH ES ejej M 90 fa 971002 MRL OXIMETER OPTION DRAWINGS INCLUDE ALL OPTIONS DETAIL B 2 Ed oko Zin gt Qm 582 o TF E 242 Ee lt ei A IL EA C3 Zor M NE3 5 amp 8 a Hose A H eos o z UE OF gt lt 5 ITEM 123 TO DATA COMM 3 PLACES PINC HEAD SCREWDRIVER MRL 002109 REQ D FOR INSTALLATION 3 CORNERS TAMPER PROOF SCREWS 4 PLACES Q V U O U research 2 E MRL 9 PLACES 2 C3 gt un 9 a TITLE 3 CORNERS oR 2 09 or PART NL DATE 7 98 2 e 2 z A CN CO C ISSUE D SHEET 2 OF 9 9 A e 2 e lt 0 9 2 c e ZA a
31. 3 4 5 6 Replace O ring Item 117 Insert coupling Item 73 into top enclosure Replace locking washer Item 86 and nut Attach Tube Item 74 to coupling Replace defibrillator assembly Item 23 Check that all cables are seated correctly and are clear of the sides of the unit Replace bottom enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 67 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 74 Blood Pressure Tube 75 f D 122 REMOVE 1 Remove bottom enclosure Item 21 2 Remove defibrillator assembly Item 23 3 Remove Tube Item 74 from BP coupling Item 73 and pump valve assembly Item 69 REPLACE 1 Connect Tube Item 74 to BP coupling Item 73 and pump valve assembly Item 69 Long nose pliers may be necessary to properly seat the tube 2 Replace defibrillator assembly Item 23 3 Check that all cables are seated correctly and are clear of the sides of the unit 4 Replace bottom enclosure Item 21 8 68 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 81 12 Lead Preamp Protection Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect 12 Lead Preamp Protection Cable Item 81 at J2 of the 12 Lead Preamp Board Item
32. 4 Multipurpose Hands Free Adapter 5 Shock Button Hands free discharge button 6 Adapter Release Button Unlocks the adapter connector from the defibrillator to allow removal Je NOTE When sliding the multipurpose hands free adapter on make sure the release button clicks into place and returns to its up position 2 14 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION Internal Paddle IP Set optional 1 Removable Electrodes 2 Cable and Handle Assembly Allows connection of internal paddle electrodes 3 Connector Allows cable and handle assembly to be removed for sterilization 4 Adapter Provides the interface between PIC and internal paddles Do not sterilize this adapter 5 Discharge Button 6 IP Adapter Release Button Unlocks the adapter connector from the defibrillator to allow removal NOTE When sliding the IP hands free adapter on make sure the release button clicks into place and returns to its up position PORTABLE INTENSIVE CARE SERVICE MANUAL 2 15 GENERAL INFORMATION Turning On the PIC turn the unit on and print a self test Press button to begin printing The unit performs a self test and prints out a test strip System On 12 06 56 Manual Mode 12 06 56 Self Test Passed 2 Press button again to stop printing Loading The check recorder icon 1 will appear the message window of Recording
33. 5 Disconnect Color Inverter Cable Item 109 at CN1 on Dual Backlight Inverter Item 96 by pulling on the cable by the connector and threading cable out of hole in Color Display Shield Item 100 REPLACE 1 Thread cable through hole in Color Display Shield Item 100 2 Connect Color Inverter Cable Item 109 at CN1 on Dual Backlight Inverter Item 96 by pushing on the connector visible metal terminals on female connector should face away from the Dual Backlight Inverter Item 96 3 Replace the Color Display Shield Item 100 4 Connect Color Inverter Cable Item 109 at J2 on Color PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 97 REMOVAL AND REPLACEMENT INSTRUCTIONS 1 Display Adapter Board Item 85 by pushing on connector visible metal terminals on female connector should face away from the Color Display Adapter Board Item 85 5 Replace Blood Pressure Pump Valve Assembly and Foam Block Items 69 amp 68 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 8 98 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL Pe CHAPTER 9 ASSEMBLY DRAWINGS This Chapter contains nine assembly drawings for the PIC System Service Drawings Part Number 991012 Chapter Overview Table of Item Numbers Top Assembly 5 Lead Unit EL Color TFT and Mono Display Options Card Cage Assembly PORTABLE INTENSIVE CARE SERVI
34. 5 22 Pulse Oximeter Performance 5 24 IBP Performance 5 25 Performance Test 5 26 PORTABLE INTENSIVE CARE SERVICE MANUAL 5 1 PERFORMANCE TEST PROCEDURES Inspection Procedures 5 2 1 Inspect unit for wear 4 Inspect the outer enclosure integral handle and display panel for cracks chipping or other obvious damage Clean away any foreign materials e In cases where fluid contaminant is observed verify that no corrosion of external or internal components has occurred Replace any damaged component prior to returning the PIC to normal use Inspect external paddles Inspect for foreign material especially in the area of the electrode plates and the shock buttons where gel or fluid can accumulate Check the electrode surfaces for pitting or deep scratches Check the cable insulation for cuts or fraying e Check the connector end of the paddles for damaged or corroded connector pins Check the latch for proper operation Check for signs of heat damage such as warpage or distortion of plastic parts could indicate that the external paddles have been subjected to a sterilization process If this type of damage is observed PIC operators must be notified that the external paddles are not intended to be sterilized Replace damaged external paddles prior to returning the PIC to no
35. 6 318v9 siQ40038 Old ASSY 8090 8 _ AIeN3SSv zoss gt E d z s E Lu o L 1 Ly aja ad Y 4 S SS 9c S HOIIMS 742005 85 50 02 ONIN 191091 Midvd 13971 S9 714 oT wo aevi 99 Will JO L9 29 v9 v9 ev Ol 335 59 sild vd 214 ASSY JAYI 22 30 Id dB wos 7 009 AlBW3ssv 3NiMV dAnd aa to z E 5 138 S9 40714 az 74 0371 21 13841 et av E 214 lt lt MNVOS XO 08 NNOO JAYI L T3Nvd 1NQM4 138V1 AVIdSIO 13 219 ASSY 9510 13 Old Flava 114055 gt E o Lr 9 3071 ONIZ HLOOL TIN Pf N3HSvM 91 WALI 714 21 JLN NNO2 312U1B WALI 40 Id d z E 5 n ZL L dO 4 1 Qd 8 1 z GZ 9L L 8 6 182 OiloMd JWv3uJ Qv31 zi 294099 18 318 2 154055 278 dWv3sd 310 vd 0 1 22 ezcres ce dYOE QVdl Z 242068 8 GNvOg Mildv v Avidsid NO102 se NNOO 8 M3HSVM stvoz9 98 48 G8 NNOO JO tvz0cG 18 QNVOB 10Nd 0731 21 6 lt 266 ge Q3NOG NildvOv AV
36. Disconnect Mono LCD Cable Item 35 from J5 5 Remove two screws Item 5 from LCD Display Adapter Board Item 49 using a 1 Phillips head screwdriver 6 Lift LCD Display Adapter Board Item 49 off of Card Cage Pre Assembly Item 48 REPLACE 1 Position LCD Display Adapter Board Item 49 on the side 8 48 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OEE of the Card Cage Pre Assembly Item 48 so that J1 is near Motherboard Item 46 2 Replace the two screws Item 5 to the LCD Display Adapter Board Item 49 using a 1 Phillips head screwdriver 3 Connect Flat Panel Display Cable Item 50 to LCD Display Adapter Board Item 49 at J1 by lifting retaining clip with fingernail or a small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should face Motherboard Item 46 Connect Mono LCD Cable Item 35 to J5 4 Connect Display Power Supply Cable to Power Supply Board Item 44 at J4 by pushing on connector Lip of female connector should go under holder on male connector 5 Replace Card Cage Pre Assembly Item 48 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 49 REMOVAL AND REPLACEMENT INSTRUCTIO
37. Failure to fire in sync mode listing in Chapter 7 Troubleshooting Guide PORTABLE INTENSIVE CARE SERVICE MANUAL 5 13 PERFORMANCE TEST PROCEDURES Transthoracic Pacemaker if equipped CAUTION High voltages can be present inside the pacer and at the pacer output Transcutaneous Pacemaker preferred test method Equipment Required Procedure Acceptable Results 5 14 Transcutaneous pacemaker analyzer with any adapter required for connection to the PIC Connect the hands free defibrillator of the PIC to the correct blue and white mating connector as supplied with the transcutaneous pacemaker analyzer Operate the analyzer according to the instructions provided with it Turn on the PIC pacer Set the MODE to ASYNC Set the RATE to 180 bpm and the OUTPUT to 180 mA Press the START button to initiate pacing into the analyzer Measure rate output current and pulse width on the analyzer RATE and OUTPUT settings can be checked in this manner Set the MODE to DEMAND Follow the instructions for the analyzer in use to verify that a pacer output occurs only when called for when the simulated heart rate drops below the RATE setting of the Pacer Rate 333 msec 5 Current voltage across a 700 load should be 126V 10 Pulse width 20 msec 5 at the 50 point of the waveform PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES i Advisory Option if equipped
38. In this case we want to change the 1 to a 0 NOTE The upgrade menu window is replaced by a numeric window PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL The password is displayed just above the numeric window with an active cursor in the first space 3 33 MENUS Options Available SAED IBP ADV Review Back 17 34 56 78 90 Space B 1234 9 0 2 4 12 34 56 78 90 Space 2 Press on the actual character C Your selection will be entered and the cursor will move to the next character in the identifier Continue this process to complete the password 3 Press the SAVE button in the Password menu to save the selection and return to the Upgrade menu A symbol should now appear after Adv indicating that the option was successfully installed 3 34 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS NENNEN Supervisor Menus Calibration Set Up Suprvsr Date Time Shifts Back Enter Passcode here Supervisor UNLOCKED Defib Pacer SAED 12Lead SetUp Diag Exit Superv Diagn SW Rev Modem Card Cal Back Software Modem Card Version Self Test Menu Menu Menu Superv Calibr NIBP SPO Out NIBP SPO Mod Out CO Cal Menu Offset Cal Menu Menu Menu
39. Item 56 be replaced every 5 years If the PIC prints a Setup Defaults Restored message or loses the time date setting the battery may have to be replaced sooner The battery should measure gt 2 75 If the battery voltage is low replace the 3 V lithium battery PORTABLE INTENSIVE CARE SERVICE MANUAL 5 17 PERFORMANCE TEST PROCEDURES 8 1 5 5 Battery Capacity Test and Reconditioning Procedure Equipment Required Procedure 5 18 Due to the critical nature of this equipment it is important to test PIC batteries at least every 90days to verify adequate available battery capacity The test should be performed every 30 days if batteries are charged in a high temperature environment above 30 C 80 F or if they are heavily used charged and discharged more than once a day Because this test completely drains the battery it also serves an important reconditioning cycle that will help ensure maximum capacity e Stopwatch or clock to measure elapsed time PIC with only the ECG monitor function activated NOTE Battery run time is different for the various PIC options available Refer to the following comparison chart to determine typical operating time for specific PIC options and battery types Battery Capacity Comparison Select Options Below to Part Minimum ECG Monitoring Time Hours Determine Minimum Number SmartPak SmartPak SuperPac Battery Run Time MRL Lite 971039 2 2 5 5
40. NIBP adult arm cuff NIBP child cuff NIBP infant cuff NIBP cuff hose 6ft NIBP cuff hose 10ft NIBP adult disposable cuff NIBP thigh disposable cuff NIBP hose for use with disposable cuffs NIBP Pediatric disposable cuff IBP Adapter cable Quick combo pad adapter 001781 002052 001930 001931 001932 001933 001950 001951 001954 001934 001910 980136 980137 980138 971029 002115 Multipurpose electrodes child KLEAN con ductive spray Adult disposable tympanic temp sensor Pediatric disposable tympanic temp sensor Reusable 10ft extension cable for all disposable temp sensors Calibration check plug airway adapter Qty 5 airway adapter Qty 50 CO adapter CO sensor SmartView software and manua CardioLog memory card 4mb CardioLog memory card 8mb CardioLog memory card 16mb Paddle holder charger Zoll pad adapter cable PORTABLE INTENSIVE CARE SERVICE MANUAL 2 23 GENERAL INFORMATION 8 B i Technical Specifications Defibrillator Waveform Precise Trapezoidal per AAMI Standard for Truncated Exponential Waveforms Waveform Details Models PIC and MRL Lite Peak current Ip and duration t at 360 Joules delivered energy The values shown are within 10 Load Ohms Ip Amps t ms 25 53 1 10 0 50 27 1 18 8 100 13 7 36 4 Waveform MRL Bipahsic optional
41. S3ONNHTO1 WNOISN3WIO S lOJDIJOQGD dM IN a 0900 10 121001 600011 2 a5 6 72 9 Hdd M380 19001 5 Hdd 91 6 X 9 MaNOS 1001 z x 26 9 825 sezoor e ONIZ OSL X 72 9 Hid MYS 199000 5 Hdd 50 X MOS s9v00 X 700 Hdd M3NOS Lwoo 9 43040238 Iwas 4 597001 au er zie 600011 e eris T 8 t x 9 LX ZC 9 Hdd MNOS 99001 005 X Ov vOO Hdd MNOS 409001 2 1 X 75 9 Hdd Ma os 919001 ONIZ HLOOL ILNI M3HSvM 08 671018 86 2 1 QNOO 3dvV1 86 00 Z90 WvOJ 031902 180 vit 5 26 008 121 819001 6 001 719001 10 10 Wo izrviise og zzsz 00 10 1 1 Em 14143534 ANSSI E X9 X9 9 X9 CHAPTER 10 SERVICE PART NUMBERS This chapter provides information about specific PIC System service part numbers The information is arranged in tables by item number and may include base part numbers item part numbers product na
42. Waveform Detals Models PIC 2 and MRL Lite 2 Load Ohms Ip Amps tphasel ms tphase2 ms 25 51 5 54 3 1 50 26 3 11 2 6 6 100 13 3 16 6 8 4 Waveform High Voltage Truncated Exponential Biphasic optional Output Energy Accuracy 1096 at 50 ohms 15 at 25 to 100 ohms Waveform Details 2 360 joules Models PIC 2H and MRL Lite 2H Load Ohms Ip Amps tphasel ms 2 25 69 3 5 1 6 0 3 2 4 6 50 37 8 6 8 7 9 4 0 5 6 100 19 8 8 6 10 6 5 8 7 1 Energy Select External 2 5 7 10 20 30 50 70 100 150 200 300 360 J Internal 2 3 4 5 6 7 8 9 10 20 30 50 J Charge Time 7 seconds 360 J with a SmartPak Plus battery after 15 discharges lt 9 seconds 360 J with a SuperPac battery after 15 discharges 15 seconds 360 J no battery 90 AC mains voltage Charge Indicator Audible and graphic 2 24 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 85 Output Adult paddles internal paddles peds adapter and multipurpose hands free adapter available Synchronizer Delivers energy within 60 msec Disarm Front panel switch Monitor Display Input 3 lead or 5 lead patient cable paddles or multipurpose hands free adapter Size 6 5 inches 16 5 cm diagonal non fade Type Electroluminescent EL display Display Resolution 640 x 480 pixels Sweep Speed 25 mm sec Lead Selections Paddles Pads I II III AVR AVL
43. You will need to provide your model and serial numbers 2 10 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION Equipment Setup s NOTE The battery shipped with the MRL product is not charged To 2 Inserting the Battery Charging Battery Packs with Optional Paddle Tray Charger charge the battery and prepare the MRL product for normal use follow the procedures below To insert the battery find the battery slot on the right side of the PIC and slide the battery in connectors first Press the battery firmly into the slot to assure proper connection of all 4 contact points on the battery The MRL Quick Charger Conditioner charges 3 standard MRL battery packs simultaneously in approximately 4 hours 1 To initiate a battery pack charge cycle insert the MRL battery into any of the 3 numbered slots in the front of the charger When the battery is firmly seated into the contacts at the back of the slot the yellow light behind the slot illuminates indicating that the battery is being charged This light remains on for the duration of the charging cycle When the battery is fully charged the yellow light flashes to indicate it is ready for use 2 A completely discharged battery SmartPak Plus pack requires approximately 4 hours to recharge and a MRL SuperPac requires approximately 8 to 10 hours Charging time varies depending on battery capacity and state of charge Deeply discharged batteries and those with hi
44. disconnect EL Display Cable Item 71 at J2 on EL Display Adapter Board Item 89 by lifting connector up 10 Disconnect Mono LCD Cable Item 35 from LCD Display Adapter Board Item 49 at J5 by very carefully lifting retaining clip with fingernails or small instrument and carefully pulling out cable The Connector is fragile 11 Disconnect Speaker Cable from Motherboard Item 46 at J105 by carefully pulling on connector 12 Disconnect Defib Power Cable from Power Supply Board Item 44 at J7 by pushing down on locking mechanism and pulling out 13 Disconnect Power Supply Cable on Battery Board Item 54 from Power Supply board Item 44 at J2 by pushing down on locking mechanism and pulling out 14 Disconnect Power Switch Cable Item 5 from Power Supply Board Item 44 at J6 by carefully pulling on connector if metal pins become bent straighten them 15 Lift Defibrillator Module Item 23 on the side where J8 is located disconnect Defib Main Cable Item 19 from Defibrillator Module Item 23 at J8 by carefully pulling out cable 16 Disconnect Pad Pickup Cable from Paddle Preamp Board Item 27 at J1 by carefully pulling on cable 17 Clear all cables and slowly slide Card Cage Pre Assembly Item 48 up along the rails 18 Disconnect Chart Recorder Cable Item 53 from Motherboard Item 46 at J114 by pressing side eject levers in and pulling out cable slide cable out from wire holder on the back of Card Cage P
45. end when button is pressed again Continuous Recording will start when the PIC is turned on if a data card is inserted SAED Startup Menu Use the SAED Startup menu to select either Manual Basic or Basic as the PIC startup option Your selection will be in effect the next time the 15 started Manual Basic NOTE The ALS supervisor passcode must be entered to go from Basic or Basic mode to Manual mode PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 27 MENUS Supervisor Menus 12 Lead A supervisor can configure options that are specific to collecting and transmitting 12 lead data These options include telephone and fax numbers the number of printout copies produced and frequency and analysis settings This menu is accessible through the Treatment Configuration Set Up menus Set Up Suprvsr Date Time Shifts Back Enter Passcode here 3 Supervisor UNLOCKED Defib Pacer SAED 12Lead SetUp Diag Exit 12 Lead Phone Fax Freq Analysis Copies Back Phone Fax Frequency Analysis Copies Entry Menu Menu Menu Menu Menu gt Telephone Proceed Next Test Exit Phone Entry Menu The Phone Entry menu allows the Name operator to add edit or delete up to Hospital 1 ospita 16 telephone numbers that can be used to 1 i Bone
46. expected Bidirectional Systole 45 BPM expected Tachycardia Response Time Response time to tachycardia alarm is on average 3 43 seconds with a range of 1 15 to 10 69 seconds per AAMI EC 13 1992 section 3 1 2 1 g Response times include a 2 5second display update interval Heart Rate BP SpO2 Resp amp Temp Alarm Audible 5 pulse 800 tone with a PW of 150 msec a PRI of 225 msec and a repetition interval of 10 seconds Visual Heart Rate Alarm causes the displayed heart rate to flash at 2 Hz This display is located at the top of the display and is 0 4 high and 0 28 to 0 840 wide depending on number of digits in the heart rate Color is amber black white or whatever the color the display text is Lead Fault Alarm Audible 3 pulse 500 Hz triplet tone with a PW of 200 msec a PRI of 310 msec When the HR alarm is set or the pacer is on the lead fault tone repeats at a repetition interval of 20 seconds Visual Lead Fault condition causes a LEAD FAULT message to be displayed on the trace along with a dashed line the width of the trace The text is 0 18 high and is the color of the display text The dashed line is 5 long the width of the display The signal is not modulated PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 85 3 8 Physiological Alarms BP SpO2 Resp amp Temp Audible See Heart Rate Alarm Visual Physiological alarms cause the displayed parameter to
47. follow the disassembly procedures to remove the BP assembly from the card cage assembly Set the assembly on insulating material close enough to the Motherboard to reconnect the flat cable that links the two together Adjustments must be made while in the BP CAL mode of the Setup Supervisor Menu The first adjustment is made to R48 while no cuff pressure is present disconnect BP hose from the PIC Set R48 so that the pressure display in the lower right corner of the BP window reads 0 Connect the PIC BP hose to a calibrated pressure gauge NIBP analyzer Use the Pump Up and Pump Down commandis to set the pressure When the pressure stabilizes compare the reading on the PIC pressure display with that of the calibrated analyzer Check the accuracy at pressure settings of 200 140 and 50 mmHg Adjust R47 so that all 3 pressure readings agree with the analyzer within 1 mmHg Excessive leak rate is usually caused by either the external hose or cuff If the air leak is internal check for hose connections that may have been disturbed during any prior service procedure Refer to the troubleshooting guide for other possible causes If overpressure sensing is not within acceptable limits replace the overpressure switch Refer to the disassembly procedures for the Blood Pressure Pump Valve Assembly Item 69 PORTABLE INTENSIVE CARE SERVICE MANUAL 5 23 PERFORMANCE TEST PROCEDURES Pulse Oximeter Performance Test Equip
48. to return to the Defibrillator Supr Defib menu Internal Energy Menu The Internal Energy menu sets the default internal energy selected when the PIC is first turned on or when internal paddles are first attached The selected Joules energy setting displays in this menu To change the setting press the UP arrow A or DOWN arrow B to increase or decrease the energy selection Options are 2 3 4 5 6 7 8 9 10 20 30 or 50 joules To prevent possible cardiac tissue damage the energy output is limited to 50joules Press EXIT C to return to the Defibrillator Supr Defib menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 23 MENUS eee Sync After CV Menu The Sync after CV cardioversion menu allows the user to configure the defibrillator to stay in the sync mode after each synchronized cardioversion If this option is Off A the defibrillator will revert to the asynchronous mode If this option is On B the defibrillator will remain in the Sync mode after each cardioversion Press EXIT to return to the Defibrillator Supr Defib menu Charge Alarm Menu ALARM Volume MAX Volume The Charge Alarm menu allows the user to select the Charge Alarm volume setting Press the ALARM VOLUME button to use the Volume icon in the Quick Access window to adjust the char
49. 1 Symbols and Icons eee 1 2 General Precautions 1 5 Monitoring Precautions 1 Defibrillator 1 8 External Pacing Precautions 1 10 Pulse Oximeter Precautions eene 1 12 Non Invasive Blood Pressure Precautions 1 13 Battery Precautions eese 1 14 Charger Precautions eese 1 15 SAED Precautions 2 1 16 IBP Precautions ien ettet et 1 16 CO Precautions 1 17 General Information 2 1 Product Overview 2 2 General Description 2 2 PIC System 2 3 PIC System Controls and Indicators 2 5 PIC System Modes sese 2 7 Initial Installation Evaluation 2 9 Equipment 2 11 Summary of Operations 2 18 Part Numbering 2 21 Options and 2 22 Technical Specifications ees 2 24 3 1 User Menu 32 Supervisor Menu Overview 3 3 Quick Access Butto
50. 46 by pushing cable into connector the insulated side of the cable should face down into the unit 2 Thread the Cable Item 82 through the ferrite on the Card Cage and connect 12 Lead Motherboard Cable Item 82 at J5 on 12 Lead Preamp Board Item 84 by pushing cable into connector the insulated side of the cable should face the 12 Lead Preamp Board 3 Replace Card Cage Pre Assembly Item 48 4 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 71 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 83 12 Lead Paddle Preamp Board 8 72 NOTE Requires Conductive Tape Item 98 and Adhesive Transfer Tape Item 121 from Fastener Kit Item 16 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect 12 Lead Preamp Protection Cable Item 81 at J3 on Paddle Preamp Board Item 83 by pulling out cable 3 Remove Memory Card Board Item 26 4 Remove Card Cage Pre Assembly Item 48 5 Remove 12 Lead Paddle Barrier Item 106 6 Disconnect Paddle Pickup Cable Item 97 at J2 on Paddle Preamp Board by pulling connector out 7 Disconnect ECG Input Connection from the 12 Lead Paddle Preamp Board at J4 and J5 by pulling on the connectors not the wires If any pins become bent straighten them 8 Slide 12 Lead Paddle Preamp Board Item 83 up and out of the unit
51. 70 W while powering monitor 300 W while charging defibrillator Charger Bays Three charges three batteries concurrently Indicators Battery Charging Ready Reconditioning Defibrillation Test Indicator Power On Reconditioner Simple one button operation Reconditioning Load 220 mA x 10 constant Optimized for signal reconditioning Recondition Cycle Time Dependent on battery capacity and state of charge typically 12 hours External Power Output Voltage 13 Volts 0 65 V Fuse Ratings Dual Line Fuses 120 VAC 2 Amp SB MRL 500218 220 VAC 1 Amp SB MRL 500241 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION L LL General Charger Operating Temperature 0 to 45 C Humidity 15 to 9596 Size 11 5 x 7 25 x 4 4 inches 29 2 x 18 4 x 11 2 cm Defibrillator Tester Built in 50 Ohm load Paddle Holder Charger Mains Line Voltage 100 to 240 10 autoranging Mains Line Frequency 50 to 60 Hz 4 596 AC Power Consumption 18 W Typical Maximum 190 W while charging defib PORTABLE INTENSIVE CARE SERVICE MANUAL 2 33 GENERAL INFORMATION 5 5 5 2 34 PORTABLE INTENSIVE CARE SERVICE MANUAL CHAPTER 3 MENUS This chapter covers in detail all the User and Suprvisory Configuration Menu Options available in the PIC System Chapter Overview User Menu 3 2 Supervisor Menu Overview
52. 8 16 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 26 Memory Card Board y SN SS 15 NOTE Requires Silicon RTV Item 37 REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove two screws Item 5 securing the Memory Card Board Item 26 3 Carefully pull Memory Card Board Item 26 away from unit Disconnect Main Memory Card Cable Item 15 at J1 by pulling on connector REPLACE 1 Install Memory Card Barrier Item 107 on bottom side of Memory Card Board Item 26 if unit has 12 lead ECG option 2 Connect Main Memory Card Cable Item 15 at J1 matching notches 3 Place Memory Card Board Item 26 in unit with J1 facing into the unit align holes and fasten with screws Item 5 4 Seal Memory Card Board Item 26 where indicated dark shading on picture with RTV Item 37 5 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 17 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 27 5 Lead Paddle Preamp Board REMOVE 1 Remove Bottom Enclosure Item 21 Remove Memory Card Board Item 26 Remove Card Cage Pre Assembly Item 48 Remove Paddle Preamp Shield Item 29 peo o Disconnect ECG Input Connectio
53. Cell Battery Item 56 REPLACE 1 Insert Coin Cell Battery Item 56 under the metal holder in the 3V Coin Cell Battery case on the Power Supply Board Item 44 at BTI 2 Replace Red Cap Item 102 of 3V Coin Cell Battery case Replace Card Cage Pre Assembly Item 48 4 Check that all cables are seated correctly and are clear of the sides of the unit 5 Replace bottom enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS NENNEN Item 57 Power Switch Cable NOTE Requires Silicon Item 37 1 Remove Bottom Enclosure Item 21 2 Disconnect Power Switch Cable Item 57 from Power Supply Board Item 44 at J6 by carefully pulling on connector if metal pins become bent straighten them 3 Unsolder three wires of Power Switch Cable Item 57 from back of Power Switch Item 58 4 Remove Silicon RTV from cable hole in unit 5 Pull Power Switch Cable Item 57 out of unit while feeding through cable hole in unit REPLACE 1 Feed un terminated end of Power Switch Cable through the cable hole near Power Switch Item 58 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 61 REMOVAL AND REPLACEMENT INSTRUCTIONS 85 LL 2 Solder three wires of Power Switch Cable Item 57 to back of Power Switch Item 58 as per Diagram 1 in Chapter 9 3 Connect Power Switch C
54. INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 93 Main Blood Pressure Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Main Blood Pressure Cable Item 93 at J215 on Motherboard Item 46 by lifting the retaining clip with fingernail or a small instrument and carefully pulling out cable 3 Disconnect Main Blood Pressure Cable Item 93 at J4 on Blood Pressure Board Item 92 by lifting the retaining clip with fingernail or a small instrument and carefully pulling out cable REPLACE 1 Connect Main Blood Pressure Cable Item 93 at J4 on Blood Pressure Board Item 92 by lifting retaining clip with fingernail or a small instrument placing cable into connector then pushing down on the retaining clip the insulated side of the cable should face the back or the retaining clip 2 Connect the Main Blood Pressure Cable Item 93 at J215 on Motherboard Item 46 by lifting up retaining clip with fingernail or a small instrument placing cable into connector then pushing the retaining clip down the insulated side of the cable should face the back of the retaining clip 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 85 REMOVAL AND REPLACEMENT INSTRUCTIONS E gt gt i Item 94 Speech Board
55. Item 96 through the Color Inverter Cable Item 109 a 7 pin cable connected to J2 of the Color Display Adapter Board Item 85 and of the Backlight Inverter Item 96 The Chart Recorder Item 36 is controlled by the main processor on the Motherboard Item 46 Control signals the 5 VDC the fused unregulated battery voltage are routed to the chart recorder from J114 of the Motherboard through the Chart Recorder Cable Item 53 The Chart Recorder Cable is mounted to the Top Enclosure Assembly Item 22 by screws Front Switch Panel 6 6 The Front Switch Panel is controlled by the main processor on the Motherboard Item 46 Signals to the Front Switch Panel are routed through the Front Panel Cable Item 31 a 12 pin FFC cable connected to J108 on the Motherboard The Pacer controls and the Sync and Pacer LEDs are controlled through the Pacer Panel Cable Item 30 a 14 pin FFC cable connected to J211 on the Motherboard The switches are arranged in a row column configuration Pressing a switch shorts a row and column together The main processor checks the Front Switch Panel for stuck keys at power up PORTABLE INTENSIVE CARE SERVICE MANUAL THEORY OF OPERATION EN 5 L1 Voice Memo and Voice Prompts Voice Memo and Voice Prompts are controlled by the main processor on the Motherboard Item 46 Control signals and the 5VDC power signals are routed to the Speech Board Item 94 at J210 Pressing the Voice Memo
56. Lead Preamp Protection Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Preamp Protection Cable Item 32 from Paddle Preamp Board Item 27 at J2 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable 3 Disconnect Preamp Protection Cable Item 32 from ECG Preamp Board Item 51 at J3 by pulling cable out of connector REPLACE 1 Connect Preamp Protection Cable Item 32 to ECG Preamp Board Item 51 at J3 by pushing cable into connector the blue side of the cable should face out 2 Connect Preamp Protection Cable Item 32 to Paddle Preamp Board Item 27 at J2 by lifting retaining clip with fingernails or small instrument placing cable into the connector checking that cable is seated straight and pushing down on the retaining clip the blue side of the cable should face the back of the retaining clip 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 25 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 34 Mono LCD Inverter Cable 8 26
57. Ohms PaceErr 017 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 018 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 019 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 020 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 021 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PreampA DErr Preamp circuit error Check Preamp Board 5 Lead Item 51 590328 12 Lead Item 84 590377 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 11 TROUBLESHOOTING GUIDE Preamp QRS Det Err Preamp circuit error Check Preamp Board 5 Lead Item 51 590328 12 Lead Item 84 590377 Preamp Lead Preamp circuit error Check Preamp Board Test Err 5 Lead Item 51 590328 12 Lead Item 84 590377 Bad SAED Motherboard circuit error Cycle unit power Transition Check Motherboard Item 46 590329 or 591329 Card Fail Memory card not formatted Format the memory card Memory card faulty Check replace memory card Memory card circuit board failure Check replace Memory Card Board Item 26 590344 Memory card Motherboard cable faulty or disconnected Check Memory Card Cable Item 15 550706 Motherboard circuit error Check Motherboard Item 46 590329 or 591329 SpeechlnitErr Speech board circuit error C
58. PIC with 5 Lead ECG amp 971042 2 2 5 5 Mono LCD Display 971044 PIC with 5 Lead ECG amp EL 971009 1 5 2 4 Display PIC with 5 Lead ECG amp 971013 1 25 1 5 3 Color LCD Display PIC with 12 Lead ECG amp 971026 1 25 1 5 3 EL Display PIC with 12 Lead ECG amp 971027 1 1 25 2 5 Color LCD Display 1 Completely charge the battery to be tested The charger indicator begins to blink when the battery is fully charged 2 Disconnect the PIC from AC power so that it is powered only from the battery to be tested Turn on the PIC monitor and note the starting time 4 Verify continued operation at intervals of 30 minutes or less PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES 5 When the battery power runs note the time This gives the duration of time that relates directly to battery capacity Compare this run time to the value given in the comparison chart above that corresponds to the PIC and battery type being use Acceptable Results Battery run time must meet or exceed the minimum time given in the comparison chart Recharge batteries fully prior to placing them back into service Corrective Action e If the actual battery run time is less than the value given in the chart repeat the test to determine if reconditioning was effective in improving available capacity If the operating time remains short remove the battery from service and replace it
59. Paddle Pickup Cable Item 97 at J2 on Paddle Preamp Board by pulling connector out REPLACE 1 Connect Paddle Pickup Cable Item 97 at J2 by pushing connector onto the metal pins 2 Replace 12 Lead Paddle Barrier Item 106 Use double stick tape 800397 Replace Card Cage Pre Assembly Item 48 4 Replace Memory Card Board Item 26 5 Connect 12 Lead Preamp Protection Cable Item 81 at J3 by pushing cable into connector the insulated side of the cable should face out of the unit 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 89 REMOVAL AND REPLACEMENT INSTRUCTIONS i Item 100 Color Display Shield and EL Display Shield 8 90 27 2 2 PLACES T N P d lt ogg 114 UNDER SHIELD REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove the Card Cage Pre Assembly Item 48 3 Remove Blood Pressure Pump Valve Assembly and the Foam Block Items 68 and 69 4 Disconnect the Color Inverter Cable Item 109 from CNI Remove Memory Card Board Item 26 6 Remove ferrite and double sided tape Item 10 from the Shield 7 Remove screws on either side of the Color Display Shield Item 100 8 Lift Color Display S
60. Preamp Board ECG option is installed This selection does not affect the filtering used to acquire a 12 lead sample Diagnostic response should be used when attempting to interpret subtle ECG changes ST segments Press the button next to a frequency to select it bold outlined box indicates the selected frequency Press EXIT to return to the Display Configuration menu In the Filter menu press the Line Filter button to turn line filters On or Off The filters remove AC mains line interferences emitted from power lines and other electrical apparatus Turn the filter off for optimal diagnostic response Press EXIT to return to the Display Configuration menu NOTE To select a different line frequency refer to line frequency ref Supervisor Line Frequency menu In the Patient Cable menu users can select a 3 lead or 5 lead patient cable Press the corresponding button to choose a lead configuration A bold outlined box indicates the selected configuration If the patient cable inserted into the PIC System does not match the selected patient cable configuration a lead fault alarm may sound Press EXIT to return to the Display Configuration menu NOTE This menu is not available on PIC Systems with 12 lead preamplifiers because the 12 lead preamp auto detects the patient cable type PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 9 MENUS Brightness and The level of brightness and c
61. Preamp Shield Item 29 Replace Card Cage Pre Assembly Item 48 Replace Memory Card Board Item 26 Check that all cables are seated correctly in connectors and are clear of the sides of the unit Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 19 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 29 5 Lead Paddle Preamp Shield 8 20 REMOVE 1 Remove Bottom Enclosure Item 21 2 If option installed remove Memory Card Board Item 26 3 Remove Card Cage Pre Assembly Item 48 4 Remove screw and washer Items 5 and 8 from Paddle Preamp Shield Item 29 using a 1 Phillips head screwdriver 5 Lift off Paddle Preamp Shield Item 29 REPLACE 1 Place Paddle Preamp Shield Item 29 over Paddle Preamp Board Item 27 and Patient Input Connector Item 40 with screw hole line up on hex spacer on Paddle Preamp Board Item 27 2 Replace screw and washer Items 5 and 8 to Paddle Preamp Shield Item 29 using a 1 Phillips head screwdriver Replace Card Cage Pre Assembly Item 48 4 Replace Memory Card Board Item 26 if option installed Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 30 Pacer Panel Cable
62. REPLACE 1 Slide 12 Lead Paddle Preamp Board Item 83 into the unit along the two rails 2 Connect ECG input connection to 12 Lead Paddle Preamp Board Item 83 at 14 and 75 by pushing connector onto the metal pins Lip on female connectors should go under PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS NENNEN holder on male connector 3 Connect Paddle Pickup Cable Item 97 at J2 by pushing connector onto the metal pins 4 Replace 12 Lead Paddle Barrier Item 106 Replace two tapes as shown in detail 2 sheet 4 5 Replace Card Cage Pre Assembly Item 48 6 Replace Memory Card Board Item 26 7 Connect 12 Lead Preamp Protection Cable Item 81 at J3 by pushing cable into connector the insulated side of the cable should face out of the unit 8 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 9 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 73 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 84 12 Lead Preamp Board 8 74 c WARNING DO NOT touch preamp board with fingers or tools because of contamination and ESD REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect 12 Lead Preamp protection Cable Item 81 at J2 by pulling on cable 3 Disconnect 12 Lead Motherboard Cable Item 82 at J5 by pulling
63. SERVICE MANUAL 6 11 THEORY OF OPERATION 8 1L 9 Data Communications Fax 6 12 The Motherboard Item 46 communicates with the CO Ox Isolation Board Item 103 through the CO Motherboard Cable Item 18 connected to J219 on the Motherboard and J4 on the CO Ox Isolation Board The probe is plugged into a connector in the Patient Input Panel Item 24 The signal from the probe is routed through the Oximeter Board Connector Cable Item 77 to the Ox Isolation Board connected at J3 Power to the CO Module passes through a fuse F1 in the Patient Input Panel Data can be sent and received through the Data Communications Port Signals are of RS232 5V levels and are sent to and from J222 on the Motherboard Item 46 via the Data Comm Cable from the I O Adapter Board Item 122 in the Bottom Enclosure Assembly Item 21 The Motherboard Item 46 communicates with the Fax Modem Board Item 105 through a 14 pin IDC cable connected to the Fax Modem Board and at J224 on the Motherboard The 5 pin fax output cable connected to the I O Adapter Board Item 101 or 122 in the Bottom Enclosure Assembly Item 21 connects the external phone connection to J5 on the Fax Modem Board Item 105 NOTE The fax option is only available on units equipped with the 12 lead ECG option PORTABLE INTENSIVE CARE SERVICE MANUAL o 1 CHAPTER 7 TROUBLESHOOTING GUIDE Th
64. SYNC mode the defibrillator will not discharge without a command e R Wave signal indicated by a SYNC marker flashing SYNC indicator and an audible beep if the R wave beeper is enabled Do not use defibrillator if excessive condensation is visible on the device Wipe only the outside with a damp cloth e Use only MRL approved disposable defibrillation and pacing pads and cables e Defibrillator paddles should be kept clean and dry when not in use When preparing electrodes and during defibrillation procedures extreme care should be exercised to prevent gel or any conductive material from forming a contact between the operator and the paddles Do not allow gel or any other conductive material to form an electrical bridge between the defibrillator electrodes or to the monitoring electrodes Electrical arcing and or patient burns could occur during defibrillation Arcing and patient burns could prevent sufficient energy delivery to the patient WARNING If conductive gel forms a continuous path between the defibrillator electrodes delivered energy may be dramatically reduced to zero In this case reposition the electrodes to eliminate the shunting path before attempting additional shocks Improper defibrillation technique can cause skin burns To limit possible skin burns use only MRL defibrillation gel on paddles insure the gel covers the entire paddle surface and press firmly against patient s chest PORTABLE INTENS
65. Seal the Speaker Cable into place using Silicon Item 37 on both sides of the hole Check that there is enough length of Speaker cable in the unit to reach J105 on Motherboard Item 46 6 Replace the Chart Recorder Cover Item 20 7 Replace the Chart Recorder Item 36 8 Insert Chart Recorder Cable into Chart Recorder housing Make sure that cable is correctly seated in the connector 9 Replace four screws Item 9 to bracket attached to Chart Recorder Cable Item 53 with a 2 Phillips head screwdriver 10 Connect Speaker Cable to Motherboard Item 46 at J105 by carefully pushing on connector Lip on female connector should go under holder on male connector 11 Check that all cables are seated correctly and are clear of the sides of the unit 12 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 59 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 56 3V Coin Cell Battery 8 60 CAUTION Performing this operation will cause loss of PIC variable settings to factory defaults The preferred settings must be restored prior to returning the PIC for use REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Remove Red Cap Item 102 off of 3V Coin Cell Battery case located on the Power Supply Board Item 44 at 1 4 Lift metal holder and remove 3V Coin
66. Voice Memo Data Record 971023 P Data Record and Review Playback 971023 amp 971024 D Data Comm Package 971073 RS 232 Record 971023 and Review 971024 Available on 12 LD Units only 0 if not a 12 Lead Unit F Faxing 971019 EEC Europe 971019 US USA 971019 AUS Australia A 12 Lead Analysis 971018 Not yet available B Faxing and Analysis 971019 amp 971018 Not yet available E English Language code also designates accessory part numbers S Spanish Europe German French Italian P Portuguese U UK A Australia M Mexico Spanish North America T South Africa 2 21 Options and Accessories Options Installed Accessories 2 22 GENERAL INFORMATION The following options and accessories are available for the PIC For future reference check off which options and accessories you currently have from the information provided on the packing list Should you want to upgrade your system or purchase additional accessories please contact MRL at 800 462 0777 L 971074 Pulse oximeter L 971023 Data Card Review Record L 971024 1 971001 NIBP and Temperature 971016 0 971005 Voice Memo 0 971073 Data Comm 971008 SAED 971019 J 12 Lead optional 0 12 Lead Interpretive Analysis L 971106 Adult paddles 001790 3 lead patient cable 971108 Adult deluxe paddles L 001794 3 lead patient cabl
67. When obtaining a new supply of disposable electrodes for monitoring defibrillation or pacing verify that they will properly connect to the existing MRL cables prior to putting in service Do not use if gel is dry Hazard The MRL PIC can deliver 360 joules of electrical energy If this electrical energy is not discharged properly as described in the User Instruction Manual the electrical energy could cause personal injury or death to the operator or bystander Always verify expiration dates on dated items such as disposable defibrillation or pacing pads monitoring electrodes and battery packs If the expiration date has passed replace the disposable items immediately Biomedical equipment and accessories such as ECG electrodes cables and oximeter probes contain ferromagnetic materials Ferromagnetic equipment must not be used in the presence of high magnetic fields created by magnetic resonance imaging MRI equipment The large magnetic fields generated by an MRI device can attract ferromagnetic equipment with an extremely violent force which could cause serious personal injury or death to persons between the equipment and the MRI device Observe all PRECAUTION and WARNING labels on the MRL PIC System and Quick Charger Conditioner Hazard Care should be exercised when operating the MRL PIC and MRL Quick Charger Conditioner in the presence of oxygen sources such as near bag valve mask devices or ventilators flammable gases
68. behind the slot will illuminate indicating that the battery is being charged When the battery is fully charged the yellow light will flash to indicate it is ready for use To initiate a battery conditioning cycle 1 Insert the battery into Slot 3 Press the red push button switch on the top of the charger behind Slot 3 3 The red reconditioning light next to the push button will light indicating that the battery pack is being exercised At the end of the exercise period the charger automatically begins a normal charge cycle The yellow battery light illuminates indicating that the battery is charging When the yellow battery light begins to flash the conditioning cycle is complete The red conditioning light remains on until the battery is removed to serve as a reminder that the battery has been exercised If an additional conditioning cycle is desired press the push button again Leave the battery in the charger until the yellow battery light begins to flash again The time required for the discharge cycle to be completed varies depending on battery capacity and state of charge A fully charged SmartPak Plus battery with normal capacity requires approximately 8 hours to discharge in the reconditioning slot and a high capacity SuperPac battery requires 18 hours Partially discharged batteries require less time After the discharge portion of the reconditioning cycle has been completed the battery pack will undergo a normal cha
69. button on the front panel initiates a sequence that digitally records sound The recordings are stored in the internal log or on a PCMCIA data card if installed and can be played back The Speech Board Item 94 generates the audible voice prompts during SAED mode Speech output is routed to the Speech Board in the Top Enclosure Assembly Item 22 through J105 on the Motherboard Item 46 1 Volt Output The Motherboard Item 46 communicates with the 1 V Output through a 5 pin cable connected to J212 on the Motherboard from the IO Adapter Board in the Bottom Enclosure Assembly Ite m21 E NOTE 1 V Output option is not present on the MRL Lite model PCMCIA Interface The Motherboard Item 46 stores detailed treatment data and status information on the PCMCIA data card through the Memory Card Board Item 26 via the Memory Card Cable Item 15 connected at J207 on the Motherboard and J1 on the Memory Card Board Item 26 Software updates and configuration parameters may be programmed using the PCMCIA data card NOTE The PCMCIA data card slot is not present on the MRL Lite model PORTABLE INTENSIVE CARE SERVICE MANUAL 6 7 THEORY OF OPERATION 1 1 w i Blood Pressure Oximeter MRL Oximeter Nellcor Oximeter 6 8 The Motherboard Item 46 communicates with the Blood Pressure Board Item 92 through the Main Blood Pressure Cable Item 93 connected to J215 on the Motherboard and J4
70. charging at normal room temperature They will decrease under cooler conditions and increase under warmer conditions PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES Battery Charge Times Battery Type Typical Recharge Time 25 C SuperPac 9 to 10 hours SmartPak Plus 4 to 5 hours SmartPak 3 5 to 4 hours Acceptable Results Defibrillator charge time will typically be 10 to 12 seconds with AC power only The maximum acceptable time is 15 seconds The DEFIB TEST indicator must flash with a 200 J output but not at 150 J Thecharge indicator should begin to blink when the battery under test is fully charged Corrective Action e Verify that the AC power cord is securely connected to a properly wired power source 100 to 240 VAC While the AC Supply Paddle Tray option requires no voltage switching the Quick Charger must be set to match the available AC voltage This is accomplished by removing and repositioning the selector insert that is a part of the AC inlet on the rear panel of the charger e Itis normal for the DEFIB TEST indicator to flash only dimly at 200 J However it should be noticeably brighter at higher levels of output energy e Verify that the battery is fully seated to ensure proper battery charging Be sure that the battery under test matches the type selected from the above chart 3 Volt Lithium Battery Check It is recommended that the 3 V lithium battery
71. configuration parameters and Treatment Log data If the 3V Coin Cell Battery Item 56 is discharged or if the Power Supply Board Item 44 is disconnected from the Motherboard Item 46 the data in the static RAM will be lost and the default configuration parameters will be restored Motherboard The main microprocessor that controls the display chart recorder and front switch panel and communicates with the other modules resides on the Motherboard Item 46 The Motherboard also contains the time date clock and the battery backed up static RAM The static RAM contains configuration parameters and Treatment Log data The processor on the Motherboard monitors the battery condition and the power source and indicates the power status by displaying a battery gauge a low battery icon or an AUX power indicator in the display area The Motherboard maintains product serial number data and purchased options in non volatile flash memory The Motherboard Item 46 communicates user input to the Defibrillator Module Item 23 or Pacer via a serial bus through a 16 pin FCC Defib Main Cable Item 19 connected to J218 of the Motherboard and 78 of the Defibrillator Module The 5 VDC used to power the Defibrillator Module microprocessor and the QRS sync pulse from the 5 Lead or 12 Lead ECG Preamp Board Item 51 or 84 are also routed through the 16 pin FFC Defib Main Cable Item 19 A Pacer blanking signal is sent to the ECG Preamp Board from the Defi
72. locking mechanism and pushing in 8 Connect Defib Power Cable to Power Supply Board Item 44 at J7 by pushing down on locking mechanism and pushing in 9 Push down all 3 previous cables into the unit 10 Lift Defibrillator Module Item 23 on the side where 78 is located connect Defib Main Cable Item 19 to Defibrillator Module Item 23 at J8 by carefully pushing in cable making sure it is seated straight The blue side of the cable should face the wall of the unit 11 Press Defibrillator Module Item 23 into the unit so that is seated correctly 12 Feed Pad Pickup Cable under Defib Main Cable Item 19 and connect Paddle Pickup Cable to Paddle Preamp Board Item 277 at J1 by carefully pushing onto connector Lip on female connector should go under holder on male connector 13 Connect Speaker Cable to Motherboard Item 46 at J105 by carefully pushing on connector Lip on female connector should go under holder on male connector 8 46 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS MN 14 For EL Display connect EL Display Cable Item 71 at J2 on EL Display Adapter Board Item 89 by pushing connector into the matching notches For Color option connect Color Display Adapter Board Item 85 15 Connect Mono LCD Cable Item 35 to LCD Display Adapter Board Item 49 at J5 by very carefully lifting retaining clip with fingernails or small
73. manual or automatic from the NIBP configuration menu In AUTO mode select desired time interval Press the BUTTON next to NIBP window to START NIBP measurement During a measurement press the button next to NIBP window to stop the NIBP measurement The cuff will deflate Attach the cable to the PIC System Attach the disposable airway adapter to the Sensor Attach the airway adapter to the intubation tube Press CO button in the Quick Access menu to begin monitoring CO A Capnography trace will be displayed PORTABLE INTENSIVE CARE SERVICE MANUAL 2 19 GENERAL INFORMATION 12 Lead optional SAED optional 2 20 Connect 12 Lead ECG patient cable to the PIC System Prep patient s skin and connect electrodes to patient to monitor select lead and adjust size as necessary NOTE To acquire 10 second 12 Lead ECG sample perform steps 3 5 Press the 12 button on the quick access window Press the ACQUIRE button B to enter you into the Active 12 Lead Mode After 10 seconds the PIC System will prompt the user that is has acquisition A snapshot and real time window will appear each showing leads I IL and III The Quick Access window will have also changed to display Analysis Save Fax Print Page and Back icons Assess Patient Confirm the patient exhibits Unconsciousness Absence of breathing Absence of pulse Press POWER switch to ON Ensure Self Test passed a
74. measurement may result When monitoring blood pressure at frequent intervals observe the cuffed extremity of the patient for signs of impeded blood flow WARNING THIS DEVICE IS NOT APPROVED FOR e USE ON NEO NATALPATIENTS Donot monitor one patient s NIBP while monitoring another patient s ECG Blood pressure measurement may be inaccurate if taken while accelerating or decelerating in a moving vehicle e NIBP measurement result is questionable or motion indication is displayed repeat the measurement If the repeated measurement result is still questionable use another blood pressure measurement method Donotuse the NIBP on cardiopulmonary bypass patients PORTABLE INTENSIVE CARE SERVICE MANUAL 1 13 SAFETY INFORMATION 8 Battery Precautions Use only MRL SmartPak or MRL SuperPac batteries in the MRL PIC Use of any other battery can damage the MRL PIC and not provide sufficient power inhibiting patient care If the Low Battery indication occurs at any time during operation immediately replace the battery pack with a battery pack known to be fully charged Always have a fully charged battery pack available as a back up Due to the critical nature of all batteries replacement of the MRL batteries is recommended at 24 month intervals Proper care and maintenance of the MRL batteries is important to ensure continuous operation during patient care If the batteries are no
75. model Useonly MRL patient cables Other cables can produce excessive artifact causing an inability to interpret the ECG Useonly ECG electrodes that meet the AAMI standard for electrode performance AAMI EC 12 Use of electrodes not meeting this AAMI standard could cause the ECG trace recovery after defibrillation to be significantly delayed The type of surface electrode and the technique used in applying the electrodes are major factors in determining the quality of the signal obtained Use high quality silver silver chloride electrodes These electrodes are designed to provide excellent baseline stability provide rapid recovery from defibrillation and minimize artifacts from patient movement When attempting to interpret subtle ECG changes ST segments etc use only the diagnostic frequency response mode Other frequency response settings may cause misinterpretation of the patient s ECG See Frequency Response in chapter 13 of the PIC User Instruction Manual for more information Excessive artifact can result due to improper skin preparation of the electrode sites Follow skin preparation instructions in chapter 4 of the PIC User Instruction Manual Do not operate the PIC System in conjunction with electrocautery or diathermy equipment Such equipment as well as equipment that emits strong radio frequency signals can cause electrical interference and distort the ECG signal displayed by the monitor thereby preve
76. on the Blood Pressure Board In addition the Pump Valve Assembly Item 69 containing the pump valve and pressure sensor is connected to the Blood Pressure Board by a combination of three 2 pin cables ending in a 7 connector at 75 The Main Blood Pressure Hose Item 74 connects the patient input to the valve The temperature sensor is connected to the unit at the Input Panel Item 24 The temperature circuitry is isolated from the chassis ground The route taken by the temperature signal to the Blood Pressure Board Item 92 depends on the oximeter used If an MRL Oximeter is used the temperature signal is routed to the Temperature Ox Interface Board Item 75 and then travels via a 5 pin cable to J2 of the Blood Pressure Board If a Nellcor Oximeter is used the temperature signal is routed through a 10 pin Blood Pressure Cable Item 87 that connects to J1 of the Blood Pressure Board The PIC can be equipped with either an MRL Oximeter or Nellcor Oximeter The Motherboard Item 46 communicates with the MRL Oximeter Board Item 90 via the Main Oximeter Cable Item 91 connected to J221 on the Motherboard and J2 on the MRL Oximeter Board At J3 the MRL Oximeter Board Item 90 is connected to the Temperature Ox Interface Board Item 75 by a 7 pin cable The oximeter probe is connected to a connector in the Input Panel Item 24 The signal is then routed to a connector on the Temperature Ox Interface Board Item 75 and to J3 o
77. on the chart along with a 6 second ECG Bright Press the BRIGHT button to brighten the display area There are five brightness settings The current brightness setting is displayed on the menu Each press of the button increases the brightness of the display once the highest brightness setting 5 is reached the next press of the button returns the brightness setting to the lowest setting 1 Contrast Press the CONTRAST button to add contrast to the display There are nine contrast settings The current contrast setting is displayed on the menu Each press of the button increases the contrast of the display once the highest contrast setting 9 is reached the next press of the button returns the contrast setting to the lowest setting 1 PORTABLE INTENSIVE CARE SERVICE MANUAL 4 7 MRL LITE PROGRAM MENU SETUP eee Setup Menus The MRL Lite has several user defined options that may be set or selected from the Setup menus Access to the Setup menus is through the MRL Lite Setup option From the Setup menus users can access the Supervisor menus set the ECG Configuration options choose to print a grid on the chart recorder paper and set the current date and time MRL Lite Alarm Setup Log Sample gt oes Setup Supr EcgConf Grid Date Time Back gt gCo Freq Filter Pt Cable Back Frequency Filter Menu Patient Menu Menu Cab
78. option is not installed Review Menu If the Memory Card Review option was purchased and a valid datacard is inserted users will be able to review patient data Defibrillator and Pacer are stored on the card on the PIC display CAUTION Disabled in Card Review CONTINUE Cancel See chapter 12 in the System User Instruction Manual for instructions on how to use this option Press EXIT to return to the Recorder Configuration menu Trend Menu Use the Trend menu to record patient vital signs BP HR OX Temp Resp IBP to the internal log and printer at every trend interval If set to Off trend data will not be collected If set to On a trend event will be generated at each elapsed time interval If set to at B P a trend event will be generated each time a BP reading occurs Press EXIT to return to the Recorder Configuration menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 19 MENUS User Menus Setup Treatment Intubate IV EPI Lido Bret Sample Clear Next Recorder Display Alarms SPO NIBP Resp Recorder Set Up Back Set Up Supvsr Date Time Shift Back Enter Set Date Set Time Active Code Menu Menu Shift Menu Menu Enter Code Menu The default access code for entry to the Supervisor menus is 1 2 3 4
79. patient being administered oxygen or nitrous oxide e Use only MRL sensors and adapters e Do not reuse airway adapters that are labeled for single patient use Prior to using airway adapter check for lodged obstructions After attaching check the sensor for proper placement of the sensor e If using the CO monitor for extended critical care replace the airway adapter every 24 hours or when it becomes occlued e Do not use with patients with a low tidal volume such as patients younger than 3 years of age or weighing less than 22 pounds or patients with a respiration rate greater than or equal to 60 breaths per minute e Accuracy is based upon 1 atmospheric pressure and no residual CO gas left in the sensor from previous expiration The trace will be displayed as if that is the case PORTABLE INTENSIVE CARE SERVICE MANUAL 1 17 SAFETY INFORMATION 1 18 PORTABLE INTENSIVE CARE SERVICE MANUAL lt 2 1 CHAPTER 2 GENERAL INFORMATION This chapter introduces the MRL Portable Intensive Care PIC System It contains a product overview a general description and equipment setup summary of operation procedures for servicing the unit an explanation of the part numbering system and a list of available options and accessories system The chapter concludes with the technical specifications Chapter Overview Product Overview duc d 22 General Description PIC System
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81. same line Fax output cable not Check Fax Output Cable on 1V connected correctly Fax Output Board Item 104 590357 and connection to Fax Modem Board Item 105 590384 593384 or 595384 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 13 TROUBLESHOOTING GUIDE Power Supply Outputs To troubleshoot the Power Supply Board Item 44 check for voltage on J1 J4 on the Motherboard Item 46 as indicated below Note that PIN 1 of J1 is located next to the transformer T2 RS Motherboard Power Supply Board PIN Voltage 1 11V 0 2V 2 5V 0 2V 3 5V 0 3V 7 14 PORTABLE INTENSIVE CARE SERVICE MANUAL 1 o CHAPTER 8 REMOVAL AND REPLACEMENT INSTRUCTIONS This chapter provides the instructions for the removal and replacement of each of the various assemblies and components of the Portable Intensive Care PIC system Chapter Overview e Required Vasa rara Eo AGE AA oh 8 1 Eistof tems e eb IS 8 2 Hemoval and Replacement Instructions 8 4 WARNING Unplug the AC power cable and remove the battery e before servicing the PIC CAUTION Use only the replacement parts and assemblies recommended in this manual In many cases substitute parts may not be suitable to insure reliable performance For example the RTV sealant Item 37 called for in several procedures mu
82. set and test Failed or damaged paddle cable Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Faulty or damaged paddle set Replace paddle set and test Failure to fire in sync mode Failed or damaged paddle cable patient cable or hands free cable Check paddle set patient cable QRS not sent to defib Internal cable defective Check Main Defib Cable Item 19 550721 Motherboard circuit failure Check Motherboard Item 46 590329 or 591329 7 2 PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE 8 Artifact on ECG Damaged patient cable Check patient cable Incorrect patient cable incompatible low quality non MRL Use MRL patient cables only Poor quality electrodes Check expiration date on electrodes ECG preamp circuit failure 5 Lead Check Pre Amp Board Item 51 590328 Paddle Pre Amp Board Item 27 590343 12 Lead Check Pre Amp Board Item 84 590377 Paddle Pre Amp Board Item 83 591379 Loss of ECG signal Patient cable not connected Check patient cable Damaged patient cable Check replace patient cable Damaged hands free cable Check replace hands free cable Poor quality electrodes Check expiration date on electrodes Faulty or damaged display Check Display in Top Enclosure Item 22 See Chapter 10 ECG preamp input cable damaged
83. the door and make sure the paper moves freely through the slot after closing the door again If the chart recorder runs but nothing is printed the paper is in backwards Rotate the spool so the inside of the paper contacts the print head PORTABLE INTENSIVE CARE SERVICE MANUAL 2 17 GENERAL INFORMATION Summary of Operations CAUTION Summary of Operations should be used asa System Setup ECG Monitoring Defibrillating 2 18 reference only by those who have already read the User Instruction Manual Please read the User Instruction Manual completely before using the PIC System Press POWER switch to OFF Connect appropriate options and accessory equipment Install charged battery or auxiliary power source Press POWER switch to ON Clear log if the graph indicates a previous patient s events are in the log Verify that the configuration menus are set appropriately Connect ECG patient cable multipurpose hands free adapter or paddles to the PIC System Prep patient s skin and connect electrodes to patient Select appropriate LEAD Adjust SIZE as necessary Monitor patient s ECG with the patient cable multipurpose hands free adapter or paddles Apply gel to paddles or apply Multipurpose electrodes to patient Select energy by pressing the ENERGY up down buttons Press CHARGE button on front panel or on apex paddle deluxe paddles After the defibrillator charges to the se
84. to wait for a QRS event from the 5 Lead or 12 Lead ECG Preamp Board Item 51 or 84 The Motherboard Item 46 illuminates the Sync LED when the SYNC mode is active When the defibrillator receives a QRS event from the preamp it sends a message to the Motherboard Item 46 causing the Sync LED to extinguish for a brief period indicating that the 5 Lead or 12 Lead ECG Preamp Board Item 51 or 84 is detecting and sending valid QRS events to the Defibrillator Module Item 23 In SYNC mode the Display and Chart Recorder mark individual QRS pulses to indicate the pulses are being recognized The Defibrillator Module Item 23 or Pacer delivers constant current rectangular pacing pulses to the patient through the Hands Free Defibrillator Cable set The Defibrillator Module requires a valid connection at both the Hands Free Paddle set and the Patient cable Corrective action messages for the operator appear in the Pacer area of the display The Defibrillator Module Item 23 uses QRS events as described in the Synchronized Cardioversion section to operate in the Demand mode The operating parameters of the Pacemaker are determined by the operator and displayed in the Pacer area of the display Inthe Demand Mode the Pacer will not put out a pulse for a period of time after a QRS Event from the patient until the time inteval indicated in the rate setting has elapsed If the patient s rate is faster than the rate set for the Pacer the Pacer wi
85. 0 05 150 Hz Filter Off On On Pt Cable 3 lead 3 Lead 5 Lead Alarms IBP HR Alarms Off On Auto Off UL Disabled On 60 300 BPM by 5 s 120 LL Disabled On 20 120 BPM by 5 s 50 Automatically determined SPO Alarmst Off On 70 99 by 1 s Off UL Disabled On 60 99 by 1 s 99 LL Disabled On 85 NIBP Alarmst NIBP Off On Set Sys Set Dia Off IBP1 Sys UL Disabled On 30 250 by 5 s 160 IBP2 Sys LL Disabled On 30 250 by 5 s 80 Dia UL Disabled 25 250 by 5 5 130 Dia LL Disabled On 25 250 by 55 50 Resp Alarm Off On Off UL Disabled On 20 150 by 5 s 30 LL Disabled On 3 100 by 5 s 15 and by 1 s 15 5 Temp Alarmt Off On Off UL Disabled On 99 109 by 15 100 F LL Disabled On 85 98 by 1 5 95 F SPO t Size x 25 x 5 x1 x2 0 25 NIBPT NIBP Manual Manual Auto 1 2 3 5 10 15 or 30 5 Stat Respiration ECG Resp Setup Size X1 X2 x4 1 Speed 5 10 20 30 60 sec 30 Response Slow Normal Fast Normal Setup Size 0 20 0 40 0 80 mmHg Speed 5 10 20 sec Response Slow normal fast Trend Trend Reset 10 min 30 min 2 hr 6 hr 12 hr Recorder Print Grid On Off On Log Print Log Print Trend Stop Print Clear Log Reviewt Continue Cancel Voice Memot Play Skip Fwd Skip Bwd Stop Trends On Off On at B P 30 sec 1 2 3 5 min at B P Set Up Suprvsr Enter code reset to 0 0 9 1 2 3 4 Date Month January thru December Day 0 31 Year 99 00 01 02 03 Time Hour 1 23 Mi
86. 10 SpO connector Green 14 Annotating chart recorder E 9 Defibrillator A a release button 8 Defibrillator connector 15 Front panel 7 ECG patient cable connector 1 System power switch 6 Battery slot 2 Display 3 5 Datacard slot 1 Volt 4 or fax RS 232 output Data comm port 1 System power switch Switch for main system power 2 Display 6 5 screen that displays ECG and other parameter information 3 1 Volt output optional Provides an analog output scaled to 1V output for 1mV input signal Used for telemetry radio transmissions Fax output optional Provides fax transmission capability on 12 Lead PIC s 4 RS 232 Data com port Part of download of internal log to a computer or external device 5 Datacard slot For system upgrades data recording and configuring 6 Battery slot Accepts MRL SmartPak Plus or MRL SuperPac batteries T ECG Patient Cable Accepts 3 lead 5 lead 12 lead MRL patient Connector cables Note Only use patient cables Excessive artifact could result 8 Defibrillator connector Allows connection of external paddles hands free adapter or internal paddles PORTABLE INTENSIVE CARE SERVICE MANUAL 2 3 GENERAL INFORMATION 5 5 2 4 10 11 12 13 14 15 Defibrillator release button 5 connector optional Connector Temp connector optional NIBP connector optional Annotating Char
87. 1046 of the selected mains voltage 6 Non Invasive Blood Pressure Analyzer e Oscillometric simulation method with Luer type cuff adapter Static pressure measurement from 0 to 300 mmHg e Repeatable programmed target values for systolic diastolic MAP and heart rate 7 Pulse Oximeter Tester Integral test finger to interface with the PIC oximeter probe Automatic or manual selection of calibration curve for the PIC e Selectable oxygen saturation levels from 70 to 99 e Selectable heart rate from 20 to 250 bpm 8 IBP Transducer Simulator e FOGG System Company Inc Denver CO Model BP 28 9 Sensor and Adapter PORTABLE INTENSIVE CARE SERVICE MANUAL 5 5 PERFORMANCE TEST PROCEDURES 85 1 Safety Testing Equipment Required Acceptable Results Corrective Action 5 6 Electrical Safety Analyzer The tests recommended for routine safety checks can be readily performed with any of a number of commercially available safety analyzers This equipment provides a reasonably safe and convenient method of verifying the degree of protection against electric shock employed by the PIC Typically the analyzers can perform the following tests Caution To prevent possible equipment damage do NOT attempt to discharge a defibrillator into the safety analyzer Ground resistance power cord only because no exposed parts of the PIC are connected to protective earth Earth leakage the leakage current
88. 3 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 41 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 47 Card Cage Bracket 8 42 DISPLAY CHOICE GROMMET EL MONO COLOR OR 49 DEPENDING REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Remove Defib Main Cable Item 19 4 Remove Power Supply Board Item 44 5 Remove Card Cage Plate Item 45 6 Remove Motherboard Item 46 REPLACE 1 Replace the Motherboard Item 46 2 Replace Card Cage Plate Item 45 Use 6 32 x 1 2 screws Item 13 3 Replace Power Supply Board Item 44 Use 6 32 x 5 16 screws Item 2 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS NENNEN 4 Replace Defib Main Cable Item 19 5 Replace Card Cage Pre Assembly Item 48 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 43 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 48 Card Cage Pre Assembly 8 44 REMOVE Remove Bottom Enclosure Item 21 Disconnect Preamp Input Cable Item 32 from Paddle Preamp Board Item 27 at J2 by lifting retaining clip with fingernails or sma
89. 3114 86 31vq SLN 31 25 I 1H2 SOIM 31111 NOlLdO 13 NOILO3NNO2 13 LNOYIO 3HL X314 LON 0q 001 WALI 96 N3ll ONITIVLSNI N3HM 310 lt 330Nn INON 1 01 PLL WALI HLIM AvidSla OL 801 Wall JO Qv3g 31 34 3189035 031 35 4 38 LSNW WAL JO SMOIO3NNOO HLOG 310N 32 19 NI 13 5 NOlldO AVIdSIG q 2 101 66N6NTV2 VA SON IMV2ITN 31I 4 Spe 6 40 6 L133HS SLN 31925 111534 TIM C ED E55 v 9 V SLixvd 1 15 D 86 31vc SOIN NAVA 3OlAddS Old aun 01 21 avn s tz S8l10JDJOQD Sv Wil SI AIGWASSV 3OVO QNVO 310N NOILISOd 0434201 NI NMOHS V 19139 7701 6 NO dasn LON 6 80109 ONON 43 J3AWOM9 06 go NO S9NKN3d3Q0 MO 6 MO 68 C 1134 33S QLA M Gi 9 9 2 68 69 7 d alin Fra An T LA His ps x JM hes 9 934 NOlldO 993 61 dOL M3I 11 dO IONI SONIA Ve MET 0114600 SIND 3155 30 143 6 ON 2 8715 OXHOMOH Mos SNOUOV J
90. 34 Mono LCD Inverter Cable 8 26 e Item 35 Mono LCD 8 27 e Item 36 Chart Recorder 8 29 tem 38 Battery Board 8 30 e Item 39 Patient Input Bracket S Lead 8 31 e Item 40 Patient Input Connector Board 5 Lead 8 32 e Item 43 Backlight 8 34 e Item 44 Power Supply 8 36 e tem 45 Card Cage Plate 8 38 e tem 46 8 40 e tem 47 Card Cage 8 41 Item 48 Card Cage Pre Assembly 8 44 Item 49 LCD Display Adapter 8 48 e tem 50 Flat Panel Display Cable 8 50 Item 51 ECG Preamp Board 5 Lead 8 52 8 2 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 52 Preamp Motherboard Cable 5 Lead 8 54 tem 53 Chart Recorder Cable 8 55 tem 54 Battery Board 8 56 e Item 55 Speaker 8 58 e tem 56 Coin Cell 8 60 e tem 57 Power Switch Cable 8 61 e tem 58 Power 5 8 63 tem 68 amp 69 Blood Pressure Pump Valve Assembly and Foam Block 8 64 e Item 71
91. 57 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 55 Speaker Assembly 8 58 APPLY SUPER GLUE TOP PIC ITEM 22 AS NECCESSARY RIV ITEM 123 TO SURFACE OF NOTE Requires Silicon RTV 37 and Super Glue 123 c REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Speaker Cable from Motherboard Item 46 at J105 by carefully pulling on connector 3 Remove four screws Item 9 from bracket covering Chart Recorder Cable Item 53 with a 2 Phillips head screwdriver 4 Remove Chart Recorder Cable Item 53 by rocking it back and forth while pulling out May require some force 5 Remove Silicon RTV from around Speaker cable 6 Remove Chart Recorder Item 36 7 Remove Chart Recorder Cover Item 20 8 Remove Silicon RTV from around Speaker Assembly Item 55 9 Remove Speaker Assembly Item 55 from the unit REPLACE 1 Feed Speaker Cable into the hole in the Chart Recorder housing 2 Attach connector body to wires using Super Glue 3 Place Speaker Assembly Item 55 with Speaker toward PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS the top of the unit in between the Chart Recorder Seal Item 7 and the plastic housing 4 Seal the Speaker Assembly Item 55 into place using Silicon RTV Item 37 5
92. 590328 12 Lead Item 84 590377 Loss of display or lines on display Display cable faulty or disconnected Check Display Cable Flat Panel Item 50 550726 EL Item 71 550711 Mono LCD Item 35 550753 Color Display cable glued to Color Display Board Assembly Item 71 550711 Faulty display adapter board Check Display Adapter Board Color Item 85 590373 EL Item 89 590341 Mono Item49 590382 Damaged or faulty display Check display part of Top Enclosure Item 22 See Chapter 10 Motherboard circuit failure Check Motherboard Item 46 590329 or 591329 PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE Error Messages The following table lists the PIC system error messages Probable causes and suggeted corrective actions are included for each error message E NOTE EXE Where possible item and part numbers are included with the corrective action If needed see Chapter 10 to obtain a specific part number for an item that is associated with multiple part numbers Error Message Probable Cause Corrective Action xxx button fail Faulty or damaged front panel Check Switches on Front Panel of Top Enclosure Item 22 See Chapter 10 Front panel motherboard cable faulty or disconnected Check Front Panel Cable Item 31 550730 Motherboard circuit error Check Motherboard Item 46 590329 or 591329 Ox Comm Fai
93. 65 Attach over Serial Number Label Item 64 Add maintenance log label Item 63 from label kit Item 65 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 11 REMOVAL AND REPLACEMENT INSTRUCTIONS E J Item 22 Top Enclosure Assembly REMOVE 1 Remove Input Panel Item 24 2 Remove AC Supply Paddle Tray Module Item 17 3 Remove Bottom Enclosure Item 21 4 Remove Card Cage Pre Assembly Item 48 5 Remove Defibrillator Module Item 23 6 Remove Paddle Preamp Shield Item 29 7 Remove Paddle Preamp Board Item 27 8 Remove Barrier for Paddle Preamp Board Item 28 9 Attached to Preamp Board for 12 Lead option Remove Chart Recorder Item 36 10 Remove Chart Recorder Cable Item 53 REPLACE 1 Replace Chart Recorder Cable Item 53 2 Replace Chart Recorder Item 36 3 Replace Barrier for Paddle Preamp Board Item 28 8 12 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS NENNEN Replace Paddle Preamp Board Item 27 Replace Paddle Preamp Shield Item 29 Replace Defibrillator Module Item 23 Replace Card Cage Pre Assembly Item 48 DO iv Check that cables are seated correctly in connectors and are clear of the sides of the unit 9 Replace Bottom Enclosure Item 21 10 Replace AC Supply Paddle Tray Module Item 17 11 Replace Input Panel Item 24 PORTABLE INTENSI
94. 7 PIC 12 lead Color TFT 571616 971042 PIC 5 lead Mono LCD 570607 972013 PIC 5 lead Color TFT Foreign 571607 972027 PIC 12 lead Color TFT Foreign 571616 10 2 PORTABLE INTENSIVE CARE SERVICE MANUAL SERVICE PART NUMBERS 85 1 5 B Item 23 Defibrillator Module MONOPHASIC PIC MRL Lite Base Part Number Item 23 Part Number 971039 596327 971077 596327 971078 596327 971079 596327 971080 596327 971087 596327 971088 596327 BIPHASIC PIC 2 MRL Lite 2 Base Part Number Item 23 Part Number 971081 597327 971082 597327 971083 597327 971084 597327 971085 597327 971086 597327 972039 597327 High Voltage BIPHASIC PIC 2H MRL Lite 2H Base Part Number Item 23 Part Number 971081 2H 597405 971082 2H 597405 971083 2H 597405 971084 2H 597405 971085 2H 597405 971086 2H 597405 972039 2H 597405 PORTABLE INTENSIVE CARE SERVICE MANUAL 10 3 Item 24 Input Panel SERVICE PART NUMBERS Base Part Number Description Item 24 Part number 971039 MRL Lite 570617 All others PIC PIC Monitor See below Order the specified part number for Item 24 based on whether the SpO NIBP Temp or IBP options are installed in the unit If your input panel has colored connectors specify 570618 NOTE Y Yes N No Suffix G Gray Y Yellow SpO5 SpO
95. 84 by pulling on the cable 3 Disconnect 12 Lead Preamp Protection Cable Item 81 at J3 of the 12 Lead Paddle Preamp board Item 83 by pulling on the cable REPLACE 1 Connect 12 Lead Preamp Protection Cable Item 81 at J3 of the 12 Lead Paddle Preamp Board Item 83 by pushing the cable into the connector the insulated side of the cable should face up out of the unit 2 Connect 12 Lead Preamp Protection Cable Item 81 at J2 of the 12 Lead Preamp Board Item 84 by pushing the cable into the connector the insulated side of the cable should face the 12 Lead Preamp Board Item 84 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 69 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 82 12 Lead Motherboard Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect 12 Lead Motherboard Cable Item 82 at J5 on 12 Lead Preamp Board Item 84 by pulling on cable 4 Disconnect 12 Lead Motherboard Cable Item 82 at J104 on Motherboard Item 46 by pulling on cable 8 70 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE 1 Connect 12 Lead Motherboard Cable Item 82 at J104 on Motherboard Item
96. AL 8 21 REMOVAL AND REPLACEMENT INSTRUCTIONS 85 1 2 Connect Pacer Panel Cable Item 30 to Motherboard Item 46 at J211 by lifting retaining clip with fingernails or small instrument placing cable into the connector checking that cable is seated straight and pushing down on the retaining clip the insulated side of the cable should face the back of the retaining clip 3 Connect the Preamp Protection Cable Item 32 or 81 to the Paddle Preamp Board Item 27 or 83 4 Replace Memory Card Board Item 26 if option was installed Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 8 22 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 31 Front Panel Cable NOTE 12 Lead shown REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Memory Card Board Item 26 if option installed 3 Disconnect the Preamp Protection Cable Item 32 or 81 from the Paddle Preamp Board Item 27 or 83 4 Disconnect Front Panel Cable Item 31 from Motherboard Item 46 at J108 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable 5 Disconnect Front Panel Cable Item 31 from Top Enclosure Assembly Item 22 by lifting retaining clip with fingernails or smal
97. Analys Biphas Fax Back Active Shift Menu The Active Shift menu allows the SEU supervisor to select and save PIC configurations for use by specific shift It also allows loading from and saving the log to a memory card Save As 1 Save As 2 Save As 3 Save to Card Load from Card Exit 3 30 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Treatment Setup Menu Unit ID Set Code Menu Printer Options Y Button 1 The default access code for accessing the supervisor menus is 1 2 3 4 set a new supervisor code enter a number of your choice 0 9 in all four number areas Press CANCEL to cancel the number code selection Press ENTER to save the new code NOTE Be sure to write down the new The Treatment Setup menu allows the supervisor to choose and customize the bottom treatment summary menu window buttons Press the UP and DOWN arrow buttons to scroll through the available options The Unit ID menu allows the supervisor to set unit and department IDs This information is printed in the System On heading on the chart recorder Cancel Enter supervisor passcode and store it ina safe place Alarms Trending Defib Pacer Treatment Miscellaneous Ex
98. BLE INTENSIVE CARE SERVICE MANUAL 2 29 GENERAL INFORMATION QpC 409JC OO AO Pulse Oximeter optional Blood Pressure optional 2 30 Resolution mmHg Respiration Range 2 60 bpm Apnea Indication 20 seconds CO2 level 5 mmHg Measurement Range 31 to 99 Heart Rate Range 30 to 250 BPM x 5 or 5 BPM whichever is less Accuracy 81to 99 296 70 to 80 396 0 to 69 unspecified Update Period Every pulse after 4 valid pulses Messages Check Probe Searching Signal OK No Signal Low Perfusion Alarms Enabled Disabled icon Testing Alarm Limits 60 lower limit 70 upper limit to 99 Probe Finger or multi site probe Technique Non invasive oscillometric method referenced to auscultatory standard using the 5th Korotkoff sound as the diastolic reference Operating Modes Automatic and manual Initial Cuff Inflation Adult and child 154 mmHg Infant 125 mmHg Automatic Cycle Times 1 2 3 5 10 30 minute intervals Blood Pressure Range Systolic 30 to 245 mmHg diastolic 10 to 210 mmHg Heart Rate Range 30 to 250 BPM 10 or 5 BPM Blood Pressure Accuracy 5 mmHg mean error 8 mmHg standard deviation PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 1 Blood Pressure Validation Blood pressure measurements determined with this device are equivalent to those obtained by a trained observer using the cuff stethoscope auscultation meth
99. CE MANUAL 9 1 S NT 0066000NONOVONNSONIMVHON 4 a J 009600 16 9 6 31vd Sid WvHOvId 193NNOOM3INI suu S3ldOIVNOBVI HOYVESSY TqVOIQO3IA 81430 vHdIS O3S 3 4 lt 2 023 10 4 Q121 SNO 1dO AVIdSIC Bro 023 66 02 8 SA3GNAN BOJ93NNCO 3L1vdadn 9 024 16 1071 3SV3 134 VILIN L6 91 6 12006 S3 LS3ANI IHOIDIOVE 822006 7TBNVd 1913 131 60902 Av1dS10 TaNvd 1v 13 Qqdvog8 YHLOW 193NNOOS3LNI 3L13AIXO THN Ir L 3uD8d MIL SOINDMLYGdAH X310N NId Z 344 06 055 2335 18 01 62 lt 064 QNVO8H N3HLON 011235 14510 Ntd 91 XIN SSE NId 2 2944 4 9 12 169 ONON 2 06S 233 NIJ 91 M3ovd G8l33Q 2 0 lt 22964 Onon 68 vHdla ASSY 9430 84 lt 066 dWVadd 334 442065 AVIAT Nogai 141 WD NId 89 l X31UN NId S 9 v22 8 6 782666 8 0 NOSST4 201 NIJ 01 Nid 9 3UIM 5 ININ Nid 5 Ee osse LOANNOOYALNI Old 3SOH Aino MION 4 Gma AVIODIN 3T La T3NVd ANNOIN 3BOHd 185063 AVION 202 ANDIN Nd Z N3385 3BONd Nid 9 ANNE IN3 1Vd LIEDES er 343 1 602055 T 0S40SS 314 NId a2 AVTDOIN Nid cT INANI 1N3 LVd LH ININ
100. Card Board Item 26 3 Disconnect Main Memory Card Cable Item 15 at J1 by pulling up on connector 4 Disconnect Fax Output Cable at 5 of Modem Board Item 105 and 1 V Output Cable at J212 of Motherboard Item 46 if Fax Modem and or 1 V Output option is installed 5 Disconnect Main Memory Cable Item 15 at J207 on Motherboard Item 46 by pulling up on connector REPLACE 1 Connect Main Memory Card Cable Item 15 at J207 on Motherboard Item 46 matching notches 2 Connect Fax Output Cable at J5 to Modem Board Item 105 and 1 V Output Cable at J212 to Motherboard Item 46 if Fax Modem and or 1 V Output option was installed 3 Connect Main Memory Card Cable Item 15 at J1 on Memory Card Board Item 46 matching notches 4 Replace Memory Card Board Item 26 in unit with J1 facing into the unit line up holes and fasten with screws Item 5 5 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 17 AC Supply Paddle Tray Module DETAIL 10 AUXILIARY POWER CONNECTOR ONLY PRESENT IF ITEM 17 IS INSTALLED REMOVE 1 Remove Input Panel Item 24 2 Remove one screw Item 4 from Auxiliary Power Con
101. E side of the cable should face the outside of the Motherboard Item 46 Replace Card Cage Pre Assembly Item 48 4 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 51 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 51 ECG Preamp Board 5 Lead 8 52 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Preamp Input Cable Item 32 from ECG Preamp Board Item 51 at J3 by pulling on cable 3 Disconnect Preamp Motherboard Cable Item 52 from ECG Preamp Board Item 51 at J2 by pulling on cable 4 Lift ECG Preamp Board Item 51 out of the unit by the white handle NOTE Hold card cage down when pulling preamp board out of card cage WARNING DO NOT touch preamp board with fingers or tools because of contamination and ESD REPLACE 1 Carefully slide ECG Preamp Board Item 51 into Card Cage Pre Assembly Item 48 along two rails making sure that the handle faces Motherboard Push in until movement stops and ECG Preamp Board Item 51 is flush with Card Cage Pre Assembly 2 Connect Preamp Motherboard Cable Item 52 to ECG Preamp Board Item 51 at J2 by pushing in cable the blue side of the cable should be face ECG Preamp Board 3 Connect Preamp Input Cable Item 32 to ECG Preamp Board Item 51 at J3 by pushing in cable the bl
102. E MANUAL PERFORMANCE TEST PROCEDURES 12 Lead ECG Data Acquisition and Fax ModemTest Equipment Required Procedure Acceptable Results Corrective Action Perform this test only if the PIC to be tested is equipped with the 12 Lead ECG option 971026 and 971027 If the PIC also has the fax modem option 971019 test the fax modem function NOTE Fax transmission requires the use of an approved telephone link Do not alter telephone numbers and other information programmed by the equipment user during this procedure Either obtain permission to use a programmed fax number or enter any other authorized number in an unused User Dial menu location 12 Lead ECG Simulator Connect the PIC 12 Lead ECG cable to the ECG simulator Adjust the simulator according to its operating instructions to generate a 12 lead test signal Set the rate and amplitude to any typical value such as 1 mV and 60 bpm Turn on the PIC and use the LEAD SELECT control to verify ECG pickup on all 12 lead settings Refer to the operating instructions for detailed information on 12 lead Quick Access menu selections Use the Patient ID menu selections to label the activity as a test Use the ACQUIRE command to obtain a 12 lead snapshot Select the Printer icon to document test results If the equipment under test has a fax modem it can be checked by selecting the telephone icon As indicated above use of this option required an approved telephone
103. EM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS urere REPLACE 1 Place Patient Input Connector Item 40 in the unit so that it fits through the hole 2 Insert Patient Input Connector Tool Item 127 into ECG Patient Cable Connector with the key at the top of the unit 3 Push in and slightly up until a click is heard and Patient Input Connector Board Item 40 fits into place 4 Place O ring Item 60 around Patient Input Connector Board Item 40 on the outside of the unit Attach the ECG Label Item 59 on the outside of the unit Replace Patient Input Bracket Item 39 Replace Paddle Preamp Board Item 27 Replace Paddle Preamp Shield Item 29 Replace Card Cage Pre Assembly Item 48 Sp po c A 10 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 11 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 33 REMOVAL AND REPLACEMENT INSTRUCTIONS J Item 43 Backlight Inverter DISPLAY BACKLIGHT 9 CABLE m 3 4 Y 4 9 NOTE Requires foam tape Item 10 from Fastener Kit Item 16 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect LCD Inverter Cable Item 34 from Backlight Inverter Item 43 at by pulling wires out of the connector 3 Disconnect Display Ba
104. EMENT INSTRUCTIONS OO 1 11 11 1 11 1 1 1 1 8 Item 85 Color Display Adapter Board 44 46 J5 J6 J4 J215 NOTE Item 85 may also include the Color Display Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect Display Power Supply Cable to Power Supply Board Item 44 at J4 by pulling on connector 4 Disconnect Flat Panel Display Cable Item 50 at J4 on Color Display Adapter Board Item 85 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable 5 Disconnect the Color Inverter Cable Item 109 at J2 on the Color Display Adapter Board Item 85 by carefully pulling the connector out 6 Remove two screws Item 5 from Color Display Adapter Board Item 85 with a 1 Phillips head screwdriver 7 Lift Color Display Adapter Board Item 85 off Card Cage Pre Assembly Item 48 REPLACE 1 Position Color Display Adapter Board Item 85 on the side of the Card Cage Pre Assembly Item 48 so that J1 is near Motherboard Item 46 8 76 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 2 Replace two screws Item 5 of the Color Display Adapter Board Item 85 using a 1 Phillips head screwdriver 3 Connect Flat Panel Display Cable Item 50 at J4 by lifting retaining clip with fingernails or small instrument placing cable
105. ENSIVE CARE SYSTEM SERVICE MANUAL 8 39 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 46 Motherboard DISPLAY CHOICE GROMMET EL MONO COLOR OR 49 on DEPENDING ON CAUTION Performing this operation will cause loss of PIC variable settings to factory defaults The preferred settings must be restored prior to returning the PIC for use Purchased options will also be lost NOTE Re order number598329 for PIC PIC 2 PIC 2H and PIC Monitor Order 599329 for MRL Lite The new Mother Board will come pre programmed with a unique serial number Contact factory to obtain upgrde codes REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Remove Defib Main Cable Item 19 4 Remove Power Supply Board Item 44 5 Disconnect Preamp Motherboard Cable Item 52 from Motherboard Item 46 at J217 by pulling on the cable or 12 Lead Motherboard Cable Item 82 at J104 8 40 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OEE 6 Disconnect Flat Panel Display Cable Item 50 from Motherboard Item 46 at J220 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable 7 Disconnect Main Blood Pressure Cable Item 93 8 Remove Speech Board Item 94 9 Disconnect Main Oxim
106. Failure of charge switch on front panel Check Charge Switch on Top Enclosure Item 22 See Chapter 10 Front panel motherboard cable connector faulty or damaged Check Front Panel Cable Item 31 550730 Failure of charge switch on paddle set damaged paddle set Check paddle set Failure of paddle set cable connector Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defibrillator circuit error Check Defibrillator Module Item 23 596327 or 597327 Motherboard circuit error Check Motherboard Item46 590329 or 591329 Motherboard defib communications error damaged or faulty cable Check Main Defib Cable Item 19 550721 System does not recognize paddle set Connect Paddle warning message on main display Confirm use of MRL paddles Check that paddle set connector is properly seated Delivers low energy Defibrillator circuit error Check Defibrillator Module Item 23 596327 or 597327 Unable to set defibrillator energy Improper energy setting Damaged cable or connector Check Front Panel Cable Item 31 550730 Improper energy setting Damaged energy switch on front panel Check Select Energy Switch on Top Enclosure Item 22 See Chapter 10 Failure to deliver energy Defibrillator circuit error Check Defibrillator Module Item 23 596327 or 597327 Discharge fire switch failure Replace paddle
107. IBP reading is 200 2mmHg Change the transducer simulator setting to 200mmHg Verify that the IBP reading is 200 2mmHg IBP readings on the display must not differ from those specified in the above procedure Verify the accuracy of the IBP transducer simulator setting If the IBP readings are still not within tolerance check the BP Board Item 92 PORTABLE INTENSIVE CARE SERVICE MANUAL 5 25 PERFORMANCE TEST PROCEDURES 85 8 j Performance Test Equipment Required Sensor and Adapter Procedure 1 Turn unit on and turn CO on by toggling the CO button on the Quick Access menu 2 Connect the CO probe to the CO input 3 Breathe into the CO sensor at a normal rate Acceptable Results Display should show CO trace and numerical reading Typical numerical readings are 36 38mmHg Corrective Action Verify CO is on and correct display settings e If CO trace or readings do not display check the CO Ox Main cable Item 91 CO Ox board Item 103 5 26 PORTABLE INTENSIVE CARE SERVICE MANUAL CHAPTER 6 THEORY OF OPERATION This chapter presents the theory of operation for the MRL PIC system The system is described in terms of its main assemblies Chapter Overview QUAM Us ates a CR Reged eA 6 1 Power Distribution 6 2 hae a e
108. IMVEC 22 31310395 SI 100126 280146 8Z01Z6 LINN Qv31 S q 2 101 66N6NTV2 VA SON IMV2ITN 3 31I 4 351 6 JO v 5 SLN 31 25 Z Q 6 6 11 0 4 Sere 86 SOR IMIN NAVA 3OlAddS Old au 59 101080 U2JD9S8J TYW 2 1 8 133HS 33S 140 5 NOILO3NNOO 1 51 13 12 M34SNVML 9 133 lt SIHL NO H33uvg 3809235 L WVYSVIC 33S 2 Wiad NOILO3NNOO L WWisd 335 318V9 N3O00W XNJ NNOILLdO 345 NOLLO3NNOD NIVW 8133d N3dO H3lHNvB8 NOIL23NNOO 2313 HWIXO 59 89 NOLLO3NNOO LNdNI dnd 3109 goo 3QIS 9 vaq 33S 1 1 335 0950 3100 EL I E 2 5 maL SNOILOANNOD 701 WSL OL NOILOANNOD LNdNI 923 2429 Ind Al IUP NSE E9 Q i 0315419345 LON SI 100176 NOlldO 4 QTTIVISNI LZ er fm z EE n Wa pis A ES pe A eee II AYNSOTONA WOLLOG S9NIOVId3M 3H0438 SJJOQNVIS Q3NOILISOd ATd3dO3Sd 3H 15 S310H 31nGQONW 813309 3LON NOLLO3
109. IVE CARE SERVICE MANUAL 1 9 SAFETY INFORMATION E j Disposable defibrillation electrodes must be used in accordance with the manufacturer s instructions Do not use expired dry electrodes or reuse disposable electrodes as improper patient contact may result in patient burns and inability of the device to function properly e The device contains an automatic disarm of the capacitor bank If the operator has not delivered the charge to a patient or test load an internal timer will disarm the capacitor bank 1 minute in manual mode and 30 seconds in SAED Basic or SAED mode after the ready charge signal The ready charge signal is indicated by a continuous audible tone and the energy availability graph displayed on the monitor Ifanew energy level is selected after the charge button is pushed and while the defibrillator is charging defibrillator will automatically charge to the new energy selection The CHARGE button need not be pressed again to select the new energy level Disconnect from the patient any medical electronic device that is not labeled defibrillation protected Before charging the defibrillator verify that the energy selected on the display is the desired output Some erythema of the skin and or minor burns may occur during defibrillation Use proper defibrillation techniques as outlined in the User Instruction Manual to minimize erythema burns External Pacing Precautions Defibril
110. IdSIG 13 102068 68 ASSY QNVOH os NIVA XO 219 318 2 2 06 16 34nsS3Md 00018 ASSY ddd 9069 z6 NwM de Old 780 56 23345 ASSY 83d srcoss e v9 08 0 9141 Avidsida Wal 30 14 6 1 yalaani ezzoos 96 old AVA 080099 2 OhBvi aNO2 3dvi 91 40 96 XO MOOTIN 4 699049 66 1 13 AVIdSIC Old i3iHs zz JO 1d 001 aa Gv Ol old iz WAL 101 08 1 ousvid eseos i 204 NOuviOs xo zoo 065066 wildv v 01 Old 17 14 W3OOW Xv3 Ob dvHO 335 a1Qwd 931 21 aava 9009 90 AMOWGA sevoog 1450 30102 67005 801 Java NDIO3NNOJ vd Old on 13 add 0906 NOISNAL add 809061 Ond WA JO il 91 wau 30 1d 0 90 234 ALINN 56006 OL 210 onw cit Old ON weas S9 Wil 30 lef git 1 2 Od OJA3H 56006 en 96 21026 VONA MGISNVUL 3NS3HXOV 3dvl 91 Wall 30 1d 11 OG Qv Ol Old 12 14 zzi i amo Wis ezi
111. NG Never position defibrillator paddles very close to or over ECG electrodes or jewlery Severe burns may result from improper contact of defibrillator paddles Before using defibirllator consult operating instructions for proper procedures After a synchronized cardioversion the SYNC mode may be cleared after each shock or disarm The user may have to reselect press the SYNC switch after each synchronized cardioversion shock performed on a patient The PIC can be configured in the Supervisor Defibrillation Set up menu to remain in the SYNC mode after each synchronized cardioversion PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION e Synchronized cardioversion can be performed in the paddle monitoring mode However it is possible that artifact can be produced by the moving paddles which could cause the defibrillator to trigger on the artifact It is recommended that monitoring in leads I II or III be used during synchronized cardioversion Paddle monitoring should not be used for elective cardioversions procedures To avoid stress to the defibrillator or the tester never attempt to repeatedly charge and discharge the defibrillator in rapid succession If a need for repetitive testing arises allow a waiting period of at least 2 minutes for every third discharge Monitoring ECG through the paddles may result in inaccurate heart rate display due to artifact Inthe
112. NNOO M3MOd 830 9 INLS0 33S 9 ISSHS 2 335 NOLLJ3NNO2 NOLLJ3NNOO QNVOS AN3llV8 9 Bv 6 133 5 338 NASAAN 03141035 SI 1001 6 NOLLdO Q3TIVISNI 830 NO 15 3 SNOILdO 71 SGNIONI SONIMVAG ino 81 39 me PSU 780146 080126 LINn 0 31 21 2 Or ISSUE D CN CO C C Q V 9 E O U O U BARRIER FLAP OPEN DETAIL 5 SHEET 5 OF 9 N lt in 1 z 5 IN z on 2 5 2 Horra 4 5 28 8 Fri eS FT 2 Eo EE 2 A 25 25 ol E ee 8 o amp E m amp zu T 2 E ig E 212 ra 5 lt Liz 2 Ooze Bc a 2 559 gt x C ug ao man 5 mz 2 CZ E 2 x E amp AG 25 E Boo 2 BS Qo gt F1 Be Ea c uS DRAWINGS INCLUDE ALL OPTIONS MONITOR NO DEFIB 971044 v 6 li 2 55 N az 12 29 14 d 55 Im 5 25 gt gt a 2 ii gt xam mi id 556 9 2 uz o 96 5 zo o uo Ed aw 2 a g o ey e gt gt go T uo ECG I
113. NPUT CONNECTION DETAIL 3 2 m m lt m i in e O lt DETAIL 2 DETAIL 1 WITHOUT SHIELD p 2 T0166N6NQV29 VNSONIMV3IN 3 1I 3 Jd 6 40 9 133HS ZLO 66 1 4 I 24H23 UN 13Vd 00 10 salva W navaa 3OlAddS Old JILIL OUl 59 101080 U2JD9S98J an18 MOTTSA 3LIHM 3MIM 034 JMM N3 2 73A SWVYOVIC NOILO3NNOO NOILO3NNO2 NOLLO3NNOD ARG NOILO3NNOO dB a m a nr i p T e Ur i A e ACh Pd E nA 1H 2 2 4 Ef D 1 d TT LJ amp Zn 9r MALOLO JN X xu E uc ONILNOY eS SL 40 5 1N3M344K ILON 1N3H31dI ALON 1 383441 ALON was e G v e 2001 6 NOILdO 1 q 2 101 66N6NTV2 VA SON IMV2ITN 31I 4 Anse 6 40 L133HS SLN 31 25 E GLOVES UN 1994 00 10 ave W NAYA ONIMYXU 3OlAddS Old aun 2 591101021090 9109591 NOILO3NNOO 1 4101 90 Ip 29 1H9 PONE gv vg
114. NS E jJ Item 50 Flat Panel Display Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect Flat Panel Display Cable Item 50 from LCD Display Adapter Board Item 49 at J1 or from Color Display Adapter Board Item 85 at J4 and from EL Display Adapter Board Item 89 at J1 by lifting retaining clip with fingernail or a small instrument and pulling out cable 4 Disconnect Flat Panel Display Cable Item 50 from the Motherboard Item 46 at J220 by lifting retaining clip with fingernail or a small instrument and pulling out cable REPLACE 1 Connect Flat Panel Display Cable Item 50 to Motherboard Item 46 at J220 by lifting retaining clip with fingernail or a small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should be facing the outside of Card Cage Pre Assembly Item 48 2 Connect Flat Panel Display Cable Item 50 to LCD Display Adapter Board Item 49 at J1 or to Color Display Adapter Board Item 85 at J4 and to EL Display Adapter Board Item 89 at J1 by lifting retaining clip with fingernail or a small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip The blue 8 50 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OE
115. Nid Od xnv anaa o Wa A33LLN8 712005 5 u3MOd SISSVHO IAC CT0T66N6NIV2 VNSSEN IAV2ITN 3 13113 6 JO L33HS 3nSSI SIN aos 6 0166 oniwa Ou 10 1 65 v 1L 66 30 86 11 3OlAddS Old au NO HN 79510 ONOM aay 69 0 023 S3 9 S 110 010Q0 2109592 AL lb _ Noudmosid TUN x ze 9 WAS Hdd 3u9s 91 8 S Hdd 91 5 x 26 9 maxas 91 Mall 430 z sss udWl ss 1 8 exze 9 91 SHdd X Ov y MANOS 9 Will JO 6 OF 900 MANOS 9 33dN0O3N Old Was Wil JO 6 sio 9r Wall 40 9 w8 ex9 W3aH05 9 30 ld 6 wg yt Gags 1804 9 Wall 1d Or X Ov v00 Hdd 5 9L Will Z L X 22 9 Hdd MWS 9L Will 40 Ld 5031 310444 Gavi s9 au S6dd Gv AMOW3N 90 0565 TINGOW AVHL 29 620146 OMVOH zoo mava 69 055 8 NIVA BIJ3 Old 318v2 12406 u3QqNOO3H8 oz 19 1 z x y 34n801oN3 dOL Assv 01 335 zz Ol 33S S9 Mil 40 14 62 davoga
116. Paper the display when the chart paper is empty or the chart recorder door is not closed properly Swing door Release lever Free end of paper on top When inserting the paper roll the free end should be over the top of the roll Roll in chart recorder with swing door closed NOTE The low paper indicator is signified by a black or red strip at d the top of the chart recorder paper When the indicator appears approximately 8 feet of paper is left on the roll 2 16 PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION LOADING CHART PAPER 1 Open the door by pushing on the release lever located on the side of the chart recorder 2 Remove the empty spool core Place the new roll of ECG paper with the free end of the paper on top of the roll Insert the new spool until it snaps onto the spool retaining arms The spool should be positioned so the inside or shiny side of the paper contacts the thermal array print head The spool should feed paper from the top 3 Pull out approximately 27 3 of paper and bring the free end of the paper around to the front of the swing out door then completely close the door 4 With the power switch on press the chart recorder button and allow the paper to feed through the roller automatically NOTE If icon flashes the display the paper is probably not s moving freely through the slot in the door or the door is not completely shut Open
117. REMOVE Remove Bottom Enclosure Item 21 2 Remove the Card Cage Pre Assembly Item 48 3 Remove the Motherboard Item 46 4 Remove Speech Board Item 94 from the Motherboard Item 46 by carefully lifting Voice Memo Board up separating it from J210 and the post REPLACE 1 Replace Speech Board Item 94 by securing it on J210 of the Motherboard Item 46 and snapping on to the post 2 Replace the Motherboard Item 46 Replace the Card Cage Pre Assembly Item 48 4 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 8 86 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 96 Dual Backlight Inverter P a EN N EN NW BACK VIEW OF ITEM 96 NOTE Requires Foam Tape 10 from Fastener Kit REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove the Color Display Shield Item 100 3 Disconnect Color Inverter Cable Item 109 at CN1 on Dual Backlight Inverter Item 96 by pulling the cable out from the connector 4 Disconnect both Display Backlight Cables from Dual Backlight Inverter Item 96 at CN2 and CN3 by pulling the cable out from the connector 5 Usea flat blade to remove the double sided foam tape Item 10 off unit REPLACE 1 Secure Dual Backlight Inver
118. SIVE CARE SERVICE MANUAL OEE Item 39 Patient Input Bracket 5 Lead 8 31 Item 40 Patient Input Connector Board 5 Lead 8 32 Item 43 Backlight 8 34 Item 44 Power Supply 8 36 Item 45 Card Cage 8 38 Item 46 Motherboard eee 8 40 Item 47 Card Cage Bracket 8 41 Item 48 Card Cage Pre Assembly 8 44 Item 49 LCD Display 8 48 Item 50 Flat Panel Display Cable 8 50 Item 51 ECG Preamp Board 5 Lead 8 52 Item 52 Preamp Motherboard Cable 5 Lead 8 54 Item 53 Chart Recorder Cable 8 55 Item 54 Battery Board 8 56 Item 55 Speaker Assembly 8 58 Item 56 Coin Cell Battery 8 60 Item 57 Power Switch Cable 8 61 Item 58 Power Switch sess 8 63 Item 68 amp 69 Blood Pressure Pump Valve Assembly amp Foam Block
119. Service Manua MRL Pic System MRL PIC Monitor P N 991011 Rev Portable Intensive Care System SERVICE INSTRUCTION MANUAL Models PIC PIC 2 PIC 2H PIC Monitor MRL Lite MRL Lite 2 MRL Lite 2H Medical Research Laboratories Inc 1000 Asbury Drive Buffalo Grove Illinois 60089 847 520 0300 Telephone 800 462 0777 Toll Free 847 520 0303 Fax www mrlinc com Internet info mrlinc com E mail 1998 1999 2000 2001 Medical Research Laboratories Inc All rights reserved Printed in the U S A MRL Part Number 991011 MRL PORTABLE INTENSIVE CARE SERVICE MANUAL Foreword User s Responsibility Manufacturer s Responsibility This manual is intended to provide information for the proper servicing of the MRL PIC DO NOT ATTEMPT TO USE THIS EQUIPMENT WITHOUT THOROUGHLY READING AND UNDERSTANDING THESE INSTRUCTIONS The user is required to be trained in basic monitoring vital signs assessment and emergency cardiac care The user should be completely knowledgeable of the information in the User Instruction Manual As with all other electronic patient care monitors good clinical judgment should be used when operating the MRL PIC User must save all shipping containers and packaging materials When shipping the PIC System and accessories for calibration service or upgrades the original shipping containers and packaging materials must be used Medical Research Laboratories Inc MRL
120. VE CARE SYSTEM SERVICE MANUAL 8 13 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 23 Defibrillator Module 8 14 CAUTION Defibrillator module may maintain high voltage on capacitor bank REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Defib Power Cable from Power Supply Board Item 44 at J7 by pushing down on locking mechanism and pulling out 3 Disconnect Defib Out connection by pushing down on lock and pulling apart connectors 4 Disconnect Pad Pickup Cable from 5 Lead Paddle Preamp Board Item 27 at J3 or 12 Lead Paddle Preamp Board Item 83 at J1 by carefully pulling on cable 5 Lift Defibrillator Module Item 23 on the side where J8 is located Disconnect Defib Main Cable Item 19 from Defibrillator Module Item 23 at J8 by pulling out cable 6 Disconnect Defib Paddle Connector Cable from Defibrillator Module Item 23 at J11 7 Remove Defibrillator Module Item 23 from unit PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE Connect Defib Paddle Connector Cable to Defibrillator Module Item 23 at J11 2 Hold Defib Paddle Connector Cable against the side wall of the unit and slide Defibrillator Module Item 23 into the unit along the 2 rails Defibrillator Module Item 23 should slide in easily and should be a loose fit when in the unit 3 Lift Defibrillator Module Item 23 a little bit on the side where J8 is
121. able Item 57 to Power Supply Board Item 44 at J6 by carefully pushing on connector Lip on female connector should go under holder on male connector 4 Use Silicon RTV Item 37 to seal the cable hole 5 Check that all cables are seated correctly and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 8 62 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OEE Item 58 Power Switch ES NOTE Requires Label Kit Item 26 REMOVE 1 Remove Bottom Enclosure Item 21 2 Unsolder three wires of Power Switch Cable Item 57 from back of Power Switch Item 58 3 Squeeze eject clips and push Power Switch Item 58 through the front of the unit 4 Remove the Power Switch Label Item 26 REPLACE 1 Push the Power Switch Item 58 into the opening in the unit Pin 1 should be at the front of the unit 2 Solder three wires of Power Switch Cable Item 57 to back of Power Switch Item 58 as per Diagram 1 in Chapter 9 Add Power Switch Label Item 26 to front of unit 4 Check that all cables are seated correctly and are clear of the sides of the unit 5 Replace bottom enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 63 REMOVAL AND REPLACEMENT INSTRUCTIONS E J Item 68 amp 69 Blood Pressure Pump Valve Assembly and Foam Block 8 64 REMOVE 1 Remo
122. acer Back Advisory Pacer option option pass pass ADV Password The Advisory Password menu allows users to add options to an MRL Menu Lite in the field Contact your MRL customer service representative for instructions on upgrading an MRL Lite Entering the The Password menu gives the operator Upgrade Password the option of moving the cursor forward or backward or clearing canceling or saving the entry Follow these instructions to upgrade the password 1 Enter a new character by pressing once on the group of characters containing the character of your choice Forward Clear Cancel Save NOTE The Upgrade menu window is replaced by a numeric window password is displayed just above the numeric window with an active cursor in the first space PORTABLE INTENSIVE CARE SERVICE MANUAL 4 19 MRL LITE PROGRAM MENU SETUP Options Available SAED IBP ADV Review Back 234 1d 2 34 56 78 90 Space 1234 9 0 12 34 56 78 90 Space 2 Press the actual character Your selection will be entered and the cursor will move to the next character in the identifier Continue this process to complete the password 3 Press the SAVE button in the Password menu to save the selection and return to the Upgrade menu A symbol should now appear after Adv indicating that the option was su
123. acing cable into connector then pushing the retaining clip toward the board and then down the insulated side of the cable should face the back of the retaining clip Check that all cables are seated correctly in connectors and are clear of the sides of the unit Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 92 Blood Pressure Board BP TEMP PROBE 93 1 CONNECTION CONNECTION 0 PUMP VALVE CABLE REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Front Panel Cable Item 31 from Motherboard Item 46 at J108 by lifting up on the retaining clip with fingernail or a small instrument and pulling out cable 3 Disconnect Blood Pressure Cable Item 92 from J2 on Oximeter Board Item 90 by lifting up on the retaining clip with fingernail or a small instrument and pulling out cable 4 Disconnect Blood Pressure Main Cable Item 93 at J4 by lifting the retaining clip with fingernail or a small instrument and carefully pulling out cable 5 Push the silver knob on the card guide with a finger or small instrument so that the Blood Pressure Board Item 92 will slide freely 6 Remove Blood Pressure Board Item 92 by sliding it out of the card guide 7 Disconnect Hose from PR1 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 83 REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE 1 Con
124. ax modem Card Review 12 lead printer Card Review card usage and location SAFETY INFORMATION ON P1 STERILE Carbon Dioxide On Carbon Dioxide Off Resets to patient 001 in card review SAED CPR timer Latching connection Do Not Sterilize Press here to unlatch PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION General Precautions The MRL PIC is intended for use by trained authorized medical personnel who are familiar with basic monitoring vital signs assessment and emergency cardiac care The MRL PIC is also intended for use by physicians at the scene of an emergency or in a hospital emergency room Federal USA law restricts this device to sale by or on the order of a physician Any authorized person using the MRL PIC should be completely knowledgeable of the information in the User Instruction Manual Accessories Use only authorized MRL accessories listed in the Introduction chapter of this manual Use of unauthorized accessories may cause the device to operate improperly and provide false measurements Sterilization Do Not attempt to sterilize any accessory or equipment part except internal defibrillator electrodes and the internal paddle cable Refer to chapter 16 of the PIC User Instruction Manual for more information Battery Care Proper care and maintenance of the MRL batt
125. ble 8 97 MRL PORTABLE INTENSIVE CARE SERVICE MANUAL IX 85 h Assembly Drawings 9 1 Table of Item Numbers Sheet 1 Top Assembly other Sheet 2 o LDead Unt der e e es Sheet 3 I2 Lead Sheet 4 Monitor No Sheet 5 MRL Oximeter Option and Power Wiring Sheet 6 MRE LITE epe Sheet 7 EL Color and Mono Display Options Sheet 8 Card Cage Assembly eee Sheet 9 Service Part Numbers 10 1 Item 21 Bottom Assembly 10 2 Item 22 Top Enclosure Assembly 10 2 Item 23 Defibrillator Module 10 3 Item 24 Input Panel eee 10 4 Item 46 Motherboard 10 4 Item 65 Label 10 5 Item 105 Fax Modem 10 5 X MRL PORTABLE INTENSIVE CARE SERVICE MANUAL CHAPTER 1 SAFETY INFORMATION This chapter provides informaton on the safe operation of the Portable Intensive Care PIC System Chapter Overview Symbols and 5 1 2 General Precautions
126. brillator Module via the Defib Main Cable Item 19 when the Pacer is pacing The Motherboard Item 46 communicates user input to the ECG Preamp Board Item 51 via an opto isolated serial bus through the 5 Lead or 12 Lead Preamp Motherboard Cable Ite m52 or 82 connected to J217 or J104 of the Motherboard and J2 of the ECG PORTABLE INTENSIVE CARE SERVICE MANUAL 6 3 THEORY OF OPERATION Preamp Board QRS sync and pacer blanking signals are also routed through Defib Main Cable Item 19 The 5VDC is routed to the ECG Preamp Board to power the optocouplers and digital buffers The rest of the ECG Preamp Board is powered through an isolated supply by the 11 VDC supply 5 Lead ECG Monitor 6 4 5 Lead ECG signals can be monitored from either the patient cable or the paddle set ECG signals from the patient cable pass through the Patient Input Connector Board Item 40 to J1 of the Paddle Preamp Board Item 27 and on to the ECG Preamp Board Item 51 via a Preamp Protection cable Item 32 The cable is connected from J3 of the ECG Preamp Board to J2 of the Paddle Preamp Board and is sheathed with an insulating shrink tube barrier to isolate the patient connected signals from grounded circuitry ECG signals from the paddle set pass from the Defibrillator Module Item 23 to J3 of the Paddle Preamp Board Item 27 through a gain stage and an analog optocoupler before being routed through the Preamp Protection Cable I
127. ccessfully installed 4 20 PORTABLE INTENSIVE CARE SERVICE MANUAL CHAPTER 5 PERFORMANCE TEST PROCEDURES The following inspections and performance tests should be performed by qualified biomedical personnel at regularly scheduled intervals Factors such as the frequency of equipment use or operational policy may dictate that these procedures be performed as often as every 90 or 180 days In any case the maximum interval should not exceed one year Chapter Overview Inspection 52 Recommended Test Equipment 5 4 Safety Testihg rera Saba foe be Eu be Heads eee 5 6 EGG MORIOE ic iu diea du ota Ro io eg ha Ra 5 7 ECG Amplitude Calibration 5 9 Heart Rate Display 5 10 Defibrillator xxi sw UR 5 11 Synchronized Discharge 5 13 Transthoracic Pacemaker if 5 14 Advisory Option 5 15 Battery Charger Test 5 16 3 Volt Lithium Battery 5 17 Battery Capacity Test and Reconditioning Procedure 5 18 Guidelines for Maintaining Peak Battery Performance 5 20 12 Lead ECG Data Acquisition and Fax Modem Test 5 21 Non Invasive Blood Pressure Performance Test
128. charger Incorrect line voltage Check Quick Charger 971104 Ingress of liquids Check Quick Charger 971104 Use of charger to charge Check Quick Charger 971104 non MRL battery Failure of Speech board circuit Check Speech Board Item 94 Advisory module failure 590345 to prompt Motherboard circuit error Check Motherboard Item 46 590329 or 591329 Speech failure speaker cable or speaker Check Speaker Assembly Item 55 550712 PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE Inappropriate Advisory module prompt Artifact or motion corrupts signal bad electrodes Check expiration date on electrodes ECG preamp circuit failure 5 Lead Check Pre Amp Board Item 51 590328 Check Paddle Pre Amp Board Item 27 590343 12 Lead Check Pre Amp Board Item 84 590377 Check Paddle Pre Amp Board Item 83 591379 Failure to obtain Faulty temperature probe Check replace probe temperature measurement BP temp module circuit Check Blood Pressure Board failure Item 92 590346 BP Motherboard Check Main Blood Pressure communications error Cable Item 93 550723 faulty or disconnected cable Faulty temperature input Check Temperature Board cable board Assembly Item 75 590372 and input panel Item 24 See Chapter 10 Inaccurate BP temp module circuit Check Blood Pressure Board temperature failure Item 92 590346 measurement
129. cklight Cable from Backlight Inverter Item 43 at CN2 by pulling the cable out from the connector 4 Usea flat blade to remove the double sided foam tape 8 34 Item 10 off the unit PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE 1 Secure Backlight Inverter Item 43 to Top Enclosure Assembly Item 22 using double sided foam tape Item 10 2 Connect LCD Inverter Cable Item 34 to Backlight Inverter Item 43 at CN1 by pushing on the connector the ridged side of the cable should face out 3 Connect Display Backlight Cable from Backlight Inverter Item 43 at CN2 by pushing on the connector The red and green dots should face out 4 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 NOTE Be careful not to flex the Backlight Inverter 43 when installing Press gently on Item 43 directly over tape PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 35 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 44 Power Supply Board DISPLAY CHOICE EL MONO COLOR 49 on DEPENDING ON GROMMET CAUTION Performing this operation will cause loss of PIC variable settings to factory defaults The preferred settings m
130. cting an analysis of 12 lead input In Automatic mode the analysis begins immediately after the data is collected In Manual mode the operator must initiate the analysis after the data is collected Copies Menu The Copies menu controls how many printed copies of the 12 lead data will be produced when the print icon button is pressed PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 29 MENUS 85 LL U Supervisor Menus Setup Supervisors are able to access and change the options in the Set Up menus The date format language and the supervisor entry passcode are examples of options that supervisors can configure from these menus Set Up Suprvsr Date Time Shifts Back Enter Passcode here Supervisor UNLOCKED Defib Pacer SAED 12Lead SetUp Diag Exit Supr Setup Shifts Treatment Upgrade Unit ID Code Printer More Back Active Treatment Identifier Set Code Print Shift Setup Menu Menu Options Menu Menu Menu Supr Setup 2 Date Temp LineFreq Audio Language Lead Back Date Temp Line Freq MANUAL Language Lead Format Format Menu Audio Menu Menu Menu Menu Menu Options Available SAED IBP Adv Review Back Options Available lt
131. d communications error faulty or disconnected cable Check Main Defib Cable Item 19 550721 Failure of power supply Check Power Supply Item 44 590337 Internal cable failure Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 ECG preamp Motherboard communications error faulty or disconnected cable Check Preamp Motherboard Cable 5 Lead Item 52 550720 12 Lead Item 82 550751 ECG preamp lead fault circuitry failure 5 Lead Check Pre Amp Board Item 51 590328 Paddle Pre Amp Board Item 27 590343 12 Lead Check Pre Amp Board Item 84 590377 Paddle Pre Amp Board Item 83 591379 Inaccurate pacing current Circuit failure Check Defibrillator Module Item 23 596327 or 597327 Failure to respond to pacer controls Front panel motherboard cable failure Check Pacer Panel Cable Item 30 550729 BP cuff does not inflate Pump valve assembly or cable failure Check BP Pump Valve Assembly Item 69 570519 BP Motherboard communications error faulty or disconnected cable Check Main Blood Pressure Cable Item 93 550723 BP module circuit failure Check Blood Pressure Board Item 92 590346 Damaged or leaky cuff or hose Check cuff and hose Cuff hose crimped of otherwise obstructed Check hose 7 4 PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE 85 5 L
132. d will appear above the heart icon in the display area The HR Alarm monitor automatically 0 sets the upper and lower heart rates gt limits at 20 of that heart rate set point or 10 beats whichever is greater A Pan n m 4 gt Each press of the AUTO button will adjust the heart rate set point and reset the auto HR alarm limits You can view the upper and lower limits that were set by going back to the HR Alarm menu The undetermined upper and lower limits have been replaced with automatically set values See the Setup menu section in this chapter for information about the Setup menu options PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP Log Menu Use the Log menu to print the log stop print of log or clear the log Press LOG to enter the Log menu and make your selection Press EXIT to close the Log menu Log Print Log Stop Print Clear Log Exit Press STOP PRINT to stop printing the Event Log The information in the log will not be affected Press the CLEAR LOG button to clear the Event Log NOTE prevent a previous patient s Event Log data from being printed with a new patient s data always clear the log prior to treating a new patient Sample Press the SAMPLE button to store a 4 second ECG internally and print a sample ECG The sample from the chart recorder will print the words Sample Event
133. damaged paddle Check paddle set ButnFail set Paddle set cable damaged Check paddle set connector cable on Top Enclosure Item 22 See Chapter 10 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr Defib circuit failure Check Defibrillator Module Chksum Item 23 596327 or 597327 DefibErr SPI Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr 008 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr 009 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr 010 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr 011 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 DefibErr 12V Bulk Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 Power supply defib cable faulty or disconnected Check Defib Power Supply Cable on Defibrillator Module Item 23 596327 or 597327 PaceErr 013 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 014 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 015 Defib circuit failure Check Defibrillator Module Item 23 596327 or 597327 PaceErr 016 Simulator related Text Check disconnect test fixture fixture error should be 50 to 700
134. davo AMONSA 778066 oz 8 dWv3sd Qv3i s 069 zz dNvV3ud 194 Old u3hivg 417029 Bz T3Nvd Y3 Yd Tava 62 0 or 3Nvd 3 Old 3189 08055 smonovev2 3a avo 4910959 d onon s 1 9 aaoo QNVOS ANilivd 082019 8 1 amwsg uiNuva woo NNOO iN3uvd 01 5 495065 o FINGOW 939 Ald ASSY L L L L L TANVd 1fldNI 219 ASSY L Y o t Eas t 1 Old lt wauoB assy Ol 335 ot ot END t t 219 091 SNOldO 510 GOV 81004 O23 968 9 023 lt 1 wa 14143530 ANSSI Q3qM ANI SI NOWdO 9NKINOdS3HHOO 31 GITIWLSNI ATINO voum fuma sew 491 ONOW Old L3MOVu8 AvidSId ONON Q121 ASSV MOVE TISNIS YGLYAANI 5 HMd ASSY BOd 55 29 9 Qvo 39vo5 Quvo JOVI 08 N3HLON ASSY M3ldvOV 19510 ONON QNVOB 31 4 N dWv3iHd 21 38 NI02 AM3LINS HOLMS H3MOd Ild dl8vo lfidNI IN3UNd 38V 43040233 l1NVH2J 1381 15 MLSNI 13871 22 49 40 I new 28066 6v Old Mev 92 055 05 00 0909
135. detection unreliable affecting the HR meter and the demand mode pacing rate Always observe the patient closely during pacing operations Consider using asynchronous pacing mode if a reliable ECG trace is unobtainable PORTABLE INTENSIVE CARE SERVICE MANUAL 1 11 SAFETY INFORMATION 8 Pulse Oximeter Precautions e Keep the MRL finger probe clean and dry e SpO measurements may be affected by certain patient conditions severe right heart failure tricuspid regurgitation or obstructed venous return e SpO measurements may be affected when using intravascular dyes in extreme vasoconstriction or hypovolemia or under conditions where there is no pulsating arterial vascular bed e SpO measurements may be affected in the presence of strong EMI fields electrosurgical devices IR lamps bright lights improperly applied sensors the use of non MRL sensors or damaged sensors in patients with smoke inhalation or carbon monoxide poisoning or with patient movement Tissue damage can result if sensors are applied incorrectly or left in the same location for an extended period of time Move sensor every 4 hours to reduce possibility of tissue damage e Do not use any oximetry sensors during MRI scanning MRI procedures can cause conducted current to flow through the sensors causing patient burns Do not apply 5 sensor to the same limb that has an NIBP cuff The SpO alarm may sound when the arterial circulat
136. ds 6 3 5 Lead ECG 6 4 DISplayS sor Dae e OR o P RR RR a n 6 5 Chart Recorder iui daa bru Reba 6 6 Front Switch 6 6 Voice Memo and Voice 5 6 7 1 Volt Output oder raten ERR REPE 6 7 PCMCIA Interface 3 Rada 6 7 Blood Pressure 6 8 bu It 6 8 Defibrillator External 6 9 Options Interconnect 6 13 Overview An Interconnect Diagram is included at the end of this chapter Use the diagram as a reference when reviewing the theory of operation information presented in this chapter Referto the part item number table Sheet 1 in Chapter 9 to identify the parts described in the theory of operation e Refer to the assembly drawings in Chapter 9 Sheets 2 9 for information on the placement and configuration of the items PORTABLE INTENSIVE CARE SERVICE MANUAL 6 1 THEORY OF OPERATION 8 0 8 Power Distribution Power Supply 6 2 The PIC can be powered from AC power or a battery The AC power cable is connected to the receptacle in the back of the optional AC Supply Paddle Tray Module Item 17 The AC Supply Paddle Tray Module contains a 12VDC power supply battery charger and defibrillator tester Th
137. ds for the SuperPac battery NOTE Perform this test at the rate of two quick discharges followed by a 30 second rest period The charge time should be approximately 7 seconds for the SmartPak Plus battery or 9seconds for the SuperPac battery NOTE Results may vary somewhat due to the reaction time involved in stopwatch operation Verify that the battery has been fully charged If the battery is fully charged see the Failure to charge listing in Chapter 7 Troubleshooting Guide If the charge time exceeds the limits given in step 4 recondition the battery pack and perform the test again If the battery pack fails the test consider the age of the battery and the frequency of use These factors determine how long a battery can continue to provide adequate performance A weak battery should be removed from service and replaced with a new fully charged battery PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES Synchronized Discharge Equipment Required Defibrillator analyzer with cardioversion delay measurement Acceptable Results The time delay between the start of the leading edge of the simulator pulse oscilloscope trigger and the leading edge of the defibrillator discharges should be 60 milliseconds or less Corrective Action Confirm proper synchronization by observing a blinking Sync LED Sync delay time is determined by fixed values not adjustable in the unit Refer to the
138. e Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 65 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 71 EL Display Cable 8 66 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect EL Display Cable Item 71 at J1 of EL Display Adapter Board Item 89 3 Disconnect EL Display Cable Item 71 at connector on back of EL Display Item 79 by gently pulling on connector REPLACE 1 Connect EL Display Cable Item 71 at J1 of EL Display Adapter Board Item 89 by pushing connector into its slot matching notches 2 Connect EL Display Cable Item 71 at J1 of EL Display Adapter Board Item 89 by pushing connector into its slot matching notches ensure that the pin 1 indicator on the cable a colored wire matches the pin 1 indicator a triangle on the EL Display Adapter Board Item 89 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 73 Blood Pressure Coupling REMOVE QU Remove bottom enclosure Item 21 Remove defibrillator assembly Item 23 Remove Tube Item 74 from coupling Item 73 Remove nut and locking washer Item 86 Remove O ring Item 117 from coupling Item 73 REPLACE 1 2
139. e refer device to qualified service personnel for verification of proper operation e Do not immerse the charger or expose it to water or other liquids Wipe only the outside with a damp cloth Tighten clamp onto power cord to prevent its accidental removal Unplug the charger prior to changing the fuse Useonly the MRL Quick Charger to power the MRL PIC System from an auxiliary power source Donotuse the MRL Quick Charger to power any non MRL devices e A depleted battery could increase defibrillator charge times tis recommended that a fully charged battery be inserted in the PIC System even when operating on auxiliary power e Note The MRL PIC System will operate from an auxiliary power source without a battery inserted if the inserted battery is depleted However under these circumstances defibrillator charge time will be slightly longer 10 seconds typical 15 sec maximum PORTABLE INTENSIVE CARE SERVICE MANUAL 1 15 SAFETY INFORMATION SAED Precautions 9 IBP Precautions WARNING Cardiac Pacemakers The presence of an internal cardiac pacemaker may adversely affect analysis results If it is known or suspected that the patient is fitted with a cardiac pacemaker follow your own locally established procedure for dealing with defibrillation of such patients The PIC in SAED mode should only be applied to victims of cardiac arrest who exhibit unconsciousness absence of breat
140. e Card Cage Pre Assembly Item 48 from unit es 29 Carefully remove Paddle Pickup Cable Item 97 from slit in Barrier Item 106 5 Remove conductive tape Item 98 from the Top Enclosure Item 22 6 Remove Transfer Tape Item 121 from Barrier Item 106 and Top Enclosure Item 22 7 Remove Barrier Item 106 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 95 REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE 1 Secure Barrier Item 106 to Top Enclosure Item 22 with Adhesive Transfer Tape Item 121 along one whole edge 2 Attach Conductive Tape Item 98 to Barrier and Top Enclosure Replace Paddle Input Cable from slit in Barrier Item 106 Replace Card Cage Assembly Item 48 Replace Memory Card Board Item 26 Qv he uo Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 8 96 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 109 Color Inverter Cable Pen Edad O D REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Blood Pressure Pump Valve Assembly and Foam Block Items 69 amp 68 3 Remove the Color Display Shield Item 100 4 Disconnect Color Inverter Cable Item 109 at J2 on Color Display Adapter Board Item 85 by pulling on the cable by the connector
141. e Configuration controls Energy charge disarm sync indicator 44 select Pacer Pacer t start stop output 21 Sync indicator 0 9 X 9 11 12 13 14 15 Voice memo Chart recorder Mute Blood pressure optional SpO optional Size Lead Hold Pacer on off Pacer indicator Pacer start stop Pacer mode Pacer output Pacer rate Quick access PORTABLE INTENSIVE CARE SERVICE MANUAL Allows documentation of audio messages Activates and deactivates the chart recorder Pressing the MUTE button once causes all audio alarms and tones to be muted for 90 seconds except defibrillator charge tones Starts or stops cuff inflation Turns on or off the pulse oximeter Selects ECG trace sizes Selects ECG input source Freezes the traces on the display Turns on off pacer circuit Automatically illuminates during pacing activity Delivers pacing stimulus to the patient or pauses delivering pacing stimulus to the patient Changes pacing mode from DEMAND to ASYNC Selects pacing output current Selects pacing output rate Initiates menu functions appearing adjacent to each button on the display when PIC System is on 2 5 GENERAL INFORMATION 2 6 16 17 18 19 20 21 Treatment Configuration controls Defib energy select Defib charge Defib disarm Defib sync Sync indicator Treatment allows documentation of specific treatment summary events and Configurat
142. e PIC can also be powered from the quick charger AUX power cable The 12VDC and the charger current are routed to the PIC electronics through a cable that connects to the Battery Board Item 54 via a connector in the top of the PIC The Battery Board contains EMI suppression circuitry and terminals for the removable battery There are two sets of redundant contact terminals for the battery The power from both the battery and the AC supply are routed to J2 on the Power Supply Board Item 44 via a cable that passes through the chassis The power supply is turned on by switching the Power Switch Item 58 on the front of the PIC The power switch is connected to J6 of the Power Supply Board Item 44 by a 5 wire cable When the AC power cable is connected and plugged into a live wall outlet the PIC draws power from the AC supply and the battery is charged by the charger The green AC Power indicator and the yellow Battery Batt Charger indicator on the AC Supply Paddle Tray Item 17 are illuminated If the battery is fully charged the Battery Charger indicator flashes and the AUX indicator appears on the display instead of the battery gauge If the AC mains voltage or AC supply output drops below a level required to supply sufficient current to the PIC the Power Supply Board Item 44 automatically switches on the battery to boost the voltage In this case the battery gauge appears on the display even though the AC power is connected The gaug
143. e corresponding MRL product PIC System PIC Monitor 991010 and Lite 991022 MRL PIC products include a 6 4 display and an annotating chart recorder An integral paddle tray AC supply shown on the MRL Lite is optional on all units The MRL PIC System is a multi parameter Monitor Defibrillator Pacer Standard functions for the PIC are ECG DEFIB PACER and RESP Upgradeable options include 12 Lead NIBP SpO TEMP AED IBP Voice Memo Fax and Data Record Review Display options include EL Color TFT and Mono LCD Acceptable batteries include the SmartPak Plus and SuperPac The MRL PIC Monitor standard functions are ECG and RESP Upgradeable options include 12 Lead NIBP 5 TEMP and IBP The PIC Monitor uses a monochrome LCD display Acceptable batteries include the SmartPak SmartPak Plus and SuperPac The MRL Lite is a Monitor Defibrillator Pacer Standard functions for the Lite are ECG and DEFIB Upgradeable options include Pacing and Advisory The Lite has a monochrome LCD display Acceptable batteries include the SmartPak SmartPak Plus and SuperPac A PCMCIA data card is not available for the Lite PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 9 LL PIC System Interfaces 13 Non Invasive Blood Pressure connector IBP2 connector Blue 12 Temp connector White IBP1 connector Blue 11 C02 connector Magenta me
144. e indicates that the battery is being discharged The Power Supply Board Item 44 contains switching circuits to generate power of 5 and 11VDC These power signals routed through J1 of the Power Supply Board to 14 of the Motherboard Item 46 where they are distributed to the remaining modules An additional cable carries 11 VDC from J4 of the Power Supply Board to the Display Adapter Board Item 49 85 or 89 The unregulated voltage from the battery 9 8 to 13 5 VDC or AC supply charges the defibrillator and powers the chart recorder thermal array The power signal is routed to the Defibrillator Module Item 23 through a 2 wire cable connected to J7 of the Power Supply Board Item 44 The power signal is also routed to the Chart Recorder Item 36 through the Motherboard Item 46 via a 2 wire PORTABLE INTENSIVE CARE SERVICE MANUAL THEORY OF OPERATION cable connected to 15 the Power Supply Board The power supply is fused with a 1 5A surface mount fuse on the Motherboard The unregulated voltage is monitored while running on battery power If the battery voltage dips below 11 7VDC for a 20 second period Low Battery condition will be indicated When the voltage dips below 9 8VDC the power supply will shut down the unit A 3 V Coin Cell Battery Item 56 on the Power Supply Board powers the clock and maintains the battery backed up static RAM on the Motherboard Item 46 The static RAM contains
145. e w intnl color code L 001537 Pediatric adapters set L 001795 5 patient cable L 971107 Hands free defibrillator L 001796 5 lead patient cable w intnl adapter color code LJ 900322 Hands free defibrillator 001720 Bitrode limb electrodes tester L 971125 Internal paddle adapter L 001797 12 Lead patient cable L 001515 Internal paddles 25mm L 001958 12 Lead patient cable IEC 1 set L 001516 Internal paddles 50mm 001798 3 Lead patient cable for 2 set 12 Lead 0 001517 Internal paddles 76mm LJ 001948 3 Lead patient cable for 3 set 12 Lead IEC L 570312 Internal paddle cable L 980128 Cardiac demonstrator 001636 MRL SmartPak battery L 001938 Fax output cable 0 001638 MRL SmartPak Plus 0 900241 Cellular phone adapter battery L 001647 MRL SuperPac L 001726 ECG electrodes L 900223 Carrying case L 002051 Defibrillator gel L 900224 External paddle pouch L 001788 Multipurpose electrodes adult 1 900225 Hands free pouch 0 001927 Disposable skin tempera ture sensor PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 1 971104 0 001739 0 001955 00211 0 001911 0 001915 001912 0 001913 0 001914 0 001922 0 001923 001942 0 001943 0 001944 001945 0 001957 0 001941 MRL Quick Charger Recorder paper SpO adapter cable Finger probe reusable adult NIBP adult thigh cuff NIBP adult large arm cuff
146. ead screwdriver 3 Remove Chart Recorder Item 36 by pulling and rocking it side to side REPLACE 1 Place Chart Recorder Item 36 into unit and rock it into place make sure that Chart Recorder Item 36 is flush with the top of the unit 2 Replace two screws on the inside bottom of the Chart Recorder Item 36 with a 2 Phillips head screwdriver until snug do not over tighten 3 Replace paper and close door 4 Add labels Items 62 and 61 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 29 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 38 Battery Board Cover REMOVE 1 Remove Input Panel Item 24 2 Remove AC Supply Paddle Tray Module Item 17 3 Remove screw Item 11 4 Liftoff Battery Board Cover Item 38 REPLACE 1 Place Battery Board Cover Item 38 over Battery Board Item 54 2 Replace screw Item 11 Replace AC Supply Paddle Tray Module Item 17 4 Replace Input Panel Item 24 8 30 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 39 Patient Input Bracket 5 Lead REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Remove Paddle Preamp Shield Item 29 4 Remove Paddle Preamp Board Item 27 5 Remove two screws Item 9 on Patient Input Bracket Item 39 with a 2 Phill
147. ed and Paper Speed Accuracy Equipment Required simulator with calibrated output rates Procedure 1 Connect ECG simulator to PATIENT input of monitor Set rate to 60 bpm and amplitude to 1 mV Press Power switch to on Set Lead Selector switch for Lead II Set Size control to 1 cm mV cmo dtes Measure distance between R wave peaks on the monitor and on the recorder chart Acceptable Results Distance between R wave peaks should be 25 22 5 millimeters on both the monitor and recorder Corrective Action Verify accurate simulator rate Replace Chart Recorder Item 36 if chart speed is not within specification 5 8 PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES i ECG Amplitude Calibration Equipment Required ECG simulator with calibrated 1 millivolt amplitude output Procedure Connect ECG simulator to PATIENT input on monitor Set simulator for 1 millivolt output at 60 bpm Turn on monitor and set Lead Selector for Lead II pee pm Set the size control on the monitor for 1 cm mv Set the frequency response of the PIC to Diagnostic 5 During interval between beats depress 1 millivolt calibration control to generate a calibration pulse on the monitor 6 Repeat steps 2 and 3 to test chart recorder amplitude calibration Acceptable Results Amplitude on display and chart recorder should be 1 cm 1 mm Corrective Action e Verify simulator amplitude accuracy man
148. em 2 on the handle of the unit using a 2 Phillips head screwdriver 3 Remove remaining nine screws Item 1 located on the bottom of the unit using a 2 Phillips head screwdriver 4 Carefully lift off Bottom Enclosure Item 21 5 Disconnect Fax Output Cable at J5 of Modem Board Item 105 if Fax Modem option is installed REPLACE 1 Make sure that Defibrillator Module Item 23 is fully seated in the unit Check that the green base of the Defibrillator Module Item 23 is flush with the top of the 3 posts into which the Bottom Enclosure screws Item 1 fit PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 2 Make sure that all cables are pushed into the unit so that none are pinched when replacing Bottom Enclosure Item 21 Connect Fax Output cable at J5 of Modem Board Item 105 if Fax Modem option is installed 3 Carefully place Bottom Enclosure Item 21 onto the back of the unit 4 Replace three screws Item 3 in the corners using a Phillips pin head screwdriver Service Part Number 002109 until snug do not over tighten 8 in lbs torque 5 Replace thirteen remaining screws Items 1 and 2 using a 2 Phillips head screwdriver until snug do not over tighten 8 in Ibs torque NOTE If replacing with a new bottom enclosure transfer Serial Number Part Number and Options on to writable label from Label Kit Item
149. ency must match the AC line current In countries where the line current is 60 1 e USA set the selection to 60 HZ In countries where the line current frequency is 50 Hz select 50 Hz Press the corresponding button to select an option A bold outlined box indicates the selected option Press EXIT to return to the Supervisor Setup menu Date Format Menu Use the Date Format menu to select a format for the month day and year The format will be used each time the date is shown in the display area and on the yy mm dd printouts mm dd yy dd mm yy The date format options are mm dd yy month day year dd mm yy day month year y y mm dd year month day Press the corresponding button to select a format A bold outlined box indicates the selected option Press EXIT to return to the Supervisor Setup menu PORTABLE INTENSIVE CARE SERVICE MANUAL 4 17 MRL LITE PRoGRAM MENU SETUP J b i Language Menu Use the Language menu to select the EX j language that will be used in the display area and on chart printouts The options 4r are English Spanish German French Italian and Portuguese Press the UP DOWN arrow buttons until the language you want to use displays 522 Press SAVE to save your selection The next time you start the MRL Lite the selected language will be in effect Cancel NOTE restore the MRL Lite la
150. enu items as shift 1 2 or Shits 3 Press the corresponding button to Defaults activate shift 1 2 or 3 Then press EXIT to change to the settings for the selected shift settings Exit Refer to Supervisor Menu Setup Active Shifts for additional information NOTE An asterisk next to a shift number indicates the settings for that shift have been saved PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 21 MENUS Supervisor Menus The Supervisor menus are only available to a supervisor after the successful entry of the supervisor passcode Using these menus a supervisor can configure the installed options The following diagram shows the structure of each Supervisor menu This section explains how to access and configure the Supervisor menu options 3 22 Treatment Intubate IV EPI Lido Bret Sample Clear Next Configuration Display Alarms SPO NIBP Resp Recorder SetUp Back T T Set Up Suprvsr Date Time Shifts Back Enter Passcode here Supervisor UNLOCKED Defib Pacer SAED 12Lead Set Up Diag Exit Supr Diagnostics SW Rev Modem Card Cal Back Supr Calibration NIBP SPO Out 9 Supr Setup Shifts Treat
151. eplacement Instructions 8 4 Item 15 Main Memory Card Cable 8 4 Item 17 AC Supply Paddle Tray Module 8 5 lem 13 05 Cable s de eee eise en 8 6 Item 19 Defib Main 8 7 Item 20 Chart Recorder 8 9 Item 21 Bottom Enclosure Assembly 8 10 Item 22 Top Enclosure Assembly 8 12 Item 23 Defibrillator Module 8 14 Item 24 Input 8 16 Item 26 Memory Card 8 17 Item 27 5 Lead Paddle Preamp Board 8 18 Item 28 Barrier for 5 Lead Paddle Board 2 eh 8 19 Item 29 5 Lead Paddle Preamp Shield 8 20 Item 30 Pacer Panel 8 21 Item 31 Front Panel Cable 8 23 Item 32 5 Lead Preamp Protection Cable 8 25 Item 34 Mono LCD Inverter Cable 8 26 Item 35 Mono LCD Cable 8 27 Item 36 Chart Recorder 8 29 Item 38 Battery Board 8 30 MRL PORTABLE INTEN
152. eries is important to insure continuous operation during patient care If the batteries are not maintained properly loss of power during patient care could result affecting patient care Always have a fully charged battery pack available as a back up Dropped or If this device has been dropped or damaged in any way refer the Damaged device to qualified service personnel for verification of performance and or servicing Ingress of Liquids To achieve the specified level of protection against spilled or splashed liquids thoroughly dry all exposed surfaces of this device prior to operation or connections to mains power Electrical Shock Hazard Do not use the MRL PIC if it has been immersed in a liquid or if liquid has spilled on it Do not clean the MRL PIC with alcohol ketone or any flammable agent Do not autoclave the MRL Conductive parts of electrodes and connectors for applied parts should not contact other conductive parts including earth Electrical Shock Hazard This device does not contain any user serviceable parts Do Internal not remove instrument covers or attempt to repair the MRL PIC System Refer servicing to qualified personnel PORTABLE INTENSIVE CARE SERVICE MANUAL 1 5 SAFETY INFORMATION Electrodes Disposable Energy Discharge Expiration Date Ferromagnetic Equipment Labels Operating Near Oxygen Patient Physical Harm Performance Treatment Summary Log 1 6
153. esult from frequent use e Check for cracks or cuts in the cable insulation and strain reliefs Inspect for bent or corroded pins nspect each patient cable snap connector because these can be susceptible to corrosion from electrode gel and other fluids that may accidentally contaminate the snaps Remove any damaged cables from service and replace them prior to returning the PIC to normal use 6 Inspect AC power cord Inspect the mains line power cord for damage that can occur if the power cord is disconnected frequently or subject to abuse when pulled from a receptacle Check the cord for cuts or cracks in the insulation and strain reliefs Inspect the connector pins for bending that could indicate abuse Replace a damaged power cord prior to returning the PIC to normal use PORTABLE INTENSIVE CARE SERVICE MANUAL 5 3 PERFORMANCE TEST PROCEDURES EN 5 Recommended Test Equipment 5 4 The following test equipment is commercially available from many manufacturers Some models combine the features of more than one required instrument into a single analyzer For example the Impulse 4000 from DNI Nevada Inc can be used to perform all of the recommended tests on a MRL Lite except electrical leakage Any equipment used must be calibrated and specified to perform within the following minimum requirements 1 ECG Simulator Normal sinus rhythm with selectable rates from 30 to 300 bpm and amplitudes
154. eter Cable Item 91 if option installed 10 Remove Card Cage Plate Item 45 11 Lift Motherboard Item 46 off of Card Cage Bracket Item 47 REPLACE 1 Place Motherboard Item 46 onto Card Cage Bracket Item 47 with Power Supply pins up and line up the screw holes 2 Replace Card Cage Plate Item 45 Use 1 2 screws Item 13 Replace Speech Board Item 94 3 Connect Flat Panel Display Cable Item 50 to Motherboard Item 46 at J220 by lifting retaining clip with fingernail or small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should be facing the outside of Card Cage Pre Assembly Item 48 4 Connect Preamp Motherboard Cable Item 52 to Motherboard Item 46 at J217 by pushing cable into connector the blue side of the cable should be facing the Motherboard Item 46 or the 12 Lead Motherboard Item 82 at J104 insulated side should face bottom of unit 5 Replace Power Supply Board Item 44 Use 5 16 screws Item 2 6 Replace Defib Main Cable Item 19 7 Replace Card Cage Pre Assembly Item 48 8 Connect Main Blood Pressure Cable Item 93 and Main Oximeter Cable Item 91 9 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 10 Replace Bottom Enclosure Item 21 11 Restore purchased options as outlined in the Supervisor Setup section of Chapter
155. f the MRL Oximeter Board Item 90 The Motherboard Item 46 communicates with the CO2 Ox Isolation Board Item 103 via the Main Oximeter Cable Item 91 connected to J221 on the Motherboard and J2 on the CO2 Ox Isolation Board The signal from the oximeter probe travels through the Patient Input Panel Item 24 to J3 of the CO2 Ox Isolation Board via Item 77 The signal is then routed to the Nellcor Oximeter module via J1 and J5 of the CO2 Ox Isolation Board PORTABLE INTENSIVE CARE SERVICE MANUAL THEORY OF OPERATION Defibrillator External Pacemaker The Defibrillator Module Item 23 5 Lead or 12 Lead ECG Preamp Board Item 51 or 84 and 5 Lead or 12 Lead Paddle Preamp Board Item 27 or 83 perform the following functions e Defibrillation Synchronized Cardioversion e Transthoracic Pacing ECG Pickup from the Paddle Set The Defibrillator Module transmits to and receives commands from the Motherboard Item 46 through 5 Lead or 12 Lead Preamp Motherboard Cable Item 52 or 82 The defibrillator continuously checks communications integrity and requires that communication be established for operation of these functions Defibrillation The defibrillator uses a capacitor bank to store enough charge to deliver a properly formed energy pulse to the patient The charge is initiated by pressing the Front Panel Charge Switch which causes the Motherboard Item 46 to send a message to the defibrillator initiatin
156. flash at 2 Hz Color is amber white or the same as the display colored text Mute Duration 90 seconds Recorder Type High resolution thermal array Annotation Time date ECG lead ECG gain heart rate defibrillation and pacing parameters and treatment summary ACLS events Paper Width 50 mm Paper Speed 25 mm sec Delay 6 seconds Frequency Response Automatically set to monitor s frequency response Treatment Summary 7 switches to record key ACLS events IV INTUB EPI LIDO etc Automatically logs into memory the type of event time and ECG sample Tx Summary Log 28 ECG events or 300 non ECG events Record Modes Manual and automatic User configurable Battery Standard Type NiCad 12 volt MRL SmartPak Plus Standard Capacity Up to 2 hours ECG monitoring or 60 full energy discharges or 1 5 hours combined ECG SpO2 and BP monitoring while pacing Actual operating times will depend on the number of features activated and the duration of their use Proper battery care is required to maintain maximum available capacity Self Test Bi color LED indicates battery charge state Green usable charge Red requires charging Low Battery Indicator Flashing low battery icon on display and flashing LED on PORTABLE INTENSIVE CARE SERVICE MANUAL 2 27 GENERAL INFORMATION 8 1 General Pacer 2 28 battery Recharge Rate 8096 in 3 5 hours 100
157. from 0 5 to 2 0 mV Sine wave with selectable frequencies from 0 05 Hz to at least 100 Hz Selectable arrhythmias including ventricular fibrillation 12 lead ECG simulation is needed for a PIC equipped with the 12 lead option 971026 and 971027 2 Defibrillator Tester Capable of accurately measuring PIC defibrillator outputs which are trapezoidal truncated exponential in shape Energy measurement from 1 to 360 J Standard 500 non inductive test load 3 Pacer Tester The ability to connect to the PIC hands free cable usually with an appropriate adapter that will also select the correct test load and measurement technique Peak current measurement from 5 to 180 mA Rate measurement from 30 to 200 bpm A test load in the range of 500 to 7000 Capable of measuring a 20 ms pulse width 4 Stop Watch or Clock When timing defibrillator charge time resolution to the nearest second is required When timing battery charge time the ability to measure a total elapsed time of approximately 4 hours is required PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES i 5 Electrical Safety Analyzer e Automatic or manual selection of the correction mains line voltage Standard test load compliant with either AAMI ES1 or 60601 1 e Measurement of leakage current from 1 to 300 uA Measurement of ground resistance in the range of 0 1 to 0 20 Isolation test voltage that is typically 1
158. g the Respiration menus Access the Respiration menus from the Treatment Configuration menus NOTE Respiration is not available when the 12 Lead option is activated Treatment Intubate IV EPI Lido Bret Sample Clear Next Recorder Display Alarms SPO NIBP Resp Recorder Set Up Back Respiration ECG Trend Back HEN ECG Resp Setup Size Speed Response Back Resp Resp Resp Size Speed Response Menu Menu Menu Resp Size Menu Use the Resp Size menu to adjust the size of the displayed respiration trace Press X1 X2 or X4 A to select the waveform size bold outlined box indicates the selected size Press EXIT B to return to the Resp Configuration menu Resp Speed Menu Use the Resp Speed menu to adjust the Respiration trace speed on the display and allow manual calculation of the respiratory rate The respiration waveform speed time it takes the trace to travel from the left side to the right side of the display options are 5 10 20 30 or 60 seconds C A bold outlined box indicates the selected speed Press EXIT to return to the Resp Configuration menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 13 MENUS Response Menu Use the Respiration Response menu to select the averaging interval that will be used during a respiration
159. g the charge sequence Bulk power for the defibrillator is provided through the 12 Volt cable which connects to the Power Supply Board Item 44 at J7 If bulk power is not present the defibrillator displays an Error Bulk 12V message appears on the Display and is sent to the Chart Recorder Item 36 The defibrillator updates the Selected Energy display and Energy Bar as itis charging When the defibrillator has stored the proper amount of energy it will accept the fire command from the various paddle sets To deliver energy to the patient the defibrillator first activates the appropriate transfer relays connecting the patient to the defibrillator through the paddle set paddle connector and internal connections Once the connection is established the defibrillator activates Solid State Devices which connect the patient to the Charge Storage Devices The defibrillator monitors the energy being delivered and terminates the pulse at the appropriate time PORTABLE INTENSIVE CARE SERVICE MANUAL 6 9 THEORY OF OPERATION Synchronized Cardioversion Transthoracic Pacing Paddle Pickup 6 10 Synchronized cardioversion follows the same sequence as described in the Defibrillator Module section except for the energy delivery trigger event When an operator depresses the Sync Switch on the Front Panel a message is sent to the defibrillator through 5 Lead or 12 Lead Preamp Motherboard Cable Item 52 or 82 informing the defibrillator
160. gher capacity take longer to charge partially discharged batteries and those with lower capacity require less time to charge NOTE Charging battery packs at temperatures above 30 C 86 F prolongs the charging time and may result in a gradual decline in battery capacity 3 Ifa fully charged battery is inserted into the charger it will be charged for a short period of time while the charger determines its state of charge When it is determined that the battery is fully charged the yellow light will flash This process may take several minutes 4 MRL SmartPaks contain NiCad batteries which tend to lose charge capacity if they are repeatedly charged after not being fully discharged or are charged at high temperatures In order to counteract these cumulative deteriorating effects periodically exercise the SmartPak by deeply discharging it in the Reconditioning Slot Slot 3 before recharging See the reconditioning schedule later in this chapter PORTABLE INTENSIVE CARE SERVICE MANUAL 2 11 GENERAL INFORMATION 85 Conditioning Battery Packs important Reconditioning with Paddle Tray Charger Connecting the Patient Cable 2 12 5 Slot 3 on the MRL Battery Charger has dual charging and reconditioning capabilities To use slot 3 only to charge a battery pack insert the MRL battery into the slot When the battery has been firmly seated into the contacts at the back of the slot the yellow light
161. ging the pressure for the reading to stabilize If a stable reading is not obtained perform the analyzer s Leak Rate Test Check the accuracy of the PIC static pressure readings at 200 140 and 50 mmHg by comparing them to the corresponding readings on the NIBP analyzer Perform the analyzer s Overpressure Test to confirm that this safety feature actuates properly Return to the normal user menu Set the NIBP analyzer to simulate a typical BP reading such as 120 80 at a heart rate of 80 bpm Test the PIC BP cycle according to the instructions for the analyzer in use Compare the readings obtained by the PIC to the parameter settings of the NIBP analyzer Static pressure readings obtained in the BP CAL mode must agree with the analyzer readings within 2 mmHg The rate of pressure loss leak rate must not exceed 6 mmHg minute The overpressure activation must occur at 300 15 mmHg It must result in release of pressure and reset of BP operation The BP readings determined by the PIC must agree with the parameter settings of the NIBP analyzer within 5 mmHg The heart rate indication must agree within 4 bpm Internal calibration adjustments are provided for the static pressure reading These adjustments should be made only by a qualified technician using a calibrated instrument NIBP analyzer of known accuracy PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES To access the adjustments
162. ging tone Press the MAX VOLUME button to set the charging tone to the maximum volume and by pass the Volume icon A bold outlined box indicates the selected option Press EXIT C to return to the Defibrillator Supr Defib menu 3 24 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Supervisor Menus Pacer The Supervisor Pacer menu is used to configure the power on mode and initial rate This menu is accessible through the Treatment Configuration Set Up menus Set Up Suprvsr Date Time Shifts Back Enter Passcode here Supervisor UNLOCKED Defib Pacer SAED 12Lead SetUp Diag Exit Supr Pacer Rate Mode Back Pacer Pacer Rate Mode Menu Menu Pacer Rate Menu Use the Pacer Rate menu to set the power on pacer rate setting The range is from 30 to 180 PPM s Press the UP arrow A or DOWN arrow B button to increase or decrease the pulse per minute PPM selection Press EXIT C to close Pacer Rate menu Pacer Mode Menu Use the Pacer Mode menu to set the power on pacing mode Press the DEMAND A or ASYNC B button If Demand is selected the PIC will supply pacing as needed If Async is selected the PIC will provide continuous pacing bold outlined box indicates the selected option Press EXIT C to close Pacer Mode menu
163. he Power Supply Board Item 44 through a 2 pin cable attached to the EL Display Adapter Board Item 89 Signals to the EL Display continue through the EL Adapter Board from J2 through the EL Display Cable Item 71 which is connected to the EL Display mounted in the Top Enclosure Assembly Item 22 The EL Display Adapter Board Item 89 contains switching circuits to enable the display power supplies PORTABLE INTENSIVE CARE SERVICE MANUAL 6 5 THEORY OF OPERATION TFT Color Display Chart Recorder Display control signals and the 5 power signals are routed to the Color Display Adapter Board Item 85 through the Flat Panel Display Cable Item 50 The cable is a 30 pin FFC cable and connects to J220 of the Motherboard Item 46 and J4 of the Color Display Adapter Board Item 85 The 11VDC power signal is routed from 14 of the Power Supply Board Item 44 through a 2 pin cable attached to the Color Display Adapter Board Item 85 Signals to the Color Display continue through the Color Display Adapter Board Item 85 from J3 through the Color Display Cable Item 108 which connects to the Color Display mounted in the Top Enclosure Assembly Item 22 The Color Display Adapter Board Item 85 contains a digital potentiometer for brightness adjustment switching circuits to enable the backlight and display power supplies The 11 VDC signal is switched by a transistor and then routed to the Dual Backlight Inverter
164. he options are 0 1 or 3 From the Mod Out Cal menu the supervisor can PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS CO Cal Menu From the menu the supervisor can check the calibration based on a Simulate 40 mmHg simulated trapezoidal signal PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 37 MENUS 3 38 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL CHAPTER 4 MRL LITE PROGRAM MENU SETUP This chapter lists the MRL LITE menu options and structure It provides the menu setup descriptions for both the user and supervisor menus Chapter Overview MAL Lite Menu 5 4 1 Basic Menu 4 3 MRL Lite 44 Setup Menus i ou uerba qus we Vue hs 4 8 ECG Configuration 4 10 Supervisor Menus 4 12 Supervisor Defibrillator 4 13 Supervisor Pacer Menu optional 4 15 Supervisor Diag Menu 4 16 Supervisor Setup Menu 4 17 Supervisor Upgrade 4 19 MRL Lite Menu Structure The MRL Lite System uses a modified version of the PIC User and Supervisor menus described i
165. he back of the retaining clip 5 Connect the Preamp Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pushing cable into connector the insulated side of the cable should face the Motherboard Item 46 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 81 REMOVAL AND REPLACEMENT INSTRUCTIONS E gt gt i Item 91 Main Oximeter Cable 8 82 REMOVE Remove Bottom Enclosure Item 21 Disconnect the Main Oximeter Cable Item 91 at J221 on Motherboard Item 46 by lifting up on the retaining clip with fingernail or a small instrument and pulling out cable Disconnect Main Oximeter Cable Item 91 at J2 on Oximeter Board Item 90 or 103 by lifting up on the retaining clip with fingernail or a small instrument and pulling out cable REPLACE 1 Connect Main Oximeter Cable Item 91 at J221 on Motherboard Item 46 by lifting up on the retaining clip with fingernail or a small instrument Place cable in connector then push the retaining clip toward the board and then down with a brown connector or just push down with a white connector the insulated side of the cable should face the back of the retaining clip Connect the Main Oximeter Cable Item 91 at J2 on Oximeter Board Item 90 or 103 by lifting up retaining clip with fingernail or a small instrument pl
166. he unit 8 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 93 REMOVAL AND REPLACEMENT INSTRUCTIONS E J Item 105 Modem Board 8 94 FAX OUTPUT CONNECTION 9 2 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Fax Output at J5 by lifting up on connector 3 Remove the Card Cage Pre Assembly Item 48 from unit 4 Disconnect Modem Cable Item 109 from J224 on Motherboard Item 46 5 Remove screws Item 5 Remove Modem Board Item 105 from Card Cage Pre Assembly Item 48 REPLACE 1 Replace Modem Board Item 105 from Card Cage Pre Assembly Item 48 lining up holes attach using screws Item 5 2 Connect Modem Cable to J224 on Motherboard Item 46 making sure to match notches Replace Card Cage Assembly Item 48 4 Connect Fax Output Cable at J5 by pushing connector into the metal pins 5 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 106 12 Lead Paddle Barrier SECURE BARRIER ON THIS END WITH TRANSFER TAPE NOTE Requires Conductive Tape 98 and Transfer Tape 24 121 from Fastener Kit 16 REMOVE 1 Remove Bottom Enclosure Item 21 Remove Memory Card Board Item 26 Remove th
167. heck Front Panel Cable Item 31 550730 Pacer Panel Cable Item 30 550729 Motherboard circuit error Check Motherboard Item 46 590329 or 591329 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 5 TROUBLESHOOTING GUIDE ENSE Failure to turn on Failed power switch Check Power Switch and Cable Items 58 and 57 500274 and 550733 Power supply circuit failure Check Power Supply Board Item 44 590337 Battery failure Recondition replace battery Motherboard circuit failure If power supply is OK or if LED s on front panel are lit but display chart recorder and beeper don t function check Motherboard Item 46 590329 or 591329 Unit shuts off without issuing Low Battery warning Battery failure Recondition replace battery Power supply circuit failure Check Power Supply Board Item 44 590337 Motherboard circuit failure Check Motherboard Item 46 590329 or 591329 Unit does not run on AC power Failure of paddle tray AC power supply If AC PWR light does not illuminate when line cord is plugged in check replace Paddle Tray AC Supply Module Item 17 971029 Failure of battery board Check Battery Board Item 54 590353 and connector to power supply board Failure of power supply board Check Power Supply Board Item 44 590337 Failure of quick Damaged contact pins Check Quick Charger 971104
168. heck Speech Board Item 94 590345 Motherboard circuit error Check Motherboard Item 46 590329 or 591329 Preampcableset fail Main preamp cable faulty or disconnected Check Main Preamp Cable Item 52 550720 Modem init fail Modem circuit failure Check Fax Modem Item 105 590384 593384 or 595384 Modem Motherboard cable not connected Check Fax Modem Item 105 590384 593384 or 595384 and connector to Motherboard Item 46 590329 or 591329 Remote fax busy Phone line busy Attempt to resend fax No answer at remote fax Connection terminated by receiving fax Attempt to resend fax Page send failed Connection terminated by receiving fax Attempt to resend fax Modem timeout during modem response Connection terminated by receiving fax Attempt to resend fax Page send failed Incompatible cellular phone or adapter Only use cellular phones and adapters recommended by MRL Connection terminated by receiving fax Attempt to resend fax PORTABLE INTENSIVE CARE SERVICE MANUAL TROUBLESHOOTING GUIDE EN No carrier External cable failed Check external cable detected or carrier lost Incompatible cellular Only use cellular phones and phone or adapter adapters recommended by MRL No dialtone External cable not Check external cable detected connected Line in use by another Check for another phone off the phone hook on
169. hield away from unit REPLACE 1 Thread the Backlight Inverter Cable Item 109 through Shield Place Color Display Shield back into unit with the cut out corner by the color display connector Adhere shield to display with one inch of double sided tape Item 10 2 Replace screws PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS EMEN 3 Replace Card Cage Assembly Item 48 4 Replace Memory Card Board Item 26 5 Tuck ferrite from Item 108 under the display shield and secure with double sided tape Item 10 6 Replace Blood Pressure Pump Valve Assembly and Foam Block Items 68 and 69 7 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 8 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 91 REMOVAL AND REPLACEMENT INSTRUCTIONS J Item 103 Oximeter Board with REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect the Preamp Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pulling on the cable 3 Disconnect the Main Oximeter Cable Item 91 at J2 by lifting up on the retaining clip with fingernail or small instrument 4 Disconnect Temperature Assembly Cable Item 75 from the Oximeter Board at J3 by pulling on connector 5 Disconnect CO Cable Item 18 at J4 by pulling on connector 6 Pu
170. hing and absence of pulse Excessive motion may affect analysis results ECG analysis should not be performed when the patient is being moved Stop all patient movement and do not touch patient when the ECG analysis is in process Take precautions to eliminate sources of motion or artifact before monitoring in SAED mode SAED mode automatically selects 200 300 360J for defibrillation energy Use of SAED mode on patients weighing less than 80 Ibs may increase the risk of myocardial tissue damage To insure compatability and electrical safety accessory pressure sensors should comply with ANSI AAMI BP 22 and IEC 601 2 34 for IBP or ANSI AAMI NS28 for ICP Follow instructions supplied with any accessory pressure sensor regarding calibration and removal of trapped air Avoid touching metal parts of any transducer while it is in contact with the patient Do not reuse any components that are labeled for single use only Transducers should be rated to withstand an accidental drop of at least a meter onto a hard surface Transducers that are subject to immersion in liquids should be rated as watertight PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION OEE CO Precautions Do not use CO sensor during MRI scanning MRI procedures can permanently damage the CO sensor e CO ETCO measurements may be affected by the presence of interfering gases or vapors Do not use on a
171. hing cable into connector The insulated side of the cable should face the Motherboard Item 46 4 Check that all cables are seated correctly in and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 8 6 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS NENNEN Item 19 Defib Main Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect Chart Power Cable at J223 on Motherboard Item 46 from Power Supply Board Item 44 at J5 by pulling on connector 4 Remove Defib Main Cable Item 19 by sliding from cable clamp on Card Cage Pre Assembly Item 48 5 Disconnect Defib Main Cable Item 19 from Motherboard Item 46 at J218 by pulling on cable 6 Disconnect Defib Main Cable Item 19 from Defibrillator Module Item 23 at J8 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 7 REMOVAL AND REPLACEMENT INSTRUCTIONS 8 8 REPLACE 1 Connect Defib Main Cable Item 19 to Defibrillator Module Item 23 at J8 Connect Defib Main Cable Item 19 to Motherboard Item 46 at J218 by pushing cable into connector and checking that cable is seated straight the blue side of the cable should face the outside of Card Cage Pre Assembly Item 48 Replace cable into clamp on Card Cage Pre Assembly Item 48 Connect Chart Po
172. hipping Campden GL55 6JX USA Gloucestershire United Kingdom Phone 847 520 0300 Phone 11 44 1 386 841926 Fax 847 520 0303 Fax 11 44 1 386 841230 declares that the CE marked product Product Name PIC Portable Intensive Care Base Units 971009 5 lead EL display 971013 5 lead Color display enor fee Device Type Defibrillator External Transcutaneous Pacemaker Multifunction Monitor 12 lead EL display 12 lead color display 5 lead LCD display 5 lead without defib complies with Council Directive 93 42 EEC Medical Device Directive of 14 June 1993 class llb Annex Il Standards General 150 9001 EN 46001 Safety IEC 601 1 60601 1 Class Continuous operation Type BF with external paddles or CF with internal paddles IEC 601 1 4 EN 60601 1 4 IEC 601 2 4 EN 60601 2 4 IEC 601 2 25 EN60601 2 25 IEC 601 2 27 EN 60601 2 27 IEC 601 2 30 EN 60601 2 30 IEC 601 2 34 EN 60601 2 34 IEC 1441 EN1441 EN 865 EN 475 EMC IEC 601 1 2 EN 60601 1 2 Date January 23 2003 el Orlinsky Director of Q A and Regulatory Affairs Table of Contents Title ete uda 1 Borward see as e ii FDA Medical Device Registration iii Declaration of Conformity eere iv Table of Contents dis eterne eer Safety Information 1
173. ible through the Treatment Configuration menus Treatment Intubate IV EPI Lido Bret Sample Clear Next Recorder Display Alarms SPO NIBP Resp Recorder Set Up Back Respiration ECG Trend Setup Trend Reset Back Trend Speed Menu Trend Speed Menu Use the Trend Speed to select the E amount of time the system will monitor the ECG or CO function The options are 10 min 30 min 2 hours 6 hours or 12 hours A The selected option is used to determine the maximum minimum E and mean rate for each of 120 intervals Depending on the option selected the display trace segments max min and mean will be 5 sec 15 sec 1 min 3 min and 6 min respectively 30 min 2 hour 6 hour 12 hour A bold outlined box indicates the selected speed Press EXIT B to return to the Trend Configuration menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 17 MENUS eee User Menus Recorder The Recorder menu allows users to configure the system recording options including print grid log review option voice memo and trends Access to this menu is through the Treatment Configuration menus Treatment Intubate IV EPI Lido Bret Sample Clear Next Recorder Display Alarms SPO NIBP Resp Recorder Set Up Back
174. ibration menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Language Lead Menu Upgrade Password Menu Forward Backspace The Language menu allows the supervisor to select the language used in the display The available languages are English Spanish French German Portuguese and Italian To change a language selection press the arrow buttons to change the language then press Save Turn the PIC off then restart it to activate the language option Cancel Save Y English Cancel Save The Lead menu allows the supervisor to change the default lead displayed on start up The Upgrade menu allows the addition of options to the PIC System in the field Contact your MRL customer service representative for instructions on upgrading the PIC System Adv Options SAED IBP ADV Review Back Options Available amp Analys Biphas_ Pacer Fax Back ENTERING THE UPGRADE PASSWORD The Password menu gives the operator the option of moving the cursor forward or backward or clearing canceling or saving the entry Follow these instructions to upgrade the password 1 Enter a new character by pressing once on the group of characters containing the character of your choice B
175. ilable only when lead select is set to when the lead select is set to PADS The frequency response selection sets the display and the chart recorder response Press the corresponding button to choose a frequency A bold outlined box indicates the selected frequency Press EXIT to close the Frequency Response menu Filter Menu Line Filter On 60 Hz 4 10 Line filters remove AC mains line interferences emitted from power lines and other electrical apparatus The line filter state On or Off and the line filter frequency selected in the supervisor menu display on this menu Press the quick access button from the Filter menu to turn the line filter option on or off Press the corresponding quick access button to Press EXIT to return to the ECG Configuration menu PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 85 1 85 Patient Cable Pt Cable PORTABLE INTENSIVE CARE SERVICE MANUAL Use the Patient Cable menu to choose a 3 lead or 5 lead patient cable If the patient cable inserted into the MRL Lite does not match the patient cable configuration selected a lead fault alarm may sound Press the corresponding quick access button to choose a different lead configuration A bold outlined box indicates the selected lead configuration Press EXIT to return to the ECG Configuration menu MRL LITE PRoGRAM MENU SETUP
176. in 4 5 hours High Capacity Type NiMH 12 volt MRL SuperPac High Capacity Up to 4 hours ECG monitoring or 110 full energy discharges or hours combined ECG SpO and BP monitoring while pacing Actual operating times will depend on the number of features activated and the duration of their use Proper battery care is required to maintain maximum available capacity Recharge Rate 80 in 7 5 hours 100 in 9 5 hours Multiple Paired Contacts Insures quick error free insertion and backup reliability Weight 10 pounds 4 95 kg basic configuration Size 13 x 12 5 x 5 3 inches 33 x 31 8 x 13 5 cm Operating Temperature 0 to 45 C Humidity NC 15 to 9596 RH 30 to 9096 with probe Vibration MIL STD 810E Shock Drop MIL STD 810E Altitude Up to 4572 M 15 000 feet Transport and Storage Temperature 30 to 70 20 to 70 C with CO probe Humidity 15 to 9596 RH non condensing Atmospheric pressure 860 to 1060 hPa Shock vibration ISTA 1A Enclosure Protection Solid Foreign Object 529 IP2X Water 529 IPX4 A I tests performed per AAMI DF 2 Defibrillation Standard Operating Power MRL SmartPak or auxiliary power from MRL Quick Charger Type External transmittances pacing PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 8 Pacer Rate 30 to 180 BPM x 5 Output Current 30 to 180 mA 10 or 5 mA whichever is greater M
177. in 5 e If the particular oximeter tester in use requires manual selection of a calibration curve verify that a curve specifically suited to the PIC has been selected Check for proper fit and alignment of the PIC oximeter probe on the test finger Consider the specified accuracy of the tester in use The PIC provides a means of adjusting the SpO reading to compensate for minor variations that are within the typical range of tester accuracy To access this adjust enter the Supervisor Dig SpO gt menu Use the up down commands to change the SpO reading by a constant value ranging from 2 to 2 PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES 8 5 L IBP Performance Test Equipment Required Procedure Acceptable Results Corrective Action IBP Transducer Simulator Connect the transducer simulator to the IBP1 input Zero the PIC IBP reading with the simulator set to 100mmHG Set the polarity switch of the simulator to the zero position Verify that the IBP reading is 100 2mmHg Change the transducer simulator setting to 100mmHg Zero the PIC IBP reading Raise the simulator setting to 200mmHg Verify that the IBP reading is 100 2mmHg Zero the PIC IBP reading with the transducer simulator set to the zero position Change the simulator to a setting of 20mmHg Verify that the IBP reading is 20 2mmHg Change the transducer simulator setting to 200mmHg Verify that the
178. in the protective earth ground wire Enclosure leakage between exposed conductive chassis points and protective ground Patient source leakage between patient leads and protective grounds or between any two patient leads Patient sink leakage Mains line voltage applied to patient leads The tests should be performed according to the operating instructions pertaining to the safety analyzer in use Electrical safety checks can be performed at intervals established by user preference The maximum length of time between checks should not exceed one year The checks must be performed following any repair of the PIC Ground resistance must not exceed 0 10 Earth leakage current must not exceed 500 UA NC normal condition or 1000 uA SFC single fault condition Enclosure leakage current must not exceed 100 UA NC or 500 uA SFC e Patient source leakage for any patient lead except paddles or pads must not exceed 10 NC or 50 WA SFC e Patient source leakage for paddles or pads must not exceed 100 NC or 500 uA SFC Patient sink leakage for any patient lead except paddles or pads must not exceed 50 SFC e Patient sink leakage for paddles or pads must not exceed 5000 SFC Remove the unit from service until any unacceptable result is rectified Possible causes of excessive leakage currents are usually related to damage insulation or mis wiring during equipment repair Excessive g
179. instrument placing cable into connector checking that the cable is seated straight and pushing down on retaining clip the white side of the cable should face the back of the retaining clip Connector is fragile 16 Connect Mono LCD Inverter Cable Item 34 to Mono LCD Display Adapter Board Item 49 at J4 by pushing on connector the ridged side of the cable should face out 17 Connect Front Panel Cable Item 31 to Motherboard Item 46 at J108 by lifting retaining clip with fingernails or small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should face the back of the retaining clip 18 Connect Pacer Panel Cable Item 30 to Motherboard Item 46 at J211 by lifting retaining clip with fingernails or small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should face the back of the retaining clip 19 Connect Blood Pressure Pump Valve Cable at J5 of Blood Pressure Board Item 92 by pushing connector on to metal pins Connect Temperature Cables Item 75 at J2 on Blood Pressure Board Item 92 lighter gray wire with 5 pin connector and J3 on Oximeter Board Item 90 darker gray wire with 7 pin connector Securely fasten small hose to valve assembly on blood pressure board 20 Connect Preamp Input Cable Item 32 to Paddle Preamp Board I
180. into connector checking that cable is seated straight and pushing down on retaining clip the insulated side of the cable should face the back of the retaining clip 4 Connect Display Power Supply Cable to Power Supply Board Item 44 at J4 by pushing on connector Lip on female connector should go under holder on male connector 5 Replace Card Cage Pre Assembly Item 48 6 Connect the Color Inverter Cable Item 109 at J2 on the Color Display Adapter Board Item 85 by pushing the connector in ensuring that the visible metal terminals face 7 Check that cables are seated correctly in connectors and clear of the sides of the unit 8 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 77 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 89 EL Display Adapter Board 8 78 REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect Display Power Supply Cable from Power Supply Board Item 44 at J4 by pulling on connector 4 Disconnect Flat Panel Display Cable Item 50 at J1 on EL Display Adapter Board Item 89 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable 5 Disconnect EL Display Cable Item 71 at J2 on EL Display Adapter Board Item 39 by pulling up on the connector 6 Remove two screws Item 5 from EL Display Adapter Board Item 89 with a 1 Phillips head scre
181. ion allows access to menu windows Selects defibrillation energy levels Initiates defibrillator to charge to selected energy Disarms charged defibrillator internally Activates the synchronization mode Light that indicates sync activation PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 85 PIC System Modes When the Semi Automatic Defibrillation SAED option has been installed the PIC can be configured to power up in one of three modes SAED Basic SAED Basic Manual defibrillation mode Each mode has a unique display and some controls and indicators may be deactivated Refer to Defibrillator Controls and Indicators section The SAED Basic mode has been designed to all those BLS personnel who have completed additional training to assess the patients vital signs NIBP and Pulse Ox In the SAED Basic mode the operator would be able to operate the Pulse Oximeter and the Non Invasive Blood Pressure In the SAED Basic mode these parameters have been disabled to simplify operations SAED Basic Mode If the PIC has been configured to power up in the SAED Basic mode only the voice memo supervisor configurable chart recorder hold and disarm controls will be active Below is an example of the active controls and display Voice Memo Lob bb e ANALYZING ECG STAND BACK Chart recorder Hold SAED BASIC MODE a
182. ion is cut off during NIBP measurements and may affect 5 measurements WARNING In some instances such as obstructed airway e the patient s breathing attempts may not produce any air exchange These breathing attempts can still produce chest size changes creating impedance changes which can be detected by the respiration detector It is best to use the pulse oximeter whenever monitoring the respirations to accurately depict the patient s respiratory condition 1 12 PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION Non Invasive Blood Pressure Precautions e Only a physician can interpret pressure measurements Blood pressure measurement results may be affected by the position of the patient his or her physiological condition and other factors Substitution of a component different from that supplied by MRL e g cuff hoses etc may result in measurement error Use only MRL cuffs and hoses Do not use a blood pressure cuff on the limb being used for IV infusion or for SpO monitoring e Accurate pressure readings may not be achieved on a person experiencing arrhythmias shaking convulsions or seizures Medication may also affect pressure readings The correct size cuff is essential for accurate blood pressure readings Blood pressure hoses must be free of obstructions and crimps e If the patient s cuff is not at heart level an error in
183. ips head screwdriver 6 Lift Patient Input Bracket Item 39 REPLACE 1 Place Patient Input Bracket Item 39 over the Patient Input Connector Item 40 2 Replace two screws Item 9 to Patient Input Bracket Item 39 with a 2 Phillips head screwdriver until snug do not over tighten 3 Replace Paddle Preamp Board Item 27 4 Replace Paddle Preamp Shield Item 29 5 Replace Card Cage Pre Assembly Item 48 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 31 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 40 Patient Input Connector Board 5 Lead X m NOTE Requires Label Kit Item 65 c REMOVE 1 8 32 Remove Bottom Enclosure Item 21 Remove Card Cage Pre Assembly Item 48 Remove Paddle Preamp Shield Item 29 Remove Paddle Preamp Board Item 27 Remove Patient Input Bracket Item 39 Insert Patient Input Connector Tool Item 127 into ECG Patient Cable Connector with the key at the top of the unit Push in and slightly press down until a click is heard and Patient Input Connector Board Item 40 loosens Remove Patient Input Connector Item 40 O ring Item 60 and ECG Label Item 59 from the unit PORTABLE INTENSIVE CARE SYST
184. is chapter has troubleshooting tables that list possible malfunctions or error messages that may occur in the PIC system The first table lists the malfunctions the probable causes and corrective actions to perform The second table is a list of error messages the probable causes and the corrective actions to perform The chapter ends with an illustration and explanation of how to troubleshoot the power source and gives the correct pin output voltages Chapter Overview s Malfinoll Dso ias mas Sar vide 7 1 Error Messages i i ue EARS 7 9 e Power Supply 7 14 Malfunctions The following table describes possible malfunctions situations that could occur with the PIC system Probable causes and suggested corrective actions are included for each type of malfunction je NOTE Where possible item and part numbers are included with Ey the corrective action If needed see Chapter 10 to obtain a specific part number for an item that is associated with multiple part numbers Malfunction Probable Cause Corrective Action Delivers 10 or Batteries not properly Recondition battery fewer shocks reconditioned Check expiration date on with charged battery See Chapter 3 battery Failure of power supply Check Power Supply Board Item 44 590337 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 1 TROUBLESHOOTING GUIDE OO Failure to charge
185. is responsible for the safety reliability and performance of the MRL Portable Intensive Care System only if the following three conditions are met e Assembly operations extensions readjustments modifications or repairs are carried out by persons authorized by MRL e The electrical installation of the relevant room complies with the appropriate requirements e The PIC equipment is used in accordance with the instructions for use To ensure patient safety and proper operation use only MRL authorized parts and accessories MRL PORTABLE INTENSIVE CARE SERVICE MANUAL FDA Medical Device Registration The FDA Safe Medical Device Act stipulates that each end user is required under penalty of law to register with the manufacturer all information pertinent to each medical device Please fill out the attached FDA Medical Device Registration postcard and return it promptly to MRL This card must be filled in and returned within 30 days of product delivery If the medical device is transferred from your possession you must notify MRL of the new registration information Please contact MRL 800 462 0777 if you have any questions regarding this notice MRL PORTABLE INTENSIVE CARE SERVICE MANUAL Declaration of Conformity Manufacturer Medical Research Laboratories Inc Response Medical Equipment Ltd 1000 Asbury Drive Bracken House Battlebrook Buffalo Grove IL 60089 C
186. is set to On or Auto the alarm icon that corresponds to the option you set will NOTE Ineither On or Auto mode an audible tone will sound and the patient s heart rate measurement will flash in the heart rate window if the alarm parameters have been exceeded Heart Rate Window HR BPM 60 When the alarm is set to Off the upper and lower limits will include the word Off and a number in parentheses The number indicates the currently set HR limit that will be active when the HR alarm is turned to On or Auto PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 85 1 38 8 TuRNING OFF THE ALARM 1 Press the OFF ON AUTO Quick Access button until Off is highlighted The word Off will appear in front of the upper and lower limit on the Quick Access menu The number in the parenthesis indicates the currently set HR limit This setting will be active when the HR Alarm is turned on 2 Press EXIT to leave the menu TO TURN ON THE ALARM OPTION 1 Press the OFF ON AUTO Quick Access button until On is highlighted Auto 2 Press the UPPER LIMIT button to i 5 2 Limit Heart Here window activate this option and highlight it 120 j with a bold box 60 3 Press the UP DOWN buttons to Y increase or decrease the upper limit power Lirit setting Exit press the Upper Limit button a second time The word
187. it PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL The Printer Options menu allows the supervisor to control the printout information on the chart recorder Turn an option On to include it in the printout Turn an option Off to exclude it from the printout but it will be sent to the log 3 31 MENUS Date Format Menu Temp Format Menu Line Freq Menu Manual Audio Menu 3 32 Use this menu to set the date format for displaying the month day and DT dd mm yy yy mm dd year mm dd yy month day year dd mm yy day month year yy mm dd z year month day To select a format press the corresponding button A then press Exit B Fahrenheit Celsius Voice Prompts Voice Mode Voice Log Temperatures readings can be set to display in Fahrenheit F or Celsius Press the corresponding Fahrenheit or Celsius button to select an option A bold outlined box indicates the selected option Press EXIT to return to the Supervisor Calibration menu The Line Frequency menu allows the supervisor to choose the desired line frequency either 50 or 60 Hz Press EXIT to return to the Supervisor Calibration menu Use the Audio menu to select the voice prompts voice memo and voice log modes These options are only available if purchased Press EXIT to return to the Supervisor Cal
188. l Oximeter motherboard cable faulty or disconnected Check Main Oximeter Cable Item 91 550722 Motherboard hardware error Check Motherboard Item 46 590329 or 591329 Oximeter hardware error Check Oximeter Board Item 90 590340 or Item 103 590390 OxAC Path Err Oximeter circuit error Check Oximeter Board Item 90 590340 or Item 103 590390 Probe error Check Oximeter probe Ox DC Path Err Oximeter circuit error Check Oximeter Board Item 90 590340 or Item 103 590390 Ox Buffer Err Oximeter circuit error Check Oximeter Board Item 90 590340 or Item 103 590390 Ox Chksum Err Oximeter circuit error Check Oximeter Board Item 90 590340 or Item 103 590390 BP Comm Fail BP Motherboard cable faulty or disconnected Check Main Blood Pressure Cable Item 93 550723 Motherboard circuit error Check Motherboard Item 46 590329 or 591329 BP circuit error Check Blood Pressure Board Item 92 590346 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 9 TROUBLESHOOTING GUIDE 1 Temp A D Err BP circuit error Check Blood Pressure Board Item 92 590346 BP RAM Err BP circuit error Check Blood Pressure Board Item 92 590346 BP DC Path Err BP circuit error Check Blood Pressure Board Item 92 590346 BP Chksum Err BP circuit error Check Blood Pressure Board Item 92 590346
189. l instrument and carefully pulling out cable Tubing Item 126 which should remain on the cable unless ES NOTE Front Panel Cable Item 31 will have a length of Shrink damaged PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 23 REMOVAL AND REPLACEMENT INSTRUCTIONS o 8 8 24 REPLACE 1 Connect Front Panel Cable Item 31 to Enclosure Assembly Item 22 by lifting retaining clip with fingernails or small instrument placing cable into the connector checking that cable is seated straight and pushing down on the retaining clip the insulated side of the cable should face the back of the retaining clip Make sure Shrink Tubing Item 126 is in place Connect Front Panel Cable Item 31 to Motherboard Item 46 at J108 by lifting retaining clip with fingernails or small instrument placing cable into the connector checking that cable is seated straight and pushing down on the retaining clip the insulated side of the cable should face the back of the retaining clip Connect the Preamp Protection Cable Item 32 or 81 to the Paddle Preamp Board Item 27 or 83 Replace Memory Card Board Item 26 if option installed Check that all cables are seated correctly in connectors and are clear of the sides of the unit Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 32 5
190. lation will take priority over external pacing Should the defibrillator be charged during the administration of external pacing the pacer will automatically be turned off and the defibrillator will charge to the selected energy Transcutaneous pacing should not be used to treat V FIB ventricular fibrillation In cases of V FIB immediate defibrillation is advised e Transcutaneous pacing may cause discomfort ranging from mild to severe depending on the patient s tolerance level muscle contractions and electrode placement In certain cases discomfort may be decreased by slightly relocating the pacing pads 1 10 PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION NENNEN e 115 important to monitor the patient closely to verify that both mechanical and electrical capture are occurring Electrical capture can be verified by observing the presence of a large ectopic beat after the pacing pulse is delivered The size and morphology of the beat are dependent on the patient In some instances the beat may appear as a relatively normal looking QRS pulse Mechanical capture can be verified by checking for signs of increased blood flow i e reddening of the skin palpable pulses increased blood pressure etc See chapter 8 of the PIC User Information Manual Continuously observe the patient during pacing administration to insure capture retention Do not leave the patient unattended when admi
191. le Menu Enter the Use the Enter Code menu to access the Supervisor 5 Supervisor menus Press RESET 0 to eset to Passcode prepare the system for a new access code Press a button to increment the corresponding digit When all four digits are correct press ENTER The Lock 9 icon on the Supervisor menu title block will open m when the correct code is entered 1 2 3 4 This code may be changed by the supervisor Write down the new supervisor code and store it in a safe place If the code is lost contact your MRL authorized service representative NOTE The default access code for entering the supervisor menus is ECG Configuration See the ECG Configuration section in this chapter for information on the ECG Configuration menus 4 8 PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 85 3 j Print Grid Menu Use the Print Grid menu choose to print SFr grid on the chart recorder paper If the Print Grid option is On the chart recorder will print a grid on plain white paper Press the corresponding button to select an option bold outlined box indicates the current selection Press EXIT to return to the Setup menu Set Date Menu Use the Set Date menu to set the current date To select the correct month press the MONTH button bold outlined box will appear around the month window Pre
192. lected energy a continuous charge tone will be heard visually and verbally clear the patient Place the paddles firmly on the patient s chest To discharge the defibrillator press both DISCHARGE buttons on the paddles or press the DISCHARGE button on the multipurpose hands free adapter PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION E i Non Invasive Pacing optional Monitoring Ll au 1893 Monitoring NIBP optional Monitor patient s ECG with the ECG patient cable Set lead to I IL or III Apply multipurpose pads to patient as illustrated on package Connect multipurpose pads to multipurpose hands free adapter Press the PACER button to turn on pacer Press the MODE button to select either DEMAND or ASYNC modes Press the RATE button to select the desired rate Press the START STOP button to initiate pacing Press the OUTPUT up arrow to increase the pacing output current until capture is obtained NOTE Ifthe defibrillator is charged the pacer will automatically 5 oq um turn off Attach appropriate SpO sensor to the patient and to the PIC System Press the BUTTON next to the 5 window to turn on the 5 monitor To display the patient s plethysmograph select Pleth in the display Trace menu Attach the appropriate size cuff and hose to the PIC System Apply the cuff snugly to the limb of the patient Select the NIBP mode
193. link and authorized fax number The ECG waveforms obtained for each lead setting should agree with those specified for the simulator in use Acquired ECG samples must be formatted to clearly display all 12 lead segments and identifying information The fax modem if available for test must successfully transmit the acquired ECG 12 lead segments and identifying information should be correct and legibly formatted for 8x11 paper size Verify that the ECG simulator generates accurate 12 lead test signals Check the patient cable if a Lead Fault message appears on some but not all lead settings Fax modem parameters may not be compatible with the test link Verify the settings in the Fax Settings Supervisory menu Be certain the settings will be correct under conditions of actual equipment use PORTABLE INTENSIVE CARE SERVICE MANUAL 5 21 PERFORMANCE TEST PROCEDURES 5 1 Non Invasive Blood Pressure Performance Test Equipment Required Procedure Acceptable Results Corrective Action 5 22 NIBP Analyzer Connect the PIC BP hose cuff assembly to the NIBP analyzer using its appropriate Luer type cuff adapter Select BP CAL as described in the operating instructions under Supervisor Menus Setup Use the Pump Up and Pump Down commands to manually adjust the PIC BP cuff In this mode static pressure is shown on the PIC display in the lower right corner of the BP window Allow a few seconds after chan
194. ll instrument and carefully pulling out cable If 12 Lead unit disconnect 12 Lead Preamp Protection Cable Item 81 at J2 on 12 Lead Preamp Board Item 84 Disconnect Paddle Pickup Cable Item 97 at J1 of 12 Lead preamp Board Item 84 by carefully pulling out connector Disconnect Front Panel Cable Item 31 from Motherboard Item 46 at J108 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable Disconnect Pacer Panel Cable Item 30 from Motherboard Item 46 at J211 by lifting retaining clip with fingernails or small instrument and carefully pulling out cable Disconnect Temperature Cable Item 75 at J2 on blood pressure board and J3 on Oximeter board Item 90 by pulling on connectors Item 92 Disconnect small hose from valve coming from Blood Pressure board Item 92 Disconnect AP Pump Valve cable at J5 on Blood Pressure Board Item 92 by pulling on connectors Disconnect Mono LCD Inverter Cable Item 34 from Mono PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OEE LCD Display Adapter Board Item 49 at J4 by pulling on the connector 8 For color option disconnect Color Display Cable Item 108 at J3 on Color Display Adapter Board Item 85 by lifting up on connector Disconnect Color Inverter Cable Item 109 at J2 on Color Display Adapter Board Item 85 by pulling connector out 9 For EL option
195. ll not put out pulses Inthe ASYNC Mode the Pacer outputs pulses at the rate set by the operator independent of the patient s own rate When the PIC is in the Paddle Pickup Mode the path for ECG information is from the Paddle electrodes through the Defibrillator Module Item 23 to J3 of 5 Lead Paddle Preamp Board Ite m27 or of 12 Lead Paddle Preamp Board Item 83 PORTABLE INTENSIVE CARE SERVICE MANUAL THEORY OF OPERATION Options 12 Lead ECG ECG signals can be monitored from the patient cable or the paddle set ECG signals from the patient cable pass through the 12 Lead Protection Board Item 88 to J4 and J5 of the 12 Lead Paddle Preamp Board Item 83 and on to the 12 Lead ECG Preamp Board Item 84 via a 22 pin FFC Preamp Protection Cable Item 81 The cable is connected from J2 of the 12 Lead ECG Preamp Board to J3 of the 12 Lead Paddle Preamp Board and is sheathed with an insulating shrink tube barrier to isolate patient connected signals from grounded circuitry ECG signals from the paddle set or hands free adapter pass from the Defibrillator Module Item 23 to J1 of the 12 Lead Paddle Preamp Board where it passes through a gain stage and an analog optocoupler before being routed through the Preamp Protection Cable Item 81 The 12 Lead Protection Board Item 88 contains EMI and defibrillator protection circuitry and an AAMI standard 12 pin connector The 12 Lead Paddle Preamp Board Item 83 contai
196. located connect Defib Main Cable Item 19 to Defibrillator Module Item 23 at J8 by carefully pushing in the cable and making sure it is seated straight in the connector The blue side of the cable should face the wall of the unit 4 Connect Pad Pickup Cable to Paddle Preamp Board Item 27 at J3 or Item 83 at J1 by carefully pushing connector onto the metal pins 5 Connect Defib Out connection by pushing down on locking mechanism and pushing connectors together 6 Connect Defib Power cables to Power Supply Board Item 44 at J7 by pushing down on locking mechanism and pushing onto connector 7 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 8 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 15 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 24 Input Panel MRL OXIMETER OPTION 971002 OXIMETER OPTION 971074 REMOVE 1 Remove three screws Item 6 on Input Panel Item 24 using a 1 Phillips head screwdriver 2 Tilt Input Panel Item 24 to the front of the unit and lift up 3 Disconnect connectors from the Input Panel Board if present REPLACE 1 Connect connectors to the Input Panel Board if present 2 Insert the two tabs on the front of Input Panel Item 24 into the top of the unit Push down into the unit 3 Replace three screws Item 6 into Input Panel Item 24 using a 1 Phillips head screwdriver
197. ltages can be present inside the defibrillator and at the defibrillator electrodes Use extreme caution when the defibrillator is charged or the case is open Defibrillator Energy Accuracy Equipment Required Defibrillator analyzer capable of measuring trapezoidal wave form output MRL DT2000A or equivalent Procedure 1 Press Power switch to ON 2 Select Energy level and charge defibrillator 3 Discharge into the analyzer Acceptable Results The maximum acceptable error is 10 or within 2 J which ever is greater Corrective Action If energy measurements are not within tolerance verify that the analyzer is accurate when measuring a trapezoidal output e If the analyzer is correct then refer to the Delivers incorrect energy listing in Chapter 7 Troubleshooting Guide PORTABLE INTENSIVE CARE SERVICE MANUAL 5 11 PERFORMANCE TEST PROCEDURES 85 Defibrillator Charge Time Equipment Required Procedure Acceptable Results Corrective Action 5 12 Stopwatch 1 Testonly fully charged battery packs 2 Operate the defibrillator on battery power at a setting of 360 joules 3 Charge the defibrillator and then discharge it into the test load of the battery charger Repeat this process 10 times allowing approximately 1 minute between each test shock 4 Measure the charge time for the 10th shock This time should be less than 7 seconds for the SmartPak Plus battery or less than 9 secon
198. m 17 if present 2 Remove Bottom Enclosure Item 21 3 Disconnect Power Supply Cable on Battery Board from Power Supply Board Item 44 at J2 by pushing down on locking mechanism and pulling out 4 Remove wire terminals from connector 76 or cut wires to remove connector 5 Remove Silicon RTV from wire hole 6 Remove Battery Board Cover Item 38 7 Slide Battery Board Item 54 from the unit REPLACE 1 Wrap tape temporarily around the wires of Battery Board Item 54 to allow easy entry into the wire hole in the back of the unit 2 Slide Battery Board Item 54 into the unit along the two rails Make sure that all 5 wires pass through the wire hole into the back of the unit PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 3 Replace Battery Board Cover Item 38 4 Remove tape from wires of Battery Board Item 54 5 Use Silicon Item 37 to seal the wire access hole around the wires 6 Insert the appropriate wires into the connector J6 following Diagram 2 in Chapter 9 7 Connect Power Supply Cable on Battery Board Item 54 to Power Supply Board Item 44 at J2 by pushing down on locking mechanism and pushing in 8 Check that all cables are seated correctly and are clear of the sides of the unit 9 Replace Bottom Enclosure Item 21 10 Replace AC Supply Paddle Tray Module Item 17 if present PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8
199. m 53 Chart Recorder Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Remove four screws Item 9 from gold bracket covering Chart Recorder Cable Item 53 with 2 Phillips head screwdriver 4 Remove Chart Recorder Cable Item 53 by rocking it back and forth while pulling out May require some force REPLACE 1 Insert Chart Recorder Cable Item 53 into Chart Recorder housing Make sure that the cable is correctly seated in the connector 2 Replace four screws Item 9 in gold bracket attached to Chart Recorder Cable Item 53 with a 2 Phillips head screwdriver 3 Replace Card Cage Pre Assembly Item 48 4 Check that all cables are seated correctly and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 55 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 54 Battery Board 8 56 BATTERY BOARD CONNECTION SEE DIAGRAM 2 SHEET 6 e Forte i STR J2HH 2 7 v ah OUN IE a LA NOTE Requires Silicon 37 REMOVE 1 Remove AC Supply Paddle Tray Module Ite
200. me and product descriptions Chapter Overview Item 21 Bottom Assembly Item 22 Top Enclosure Assembly Item 23 Defibrillator Module Item 24 Input Panel Item 46 Motherboard Item 65 Label Kit Item 105 Fax Modem Board NOTE Refer to Sheet 1 of the Assembly Drawings in Chapter 9 to m associate a part number with an item number Refer to the part number of the unit the explanation of the Part Numbering System in Chapter 2 to determine the appropriate replacement parts for your PIC PIC Monitor or MRL Lite system PORTABLE INTENSIVE CARE SERVICE MANUAL 10 1 SERVICE PART NUMBERS 1 Item 21 Bottom Assembly Base Part Number Description Item 21 Part number 971039 MRL Lite 570620 971044 PIC Monitor 570620 others PIC See below Specify PIC part numbers as follows 570606 Color Fax Data Color Y Yellow G Gray Fax F Fax Option 971019 installed Data R Data Comm Package 971073 installed Fax Data Comm RS 232 Item 21 Part Number N N 570606 G or Y Y N 570606 GF or YF N Y 570606 GR or YR Y Y 570606 GRF or YRF Item 22 Top Enclosure Assembly Base Part Description Item 22 Part Number Number 971039 MRL Lite 570619 971044 PIC Monitor 570614 971009 PIC 5 lead EL 570607 971013 PIC 5 lead Color TFT 570607 971026 PIC 12 lead EL 571616 97102
201. measurement Sow Normal Slow averages the respiratory rate on a moving 60 second average Normal averages the respiratory rate on a moving 30 second average Fast averages the respiratory rate on a breath by breath basis Press a button D to select a response rate A bold outlined box indicates the selected response Press EXIT B to return to the Resp Configuration menu 3 14 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS User Menus Respiration CO2 Respiration data is sourced from ECG leads or the sensor and defaults to the CO sensor if active for improved accuracy and response Use the menu to configure the size speed and response display settings Access this menu from the Treatment Configuration menus Treatment Intubate IV EPI Lido Bret Sample Clear Next Recorder Display Alarms SPO NIBP Resp Recorder Set Up Back Respiration ECG Trend Back Setup Size Speed Response Reset Back CO CO Size Speed Response Menu Menu Menu CO Size Menu Use the CO Size menu to select the displayed trace size Press a 0 to 80 mmHg button A to select a size scale O to 0 to 40 mmHg 80 mmHg 0 to 40 mmHg or 0 to 0 to 20 mmHg 20 mmHg A bold outlined b
202. ment Required Procedure Acceptable Results Corrective Action 5 24 Use this procedure to verify proper performance of the PIC 5 option at normal intervals or whenever the SpO probe is replaced Pulse Oximeter Tester with the correct calibration curve for the MRL model PIC if the tester in use requires these custom curves 1 Attach the PIC oximeter probe to the test finger on the oximeter tester and operate the tester according to the instructions for the particular tester in use 2 To ensure that the PIC is using the oximeter signal to determine its displayed heart rate disconnect or disable other signal inputs from which the heart rate could be derived ECG or BP 3 Setthe simulated oxygen saturation level on the oximeter tester to an available setting closest to 70 Set the tester s simulated heart rate to any available setting within a range of typical values between 60 and 120 bpm 4 With the PIC SpO function set to ON verify that a Signal OK message is displayed in the SpO window Allow the PIC SpO and HR readings to stabilize and compare them to the settings of the tester 5 Repeat step 4 at available settings of the tester that are closest to 80 90 and 99 The accuracy of PIC readings must be within 3 for oxygen saturation levels from 70 to 80 e The accuracy of PIC SpO readings must be within 2 for oxygen saturation levels from 81 to 99 e Heart rate accuracy should be with
203. ment Upgrade UnitID Code Printer Back Options Available SAED IBP Adv Review Back Options Available lt _ __ Analysi Biphas Pacer Fax Back Supr Setup 2 ag Date Temp LineFreq Audio Language Lead Back 12 Lead Phone Fax Freq Analysis Copies Back dee Supr SAED ALSCode E Prot Audio Startup Back Supr Pacer Rate Mode Back Supr Defib Ext Eng Int Eng Mode Alarm Back PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Supervisor Menus Defibrillator A supervisor can configure the defibrillator external internal and sync settings from the Defibrillator menu This menu is accessible through the Treatment Configuration Set Up menus Set Up Suprvsr Date Time Shifts Back Enter Passcode here gt Supervisor UNLOCKED Defir Pacer SAED 12Lead SetUp Diag Exit gt Supr Defib ExtEng Int Eng Mode Alarm Back Ext Int Sync Charge Energy Energy After CV Alarm Menu Menu Menu Menu External Energy The Ext External Energy menu sets the Menu default energy selected when the PIC is first turned on The selected setting displays in this menu To change the setting press the UP arrow A or DOWN arrow B to increase or decrease the selection Options are 2 5 7 10 20 30 50 70 100 150 200 300 or 360 joules Press EXIT C
204. n Set the ENERGY SELECT control to 360 J Use a stopwatch or the second hand on a clock to measure the approximate time required to charge the defibrillator to full energy 3 Reduce the energy setting to 200 J Use a defibrillator tester to verify that the actual output is within 10 20 J Also verify that the 150 J output is within 10 If this required accuracy cannot be confirmed refer to the procedure for testing defibrillator energy accuracy 4 When defibrillator outputs are confirmed to be correct test the integral DEFIB TEST function by discharging into the test load located in the paddle tray AC Supply Paddle Tray Option or on either side of the Quick Charger First charge the defibrillator to 1 5 0J and discharge it into the test load while observing that the DEFIB TEST indicator does not blink Then repeat the test at 200 J while observing that the DEFIB test indicator blinks 5 Turn off the PIC but keep the AC power connected Insert depleted battery into the charger or directly into the PIC if testing the AC Supply Paddle Tray The charger should come on continuously and stay on as along as the battery is charging Note the starting time for the battery charging period 6 Allow a period of time for the battery to fully charge This period will depend on the type of battery being tested Refer to the following chart to determine typical charge time for the different battery types available The times given are for
205. n Chapter 3 The MRL Lite Menu structure consists of four menu options and the controls used to adjust the display area brightness and contrast The MRL Lite Menu is located along the bottom of the MRL Lite display area as shown in the following diagram PORTABLE INTENSIVE CARE SERVICE MANUAL 4 1 MRL LITE PROGRAM MENU SETUP E 4 2 Quick Access buttons select a menu button option then press these buttons to use the programmable menus s 78g D T 1 pee Menu buttons press to select and display a programmable menu Press a Menu button to select or activate a menu option and display the associated programmable menu along the left side of the display area Press a Quick Access button located to the left of the display area to select or activate the a programmable menu option PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP Basic Menu Structure The basic MRL Lite Menu options display at system startup and are used to set up many of the system functions including Alarm Setup Log e Sample Brightness Contrast MRL Lite Alarm Setup Log Sample 2 Y Y Meno Menu SERIE Gone Supr EcgConf Grid Date Time Back Grid Date Time Menu Menu Menu
206. n from Paddle Preamp Board Item 27 at J1 by pulling on the connector Do not pull on the wires See detail 2 sheet 3 on the service assembly drawing 6 Slide Paddle Preamp Board Item 27 up and out of unit REPLACE 1 Slide Paddle Preamp Board Item 27 into unit along the 2 rails 2 Connect ECG Input Connection to Paddle Preamp Board Item 27 at J1 by pushing the connector onto the metal pins Lip on female connector should go under holder on male connector Replace Paddle Preamp Shield Item 29 Replace Card Cage Pre Assembly Item 48 Replace Memory Card Board Item 26 Qv UE Go cU Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 8 18 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 28 Barrier for 5 Lead Paddle Preamp Board SLIDE BARRIER BETWEEN PIC AND PCB REMOVE Bw m Remove Bottom Enclosure Item 21 Remove Memory Card Board Item 26 Remove Card Cage Pre Assembly Item 48 Remove Paddle Preamp Shield Item 29 Remove Paddle Preamp Board Item 27 Slide Barrier for 5 Lead Paddle Preamp Board Item 28 out of unit REPLACE 1 Slide Barrier for 5 Lead Paddle Preamp Board Item 28 into unit with cut out over Patient Input Connector Item 40 housing Replace Paddle Preamp Board Item 27 Replace Paddle
207. nal energy setting that will be active when the MRL Lite is first turned on without paddles or when internal paddles are first attached The current selected default energy setting is displayed in this menu The options are 2 3 4 5 6 7 8 9 10 20 30 or 50 Joules To prevent possible cardiac tissue damage the energy output is limited to 50 Joules To change the default energy setting press the up arrow to increase or the down arrow to decrease the energy selection Press EXIT to return to the Supervisor menu PORTABLE INTENSIVE CARE SERVICE MANUAL 4 13 MRL LITE PRoGRAM MENU SETUP Sync After CV Use the Sync After CV cardioversion menu to configure the defibrillator to stay in the sync mode after each synchronized cardioversion If this option is Off the defibrillator will revert to the Asynchronous mode If the option 16 On the defibrillator will remain in the Sync mode after each cardioversion Press a button to select an option A bold outlined box indicates the selected option Press EXIT to return to the Supervisor menu 4 14 PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP 8 1 Supervisor Pacer Menu optional Ope Defib Pacer Setup Diag Back Rate Mode Back Rate Mode Menu Menu Rate Menu Mode Menu Demand Async
208. nd battery icon is not LOW Remove or loosen patient s clothing if necessary for application of pads Check expiration date of the pads Do not use pads that have expired Remove disposable multipurpose pads from packaging Use MRL Multipurpose electrodes model 001789 for adult patients only Remove protective cover from pads and apply the pads to the patient Apply the RA pad to the patient s right side to the side of the breast bone and below the collar bone Apply the LL pad over the patient s ribs to the left of the nipple Follow display messages and voice prompts PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION Part Numbering System PIC System Part MRL uses a part numbering system that allows both the user and Numbering service technician to understand what type of unit and installed options are in each PIC System 9710 X XX Color SpO2 CO2 NIBP IBP VM Adv Rec Rev 12LD Options Language PORTABLE INTENSIVE CARE SERVICE MANUAL X Color SpO2 CO2 NIBP IBP VM Adv Rec Rev 12 Ld Opt Lang 09 PIC 5 lead EL Display 13 PIC 5LD Color TFT Display 26 PIC 12LD EL Display 27 PIC 12LD Color TFT Display 42 PIC 5LD Mono LCD Display Gray Installed 971002 Y G S 0 Not Installed C Installed 971016 B Installed 971001 1 One channel 2 2 channels 971017 V Voice Memo 971005 A SAED 971008 amp 971005 Included
209. nect Hose to PR1 making sure it is securely fastened 2 Connect the Main Oximeter Cable Item 91 at J2 on Oximeter Board Item 90 by lifting up retaining clip with fingernail or a small instrument placing cable into connector then pushing the retaining clip toward the board and then down 3 Connect Blood Pressure Main Cable Item 93 at J4 by lifting the retaining clip placing cable in connector and pushing retaining clip the insulated side of the cable should face up 4 Slide the rest of the board into Card Cage Pre Assembly Return locking mechanism to the locked position by pushing the plastic side in with a finger or small instrument such that the mechanism clicks into place and the silver side in protruding 6 Connect the Cable from the Pump Valve Assembly Item 69 at J5 by pushing connector onto the metal pins 7 Connect the Temperature Probe Assembly Item 75 to the Blood Pressure Board at J2 by pushing connector onto metal pins 8 Connect Front Panel Cable Item 31 to Motherboard Item 46 at J108 by lifting up on the retaining clip with fingernail or a small instrument placing cable into connector checking that the cable it seated straight and pushing down on retaining clip the insulated side of the cable should face the back of the retaining clip 9 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 10 Replace Bottom Enclosure Item 21 8 84 PORTABLE
210. nector using a 2 Phillips head screwdriver 3 Liftup Auxiliary Power Connector 4 Slide AC Supply Paddle Tray Module Item 17 up along the back side of the unit REPLACE 1 Slide AC Supply Paddle Tray Module Item 17 down along the back side of the unit Both metal clips should lock into place 2 Push Auxiliary Power Connector down onto the top of the unit making sure the 4 white plastic connectors are pushed into the correct holes 3 Replace one screw Item 4 into Auxiliary Power Connector using a 2 Phillips head screwdriver 4 Replace Input Panel Item 24 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 5 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 18 CO Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Ifa5 Lead model disconnect the Preamp Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pulling on the cable 3 Disconnect CO Cable Item 18 from Oximeter Board Item 103 at J4 by pulling on connector 4 Disconnect CO Cable Item 18 from Motherboard Item 46 at J219 by pulling on connector REPLACE 1 Connect CO Cable Item 18 to Motherboard Item 46 at J219 by pushing connector onto metal pins 2 Connect CO Cable Item 18 to Oximeter Board Item 103 at J4 by pushing connector onto metal pins 3 5 model connect the Preamp Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pus
211. ngernail or small instrument and carefully pulling out cable Connector is fragile REPLACE 1 Connect Mono LCD Cable Item 35 to LCD Display Adapter Board Item 49 at J5 by very carefully lifting retaining clip with fingernail or small instrument placing cable into connector checking that the cable is seated straight and pushing down on retaining clip The white side of the cable should face the back of the retaining clip Connector is fragile PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 27 REMOVAL AND REPLACEMENT INSTRUCTIONS 8 5 L 2 Connect Mono LCD Cable Item 35 to Top Enclosure Assembly Item 22 at J5 by very carefully lifting retaining clip with fingernail or small instrument placing cable into connector checking that the cable is seated straight and pushing down on retaining clip The white side of the cable should face the back of the retaining clip Connector is fragile 3 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 8 28 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 36 Chart Recorder c NOTE Requires Label Kit Item 65 REMOVE 1 Open Chart Recorder Door and remove paper roll 2 Remove two screws on the inside bottom of the Chart Recorder Item 36 with a 2 Phillips h
212. nguage setting to English press the Mute and VOL buttons at the same time Code Menu Use the Set Code menu to select the poem supervisor access code The default code is 1 2 3 4 To set a new supervisor code press a button to increment the corresponding digit until the number of your choice appears The range for each digit of the Enter code is 0 9 Press CANCEL to cancel the number code selection Press ENTER to save the code Cancel NOTE Remember to write down the new supervisor code and store it in a safe place Use the Printer menu to disable hardcopy printouts when specific events occur ECG Events are events generated by Printer Menu Defib Pacer On when the Sample button is pressed Miscellaneous events are system status ECG Events events such as System On and Low On Miscellaneous Battery messages n Select OFF to disable printouts at the time the event occurs Chart printouts for these events can only be obtained when the event log is printed Press ON to generate printouts when the event occurs and when the event log is printed 4 18 PORTABLE INTENSIVE CARE SERVICE MANUAL MRL LITE PRoGRAM MENU SETUP Supervisor Upgrade Menu Defib Pacer Setup Back Line Freq Date Upgrade Language Code Back Enter supervisor password Options Available Adv P
213. nistering external pacing therapy Someerythema of the skin and or minor burns may occur under the pacing electrodes in some patients For prolonged periods of pacing 24 hours periodically inspecting the skin beneath the electrodes when patient s condition allows is recommended Discontinue external pacing if the skin is affected and if another form of pacing is available Disposable defibrillation pacing electrodes must be used in accordance with the manufacturer s instructions Do not use expired dry electrodes or reuse disposable electrodes as improper patient contact may result in patient burns and inability of the device to function properly The pacing rate determination can be adversely affected by artifact If the patient s pulse and the heart rate display are significantly different external pacing pulses may not be delivered when required WARNING PACEMAKER PATIENTS The MRL PIC includes a pacemaker rejection circuit The following warning is in accordance with the disclosure requirement of AAMI Standard EC 13 3 1 2 1 8 The rate meter may continue to count the pacemaker rate during some occurrences of cardiac arrest or some arrhythmias Do not rely upon the heart rate meter alarms to assess the patient s condition Keep pacemaker patients under close surveillance Note This warning is an AAMI requirement that applies to all ECG monitors regardless of make or model e Artifact and ECG noise can make R wave
214. ns and Icons 3 5 Quick Access Buttons and Pop up Menus 3 6 User MEIU S cree eene errore tet ener oer 3 7 User Menus Display eene 3 8 User Menus 3 11 User Menus Non Invasive Blood Pressure 3 12 User Menus Respiration ECQ 3 13 User Menus Respiration 3 15 User Menus Respiration Trend 3 17 VI MRL PORTABLE INTENSIVE CARE SERVICE MANUAL AEN User Menus Recorder eese 3 18 User Menus Setup 2 iur 3 20 Supervisor Menus 2 3 22 Supervisor Menus Defibrillator 3 23 Supervisor Menus Pacer 3 25 Supervisor Menus 3 26 Supervisor Menus 12 3 28 Supervisor Menus 3 30 Supervisor Menus Calibration 3 35 MRL LITE Program Menu Setup 4 1 MRL Lite Menu Structure 4 1 Basic Menu Structure 4 3 MRE Lite Men s 4 4 Setup Menus 4 8 ECG Configuration Menu
215. ns the paddle pickup preamplifier protection circuitry and the impedance transformers for detecting paddle set and pacer pad lead faults The 12 Lead ECG Preamp Board Item 84 contains ECG gain and filtering circuitry QRS detection circuitry lead fault detection circuits and pace detection blanking circuits A microprocessor on the 12 Lead ECG samples and digitizes the ECG and sends the data to the Motherboard Item 46 via an opto isolated serial bus Communication to the Motherboard passes through a 22 pin FFC Motherboard Cable Item 82 connected to J104 of the Motherboard and J5 of the 12 Lead ECG Preamp Board In addition the QRS Sync pulse to the Defibrillator Module Item 23 and the Pace Blanking signal from the defibrillator pass through Item 19 via the Motherboard The optocouplers and digital buffers on the ECG Preamp Board are powered by 5 VDC The rest of the 12 Lead ECG Preamp Board is powered through an isolated supply by the 11VDC supply The 11 VDC supply is fused on the 12 Lead ECG Preamp Board IBP The Motherboard Item 46 communicates with the Blood Pressure Board Item 92 via the Main Blood Pressure Cable Item 93 connected to J215 on the Motherboard and J4 on the Blood Pressure Board The signals from the IBP1 and IBP2 probes travel through the Patient Input Panel Item 24 to J1 via a 9 pin cable An isolated supply runs off 11 VDC and through fuses F2 and in the Patient Input Panel PORTABLE INTENSIVE CARE
216. nting accurate rhythm analysis PORTABLE INTENSIVE CARE SERVICE MANUAL 1 7 SAFETY INFORMATION Do not operate the PIC in close proximity to any other monitor with respiration measurements The two devices could affect the respiration accuracy Any external connection to the 1V or MOD outputs must comply with clause 19 of IEC 601 1 for leakage current and must not exceed 450 mA Shock Hazard Use of accessories other than those specified in the operating instructions may adversely affect patient leakage currents Certain line isolation monitors may cause interference on the ECG display and may inhibit heart rate alarms Defibrillator Precautions 1 8 The MRL PIC can deliver 360 joules of electrical energy If this electrical energy is not discharged properly as described in the User Instruction Manual the electrical energy could cause personal injury or death to the operator or bystander The operator and all other people must stand clear of the patient the bed and all conductive surfaces that are in contact with the patient during defibrillation The electrical energy delivered to the patient could also be delivered to any other person who is in contact with the patient or the conductive surface Do not use the defibrillator in the presence of oxygen sources such as near bag valve mask devices or ventilators flammable gases or anesthetics These environments can produce fire or explosion hazards WARNI
217. ntrast Back Trace Frequency Filter Pt Cable Brightness Contrast Menu Menu Menu Menu Function Function In the Trace menu users can choose from several ECG trace display parameters including Resp Pleth or Off for waveforms 2 or 3 If the PIC includes the 12 lead option users can select lead I AVR aVL aVF V1 2 3 4 5 6 2 Pleth or Off for waveform 2 or 3 Press the UP and DOWN arrow buttons to select an option Press SAVE to save the current selections ECG Waveform bake ede ECG and Waveform 2 Resp Resp and Pleth Waveform Resp x1 5s Pleth PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Frequency Menu Limited zm 2 20 Hz Monitor 1 40 Hz Filt Diag 0 05 40 Hz Diagnostic 0 05 150 Hz Exit Filter Menu Line Filter On 60 Hz Patient Pt Cable Menu Use the Frequency menu selections to set the display and chart recorder responses Four frequency options are available Limited response is best used for paddle monitoring applications Monitor response is best used for general ECG monitoring applications Filt Diag is best used in the field when noise and or artifacts are a problem This option is only available if the 12 Lead
218. nute 0 60 Active Shift Shift 1 Shift 2 Shift 3 Defaults 3 2 T If option has been purchased PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Supervisor Menu Overview Menu Submenu Choices Choice Range Factory Default Defibrillator Ext Energy 2 5 7 10 20 30 50 70 100 150 200 Joules 200 300 360 Int Energy 2 3 4 5 6 7 8 9 10 20 30 50 20 Joules Mode On Off Off sync after cv Charge Alarm Alarm Volume Max Volume OK Pacer Rate 30 180 by 5 s 100 and 10 s gt 100 60 Mode Async or Demand Demand SAEDt Set ALS Code 0 0 9 1 0 0 9 2 0 0 9 3 0 0 9 4 Cancel Required not required Required E Prot SAED 200 200 360 or 200 300 360 200 300 360 Protocol Joules SAED Audiot Memo Start Stop Continuous Continuoust Memo Startup Manual Basic Basic Basic 12 Leadt Phone Name Prefix Phone Number Postfix 16 phone numbers Receiver Type Copies 1 2 3 4 5 1 Fax Grid Full Grid Partial Grid Full Grid Audio Output On off On Baud Rate 2400 4800 7200 9600 Fast Fax Enabled Disabled Disabled Freq Filt Diag Diagnostic Analysis Manual Automatic Set Up Shifts Save as 1 2 3 Save to card Load from card Treatment Button 1 2 3 4 5 Intubate Lido Bret CPR Arrival Intubate IV Event Atrop IV Surg Sedate EPI Lido Bret Narcotic Dry Agt Anesth Custom1 2 3 4 5 Sample IV EPI Upg
219. od within the limits prescribed by the American National Standard Institute Alarms Artifact Check Cuff Tighten Cuff Cuff Leak Motion Alarm Limits Systolic 30 to 245 mmHg Diastolic 25 to 210 mmHg IBP Number of Channels 2 Display Numerical and one or two graphical waveforms Numerical Systolic Diastolic Mean pressure Waveform Display Ranges 40 80 160 300mmHg Waveform Labels ART CVP PA ICP Misc P Pressure range 30 to 300mmHg Accuracy 2 mmHg or 2 of reading whichever is greater plus transducer error Transducer Sensitivity SjuV V mmHg Offset 125 mmHg including transducer offset Excitation Impedance Range 150 to 10 000 ohms Excitation Voltage 4 75 0 25 VDC Connector 6 pin circular MS3100 series Connect to A B C D E Signal Type Sig Exc Sig Exc shield Temperature with Measurement Range 0 to 50 C NIBP optional PORTABLE INTENSIVE CARE SERVICE MANUAL 2 31 GENERAL INFORMATION 85 LL MRL Quick Charger 2 32 Accuracy 0 2 Resolution 0 1 Scale Fahrenheit or Celsius Probe YSI Series 400 Alarm Limits High 99 109 F 37 42 and low 85 98 F 29 36 alarm limits Mains Line Voltages 100 to 240 VAC four user selectable ranges 100 120 220 240 VAC Mains Line Frequency 50 to 60 Hz AC Power Consumption 50 W while charging batteries only
220. odes Demand and asynchronous Status Indicators ECG lead fault pace lead fault pace marker on monitor and chart start stop LED Pulse Type Rectangular constant current Pulse Width 20 ms Refractory Period 250 ms Output Protection 360 Joules SAED Rhythm The PIC SAED algorithm exceeds the requirements of ANSI AAMI Recognition DF39 1993 section 3 3 18 and the sensitivity and specificity levels Performance recommended by the AHA Automatic External defibrillators for Public Access Use Recommendations for Specifying and Reporting Arrhythmia Analysis Algorithm Performance The test database includes shockable rhythms consisting of ventricular fibrillation rhythms 2150uV and wide complex ventricular tachycardia at a rate greater than 160 BPM Non shockable rhythms include various sinus rhythms including supraventricular tachycardia atrial fibrillation atrial flutter sinus rhythm with PVC s asystole pacemaker rhythms and ventricular tachycardia with a rate less than 160 BPM and or narrow complexes Rhythm Recognition Test Results Specificity non shockable Exceeds AAMI Requirement gt 95 and recommendation gt 99 Sensitivity VFIB Exceeds AAMI Requirement and AHA recommendation gt 90 Sensitivity VTACH Exceeds AAMI Requirement and AHA recommendation gt 75 optional Mainstream CO CO and ETCO display Range 0 to 76 mmHg Accuracy CO2 4 mmHg lt 40 mmHg 10 240mmHg PORTA
221. on cable 4 Disconnect Paddle Pickup Cable at Pickup Preamp at J1 by carefully pulling out connector 5 Disconnect front panel cable Item 31 from Motherboard Item 46 at J108 6 Lift 12 Lead Preamp Board Item 84 out of Card Cage Pre Assembly NOTE Hold Card Cage down when pulling preamp board out of card cage REPLACE 1 Carefully slide 12 Lead Preamp Board Item 84 into Card Cage Pre Assembly along two rails making sure that J5 and PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS J2 face up and towards the Motherboard Item 46 Push in until movement stops and 12 Lead Preamp Board Item 84 is flush with the Card Cage Pre Assembly 2 Connect paddle pickup input cable at J1 by pushing cable into connector 3 Connect front panel cable Item 31 at Motherboard Item 46 J108 4 Connect 12 Lead Motherboard Cable Item 82 at J5 by pushing cable into connector the insulated side of the cable should face the 12 Lead Preamp Board Item 84 5 Connect 12 Lead Preamp protection Cable Item 81 at J2 by pushing cable into connector the insulated side of the cable should face the 12 Lead Preamp Board Item 84 6 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 75 REMOVAL AND REPLAC
222. ontrast in the PIC display is adjustable Contrast Options Press the BRIGHT button to brighten the display Press the CONTRAST button to add contrast to the display Each press of a button will increase the brightness or contrast setting until the highest setting is reached The next press of the button will return the setting to the lowest level NOTE The Brightness and Contrast buttons are only visible if your display type supports variable brightness and contrast 3 10 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS User Menus SPO From the SPO menu users can configure the pulse oximeter size The Pleth Plethysmograph waveform display is automatically gain controlled and is not directly proportional to the pulse volume The SPO options are accessed from the Treatment Configuration menus Treatment Intubate IV EPI Lido Bret Sample Clear Next Configuration Display Alarms SPO NIBP Resp Recorder Set Up Back SPO Size Back SPO Size Menu SPO Size Menu In the Size menu users can choose from four Pleth sizes A bold outlined box indicates the selected size To choose a different size configuration press the corresponding button Press EXIT to return to the SPO Configuration menu d NOTE The Plethysmograph waveform is automatically gain controlled to optimize the wavef
223. or anesthetics These environments can produce fire or explosion hazards Place the PIC System accessories and cables in a position where they cannot harm the patient should they fall Keep all cables and hoses away from patient s neck The MRL PIC System may not meet performance specifications if stored transported or used outside the specified storage or operating environmental range limits To prevent incorrect trending data from being printed clear the Treatment Summary Log from the Recorder Log menu prior to use on a new patient PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION Monitoring Precautions WARNING PACEMAKER PATIENTS The MRL PIC e includes a pacemaker rejection circuit The following warning is in accordance with the disclosure requirement of AAMI Standard EC13 3 1 2 1 8 The rate meter may continue to count the pacemaker rate during some occurrences of cardiac arrest or some arrhythmias Do not rely upon the heart rate meter alarms to assess the patient s condition Keep pacemaker patients under close surveillance Pacemaker pulses of the type specified in AAMI 1992 section 3 1 4 are detected at amplitudes greater than 20mV and rejected by the heart rate display However pacemaker pulses that are superimposed on the ECG at very low amplitudes may be counted by the heart rate display Note This warning is an AAMI requirement that applies to all ECG monitors regardless of make or
224. or disconnected Check Preamp Input Cable 5 Lead Item 32 550719 12 Lead Item 81 550752 Motherboard ECG preamp communications error Check Motherboard Item 46 590329 or 591329 Check Preamp Board 5 Lead Item 51 590328 12 Lead Item 84 590377 Motherboard ECG preamp cable damaged or disconnected Check Preamp Motherboard Cable 5 Lead Item 52 550720 12 Lead Item 82 550751 Preamp circuit failure 5 Lead Check Pre Amp Board Item 51 590328 Paddle Pre Amp Board Item 27 590343 12 Lead Check Pre Amp Board Item 84 590377 Paddle Pre Amp Board Item 83 591379 Failure of power supply Check Power Supply Item 44 590337 Failure to obtain capture while pacing Poor quality electrodes Check expiration date on electrodes Incorrect current Pacer circuit failure Check Defibrillator Module Item 23 596327 or 597327 PORTABLE INTENSIVE CARE SERVICE MANUAL 7 3 TROUBLESHOOTING GUIDE i Failure to pace Faulty or disconnected ECG patient cable Check replace ECG Cable Poor quality electrodes Check expiration date on electrodes Use of incorrect electrodes incompatible non MRL Use MRL electrodes only Faulty or disconnected pacer cable Check hands free adapter cable assembly Defib pacer circuit board failure Check Defibrillator Module Item 23 596327 or 597327 Defib pacer Motherboar
225. orm display The waveform will not correlate with the patient s pulse strength PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 11 MENUS User Menus Non Invasive Blood Pressure The three non invasive blood pressure NIBP reading modes are available Users select the NIBP mode from the NIBP Setup menu which is accessed through the Treatment Configuration menus Treatment Intubate IV ERI Lido Bret Sample Clear Next Configuration Display Alarms SPO NIBP Resp Recorder Set Up Back NIBP Setup Menu NIBP Setup Menu In the NIBP Setup menu users can select the Manual Auto or Stat mode NIBP Setur Manual a blood pressure reading will be taken each time Manual the NIBP button is pressed e Automatic Auto a blood pressure reading will be taken at the indicated interval To increase or decrease the interval press the UP or DOWN arrow buttons Stat blood pressure readings will be taken one after another for five minutes starting from the time the NIBP button is pressed A bold outlined box indicates the selected NIBP Setup configuration Press EXIT to return to the Configuration menu 3 12 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS User Menus Respiration ECG Respiration data is sourced from ECG leads Users can configure the size speed and response settings of the ECG respiration display usin
226. ox indicates the selected option Press EXIT B to return to the Configuration menu Speed Menu Use the CO Speed menu to adjust the displayed trace speed 5 10 or 20 seconds and allow manual calculation of the respiratory rate Press a button C to select the trace redraw speed time trace travels from the left side of the display to the right A bold outlined box indicates the selected speed Press EXIT to return to the CO Configuration menu PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 15 MENUS E i Response Response adjusts the averaging Menu interval during a CO measurement Press a button D to select a rate Slow E Normal Slow averages the CO levelona p moving 60 second average Normal averages the CO level on a moving 30 second average Fast averages the level on breath by breath basis A bold outlined box indicates the selection Press EXIT to return to the CO Configuration menu Reset Option The Reset option sends a Reset signal to the sensor The signal is used for diagnostic purposes only 3 16 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS User Menus Respiration Trend Use the Trend Respiration menu to configure the trend speed setting This menu is access
227. p Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pulling on cable 3 Disconnect the Main Oximeter Cable Item 91 at J2 by lifting up on the retaining clip with fingernail or a small instrument 4 Disconnect Temperature Assembly Cable Item 75 from the Oximeter Board at J3 by pulling on connector 5 Push the silver knob on the card guide with finger or a small instrument so that the Oximeter Board Item 90 will slide freely in the card guide 6 Remove the Oximeter Board Item 90 by sliding it out of the card guide in the Card Cage Pre Assembly Item 48 REPLACE 1 Replace Oximeter Board Item 90 by sliding the board into the card guide of the Card Cage Pre Assembly Item 48 with connectors J2 and J3 facing up and towards the Motherboard Item 46 2 Return the locking mechanism to the locked position by pushing the plastic side in with a finger or small instrument such that the mechanism clicks into place and the silver knob protrudes PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 3 Connect Temperature Assembly Cable Item 75 at J3 on Motherboard Item 46 by pushing connector onto the metal pins 4 Connect the Main Oximeter Cable Item 91 at J2 by lifting retaining clip placing cable into connector pressing the retaining clip to the cable and then down The insulated side of the cable should face t
228. rade SAED 2 IBP ADV Record Review Biphasic Pacer Fax Unit ID Department ID Unit ID 1 1 Code 0 0 9 1 0 0 9 2 0 0 9 3 0 0 9 4 Cancel Printer Alarms On Off On Defib Pacer On Off On Trending On Off On Treatments On Off On Miscellaneous On Off On PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 3 3 MENUS Submenu Choices Choice Range Factory Default More Date mm dd yy dd mm yy yy mm dd mm dd yy Temp Fahrenheit F Celsius C F Line Freq 60 Hz 50 Hz 60 Hz Audiot Voice Prompts Enabled Disabled Disabled Voice Mode Memo Start Stop Memo Continuous Voice Log Enabled Disabled Enabled Language English Spanish French German Portuguese Italian Lead 11 Calibration Software Rev Motherboard Preamp Defib Oximeter Modem Run Self Test Card Card Info Card Erase Program PIC Cal NIBPT Pump Up Pump Down SPOst 2 1 0 1 2 Mod Out 0 m V 1 mV MAX MAX Off Simulate Reset T If option has been purchased 3 4 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL MENUS Quick Access Buttons and Icons Basic Quick Access Buttons and Icons Quick Access buttons and icons are located along the left side of the PIC display window Press a button next to an icon to select a PIC System option or function Charge 6
229. re Assembly Item 48 If installed disconnect Memory Card Cable Item 15 from Motherboard at J207 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 45 REMOVAL AND REPLACEMENT INSTRUCTIONS 8 REPLACE 1 Clear all cables from center of unit 2 Connect Chart Recorder Cable Item 53 to Motherboard Item 46 at J114 by lining up white arrows and pushing until a click 1s heard slide cable into wire holder on the back of Card Cage Pre Assembly Item 48 Connect Memory Card Cable Item 15 at J207 on Motherboard if option installed 3 Push the Grommet of Display Adapter Power Supply Cable into the hole in Card Cage Pre Assembly Item 48 near Speaker Cable connection at J105 on Motherboard Item 46 4 Carefully slide Card Cage Pre Assembly Item 46 into the unit on the 2 rails Card Cage Pre Assembly Item 48 should slide in easily without resistance Paddle Preamp Board Item 27 may need to be pushed against the wall or the red battery cap of 3V coin cell Battery case Item 56 on Power Supply Board Item 44 may need to be pushed down 5 Push Display Adapter Power Supply Cable into the space between Battery and Chart Recorder housing 6 Connect Power Switch Cable to Power Supply Board Item 44 at J6 by carefully pushing on connector Lip on female connector should go under hole on male connector 7 Connect Power Supply Cable on Battery Board Item 54 to Power Supply Board Item 44 at J2 by pushing down on
230. rging cycle To recondition the battery in the unit using the paddle tray charger option perform the battery capacity test and reconditioning procedure in Chapter 5 Make sure the connector on the cable is firmly pushed into the patient connector interface PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION Connecting the Slide the adapter inward along Defibrillator the guide plate on the Defibrillator Connector Adapter defibrillator interface Make Defibrillator connector release button sure the adapter is pushed snug against the plastic housing to assure a solid connection Make sure that the release button clicks into place and returns to UB Note When sliding the defibrillator adapter Its up position on make sure the release button clicks into place and returns to its up position Fig 1 AR Connect defibrillator paddles or hands free adapter by sliding connector on here Insert battery here Apex Paddle Discharge button Apex Paddle Discharge button Energy selection button Charge button PORTABLE INTENSIVE CARE SERVICE MANUAL 2 13 GENERAL INFORMATION Defibrillation Multipurpose Hands Free Adapter and Electrodes optional Hands Free Pads and Internal Paddles 1 Multipurpose Pads 2 Pad Connector Connects to patient connector 3 Patient Connector Accepts disposable monitoring defibrillation non invasive pacing pads MRL part 001789
231. rmal use Inspect hands free paddle cable nspect the hands free paddle cable for any signs of wear or damage such as cuts or cracks in cable insulation bending or corroding of connector pins or heat related damage that could indicate exposure to a sterilization process If this type of damage is observed PIC operators must be notified that the hands free cable is not intended to be sterilized Replace a damaged hands free cable prior to returning the PIC to normal use Inspect internal paddle electrodes paddle cable and paddle adapter nspect the internal paddle electrodes and cable for signs of damage or deterioration that can occur with repeated exposure to sterilization processes PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES Check for cracking chipping or peeling of the electrode insulation Check for cuts or cracks in the cable insulation and handles Inspect the cable connector casing for cracks or distortion Inspect for bent or corroded connector pins The internal paddle adapter which interfaces the internal paddle cable with the PIC is not intended to be sterilized If this type of damage is observed PIC operators must be notified that the internal paddle adapter is not intended to be sterilized Replace damaged items prior to returning the PIC to normal use 5 Inspect cables nspect all patient cables for signs of wear or damage that can r
232. round resistance indicates a need to replace the AC power cord PORTABLE INTENSIVE CARE SERVICE MANUAL PERFORMANCE TEST PROCEDURES 85 L 5 ECG Monitor Frequency Response Diagnostic Bandwidth Equipment Required Procedure Acceptable Results Corrective Action ECG simulator with 1 mV sine wave selectable in frequency from 0 05 to 100 Hz Connect the ECG simulator to the PATIENT input on the monitor Set the ECG simulator for 0 05 Hz sinusoidal output at mV peak to peak Turn on monitor and set Lead Selector switch to Lead II Set the size control to 1 cm mv Set the frequency response of the PIC to Diagnostic Start the chart recorder and record several cycles of the test signal Repeat steps 1 through 5 with the simulator frequency set to 100 Hz The amplitude of the recorded test signals in steps 5 and 6 must be 7 0 5 mm NOTE This measurement is made from peak to peak which are spaced 10 cm apart for the 0 05 Hz test signal If measured bandwidth is unacceptable verify that the simulator output is constant over the frequency range Frequency response is determined by fixed component values not adjustable in the monitor Replace the ECG preamp board Item 51 if not within specifications Refer to Chapter 7 Troubleshooting Guide for additional information PORTABLE INTENSIVE CARE SERVICE MANUAL 5 7 PERFORMANCE TEST PROCEDURES 85 9 Sweep Spe
233. sh the silver knob the center card guide with a finger or a small instrument so that the Oximeter Board Item 103 will slide freely in the card guides 7 Remove the Oximeter Board Item 103 by sliding it out of the card guides in the Card Cage Pre Assembly Item 48 REPLACE 1 Replace Oximeter Board Item 103 by sliding it into card guides in the Card Cage Pre Assembly Item 48 with connectors J2 and J3 up and facing Motherboard Item 46 2 Return the locking mechanism to the locked position by pushing the plastic side in with a finger or small instrument so the silver knob protrudes 8 92 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 3 Connect CO Cable Item 18 to Oximeter Board Item 103 at J4 by pushing connector onto the metal pins 4 Connect Temperature Assembly Cable Item 75 at J3 on Motherboard Item 46 by pushing connector onto metal pins 5 Connect the Main Oximeter Cable Item 91 at J2 by lifting retaining clip placing cable in the connector and pressing clip in The insulated side of the cable should face the back of retaining clip 6 Connectthe Preamp Motherboard Cable Item 52 at J217 on the Motherboard Item 46 by pushing cable into connector The insulated side of the cable should face the Motherboard Item 46 7 Check that all cables are fully seated in connectors and are clear of the sides of t
234. ss the UP DOWN arrow to toggle through the months until the desired month displays Repeat this procedure to set the day and year When finished press SAVE Set Time Menu Use the Set Time menu to set the current time To select the correct time press the HOUR button A bold outlined box will appear around the hour window Press the UP DOWN arrow buttons to toggle through the hours until the desired hour displays Repeat this procedure to set the minute option When finished press SAVE PORTABLE INTENSIVE CARE SERVICE MANUAL 4 9 MRL LITE PROGRAM MENU SETUP eee ECG Configuration Menus Access to the ECG Configuration menus and options is through the MRL Lite and Setup menus Use the ECG Configuration menu to set the frequency response line filter and select the patient cable type Frequency There are three frequency response Response Freq Options Limited Monitor and Menus Diagnostic 2 20 Hz Limited is automatically selected Monitor for paddle monitoring application 0 5 40Hz Monitoring is recommended for Diagnostic general ECG monitoring 0 05 150 Hz applications Exit Diagnostic should be used when attempting to interpret subtle ECG changes ST segments For optimal diagnostic response the line filter should be turned Off PDL Monitor and Limited responses are available only NOTE Limited response is ava
235. st be electronic grade Standard grades of RTV are not acceptable because they can be corrosive during their curing process Refer to the assembly drawings in Chapter 9 and the troubleshooting tables in Chapter 10 of this manual for additional information Required Tools e 1 Phillips round blade screw driver e 2 Phillips round blade screw driver e 2 Phillips pin head screw driver MRL Part Number 002109 Long nose pliers PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 1 REMOVAL AND REPLACEMENT INSTRUCTIONS 8 List of Items e tem 15 Main Memory Card Cable 8 4 tem 17 AC Supply Paddle Tray Module 8 5 Item 18 CO 8 6 e tem 19 Defib Main 8 7 e tem 20 Chart Recorder 8 9 tem 21 Bottom Enclosure Assembly 8 10 e tem 22 Top Enclosure Assembly 8 12 e Item 23 Defibrillator Module 8 14 e Item 24 Input Panel 8 16 tem 26 Memory Card Board 8 17 tem 27 5 Lead Paddle Preamp Board 8 18 tem 28 Barrier for 5 Lead Paddle Preamp Board 8 19 tem 29 5 Lead Paddle Preamp Shield 8 20 e tem 30 Pacer Panel 8 21 e tem31 Front Panel 8 23 e tem 32 5 Lead Preamp Protection Cable 8 25 e tem
236. switch 3 gt lt i Open and carefully unpack each carton Examine the instrument and accessories for signs of damage Check the packing list to determine that all accessories have been received Save all packing materials invoicing and any other paperwork Connect defibrillator paddles or hands free adapter by sliding connector on here Insert battery here To DETERMINE INITIAL INSTALLATION CONDITION In order to ensure that the device is running properly after shipping follow the instructions below 1 Connect defibrillator multipurpose hands free adapter Charge all batteries prior to first use Insert a fully charged MRL SmartPak battery into the battery slot or use the auxiliary power cable from the MRL Quick Charger or use the AC power cord from the paddle holder Press the PIC System power switch to the on position The PIC System will perform a series of self tests and a Self Test Passed message will be printed on the chart recorder paper PORTABLE INTENSIVE CARE SERVICE MANUAL 2 9 GENERAL INFORMATION 6 Installed options will appear on the display after the self test has been completed Compare the installed options on the display with the options you checked off on previous page 7 To set time and date see Chapter 3 8 Perform daily shift test see Chapter 5 9 To review default menu settings see Chapter 3 If you note any discrepancies please contact MRL
237. t could result in severe personal injury or death Caution Hazards or unsafe practices that could result in minor personal injury or product damage Note Points of particular interest for more efficient or convenient operation 1 2 PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION Icons Graphical and text icons listed below may be found on the display of the PIC System during operation 1 1 ge we PORTABLE INTENSIVE CARE SERVICE MANUAL Alarm off Alarm on Alarm lower limit set Alarm upper limit set Automatic HR Alarm set Alarm push to disable Animated recording icon Battery full Battery low warning Battery partially depleted Auxiliary power Blood pressure pump 1 Blood pressure pump 2 Calibration Pulse 12 Lead MOD 1V Card Check chart recorder Auto heart rate undetermined Auto heart rate set at 60 BPM Modulated outputv Mute One volt output QRS beeper off QRS beeper on Volume level Supervisor menu locked Supervisor menu unlock Notch filter On Analyze Internal log Card Review card usage 1 3 tH 5 gt Hj B CARD USAGE 1 4 Invasive Blood Pressure Analyze 12 lead Card Review 12 lead Next Page 12 lead save function 00 CPRTIMER F
238. t maintained properly loss of power during patient care could result affecting patient care The battery packs contain materials such as stainless steel cadmium and nickel which can be recycled They must be disposed of properly Consult local authorities for proper disposal PORTABLE INTENSIVE CARE SERVICE MANUAL SAFETY INFORMATION Charger Precautions Charge only MRL SmartPak or MRL SuperPac batteries in the MRL Quick Charger Conditioner Charging any other battery can cause damage to the MRL Quick Charger e Do not insert objects into or block the charger s ventilation ports e When testing the defibrillator on the charger s defibrillation output tester ensure that the paddle surface is positioned properly in the paddle test well Do not use gel during this test and ensure that the paddle surface is not contacting the metal charger frame When discharging the paddles into the tester press the paddles firmly into the test well to prevent pitting the paddle surfaces Only test MRL defibrillators on the charger s defibrillation output tester Testing other brands of defibrillators will damage the charger s defibrillation output tester e Do not take charger or paddle holder apart or attempt to repair it yourself The MRL charger should not be used in the presence of flammable anesthetics or materials e If the charger has been dropped or shows visible signs of abus
239. t recorder Front panel Unlocks the defibrillation connector from the defibrillator to allow removal of external paddles hands free adapter or internal paddles Note When sliding defibrillation connector make sure the release button clicks into place and returns to its up position Allows connection of MRL pulse oximeter sensors Allows connection of MRL CO cable or cable adapter Allows connection of MRL temperature probe Allows connection of MRL non invasive blood pressure cuffs Accepts standard 50 mm paper Control panel with buttons for PIC System operation PORTABLE INTENSIVE CARE SERVICE MANUAL GENERAL INFORMATION 8 PIC System Controls and Indicators 1 Voice memo 2 Chart recorder 3 Mute 4 Blood pressure 5 5 02 6 Monitor size T Monitor lead 8 Monitor hold vono ER as MONITOR AN Zt Dakik Size Lead COP Display ol 5 E Mode NZ Rate ZA RN ce m _ JDEFIBRIILATOR EXCEL cuoc TES 9 LSA Ei E 3i 12 14 16 17 18 19 20 on off Ede Pacer Pacer 15 Quick Access Treatment amp Defib Defi 224 mode rat
240. tem 27 at J2 by lifting retaining clip with fingernails or small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the blue side of the cable should face the back of the retaining clip 21 If 12 Lead unit connect Paddle Pickup Cable Item 97 at J1 on 12 Lead Preamp Board Item 84 Connect 12 Lead Preamp Protection Cable Item 81 at J2 on 12 Lead Preamp Board Item 84 by pushing in cable insulated side of cable should face 12 Lead Preamp Board 22 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 23 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 47 REMOVAL AND REPLACEMENT INSTRUCTIONS E gt gt Jj Item 49 LCD Display Adapter Board NOTE Ifthe display Item 42 has two white wires connected to the Backlight Inverter 43 use Part Number 591382 for Item 49 If two white and pink wires are connected to the Backlight Inverter Item 43 use Part Number 590382 for Item 49 REMOVE 1 Remove Bottom Enclosure Item 21 2 Remove Card Cage Pre Assembly Item 48 3 Disconnect Display Power Supply Cable from Power Supply Board Item 44 at J4 by pulling on the connector 4 Disconnect Flat Panel Display Cable Item 50 from LCD Display Adapter Board Item 49 at J1 by lifting retaining clip with fingernail or a small instrument and pulling out cable
241. tem 32 to the ECG Preamp Board The Patient Input Connector Board Item 40 contains EMI and defibrillator protection circuitry and the AAMI standard 6 pin connector The Paddle Preamp Board Item 27 contains the paddle pickup preamplifier protection circuitry and the impedence transformers for detecting paddle set and pacer pad lead faults The ECG Preamp Board Item 51 contains ECG gain and filtering circuitry QRS detection circuitry lead fault detection circuits and pace detection blanking circuits microprocessor on the ECG Preamp Board samples and digitizes the ECG and sends the data to the Motherboard Item 46 via an opto isolated serial bus Communication to the Motherboard Item 46 passes through a 22 pin FCC Preamp Motherboard Cable Item 52 connected to J217 of the Motherboard and J2 of the ECG Preamp Board In addition the QRS sync pulse to the Defibrillator Module Item 23 and the pace blanking signal from the defibrillator pass through the Defib Main Cable Item 19 to the Motherboard Item 46 The optocouplers and digital buffers on the ECG Preamp Board are powered by 5VDC The rest of the ECG Preamp Board Item 51 is powered through an isolated supply by the 11VDC supply The 11VDC supply is fused on the ECG Preamp Board PORTABLE INTENSIVE CARE SERVICE MANUAL THEORY OF OPERATION Displays The LCD EL and TFT Color Displays are controlled by the main processor and a display co processor on
242. ter Item 96 to Top Enclosure Assembly Item 22 using the double sided foam tape Item 10 Use caution when pushing on tape Do not flex board 2 Connect both Display Backlight Cables at CN2 and CN3 by pushing on connector arrows on male and female connectors should match up PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 87 REMOVAL AND REPLACEMENT INSTRUCTIONS 8 B J amp B i 3 Thread Color Inverter Cable Item 109 through hole in Shield Item 100 and connect at CN1 on Dual Backlight Inverter Item 96 by pushing on connector visual metal terminals on the connector will face away from Dual Backlight Inverter Item 96 4 Replace the Color Display Shield Item 100 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosure Item 21 when installing Press gently on it directly over foam tape ES NOTE careful not to flex the Dual Backlight Inverter Item 96 8 88 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 97 Paddle Pickup Cable REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect 12 Lead Preamp Protection Cable Item 81 at J3 on Paddle Preamp Board Item 83 by pulling out cable 3 Remove Memory Card Board Item 26 4 Remove Card Cage Pre Assembly Item 48 5 Remove 12 Lead Paddle Barrier Item 106 6 Disconnect
243. the Motherboard Item 46 LCD Display Display control signals and the SVDC power signals are routed to the LCD Display Adapter Board Item 49 through the Flat Panel Display Cable Item 50 The cable is a 30 pin FFC cable and connects to J220 of the Motherboard Item 46 and J1 of the LCD Display Adapter Board Item 49 The 11 VDC power signal is routed from J4 of the Power Supply Board Ite m44 through a 2 pin cable attached to the LCD Adapter Board Signals to the LCD Display continue through the LCD Adapter Board from J5 through a Mono LCD Cable Item 35 which is connected to the LCD Display mounted in the Top Enclosure Assembly Item 22 The LCD Display Adapter Board Item 49 contains a digital potentiometer for brightness and contrast adjustment switching circuits to enable the backlight and display power supplies and an adjustable LCD bias voltage power supply The 11 VDC signal is switched by a transistor and then routed to the Backlight Inverter Item 43 through the LCD Inverter Cable Item 34 a 5 pin cable connected to J4 of the LCD Display Adapter Board and of the Backlight Inverter EL Display Display control signals and the 5VDC power signals are routed to the EL Display Adapter Board Item 89 through the Flat Panel Display cable Item 50 The cable a 30 pin FFC cable connects to J220 of the Motherboard Item 46 and J1 of the EL Display Adapter Board Item 89 The 11 VDC power signal is routed from J4 of t
244. tors and are clear of the sides of the unit 7 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 37 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 45 Card Cage Plate DEPENDING ON DISPLAY CHOICE EL MONO COLOR GROMMET d 4 RJ 4 REMOVE Remove Bottom Enclosure Item 21 Remove Card Cage Pre Assembly Item 48 Remove Defib Main Cable Item 19 Remove Power Supply Board Item 44 Moo ge Da dpa us Remove four screws Item 13 from Card Cage Plate Item 45 using 2 Phillips head screwdriver 6 Lift Card Cage Plate Item 45 8 38 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS REPLACE 1 Feed Chart Power Cable through hole in the Card Cage Plate Item 45 2 Place Card Cage Plate Item 45 onto Motherboard Item 46 and align the screw holes 3 Replace four screws Item 13 to the Card Cage Plate Item 45 using a 2 Phillips head screwdriver Use 12 screws Item 13 4 Replace Power Supply Board Item 44 Use 5 16 screws Item 2 5 Replace Defib Main Cable Item 19 6 Replace Card Cage Pre Assembly Item 48 7 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 8 Replace Bottom Enclosure Item 21 PORTABLE INT
245. ue side of the cable should face the inside of the Card Cage PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Pre Assembly 4 Check that all cables are seated correctly and are clear of the sides of the unit 5 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 53 REMOVAL AND REPLACEMENT INSTRUCTIONS E i Item 52 Preamp Motherboard Cable 5 Lead 8 54 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect Preamp Motherboard Cable Item 52 from ECG Preamp Board Item 51 at J2 by pulling on cable WARNING DO NOT touch preamp board with fingers or tools because of contamination and ESD 3 Disconnect Preamp Motherboard Cable Item 52 from Motherboard Item 46 at J217 by pulling on cable REPLACE 1 Connect Preamp Motherboard Cable Item 52 to Motherboard Item 46 at J217 by pushing cable into connector the blue side of the cable should be facing Motherboard 2 Connect Preamp Motherboard Cable Item 52 to ECG Preamp Board Item 51 at J2 by pushing in cable the blue side of the cable should be face ECG Preamp Board 3 Check that all cables are seated correctly and are clear of the sides of the unit 4 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS OEE Ite
246. ust be restored prior to returning the PIC to use REMOVE 1 Remove Bottom Enclosure Item 21 Remove Card Cage Pre Assembly Item 48 Remove Defib Main Cable Item 19 ow m Disconnect Display Adapter Supply Cable from Power Supply Board Item 44 at J4 by pulling on the connector 5 Disconnect Chart Power Cable from Power Supply Board Item 44 at J5 by pulling on the connector 8 36 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS 5 SEEN 6 Remove four screws Item 2 from Power Supply Board Item 44 using 2 Phillips head screwdriver 7 Remove the Power Supply Board Item 44 from the Card Cage Pre Assembly Item 48 REPLACE 1 Place Power Supply Board Item 44 onto Card Cage Pre Assembly Item 48 with J5 Chart Power Cable connector near Chart Power Cable and line up the screw holes Make sure that all 16 pins of Motherboard Item 46 are inserted into Power Supply Board Item 44 2 Replace the four screws Item 2 to the Power Supply Board Item 44 using a 2 Phillips head screwdriver Use 5 16 screws Item 2 3 Connect LCD Display Adapter Cable to Power Supply Board Item 44 at J4 by pushing on the connector Lip on female connector should go under holder on male connector 4 Replace Defib Main Cable Item 19 5 Replace Card Cage Pre Assembly Item 48 6 Check that all cables are seated correctly in connec
247. vasive Blood Pressure Performance Test 5 22 Pulse Oximeter Performance Test 5 24 IBP Performance 5 25 Berformance West t 5 26 MRL PORTABLE INTENSIVE CARE SERVICE MANUAL VII Theory of Operation iecit 6 1 OVERVIEW iii side eet te nee e tee 6 1 Power 2 6 2 Motherboard ete eee 6 3 5 Lead ECG 6 4 Displays 6 5 Chart Recorder ei tert tq dts 6 6 Front Switch Panel sese 6 6 Voice Memo and Voice 6 7 I Volt Output siet eee cedes es 6 7 PCMCIA 6 7 Blood PressUte i nia deter eher ertet ee 6 8 Oxiimeters EE REIS 6 8 Defibrillator External Pacemaker 6 9 OptiOns 33 niceties wen iar 6 10 Interconnect Diagram 6 13 Troubleshooting Guide 7 1 Malfunctions i nr nhe intret dedi eu 7 1 Error Messages este ptr per er 7 9 Power Supply Outputs eene 7 14 Removal and Replacement Instructions 8 1 Required Tools ee eee 8 1 Last of sae a 8 2 Removal and R
248. ve Bottom Enclosure Item 21 2 Disconnect small hose from valve which runs from Blood Pressure Board Item 92 3 Disconnect the longer larger Hose Item 74 from the valve which runs from Blood Pressure Coupling Item 73 4 Disconnect Pump Valve Cable at J5 of Blood Pressure Board Item 92 by carefully pulling on connector 5 Carefully lift Foam Block Item 68 and Blood Pressure Pump Valve Assembly Item 69 together from unit REPLACE 1 Place Foam Block Item 68 and Blood Pressure Pump Valve Assembly Item 69 ensuring that the Foam Block sits correctly with the slanted side up against the front panel wall 2 Connect cable at J5 of the Blood Pressure Board Item 92 by pushing connector onto the metal pins 3 Connectthe longer larger Hose Item 74 to the valve at the nozzle counter clockwise of the pump hose connection ensuring that the Hose Item 74 is securely connected to the nozzle PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS M NENNEN 4 Connect the small hose from the Blood Pressure Board Item 92 to the valve at the nozzle clockwise of the hose sensor connection ensuring that the hose is securely connected to the nozzle Rotate the pump so the hose between the pump and valve is not crimped 5 Check that all cable are seated correctly in connectors and are clear of the sides of the unit 6 Replace Bottom Enclosur
249. wdriver 7 Lift EL Display Adapter Board Item 89 off Card Cage Pre Assembly Item 48 REPLACE 1 Position EL Display Adapter Board Item 89 on the side of the Card Cage Pre Assembly Item 48 so that J1 is near Motherboard Item 46 2 Replace two screws Item 5 of the EL Display Adapter Board Item 89 using a 1 Phillips head screwdriver 3 Connect EL Display Cable Item 71 at J2 on EL Display Adapter Board Item 39 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS BEEN 4 Connect Flat Panel Display Cable Item 50 at J1 by lifting retaining clip with fingernails or small instrument placing cable into connector checking that cable is seated straight and pushing down on retaining clip the insulated side of the cable should face the back of the retaining clip 5 Connect Display Power Supply Cable to Power Supply Board Item 44 at J4 by pushing on connector Lip on female connector should go under holder on male connector 6 Replace Card Cage Pre Assembly Item 48 7 Check that all cables are seated correctly in connectors and are clear of the sides of the unit 8 Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 79 REMOVAL AND REPLACEMENT INSTRUCTIONS E J Item 90 Oximeter Board without 8 80 REMOVE 1 Remove Bottom Enclosure Item 21 2 Disconnect the Pream
250. wer Cable at J223 on Motherboard Item 46 to Power Supply Board Item 44 at J5 by pushing connector onto metal pins Lip on female connector should go under retainer on male connector Chart Power Cable should be over Defib Main Cable Item 19 Replace Card Cage Pre Assembly Item 48 Check that all cables are seated correctly in connectors and are clear of the sides of the unit Replace Bottom Enclosure Item 21 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL REMOVAL AND REPLACEMENT INSTRUCTIONS Item 20 Chart Recorder Cover REMOVE 1 Remove Chart Recorder Item 36 2 Lift the Chart Recorder Cover Item 20 REPLACE 1 Insert Chart Recorder Cover Item 20 Make sure it fits properly 2 Replace Chart Recorder Item 36 PORTABLE INTENSIVE CARE SYSTEM SERVICE MANUAL 8 9 REMOVAL AND REPLACEMENT INSTRUCTIONS Item 21 Bottom Enclosure 8 10 EN 3 CORNERS REQ D FOR INSTALLATION TAMPER PROOF SCREWS 64 PIN HEAD SCREWDRIVER e P N 002109 4 1 O J 9 PLACES CHES 4 PLACES NOTE Requires Label Kit Item 65 REMOVE 1 Remove three pin head screws Item 3 in three of the corners using a Phillips pin head screwdriver Service Part Number 002109 2 Remove four screws It
251. y simulators deliver calibrated output only in certain lead positions e Verify proper setting of Size control for cm mV ECG amplitude If amplitude is still out of range adjust R46 on the 5 lead ECG preamp board Item 51 ECG amplitude cannot be adjusted on a 12 lead ECG preamp board PORTABLE INTENSIVE CARE SERVICE MANUAL 5 9 PERFORMANCE TEST PROCEDURES 5 Heart Rate Display Accuracy Equipment Required Procedure Acceptable Results Corrective Action ECG simulator with calibrated adjustable output rate 1 Connectsimulator to the PATIENT input on the monitor 2 Setsimulator output for 1 millivolt Select a rate which falls within range of 20 to 300 bpm 3 Turn on monitor Set Lead Selector switch to Lead II Set Size control for 1 cm mv amplitude on monitor 4 Allow rate meter to stabilize approximately 30 seconds then note the reading Run the chart recorder to obtain a printed heart rate 5 Select several other rates within 20 to 300 bpm range Allow rate meter to stabilize 30 seconds after each rate change then note the reading For each heart rate checked heart rate must not differ by more than 5 from actual rate Verify simulator rate setting accuracy If heart rate is still out of range refer to the Artifact on ECT listing in Chapter 7 Troubleshooting Guide PORTABLE INTENSIVE CARE SERVICE MANUAL 5 10 PERFORMANCE TEST PROCEDURES Defibrillator o CAUTION Lethal vo

PIC Service Manual - Frank`s Hospital Workshop

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