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A2W-QRG - Arrow International, Inc.

1. Inflate E Adjusts the inflation point in Operator mode Inflation occurs earlier when the left arrow is depressed and later when the right arrow is depressed Allows the operator to optimize timing by monitoring the hemodynamic changes produced on the AP waveform m 1 tz 1 Move the inflation point to the 2 Slowly move the inflation point 7 right until you can clearly see the to the left until the dicrotic notch dicrotic notch DN on the arterial 40ms in front of the DN is no pressure waveform green arrow longer visible 3 Check Augmentation Generally AUG should be greater than SYS If not additional assessment of the patient or IABP may be required Control and Function Keys Deflate DEFLATE E Adjusts the deflation point in Operator mode Deflation occurs earlier when the left arrow is depressed and later when the right arrow is depressed Allows the operator to optimize timing by monitoring the hemodynamic changes produced on the AP waveform ae i i zz HERS BERL SEE 1 Move the deflation point to the 2 Move the deflation point to the 3 Return the ASSIST RATIO to 1 1 left to see the effect on the AP right to lower the ASYS while waveform yellow arrow Note the simultaneously keeping the ADIA rise in the ASYS and the U shape lower than or equal to the DIA of the ADIA Control and Function Keys ARRHYT
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3. Large Helium Leak e Purge Failure TRIGGER LOSS ALARMS CLASS 2 ALARMS e Stand by alarm disabled e Pump in Stand by for greater than 3 minutes e ECG trigger loss Operator mode e AP trigger loss Operator mode e ECG lead fault Operator mode e Trigger loss AutoPilot mode AUDIBLE ALERTS CLASS 3 ALERTS e Drain failure e Deflation beyond 100 Operator mode e Insufficient Time to Inflate e Insufficient time to Deflate e Battery Inoperative e System Running on Battery e Battery time less than 20 10 and 5 minutes e Possible ECG detected e Weaning Step Complete e Arterial Pressure alarm e Low Helium Tank Pressure e AP FOS Signal Weak e AP FOS CAL key miss ing or corrupt e AP FOS Sensor out of range MESSAGE ALERTS CLASS 4 ALERTS e Possible Late Deflation e Erratic Trigger R Wave Deflation e Erratic Triggering e ECG Lead Fault Autopilot mode e No ECG Signal Available e No AP Signal Available e Arrhythmia Timing not available e Bad Real time clock Battery e Bad Ram Battery 7 Z Q H O lt x oc Lu N Alarms Alerts GAS ALARMS CLASS 1 ALARMS e Reset alarm e Review alarm message and troubleshooting information e Correct condition if known e Restart pump e Review alarm strip e If alarm persists refer to Chapter 8 of the Operator s manual for further information TRIGGER LOSS ALARMS CLASS 2 ALARMS e Correct condition if known Ma
4. 1 8 pumping assisted AP values appear in white and unassisted AP values appear in yellow subscript Balloon Connection Push firmly right side up or upside down it does not matter ay Start Up f Verify MY Aror LOT MODE 10S Flashing Heart Icon trig Ri White Overlay on ECG Both denote valid trigger 112 ESHE Correct IAB Volume display J Adequate Helium display RED BAR indicates less than 125 PSI in tank Press Pump ON Control and Function Keys ECG Select ECG SELECT provides selection choices for desired LEAD input q gt source and gain mode To change a skin lead press ECG SELECT once The current lead se is highlighted in white Press the soft key under the desired LEAD label to switch leads AUTOGAIN is the preset gain mode To manually gain the ECG lead press the soft key to change the white highlight to manual and adjust gain as desired To select an ECG that is brought in from another monitor source press the ECG SELECT key twice NOTE Illuminated LED indicates source selected ELECT LEAD OR PRESS ECG SELECT AGAIN TO SELECT MONITOR AUTO Control and Function keys Control and Function Keys AP Select bead C AP SELECT provides selection for source scale alarm parameter and limit as well as zero and calibration functions To change input source press AP SELECT twice Note Illuminated LED indicates source selected AP scaling is auto
5. B Light bulb Icon Legend Black light bulb with blue square E FiberOptix IAB not connected Blue light bulb E FiberOptix IAB not zero d prior to insertion Connect blue sensor and Cal Key PRIOR to insertion Verify Aiito Zero via aihe tone green light bulb and AP FOS Spa ace Zero d message appears to insertion m To perom manual Zero of FiberOptix IAB White light bulb E FiberOptix IAB cal value manually adjusted Red X through light bulb E FiberOptix unavailable Press AP select once Press soft key under Verify green light display and fiber optic sensor for Zero AP FOS Zero d message appears Arterial Pressure Patient Connections cont Alternate arterial pressure signal options m Standard transduced central lumen Select transducer cable a i _ TRANSDUCER J ZERO J Level as usual open stopcock press transducer zero Close stopcock verify waveform on screen Press AP select to highlight xducer Arterial Pressure Patient Connections cont Alternate arterial pressure signal options m To slave arterial pressure from remote monitor Standard 1 4 phono Connect to pump Press AP select to Zeroing procedure cable highlight monitor performed at primary monitor NOTE In OFF and STANDBY modes unassisted AP values appear in white on right side of screen In ON mode in 1 1 pumping assisted AP values appear in white In ON mode in 1 2 1 4 and
6. HMIA Arrhythmia Timing TIMING The arrhythmia timing key activates or deactivates the arrhythmia timing and or R wave deflation function of the pump when in AutoPilot mode The AutoCAT 2 system will automatically recognize arrhythmias and implement real time R wave deflation when the arrhythmia timing function is ON and conditions are acceptable for R wave deflation This will be indicated by the LED light on ON OFF E If automatic R wave deflation is NOT desired press the ARRHYTHMIA TIMING ON OFF key then the soft key under ARR TIMING until OFF is displayed ARRHYTHMIA TIMING OFF will be displayed on the screen when an arrhythmia is present and an alternate algorithm will be utilized for deflation ARP TIMING R WFWE DEF IFF E To select R wave deflation ON at all times press the ARRHYTHMIA TIMING ON OFF key then the soft key under R WAVE DEFL until ON ARR TIMING RAWE DE is displayed In this case R wave deflation AFIB trigger will be W selected whether an arrhythmia is present or not Control and Function Keys Trigger Modes Operator Mode Only Select Operator mode and then Press the trigger key to change trigger E h TRIGGER modes The selections will appear on the bottom of the display k TE T m PATTERN Preset trigger triggers on ECG Recommended for regular rhythms with normal QRS complex and HR lt 130 Rejects pacer spikes m PEAK Triggers on ECG Recommended for regular rhythm
7. O aN Cardiac Assist a FIBEROPT X ARROW 24 HOUR INTRA AORTIC BALLOON PRODUCT SUPPORT US and Canada 800 447 IABP 800 447 4227 AN ARROW INTERNATIONAL Modes of Operation AutoPilot m Pump Selects ECG AP source lead Continuously monitors all available ECG signals and selects an alternate lead if current ECG signal is lost or noisy m Pump Sets Timing Automatically sets inflation and deflation based on current patient condition and timing method selected m Automatic Trigger Selection Selects and changes trigger mode based on patient condition Selects next best trigger source if present one is lost Operator User selects ECG and AP sources and adjusts as needed E User sets Timing E User selects Trigger AUTOPILOT MODE gt OPERATOR nese of operasion S Power On m Power on E LED indicates the pump is plugged in LED indicates 80 charge on the battery ECG Patient Connections l 5lead ECG Cable Skin lead connection a SKIN selection is preset Lead selected is displayed offers 12 lead capability m Alternate ECG Signal Option jj a y Standard 1 4 phono cable y Phono to Phono connection AutoPilot will automati Monitor source displayed source available cally select if first ECG rae cmmectons Arterial Pressure Patient Connections a BEST ee via aaah as IA
8. assess and optimize timing in Operator mode and to wean patient from IABP support m ASSIST RATIO 1 4 Initiates one inflation deflation cycle for every fourth cardiac cycle Used to wean patient from IABP support ASSIST RATIO 1 8 Initiates one inflation deflation cycle for every eighth cardiac cycle Used to wean patient from IABP support Balloon Volume Control and Function Keys Press BALLOON VOLUME key Select INCREASE DECREASE until desired volume is displayed Press FULL VOLUME to return to volume based on balloon connector Press APPLY key to initiate change Press CANCEL key to Ose cancel change DELIVERY UOLUPE 2 29 9 C C Go M gt FULL DECREASE INCREASE VOLUME Control and Function Keys Recorder To change recorder settings Press HOME Press RECORDER SETUP Select desired waveforms or set recorder automatic print interval Recorder will print waveforms highlighted in white Press soft key under desired waveforms to select or de select AUTO PRINT CYCLE TIME OFI Control and Function Keys Alarm Control RESET VECET Silences the audible alarm tone and clears the alarm message a nd lt 4 If pumping was interrupted the alarm message is not cleared until STNDBY or ON is pressed If there is more than one alarm condition one message is cleared at a time ON OFF Turns pneumatic alarms audio recording drain and refill on or off Alarm messa
9. cursor on the right hand side Alarms Alerts NOTE An alarm may cause the pump to stop pumping The pump will display a message on the screen to assist in troubleshooting Once the condition is corrected To resume pumping Press Alarm RESET Press Pump ON If the alarm condition repeatedly appears refer to the Operator s Manual for further information or call Arrow s IABP support line at 800 447 IABP GAS ALARMS TRIGGER LOSS ALARMS AUDIBLE ALERTS CLASS 1 ALARMS CLASS 2 ALARMS CLASS 3 ALERTS e Pump to OFF e Pump to Stand by e Pump remains ON e IAB deflated e IAB deflated e Audible alarm e Helium vented to e Helium maintained in e Alarm troubleshooting atmosphere bellows message displayed e Audible alarm e Audible alarm e Automatic reset of some alarms when con dition is corrected e Freeze display e Alarm troubleshooting message displayed e Alarm troubleshooting message displayed e Automatic reset of some alarms when con dition is corrected PUMP ACTIONS e Prints 10 second strips 3 prior to alarm 7 after alarm MESSAGE ALERTS CLASS 4 ALERTS e Pump remains ON e Alarm troubleshooting message displayed e Automatic reset of some alarms when condition is corrected l Alarms Alerts f oc lt l lt Alarms Alerts GAS ALARMS CLASS 1 ALARMS e System error alarms 1 8 e Unable to Refill e Possible Helium loss 2 and 3 e High Pressure e High Baseline e
10. ge will be displayed To select alarm time off press key under desired setting Time remaining for alarms off is displayed above AP Scale Press ON OFF again to turn on alarms NOTE DO NOT leave pump unattended with pneumatic alarms disabled T TIME FOR ALAR 0 Control and Function Keys Home m AP SCALING Selects AP Scaling mode and scales for display and recorder m RECORDER SETUP Selects waveforms to be recorded and time interval for automatic recordings m WEANING SETUP Allows the user to make changes in volume and or assist ratio and set the time interval for the weaning step It allows the user to start the weaning step and cancel the weaning step m SHOW STATUS This key will display a summary of all current operational settings as well as selected information which is tracked by the AutoCAT 2 Control and Function Keys Home continued m AUDIO SETUP Allows the user to set the key volume and turn it ON OFF and independently set alarm volume m HEMODYNAMICS Automatically calculates 1 AUG SYS 2 AUG ADIA Freezes the hemodynamic numbers for 30 seconds and displays the assisted pressures in white and the unassisted pressures in yellow m CLOCK SETUP Allows the user to set the time and date for the pump RECORDER WEANING SHOW AUDIO HE CLOCK SETUP SETUP SATUS nE TUP DYNAMICS SETUP Cursor Moves horizontal cursor to desired assessment point Value is displayed above
11. matic based on patient waveform To change AP scale press AP SELECT once Then press the soft key under AP SCALING and select desired scale To enable an AP alarm press AP SELECT once then press the soft key under AP Alarm Off This will turn the alarm ON Press the soft key under AP ALARM MAP to toggle between a mean AP or augmentation alarm Select the desired alarm limit by pressing the soft key to raise gt or lower lt the limit A yellow box will appear on the display to the left of the arterial pressure waveform indicating the selected AP alarm source and the limit 0 ZERO PRESS ZERO TO CAL PRESS CAI Control and Function Keys PURPF STATUS Pump Status m ON Starts pumping If pressed before STNDBY pumping starts after one purge cycle and the pneumatic system fills with helium to 2 5mmHg NOTE The first time pump ON is pressed a special purge cycle is initiated This is a purge beat followed by 9 beats and is repeated automatically up to three times to optimize helium concentration m STANDBY If pump is ON immediately stops pumping but does not vent the pneumatic system Ifthe pump is OFF completes a four beat purge cycle and pressurizes the pneumatic system to 2 5mmHg After three minutes in the standby position the system will issue an audible alert m OFF Immediately stops pumping deflates the balloon and vents the pneumatic system to atmosphere Control and Function Keys
12. ny alarms will reset automatically when the condition is cleared OR e Reset alarm e Review alarm message and troubleshooting information e Correct condition if known e Restart pump e f alarm persists refer to Chapter 8 of the Operator s manual for further information AUDIBLE ALERTS CLASS 3 ALERTS Correct condition if known Many alarms will reset automatically when the condition is cleared OR Reset alarm eReview alarm message and troubleshooting information Correct condition if known elf alarm persists refer to Chapter 8 of the Operator s manual for further information MESSAGE ALERTS CLASS 4 ALERTS e Correct condition if known Many alarms will reset automatically when the condition is cleared OR e Reset alarm e Review alarm message and troubleshooting information e Correct condition if known elf alarm persists refer to Chapter 8 of the Operator s manual for further information Notes www arrowintl com Caution Federal law restricts this device to sale by or on order of a physician b o ARROW Contents of unopened undamaged package are sterile Disposable INTERNATIONAL Refer to package insert for current warnings indications contraindications precautions and instructions for use U S Patent Nos 6 258 035 6 569 103 and 6 887 206 Applicable to software version 2 22 and greater A2W ORG 9 05 5M CRB 05 0288 2005 Arrow International Inc
13. s with HR gt 130 Recommended for wide or abnormal QRS complexes Recommended for irregular rhythms when R wave deflation is not desired Rejects pacer spikes Control and Function Keys Trigger Modes Operator Mode Only m AFB O Trice D Triggers on ECG Recommended for irregular rhythms Provides A REAL TIME R wave deflation Rejects pacer spikes m VPACE Uses V pacer spikes to trigger MUST BE 100 PACED For V or AV sequential pacers Recommended for V or AV paced rhythms with poor ORS complex m APACE Uses A pacer spikes to trigger MUST BE 100 PACED For Atrial pacers only Recommended for A paced rhythms with poor QRS complex Control and Function Keys Trigger Modes Operator Mode Only m AP Uses AP waveform to trigger Recommended when ECG is not available or too noisy AP NOT RECOMMENDED FOR IRREGULAR RHYTHMS TRIGGER E INTERNAL Uses IABP internal signal for triggering Used only when patient has no ECG and no Cardiac Output ASYNCHRONOUS TO PATIENT CARDIAC ACTIVITY Press INT again to confirm Not available in AutoPilot mode Control and Function Keys Assist Ratio m ASSIST RATIO 1 1 Initiates one inflation deflation cycle for each cardiac cycle Preset assist ratio at start up Maximizes counterpulsation support m ASSIST RATIO 1 2 Initiates one inflation deflation cycle for every other cardiac cycle Generally used to

A2W-QRG - Arrow International, Inc.

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