TM-2560G / TM-2564G TM-2560GP / TM-2564GP VITAL SENSOR GRAPHIC MODEL INSTRUCTION MANUAL WM+PD4000753
© 2004 A&D Company Ltd. All rights reserved. No part of this publication may be reproduced, transmitted, transcribed, or translated into any language in any form by any means without the written permission of A&D Company Ltd. The contents of this manual and the specifications of the instrument covered by this manual are subject to change for improvement without notice.
Compliance Compliance with FCC Rules This device complies with Part 15 of the FCC Rules. Operation is subject to the following two conditions: (1) This device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation. (FCC = Federal Communications Commission in the U.S.A.) Compliance with European Directive 93/42 EEC for Medical Products This device conforms to European Directive 93/42 EEC for Medical Products.
General Precautions To handle the instrument properly and safely, read the instruction manual thoroughly and be fully knowledgeable about the instrument before use. The following are general precautions on handling the instrument safely and safety of patients and operators. Precautions specific to the instrument will appear in the relevant pages. The following points should be considered when you install or store the instrument. Install or store the instrument away from moisture.
High frequency interference by electrosurgery or energy discharged by a defibrillator may damage the instrument. Follow the precautions described in the manual for each device. (The instrument is protected against the energy discharged by a defibrillator only when the accessory ECG extension cable is used.) During electrosurgery, do not connect the ECG electrodes to the patient. (They may cause the patient to be burned.) Do not use a cellular telephone near the instrument.
High-frequency noises from other devices through the electrical outlet Locates the noise source and eliminate its route using adequate measures such as a noise elimination device. Turn off the device that serves as a noise source, if possible. Use another electrical outlet. Static electricity discharged by the instrument or the environment Discharge static electricity fully from the operator and the patient before use. Humidify the room.
Safety Precautions The following are the cautions on measurements and sensors. Blood pressure measurement Warning Blood pressure may not be measured when noise, such as consecutive irregular heart rhythm and physical movement, is present. Check the reliability of the measured value by displaying or printing the pulse graph. The instrument takes preventive measures against artifact and shock. However, if you have some doubts about the measured values, check the blood pressure by other methods.
Heart rate/pulse rate measurement Warning Monitor a patient using a pacemaker closely while measuring the heart rate. Do not diagnose arrhythmia other than bradycardia or tachycardia by using the pulse rate displayed and detected by the instrument. Caution The instrument employs three types of heart rate/pulse rate detection methods. Heart rate by QRS detection from the ECG waveform (Only for models with ECG) (The value is displayed in green.
SpO2 sensor Use a Nellcor sensor listed in the following table. Type Model Parts # Compatibility MAX A Yes MAX AL Yes Disposable OXISENSOR MAX P MAX I Yes Yes Reusable MAX N No MAX R Yes DURA-Y Yes DS100A Yes RS10 No OXIBAND OXI-A/N OXI-P/1 Yes Yes Read the instruction manual supplied for the sensor carefully before use. Warning Finger clip type sensor • Use only for adult fingers. Do not use the sensor on other body parts. • For short term monitoring.
Unpacking / Inspection Caution This is a precision instrument. Handle it with care. Strong shock may cause failure. Note This instrument is delivered in a packing box designed to prevent damage during normal transportation. When unpacking the instrument, check it for damage. If your instrument has been damaged, contact the agent you purchased it from. Retain the packing materials, which are required to transport this instrument.
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Contents Compliance................................................................................................................................................. i Warning Definitions ................................................................................................................................... i General Precautions ................................................................................................................................. ii Safety Precautions....................
6-6 Measuring the ECG................................................................................................................................... 33 6-7 Measuring the SpO2 .................................................................................................................................. 34 6-8 Measuring the Temperature (Optional) ..................................................................................................... 34 6-9 Measuring the Heart Rate/Pulse Rate .............
1. Introduction Thank you for purchasing Vital Sensor Graphic Model from A&D. This manual was written for the TM-256XG series. Available functions depend on the model. Please read the manual carefully before using the instrument in order to ensure a sufficient understanding of the TM-256XG series and provide proper use. Store the manual in a readily available location.
2. Specifications 2-1 Models TM-2560G TM-2564G TM-2560GP TM-2564GP Blood pressure measurement ECG measurement SpO2 measurement Limit function Interval measurement Printing function 2-2 Main Unit Without printer: 160 (W) x 143 (H) x 138 (D) mm With printer: 205 (W) x 143 (H) x 138 (D) mm Excluding the rubber feet and handle Without printer: Approx. 1.2 kg Mass With printer: Approx. 1.
* Available only when the optional thermometer and temperature receiver unit are connected.
3.
3-2 TM-2560GP/TM-2564GP 7
3-3 Top Operation Panel 1 2 Name NIBP START/STOP key ALARM OFF key 3 HOME key 4 PAUSE key 5 6 / / / keys QUICK SETTING key Function Starts or stops the blood pressure measurement. Stops the alarm buzzer. (Refer to "6-10 Alarm function".) Selects a home display to be displayed. Returns to the home display when the list, trend or setting mode is displayed. Pauses the ECG waveform or plethysmograph. Returns to the previous home display when pressed again.
3-4 Printer Keys TM-2564GP 1 Name ECG RECORD START/STOP key 2 LIST key 3 4 FEED key PAPER END lamp TM-2560GP Function Prints the ECG waveform. Functions as the PAUSE key when the waveform is printed. Prints the memory data in tabular form. (Refer to "6-13 Printing the Measurement Data") Feeds the paper. Illuminates when paper runs out or the printer case is open. 3-5 Symbols Description Symbol Indicates to refer to the instruction manual. I Indicates that the POWER switch is "ON".
4. Preparation Before Use 4-1 Installation Site When installing the instrument, consider "General Precautions" appearing in an earlier part of the instruction manual. 4-2 Power Supply The instrument can be operated using an AC adapter or battery. When an AC adapter is used: 1. Connect the supplied power cable to the AC adapter. Insert the plug on the other end of the power cable into an electrical outlet. 2. Insert the AC adapter cable into the AC adapter jack on the rear of the instrument.
When the battery is used: 1. Remove the power cable from the electrical outlet. 2. Remove the screw from the battery compartment cover on the rear of the instrument. 3. Slide the cover to remove it. 4. Insert the battery connector into the connector port of the battery compartment as shown in the illustration. 5. Install the battery as shown in the illustration, using much care to avoid damaging the cables. Mate the portion that the cables come out to the groove of the battery compartment. 6.
Charging the battery Charging starts when the AC adapter is connected to the instrument, regardless of the power switch status. It takes 15 hours to complete charging. The battery capacity lowers due to self-discharge. To compensate the capacity lost due to self discharge, intermittent charging is performed automatically. When charging a battery with small charging capacity, supplementary charging of about one hour is performed. Charging status is indicated by the charging lamp.
4-3 Installation Procedure Warning • Do not use damaged cables and sensors. • Use the specified cables and sensors only. • The ECG unit is protected against defibrillator discharge only when the supplied ECG extension cable is used. 1. Confirm that the power switch is turned off. 2. Connect the cuff hose to the CUFF connector of the instrument. Use the 1.5-m hose to extend it, if necessary. 3. Connect the SpO2 extension cable to the SpO2 connector of the instrument and lock it. 4.
5. Displays 5-1 Home Display Press the HOME key to indicate the home display. There are six home display types 1. Blood pressure 2 traces (Default display) 6. Sleep mode Emphasizes the blood pressure values Blank display 2. Waveform 2 traces 5. Temperature 1 trace Lengthened waveform display area Emphasizes the heart rate and SpO2 3. Pulse graph 1 trace 4.
Displayed items depend on the display screen selected. Below is a list of displayed items for each display. Home display 1 Blood pressure 2 traces Waveform 2 traces Pulse graph 1 trace Temperature 2 traces Temperature 1 trace Sleep mode Waveform Two (3.2 seconds) Blood pressure Pulse graph ⎯ Large HR/PR SpO2 Temperature Medium ⎯ Two Small Medium ⎯ (4 seconds) One 3 Medium Available Large (4 seconds) Two 4 Medium Medium ⎯ (3.
Description of the home display Here, the basic parameters are described as they appear in the home display. Please note that the composition depends on the instrument model.
Name Displayed item Systolic blood pressure Systolic blood pressure (When an alarm occurs) Blood pressure error 1 Systolic blood pressure display Quick systolic "SYS" " " (Red circle) Diastolic blood pressure 2 Diastolic blood pressure display Diastolic blood pressure (When an alarm occurs) Cuff pressure "DIA" " " (Red circle) 3 Mean blood pressure display Mean blood pressure "MAP" Heart rate/Pulse rate "HR" / "PR" 4 Heart rate Pulse rate display Heart mark Heart rate/Pulse rate (When an alar
Continued SpO2 value 5 SpO2 display SpO2 value (When an alarm occurs) "%" " " (Red circle) 6 ECG waveform display 7 Plethysmograph Plethysmograph display 8 Patient display 9 Measuring interval display 10 11 12 13 14 Measuring time display Blood pressure unit display Error message ECG lead display ECG displaying magnification display ECG waveform Patient to measure blood pressure Interval to measure blood pressure "CYCLE" Blood pressure measuring time Blood pressure unit Blood pressure measurem
Continued 19 20 21 22 Message box Pacemaker detection SpO2 pulse bar graph display Blood pressure pulse graph display Message Pacemaker detection SpO2 pulse bar graph Blood pressure pulse graph •Displays the connection status with the options and other messages. •Displayed when "ON" is selected for pacemaker detection. •Displays the bar graph in synchronization with the SpO2 pulse. •Displays the pulse graph obtained during blood pressure measurement.
5-2 List Display When the home display is being shown, press the LIST key ( key) to go to the list display. Note • When the list display is being shown, press the HOME key to return to the home display. • The memory data is erased in the list display. Refer to "6-11 Storing/Deleting data" for details. • In the list display, after about 5 minutes of inoperation, the latest page will be indicated.
5-3 Trend Display When the home display is being shown, press the TREND key ( key) to indicate the trend display of the latest 24 hours. Note • When the trend display is being shown, press the HOME key to return to the home display. • In the trend display, after about 5 minutes of inoperation, the latest page will be indicated.
10 11 Power supply display Current time display Power supply type Current time •Displays the power currently used. •Displays the remaining battery charge. •Displays the current time. 5-4 Pause Display When the home display is being shown, press the PAUSE key to pause the waveform. Note • When the display is paused, press the HOME key or PAUSE key to return to the home display.
5-5 Setting Mode Display When the home display is being shown, press the MENU key ( key) to indicate the setting mode display. Note • When the setting mode display is being shown, press the HOME key to return to the home display. • The setting mode display of any setting item consists of menu, submenu and the value.
5-6 Quick Setting Window When the home display is being shown, press the QUICK SETTING key to open the quick setting window. Note • When the quick setting window is being shown, press the HOME key to close the window. Refer to "6-4 Quick Setting Mode" for details.
6. Operation 6-1 Turning on the POWER switch Turn the POWER switch on. After several seconds of self-check, the home display appears. Note • When the self-check detects any error, the error code is displayed. The error code display of some errors is frozen. Refer to "7-6 Error Codes" for how to solve the error. • The self-check checks the data in memory. The duration of the self-check depends on the number of memory data.
Attaching the ECG electrodes Warning Check the electrode attaching condition in a certain time interval. If skin integrity changes, move the sensor to another site. Caution • Before attaching the electrodes, use alcohol to clean the body sites where the electrodes are to be attached. Oil or perspiration on the site increases the contact resistance and causes poor contact between electrode and patient. • Wipe the body sites that are wet with the alcohol, using a clean, dry cotton.
Applying the SpO2 sensor Use the sensor appropriate for the patient. Refer to the instruction manual for each SpO2 sensor for how to apply the sensor. Warning • Read the SpO2 sensor instruction manual for proper use. • Applying the sensor on a body part other than specified or using it longer than specified may cause the patient to suffer physical injury. Caution Do not apply the SpO2 sensor too tight. Note • Do not apply the sensor on the same arm with an arterial catheter inserted or the cuff attached.
6-3 Setting Mode Here, various setting procedures are described. The items available for setting depends on the model. Basic operation Menu Sub menu Set value 1. In the home display, press the MENU key ( key) to indicate the setting mode display.. 2. The selected menu and sub menu items are highlighted, and the value of the selected item appears in the box at the upper right corner. 3. Press the key to go to the next menu. 4.
5. Press the or key to change the value. 6. The changed value is confirmed when: Moved to the next menu or sub menu. The HOME key is pressed to return to the home display. Note • In the setting mode display, after about 5 minutes of inoperation, the home display will be indicated. • When setting the clock, note the following. The time in the clock menu indicates that of when the clock menu is displayed, and it remains the same as long as the clock menu is displayed.
Continued ECG Gain x1/2, x1, x2, x4 ⎯ Time base 6.25.12.5, 25.0 mm/s Lead l, ll, lll Hum filter OFF, ON Return time 0.5, 3.2 s Pacemaker ON, OFF ⎯ Upper ECG, SpO2 Lower ECG, SpO2 Year Month Day Hour Minute Alarm sound Click sound 2000-2099 1-12 1-31 0-23 00-59 1-4 (2) 0-4 (2) Pulse sound 0-4 (2) Storage cycle OFF, 1, 2, 2.5, 3, 5, 10, 15 Temp.
6-4 Quick Setting Mode Here, the quick setting mode is described, to change the values that are frequently used, or to change the values while watching the waveform. The items available for setting depend on the model. Basic operation Quick setting window Set value 1. In the home display, press the QUICK SETTING key. 2. The quick setting window opens and the selected value is highlighted. 3. Press the QUICK SETTING key to open the next menu. 4. Press the or key to select the item. 5.
Menu Sub menu Cycle Setting range OFF, CON, 2.5, 3, 5, 10, 15, 20, 30, 60, 90, 120 NIBP AUTO, 100-260 (by 20) Pressurization SYS Limits HR/PR Upper Lower Upper Lower OFF, 50-250 (by 10) OFF, 30-200 (by 10) OFF, 50-220 (by 10) OFF, 30-150 (by 10) Unit Description Sets the cycles for interval min measurement. Sets the pressurization value for blood pressure measurement. "AUTO": Detects the pulse at mmHg the start of pressurization to pressurize properly. During interval measurements, "AUTO" is used.
Interval measurement 1. Set the cycle to a value other than "OFF". 2. "CYCLE:∗∗∗" appears at the bottom of the home display and starts the interval measurement. 3. Blood pressure starts to be measured at the exact-time synchronized with the built-in clock. 4. To end the interval measurement, set the cycle to "OFF". Note • During interval measurement, pressurization is performed by "AUTO".
6-7 Measuring the SpO2 1. Turn on the POWER switch to start the SpO2 measurement. Note • In SpO2 measurement, the function of automatically compensating the LED to obtain suitable emission for the patient works. Thus, it may take approximately 30 seconds to display the measured value. • Do not apply the sensor on the same arm with the cuff attached. SpO2 may not be measured correctly during blood pressure measurement. 6-8 Measuring the Temperature (Optional) 1. Set the temp. probe to be used. 2.
6-10 Alarm Function Limit mark When the limit values are set, the limit mark appears in red as shown in the illustration. When the measurement value exceeds the upper or lower limit value, the value and the alarm lamp flash, and the alarm buzzer sounds. The alarm buzzer can be stopped by pressing the ALARM OFF key.
Deleting the data 1. In the home display, press the key to go to the list display. 2. Press the key to indicate the memory deletion display. 3. Press the key to cancel the deletion and return to the list display. 4. Press the key to perform deletion. After deletion, the list display appears. Caution When deleting the data, use much care not to delete important data.
6-12 Power Supply The power supply information, as shown below, appears at the lower right side of the display. Power supply symbol Description The instrument is working on the AC adapter. The instrument is working on the battery. • The battery charge is full. The instrument is working on the battery. • The battery charge has decreased. Charging is required soon. The instrument is working on the battery. • The battery charge has been drained. Charging is required immediately.
Printing the ECG waveform When the ECG RECORD START/STOP key is pressed in other than the setting mode display, an ECG waveform of 16 seconds is printed. It takes about 30 seconds to print it out. With the waveform, the date, time and HR (heart rate), taken when the ECG RECORD START/STOP key is pressed, is printed. The waveform for calibration is printed at the beginning and end of the waveform data. (The waveform for calibration indicates that for 1mV.) The printing speed is fixed to 25mm/sec.
Trend printing Prints the measurement data in trend form, using the symbols below: = Systolic, Diastolic = SpO2, x = heart rate/pulse rate, + = temperature ECG waveform 39
6-14 Function Setting Here, the function setting procedure is described. Note • The settings can be changed to suit to the operating environment. • Turning off the POWER switch during the setting operation will cancel the operation. Setting procedure 1. While holding down the QUICK SETTING key, turn on the POWER switch to indicate the function setting display. The selected item is highlighted. 2. Press the or key to select the item. 3. Press the or key to change the value. 4.
No. S00 Setting item Station address Setting range 0-98 (0) Description To connect an option. To connect an option. S10 Communication mode 1-10 (1) To be selected, depending on the option. 1200, 2400, 4800, To connect an option. S11 Baud rate 9600, 19200, 38400 To be selected, depending on the option To connect an option. S12 Data bit 7, 8 To be selected, depending on the option To connect an option.
7. Maintenance 7-1 Cleaning Caution • Before cleaning, turn off the power and remove the AC adapter. • Do not pour water on the instrument or use water for cleaning. This instrument is not waterproof. • Do not sterilize the instrument by gaseous sterilization or using an autoclave. • Do not use solvents such as thinner and benzine for cleaning. That may deform or discolor the instrument. Clean the instrument as described below: Clean the instrument exterior with a dry soft cloth.
7-2 Calibration This is a precision instrument. Perform a checkup periodically. Checking the pressure accuracy Connect the pressure generator and the manometer to the instrument as shown in the illustration. Use the optional 500-cc cylinder or the cuff wrapped loosely around a cylinder. 500-cc cylinder (Cuff) Instrument Manometer (Mercury sphyg-momano Pump (Rubber ball) While holding down the HOME key, turn on the POWER switch. "M01" appears at the upper left of the display.
7-3 Assembling the Cuff Replacing the cuff cloth Insert the rubber hose completely into the cuff cloth. From the bladder opening, pull out the bladder with the rubber hose. After replacing the cuff cloth, put back the bladder and the rubber hose through the bladder opening. Pull out the rubber hose through the rubber hose opening. Be sure to pull out all of the rubber hose. Otherwise, when pressurized, the bladder may inflate at the opening and burst.
7-6 Error Codes When the instrument detects an erroneous measurement condition, the following error codes are displayed. Error code Symptom Blood pressure related errors Zero point error in the pressure E00 sensor circuit E11 Can not pressurize. E12 Pressurizing speed is too slow. E13 Pressurizing speed is too fast. Measurement time is too long. Constant exhaustion speed is too slow. E22 Exhaustion speed is too fast. E23 Excessive pressure is detected.
8. Accessories/Options Item Type Cuff (without hose) Neonate 10 pcs. Neonate 10 pcs. Disposable type Neonate 10 pcs. Neonate 10 pcs. Infant Arm circumference 7-12 cm Child Arm circumference 10-17 cm Small Arm circumference 15-22 cm Adult Arm circumference 20-31 cm Large Arm circumference 31-41 cm Spare cuff cloth 2 pcs./set (For TM9112B-1) Hose (with connector) 1.5 m 2.0 m 2.0 m for neonates 3.5 m for neonates ECG related ECG electrode (150 pcs.
Appendix A: Measuring Principle A-1 Blood Pressure Measuring principle Wrap the cuff around the upper arm. Inflate the cuff to a pressure exceeding the systolic blood pressure. Then, exhaust the air from the cuff gradually. While the pressure is detected in the cuff in the air exhaustion stage, the pulse waveform appears in synchronization with the heart rate. The pulse waveform suddenly increases near the systolic blood pressure.
Causes of errors The pulse during blood pressure measurement is indicated in a graph, which can be an objective indicator of the reliability in the measurement accuracy. When noises occur due to irregular heart rhythm or physical movements, the amplitude changes abnormally in the graph. When it happens, blood pressure should be measured again, or be checked using other methods. The following are the main causes of errors in Pulse graph blood pressure measurement.
A-2 SpO2 Measuring principle Oxygen, bound to hemoglobin, is carried by blood. Hemoglobin that is bound to oxygen is called oxygenated hemoglobin (HbO2), and that is not bound to oxygen is called reduced hemoglobin (Hb). Arterial oxygen saturation is the percentage of oxygenated hemoglobin in the blood. Arterial oxygen saturation = HbO2 / (Hb+ HbO2) Oxygen-rich arterial blood is red while venous blood after the oxygen has been removed is dark.
Causes of errors In the pulse oximeter, adequate waveform implies the reliability. Always check the plethysmograph or bar graph for noises and disturbances. When noises or disturbances occur, check the probe Plethysmograph connection or patient condition. The following are the main causes of errors in arterial oxygen saturation measurement. Pulse bar graph Abnormal hemoglobin Besides oxygenated hemoglobin and reduced hemoglobin, there are carboxyhemoglobin (COHb) and methemoglobin (MetHb).
Appendix B: External Dimensions TM-2560G / TM-2564G TM-2560GP / TM-2564GP Unit: mm 51
