Users Manual Part 1

54
Nerve Integrity Monitor
16 No EMG response to direct stimulation.
Inadequate stimulus intensity. Increase stimulus intensity.
Paralyzing anesthetic in use. Eliminate paralyzing anesthetic.
White Stimulus Return electrode (+) electrode has
fallen out or is not connected.
Check stimulator cathode (-) connections.
Stimulator probe not connected.
Patient Interface stimulator fuse blown.
STIM1 (EMG) Patient Interface fuse REF 8253075.
Check fuse in STIM1 (EMG) Patient Interface. Replace if
necessary with REF 8253075 only.
Not holding probe on nerve long enough. Hold probe tip to nerve for at least 1 second.
Nerve not contacted with ush tip.
Contact the ush tip of the probe perpendicular to the
nerve.
Volume control too low.
Event threshold set too high.
Check and correct volume and event threshold.
Excessive current shunting in surgical eld. Remove uids from surgical stimulating area.
No electrodes in innervated muscle tissue. Nerve not
stimulated.
Place channel electrodes in muscle to be monitored.
Check EMG tube placement if applicable.
17
Unexpected EMG responses when not
directly stimulating nerve.
Unexplained continuous “train” EMG response.
Identify and eliminate possible source of “train” stimulation:
• Cold irrigation.
• Stray heat from electrocautery bovie.
• Laser heat.
• Retraction on nerve or muscles being recorded.
• Patient waking from anesthesia.
• Nerve drying.
• Ultrasonic aspirator.
Nerve or monitoring area being stimulated or
manipulated by other thermal or mechanical means.
Identify and eliminate source of inadvertent manipulation.
Patient interface troubleshooting
Symptom Cause Solution
1
The patient interface does not wirelessly
connect to the NIM Vital system at start-up.
Patient Interface is not paired with the system.
Place the patient Interface in the dock located at the rear of
console. Select a procedure and navigate to the Connection
screen. Remove the patient Interface after three seconds
and verify the wireless connection indicated on the console
screen and the blue wireless symbol light on patient
Interface changes from blinking to solid. If the wireless
connection continues to fail, attach the patient Interface
cable for wired operation.
The battery charge is depleted.
Re-dock the patient Interface in the dock located at the rear
of the console. Check the battery charge icon on the NIM
Vital screen to verify the battery level. If low, connect the
patient Interface cable for wired operation or re-dock the
patient Interface in the charging cradle.
Connect the patient Interface cable for wired operation and
battery charging.
2
The patient interface does not work in the
wireless conguration during the surgical
procedure.
The battery charge is depleted.
Connect the patient interface cable for wired operation and
battery charging.
A non-typical electrical interference in the operating
theater from a miscellaneous source.
3
The patient interface does not work in
wired mode.
The patient interface cable is not fully inserted into
the patient interface and/or the NIM Vital console.
Check cable connections at the patient interface and NIM
Vital console ends to ensure full insertion and connection.
Full insertion is indicated by a tactile click. If the condition
persists contact Medtronic Customer Service.
Reprocessing and maintenance
Cleaning
The cleaning instructions detailed below apply to the NIM Vital cart, system monitor, patient interface and cable (if using a wired
patient interface), muting detector and cable(s), printer and printer cable, power cords and a USB ash drive:
• Disconnect all cables from the system components.
• Clean the units by wiping them down with a soft, lint-free cloth dampened with a solution of one of the following detergents:
— a pH-neutral (pH 6-8), enzymatic detergent
— a mild-alkaline (pH8-11), non-enzymatic detergent
The detergent should be used at the concentration and temperature recommended by the detergent manufacturer. The
temperature of the detergent solution should not exceed 40º C (104º F).
• Wipe in a single direction and away from vents and crevices to avoid introducing contaminants into the system.
• After cleaning heavily soiled areas, use another clean cloth to mitigate cross contamination.
• Continue wiping until visible organic soil has been removed.
• If contamination is suspected in areas not accessible for wiping (for example: crevices, on the inside of the Patient Interface clips),
clean those areas using a brush moistened in the detergent solution until visible soil has been removed.
FCC use only, not for Medical use