Nihon Kohden ZM-940PA Telemetry Medical Transmitter User Manual Cover 2 ZM940PA OM pmd

Nihon Kohden Corporation Telemetry Medical Transmitter Cover 2 ZM940PA OM pmd

User Manual

TRANSMITTERZM-940PA0614-009881
Model: ZM-940PAManual code no.: 0614-009881Reader Comment CardWe welcome your comments about this manual. Your comments and suggestions help usimprove our manuals. Please circle the number for each of the following statementscorresponding to your evaluation and add comments in the space provided.Fax or send your completed comment card to:Fax: +81 (3) 5996-8100International Div., Sales Promotion Section, Nihon Kohden Corp., 1-31-4, NishiochiaiShinjuku-ku, Tokyo 161-8560, JapanStrongly Agree 1 Disagree 4Agree 2 Strongly Disagree 5Neutral 3This manual is organized. 12345I can find the information I want. 12345The information is accurate. 12345I can understand the instructions. 12345The illustrations are appropriate and helpful. 12345The manual length is appropriate. 12345Comments:Thank you for your cooperation. We appreciate it very much.Name:Occupation/Position:Hospital/Company:Address:Phone:cutting line
Operator's Manual ZM-940PA iContentsGENERAL HANDLING PRECAUTIONS .................................................................... iWARRANTY POLICY ............................................................................................... iiiEquipment Authorization Requirement ................................................................... iiiEMC RELATED CAUTION ....................................................................................... ivConventions Used in this Manual and Instrument ................................................. viiWarnings, Cautions and Notes ......................................................................... viiExplanations of the Symbols in this Manual and Instrument ........................... viiiIntroduction ....................................................................................................................1Panel Description .......................................................................................................... 2Front Panel ............................................................................................................... 2Rear Panel ............................................................................................................... 3Top Panel ................................................................................................................. 4Bottom Panel ............................................................................................................ 4LCD .......................................................................................................................... 6Note on Parameter Settings .......................................................................................... 8Important Safety Information ......................................................................................... 9General .................................................................................................................... 9Output Signal ........................................................................................................... 9Preparation .................................................................................................................. 10Installing (Replacing) Batteries ............................................................................. 10WARNING and CAUTION for Battery Handling ............................................... 10Battery Lifetime ................................................................................................. 10Installing (Replacing) Batteries ........................................................................ 11Situations Requiring Battery Replacement ..................................................... 12Battery Condition Indication ............................................................................. 12Turning the Transmitter On/Off ............................................................................... 13Turning On the Power ....................................................................................... 13Turning Off the Power ....................................................................................... 13Check Items Before Use .................................................................................. 13Check Items After Power On ............................................................................ 14Check Items After Use ...................................................................................... 14Changing the Transmitter Channel ............................................................................. 15Changing Parameter Setup Settings .......................................................................... 16Parameter Setup Setting List ................................................................................. 16Displaying the PARAMETER SETUP Screen ....................................................... 17Changing Settings ................................................................................................. 18
ii Operator's Manual ZM-940PASELECTABLE INTERVALS .............................................................................. 18INITIAL INTERVAL ............................................................................................ 18INITIAL CUFF PRESS ...................................................................................... 18NIBP MODE AFTER STAT ................................................................................ 19START/FINISH SOUND .................................................................................... 19OLD NIBP DATA/AFTER .................................................................................. 19INHIBIT SpO2 DURING NIBP ........................................................................... 202ND PARAMETER ........................................................................................... 20LEADS OFF DISPLAY ...................................................................................... 21ECG ELECTRODE ........................................................................................... 21Changing System Setup Settings ............................................................................... 22System Setup Setting List ...................................................................................... 22Displaying the SYSTEM SETUP Screen ............................................................... 22Changing Settings ................................................................................................. 23CHANNEL/TYPE .............................................................................................. 23PRESSURE UNIT ............................................................................................ 23LANGUAGE ...................................................................................................... 24BRIGHTNESS .................................................................................................. 24SYSTEM INITIALIZE ......................................................................................... 24Attaching NIBP Cuff, Electrodes and SpO2 Probe to the Patient ................................ 25Attachment Examples ............................................................................................ 25Attaching the NIBP Cuff ......................................................................................... 26Selecting the NIBP Cuff .................................................................................... 26Connecting the NIBP Cuff to the Transmitter .................................................... 29Attaching the NIBP Cuff to the Patient ............................................................. 31Attaching Electrodes .............................................................................................. 35Selecting Electrode Lead ................................................................................. 35Connecting the Electrode Lead to the Transmitter ........................................... 36Selecting the Electrode Position ...................................................................... 36Attaching Electrodes to the Patient and Connecting the Electrode Leads toDisposable Electrodes ..................................................................................... 40Electrode Position for Respiration Monitoring ................................................. 41Attaching the SpO2 Probe ...................................................................................... 43Selecting the SpO2 Probe ................................................................................ 43Connecting the SpO2 Probe to the Transmitter ................................................ 46Attaching the Probe to the Patient ................................................................... 46Locking the Keys on the Transmitter ........................................................................... 48Monitoring .................................................................................................................... 49NIBP Monitoring ..................................................................................................... 49Selecting the Initial Cuff Inflation Pressure ...................................................... 49Selecting the Measurement Mode and Interval ............................................... 49Measuring NIBP ............................................................................................... 50
Operator's Manual ZM-940PA iiiMonitoring SpO2 during NIBP Measurement ................................................... 53ECG and Respiration Monitoring .......................................................................... 53Electrode Detachment ..................................................................................... 55SpO2 Monitoring ..................................................................................................... 56SpO2 and PR Display Order ............................................................................. 57Monitoring SpO2 during NIBP Measurement ................................................... 57Display and Message List ........................................................................................... 59Battery Indication ................................................................................................... 59ECG/Respiration .................................................................................................... 59SpO2....................................................................................................................... 60NIBP ....................................................................................................................... 61Troubleshooting ........................................................................................................... 62Transmitter ............................................................................................................. 62ECG/Respiration .................................................................................................... 63SpO2....................................................................................................................... 63NIBP ....................................................................................................................... 64Maintenance ................................................................................................................ 661. External Check ............................................................................................ 662. Transmitter Channel ..................................................................................... 663. LCD Display ................................................................................................. 684. Key Operation .............................................................................................. 695. NIBP Cuff for Attaching Transmitter to Patient Arm ...................................... 70Maintenance Check Sheet .................................................................................... 71Repair Parts Availability Policy .................................................................................... 72Lifetime and Disposal .................................................................................................. 73Disposing of Used Batteries .................................................................................. 73Battery Lifetime ................................................................................................. 73Disposal ........................................................................................................... 73Disposing of Electrodes, SpO2 Probes and NIBP Cuffs ........................................ 73Cleaning, Disinfection and Sterilization ...................................................................... 74Transmitter and Electrode Leads ........................................................................... 74Cleaning ........................................................................................................... 74Disinfection....................................................................................................... 74SpO2 Probe ............................................................................................................ 75YP-943P/944P NIBP Cuffs ..................................................................................... 75Cleaning ........................................................................................................... 75Disinfection....................................................................................................... 75Specifications .............................................................................................................. 76Measuring Parameters..................................................................................... 76Transmitting Data ............................................................................................. 76Displayed Data................................................................................................. 76ECG Measurement........................................................................................... 76
iv Operator's Manual ZM-940PARespiration Measurement ............................................................................... 76SpO2 Measurement .......................................................................................... 76NIBP Measurement .......................................................................................... 77Pulse Rate ........................................................................................................ 77Transmitter ........................................................................................................ 77Power Requirements........................................................................................ 77Dimension and Weight..................................................................................... 77Environment ..................................................................................................... 78Safety Standards .............................................................................................. 78Electromagnetic Compatibility ......................................................................... 79Electromagnetic Emissions .............................................................................. 79Electromagnetic Immunity ................................................................................ 80Recommended Separation Distance between Portable and Mobile RFCommunications Equipment............................................................................ 82System Composition for EMC Test ................................................................... 82Standard Accessories ................................................................................................. 83Options ........................................................................................................................ 84Transmitter ........................................................................................................ 84ECG/RESP ....................................................................................................... 84NIBP ................................................................................................................. 84SpO2................................................................................................................. 85Transmission Frequencies .......................................................................................... 86
Operator's Manual ZM-940PA iGENERAL HANDLING PRECAUTIONSThis device is intended for use only by qualified medical personnel.Use only Nihon Kohden approved products with this device. Use of non-approvedproducts or in a non-approved manner may affect the performance specifications ofthe device. This includes, but is not limited to, batteries, recording paper, pens,extension cables, electrode leads, input boxes and AC power.Please read these precautions thoroughly before attempting to operate the instrument.1. To safely and effectively use the instrument, its operation must be fully understood.2. When installing or storing the instrument, take the following precautions:(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessivehumidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air.(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock,even during transport.(3) Avoid placing in an area where chemicals are stored or where there is danger of gasleakage.(4) The power line source to be applied to the instrument must correspond in frequencyand voltage to product specifications, and have sufficient current capacity.(5) Choose a room where a proper grounding facility is available.3. Before Operation(1) Check that the instrument is in perfect operating order.(2) Check that the instrument is grounded properly.(3) Check that all cords are connected properly.(4) Pay extra attention when the instrument is in combination with other instruments toavoid misdiagnosis or other problems.(5) All circuitry used for direct patient connection must be doubly checked.(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.4. During Operation(1) Both the instrument and the patient must receive continual, careful attention.(2) Turn power off or remove electrodes and/or transducers when necessary to assure thepatient’s safety.(3) Avoid direct contact between the instrument housing and the patient.5. To Shutdown After Use(1) Turn power off with all controls returned to their original positions.(2) Remove the cords gently; do not use force to remove them.
ii Operator's Manual ZM-940PA(3) Clean the instrument together with all accessories for their next use.6. The instrument must receive expert, professional attention for maintenance andrepairs. When the instrument is not functioning properly, it should be clearlymarked to avoid operation while it is out of order.7. The instrument must not be altered or modified in any way.8. Maintenance and Inspection:(1) The instrument and parts must undergo regular maintenance inspection at least every 6months.(2) If stored for extended periods without being used, make sure prior to operation that theinstrument is in perfect operating condition.(3) Technical information such as parts list, descriptions, calibration instructions or otherinformation is available for qualified user technical personnel upon request from yourNihon Kohden distributor.9. When the instrument is used with an electrosurgical instrument, pay carefulattention to the application and/or location of electrodes and/or transducers to avoidpossible burn to the patient.10. When the instrument is used with a defibrillator, make sure that the instrument isprotected against defibrillator discharge. If not, remove patient cables and/ortransducers from the instrument to avoid possible damage.
Operator's Manual ZM-940PA iiiWARRANTY POLICYNihon Kohden Corporation (NKC) shall warrant its products against all defects in materials andworkmanship for one year from the date of delivery. However, consumable materials such asrecording paper, ink, stylus and battery are excluded from the warranty.NKC or its authorized agents will repair or replace any products which prove to be defectiveduring the warranty period, provided these products are used as prescribed by the operatinginstructions given in the operator’s and service manuals.No other party is authorized to make any warranty or assume liability for NKC’s products.NKC will not recognize any other warranty, either implied or in writing. In addition, service,technical modification or any other product change performed by someone other than NKC orits authorized agents without prior consent of NKC may be cause for voiding this warranty.Defective products or parts must be returned to NKC or its authorized agents, along with anexplanation of the failure. Shipping costs must be pre-paid.This warranty does not apply to products that have been modified, disassembled, reinstalled orrepaired without Nihon Kohden approval or which have been subjected to neglect or accident,damage due to accident, fire, lightning, vandalism, water or other casualty, improper installationor application, or on which the original identification marks have been removed.In the USA and Canada other warranty policies may apply.CAUTIONUnited States law restricts this device to sale by or on the order of a physician.Equipment Authorization RequirementOperation of this equipment requires the prior coordination with a frequency coordinatordesignated by FCC for the Wireless Medical Telemetry Service.
iv Operator's Manual ZM-940PAEMC RELATED CAUTIONThis equipment and/or system complies with IEC 60601-2 International Standardfor electromagnetic compatibility for medical electrical equipment and/orsystem. However, an electromagnetic environment that exceeds the limits orlevels stipulated in IEC 60601-1-2, can cause harmful interference to theequipment and/or system or cause the equipment and/or system to fail toperform its intended function or degrade its intended performance. Therefore,during the operation of the equipment and/or system, if there is any undesireddeviation from its intended operational performance, you must avoid, identifyand resolve the adverse electromagnetic effect before continuing to use theequipment and/or system.The following describes some common interference sources and remedialactions:1.Strong electromagnetic interference from a nearby emitter source such as anauthorized radio station or cellular phone:Install the equipment and/or system at another location. Keep the emittersource such as cellular phone away from the equipment and/or system, orturn off the cellular phone.2.Radio-frequency interference from other equipment through the AC powersupply of the equipment and/or system:Identify the cause of this interference and if possible remove this interferencesource. If this is not possible, use a different power supply.3.Effect of direct or indirect electrostatic discharge:Make sure all users and patients in contact with the equipment and/or systemare free from direct or indirect electrostatic energy before using it. A humidroom can help lessen this problem.4.Electromagnetic interference with any radio wave receiver such as radio ortelevision:If the equipment and/or system interferes with any radio wave receiver, locatethe equipment and/or system as far as possible from the radio wave receiver.5.Interference of lightningWhen lightning occurs near the location where the equipment and/or system isinstalled, it may induce an excessive voltage in the equipment and/or system.In such a case, disconnect the AC power cord from the equipment and/orsystem and operate the equipment and/or system by battery power, or use anuninterruptible power supply.
Operator's Manual ZM-940PA v6.Use with other equipmentWhen the equipment and/or system is adjacent to or stacked with otherequipment, the equipment and/or system may affect the other equipment.Before use, check that the equipment and/or system operates normally withthe other equipment.7.Use of unspecified accessory, transducer and/or cableWhen an unspecified accessory, transducer and/or cable is connected to thisequipment and/or system, it may cause increased electromagnetic emissionor decreased electromagnetic immunity. The specified configuration of thisequipment and/or system complies with the electromagnetic requirementswith the specified configuration. Only use this equipment and/or system withthe specified configuration.8.Use of unspecified configurationWhen the equipment and/or system is used with the unspecified systemconfiguration different than the configuration of EMC testing, it may causeincreased electromagnetic emission or decreased electromagnetic immunity.Only use this equipment and/or system with the specified configuration.9.Measurement with excessive sensitivityThe equipment and/or system is designed to measure bioelectrical signalswith a specified sensitivity. If the equipment and/or system is used withexcessive sensitivity, artifact may appear by electromagnetic interferenceand this may cause mis-diagnosis. When unexpected artifact appears, inspectthe surrounding electromagnetic conditions and remove this artifact source.If the above suggested remedial actions do not solve the problem, consult yourNihon Kohden distributor or representative for additional suggestions.This equipment complies with International Standard IEC 60601-1-2 (1993) whichrequires CISPR11, Group 1, Class B. Class B EQUIPMENT is equipment suitablefor use in domestic establishments and in establishments directly connected toa low voltage power supply network which supplies buildings used for domesticpurposes.
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Operator's Manual ZM-940PA viiConventions Used in this Manual and InstrumentWarnings, Cautions and NotesWarnings, cautions and notes are used in this manual to alert or signal the reader to specificinformation.WARNINGA warning alerts the user to the possible injury or death associated with the useor misuse of the instrument.CAUTIONA caution alerts the user to possible injury or problems with the instrumentassociated with its use or misuse such as instrument malfunction, instrumentfailure, damage to the instrument, or damage to other property.NOTEA note provides specific information, in the form of recommendations,prerequirements, alternative methods or supplemental information.
viii Operator's Manual ZM-940PASymbol Description Symbol DescriptionFull battery Replace batteryNIBP cannot be measuredReplace battery Check electrodeSymbol Description Symbol DescriptionDefibrillation proof type BFapplied part Direct currentDefibrillation proof type CFapplied part Serial numberAttention, consult operator’smanual Year of manufactureDirection for attachingbattery cover CSA markOn LCDExplanations of the Symbols in this Manual and InstrumentThe following symbols found in this manual/instrument bear the respective descriptions asgiven.On PanelSymbol Description Symbol DescriptionBattery position Attention, consult operator’smanualInside Battery Case
Operator's Manual ZM-940PA 1IntroductionThe ZM-940PA transmitter transmits ECG, respiration, SpO2, NIBP and pulse waveform froma patient to a Nihon Kohden monitor for continuous monitoring. The transmitter can changechannels when connected to the QI-901PK channel writer. The front LCD displays SpO2%,NIBP, pulse rate, pulse waveform amplitude, electrode condition mark, battery condition andNIBP measuring mode and interval.Read the operator’s manual for the receiving monitor together with this manual before operation.CAUTION• Do not use the same channel for different patients. Otherwise, two patients’data will be lost due to mutual modulation interference, or another patient’sdata may appear on the receiving monitor screen.• Do not use transmitters of adjacent channels in a hospital. Otherwise, radiowaves from one transmitter affect the receiver of the adjacent channel’stransmitter and there may be interference.• Do not use the same transmitter on more than one patient at the same time.Do not connect different sensors on different patients to the same transmitter.NOTE• To prevent interference between channels, assign a channel administrator inthe hospital and only he or she should manage channel assignment.• Use Nihon Kohden parts and accessories to assure maximum performancefrom your instrument.• For stable signal reception, it is recommended to use a diversity antennasystem on the receiving monitor. Otherwise, spike noise from transient fadingof electric field strength (for example, people moving) may interfere with thetransmitter signal and may be mistaken as an arrhythmia on the receivingmonitor.• NIBP cannot be measured on a neonate. (ECG, respiration and SpO2 can bemonitored on a neonate.)
2 Operator's Manual ZM-940PAPanel DescriptionFront PanelLCD:Displays measuring data, settings andother information.Battery case:Contains three 1.5 V AA batteries.NIBP START/STOP key:Starts/stops NIBP measurement inselected mode.NIBP INTERVAL key:Selects NIBP measurement mode.WARNINGClose the battery case cover during operation.If the transmitter is used with the battery case cover open, the patient may getan electrical shock when defibrillation is performed, and electrostatic dischargeby the patient may intermittently interfere with the waveform or data.Refer to the WARNING below.(This symbol is attached to the rear of thebattery case cover.)
Operator's Manual ZM-940PA 3Rear PanelLock plate:Fastens the transmitter to an NIBP cuff.Refer to the WARNING below.WARNINGThis transmitter is not waterproof. If detergent or liquid spills into thetransmitter, stop using it and contact your Nihon Kohden distributor. If a wettransmitter is used, the patient or anyone in contact with the transmitter mayreceive an electric shock or patient leakage current over the allowed amountmay flow.
4 Operator's Manual ZM-940PATop PanelECG/impedance RESP socket:Connects the electrode lead formeasuring ECG and/or respirationby the impedance method.NIBP socket:Connects the cuff hose.Refer to the symbol page.Refer to the WARNING on thenext page.Refer to the WARNING on thenext page.Refer to the symbolpage.Channel number label:Indicates the channel number of thetransmitter. Attach the channel number labelto the panel of the monitor.SpO2 socket:Connects the SpO2probe.Bottom PanelRefer to the WARNING on the nextpage.Refer to the symbol page.
Operator's Manual ZM-940PA 5WARNING• Before performing defibrillation, check that the electrode leads and SpO2probe attached to the patient are properly connected to the transmitter.Touching the metal parts of disconnected leads and probes causes seriouselectrical shock or injury by discharged energy.• When performing defibrillation, all persons must keep clear of the bed andmust not touch the patient, any equipment connected to the patient or themetal parts of leads and probes connected to the patient. Failure to follow thiswarning may result in serious electrical burn, shock or other injury.• When performing defibrillation, discharge as far as possible from electrodesand medicine on the chest of the patient. If there is a possibility that thedefibrillator paddle could touch electrodes and medicine, remove electrodesand medicine from the patient. If the defibrillator contacts these materials, thedischarged energy may cause serious electrical burn on the patient.• When using this transmitter with an ESU, the ESU return plate and theelectrodes for monitoring must be firmly attached to the patient. If the returnplate is not attached correctly, it may burn the patient’s skin where theelectrodes are attached. Refer to the instruction manual for the ESU.CAUTIONDo not shake or swing the transmitter holding the leads/cables connected to thetransmitter. The transmitter may come off and injure someone or damagesurrounding instruments.
6 Operator's Manual ZM-940PALCDLOCKKEYS1234567891011No. Name Description1 NIBP SYS Displays NIBP systolic value.2 NIBP DIA Displays NIBP diastolic value.3 NIBP MEAN Displays NIBP mean value.“CUFF” is displayed with the cuff inflation pressure duringmeasurement.4 Check electrode mark Appears when an electrode or electrode lead becomesdetached during ECG measurement.5 Battery replacement mark Appears when the batteries are weak. For details, refer tothe “Battery Condition Indication” section.6 Message display area Displays messages.When ECG is monitored with 6 electrodes and an electrodeor electrode lead is detached, “Check electrode” is indicatedas below, depending on the PARAMETER SETUP setting.Refer to the “Changing Parameter Setup Settings” and “ECGand Respiration Monitoring” sections.LEADS OFF DISPLAY set to CHARECG ELECTRODE set to AHALEADS OFF DISPLAY set to CHARECG ELECTRODE set to IECLEADS OFF DISPLAY set to IMAGE
Operator's Manual ZM-940PA 7No. Name Description7 NIBP measurement mode Displays NIBP measurement mode. When set to auto mode,the measurement interval is displayed.8 NIBP interval bar graph In auto NIBP measurement, the remaining time from the lastmeasurement to the next measurement is displayed as a bargraph.9 Pulse level bar graph Displays pulse level in 7 steps.10 %SpO2Displays SpO2 data.11 PR Displays pulse rate when NIBP or SpO2 is measured. Whenthe SpO2 probe is attached to the patient, the real time pulserate is displayed. When the SpO2 probe is not attached to thepatient, the pulse rate at the end of NIBP measurement isdisplayed.
8 Operator's Manual ZM-940PANotes on Parameter SettingsWhen monitoring NIBP and SpO2, the following setting must be set as indicated in the table toproperly transmit the monitoring data to the receiving monitor. Otherwise, SpO2 cannot bemonitored properly during NIBP measurement.Some receiving monitors require the software to be upgraded. For details, contact your NihonKohden distributor.SpO2 probe attachment site INHIBIT SpO2 DURING NIBP settingProbe attached to the same limb as the cuff ONProbe attached to the limb without cuff* OFF* When the SpO2 probe is attached to the same limb as the NIBP cuff and the cuff isinflated, the SpO2 value becomes unstable and SpO2 or PR alarm may occur.
Operator's Manual ZM-940PA 9Output SignalWARNINGDo not use the output signal from the receiving monitor as the synchronizationsignal for other equipment such as IABP, MRI, echocardiography or defibrillatorbecause there may be time delay between the monitor and the other equipmentcaused by waveform transmission delay and spike noise may interfere on theoutput signal and be mistaken as a trigger.Important Safety InformationGeneralWARNING• Never use this transmitter in the presence of any flammable anesthetic gas orhigh concentration oxygen atmosphere. Failure to follow this warning maycause explosion or fire.• Never use this transmitter in a high-pressure oxygen medical care tank.Failure to follow this warning may cause explosion or fire.• Do not take this transmitter into the MRI test room. This transmitter is notdesigned to be used during MRI tests.
10 Operator's Manual ZM-940PAInstalling (Replacing) BatteriesWARNING and CAUTION for Battery HandlingWARNING• Do not dispose of the battery in fire because it may explode.• Do not use a disassembled or damaged battery. The contents of the batteryare harmful and the battery may catch fire.• If the contents of the battery contact the skin or clothes, immediately wash itthoroughly with water.• Never short-circuit the + and – terminals. The battery may overheat and catchfire.• Take care that the patient does not swallow batteries.CAUTION• Refer to the battery and battery charger manuals for details on handling thebatteries.• Do not handle the batteries with wet hands.• When the transmitter is not in use, remove batteries. When batteries areinstalled, battery power is consumed even if measurement is not performed.Especially, when NiMH batteries remain in the transmitter when thetransmitter is not in use, the battery may become unusable fromoverdischarge and leak liquid which will damage the transmitter.• The battery charger must be used outside the patient environment.Battery LifetimeUse three AA type alkaline dry cell batteries. NiMH rechargeable batteries can also be used.PreparationType Lifetime (Measuring parameters)ECG, SpO2, NIBP ECG, SpO2ECG onlyNiMH secondary 2 days 2 days 2.5 daysAlkaline primary 1 day 2.5 days 3 daysThe above data is when new batteries are used at room temperature, NIBP is measured in automode at 60 minute intervals and SpO2 is measured on an index finger of a male patient withweight 60 kg.Operation time depends on the thickness of SpO2 probe attachment site.
Operator's Manual ZM-940PA 11NOTEWhen using rechargeable NiMH batteries, shallow charging/dischargingshortens battery capacity. For details, refer to the battery operator’s manual.Installing (Replacing) BatteriesCAUTIONBattery replacement must be performed by medical staff. When replacingbatteries of the transmitter currently used for a patient, disconnect electrodeleads from the transmitter before replacing batteries or do not touch the patientduring replacement.If electrode leads are attached to the patient and a person replacing batteries touches the patientduring battery replacement, patient leakage current over the allowed amount may flow.CAUTION• Replace all batteries at the same time.• Do not use different types of batteries together.NOTEInsert the batteries with the correct polarity (+ and –).Procedure1. Remove the battery case cover.2. Insert three new or fully charged batteries into thebattery case observing the correct polarity.
12 Operator's Manual ZM-940PA3. Close the cover.NOTERemove the batteries before disposing of thetransmitter.Situations Requiring Battery ReplacementReplace the batteries when any of the following occurs.• The transmitter LCD displays the “ ” or “ ”mark.• The transmitter generates a constant alarm (continuous “peep” sound).• The transmitter LCD does not display anything when the power is turned on.• The monitor displays the battery replacement message on the screen.Battery Condition IndicationThe battery condition is indicated as follows.Indication Condition Receiving MonitorFully charged battery Batteries are full. There is no indication onthe monitor.Batteries are low. Replacebatteries.Batteries are low. NIBP cannotbe measured. Replace batteries.Message requiring battery replacement isdisplayed.Noindication Dead batteries No signal can be transmitted to the monitor.There is no indication on the monitor.
Operator's Manual ZM-940PA 13Turning the Transmitter On/OffTurning On the PowerWhen the batteries are installed correctly, the power isturned on. A one second “peep” sounds and the startupscreen appears. (There is no “peep” sound when there isno battery power.)NOTEReplace the batteries when the LCD displaysthe “ ” or “ ”mark.Turning Off the PowerTo turn off the power, remove batteries.PeepCheck Items Before UseBefore turning on the transmitter power, check the following to confirm that the transmitter canbe used in normal and safe condition.Appearance• There are no damaged or dirty parts on the outside of the transmitter (LCD, keys, sockets,battery case cover, battery case, lock plate, etc.).• The transmitter is completely dry.• The electrode lead, SpO2 probe and NIBP cuff are not broken.• There are no damaged or dirty parts on the disposable SpO2 probe, disposable electrodes ordisposable NIBP cuff.Batteries• The battery polarity is correct.• The battery case spring is firmly fixed and the battery is not loose.• The battery case cover is firmly closed.Channel Setting• The transmitter channel corresponds to those of the receiving monitor.• There is no transmitter in the surrounding area with the same channel.
14 Operator's Manual ZM-940PACheck Items After Power OnAfter turning on the power, check the following.Power On• The transmitter generates about a one second “peep” sound and the startup screen appears.• The transmitter does not generate a continuous “peep” sound.• The transmitter does not give excessive heat.• The transmitter LCD displays a “ ” mark.• The transmitter does not interfere with the operation of other medical instruments in use.Basic Operation• The “signal loss” message is not displayed on the receiving monitor when the transmitter isinside the receiving range of the monitor.• The battery replacement message is not displayed on the monitor.• The keys on the transmitter function properly.• The LCD brightness is appropriate. To adjust brightness, refer to the “Changing SystemSetup Settings” section.Check Items After UseTo use the transmitter in safe and optimum condition for next time, check the following.Before Turning Power Off• Temporarily changed settings are changed back to the previous settings.• There was no malfunction on the transmitter.Storage• ECG electrode leads, SpO2 probe and NIBP cuff are cleaned and disinfected.• When the transmitter gets wet, liquid is wiped off and the transmitter is thoroughly dried.• There are enough consumables, such as disposable electrodes.• The transmitter power is turned off by removing batteries from the transmitter.• Dead batteries are disposed of properly.
Operator's Manual ZM-940PA 15Changing the Transmitter ChannelThe channel of the transmitter can be changed. The optional QI-901PK Channel Writer isrequired.WARNINGThe following action must be taken to properly receive the transmitter signal ofthe correct patient on the receiving instrument. Otherwise, there may be signalloss or signals may mix causing a serious accident, such as monitoring adifferent patient.• Assign a channel administrator in the hospital and only he or she shouldmanage channel assignment on his or her responsibility.• The channel administrator must manage the channels in the facility so thatthere is no signal interference.• When the transmitter channel is changed, the channel administrator mustcheck that the channel on the receiving monitor is also changed and the signalis properly received.• The channel administrator must replace the channel number label on thetransmitter with the new one after changing the channel.NOTEThe software version of the QI-901PK channel writer must be 02-01 or later tochange the channel on the ZM-940PA transmitter.To check the transmitter channel, refer to “CHANNEL” in the “Changing System SetupSettings” section.
16 Operator's Manual ZM-940PAChanging Parameter Setup SettingsThe initial settings on the PARAMETER SETUP screen must be changed before monitoring.Changing these settings during monitoring interrupts monitoring.Parameter Setup Setting ListThe factory default settings are underlined.Setting Item Description SettingsSELECTABLEINTERVALSSelect the NIBP measurement modes forthe mode selection.STAT, 5, 10, 15, 30, 60,120, 240INITIALINTERVALSelect the initial NIBP measurementmode at power on.MAN., 5 min, 10 min,15 min, 30 min, 60 min,120 min, 240 minINITIAL CUFFPRESS Select the NIBP cuff inflation pressure.120 mmHg, 150 mmHg,180 mmHg, 210 mmHg,240 mmHgNIBP MODEAFTER STATSelect the NIBP measurement modeafter completing STAT measurement.MAN., 5 min, 10 min,15 min, 30 minSTART/FINISHSOUNDTurn ON or OFF the sound for NIBPmeasurement start/finish. ON, OFF/ON, OFFOLD NIBP DATA AFTERSelect whether to hide or dim the NIBPdata after measurement and how long towait after measurement to dim or hide it.DATA: HIDE, DIMAFTER: 5 min, 10 min,30 minINHIBIT SpO2DURING NIBPTurn SpO2 monitoring on or off duringNIBP measurement. ON, OFF2ND PARAMETER Set SpO2 and PR display order. SpO2, PRLEADS OFFDISPLAYSelect the mode for displaying electrodeoff. This setting is only available whenECG is monitored with 6 electrodes.CHAR, IMAGEECG ELECTRODESelect the electrode lead type. Thissetting is only available when CHAR isselected for LEADS OFF DISPLAY.IEC, AHA
Operator's Manual ZM-940PA 173. Press the NIBP START/STOP key to enter the PARAMETER SETUP screen.When the cursor is moved to “EXIT” by pressing the NIBP INTERVAL key and the NIBPSTART/STOP key is pressed, the startup screen appears, then the monitoring screenappears.4. To select or change a setting, press the NIBP START/STOP key.To move the cursor, press the NIBP INTERVAL key.Selects or changes settingMoves cursorWhen the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and theNIBP START/STOP key is pressed, the SETUP screen appears.Displaying the PARAMETER SETUP Screen1. Remove one battery.2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.The SETUP screen appears.
18 Operator's Manual ZM-940PAINITIAL INTERVALSelect the initial NIBP measurement mode at power on.1. Press the NIBP INTERVAL key to move thecursor to “INITIAL INTERVAL”.2. Press the NIBP START/STOP key to selectthe mode. Selectable modes are the modesselected for “SELECTABLE INTERVALS”and “MAN.” (MANUAL).INITIAL CUFF PRESSSelect the NIBP cuff inflation pressure.1. Press the NIBP INTERVAL key to move thecursor to “INITIAL CUFF PRESS”.2. Press the NIBP START/STOP key to selectthe inflation pressure from 120, 150, 180, 210and 240 mmHg.1. Press the NIBP INTERVAL key to move thecursor to the desired mode.2. Press the NIBP START/STOP key to select orunselect the mode. Selectable modes are: STAT,5, 10, 15, 30, 60, 120 and 240 min.Changing SettingsSELECTABLE INTERVALSDuring monitoring, when the NIBP INTERVAL key is pressed, the measurement mode changesaccording to the modes selected in this item. MANUAL mode is already selected for the modeselection.
Operator's Manual ZM-940PA 19START/FINISH SOUNDTurn on or off the sound for NIBP measurement start and finish.Start sound End sound1. Press the NIBP INTERVAL key to move thecursor to “START/FINISH SOUND”.2. Press the NIBP START/STOP key to turn ONor OFF.OLD NIBP DATA/AFTERSelect whether to dim or hide the NIBP data after measurement and how long to wait after NIBPmeasurement to dim or hide it.1. Press the NIBP INTERVAL key to move thecursor to “OLD NIBP DATA/AFTER”.2. Press the NIBP START/STOP key to select thesetting.DATA: DIM NIBP data is dimmed after the “AFTER” interval.HIDE NIBP data is hidden after the “AFTER” interval. “– – –” is displayed on thescreen.AFTER: Select the interval after NIBP measurement to dim or hide.Dimmed HiddenNIBP MODE AFTER STATSelect the NIBP measurement mode after completing the STAT measurement.1. Press the NIBP INTERVAL key to move thecursor to “NIBP MODE AFTER STAT”.2. Press the NIBP START/STOP key to selectthe mode. The selected mode is automaticallyselected for “SELECTABLE INTERVALS”as well.
20 Operator's Manual ZM-940PAINHIBIT SpO2 DURING NIBPSet whether or not to monitor SpO2 during NIBP measurement.When the SpO2 probe is attached to the same limb as the NIBP cuff and this setting is set toOFF, the pulse may become unstable and SpO2 or PR alarm may occur. It is recommended toset this setting to ON so that SpO2 is not measured during NIBP measurement.When the SpO2 probe is attached to the other limb from the NIBP cuff, this setting can be set toOFF.NOTEWhen this “INHIBIT SpO2 DURING NIBP” is set to OFF, refer to the “MonitoringSpO2 during NIBP Measurement” section.1. Press the NIBP INTERVAL key to move thecursor to “INHIBIT SpO2 DURING NIBP”.2. Press the NIBP START/STOP key to select“ON” or “OFF”.ON: Stops SpO2 monitoring during NIBP measurement.OFF: SpO2 is monitored during NIBP measurement.2ND PARAMETERSet the display order of SpO2 and PR.When set to SpO2When set to PR1. Press the NIBP INTERVAL key to move thecursor to “2ND PARAMETER”.2. Press the NIBP START/STOP key to select“SpO2” or “PR”.
Operator's Manual ZM-940PA 21LEADS OFF DISPLAYSelect the mode for displaying electrode off. This setting is only available when ECG ismonitored with 6 electrodes.1. Press the NIBP INTERVAL key to move thecursor to “LEADS OFF DISPLAY”.2. Press the NIBP START/STOP key to select“CHAR” or “IMAGE”.ECG ELECTRODESelect the electrode lead type. This setting is only available when “CHAR” is selected forLEADS OFF DISPLAY.When set to CHAR When set to IMAGE1. Press the NIBP INTERVAL key to move the cursorto “ECG ELECTRODE”.2. Press the NIBP START/STOP key to select “IEC”or “AHA”.AHA: RA, LA, LL, Va, VbIEC: R, L, F, Ca, Cb
22 Operator's Manual ZM-940PAChanging System Setup SettingsNOTEChanging System Setup settings must be done only by a qualified personnel.System Setup Setting ListThe factory default settings are underlined.Setting Item Description SettingsCHANNEL Displays the transmitter channel.PRESSURE UNIT Select the units for NIBP. mmHg, kPaLANGUAGE Select the language for screen display. JPN, ENGBRIGHTNESS Select the LCD brightness. 1, 2, 3, 4SYSTEMINITIALIZEInitializes all settings to the factory defaultsettings.Displaying the SYSTEM SETUP Screen1. Remove one battery.2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.The SETUP screen appears.3. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.4. Press the NIBP START/STOP key to enter theSYSTEM SETUP screen.When the cursor is moved to “EXIT” bypressing the NIBP INTERVAL key and theNIBP START/STOP key is pressed, the startupscreen appears, then the monitoring screenappears.
Operator's Manual ZM-940PA 235. To select or change a setting, press the NIBP START/STOP key.To move the cursor, press the NIBP INTERVAL key.Selects or changes settingMoves cursorWhen the cursor is moved to “RETURN” by pressing the NIBP INTERVAL key and theNIBP START/STOP key is pressed, the SETUP screen appears.Changing SettingsCHANNELThe channel of this transmitter is displayed.Channel of this transmitterPRESSURE UNITSelect the unit for NIBP.1. Press the NIBP INTERVAL key to move thecursor to “PRESSURE UNIT”.2. Press the NIBP START/STOP key to select“mmHg” or “kPa”.
24 Operator's Manual ZM-940PALANGUAGESelect the language for screen display.1. Press the NIBP INTERVAL key to move thecursor to “LANGUAGE”.2. Press the NIBP START/STOP key to select thelanguage.SYSTEM INITIALIZEDo the following procedure to initialize the settings to the factory default settings.1. Press the NIBP INTERVAL key to move the cursor to “SYSTEM INITIALIZE”.2. Press the NIBP START/STOP key. The “EXECUTE” message appears.3. Press the NIBP START/STOP key to initialize the settings to the factory default settings.BRIGHTNESSSelect the LCD brightness.1. Press the NIBP INTERVAL key to move thecursor to “BRIGHTNESS”.2. Press the NIBP START/STOP key to select theLCD brightness from 1 to 4.1234Light .............................. Dark
Operator's Manual ZM-940PA 25Attaching NIBP Cuff, Electrodes and SpO2 Probeto the PatientThe transmitter can be attached to an arm of the patient or placed on the bedside. The requiredlength of the electrode leads and SpO2 probe cable depends on how the transmitter is to beattached to the patient.NOTEMonitoring SpO2 during NIBP MeasurementWhen the SpO2 probe is attached to the same limb as the NIBP cuff, the bloodflow decreases during NIBP measurement and pulse wave cannot be detectedand SpO2 cannot be monitored properly. When “INHIBIT SpO2 DURING NIBP” onthe PARAMETER SETUP screen is set to ON (factory default setting), SpO2monitoring is paused during NIBP measurement to avoid SpO2 alarmoccurrence. However, when monitoring SpO2 on the same limb as NIBP, becareful when reading SpO2 values.When monitoring SpO2 is important, attach the probe to the limb to which theNIBP cuff or catheter is not attached.Attachment ExamplesWhen transmitter is attached on anarmWhen transmitter is placed on a bedsideNOTEWhen placing the transmitter on a bedside,place it on a stable and flat place. If thetransmitter falls off, it may be damaged.
26 Operator's Manual ZM-940PAAttaching the NIBP CuffSelecting the NIBP CuffSelect the NIBP cuff appropriate for the patient.NOTENIBP cannot be measured on neonates using this transmitter.Reusable CuffsWhen attaching the transmitter to the patient arm, a special NIBP cuff is required. An optionalYN-990P extension hose (1.5 m) is available to extend the length between the NIBP socket onthe transmitter and NIBP cuff (e.g. when not attaching the transmitter to the patient arm andplacing the transmitter on a bedside).Reusable cuff Model Width (cm) Air hose length (cm)Standard YP-943P 13 15For adult Large YP-944P 15 15When not attaching the transmitter to the patient arm, the following cuffs can be used. To usethese cuffs, an optional YN-990P extension hose (1.5 m) is required.Reusable cuff Model Width (cm) Air hose length (cm)For infants YP-960T 5Small YP-961T 7Forchildren Standard YP-962T 10Standard YP-963T 13For adults Large YP-964T 1515WidthWidthAir hoseAir hose
Operator's Manual ZM-940PA 27Disposable CuffsCAUTIONThe disposable cuffs are not sterilized. If necessary, sterilize the disposablecuffs using glutaraldehyde solution by following the instructions for theglutaraldehyde.When not attaching the transmitter to the patient arm, the following disposable cuffs can be used.To use these cuffs, an optional YN-990P extension hose (1.5 m) is required.YN-990P extension hose, 150 cmWidthReusable cuff Model Width (cm) Air hose length (cm)For infants YP-910P 6For children YP-912P 9Small YP-913P 12Standard YP-914P 14For adultsLarge YP-915P 1620Extension HoseCAUTIONWhen using an extension hose, check that the extension hose is not bent orsqueezed. Otherwise, the cuff may not inflate or deflate. If the cuff cannotdeflate, it may cause congestion on the patient at the cuff attachment site.Air hose
28 Operator's Manual ZM-940PAReference for selecting a cuffThe AHA (American Heart Association) recommends that the cuff width be 40% of thecircumference of the upper arm. Refer to the following graph and select the cuff which suits thepatient’s arm.NOTE• If a range of arm circumference appropriate for the cuff is prescribed, use acuff within that range.• To obtain accurate measured values, select a wide cuff which can be attachedto the upper arm. Measuring with a very narrow cuff may result in measuredvalues higher than the actual values.• The YP-943P NIBP cuff is for standard size adult. Do not use this cuff when itdoes not fit the patient.1510510 20 30 40 500201510510 20 30 40 50 60060Cuff width (cm)Arm circumference (cm)Infants YP-960TChildren small YP-961TChildren standard YP-962TAdults standard YP-943P (cuff for transmitter) YP-963TAdults large YP-944P (cuff for transmitter) YP-964TCuff Width and Arm CircumferenceReusable CuffsCuff width (cm)Arm circumference (cm)Infants YP-910PChildren standard YP-912PAdults standard YP-914PAdults large YP-915PDisposable CuffsAdults small YP-913P
Operator's Manual ZM-940PA 29Connecting the NIBP Cuff to the TransmitterWhen Using YP-943P/944P NIBP CuffTo attach the YP-943P/944P NIBP cuff to the transmitter, the lock plate is required.D ringBeltAir hoseFront coverFront cover openBelt for the strapLock plate pocketFor attaching the NIBP cuff to the transmitterNOTEDo not roll up or put weight on the cuff with the lockplate attached to it. Otherwise, the lock plate maybreak.Lock plateYP-943P/944P NIBP cuffTop tabBottom tab
30 Operator's Manual ZM-940PA1. Remove the lock plate from thetransmitter.2. Insert the lock plate into the lock platepocket on the NIBP cuff.3. Attach the transmitter to the lock plateby inserting the tabs on the lock plateinto the slots on the transmitter.4. Cover the transmitter with the frontcover of the NIBP cuff.5. Connect the air hose to the NIBP socketon the transmitter. Turn the cuffconnector joint until it clicks.12
Operator's Manual ZM-940PA 31When Using YP-960T series or YP-910P series NIBP CuffTo use these NIBP cuffs, an optional YN-990P extension hose (1.5 m) is required.NOTEConnect the joints properly. If there is an air leak, NIBP cannot be measuredproperly.1. Connect the NIBP cuff to the extension hose.2. Connect the other end of the extension hose tothe NIBP socket on the transmitter. Turn thejoint clockwise until it clicks.To disconnect the cuff from the transmitter,turn the hose joint counterclockwise.Attaching the NIBP Cuff to the PatientWARNINGBe careful when measuring NIBP on a patient with known bleeding disorders orcoagulation. After NIBP measurement, there may be dot hemorrhage, orcirculatory disorder by thrombus where the cuff was attached.CAUTION• Do not wrap the cuff on an arm or thigh which is used for injection. NIBPmeasurement on an arm or thigh which is used for injection may cause areflux of blood and stop injection.• Do not wrap the cuff too tight. It may cause poor blood circulation andcongestion. If the cuff is wrapped too loosely, the NIBP value may beincreased.• If the skin gets irritated or redness appears on the skin from the cuff, changethe attachment site or stop using the cuff.
32 Operator's Manual ZM-940PA• NIBP and SpO2 can be measured on the same limb, but the SpO2 monitoringmay not be accurate during NIBP measurement. Be careful when reading theSpO2 values.*• Do not reuse disposable cuffs.* Monitoring SpO2 during NIBP MeasurementWhen the SpO2 probe is attached to the same limb as the NIBP cuff, the blood flow decreasesduring NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitoredproperly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen isset to ON (factory default setting), SpO2 monitoring is paused during NIBP measurement toavoid SpO2 alarm occurrence. However, when monitoring SpO2 on the same limb as theNIBP, be careful when reading SpO2 values.NOTE• Measuring NIBP at a site other than the upper arm gives different values fromthose measured at the upper arm. When making diagnosis based on the NIBPvalues, measure NIBP on an upper arm.• To accurately detect the pulsatile flow of the artery, the cuff should bewrapped around a bare upper arm.• Do not use an abnormal cuff. The cuff deteriorates from use and cleaning.Before use, check the cuff and confirm that there is no flaw, crack or hole in it.Be careful not to damage the inflation bag. If the inflation bag has a hole or aflaw, it may burst during use. Dispose of an abnormal cuff and replace it witha new one.• Refer to the NIBP cuff manual for details.Cuff PositionPlace the cuffed upper arm (brachium) at the same height asthe patient’s heart. If the cuff is not at the same level as theheart, the weight of the blood affects the blood pressurereading. The pressure difference per unit height is 0.7mmHg/cm. The blood pressure reading decreases when thearm is higher than the heart and increases when lower.The best measuring condition is when the patient is lying onhis/her back with arms and legs relaxed. If the cuff positioncannot be on the same level as the heart, the displayed bloodpressure reading must be mathematically adjusted.HeartWhen placing thetransmitter on a bed, makesure that the hose is notbent.
Operator's Manual ZM-940PA 33Using the YP-943P/944P NIBP Cuff1. Attach the NIBP cuff to the transmitter. Refer tothe “Connecting the NIBP Cuff to theTransmitter” section.2. Insert the end of the cuff into the belt and thenthrough the D ring as shown at left.3. Fold back the cuff at the D ring and fasten itusing the velcro tape.Make sure that the cuff is not attached on a joint.NOTEThe cuff must not wrap around the elbow.D ringBeltEnd of cuff
34 Operator's Manual ZM-940PAAttaching the Strap to the TransmitterNOTE• Use the strap to prevent the transmitter from falling.• Do not attach the clip to hard objects such as thick cloth or zipper. It will breakthe clip.Attach a strap provided with the transmitter to the NIBP cuff and patient clothes.To open the clip, firmlypull out the tab indirection of the arrow. To adjust the strap length,push down the tab on theadjuster and slide.1. Adjust the length of the strap.2. Clip one end of the strap to the belt for the strapon the NIBP cuff.3. Clip the other end of the strap to the patient’sclothes as shown left.Belt for the strap on the NIBP cuff
Operator's Manual ZM-940PA 35Attaching ElectrodesSelecting Electrode LeadCAUTIONUse only Nihon Kohden specified electrode leads. With electrodes and electrodeleads other than specified ones, the “CHECK ELECTRODE” message appearsand monitoring may stop.The following electrode leads can be used on the transmitter (option).ARTERYRANGEUsing the YP-960T series Reusable Cuffs or YP-910P series Disposable Cuffs1. Put the cuff on the upper arm so that the mark of “ARTERY ” aligns with the arteryof the patient.2. Wrap the cuff so that “INDEX ” comeswithin the “ RANGE ”.If “Index ” is not within the “ RANGE”, change the cuff size.BR-903PA,3 electrodes,clip typeBR-913PA,3 electrodes,snap typeBR-906PA,6 electrodes,clip typeBR-916PA,6 electrodes,snap type
36 Operator's Manual ZM-940PAConnecting the Electrode Lead to the TransmitterConnect the electrode lead to the ECG/RESP socket on the transmitter.When the transmitter is attached on an armCAUTIONHold the connector of the electrode lead when connecting/disconnecting theelectrode lead. If you disconnect the electrode lead by pulling the lead, itdamages the electrode lead.Selecting the Electrode PositionFollow the physician’s instructions for electrode placement when available.For ECG monitoring, electrodes are attached only on the chest to allow patient movement andobtain continuous stable ECG. Following leads are examples. When also monitoringrespiration, refer to the “Electrode Position for Respiration Monitoring” section.NOTEThe optimum electrode positions for ECG measurement of a patient are notalways optimum for respiration measurement of the patient. Select positionssuitable for both ECG and respiration measurements, or positions which havepriority for one measurement.
Operator's Manual ZM-940PA 37Six ElectrodesThe 6-electrode method with lead II and lead V5 is effective for monitoring myocardial ischemia.You can improve monitoring accuracy considerably by adding lead V4 to this combination. Vaand Vb can be at any position of the standard 12 leads V1 to V6, but V4 and V5 are mostappropriate for myocardial ischemic monitoring.RA/R LA/LRL/RF LL/FVa/CaVb/CbSymbol Lead ColorElectrode Position AHA IEC AHA IECLeft infraclavicular fossa LA L Black YellowRight infraclavicular fossa RA R White RedBelow lowest rib on the left anterior axillary line LL F Red GreenRight anterior axillary line at the same level asLL/F RL RF Green BlackFifth intercostal space on the left midclavicularline. (V4 position of standard 12 leads) Va Ca Brown-blueWhite-brownLeft anterior axillary line at the same level as Va.(V5 position of standard 12 leads) Vb Cb Brown-orangeWhite-black
38 Operator's Manual ZM-940PAStandard limb leadsMonopolar limb leadsMonopolar chest leadsLead I Lead II Lead IIIaVR lead aVL lead aVF leadV1 to V6 leadstoRARARA RA RARARALALALALALALALALLLLLLLL LLLLLLN (RL)N (RL)N (RL) N (RL) N (RL)N (RL)N (RL)Lead Position
Operator's Manual ZM-940PA 39Three Electrodes• Lead MII, which is similar to standard lead II, used when ECG measurement has prioritySymbol Lead ColorElectrode Position AHA IEC AHA IECLeft infraclavicular fossa LA L Black YellowRight infraclavicular fossa RA R White RedBelow lowest rib on the leftanterior axillary line LL F Red Green• Lead MI, which is similar to standardlead IChange F/LL and L/LA of the leadMII.• Lead MIII, which is similar to standard leadIII.Change R/RA and L/LA of the lead MII.If the electrode position shown above is not available due to chest surgery, attach the electrodesto the root of the limbs or below the clavicles for stable ECG monitoring.
40 Operator's Manual ZM-940PAAttaching Electrodes to the Patient and Connecting the Electrode Leads toDisposable ElectrodesPrepare the Patient SkinShave off excessive body hair.To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistenedwith alcohol. Thoroughly dry the skin with a clean cotton pad.NOTE• For a patient with frequent body movement, rub the sites with Skinpure skinpreparation gel. However, do not use Skinpure skin preparation gel onsensitive skin.• Do not place electrodes on a wound or on an inflamed, wrinkled or uneven skinsurface.Attaching Electrodes to the PatientCAUTIONDo not reuse disposable products.NOTE• To maintain good contact between the electrode and skin, check that the pasteof the disposable electrode is not dry.• When contact between the disposable electrode and skin becomes poor,replace electrodes with new ones immediately. Otherwise, contact impedancebetween the skin and the electrode increases and the correct ECG cannot beobtained.Refer to the electrode operator’s manual for details.1. Carefully remove the backing paper from the electrode.Avoid touching the adhesive surface.2. Place the electrode on the previously cleaned skin.Pay attention to the electrode lead color and symbol.3. Clip the electrode lead to the electrode.4. Fasten the electrode lead wire with surgical tape withan extra length of wire between the tape and theelectrode. This lessens the movement of electrodeleads by body movement and helps stable monitoring.
Operator's Manual ZM-940PA 41Electrode Position for Respiration MonitoringPlace the R/RA and F/LL electrodes so that the lungs are between the electrodes.NOTEThe optimum electrode positions for ECG measurement of a patient are notalways optimum for respiration measurement of the patient. Select positionssuitable for both ECG and respiration measurements, or positions which havepriority for one measurement.Electrode Position ExamplesNOTEThe following examples are when monitoring with 3 electrodes. ECG cannot bemonitored correctly when electrodes are attached as the following exampleswhen monitoring with 6 electrodes.Position 1In this position, respiration measurement is available; however, there is a difference in amplitudebetween different patients.R or RA F or LLRight infraclavicularfossaFifth intercostal space on theleft midclavicular line, V4Position 2In this position, the waveform amplitude is usually large and the ECG lead is similar to LeadMII. This position can be generally recommended.R or RA F or LLRight infraclavicularfossaFifth intercostal space on theleft midaxillary line, V6
42 Operator's Manual ZM-940PAPosition 3In this position, the respiration waveform is optimum, but the ECG lead is unusual.R or RA F or LLRight midaxillary at thehorizontal level of V4Fifth intercostal space on theleft midaxillary line, V6Position 4In this position, the respiration measurement is influenced by the impedance variation of theabdomen, so the cardiac pulse wave included in the respiration wave is reduced. Note that thewaveform is inverted in phase compared with the chest movement (the waveform goes downduring inspiration). It is difficult to measure the ECG at the same time.R or RA F or LLLowest rib on the rightanterior axillary lineLowest rib on the leftanterior axillary line
Operator's Manual ZM-940PA 43Attaching the SpO2 ProbeSelecting the SpO2 ProbeSelect an appropriate probe for the patient.CAUTION• Use Nihon Kohden specified SpO2 probe to assure maximum performancefrom your instrument.• Do not use damaged or disassembled probe. It causes incorrectmeasurement and may hurt the patient.Reusable ProbesWhen using a TL-201T finger probe, choose the appropriate cable length for attachment.Probe Cable Length Patient Attachment site0.6 mFinger probe TL-201T1.6 mAdult or children20 kg or moreFingerAdult or Infant3 kg or moreFinger or toeMulti-site probe TL-220TNeonate3 kg or lessInstep and soleAttachment tape
44 Operator's Manual ZM-940PADisposable ProbesCAUTION• Use the disposable probe only for one patient. Never reuse the disposableprobe for another patient because it causes cross infection.• Disposable probes are not sterilized.Probe Patient Attachment siteTL-251T Adult30 kg or moreFinger or toeTL-252T Child3 to 40 kgFinger or toeTL-253T Neonate3 kg or lessInstep and soleLow birth weight infant1 kg or lessInstep andsoleAttachmenttape SNeonate or Child3 kg or moreFinger or toe Attachmenttape SMulti-site Y probe TL-260TNeonate3 kg or lessInstep andsoleAttachmenttape LAdult50 kg or moreFingerTL-051S/052SCable length TL-051S: 80 cmTL-052S: 160 cmNeonate3 kg or lessInstep and soleChild or Adult15 to 50 kgFingerTL-061S/062SCable length TL-061S: 80 cmTL-062S: 160 cmInfant3 to 15 kgToeAttachment tape40 mm35 mm
Operator's Manual ZM-940PA 45Model Patient Attachment siteTL-271T Adult30 kg or moreTL-272T Child10 to 50 kgFinger or toeNeonate3 kg or less InstepTL-273TAdult40 kg or moreTL-274T Infant3 to 20 kg Finger or toe
46 Operator's Manual ZM-940PACAUTIONHold the connector when connecting/disconnecting the probe. If you disconnectthe SpO2 probe by pulling the cable, it damages the cable.Attaching the Probe to the PatientAttach the probe to the patient by referring to the probe’s manual. Make sure that the lightemitter and photo detector of the probe face each other at the attachment site.WARNING• When using a TL-201T finger probe, do not fasten it to a finger by wrapping theprobe to the site with some tape. It may cause poor blood circulation,congestion, pressure necrosis or burn.• When using probes other than a TL-201T finger probe, do not wrap the tape tootight. Check the blood circulation condition by observing the skin color andcongestion at the skin peripheral to the probe attachment site. Even for short-term monitoring, there may be burn or pressure necrosis from poor bloodcirculation, especially on neonates or low birth weight infants whose skin isdelicate. Accurate measurement cannot be performed on a site with poorperipheral circulation.Connecting the SpO2 Probe to the TransmitterConnect the probe to the SpO2 socket on the transmitter.When the transmitter is attached on an arm
Operator's Manual ZM-940PA 47• Check the circulation condition by observing the skin color of the measuringsite and the pulse waveform. Change the measuring site every 8 hours fordisposable probes and every 4 hours for reusable probes. The skintemperature may increase at the attached site by 2 or 3°C (4 or 5°F) andcause a burn or pressure necrosis. When using the probe on the followingpatients, take extreme care and change the measurement site morefrequently according to symptoms and degree.• A patient with a fever• A patient with a peripheral circulation insufficiency• Neonate or low birth weight infant with delicate skinCAUTION• If the attachment site is dirty with blood, clean the attachment site beforeattaching the probe. If there is nail polish on the attachment site, remove thepolish. Otherwise, the amount of transmitted light decreases and themeasured data may be incorrect or measurement cannot be performed.• If the skin gets irritated or redness appears on the skin from the probe,change the attachment site or stop using the probe.• When the probe is attached on an appropriate site with sufficient circulation,but the error message confirming the probe attachment repeatedly appears,the probe may be deteriorated. Replace it with a new one.• Do not use a probe that is deteriorated by aging. Accurate measurementcannot be performed.• When using probes other than a TL-201T finger probe on a neonate, be carefulwhen removing the adhesive tape from neonatal skin.• When removing a probe taped to the skin, do not pull the cable. Otherwise thecable may break.• When removing the probe from the attachment tape, do not pull the sensorcable. Otherwise the cable may get damaged.• Before using the TL-260T multi-site Y probe, be sure to attach the probe to thesponge attachment tape S or L. Do not use the probe without the spongeattachment tape attached. It causes incorrect measurement and may damagethe attachment site on the skin.• When fixing the TL-260T multi-site Y probe with the sponge attachment tape,confirm that the adhesive part of the tape is not on the skin. The adhesive maycause oversensitive symptoms on the skin such as redness or itch. If theadhesive touches the skin, remove it carefully and slowly because neonatalskin is very delicate.• Do not use a dirty sponge attachment tape. The measurement value may beincorrect.• Refer to the probe instruction manual for details.
48 Operator's Manual ZM-940PALocking the Keys on the TransmitterTo prevent the patient from pressing the keys on the transmitter during monitoring, you can lockthe NIBP START/STOP and NIBP INTERVAL keys.1. Press the NIBP INTERVAL key for about 3 seconds.2. A “pip, pip” sounds and the “LOCK KEYS” message is displayed on the LCD.LOCKKEYSPip, pipWhen the NIBP START/STOP key or NIBP INTERVAL key is pressed while the keys arelocked, the “PRESS INT. KEY 3S TO UNLOCK” message appears.To unlock the keys:1. Press the NIBP INTERVAL key for about 3 seconds.2. A “pip, pip” sounds and the keys are unlocked. The “UNLOCK KEYS” message appearsand the keys are unlocked.
Operator's Manual ZM-940PA 49When preparation is done, monitoring starts.NIBP Oscillometric MethodNIBP is measured from the change in amplitude pattern of pulsatile oscillation in cuff pressureas the cuff pressure is reduced from above systolic to below diastolic pressure. The occlusive-oscillometry method uses this to determine the systolic, diastolic and mean arterial pressure.NIBP MonitoringSelecting the Initial Cuff Inflation PressureThe initial cuff inflation pressure can be changed on the PARAMETER SETUP screen. Thedefault setting is 180 mmHg. To change the setting, refer to the “Changing Parameter SetupSettings” section.Selecting the Measurement Mode and IntervalMeasurement ModesThere are three measurement modes: manual, auto and STAT. The selected mode or interval isdisplayed at the lower right of the screen.The measurement mode and interval can be changed by pressing the NIBP INTERVAL key.When the key is pressed, the measurement mode changes according to the modes selected at“SELECTABLE INTERVALS” on the PARAMETER SETUP screen. MANUAL mode isalready selected for the mode selection.To select the modes for the mode selection, refer to the “Changing Parameter Setup Settings”section.Manual MeasurementIn Manual mode, a single NIBP measurement is performed when the NIBP START/STOP keyis pressed.STAT (Continuous) MeasurementIn STAT mode, measurement is continuously repeated for 15 minutes after the NIBP START/STOP key is pressed.When the STAT measurement for 15 minutes is completed, the measurement mode automaticallychanges to the Manual mode or Auto mode of selected interval depending on the “NIBP MODEMonitoring
50 Operator's Manual ZM-940PAAFTER STAT” setting on the PARAMETER SETUP screen. The default setting is Manualmode. Refer to the “Changing Parameter Setup Settings” section.The STAT measurement completes within 15 minutes. When more than 12 minutes elapse fromthe start of measurement, there will be no more measurement performed and the measurementmode changes to the mode selected for “NIBP MODE AFTER STAT” on the PARAMETERSETUP screen.Auto MeasurementIn Auto mode, measurement is performed automatically at the preset time intervals.In Auto mode, a single measurement can be performed by pressing the NIBP START/STOP keybetween auto measurements.Measuring NIBPWARNING• Be careful when measuring NIBP on a patient with known bleeding disordersor coagulation. After NIBP measurement, there may be dot hemorrhage, orcirculatory disorder by thrombus where cuff is attached.• NIBP measurement may be incorrect in the following cases.• When using an electrical surgery unit.• When there is body movement.• When the pulse wave is small (insufficient peripheral circulation).• Too many arrhythmia.• When there is vibration.• When there is a rapid blood pressure change.• During CPR.• When performing NIBP measurements in STAT mode or 5 minute intervals,periodically remove the cuff from the patient for ventilation. Otherwise, theskin temperature may increase at the cuff attachment site by 2 or 3°C (4 or5°F). When measuring a patient with a fever or peripheral circulationinsufficiency, it may cause a burn.CAUTIONWhen performing NIBP measurement repeatedly, have a rest betweenmeasurements to recover adequate circulation.
Operator's Manual ZM-940PA 51NOTE• When measuring patients who are conscious, help the patient to relax.Measurement may not be accurate if the patient’s arm is tense or if the patienttalks.• The data for measurement on a leg tends to be higher than measurement onthe arm. When making diagnosis based on the NIBP values, measure NIBP onan upper arm.• Do not apply pressure to the cuff or air hose. NIBP may not be measuredcorrectly because of noise or NIBP measurement may stop due to the NIBPsafety circuit.• When the transmitter is attached to the patient arm and the NIBPmeasurement is performed when moving, tell the patient to relax and keepquiet. Otherwise, measurement may be stopped or remeasurement isrepeated due to body movement.• If there is an abnormal noise generated during measurement, stop using thetransmitter and contact your Nihon Kohden distributor.• Do not measure NIBP of a patient on whom an IABP is being used.Measurement may be incorrect due to the mixing of the patient’s own pulseand IABP pulse.• NIBP cannot be measured on a neonate using this transmitter.1. Select the measurement mode by pressing the NIBP INTERVAL key.2. Press the NIBP START/STOP key to perform measurement.
52 Operator's Manual ZM-940PAThe cuff is inflated and the inflation pressure is displayed on the screen.In manual mode: Measurement is performed once.In STAT mode: Measurement is performed repeatedly for 15 minutes.In auto mode: The first measurement is performed when the NIBP START/STOP keyis pressed. The second measurement is performed when the current timein the transmitter reaches the selected time interval.To stop measurement during measurement, press the NIBP START/STOP key again.In STAT mode, after completing the STAT measurement, the measurement mode changes tothe mode set for “NIBP MODE AFTER STAT” on the PARAMETER SETUP screen.In auto mode, to stop measurement in auto mode, change the mode to manual. To cancelone measurement, press the NIBP START/STOP key during measurement.After the measurement is complete, the measured data is displayed on the screen and istransmitted to the monitor.Inflation pressureWhen SpO2 is not monitored, the pulse rate at the end of NIBP measurement is displayed.During auto mode measurement, the measurement mode can be changed. During the interval,press the NIBP INTERVAL key to change the mode. When “MANUAL” is displayed for morethan one second, the measurement in auto mode is stopped.A buzzer can be set to sound at the start and end of NIBP measurement. Refer to the “ChangingParameter Setup Settings” section.
Operator's Manual ZM-940PA 53Data Display After NIBP MeasurementWhen the time set at “OLD NIBP DATA” on the PARAMETER SETUP screen elapses afterthe last measurement, the NIBP data is dimmed or hidden. Whether to dim or hide the old datacan also be selected at “OLD NIBP DATA”. Refer to the “Changing Parameter Setup Settings”section.Monitoring SpO2 during NIBP MeasurementWhen the SpO2 probe is attached to the same limb as the NIBP cuff, the blood flow decreasesduring NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitoredproperly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen is setto ON (factory default setting), SpO2 monitoring is paused during NIBP measurement to avoidSpO2 alarm occurrence. However, when monitoring SpO2 on the same limb as the NIBP, becareful when reading SpO2 values.ECG and Respiration MonitoringWhen the electrodes are attached and the ECG leads are connected to the electrodes, heart rate,ECG, respiration rate and respiration waveform appear on the monitor.When 6 leads are used on this transmitter, up to 8 lead (I, II, III, aVR, aVL, aVF, Va and Vb) ofECG waveforms can be displayed on the receiving monitor. The heart rate is also measured.When 3 leads are used, one channel ECG waveform of lead II can be displayed on the receivingmonitor. Refer to the operator’s manual of the monitor for details.Respiration is monitored by measuring changes in impedance between the RA and LL ECGelectrodes. This transmitter sends the changes in impedance to the monitor as a respirationwaveform. The monitor displays the respiration waveform and calculates respiration rate. Referto the operator’s manual of the monitor for details.WARNINGInteraction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiacmonitoring and Diagnostic Equipment*The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker may be affected by the transmitter which isconnected to the same patient. If this occurs, the pacemaker may pace at itsmaximum rate and the transmitter may give incorrect data to the monitor. If thisoccurs, disconnect the electrode leads from the patient or change the setting on
54 Operator's Manual ZM-940PAthe pacemaker by referring to the pacemaker’s manual. For more details,contact your pacemaker distributor or Nihon Kohden distributor.* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectricimpedance measurement (BIM). Many medical devices in addition to pacemakers use thistechnology. When one of these devices is used on a patient with an active, minute ventilationrate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signalscreated in the patient, resulting in an elevated pacing rate.For more information, see the FDA web site.http://www.fda.gov/cdrh/safety.htmlWARNINGWhen using this transmitter with an ESU, the ESU return plate and theelectrodes for monitoring must be firmly attached to the patient. If the returnplate is not attached correctly, it may burn the patient’s skin where theelectrodes are attached. Refer to the instruction manual for the ESU.CAUTIONTurn off the power of cell telephones, small wireless devices and other deviceswhich produce strong electromagnetic interference. Otherwise, the waveformsand measurements are affected by such interference and the displayed datamay be incorrect.NOTE• Noise generated from an electrosurgery unit may interfere on an ECGwaveform, but will not damage it.• If an electric blanket is used and incorrect heart rate is displayed on themonitor, turn off the pacing spike detection on the monitor.• Turn the pacing spike detection to ON on the monitor when monitoring apacemaker patient. Pacing pulse is detected by the transmitter andtransmitted to the monitor. If the pacing spike detection is turned OFF, QRSand pacemaker spike may not be distinguished and pacemaker failure maynot be recognized.
Operator's Manual ZM-940PA 55Electrode DetachmentIn the following conditions, the check electrode indication is displayed on the LCD of thetransmitter and the “CHECK ELECTRODE” message is displayed on the monitor.• Electrode is detached from skin.• Electrode lead is disconnected from the electrode.• Polarization voltage between the electrode and skin is excessively high.In these cases, check the cause and if necessary, replace electrodes with new ones.CAUTIONWhen the “ELECTRODE OFF” or “CHECK ELECTRODE” message is displayedon the receiving monitor, check electrodes and electrode leads and remove thecause. While the “ELECTRODE OFF” or “CHECK ELECTRODE” message isbeing displayed, there is no ECG monitoring and no alarms.Check Electrode Indication on the Transmitter when Monitoring with 3 ElectrodesThe “ ” mark is displayed. Check electrode symbolCheck Electrode Indication on the Transmitter when Monitoring with 6 ElectrodesThe “ ” mark and either the detached lead or detached electrode position is indicated,depending on the LEADS OFF DISPLAY setting on the PARAMETER SETUP screen.Check electrode indicationWhen LEADS OFFDISPLAY is set to CHAR, thedetached lead is indicatedWhen LEADS OFFDISPLAY is set to IMAGE,the detached electrodeposition is indicated with XCheck electrode symbol
56 Operator's Manual ZM-940PASpO2 MonitoringWhen monitoring starts, SpO2 and pulse waveform are sent to the monitor and SpO2, pulse rateand pulse level bar graph are displayed on the transmitter LCD.WARNING• Measurement may be incorrect in the following cases.• When the patient’s carboxyhemoglobin or methemoglobin increasesabnormally.• When dye is injected in the blood.• When using an electrical surgery unit.• During CPR.• When there is body movement.• When there is vibration.• When measuring at a site where there are venous pulses.• When the pulse wave is small (insufficient peripheral circulation).• When using an IABP (intra-aortic balloon pump).• Check the circulation condition by observing the skin color of the measuringsite and pulse waveform. Change the measuring site every 8 hours fordisposable probes and every 4 hours for reusable probes. The skintemperature may increase at the attached site by 2 or 3°C (4 or 5°F) andcause a burn or pressure necrosis. When using the probe on the followingpatients, take extreme care and change the measurement site morefrequently according to symptoms and degree.• A patient with a fever• A patient with peripheral circulation insufficiency• Neonate or low birth weight infant with delicate skin• When not monitoring SpO2, disconnect the SpO2 cable from the transmitter.Otherwise, noise may interfere from the probe sensor and incorrect data isdisplayed on the screen.CAUTION• Turn off the power of cell telephones, small wireless devices and other deviceswhich produce strong electromagnetic interference. Otherwise, thewaveforms and measurements are affected by such interference and thedisplayed data may be incorrect.• Normally external light does not affect monitoring, however, strong light suchas an operating lamp or sunlight may affect monitoring. If affected, cover themeasuring site with a blanket.
Operator's Manual ZM-940PA 57• Do not pull or bend the probe cable, and do not run over the probe cable withcaster feet. Do not immerse the probe cable in detergents or water. Failure tofollow these cautions may cause cable discontinuity, short circuit, skin burnon the patient and incorrect measurement data. Replace any broken probewith a new one.• When the probe is attached on an appropriate site with sufficient circulationand the error message confirming the probe attachment repeatedly appears,the probe may be deteriorated. Replace it with a new one.• When the probe failure message appears on the screen, replace it with a newone. Otherwise SpO2 data may not be accurate.• While a patient is on medication which causes vasodilation, the pulsewaveform may change and in rare cases the SpO2 value may not be displayed.NOTEIn order to maintain sufficient blood circulation, keep the measurement sitewarm by covering it with a blanket or something similar. Warming the site iseffective, especially for a patient with a small pulse amplitude.SpO2 and PR Display OrderYou can select the display order for SpO2 and PR (pulse rate) on the LCD. Refer to the“Changing Parameter Setup Settings” section.Monitoring SpO2 during NIBP MeasurementWhen the SpO2 probe is attached to the same limb as the NIBP cuff, the blood flow decreasesduring NIBP measurement and pulse wave cannot be detected and SpO2 cannot be monitoredproperly. When “INHIBIT SpO2 DURING NIBP” on the PARAMETER SETUP screen is setto ON (factory default setting), SpO2 monitoring is paused during NIBP measurement to avoidSpO2 alarm occurrence. However, when monitoring SpO2 on the same limb as NIBP, be carefulwhen reading SpO2 values.When monitoring SpO2 is important, attach the probe to the limb to which the NIBP cuff orcatheter is not attached.When SpO2 monitoring is paused during NIBP measurement, the SpO2 value just before thestart of NIBP measurement and an mark are displayed on the transmitter for 30 seconds.When NIBP measurement is not completed after 30 seconds, “– – –” is displayed for the SpO2value. The same data also appears on the monitor screen.
58 Operator's Manual ZM-940PANOTE• When continuous SpO2 monitoring is necessary, attach the probe to the limb towhich the NIBP cuff is not attached and set “INHIBIT SpO2 DURING NIBP” onthe PARAMETER SETUP screen to OFF.• When the probe is attached to the same limb as the NIBP cuff, set the syncsource to a parameter other than SpO2 on the receiving monitor.• When monitoring SpO2 during STAT NIBP measurement, attach the probe to thelimb to which the NIBP cuff is not attached.
Operator's Manual ZM-940PA 59Display and Message ListIndication Cause CountermeasureFully charged batteryBatteries are low.Batteries are low. NIBP cannot be measured.Noindication Dead batteriesReplace batteries.Battery IndicationECG/RespirationIndication Cause CountermeasureElectrode lead is disconnected from theelectrode.Firmly connect the electrodelead to the electrode.Electrode lead is disconnected from thetransmitter.Firmly connect the electrodelead to the transmitter.Electrode lead discontinuity. Replace the electrode leadwith a new one.Electrode is not firmly attached to the skin.Polarization voltage is abnormally high.Replace the electrode with anew one.When monitoring ECG with 6 electrodes, the electrode or lead detached position is indicated byeither lead or electrode position. This is set at LEADS OFF DISPLAY on the PARAMETERSETUP screen. Refer to the “Changing Parameter Setup Settings” section.LEADS OFF DISPLAY set to CHARECG ELECTRODE set to AHALEADS OFF DISPLAY set to CHARECG ELECTRODE set to IECLEADS OFF DISPLAY set to IMAGE
60 Operator's Manual ZM-940PAMessage Cause CountermeasureDuring NIBPmeasurementSpO2 monitoring is paused forNIBP measurement.Wait for NIBP measurement tofinish.Considerable body movement.Detectingbodymovement The probe is not attached tothe patient properly.When the message is displayedfrequently, check the patientcondition and, if necessary, changethe attachment site.SpO2 CHECKPROBEThe probe is not attached tothe patient properly.Attach the probe to the patientproperly.The probe is not attached atthe appropriate site.Attach the probe to a site 6 to 14mm thick.SpO2 CHECKPROBE SITE Probe is expired. Replace the probe with a new one.Searching for the correct pulsewave.Wait until the pulse wave isdetected.The SpO2 value cannot beobtained because thewaveform is unstable.SpO2 DETECTINGPULSEThe probe is not attached tothe patient properly.Attach the probe to the patientproperly.SpO2 LIGHTINTERFERENCESpO2 measurement site isunder fluorescent light,surgical light, sunlight, etc.Cover the measurement site with ablanket or cloth.Probe is expired. Replace the probe with a new one.SpO2 PROBEFAILURE Probe is damaged or short-circuited. Replace the probe with a new one.Poor peripheral circulation. Check the patient condition andchange the attachment site.SpO2 WEAK PULSE The probe is attached tootightly and is obstructing theblood circulation.Check the probe attachmentcondition and if necessary,reattach the probe.SpO2
Operator's Manual ZM-940PA 61NIBPMessage Cause CountermeasureThe cuff and extension hose are notproperly connected.The cuff hose (or extension hose) isnot properly connected to the NIBPsocket.Connect them properly.NIBP AIR LEAKThe cuff or extension hose isdamaged. Replace with a new one.The patient’s pulse wave is small. Measure by palpation or auscultation.NIBP CANNOTDETECT PULSE The cuff is not wrapped on thepatient properly. Wrap the cuff on the patient properly.NIBP CUFFOCCLUSION Transmitter malfunction.Immediately remove the cuff from thepatient and contact your Nihon Kohdendistributor.NIBP HIGH CUFFPRESSEnormous pressure was applied bythe pressure of the cuff. Remove the cause.NIBP INFLATIONPRESS LOW Insufficient cuff inflation pressure.Wait for the remeasurement to beperformed with increased cuff inflationpressure.NIBP MEAS TIME-OUTThe measuring time exceeded thespecified time due to arrhythmia,body movement, vibration or, cuffor air hose being squeezed.Remove the cause if the cause is bodymovement, vibration or squeezing ofcuff or hose.NIBP MODULEFAILURE Module malfunction. Contact your Nihon Kohdendistributor.NIBP REMEASURINGNIBP is being remeasured due toarrhythmia, body movement,vibration or, cuff or air hose beingsqueezed.If the message still appears afterremeasurement, remove the cause ifthe cause is body movement, vibrationor squeezing of cuff or hose.Check that the hose is not bent orsqueezed.NIBP SAFETYCIRCUIT RUNNING(When this message isdisplayed, measurementcannot be performed for40 seconds.)Measurement stopped by the safetycircuit.Wait 40 seconds, then performremeasurement. If the message stillappears, contact your Nihon Kohdendistributor.NIBP SYS OUT OFRANGEThe maximum blood pressurecannot be measured even when thecuff inflation pressure exceeded 280mmHg when using adult cuff.Measure by palpation or auscultation.The patient’s pulse wave is toosmall. Measure by palpation or auscultation.The cuff is wrapped too loosely. Wrap the cuff properly.NIBP WEAK PULSEThe cuff size is not appropriate. Use the appropriate cuff.NIBP ZEROING NIBP zero balance is beingadjusted.Do not touch the cuff during zeroing.Wait for the message to disappear.
62 Operator's Manual ZM-940PAIf the problem still remains after checking the following, contact your Nihon Kohden distributor.TransmitterProblem Cause CountermeasureBatteries are not installedcorrectly. The batterypolarity is wrong.Install the batteries correctly.Nothing isdisplayed on theLCD afterturning thepower on.Batteries are completelydischarged.Replace the batteries with new ones.LCD is difficultto see (too darkor too light).LCD brightness is notappropriate.Change the LCD brightness on theSYSTEM SETUP screen. Refer to the“Changing System Setup Settings”section.The channel of thetransmitter and monitordoes not match.Set the correct channel on the monitor.Nothing isdisplayed on themonitor afterturning thetransmitterpower on.The software version ofthe multiple patientreceiver is old.Upgrade the multiple patient receiversoftware to receive signal from thetransmitter. The software version must be01-09 or later.Another transmitter of thesame channel is usednearby.Turn the transmitter power off. If themonitor still receives a signal, there is ahigh probability that another transmitterof the same channel is used nearby.Follow the instruction of your channeladministrator and use another transmitterof a different channel.Signals are mixing. Follow the instructions of your channeladministrator and use another transmitterof a different channel.Signal receivingcondition is poor.The transmitter isdamaged.Contact your Nihon Kohden distributor.Troubleshooting
Operator's Manual ZM-940PA 63ECG/RespirationProblem Cause CountermeasureThe heart rate isunstable.Pacing detection setting on themonitor is not correct.Turn off the pacing detection settingon the monitor.When monitoring a pacemakerpatient, turn on pacing detection.Electrode lead is disconnectedfrom the electrode.Firmly connect the electrode lead tothe electrode.Electrode lead discontinuity Replace the electrode lead with a newone.Electrode is not firmlyattached to the skin.Replace the electrode with a new one.The “CHECKELECTRODE”message appearson the receivingmonitor.Polarization voltage isabnormally high.Use Nihon Kohden specifiedelectrodes.The gel on the electrode isdried out.The gel on the electrode iscoming off.Replace the electrode with a new one.Electric blanket is used. Cover the blanket with a shield cover.ECG baseline isthick.(Hum isoverlapping)Hum filter is set to OFF on themonitorSet the filter to ON.The gel on the electrode isdried out.Respirationwaveformmeasurement isunstable.The gel on the electrode iscoming off.Replace the electrode with a new one.SpO2Problem Cause CountermeasureThe probe size is notappropriate for the patient.Use the appropriate probe for the patient.Probe attachment conditionis poor. Probe is partlydetached from the skin.External light gets in.Firmly attach the probe according to theprocedure in the probe operator’s manual.Measurement site is dirty.Patient is wearing nailpolish.Remove dirt and nail polish.When the probe and cuff are attached tothe same limb, set “INHIBIT SpO2DURING NIBP” setting on thePARAMETER SETUP screen to ON.SpO2 data isunstable andnot reliable.Probe is attached to thesame limb that is used forNIBP measurement.Attach the probe to the opposite limb.Avoid a site where blood circulationcondition changes greatly.
64 Operator's Manual ZM-940PANIBPProblem Cause CountermeasureThe cuff hose is not connectedto the NIBP socket properly.Connect the cuff hose to the socketproperly.Cuff inflationpressure is less than10 mmHg. The cuff is not wrappedaround the arm or is wrappedtoo loosely.Wrap the cuff around the upperarm.The cuff hose is not connectedto the NIBP socket.Connect the cuff hose to the socketfirmly.The cuff does notinflate when theNIBP START/STOPkey is pressed.The cuff hose or extensionhose may be folded orsqueezed when the cuffpressure display on the screenincreases quickly but theactual cuff does not inflate.Check the cuff hose and air hose.The cuff size is not correct. Select the cuff which fits thepatient’s limb circumference.The cuff is not wrappedaround the arm correctly.Wrap the cuff around the upperarm, not too tightly or too loosely.NIBP data is not correctbecause of body movement.Prevent the patient from movingduring measurement.Check that nothing is touching thecuff during measurement.Abnormalmeasurement resultsare displayed.Vibration on the cuff.Change the measuring site.The cuff is suddenlydeflated duringinflation.The NIBP START/STOP keyis pressed during inflation.Auto modemeasurement doesnot start even whenthe time interval haspassed.The NIBP INTERVAL key ispressed and the measurementmode is changed.Check the measurement mode andinterval.The cuff suddenlyinflates.The measurement mode is setto auto mode.Check the time interval. Ifnecessary, stop measurement.Cannot connect cuffto the air hose.Unspecified cuff is used. Use a cuff specified by NihonKohden.
Operator's Manual ZM-940PA 65Problem Cause CountermeasureVibration on the cuff. Check that nothing is touching thecuff during measurement.The cuff hose or extensionhose is bent or squeezed.Remove the cause.Cannot measureNIBP.The cuff has worn out. Use a new cuff.Increase the measuring interval.Blood congestionoccurs.Measuring over a longperiod of time at shortintervals.Do not measure NIBP over a longtime.Thrombus occurs. Measuring on a patientwith known bleedingdisorders or coagulation.Do not perform NIBP measurementon such a patient.NIBP data on thescreen is --- or dark.The time set for “OLDNIBP DATA” on thePARAMETER SETUPscreen elapsed from the lastmeasurement.When NIBP is measured again, thedata is displayed in normalbrightness.Three loud pipsounds indictingNIBP measurementcannot be started.The cuff is not deflatedenough to start anothermeasurement.Wait 30 seconds and measure again.
66 Operator's Manual ZM-940PATo use the instrument in safe and optimum condition, perform maintenance check once every sixmonths.CAUTIONDo not disassemble the transmitter when performing maintenance andinspection. Do not repair the transmitter. When there is any problem with thetransmitter after maintenance and inspection, contact your Nihon Kohdendistributor.A maintenance check sheet is provided at the end of this section. Make a copy of this checksheet before performing maintenance check.1. External Check• There are no damaged or dirty parts on the outside of the transmitter.• The battery case cover is not damaged, the spring is firmly fixed and the battery case covercan be closed firmly.• NIBP socket is not damaged.• Keys are not damaged.• Electrode leads are not damaged.• There is no blood or chemicals on the transmitter.2. Transmitter ChannelCheck that the channel of the transmitter and the label match.1. Check that the channel number label attached to the transmitter is not torn or removed.MaintenanceChannel label
Operator's Manual ZM-940PA 672. Remove one battery.3. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.The SETUP screen appears.4. Press the NIBP INTERVAL key to move the cursor to “SYSTEM SETUP”.5. Press the NIBP START/STOP key to enterthe SYSTEM SETUP screen. The channel ofthis transmitter is displayed.6. Check that the channel displayed on the LCDmatches the label on the transmitter.Channel
68 Operator's Manual ZM-940PA3. LCD DisplayCheck that there are no dots missing on the LCD.1. Remove one battery.2. While pressing the NIBP START/STOP and NIBP INTERVAL keys, install the battery.The SETUP screen appears.3. Press the NIBP INTERVAL key twice to move the cursor to “MANUAL CHECK”.4. Press the NIBP START/STOP key toenter the MANUAL CHECK screen.5. Check that the cursor is on “LCDTEST” and press the NIBP START/STOP key.
Operator's Manual ZM-940PA 696. Every time the NIBP INTERVAL key is pressed, the screen changes as below. Check thatthere are no dots missing.When the NIBP START/STOP key is pressed, the screen returns to the MANUALCHECK screen.4. Key OperationNIBP START/STOP Key1. Attach the NIBP cuff to your upper arm.2. Press the NIBP START/STOP key. Check that the cuff inflates and deflates properly.3. Press the NIBP START/STOP key again. During inflation, press the NIBP START/STOPkey to check that the cuff deflates properly.NIBP INTERVAL Key1. Press the NIBP INTERVAL key and check that the NIBP measuring mode can be changed.2. Select any interval and press the NIBP START/STOP key to perform auto measurement.Check that the NIBP is measured at the selected interval.
70 Operator's Manual ZM-940PA5. NIBP Cuff for Attaching Transmitter to Patient ArmThe NIBP cuff is a consumable. Check the following and when necessary, replace it with a newone.Appearance• There are no dirty parts.• There are no broken stitches on the cuff.• The label on the cuff is readable.• The velcro tape on the cuff is not removed and there are no broken stitches.• The lock plate is not damaged and functions properly.Inflation bag• The inflation bag is not torn or damaged.• There is no water inside the inflation bag.• The connector on the inflation bag is not damaged.
Operator's Manual ZM-940PA 71Maintenance Check SheetHospital/Organization:Service Personnel:Instrument Name: TransmitterInstrument Model: ZM-940PAInstrument Serial Number:Hardware Revision Number:Software Revision Number:1. External Check OK No2. Transmitter Channel OK No3. LCD Display OK No4. Key Operation OK No5. NIBP Cuff for Attaching Transmitter to Patient Arm OK NoOverall JudgementOKCan be used but needs maintenanceMaintenance required. Cannot be used.
72 Operator's Manual ZM-940PARepair Parts Availability PolicyNihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain theperformance of the instrument) for a period of 8 years from the date of delivery. In that periodNKC or its authorized agents will repair the instrument. This period may be shorter than 8 yearsif the board or part necessary for the faulty section is not available.
Operator's Manual ZM-940PA 73Disposing of Used BatteriesBattery LifetimeReplace the batteries when the battery replacement indication appears on the transmitter. Whenusing rechargeable batteries, recharge them.Lifetime and DisposalType Lifetime (Measuring parameters)ECG, SpO2, NIBP ECG, SpO2ECG onlyNiMH secondary 2 days 2 days 2.5 daysAlkaline primary 1 day 2.5 days 3 daysThe above data is when new batteries are used at room temperature, NIBP is measured in automode at 60 minute intervals and SpO2 is measured on an index finger of a male patient withweight 60 kg.Operation time depends on the thickness of SpO2 probe attachment site.DisposalNOTERemove the batteries before disposing of the transmitter.Before disposing of the batteries, check with your local solid waste officials for details in yourarea for proper disposal. It may be illegal to dispose of these batteries in the municipal wastestream.Disposing of Electrodes, SpO2 Probes and NIBP CuffsRefer to the manual of each item.
74 Operator's Manual ZM-940PATransmitter and Electrode LeadsCAUTION• This transmitter is not waterproof. If detergent or liquid spills into thetransmitter, stop cleaning/disinfecting/sterilizing it and contact your NihonKohden distributor. The transmitter needs to be checked for safety andfunction before use.• Before cleaning or disinfecting the transmitter, remove the batteries from thetransmitter.• The transmitter cannot be sterilized.CleaningWipe the transmitter and electrode leads with a soft cloth moistened with disinfecting alcohol orneutral detergent diluted with water. After cleaning, dry them completely.DisinfectionCAUTION• Do not immerse the electrode lead connector in liquid.• Do not disinfect with hypochlorous acid.• Use the recommended concentration.Wipe the outside surface of the transmitter and electrode lead with a non-abrasive clothmoistened with any of the disinfectants listed below. Use the recommended concentration.Disinfectant Concentration (%)Glutaraldehyde solution 2.0Hydrochloric alkyl diaminoethylglycine 0.5Benzalkonium chloride 0.2Benzethonium chloride solution 0.2Chlorohexidine gluconate solution 0.5Cleaning, Disinfection and Sterilization
Operator's Manual ZM-940PA 75SpO2 ProbeRefer to the probe manual.YP-943P/944P NIBP CuffsCAUTION• Do not autoclave.• Use only glutaraldehyde solution.• Never allow liquid to get inside the rubber cuff.• Do not sterilize or disinfect the cuff with ultraviolet light or ozone.CleaningTo clean the cuff, remove the lock plate and carefully pull out the inflation bag from the clothcover.Cloth cover: Wash with neutral detergent and water. Thoroughly dry it. When washing in awashing machine, put it in a net.Inflation bag: Wipe with a soft cloth or cotton moistened with disinfecting alcohol.Thoroughly dry it.DisinfectionTo disinfect the cuff, use glutaraldehyde solution. Use the recommended concentration of thedisinfectant. Refer to the disinfectant manual for details. After disinfection, clean the cuff asdescribed above.
76 Operator's Manual ZM-940PAMeasuring ParametersMeasuring waveforms: ECG, Respiration in impedance method, pulseMeasuring numeric data: SpO2, NIBP, pulse rateTransmitting DataWaveform data: ECG, respiration, pulse waveNumeric data: SpO2 and NIBPStatus information: Battery replacement, channel ID, type of transmitter, checkelectrodes, abnormal polarization voltage, pacing data, SpO2statusDisplayed DataSpO2, NIBP, pulse rate, pulse wave bar graph, check electrode, battery replacement, NIBPmeasurement mode and status informationECG MeasurementChannels: 4Input range: ±5 mV or moreDC offset: ±500 mV or moreInput impedance: 5 MΩ or more (5 Hz)Pacing pulse detection: ANSI/AAMI EC13Based upon Pacemaker pulse rejection CapabilityRespiration MeasurementMeasuring method: Impedance methodImpedance range: 0 to 2 kΩ or lessSpO2 MeasurementDisplay range: Depends on the receiving monitorMeasuring range: 0 to 100%, in 1% stepsMinimum display range: 1%Measuring accuracy (When the measuring accuracy of the SpO2 probe is not considered):±1 (80% ≤ SpO2 ≤ 100%)±2 (50% ≤ SpO2 < 80%)Less than 50% is not specified.(When considering the measuring accuracy of the SpO2 probe):±2 (80% ≤ SpO2 ≤ 100%)±3 (70% ≤ SpO2 < 80%)Less than 70% is not specified.Specifications
Operator's Manual ZM-940PA 77NIBP MeasurementDisplayed items: Systolic, diastolic, meanCuff pressure display range: 0 to 300 mmHgMeasurement modes: Manual, STAT, auto at 5, 10, 15, 30, 60, 120 or 240 minuteintervalPulse RateMeasuring range: 30 to 200 beats/minute ±8 beats/min (NIBP)30 to 250 beats/min ±3% ±1 beat/min (SpO2)TransmitterFCC regulation: FCC part 95 Subpart HWireless Medical Telemetry Service (WMTS)Field strength limits: <200 mV/m (at 3 m)Undesired emission: below 960 MHz: 200 µV/m (at 3 m)above 960 MHz: 500 µV/m (at 3 m)Antenna: InternalTransmission channel: indicated on the transmitterTransmission frequency range: 608.0250 to 613.9750 MHzChannel spacing: 50 kHz (25 kHz when interleave)Type of emission: F1DOccupied bandwidth: <20 kHzEffective radiated power: 1.0 mW (conducted)Power RequirementsOperating voltage: 3.2 to 4.8 VBattery type: Three AA type NiMH secondary batteriesThree AA type alkaline dry cell primary batteriesBattery lifetime:Type Lifetime (Measuring parameters)ECG, SpO2, NIBP ECG, SpO2ECG onlyNiMH secondary 2 days 2 days 2.5 daysAlkaline primary 1 day 2.5 days 3 daysThe above data is when new batteries are used at room temperature, NIBP ismeasured in auto mode at 60 minute intervals and SpO2 is measured on an indexfinger of a male patient with weight 60 kg.Operation time depends on the thickness of SpO2 probe attachment site.Dimension and WeightDimension: 114 W × 103 H × 58 D (mm)Weight: 280 g ±30 g (excluding batteries, NIBP cuff and otheraccessories)
78 Operator's Manual ZM-940PAEnvironmentOperating environmentOperating temperature: 5 to 40°C, 41 to 104°FWhen using NIBP cuff, 10 to 40°C, 50 to 104°FOperating humidity: 30 to 85% (non-condensing)Operating atmospheric pressure: 70 to 106 kPaStorage environmentStorage temperature: −20 to 65°C, −4 to 149°FStorage humidity: 10 to 95%Storage atmospheric pressure: 70 to 106 kPaSafety StandardsSafety standard: CAN/CSA-C22.2 No. 601-1 M90:1990CAN/CSA-C22.2 No. 601-1. 1S1-94:1994CAN/CSA-C22.2 No. 601-1. 1B-90:R2002CAN/CSA-C22.2 No. 60601-2-49-04:2004IEC 60601-1:1988IEC 60601-1 Amendment1:1991IEC 60601-1 Amendment2:1995IEC 60601-1-2:2001IEC 60601-2-27:1994IEC 60601-2-30:1999IEC 60601-2-49:2001According to the type of protectionagainst electrical shock: INTERNALLY POWERED EQUIPMENTAccording to the degree of protectionagainst electrical shock:ECG and impedance method respiration: DEFIBRILLATION-PROOF TYPE CF APPLIEDPARTSpO2 and NIBP: DEFIBRILLATION-PROOF TYPE BF APPLIEDPARTAccording to the degree of protectionagainst harmful ingress of water: IPX0 (Ordinary equipment)According to the degree of safety ofapplication in the presence of aFLAMMABLE ANAESTHETICMIXTURE WITH AIR, OR WITHOXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence ofFLAMMABLE ANAESTHETIC MIXTURE WITHAIR, OR WITH OXYGEN OR NITROUS OXIDEAccording to the mode of operation: CONTINUOUS OPERATION
Operator's Manual ZM-940PA 79Electromagnetic CompatibilityIEC 60601-1-2 (2001)Emissions: CISPR11 Group1,Class BElectromagnetic EmissionsThis Model ZM-940PA is intended for use in the electromagnetic environment specified below.The customer or the user of the ZM-940PA should assure that it is used in such an environment.Emissions test Compliance Electromagnetic environment guidanceRF emissionsCISPR 11Group 1 The ZM-940PA uses RF energy only for itsinternal function. Therefore, its RF emissions arevery low and are not likely to cause anyinterference in nearby electronic equipment.RF emissionsCISPR 11Class BHarmonic emissionsIEC 61000-3-2Not applicableVoltage fluctuations/flicker emissionsIEC 61000-3-3Not applicableThe ZM-940PA is suitable for use in allestablishments, including domestic establishments.
80 Operator's Manual ZM-940PAElectromagnetic ImmunityThis Model ZM-940PA is intended for use in the electromagnetic environment specified below.The customer or the user of the ZM-940PA should assure that it is used in such an environment.Immunity test IEC 60601 testlevelCompliancelevelElectromagneticenvironment -GuidanceElectrostaticdischarge(ESD)IEC 61000-4-2±6 kV contact±8 kV air±6 kV contact±8 kV airFloors should be wood,concrete or ceramic tile. Iffloors are covered withsynthetic material, the relativehumidity should be at least30%.Electrical fasttransient/ burstIEC 61000-4-4±2 kV for powersupply lines±1 kV forinput/output linesNot applicableSurgeIEC 61000-4-5±1 kV differentialmode±2 kV common modeNot applicableVoltage dips,shortinterruptionsand voltagevariations onpower supplyinput linesIEC 61000-4-11<5% UT (>95% dip inUT) for 0.5 cycle40% UT (60% dip inUT) for 5 cycles70% UT (30% dip inUT) for 25 cycles<5% UT (>95% dip inUT) for 5 sNot applicablePowerfrequency(50/60 Hz)magnetic fieldIEC 61000-4-83 A/m 3 A/m Power frequency magnetic fieldsshould be at levels characteristicof a typical location in a typicalcommercial or hospitalenvironment. NOTE UT is the AC mains voltage prior to application of the test level
Operator's Manual ZM-940PA 81Immunity test IEC 60601test levelCompliancelevelElectromagnetic environment -guidanceConducted RFIEC 61000-4-6Radiated RFIEC 61000-4-33 Vrms3 V/m 80 MHzto 2.5 GHz3 Vrms3 V/m 80 MHzto 2.5 GHzPortable and mobile RF communicationsequipment should be used no closer to anypart of the ZM-940PA, including cables,than the recommended separation distancecalculated from the equation applicable tothe frequency of the transmitter.Recommended separation distanced = 1.2√Pd = 1.2√P 80 MHz to 800 MHzd = 2.3√P 800 MHz to 2.5 GHzwhere P is the maximum output powerrating of the transmitter in watts (W)according to the transmitter manufacturerand d is the recommended separationdistance in meters (m).Field strengths from fixed RF transmitters,as deter mined by an electromagnetic sitesurvey*1, should be less than the compliancelevel in each frequency range*2.Interference may occur in the vicinity ofequipment marked with the followingsymbol:NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected byabsorption and reflection from structures, objects and people.*1Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones andland mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predictedtheoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, anelectromagnetic site survey should be considered. If the measured field strength in the location in whichthe ZM-940PA is used exceeds the applicable RF compliance level above, the ZM-940PA should beobserved to verify normal operation. If abnormal performance is observed, additional measures may benecessary, such as re-orienting or relocating the ZM-940PA.*2Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
82 Operator's Manual ZM-940PARecommended Separation Distances between Portable and Mobile RFCommunications EquipmentThe ZM-940PA is intended for use in an electromagnetic environment in which radiated RFdisturbances are controlled. The customer or the user of the ZM-940PA can help preventelectromagnetic interference by maintaining a minimum distance between portable and mobileRF communications equipment (transmitters) and the ZM-940PA as recommended below,according to the maximum output power of the communications.System Composition for EMC TestThe ZM-940PA bedside monitor is tested to comply with IEC 60601-1-2 (2001) with thefollowing composition. If any part which is not specified by Nihon Kohden is used, the EMCspecifications may not comply.Separation distance according to frequency of transmitter (m)Rated maximum output power of transmitter (W)150 kHz to 80 MHzd = 1.2√P80 MHz to 800 MHzd = 1.2√P800 MHz to 2.5 GHzd = 2.3√P0.01 0.12 0.12 0.230.1 0.38 0.38 0.731 1.2 1.2 2.310 3.8 3.8 7.3100 12 12 23For transmitters rated at a maximum output power not listed above, the recommended separationdistance d in meters (m) can be estimated using the equation applicable to the frequency of thetransmitter, where P is the maximum output power rating of the transmitter in watts (W) accordingto the transmitter manufacturer. NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency rangeapplies.NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation isaffected by absorption and reflection from structures, objects and people.Units Cable lengthZM-940PA transmitter ---YP-943P NIBP cuff 0.15 mBR-906P ECG electrode lead 0.8 mTL-201T finger probe 1.6 m
Operator's Manual ZM-940PA 8312Standard AccessoriesNo. Name Model Q’ty Supply Code No.1 NIBP cuff for adult, standard YP-943P 1 S938B2 Strap --- 1 Y23634No. Name Model Q’ty Supply Code No.3 Battery case cover 1 6144-0120044 Lock plate 1 6113-049585The following parts are available for replacement.Lock plate is astandard accessory ofthe YP-943P/944PNIBP cuff.
84 Operator's Manual ZM-940PAName Width(cm)Air HoseLength(cm)Model Q’tySupplyCodeNo.Standard 13 YP-943P* S938BCuff for adult, forattaching transmitter topatient arm Large 15 15 YP-944P* 1S938CCuff for infants 5 YP-960T S943ASmall 7 YP-961T S943BCuff for children Standard 10 YP-962T S943CStandard 13 YP-963T S944BCuff for adult Large 1515YP-964T1S944CDisposable cuff for infants 6 YP-910P ---Disposable cuff for children 9 YP-912P ---Small 12 YP-913P ---Standard 14 YP-914P ---Disposable cuff for adultsLarge 1620YP-915P20---Extension hose 150 YN-990P 1 S903NIBP* The lock plate is provided with these NIBP cuffs.CAUTIONUse only Nihon Kohden electrodes, electrode leads, SpO2 probes and NIBP cuffsto assure maximum performance from your instrument.TransmitterChannel writer, QI-901PKECG/RESPOptionsName Application Model Q’ty Supply Code No.3 electrodes,clip type,lead length 80 cm BR-903PA 1 K911A3 electrodes, snap type,lead length 80 cm BR-913PA 1 K910B6 electrodes,clip type,lead length 80 cm BR-906PA 1 K912AElectrodelead6 electrodes,snap type,lead length 80 cm BR-916PA 1 K915A
Operator's Manual ZM-940PA 85SpO2Name CablelengthModel/Code No. Q’ty SupplyCode No.0.6 m P225HFinger probe (reusable) 1.6 m TL-201T P225FMulti-site probe (reusable) TL-220T1P225GSpO2 probe (for adult, disposable) TL-251T P201ASpO2 probe (for child, disposable) TL-252T P201BSpO2 probe (for neonate,disposable) TL-253T P201CMulti-site Y probe(for low birth weight infant/child/neonate, disposable)TL-260T5P205ASpO2 probe (for adult, disposable) TL-271T P203ASpO2 probe (for child, disposable) TL-272T P203BSpO2 probe (for neonate/adult,disposable) TL-273T P203CSpO2 probe (for child/infant,disposable)1.6 mTL-274T24P203D0.8 m TL-051S P228ASpO2 probe(for adult/neonate,disposable) 1.6 m TL-052S P228B0.8 m TL-061S P229ASpO2 probe (for child/infant,disposable) 1.6 m TL-062S5P229BCOTTONY tape 340703 20 P259Foam tape for TL-051S/052S/061S/062S 4 × 25 package P260Attachment tape for TL-220T/251T/252T/253T 3 × 30 package P263Attachment tape S for TL-260T P260AAttachment tape L for TL-260T--- ---24 P260B
86 Operator's Manual ZM-940PATransmission FrequenciesUSABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCTransmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.608.0250 9002 608.7750 9062 609.5250 9122608.0500 9004 608.8000 9064 609.5500 9124608.0750 9006 608.8250 9066 609.5750 9126608.1000 9008 608.8500 9068 609.6000 9128608.1250 9010 608.8750 9070 609.6250 9130608.1500 9012 608.9000 9072 609.6500 9132608.1750 9014 608.9250 9074 609.6750 9134608.2000 9016 608.9500 9076 609.7000 9136608.2250 9018 608.9750 9078 609.7250 9138608.2500 9020 609.0000 9080 609.7500 9140608.2750 9022 609.0250 9082 609.7750 9142608.3000 9024 609.0500 9084 609.8000 9144608.3250 9026 609.0750 9086 609.8250 9146608.3500 9028 609.1000 9088 609.8500 9148608.3750 9030 609.1250 9090 609.8750 9150608.4000 9032 609.1500 9092 609.9000 9152608.4250 9034 609.1750 9094 609.9250 9154608.4500 9036 609.2000 9096 609.9500 9156608.4750 9038 609.2250 9098 609.9750 9158608.5000 9040 609.2500 9100 610.0000 9160608.5250 9042 609.2750 9102 610.0250 9162608.5500 9044 609.3000 9104 610.0500 9164608.5750 9046 609.3250 9106 610.0750 9166608.6000 9048 609.3500 9108 610.1000 9168608.6250 9050 609.3750 9110 610.1250 9170608.6500 9052 609.4000 9112 610.1500 9172608.6750 9054 609.4250 9114 610.1750 9174608.7000 9056 609.4500 9116 610.2000 9176608.7250 9058 609.4750 9118 610.2250 9178608.7500 9060 609.5000 9120 610.2500 9180
Operator's Manual ZM-940PA 87USABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCTransmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.610.2750 9182 611.1000 9248 611.9250 9314610.3000 9184 611.1250 9250 611.9500 9316610.3250 9186 611.1500 9252 611.9750 9318610.3500 9188 611.1750 9254 612.0000 9320610.3750 9190 611.2000 9256 612.0250 9322610.4000 9192 611.2250 9258 612.0500 9324610.4250 9194 611.2500 9260 612.0750 9326610.4500 9196 611.2750 9262 612.1000 9328610.4750 9198 611.3000 9264 612.1250 9330610.5000 9200 611.3250 9266 612.1500 9332610.5250 9202 611.3500 9268 612.1750 9334610.5500 9204 611.3750 9270 612.2000 9336610.5750 9206 611.4000 9272 612.2250 9338610.6000 9208 611.4250 9274 612.2500 9340610.6250 9210 611.4500 9276 612.2750 9342610.6500 9212 611.4750 9278 612.3000 9344610.6750 9214 611.5000 9280 612.3250 9346610.7000 9216 611.5250 9282 612.3500 9348610.7250 9218 611.5500 9284 612.3750 9350610.7500 9220 611.5750 9286 612.4000 9352610.7750 9222 611.6000 9288 612.4250 9354610.8000 9224 611.6250 9290 612.4500 9356610.8250 9226 611.6500 9292 612.4750 9358610.8500 9228 611.6750 9294 612.5000 9360610.8750 9230 611.7000 9296 612.5250 9362610.9000 9232 611.7250 9298 612.5500 9364610.9250 9234 611.7500 9300 612.5750 9366610.9500 9236 611.7750 9302 612.6000 9368610.9750 9238 611.8000 9304 612.6250 9370611.0000 9240 611.8250 9306 612.6500 9372611.0250 9242 611.8500 9308 612.6750 9374611.0500 9244 611.8750 9310 612.7000 9376611.0750 9246 611.9000 9312 612.7250 9378
88 Operator's Manual ZM-940PAUSABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCUSABANDCHANNELSPACINGCTransmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.Transmissionfrequency(MHz)25 kHz stepChannel No.612.7500 9380 613.1750 9414 613.6000 9448612.7750 9382 613.2000 9416 613.6250 9450612.8000 9384 613.2250 9418 613.6500 9452612.8250 9386 613.2500 9420 613.6750 9454612.8500 9388 613.2750 9422 613.7000 9456612.8750 9390 613.3000 9424 613.7250 9458612.9000 9392 613.3250 9426 613.7500 9460612.9250 9394 613.3500 9428 613.7750 9462612.9500 9396 613.3750 9430 613.8000 9464612.9750 9398 613.4000 9432 613.8250 9466613.0000 9400 613.4250 9434 613.8500 9468613.0250 9402 613.4500 9436 613.8750 9470613.0500 9404 613.4750 9438 613.9000 9472613.0750 9406 613.5000 9440 613.9250 9474613.1000 9408 613.5250 9442 613.9500 9476613.1250 9410 613.5500 9444 613.9750 9478613.1500 9412 613.5750 9446

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