A&D | TM-2564G | Instruction manual | A&D TM-2564G Instruction manual

A&D TM-2564G Instruction manual
TM-2560G / TM-2564G
TM-2560GP / TM-2564GP
VITAL SENSOR
GRAPHIC MODEL
INSTRUCTION MANUAL
WM+PD4000753
© 2004 A&D Company Ltd. All rights reserved.
No part of this publication may be reproduced, transmitted, transcribed, or translated
into any language in any form by any means without the written permission of A&D
Company Ltd.
The contents of this manual and the specifications of the instrument covered by this
manual are subject to change for improvement without notice.
Compliance
Compliance with FCC Rules
This device complies with Part 15 of the FCC Rules. Operation is subject to the following two
conditions: (1) This device may not cause harmful interference, and (2) this device must accept any
interference received, including interference that may cause undesired operation.
(FCC = Federal Communications Commission in the U.S.A.)
Compliance with European Directive 93/42 EEC for Medical Products
This device conforms to European Directive 93/42 EEC for Medical Products. This is evidenced by
the CE mark of conformity accompanied by the reference number of a designated authority.
Warning Definitions
The warnings described in this manual have the following meanings:
Warning
Disregarding the warning could result in bodily injury or damage to the instrument.
Caution
Disregarding the caution could result in loss of important user data or damage to the
instrument.
Note
Provides information useful for the user to operate the instrument.
In addition to these shown above, there are more precautions specific to each section. Read the manual
carefully and observe the precautions.
i
General Precautions
To handle the instrument properly and safely, read the instruction manual thoroughly and be fully
knowledgeable about the instrument before use.
The following are general precautions on handling the instrument safely and safety of patients and
operators. Precautions specific to the instrument will appear in the relevant pages.
The following points should be considered when you install or store the instrument.
Install or store the instrument away from moisture.
Install or store the instrument in an environment where the instrument is not badly affected by
extreme temperature, humidity, atmospheric pressure, direct sunlight, draft, dust, salinity or sulfur
content in the air.
Install or store the instrument in a secure and stable location.
Do not install or store the instrument where chemicals, and corrosive or explosive gases are stored
or present.
Install the instrument where a 3-pin electrical outlet adequate to the instrument is provided.
This instrument is not of the explosion-proof type. Do not use the instrument where flammable
materials, such as a flammable anesthetic, are used.
The following points should be considered before use
Check to make sure the instrument operates safely and accurately.
Check all hoses and cables for proper connection and deterioration.
When the instrument is used in combination with other instruments, pay extra attention to avoid
mis-diagnosis or other problems especially leakage current. Check all connections to make sure
they do not interfere with each other.
When other telemeters are used, check that mutual interference will not cause a problem.
When the instrument is operated using batteries, check that the specified batteries are used and
they are installed properly and in good conditions.
Use the AC adapter provided with the instrument.
Use the specified sensors.
The following points should be considered during use.
The instrument should be used only during the time required for diagnosis and medical treatment.
Check the patient and the instrument during use.
If medical or operational problems are found in the instrument or the patient, stop using the
instrument immediately, check the status of the patient and take proper actions.
Do not allow a patient to touch or operate the instrument.
Do not use the instrument where strong magnetic or electrical field exists.
Do not use the instrument on a patient using a heart-lung machine.
ii
High frequency interference by electrosurgery or energy discharged by a defibrillator may damage
the instrument. Follow the precautions described in the manual for each device.
(The instrument is protected against the energy discharged by a defibrillator only when the
accessory ECG extension cable is used.)
During electrosurgery, do not connect the ECG electrodes to the patient. (They may cause the
patient to be burned.)
Do not use a cellular telephone near the instrument. It could affect the instrument's operation.
The following points should be considered after use.
Follow a predetermined procedure to return the operation switches to their original positions, and
then turn off the power.
Do not forcibly pull out the cables and hoses.
Keep the instrument clean and in proper operating condition so that it can be used without problem
during the next operation.
Clean the accessories and arrange them before storage.
Perform the following when the instrument malfunctions.
Secure the patient’s or operator's safety.
Turn the power off and disconnect the power cable from the outlet.
Affix a notice such as “Out of Order” and “Do Not Use” on the device. Ask the nearest dealer for
services.
Do not disassemble or modify the device.
Perform regular maintenance and inspection of the instrument.
This is a precision instrument. Please check all functions and cables periodically.
If the instrument is used for the first time after an extended period of storage, check it for proper
operation.
Use a soft, dry cloth for removing stains from the instrument. Do not use solvents such as thinner or
benzine.
Strong electromagnetic waves may affect the instrument performance.
When the instrument is used near a strong electromagnetic field, it may malfunction and noises occur
in the waveform. If the instrument malfunctions unpredictably, check the environment for
electromagnetic fields and take adequate measures.
The following are typical causes of electromagnetic fields and measures against them.
Cellular telephones
Electric waves transmitted by a cellular telephone can cause the instrument to malfunction.
Turn off cellular telephones and other radio devices in medical facilities.
iii
High-frequency noises from other devices through the electrical outlet
Locates the noise source and eliminate its route using adequate measures such as a noise
elimination device.
Turn off the device that serves as a noise source, if possible.
Use another electrical outlet.
Static electricity discharged by the instrument or the environment
Discharge static electricity fully from the operator and the patient before use.
Humidify the room.
Lightening
Lightening occurring nearby may induce great amount of voltage to the instrument. Under such a
condition, operate the instrument as follows:
Disconnect the power cable from the electrical outlet and use the battery.
Use the uninterruptible power system that complies with IEC60601-1.
When using the instrument cause noise to the receiver such as a TV or radio, locate those
receivers away from the instrument.
Environmental protection
Remove the built-in lithium battery from the instrument when the instrument is to be disposed of.
iv
Safety Precautions
The following are the cautions on measurements and sensors.
Blood pressure measurement
Warning
Blood pressure may not be measured when noise, such as consecutive irregular heart
rhythm and physical movement, is present. Check the reliability of the measured value
by displaying or printing the pulse graph.
The instrument takes preventive measures against artifact and shock. However, if you
have some doubts about the measured values, check the blood pressure by other
methods.
Position the cuff at the same height as the patients heart. Otherwise, a measurement
error may occur.
Use the cuff appropriate to the patient's arm circumference. Otherwise, a measurement
error may occur.
The maximum length of the hose is 3.5 (2 m + 1.5 m) meters long. Using a longer hose
may lower the amplitude level of the detected pulse and affect the measurement.
Do not use a twisted or tangled hose as it is. The air may be trapped in the cuff and
cause peripheral circulation disorder by stopping the blood circulation in the arm.
Measuring the blood pressure may cause minor hemorrhaging beneath the skin. The
hemorrhage is temporary and disappears with time.
Do not attach the cuff on a scar. The scar may worsen and cause infection.
Do not attach the cuff on an arm where intravenous drip or blood transfusion is
performed.
Cuff
Warning
The cuff contains dry natural rubber.
Natural rubber can cause allergic reactions such as itching, redness, hives, swelling,
fever, breathing difficulty, asthmatic reactions, blood pressure drop and shock. If the
patient exhibits such a symptom, stop using the instrument immediately and seek
medical treatment.
v
Heart rate/pulse rate measurement
Warning
Monitor a patient using a pacemaker closely while measuring the heart rate.
Do not diagnose arrhythmia other than bradycardia or tachycardia by using the pulse
rate displayed and detected by the instrument.
Caution
The instrument employs three types of heart rate/pulse rate detection methods.
Heart rate by QRS detection from the ECG waveform (Only for models with ECG)
(The value is displayed in green.)
Pulse rate by arterial oxygen saturation (SpO2) measurement
(The value is displayed in blue.)
Pulse rate by blood pressure measurement
(The value is displayed in yellow.)
Transcutaneous arterial oxygen saturation measurement
Warning
Correct measurements may not be performed in the following cases:
• When pigment is introduced into the blood vessel
• When nails are coated with nail polish
• When physical movement is present
• When the sensor is firmly tightened.
• When carboxyhemoglobin and/or methemoglobin concentration cannot be ignored.
• During electrosurgery
• During CPR
• When measured on the body part where venous pulsations exist
• When the pulse wave is small
• When the patient has low perfusion
• When the sensor temperature is out of the range of 28°C to 42°C.
When not in use, disconnect the cable from the instrument. Noise may enter an unused
sensor, causing an erroneous display.
Always monitor the SpO2 plethysmograph and pulse wave bar graph to check against
bad blood circulation.
Excessive light may cause inaccurate measurements. In such cases, cover the sensor
with an opaque material.
Use the specified SpO2 sensor for accurate measurement.
If the sensor is wrapped too tightly or supplemental tape is applied, venous pulsations
may lead to inaccurate saturation measurements.
vi
SpO2 sensor
Use a Nellcor sensor listed in the following table.
Type
Model
Parts #
Compatibility
MAX A
Yes
MAX AL
Yes
Disposable
OXISENSOR
MAX P
MAX I
Yes
Yes
Reusable
MAX N
No
MAX R
Yes
DURA-Y
Yes
DS100A
Yes
RS10
No
OXIBAND
OXI-A/N OXI-P/1
Yes
Yes
Read the instruction manual supplied for the sensor carefully before use.
Warning
Finger clip type sensor
• Use only for adult fingers. Do not use the sensor on other body parts.
• For short term monitoring. If the sensor is to be used for 4 hours or longer, alternate
fingers used. For extended monitoring, use a flex type sensor.
• Do not affix the sensor to the finger with tape. This may cause congestion or edema,
resulting in skin damage.
• When cleaning the sensor, clean with a cloth moistened with 70% alcohol or other
disinfectant.
Flex type / Disposable sensor
• Though the sensor is suitable for long term monitoring, check the skin and sensor
mount at fixed intervals (every 8 hours). If a change or discoloration in skin is detected,
move the sensor to another area.
• If strong light affects the sensor, cover it with an opaque material.
• When securing the sensor with tape, avoid tightening too strongly to prevent
congestion and edema.
• If the patients exhibit allergic reactions to the adhesive tape, stop using the sensor.
Care must be taken while peeling off adhesive tape.
The temperature on the body part where the SpO2 sensor is attached rises by 2°C to
3°C, that may cause compression necrosis or burns. If the patient has a fever or suffers
from peripheral circulation disorder, change the sensor site frequently.
Caution
The disposable sensor is sterilized for single use on a single patient. Do not re-use it
on another patient.
Note
Refer to the manual of each sensor for details.
vii
Unpacking / Inspection
Caution
This is a precision instrument. Handle it with care. Strong shock may cause failure.
Note
This instrument is delivered in a packing box designed to prevent damage during normal
transportation. When unpacking the instrument, check it for damage. If your instrument has been
damaged, contact the agent you purchased it from. Retain the packing materials, which are required to
transport this instrument.
Check that the following articles are included when you unpack the instrument.
TM-2560G
TM-2564G
Main unit
Instruction manual
Adult cuff with 2-meter hose
1.5-meter hose
SpO2 extension cable
ECG extension cable
ECG patient cable
AC adapter
Power cable
Printer paper (white) 5 rolls
Printer paper (graph) 2 rolls
SpO2 sensor pack
(with instruction manual)
Battery
= Available
viii
TM-2560GP
TM-2564GP
ix
Contents
Compliance................................................................................................................................................. i
Warning Definitions ................................................................................................................................... i
General Precautions ................................................................................................................................. ii
Safety Precautions.................................................................................................................................... v
Unpacking / Inspection.......................................................................................................................... viii
1. Introduction ........................................................................................................................................... 3
1-1 Features ...................................................................................................................................................... 3
2. Specifications........................................................................................................................................ 4
2-1 Models ......................................................................................................................................................... 4
2-2 Main Unit ..................................................................................................................................................... 4
2-3 Measurement .............................................................................................................................................. 5
3. Part Names ............................................................................................................................................ 6
3-1 TM-2560G/TM-2564G ................................................................................................................................. 6
3-2 TM-2560GP/TM-2564GP ............................................................................................................................ 7
3-3 Top Operation Panel.................................................................................................................................... 8
3-4 Printer Keys................................................................................................................................................. 9
3-5 Symbols....................................................................................................................................................... 9
4. Preparation Before Use ...................................................................................................................... 10
4-1 Installation Site .......................................................................................................................................... 10
4-2 Power Supply ............................................................................................................................................ 10
4-3 Installation Procedure................................................................................................................................ 13
4-4 Printer Paper Loading Procedure.............................................................................................................. 13
5. Displays ............................................................................................................................................... 14
5-1 Home Display ............................................................................................................................................ 14
5-2 List Display ................................................................................................................................................ 20
5-3 Trend Display ............................................................................................................................................ 21
5-4 Pause Display ........................................................................................................................................... 22
5-5 Setting Mode Display ................................................................................................................................ 23
5-6 Quick Setting Window ............................................................................................................................... 24
6. Operation ............................................................................................................................................. 25
6-1 Turning on the POWER switch.................................................................................................................. 25
6-2 Attaching the Cuff/ECG Electrodes/SpO2 Sensor ..................................................................................... 25
6-3 Setting Mode ............................................................................................................................................. 28
6-4 Quick Setting Mode ................................................................................................................................... 31
6-5 Measuring the Blood Pressure.................................................................................................................. 32
1
6-6 Measuring the ECG................................................................................................................................... 33
6-7 Measuring the SpO2 .................................................................................................................................. 34
6-8 Measuring the Temperature (Optional) ..................................................................................................... 34
6-9 Measuring the Heart Rate/Pulse Rate ...................................................................................................... 34
6-10 Alarm Function ........................................................................................................................................ 35
6-11 Storing/Deleting Data............................................................................................................................... 35
6-12 Power Supply .......................................................................................................................................... 37
6-13 Printing the Measurement Data .............................................................................................................. 37
6-14 Function Setting ...................................................................................................................................... 40
7. Maintenance ........................................................................................................................................ 42
7-1 Cleaning .................................................................................................................................................... 42
7-2 Calibration ................................................................................................................................................. 43
7-3 Assembling the Cuff .................................................................................................................................. 44
7-4 Disposing of the Instrument ...................................................................................................................... 44
7-5 Before Asking for a Repair ........................................................................................................................ 44
7-6 Error Codes ............................................................................................................................................... 45
8. Accessories/Options .......................................................................................................................... 46
Appendix A: Measuring Principle .......................................................................................................... 47
A-1 Blood Pressure ......................................................................................................................................... 47
A-2 SpO2 .......................................................................................................................................................... 49
Appendix B: External Dimensions ........................................................................................................ 51
2
1. Introduction
Thank you for purchasing Vital Sensor Graphic Model from A&D. This manual was written for the
TM-256XG series. Available functions depend on the model.
Please read the manual carefully before using the instrument in order to ensure a sufficient understanding
of the TM-256XG series and provide proper use. Store the manual in a readily available location.
1-1 Features
All-in-one monitor instrument allows measurement of blood pressure, arterial oxygen saturation
(SpO2), and heart rate by the ECG. (Monitors vital signs information of general ward inpatients.)
TFT color LCD for easy recognition of measurement values and waveform.
The oscillometric method is used for blood pressure measurement.
The automatic pressurization function pressurizes to an optimum pressure according to the
patient’s blood pressure to prevent excessive pressurization.
The interval measurement is an exact-time measurement synchronized with the built-in clock,
allowing the patient record and anesthesia data to be recorded.
In the interval measurement mode, the quick systolic blood pressure detection function displays the
predicted systolic blood pressure value.
The pulse oximeter is provided with a function to compensate for variations in the quantity of light
transmitted according to the tissue density and skin coloration at the measurement site.
An optional temperature receiver unit is available for monitoring the temperature continuously.
An optional extension box is available for selecting various types of communications functions.
A rechargeable battery is available for using the instrument during transportation or where there is
no AC power supply.
The instrument is lightweight, compact and easy to carry.
3
2. Specifications
2-1 Models
TM-2560G
TM-2564G
TM-2560GP
TM-2564GP
Blood pressure measurement
ECG measurement
SpO2 measurement
Limit function
Interval measurement
Printing function
2-2 Main Unit
Without printer: 160 (W) x 143 (H) x 138 (D) mm
With printer: 205 (W) x 143 (H) x 138 (D) mm
Excluding the rubber feet and handle
Without printer: Approx. 1.2 kg
Mass
With printer: Approx. 1.4 kg
Excluding the battery and printer paper
AC adapter (TB223)
Input: 100-240 VAC, 50-60 Hz, 65-86 VA
Output: 15 VDC, 2A
Power supply
Battery (AX-HHR-21HL24G1)
Type: Nickel-metal-hydride
Operating hours: Approx. 1.5 hours when a new battery is used
with 5-minute interval and without printing
Protection against electrical On AC adapter: Class 1
shock
On battery: Internally powered equipment
Systolic blood pressure, diastolic blood pressure, heart rate (pulse
rate) ,SpO2, and temperature*
Limit function
Flashes value and alarm lamp, and sounds alarm in an
emergency
Display
Backlit TFT color LCD (5 inches, 320 x 234 dots)
Waveform: ECG waveform, plethysmograph
Number of waveforms: Maximum 2 traces
Waveform display method: Stationary trace
Displaying function
Values: Systolic, diastolic, mean, heart rate (pulse rate), SpO2, temperature*
List:
Systolic, diastolic, heart rate (pulse rate), SpO2, temperature*
Trend: Systolic, diastolic, heart rate (pulse rate), SpO2, temperature*
Pause: ECG waveform, plethysmograph
Thermal line printer
Printer
Paper width: 58 mm
Waveform printing: ECG waveform (16 seconds)
Printing function
Graph, list, trend printing: Systolic, diastolic, heart rate (pulse
rate), SpO2, and temperature*
Number of memory data: 400
Memory function
Storage cycle: 1, 2, 2.5, 3, 5, 10, 15 minutes
Time: Built-in lithium battery
Backup function
Memory data: Non-volatile memory
Operating temperature/humidity +10°C to +40°C, 85%RH or less
Storing temperature/humidity
-20°C to +55°C, 95%RH or less
Operating atmospheric pressure 70 to 106 kPa
External dimensions
4
* Available only when the optional thermometer and temperature receiver unit are connected.
2-3 Measurement
Blood pressure
Blood pressure
interval measurement
SpO2
ECG
Measurement method: Oscillometric method
Pressure detection method: Semiconductor pressure sensor
Pressure range: 0 - 300 mmHg
Pressure accuracy: ± 3 mmHg
Measurement range: Blood pressure: 10 - 280 mmHg
Pulse rate: 30 - 200 bpm (Neonate: 30 - 240 bpm)
Pressurizing method: Diaphragm pump
Pressure control method: ECEV
Rapid air exhaust system: Electromagnetic valve
Safety mechanism: The electromagnetic valve opens when approx. 320
mmHg or greater is detected.
For neonates, the electromagnetic valve opens when
160 mmHg is detected.
Degree of protection against electrical shock: Type BF
Intervals: CON, 2.5, 3, 5, 10, 15, 20, 30, 60, 90, 120 min.
Maximum length of CON measurement is 5 minutes. After five minutes,
the interval is switched to 5-min interval automatically.
Measurement method: 2-wavelength pulse oximetry
Measurement range: 40 - 100%
Accuracy: ± 3 %(70-100%)
Pulse rate measurement range: 30 - 250 bpm
Degree of protection against electrical shock: Type BF
Patient input
Lead: 3-lead (Lead l, ll, lll)
Input impedance: 5 MΩ or greater
Input circuit current: 10-7 A or less
Differential dynamic range: ±300 mV
Degree of protection against electrical shock: Type CF
Measurement
Frequency characteristics: 0.3 - 60 Hz (when 0.5 second of time constant
is selected)
0.05 - 200 Hz (when 3.2 seconds of time
constant is selected)
Hum elimination: 50/60 Hz
Measurement range: 20 - 300 bpm
Caution
For safety and best performance, use the specified accessories and options.
If ECG electrodes other than specified are used, use much care. A great offset may
occur.
5
3. Part Names
3-1 TM-2560G/TM-2564G
6
3-2 TM-2560GP/TM-2564GP
7
3-3 Top Operation Panel
1
2
Name
NIBP START/STOP key
ALARM OFF key
3
HOME key
4
PAUSE key
5
6
/
/
/
keys
QUICK SETTING key
Function
Starts or stops the blood pressure measurement.
Stops the alarm buzzer. (Refer to "6-10 Alarm function".)
Selects a home display to be displayed.
Returns to the home display when the list, trend or setting mode
is displayed.
Pauses the ECG waveform or plethysmograph.
Returns to the previous home display when pressed again.
Goes to the following display from the home display.
key: Goes to the setting mode display.
key: Goes to the list display.
key: Goes to the trend display.
In a display other than the home display, each key functions as
described in the key function guidance at the bottom of the
display.
Opens the quick setting window. (Refer to "5-6 Setting Mode
Display" and "6-4 Quick Setting Window".)
8
3-4 Printer Keys
TM-2564GP
1
Name
ECG RECORD
START/STOP key
2
LIST key
3
4
FEED key
PAPER END lamp
TM-2560GP
Function
Prints the ECG waveform.
Functions as the PAUSE key when the waveform is printed.
Prints the memory data in tabular form. (Refer to "6-13 Printing the
Measurement Data")
Feeds the paper.
Illuminates when paper runs out or the printer case is open.
3-5 Symbols
Description
Symbol
Indicates to refer to the instruction manual.
I
Indicates that the POWER switch is "ON".
Indicates that the POWER switch is "OFF".
Indicates that the degree of protection against electrical shock is type BF.
(Applicable to the SpO2 sensor)
Indicates that the degree of protection against electrical shock is type CF.
(Applicable to the ECG patient cable)
Indicates that the degree of protection against electrical shock is type BF.
(Defibrillator protection)
(Applicable to the cuff)
Indicates that the degree of protection against electrical shock is type CF.
(Defibrillator protection)
(Applicable to the ECG patient cable when used with the AX-KO1839 extension
cable)
Indicates that the battery is being charged.
9
4. Preparation Before Use
4-1 Installation Site
When installing the instrument, consider "General Precautions" appearing in an earlier part of the
instruction manual.
4-2 Power Supply
The instrument can be operated using an AC adapter or battery.
When an AC adapter is used:
1. Connect the supplied power cable to the
AC adapter. Insert the plug on the other
end of the power cable into an electrical
outlet.
2. Insert the AC adapter cable into the AC
adapter
jack
on
the
rear
of
the
instrument.
Caution
Use the specified power cable and AC adapter only.
10
When the battery is used:
1. Remove the power cable from the
electrical outlet.
2. Remove the screw from the battery
compartment cover on the rear of the
instrument.
3. Slide the cover to remove it.
4. Insert the battery connector into the
connector
port
of
the
battery
compartment as shown in the illustration.
5. Install the battery as shown in the
illustration, using much care to avoid
damaging the cables. Mate the portion
that the cables come out to the groove of
the battery compartment.
6. Slide the cover to install it.
7. Screw the cover.
Caution
Use the specified battery only.
Switching the power supply
When the AC adapter does not supply power, under the conditions as described below, the instrument
automatically starts battery operation.
The AC adapter cable is removed from the instrument.
The power cable is removed from the electrical outlet.
Power failure
Caution
Power supply is switched automatically. The power supply currently used appears at
the lower right side of the display. Refer to "6-12 Power Supply" for details.
11
Charging the battery
Charging starts when the AC adapter is connected to the instrument, regardless of the power switch
status. It takes 15 hours to complete charging.
The battery capacity lowers due to self-discharge. To compensate the capacity lost due to self
discharge, intermittent charging is performed automatically.
When charging a battery with small charging capacity, supplementary charging of about one hour is
performed.
Charging status is indicated by the charging lamp.
Charging lamp
Charging status
Charging of 15 hours is being
performed.
Right after the AC adapter is connected.
Intermittent charging of 4 hours is being
Lit continuously.
performed.
Occurs about once a week when the AC
adapter is kept connected after 15-hour
charging.
Supplementary charging is being
Flashes every ten performed.
seconds
Occurs in the early stage of 15-hour
charging.
Normal condition
Normal condition
Normal condition when the lamp
stops flashing and is lit after a
maximum of 4 hours.
Remove the battery once and
install again. If the condition
persists, replace the battery.
Normal condition.
Flashes every two
Error
seconds
Not lit
Description
Charging is complete.
Note
• When the operating hours of the battery are short even after charging, replace the battery. Refer to "8-1
Accessories/Options" for ordering information.
• Replace the battery every two years.
• The battery may have deteriorated before two years of use, due to the environment and usage
conditions.
• For battery operation, refer to "6-12 Power Supply".
• When the charging lamp will not light right after the AC adapter is connected, remove the battery and
install it again.
12
4-3 Installation Procedure
Warning
• Do not use damaged cables and sensors.
• Use the specified cables and sensors only.
• The ECG unit is protected against defibrillator discharge only when the
supplied ECG extension cable is used.
1. Confirm that the power switch is turned
off.
2. Connect the cuff hose to the CUFF
connector of the instrument. Use the
1.5-m hose to extend it, if necessary.
3. Connect the SpO2 extension cable to the
SpO2 connector of the instrument and
lock it.
4. Connect the SpO2 cable to the SpO2
extension cable.
5. Connect the ECG extension cable to the
ECG
connector
of
the
instrument.
Confirm that it is securely connected.
6. Connect the ECG patient cable to the
ECG extension cable.
4-4 Printer Paper Loading Procedure
1. Press the printer cover open switch to
open the printer cover.
2. Load the printer paper as shown in the
illustration, and close the cover.
3. Press the FEED key to check that the
paper is fed properly.
4. Cut the leading edge of the printer paper
at a right angle.
13
5. Displays
5-1 Home Display
Press the HOME key to indicate the home display. There are six home display types
1. Blood pressure 2 traces (Default display)
6. Sleep mode
Emphasizes the blood pressure values
Blank display
2. Waveform 2 traces
5. Temperature 1 trace
Lengthened waveform display area
Emphasizes the heart rate and SpO2
3. Pulse graph 1 trace
4. Temperature 2 traces
Displays the pulse graph
Displays all values in a balanced way
14
Displayed items depend on the display screen selected. Below is a list of displayed items for each
display.
Home display
1
Blood
pressure 2
traces
Waveform
2 traces
Pulse graph
1 trace
Temperature
2 traces
Temperature
1 trace
Sleep mode
Waveform
Two
(3.2 seconds)
Blood
pressure
Pulse
graph
⎯
Large
HR/PR
SpO2
Temperature
Medium
⎯
Two
Small
Medium
⎯
(4 seconds)
One
3
Medium
Available Large
(4 seconds)
Two
4
Medium
Medium
⎯
(3.2 seconds)
One
5
Medium
Large
⎯
(4 seconds)
6
⎯
⎯
⎯
⎯
* The acronyms used in the display have the following meanings:
2
Medium
Message
⎯
Available
⎯
⎯
Medium
Available
Small
Available
⎯
⎯
SYS: Systolic blood pressure
DIA: Diastolic blood pressure
MAP: Mean arterial pressure
HR: Heart rate
PR: Pulse rate
bpm: Beats per minute
* "Large", "Medium" and "Small" indicate the comparison of the item indicated in each display. For
example, "Middle" of the blood pressure is not the same as "Middle" of the temperature.
* When the temperature probe ID is set to "OFF", two home displays of "Temperature 2 traces" and
"Temperature 1 trace" will not be displayed.
Note
• A home display other than the sleep mode display will be stored in non-volatile memory if it is left
displayed for five seconds. Then, that home display is displayed every time the power is turned on.
• In the sleep mode display, the backlit amount will be reduced after five seconds.
• When a temperature alarm occurs in the display with no temperature display, the display returns to the
default display automatically.
• When any key is pressed in the sleep mode display, the display returns to the home display.
• When an alarm occurs in the sleep mode display, the display returns to the home display.
• In the sleep mode display, no buzzer for interval measurement is available.
15
Description of the home display
Here, the basic parameters are described as they appear in the home display.
Please note that the composition depends on the instrument model.
TM-2564G standard home display (Blood pressure 2 traces)
TM-2564G Pulse graph
16
Name
Displayed item
Systolic blood pressure
Systolic blood pressure
(When an alarm occurs)
Blood pressure error
1
Systolic blood
pressure
display
Quick systolic
"SYS"
" " (Red circle)
Diastolic blood pressure
2
Diastolic blood
pressure
display
Diastolic blood pressure
(When an alarm occurs)
Cuff pressure
"DIA"
" " (Red circle)
3
Mean blood
pressure
display
Mean blood pressure
"MAP"
Heart rate/Pulse rate
"HR" / "PR"
4
Heart rate
Pulse rate
display
Heart mark
Heart rate/Pulse rate
(When an alarm occurs)
"bpm"
" " (Red circle)
Displaying color
Description
•Displays the value after measurement.
•Retained until the next measurement.
•Flashes in red when the limit values are exceeded.
•Retained until the next measurement.
•Flashes the error code when an error occurs.
•Retained until the next measurement.
•Flashes the predicted value during interval
measurement.
•The value is not monitored by the limit function.
•Replaced with the final value after measurement.
•Displayed at the upper left side to indicate that the
systolic blood pressure value is displayed.
•Displays a red circle near "SYS" when the limit
values are set.
•Displays the value after measurement.
•Retained until the next measurement.
•Flashes in red when the limit values are exceeded.
•Retained until the next measurement.
•Displays the cuff pressure value during
measurement.
•Displayed at the upper left side to indicate that the
diastolic blood pressure value is displayed.
•Displays a red circle near "DIA" when the limit
values are set.
•Displays the value after measurement.
•Retained until the next measurement.
•Displayed near the value to indicate that the mean
blood pressure value is displayed.
•Displays as specified in the function setting. (Refer
to "6-14 Function Setting".)
When "AUTO" is selected, displays the value
according to the order of precedence of ECG, SpO2
and blood pressure.
•When no values are detected, displays the ECG
status.
Displays " - - - " during pulse detection, and "LF"
when the electrode is off the proper site.
•Displays "HR" to indicate that heart rate is
displayed in ECG measurement.
•Displays "PR" to indicate that pulse rate is
displayed in SpO2 or blood pressure measurement.
•Flashes in synchronization with the heart rate/pulse
rate.
•Flashes in red when the limit values are exceeded.
•Retained until the value is within the limit values.
•Displayed as the unit of heart rate/pulse rate.
•Displays a red circle near "HR" or "PR" when the
limit values are set.
•Displays the heart rate by the ECG measurement in
green.
•Displays the pulse rate by the SpO2 measurement
in blue.
•Displays the pulse rate by the blood pressure
measurement in yellow.
17
Continued
SpO2 value
5
SpO2 display
SpO2 value
(When an alarm occurs)
"%"
" " (Red circle)
6
ECG waveform
display
7
Plethysmograph
Plethysmograph
display
8
Patient display
9
Measuring
interval display
10
11
12
13
14
Measuring time
display
Blood pressure
unit display
Error message
ECG lead
display
ECG displaying
magnification
display
ECG waveform
Patient to measure
blood pressure
Interval to measure
blood pressure
"CYCLE"
Blood pressure
measuring time
Blood pressure unit
Blood pressure
measurement error
ECG lead
ECG displaying
magnification
15
Alarm off mark
Alarm off mark
16
Current time
display
Current time
17
Power supply
display
Power supply
Temperature probe ID
Temperature value
18
Temperature
display
Antenna mark
Temperature value
(When an alarm occurs)
"°C "
" " (Red circle)
•Updates the value during measurement.
•Displays " - - - " during pulse detection, and "LF"
when the sensor is not connected.
•Flashes in red when the limit values are exceeded.
•Retained until the value is within the limit values.
•Displayed as the unit of SpO2.
•Displays a red circle near "SpO2" when the limit
values are set.
•Displays the ECG waveform in the preset sweep
rate.
•Not available for TM-2560G/TM-2560GP.
•Displays the SpO2 plethysmograph in the preset
ECG sweep rate.
•Two displays for TM-2560G/TM-2560GP. (The
sweep rate is fixed to 25 mm/s.)
•Displays "ADULT" to indicate that the patient whose
blood pressure to be measured is adult.
•Displays the preset blood pressure measuring
interval.
•Displayed to indicate that the blood pressure
measuring interval is displayed.
•Displays the time the blood pressure is measured.
•Displays "mmHg" as the unit of blood pressure.
•Displays the error that occurs during blood
pressure measurement.
•Displays the preset lead type as "l", "ll", or "lll".
•Displays the preset ECG displaying magnification.
•Illuminates when the ALARM OFF key is pressed to
stop the alarm.
•Displays the current time.
•Displays the power currently used.
•Displays the remaining battery charge when the
battery is used. (Refer to "6-12 Power Supply".)
•Displays the preset temperature probe ID as "T-∗∗".
•Updates during measurement using the
temperature probe.
•Displays " - - - " when communication with the
probe is disconnected.
•Displays the communication status by the number
of antennas.
•Flashes in red when the limit values are exceeded.
•Retained until the value is within the limit values.
•Displayed as the unit of temperature.
•Displays a red circle near temperature probe
display when the limit values are set.
18
Continued
19
20
21
22
Message box
Pacemaker
detection
SpO2 pulse bar
graph display
Blood pressure
pulse graph
display
Message
Pacemaker detection
SpO2 pulse bar graph
Blood pressure pulse
graph
•Displays the connection status with the options and
other messages.
•Displayed when "ON" is selected for pacemaker
detection.
•Displays the bar graph in synchronization with the
SpO2 pulse.
•Displays the pulse graph obtained during blood
pressure measurement.
SYS: Systolic blood pressure
DIA: Diastolic blood pressure
MAP: Mean arterial pressure
HR: Heart rate
PR: Pulse rate
bpm: Beats per minute
19
5-2 List Display
When the home display is being shown, press the LIST key (
key) to go to the list display.
Note
• When the list display is being shown, press the HOME key to return to the home display.
• The memory data is erased in the list display. Refer to "6-11 Storing/Deleting data" for details.
• In the list display, after about 5 minutes of inoperation, the latest page will be indicated.
1
Name
Number of data
display
Displayed item
Number of data
2
List display
List of measured
values
3
Page number
display
Page number
4
Alarm display
Alarm
5
Key operation
display
Scrolling
Erase data
6
Power supply
display
Power supply type
7
Current time
display
Current time
Description
•Displays the number of data stored in memory.
•Displays the memory data in order of storage. The
greater the number is, the newer the data is.
•Displays the number, date, and the values of
memory data.
•Displays the page number/total page to indicate
where the displayed data is among the whole data.
•The value will be highlighted when it exceeds the
limit values.
•Press the
/
keys to scroll up or down the
pages.
key to erase the memory data.
•Press the
•Displays the power currently used.
•Displays the remaining battery charge when the
battery is used. (Refer to "6-12 Power Supply ".)
•Displays the current time.
20
5-3 Trend Display
When the home display is being shown, press the TREND key (
key) to indicate the trend display of the latest 24
hours.
Note
• When the trend display is being shown, press the HOME key to return to the home display.
• In the trend display, after about 5 minutes of inoperation, the latest page will be indicated.
1
2
3
4
Name
Displayed item
Number of data display Number of data
Time scaling
Trend time width
Page number
Page number
display
Scale display
Measured values
5
Graph display
Trend end time
display
Trend start time
display
Time scaling of
the trend display
8
Scroll bar display
Scroll bar
9
Key operation
display
6
7
Time scaling
Scrolling
Description
•Displays the number of data stored in memory.
•Displays the time width of the trend currently displayed.
•Displays the page number/total page to indicate where
the displayed data is among the whole data.
•Displays blood pressure data in bar graph in the range
of 0 to 200 mmHg.
in the range of 60 to 100%.
•Displays SpO2 data using
•Displays heart rate/pulse rate data using
in the
range of 0 to 200 bpm.
•Displays temperature data using in the range of 25 to
45°C.
•Displays the start and end time of the trend.
•Displays the bar graph to indicate where the displayed
trend is in the 24-hour scale.
•Press the
/
keys to change the time scale.
(1, 2, 3, 6, 12, 24 hours).
/
keys to scroll up or down the
•Press the
pages.
21
10
11
Power supply
display
Current time
display
Power supply
type
Current time
•Displays the power currently used.
•Displays the remaining battery charge.
•Displays the current time.
5-4 Pause Display
When the home display is being shown, press the PAUSE key to pause the waveform.
Note
• When the display is paused, press the HOME key or PAUSE key to return to the home display.
• In the Pause display, press the ECG RECORD START/STOP key to print the ECG waveform of 16
seconds occurred right before the PAUSE key is pressed.
• In the pause display, after about 5 minutes of inoperation, the home display will be indicated.
22
5-5 Setting Mode Display
When the home display is being shown, press the MENU key (
key) to indicate the setting mode
display.
Note
• When the setting mode display is being shown, press the HOME key to return to the home display.
• The setting mode display of any setting item consists of menu, submenu and the value.
Name
Displayed item
1
Menu display
Setting menu items
2
Sub menu
display
Setting sub menu
items
3
Set value
display
Set value
4
Key operation
display
Menu
Sub menu
Parameters
Return
5
Limits bar graph
display
Limit values bar graph
Description
•Displays the list of menu items, with one currently
selected being highlighted.
•Press the
key to select the item to be changed.
•Displays the list of sub menu items corresponding
to the selected menu, with one currently selected
and its value being highlighted
key to select the item to be changed.
•Press the
•Displays the set value of the selected item.
or
key to change the value.
•Press the
key to select the menu to be set.
•Press the
key to select the submenu to be set.
•Press the
or
key to change the value.
•Press the
•Press the HOME key to quit the setting mode
display and return to the home display.
•Displayed only when the limit values are set.
•Displays the upper and lower limit values in bar
graph
23
5-6 Quick Setting Window
When the home display is being shown, press the QUICK SETTING key to open the quick setting
window.
Note
• When the quick setting window is being shown, press the HOME key to close the window. Refer to "6-4
Quick Setting Mode" for details.
1
Name
Quick setting
window
Displayed item
Quick setting window
2
Setting items
display
Setting items
3
Set value
display
Set value
Menu
4
Key operation
display
Item
Parameters
Return
Description
•Sets the items that are changed frequently.
•Overwritten in the home display.
•Displays the quick setting items corresponding to
the menu and sub menu selected in the setting
mode display.
•Displays the currently set value, with one currently
selected being highlighted
•Press the quick setting key to select the menu to be
set.
•Press the
or
key to select the submenu to
be set.
or
key to change the value.
•Press the
•Press the HOME key to close the quick setting
window.
24
6. Operation
6-1 Turning on the POWER switch
Turn the POWER switch on. After several seconds of self-check, the home display appears.
Note
• When the self-check detects any error, the error code is displayed. The error code display of some
errors is frozen. Refer to "7-6 Error Codes" for how to solve the error.
• The self-check checks the data in memory. The duration of the self-check depends on the number of
memory data.
6-2 Attaching the Cuff/ECG Electrodes/SpO2 Sensor
Consider "Safety Precautions" appearing in an earlier part of the instruction manual, when attaching the
Cuff/ECG electrodes/SpO2 sensor.
Attaching the cuff
1. Hold the cuff with the hose pointing
toward the lower part of the arm.
2. Wrap the cuff around the upper arm,
about 3 5 cm above the elbow, with the
ARTERY mark on the artery, as shown in
the illustration.
3. Allow some slack between the cuff and
arm so that a finger or two can be
inserted.
4. When the cuff inner end is not within the
area labeled RANGE, the cuff size is not
appropriate. Replace the cuff.
Note
• Constriction of the upper arm, caused by rolling up a shirt sleeve, may prevent accurate readings.
• When the size of the supplied cuff does not fit the patient, refer to "8-1 Accessories/Options" to find the
proper sized cuff.
25
Attaching the ECG electrodes
Warning
Check the electrode attaching condition in a certain time interval.
If skin integrity changes, move the sensor to another site.
Caution
• Before attaching the electrodes, use alcohol to clean the body sites where the
electrodes are to be attached. Oil or perspiration on the site increases the contact
resistance and causes poor contact between electrode and patient.
• Wipe the body sites that are wet with the alcohol, using a clean, dry cotton.
• Do not use the disposable electrode when the paste is dry.
For ECG monitoring, the chest lead configuration as shown below is recommended. It provides the
waveform that is similar to that obtained using the standard bipolar limb lead.
Quasi limb lead using three electrodes
Note
• To ensure stable monitoring, connect cables firmly and attach the electrodes securely so that they are
in good contact throughout monitoring
• Some patients have a weak R-wave pulse. In that case, change the induction method.
26
Applying the SpO2 sensor
Use the sensor appropriate for the patient.
Refer to the instruction manual for each SpO2 sensor for how to apply the sensor.
Warning
• Read the SpO2 sensor instruction manual for proper use.
• Applying the sensor on a body part other than specified or using it longer than
specified may cause the patient to suffer physical injury.
Caution
Do not apply the SpO2 sensor too tight.
Note
• Do not apply the sensor on the same arm with an arterial catheter inserted or the cuff attached. Using
the same arm will lower the reliability of the measurement data.
Attaching the temperature probe
The temperature probe and the temperature receiver unit are optional. The temperature receiver unit is to
be connected to the OPTION connector.
For how to use them, refer to the relevant instruction manuals.
Caution
The temperature probe that can be used with the instrument is of the wireless type.
The signal reception condition depends on the environment. Keep it away from
electrical noise sources.
27
6-3 Setting Mode
Here, various setting procedures are described. The items available for setting depends on the model.
Basic operation
Menu
Sub menu
Set value
1. In the home display, press the MENU key (
key)
to indicate the setting mode display..
2. The selected menu and sub menu items are
highlighted, and the value of the selected item
appears in the box at the upper right corner.
3. Press the
key to go to the next menu.
4. Press the
key to go to the next sub menu
28
5. Press the
or
key to change the value.
6. The changed value is confirmed when:
Moved to the next menu or sub menu.
The HOME key is pressed to return to the home
display.
Note
• In the setting mode display, after about 5 minutes of inoperation, the home display will be indicated.
• When setting the clock, note the following.
The time in the clock menu indicates that of when the clock menu is displayed, and it remains the same
as long as the clock menu is displayed. The actual clock of the instrument continues normal operation.
Changing any item of the clock menu is reflected and resets the clock.
• When an alarm occurs, the display will return to the home display.
Setting items
Menu
Limits
Sub menu
Upper
SYS
Lower
Upper
DIA
Lower
Upper
HR/PR
Lower
Upper
SpO2
Lower
Upper
Temp
Lower
Cycle
Pressurization
NIBP
Patient
Notice buzzer
Setting range
Unit
Description
OFF, 50-250 (by 10), 200
OFF, 30-200 (by 10), 70
mmHg Sets the limit values for alarm.
OFF, 30-200 (by 10), 150
OFF, 10-200 (by 10), 40
Note
OFF, 50-220 (by 10), 170
When the lower limit value for
bpm
SpO2 measurement has been
OFF, 30-150 (by 10), 40
set to be less than 85%, it will
OFF, 75-99 (by 1)
%
be reset to the default setting
OFF, 50-99 (by 1), 85
upon power-on.
OFF, 30-44 (by 0.5)
°C
OFF, 26-40 (by 0.5)
OFF, CON, 2.5, 3, 5, 10,
Sets the cycles for interval
min
15, 20, 30, 60, 90, 120
measurement.
Sets the pressurization value for
blood pressure measurement.
"AUTO": Detects the pulse at
AUTO, 100-260 (by 20)
mmHg the start of pressurization to
pressurize properly.
During interval measurements,
"AUTO" is used.
Adult, Neonate
"Adult": Other than neonates
⎯
"ON": Sounds a buzzer 15
OFF, ON
seconds before starting an
⎯
interval measurement.
Underlined items: Default settings
29
Continued
ECG
Gain
x1/2, x1, x2, x4
⎯
Time base
6.25.12.5, 25.0
mm/s
Lead
l, ll, lll
Hum filter
OFF, ON
Return time
0.5, 3.2
s
Pacemaker
ON, OFF
⎯
Upper
ECG, SpO2
Lower
ECG, SpO2
Year
Month
Day
Hour
Minute
Alarm sound
Click sound
2000-2099
1-12
1-31
0-23
00-59
1-4 (2)
0-4 (2)
Pulse sound
0-4 (2)
Storage cycle
OFF, 1, 2, 2.5, 3, 5, 10,
15
Temp. probe
OFF, 1-10
Display
ON, OFF
Brightness
10-100% (60%) (by 5)
%
Auto print
OFF, list, graph, trend
⎯
⎯
⎯
Waveform
Clock
Volume
Sets the display gain of the
ECG waveform.
Sets the sweep rate of the
ECG waveform. Also applied
to the plethysmograph.
Sets the ECG lead.
Set the ON/OFF of the hum
filter of the ECG unit.
Sets the time constant of the
ECG unit.
"ON": Highlights the pacemaker
in the ECG waveform and
prevents mis-counting of the
heart rate by the pacemaker.
"OFF" is selected upon power-on.
Sets the waveform displayed
at the upper area.
Sets the waveform displayed
at the lower area.
Sets the clock.
⎯
min
System
⎯
Underlined items: Default settings
30
Sets the alarm buzzer volume
Sets the key click volume
Sets the pulse detection
buzzer volume.
Sets the memory interval to
store the values except blood
pressure.
Blood pressure values are
stored each time they are
measured, regardless of this
setting.
Sets the temperature probe
ID used.
"OFF": Does not display the
measurement values.
Sets the brightness of the
backlight.
Sets the auto printing.
6-4 Quick Setting Mode
Here, the quick setting mode is described, to change the values that are frequently used, or to change the
values while watching the waveform. The items available for setting depend on the model.
Basic operation
Quick setting window
Set value
1. In the home display, press the QUICK SETTING
key.
2. The quick setting window opens and the selected
value is highlighted.
3. Press the QUICK SETTING key to open the next
menu.
4. Press the
or
key to select the item.
5. Press the
or
key to change the value.
6. The changed value is confirmed when:
Moved to the next window or other time.
The HOME key is pressed to return to the home
display.
31
Menu
Sub menu
Cycle
Setting range
OFF, CON, 2.5, 3, 5, 10,
15, 20, 30, 60, 90, 120
NIBP
AUTO, 100-260 (by 20)
Pressurization
SYS
Limits
HR/PR
Upper
Lower
Upper
Lower
OFF, 50-250 (by 10)
OFF, 30-200 (by 10)
OFF, 50-220 (by 10)
OFF, 30-150 (by 10)
Unit
Description
Sets the cycles for interval
min
measurement.
Sets the pressurization value for
blood pressure measurement.
"AUTO": Detects the pulse at
mmHg the start of pressurization to
pressurize properly.
During interval measurements,
"AUTO" is used.
mmHg
Sets the limit values for alarm.
bpm
Gain
x1/2, x1, x2, x4
⎯
Time base
6.25.12.5, 25.0
mm/s
ECG
Sets the display gain of the
ECG waveform.
Sets the sweep rate of the
ECG waveform. Also applied
to the plethysmograph.
Underlined items: Default settings
6-5 Measuring the Blood Pressure
Caution
If the instrument malfunctions during measurement, for example, the air is not
exhausted, remove the cuff from the patient immediately.
Blood pressure measuring procedure
1. Press the NIBP START/STOP key to start a measurement.
2. When "AUTO" is selected for pressurization, the cuff pressure is adjusted automatically to the
patient's blood pressure value. Otherwise, the cuff is pressurized to the set value.
3. After measurement, the air is rapidly exhausted from the cuff and the measurement values are
displayed. When the pulse rate by the ECG or SpO2 unit is not available, the pulse rate obtained by
blood pressure measurement is displayed.
4. When the blood pressure can not be detected, the measurement is repeated three times.
Note
• Make sure that the cuff is at the same level as the patient's heart.
• Advise the patient to sit comfortably and relax, remain still and keep quiet during measurement.
• To cancel a measurement that is in progress, press the NISB START/STOP key.
• When an error occurs during measurement, the error code appears in the SYS display and the error
message appears at the bottom of the display.
32
Interval measurement
1. Set the cycle to a value other than "OFF".
2. "CYCLE:∗∗∗" appears at the bottom of the home display and starts the interval measurement.
3. Blood pressure starts to be measured at the exact-time synchronized with the built-in clock.
4. To end the interval measurement, set the cycle to "OFF".
Note
• During interval measurement, pressurization is performed by "AUTO".
• While in the interval measurement mode, blood pressure can be measured at any time by pressing the
NIBP START/STOP key.
• When the notice buzzer is set to "ON", the buzzer sounds 15 seconds before the interval measurement
starts.
Continuous measurement
1. Set the cycle to "CON".
2. "CYCLE: CON" appears at the bottom of the home display and starts the continuous measurement
after 10 seconds.
3. After 5 minutes, the continuous measurement switches to the 5-minute interval measurement, and
the display switches from "CYCLE: CON" to "CYCLE: C-5".
4. To perform the continuous measurement again, go to the setting mode to set the cycle to "CON".
Quick systolic display
During interval measurement, the predicted systolic blood pressure flashes. It is replaced with the
measured value after measurement
6-6 Measuring the ECG
1. Turn on the POWER switch to start the ECG measurement.
2. Set the conditions appropriate for measurement.
Note
• The instrument performs real-time detection of the QRS wave, measures the RR interval, and converts
it into the heart rate.
• It may take about 10 seconds to display the heart rate after attaching the ECG electrodes.
• Some patients have a weak R-wave pulse. In that case, change the induction method.
33
6-7 Measuring the SpO2
1. Turn on the POWER switch to start the SpO2 measurement.
Note
• In SpO2 measurement, the function of automatically compensating the LED to obtain suitable emission
for the patient works. Thus, it may take approximately 30 seconds to display the measured value.
• Do not apply the sensor on the same arm with the cuff attached. SpO2 may not be measured correctly
during blood pressure measurement.
6-8 Measuring the Temperature (Optional)
1. Set the temp. probe to be used.
2. The instrument starts to receive the signal from the wireless temperature probe. Refer to the
instruction manuals of the temperature probe and the temperature receiver unit for details.
Note
• The communication status is displayed by the antenna mark.
6-9 Measuring the Heart Rate/Pulse Rate
The heart rate and pulse rate are measured in three ways, using the instrument.
The values are displayed according to the order of precedence of ECG, SpO2 and blood pressure
The heart mark starts to flash and the sound is generated to synchronize the pulse detection.
Note
• The heart rate/pulse rate is displayed in different colors to indicate what measures the value.
Green = ECG , Blue = SpO2, Yellow = blood pressure
• The synchronized sound can be turned off by the volume setting.
• The heart rate/pulse rate measurement can be specified in the function setting. Refer to "6-14 Function
Setting".
34
6-10 Alarm Function
Limit mark
When the limit values are set, the limit mark appears in red as shown in the
illustration.
When the measurement value exceeds the upper or lower limit value, the
value and the alarm lamp flash, and the alarm buzzer sounds.
The alarm buzzer can be stopped by pressing the ALARM OFF key. At this
time, the alarm lamp switches from flashing to illuminated constantly
Warning
• The alarm, which occurs during blood pressure measurement, will be stopped by
pressing the ALARM OFF key, or when the next measurement starts.
• The alarm, which occurs during ECG, SpO2 or temperature measurement, will be
stopped by pressing the ALARM OFF key. If the condition that caused the alarm
persists after two minutes, the alarm will sound again. (The ALARM OFF mark
illuminates while the alarm is stopped.)
6-11 Storing/Deleting Data
Note
• The number of data to be stored is 400. Once exceeded, the older data will be erased to store the
newer data.
Storing the data
Data (date, systolic/diastolic blood pressure, heart rate/pulse rate, SpO2 value and temperature) is stored
each time a measurement is performed.
Storing the data using the storage cycle
When the storage cycle is set, the data (date, heart rate/pulse rate, SpO2 value and temperature) is
stored automatically at the set interval.
Note
• When the storage cycle is set, the memory function is working while the POWER switch is turned on.
Set the storage cycle to "OFF" when the memory function is not necessary.
35
Deleting the data
1. In the home display, press the
key to go to the
list display.
2. Press the
key to indicate the memory deletion
display.
3. Press the
key to cancel the deletion and return
to the list display.
4. Press the
key to perform deletion. After
deletion, the list display appears.
Caution
When deleting the data, use much care not to delete important data.
36
6-12 Power Supply
The power supply information, as shown below, appears at the lower right side of the display.
Power supply symbol
Description
The instrument is working on the AC adapter.
The instrument is working on the battery.
• The battery charge is full.
The instrument is working on the battery.
• The battery charge has decreased. Charging is required soon.
The instrument is working on the battery.
• The battery charge has been drained. Charging is required immediately.
Note
• When the instrument detects the decrease of the battery capacity, the battery mark flashes and the
buzzer sounds.
6-13 Printing the Measurement Data
Caution
Cutting the paper forcibly or during printing may damage the print head.
Auto printing
When "List" or "Trend" is selected for "Auto print" in the setting mode, printing is performed
automatically each time blood pressure is measured and at the preset storage cycle. Printing at the
storage cycle is not available when the storage cycle is set to "OFF".
When "Graph" is selected for "Auto print" in the setting mode, printing is performed automatically each
time blood pressure is measured.
Memory printing
When the LIST key is pressed in other than the list display, a maximum of 10 of the newest data in the
list display is printed.
When the LIST key is pressed in the list display, a maximum of 10 data displayed in the list display is
printed.
When the LIST key is pressed and held for 3 seconds or more in any display, all the data stored in
memory is printed.
To cancel the on-going printing, press the LIST key.
37
Printing the ECG waveform
When the ECG RECORD START/STOP key is pressed in other than the setting mode display, an ECG
waveform of 16 seconds is printed. It takes about 30 seconds to print it out.
With the waveform, the date, time and HR (heart rate), taken when the ECG RECORD START/STOP
key is pressed, is printed.
The waveform for calibration is printed at the beginning and end of the waveform data. (The waveform
for calibration indicates that for 1mV.)
The printing speed is fixed to 25mm/sec. And the printing is performed at the same gain as the display gain.
To cancel the on-going printing, press the ECG RECORD START/STOP key.
Print sample
List printing
Prints the measurement data in tabular form.
Highlights the alarmed data.
Graph printing
Prints the measurement data in graph form.
Highlights the alarmed data.
The dotted lines indicate the systolic and diastolic
blood pressures.
38
Trend printing
Prints the measurement data in trend form, using the
symbols below:
= Systolic, Diastolic
= SpO2, x = heart rate/pulse rate, + = temperature
ECG waveform
39
6-14 Function Setting
Here, the function setting procedure is described.
Note
• The settings can be changed to suit to the operating environment.
• Turning off the POWER switch during the setting operation will cancel the operation.
Setting procedure
1. While holding down the QUICK SETTING key, turn
on the POWER switch to indicate the function
setting display. The selected item is highlighted.
2. Press the
or
key to select the item.
3. Press the
or
key to change the value.
4. Press the HOME key to store the setting. "Now
saving" appears, and then the display returns to
the previous display.
5. Turn off the POWER switch. Next time the
POWER switch is turned on, the instrument
functions as specified in the system settings.
40
No.
S00
Setting item
Station address
Setting range
0-98 (0)
Description
To connect an option.
To connect an option.
S10 Communication mode
1-10 (1)
To be selected, depending on the option.
1200, 2400, 4800, To connect an option.
S11 Baud rate
9600, 19200, 38400 To be selected, depending on the option
To connect an option.
S12 Data bit
7, 8
To be selected, depending on the option
To connect an option.
S13 Stream mode
OFF, ON
To be selected, depending on the option
Whether to retain the previous data or not
S21 Previous data hold
OFF, ON
when the POWER switch is turned off.
"ON" to retain.
Sets the number of ECG pulse rate data
S22 Averaging pulse
1, 4, 8
for moving average.
Whether to use an exact-time measurement
Just
in
time
S23
OFF, ON
for blood pressure or not.
measurement
"ON" to use.
Whether to sound an alarm when the
S24 Sensor removal alarm
OFF, ON
sensor removal is detected.
"OFF" not to sound.
Specifies whether to display, heart rate or
pulse rate and pulse sound.
AUTO, ECG, SpO2,
"AUTO" to sound pulse in synchronization
S25 Heart rate -pulse
NIBP
with the pulse detected according to the
order of precedence.
Underlined items: Default settings
41
7. Maintenance
7-1 Cleaning
Caution
• Before cleaning, turn off the power and remove the AC adapter.
• Do not pour water on the instrument or use water for cleaning. This instrument is not
waterproof.
• Do not sterilize the instrument by gaseous sterilization or using an autoclave.
• Do not use solvents such as thinner and benzine for cleaning. That may deform or
discolor the instrument.
Clean the instrument as described below:
Clean the instrument exterior with a dry soft cloth.
If the instrument is stained with blood, chemical substance, or dirt, wipe the instrument off using a cloth
dampened with a mild detergent.
For cleaning a patient's body site to apply a sensor, follow the procedure of each hospital.
To disinfect the cuff, wipe the surface which comes into contact with the skin with alcohol such as 70%
isopropyl. Do not wash the cuff.
Discard the disposables after use. To disinfect the optional SpO2 sensor or the extension cable, use
alcohol such as 70% isopropyl or bleach diluted by 10%.
Wipe the ECG extension cable and ECG patient cable with alcohol such as 70% isopropyl.
42
7-2 Calibration
This is a precision instrument. Perform a checkup periodically.
Checking the pressure accuracy
Connect the pressure generator and the manometer to the instrument as shown in the illustration.
Use the optional 500-cc cylinder or the cuff wrapped loosely around a cylinder.
500-cc cylinder
(Cuff)
Instrument
Manometer
(Mercury
sphyg-momano
Pump
(Rubber ball)
While holding down the HOME key, turn on the POWER switch. "M01" appears at the upper left of the
display.
Press the NIBP START/STOP key to be in the pressure calibration mode. The pressure value appears in
the SYS/DIA display. Pressurize to 200 mmHg, and then 100 mmHg, using the pump. Compare the value
displayed on the instrument with the pressure displayed on the manometer. The difference should be
within ±4 mmHg.
Turn off the POWER switch.
Checking the exhaustion speed
Connect the optional 500-cc cylinder or the equivalent to the instrument as shown in the illustration.
Instrument
500-cc cylinder
(Equivalent)
While holding down the HOME key, turn on the POWER switch. "M01" appears at the upper left of the
display. Press the
key to display "M02".
Press the NIBP START/STOP key to start constant exhaustion. The pressure value appears in the middle
left display and the exhaustion speed in the lower display. The exhaustion speed displayed after checking
should be 50±20 (5.0±2.0 mmHg/sec).
Turn off the POWER switch.
If the accuracy can not be obtained, contact your nearest A&D sales representative for inspection.
43
7-3 Assembling the Cuff
Replacing the cuff cloth
Insert the rubber hose completely into the cuff cloth. From the
bladder opening, pull out the bladder with the rubber
hose.
After replacing the cuff cloth, put back the bladder and
the rubber hose through the bladder opening. Pull out
the rubber hose through the rubber hose opening.
Be sure to pull out all of the rubber hose. Otherwise, when
pressurized, the bladder may inflate at the opening and
burst.
7-4 Disposing of the Instrument
When recycling or disposing of the instrument, follow the local regulations.
Battery
When disposing of the used battery, insulate the battery lead connector with tape and follow the local
regulations.
Cuffs and sensors
The cuffs and sensors used by the patient may cause infection. Dispose of them as medical waste.
Built-in lithium battery
When disposing of the instrument, remove the built-in lithium battery.
When disposing of the battery, insulate it with tape and follow the local regulations.
7-5 Before Asking for a Repair
Before asking for a repair, check the instrument error codes in "7-6 Error Codes" or read "Appendix A:
Measuring Principle" to see whether the measurement was performed correctly.
If normal operation of the instrument cannot be recovered even after these actions have been taken,
contact the agent where you purchased the instrument or the nearest A&D sales representative.
Caution
Only qualified service personnel are allowed to open the case to repair the instrument.
Do not attempt to open the instrument.
44
7-6 Error Codes
When the instrument detects an erroneous measurement condition, the following error codes are
displayed.
Error code
Symptom
Blood pressure related errors
Zero point error in the pressure
E00
sensor circuit
E11
Can not pressurize.
E12
Pressurizing speed is too slow.
E13
Pressurizing speed is too fast.
Measurement time is too long.
Constant exhaustion speed is
too slow.
E22
Exhaustion speed is too fast.
E23
Excessive pressure is detected.
E42
Insufficient pressurization
E43
No pulse is detected.
E44
Physical movement is detected.
The diastolic blood pressure
E45
cannot be determined.
The mean blood pressure
E46
cannot be determined.
The systolic blood pressure
E48
cannot be determined
The pulse rate cannot be
E61
determined.
The blood pressure value is
E63
inappropriate.
SpO2 related errors
E30
SpO2 self test error
E31
SpO2 sensor error
ECG related errors
E35
ECG self test error
E36
Defective ECG circuit
Other error
E80
System error
E21
Remedy
Exhaust air from the cuff and turn on the power
again.
Check the cuff and hose for correct connection or
check them for being folded.
Confirm that the patient setting is correct. (Adult,
Neonate)
Check the cuff and hose for correct connection or
check them for being folded.
Check the cuff for correct placement or check the
patient for physical movement or for irregular pulse.
Turn on the power again.
Confirm that the specified sensor is connected.
Turn on the power again.
Turn on the power again.
Note
• Cuffs and sensors are consumables. If a measurement error occurs frequently, they must be replaced.
Refer to "8 Accessories/Options" for detail information.
• When the optional expansion box is connected, error codes other than listed in the table may appear.
Refer to the expansion box instruction manual for details.
45
8. Accessories/Options
Item
Type
Cuff (without hose)
Neonate
10 pcs.
Neonate
10 pcs.
Disposable type
Neonate
10 pcs.
Neonate
10 pcs.
Infant
Arm circumference
7-12 cm
Child
Arm circumference 10-17 cm
Small
Arm circumference 15-22 cm
Adult
Arm circumference 20-31 cm
Large
Arm circumference 31-41 cm
Spare cuff cloth 2 pcs./set (For TM9112B-1)
Hose (with connector)
1.5 m
2.0 m
2.0 m for neonates
3.5 m for neonates
ECG related
ECG electrode (150 pcs.)
ECG patient cable
ECG extension cable
SpO2 related
Durasensor (Finger clip)
Oxiband (Adult / Neonate)
Oxiband (Pediatric / Infant)
Oxisensor (Adult disposable sensor)
Oxisensor (Pediatric disposable sensor)
Oxisensor (Infant disposable sensor)
Oxisensor (Adult / Neonate disposable sensor)
Oxisensor (Nasal disposable sensor)
Dura-Y sensor
Extension cable (1.2 m)
Extension cable (2.4 m)
Temperature related
Temperature receiver unit
Temperature probe (Body surface type)
Temperature probe (Axillary type)
Power supply
AC adapter
Battery
Printer paper
Graph (5 rolls/set)
White (5 rolls/set)
Other
Table
2 cm wide
3 cm wide
4 cm wide
5 cm wide
TM9155
TM9156
TM9157
TM9158
TM9114B-1
TM9116B-1
TM9113B-1
TM9112B-1
TM9111B-1
AX-13A37452-S
TM9131-150
TM9131-200
TM9131UN-200
TM9131UN-350
AX-10502P30-S
AX-KO1924
AX-KO1839
AX-SPDS-100A
AX-SPOXI-A/N
AX-SPOXI-P/I
AX-SPMAX-A-S
AX-SPMAX-P-S
AX-SPMAX-I-S
AX-SPMAX-N-S
AX-SPMAX-R-S
AX-SPD-YS
AX-SPDEC4
AX-SPDEC8
TM2560G-10
TM2560G-12
TM2560G-11
AX-TB223
AX-HHR-21HL24G1
AX-PP157-S
AX-PP132-S
TM2560G-03
46
Appendix A: Measuring Principle
A-1 Blood Pressure
Measuring principle
Wrap the cuff around the upper arm. Inflate the cuff
to a pressure exceeding the systolic blood pressure.
Then, exhaust the air from the cuff gradually. While
the pressure is detected in the cuff in the air
exhaustion stage, the pulse waveform appears in
synchronization with the heart rate.
The pulse waveform suddenly increases near the
systolic blood pressure. It increases further with
exhaustion until it reaches the highest in amplitude,
then decreases gradually. The changes in the pulse
waveform are illustrated to the right.
The oscillometric blood pressure measurement
evaluates the point where the amplitude increases
suddenly after the pulse in the cuff pressure is
detected, as the systolic blood pressure, the point
where the amplitude reaches the highest, as the
mean blood pressure, and the point where the amplitude decreases gradually and becomes small, as the
diastolic blood pressure.
Actually, the pressure sensor detects the subtle changes in the cuff pressure with time, stores the pulse
waveform in memory, and evaluates the systolic and diastolic blood pressures according to the
oscillometric measurement algorithm.
The details in the algorithm vary with the blood pressure monitor. Blood pressure values of adults and
infants, measured by the oscillometric method, compare with those measured by the auscultatory method.
Diastolic blood pressure is defined to be the end point of phase 4 in the auscultatory method.
The pulse waveform of the cuff pressure depends on the characteristics of the cuff material. Therefore,
using the specified cuff, the measurement accuracy is maintained according to the measurement
algorithm.
The length of the hose is to be within 3.5 m, in consideration of the damping characteristics due to pulse
wave propagation.
47
Causes of errors
The pulse during blood pressure measurement is indicated in a graph,
which can be an objective indicator of the reliability in the measurement
accuracy. When noises occur due to irregular heart rhythm or physical
movements, the amplitude changes abnormally in the graph. When it
happens, blood pressure should be measured again, or be checked
using other methods. The following are the main causes of errors in
Pulse graph
blood pressure measurement.
Cuff position
The cuff should be at the same level as the heart. Otherwise, a measurement error occurs. For example,
if the cuff is 10 cm lower than the heart level, the blood pressure measures 7 mmHg higher.
Cuff size
The cuff size should be adequate. Otherwise, a measurement error occurs. The small cuff yields high
blood pressure, regardless of the proper cuff pressure or normal artery. The large cuff yields low blood
pressure, especially for those who suffer from severe arteriosclerosis or have abnormal arterial valve. The
wrong cuff size is the main reason of the big difference that occurs between the results taken by invasive
blood pressure measurement and by oscillometric blood pressure measurement.
The cuff has the area labeled RANGE on it. When attached, the cuff inner end should be within the area
labeled RANGE. Using the indicator, select the proper cuff for the patient.
The accuracy of the blood pressure monitor is guaranteed using the pressure accuracy of the pressure
sensor, exhaust characteristics and measurement algorithm, as long as the proper cuff and hose are
used.
Check the pressure accuracy of the pressure sensor and exhaust characteristics periodically as specified
in "7-2 Calibration".
48
A-2 SpO2
Measuring principle
Oxygen, bound to hemoglobin, is carried by blood. Hemoglobin that is bound to oxygen is called
oxygenated hemoglobin (HbO2), and that is not bound to oxygen is called reduced hemoglobin (Hb).
Arterial oxygen saturation is the percentage of oxygenated hemoglobin in the blood.
Arterial oxygen saturation = HbO2 / (Hb+ HbO2)
Oxygen-rich arterial blood is red while venous blood
after the oxygen has been removed is dark. The
difference in color comes from the difference in
light-absorbing
properties
of
oxygenated
hemoglobin and reduced hemoglobin. (Refer to
Figure A-1.)
A
pulse
oximeter
uses
the
difference
in
light-absorbing properties of hemoglobin to obtain
arterial oxygen saturation.
When the optical density of the body surface is
obtained optically, it is the characteristic of the
body part that includes tissue, venous blood and
arterial blood. (Refer to Figure A-2.) The area that
the optical density is pulsating due to the heart
pumping function is called the photoelectric pulse
and reflects the arterial blood properties. When
measuring the photoelectric pulse using two
Figure A-1
wavelengths, the ratio in amplitudes is obtained
temporarily as the arterial oxygen saturation.
Figure A-2
49
Causes of errors
In the pulse oximeter, adequate waveform implies
the reliability. Always check the plethysmograph or
bar graph for noises and disturbances. When
noises or disturbances occur, check the probe
Plethysmograph
connection or patient condition. The following are
the main causes of errors in arterial oxygen
saturation measurement.
Pulse bar graph
Abnormal hemoglobin
Besides oxygenated hemoglobin and reduced hemoglobin, there are carboxyhemoglobin (COHb) and
methemoglobin (MetHb). They do not carry oxygen and are called abnormal hemoglobin. Normally,
carboxyhemoglobin is about 1%. Methemoglobin is abundant in neonates, but it decreases to a negligible
level as they grow. When abnormal hemoglobin has increased due to carbon dioxide poisoning or
methemoglobinemia, a measurement error occurs. For those suffering from these conditions,
2-wavelengh pulse oximeter can not be used.
Venous pulsations
When the sensor is secured tightly with tape, the venous pulsations may be also detected and the lower
arterial oxygen saturation is obtained.
Low perfusion
When peripheral circulation disorder exists, pulses enough to detect the arterial oxygen saturation can not
be obtained. Do not secure the sensor too tightly with tape or do not place the probe at the same location
for a long period of time.
A pulse oximeter does not require calibration. Check the performance using the optional checker
periodically.
50
Appendix B: External Dimensions
TM-2560G / TM-2564G
TM-2560GP / TM-2564GP
Unit: mm
51
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