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ResMed Nox A1, How To Use Manual

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ResMed Nox A1 How To Use Manual Download Page 18

18

Patient hook-up

3 disposable adhesive electrodes (PN 7073775)

Electrode site:

Connection to the Nox A1:

Scrub the patient’s skin with NuPrep before placing the adhesive 
electrodes.
F

 - On the midline and 1 cm above the inferior border of the mandible.

1 

-  2 cm below the inferior border of the mandible and 2 cm right  

of the midline.

2

 -  2 cm below the inferior border of the mandible and 2 cm left  

of the midline.

• 

Place the chin EMG electrodes

Equipment needed:

Connect corresponding electrodes to the inputs F, 1 and 2.

Summary of Contents for Nox A1

Page 1: ...ResMed com NoxA1 How to use your Nox A1 ambulatory recordings Noxturnal version 5 1 ...

Page 2: ...tient hook up page 14 Check signals page 26 Clean devices and accessories page 38 Score a recording Download data page 41 Analyse data page 42 Generate a report page 51 Open an existing recording page 53 Troubleshooting page 54 Consumables and accessories page 59 2 ...

Page 3: ...cannula with filter x2 Disposable RIP belts Sizes XSx1 Sx1 Mx1 Lx1 XLx1 Battery 1 5V AA x2 Battery 1 5V AAA x4 Nox A1 Recorder Nonin 3150 oximeter and SpO2 sensor size M Noxturnal software CD EEG 5 lead gold electrode cable x2 USB cable EKG and PLM cables EEG head cable ...

Page 4: ...or light 8 Pressure lock Connects to external nasal cannula mask pressure tube 9 Unipolar input EEG channels 10 Reference ground input 11 Bipolar inputs EKG and PLM inputs 12 Battery lid Covers the battery and the USB connector 13 Battery lid pin Keeps battery compartment closed 14 Metal snaps Connect to thorax RIP belt 15 Metal snaps Connect to abdomen cable Nox A1 system 5 6 5 7 14 13 9 8 11 10 ...

Page 5: ... via an extension cable Signals available with the ResMed S9 Flow Pressure Leak Signals available with the Radiometer ptCO2 SpO2 Pulse 7073481 Bluetooth Nox W7 Link Kit S Enables data transfer between the Nox A1 and SenTec Digital Monitor Can be connected to the serial port of the SenTec monitor Signals available with the SenTec ptCO2 SpO2 Pulse Pulsation Index 7073480 Differential pressure sensor...

Page 6: ...6 Nox A1 system Configure a recording Insert batteries Patient hook up Check signals Clean devices and accessories Download data Ambulatory study ...

Page 7: ...7 Configure a recording ...

Page 8: ... your computer Open the battery lid of the Nox A1 using the opening tool provided and connect the device to the USB port of the computer Configure a recording In Noxturnal software click on Recording Configure device to open the configuration wizard ...

Page 9: ...9 Step 1 Select a recording type Choose a suitable recording type from the drop down list Enter the BDA number shown on the back of your oximeter Configure a recording Click on Next to continue ...

Page 10: ...10 Configure a recording Step 2 Schedule recording Start Recording At option is recommended Select 1 The number of nights 2 The start time 3 The date 4 The duration Click on Next to continue 1 2 3 4 ...

Page 11: ...aracteristics Add at least patient s First and Last names or patient ID before finishing The Tags fields can be used to link keywords to the patient in order to easily find him later in the recordings library Use the Edit button to enter more detailed information about your patient before the hookup Click on Finish ...

Page 12: ...12 End configuration Click on Finish to close this window and disconnect the device Configure a recording ...

Page 13: ...atteries that are recommended for the Nox A1 device are 2700mAh Powerex or 2500mAh Panasonic Eneloop pro They last for 8 to 10 hours of recording Alkaline batteries are not compatible with the Nox A1 device For the Nonin 3150 oximeter 2 AAA batteries Alkaline batteries last for up to 24h It is recommended that they are replaced every 2 recordings Rechargeable batteries should be recharged complete...

Page 14: ...14 Patient hook up ...

Page 15: ...s 1 2 3 1 Clip the abdomen cable to the back of the device and snap the clips onto the patient s pyjamas 2 Wrap the RIP belt around the patient s thorax and snap it at the back of the device 3 Repeat this for the abdomen belt and snap it to the cable ...

Page 16: ...ction to the Nox A1 2 disposable adhesive electrodes PN 7075209 The EKG cable must be plugged into the bipolar EKG channel Scrub the patient s skin with NuPrep before placing the adhesive electrodes Under the right clavicle On the 7th left rib Place the EKG cable Equipment needed ...

Page 17: ...rodes PN 631526 Scrub the patient s skin with NuPrep before placing the adhesive electrodes Electrodes must be placed on the tibialis anterior muscle If needed secure the electrodes with tape and or a Surgilast net Place the PLM cables Equipment needed Connect the black cable left leg to the LM1 bipolar input and the grey cable right leg to the LM2 bipolar input ...

Page 18: ...g the adhesive electrodes F On the midline and 1 cm above the inferior border of the mandible 1 2 cm below the inferior border of the mandible and 2 cm right of the midline 2 2 cm below the inferior border of the mandible and 2 cm left of the midline Place the chin EMG electrodes Equipment needed Connect corresponding electrodes to the inputs F 1 and 2 ...

Page 19: ...ith NuPrep and attach the electrode to the forehead by gently pressing on the white ring of the electrode 3 Connect the 2 EEG lead cables as shown below 4 Pre position the cups on the head Place the EEG head cable Before attaching the electrodes it is important to properly position the ground reference of the EEG head cable ...

Page 20: ... 3 cm below the occipital protuberance and 3 cm from the midline C3 and C4 are on the pre auricular points axis and 7 cm from the midline M1 and M2 are respectively on the left and the right mastoids behind the ear F3 and F4 are 1 cm before the hair line and 4 cm from the midline Place the electrodes 10 20 system ...

Page 21: ...s gel with gauze Ten20 conductive paste PN 7073512 2 Fill the cups with Ten20 conductive paste and place them on the correct spots EC2 electrode cream PN 7073513 3 Place a small amount of EC2 cream on a piece of gauze Place the gauze over the cup and onto the patient s scalp so the cup stays in place Cotton bud and gauze Attach the EEG electrodes ...

Page 22: ... Pull the cannula tubing over the ears Slide the bolo up under the chin so it is snug but not too tight Attach the nasal cannula Connect the nasal cannula with the filter to the pressure input of the Nox A1 You can put a little piece of tape on the cannula on either cheek to hold it securely in place ...

Page 23: ...handed or on their right wrist if they are left handed 2 Then place the probe on the index finger The fingertip should reach the end of the probe but should not go past it Push the grey activation button if the device doesn t start automatically 3 Wrap tape around the finger to secure the sensor cable 1 2 3 ...

Page 24: ...PN 7072097 Mask adapter PN 26915 Connect the pressure tubing to the mask and the Nox A1 1 Insert a filter into the pressure input of the Nox A1 where you would usually insert the nasal cannula 2 Screw the male luer lock connector of the pressure tubing into the filter 3 Connect the female luer lock connector of the tubing to the pressure port of the mask adapter Set up picture 1 2 3 ...

Page 25: ...e inserted and that you are using 2 new filters 1 Connect the green part of the flow sensor to the therapy device output 2 Connect the transparent part of the flow sensor to the patient tubing 3 Connect the red and black cable to input 1 or 2 of the Nox A1 4 Connect the white cable to the black and red cable and plug it into the Airflow input of the differential pressure sensor 5 Put the gain of t...

Page 26: ...26 Check signals ...

Page 27: ...e Perform biocalibration View live signals Check Nox A1 status and parameters battery status device profile start time etc How to use Turn on the Nox A1 and open the app Check that the app is in Ambulatory Mode if needed change the app mode in the settings A list of all devices previously connected to the tablet will be displayed Find your device on the list of available devices check the serial n...

Page 28: ...x A1 Create a new recording PATIENT Enter or modify patient information CONFIG Choose recording type and recording start date and time SENSORS Check signal quality and impedance BIOCAL Perform biocalibration TRACES View live signals DEVICE View information about the device and the recording ...

Page 29: ...ion Check signals Save modifications On this tab you can Verify and or choose the recording type Enable or disable the audio playback Verify or choose the Bluetooth address of your oximeter Enter the start date and time of the recording ...

Page 30: ...placed Bad impedance value Note shows the worst rating impedance value of all EEG electrodes If the patient hook up wasn t completely finished when the Nox A1 was turned ON you should start an impedance check as indicated below to obtain a reliable value Once the global verification is complete click on the icon at the bottom left to start an impedance check and visualise the impedance of each EEG...

Page 31: ...k signals Click on Start impedance check Wait for about 10 sec for the impedances to be displayed Note ExG signal quality is degraded during an impedance check The test ends when you change tab or when you disconnect from the device ...

Page 32: ...heck signals Fair connection Bad connection Good connection Cable colour Impedance 0 5kΩ Good connection 5 20kΩ Fair connection 20kΩ Bad connection 100kΩ No contact Re attach the electrode if the impedance colour is red or black ...

Page 33: ...k of the quality of every respiratory and ExG signal Note The recording must be ON to access biocalibration Signals and events will be saved in the device and included in the night recording Click on Start recording to record signals and score biocalibration events ...

Page 34: ... expected For example Task Hold breath for 10 seconds Expected result All respiration gauges run flat Choose the biocalibration procedure You can create your own procedure using the Noxturnal software Change time base Choose signals to display Choose the biocalibration task ...

Page 35: ...35 View signals Check signals Reset default scale Automatically adjust signals scale Use two fingers to zoom in on the signals and the scale Press twice on a signal to change its height and scale ...

Page 36: ... device status and configuration Check signals Before closing the app check all information on the device tab especially Device time Scheduled recording start time Click on to disconnect the Nox A1 from the app ...

Page 37: ... turn on the device and check that The device time is correct The battery level is high enough The countdown corresponds to the recording start time Device time Battery indicator Countdown Once checks are complete the patient can go home No action from them is required ...

Page 38: ...38 Clean devices and accessories ...

Page 39: ...nt and the connectors Abdomen cable EKG PLM cable EEG head cable EEG lead Clean the gold cup electrode cables with alcohol free soap A toothbrush can be used to scrub the cups to remove paste and debris Be careful not to scrub too aggressively to avoid damaging the gold plating Oximeter 3150 Wipe the device with a soft cloth dampened with a 10 bleach 90 water solution household bleach containing l...

Page 40: ...40 Score a recording ...

Page 41: ... device to the computer using the USB cable and click on Download Recording Noxturnal automatically starts downloading and analysing data Download and analysis progress is displayed The process should take about 10 minutes Download data ...

Page 42: ...sults page The recording results page is arranged as follows 1 Patient information 2 Sleep stages 3 Severity indicator 4 Signals and events overview 5 Analysis statistics 6 Commands Analyse data 2 1 3 6 5 4 ...

Page 43: ...43 Analyse data Change patient information Click on Edit or on the patient icon to complete or modify patient information ...

Page 44: ... analysis Move the markers highlighted below to manually define the start and end of the analysis Recording statistics on the right side are automatically adjusted after every modification You will find the same markers on every signal sheet ...

Page 45: ...se data Exclude part of the recording Click and drag your mouse in the Periods area below and select Score Invalid Data To delete an invalid data period click on the red hatched area and click on Delete period ...

Page 46: ...uld be questioned On the right side of the page the Signal quality percentage shows the lowest quality rating obtained across all 4 signals Please note that if problematic areas of the study are excluded the signal quality will increase and study will be considerably improved Click on View Signals to start scoring SpO2 Quality Signal Quality Airflow Quality Abdomen Quality Thorax Quality ...

Page 47: ...gnals Click on the Signals Data tab on the right side of your screen and select the signals to display To move signals in the workspace click on them when the mouse is shaped like a hand and drag them up and down Check the boxes of the signals you want to display ...

Page 48: ...reate a workspace layout Click on and select New Workspace Layout to create a personalised layout Your new workspace layout is now in the drop down list You can load it modify it and save the changes using the menu Enter a name and click on OK ...

Page 49: ...the event and press the Delete key Hold the Alt key and click on the event Right click on the event and select the intended option To score sleep stages click on the automatically scored stage and use the numeric keypad to confirm or change it Analyse data Keyboard shortcut Event O Obstructive apnea C Central apnea M Mixed apnea H Hypopnea D Desaturation 0 Wake 1 N1 2 N2 3 N3 5 REM ...

Page 50: ...nd M2 0 3 Hz 35 Hz 70 μv cm EOG E1 and E2 0 3 Hz 35 Hz 100 μv cm EMG Chin 1 F and 1 2 left right leg 10 Hz 100 Hz 100 μv cm EKG 0 3 Hz 70 Hz Automatic Right click on the ExG signal and choose the corresponding filter in the menu Filter Filter presets You can manually adjust filter values in the menu Filter out frequencies below above ...

Page 51: ...of a recording click on the Bookmark tab at the bottom left of your screen Click on Add bookmark enter a description of the screenshot and click on OK If you don t want this screenshot to appear in the report uncheck the corresponding box or delete the bookmark ...

Page 52: ...nd generate a report Click on the patient icon and then on Interpretation Notes to access the writing window Once your interpretation is written click on OK at the bottom right to confirm Then go to the Report menu and select the appropriate report ...

Page 53: ...53 Open an existing recording Click on Library to access existing recordings Use the Search for field to find your patients more quickly ...

Page 54: ...54 Troubleshooting ...

Page 55: ...imeter Solution 2 Press the grey activation button on the left top of the oximeter for two seconds I can t connect to the Nox A1 Solution 1 Remove and re insert again the battery into the Nox A1 and try again EEG signals appear to be erroneous Solution 1 Check the signal impedance If they are red or black check the placement of the electrodes Solution 2 Check that the software filters are ON right...

Page 56: ... the USB cable into the computer 2 Open the battery door of the Nox A1 3 Push and hold the central and right buttons simultaneoustly 4 Plug the mini USB cable into the device 5 Make sure that the word Erasing is displayed on the screen of the Nox A1 Troubleshooting Reset a Nox A1 56 ...

Page 57: ... it is recommended that you follow the reset process described below 1 Remove the two batteries and disconnect the probe from the oximeter 2 Wait for 1 minute and reinsert the batteries 3 Press and hold down the grey activation button for 3 seconds until the screen turns on 4 Reconnect the probe 5 The device is now reset ...

Page 58: ...nterval of your window Automatically adjust the size of signals to fit into the window Automatically adjust the scale of each signal Open the advanced menu of the sheet Activate audio playback of the recording Open scoring menu Activate single click scoring Show or hide the top pane Show or hide the bottom pane Search for a signal or an event Go back to the previous result Go to the next result Op...

Page 59: ...59 Consumables and accessories ...

Page 60: ...istor for adult Disposable effort belts 7072086 Nox RIP Belts Disposable x20 Pediatric 7072077 Nox RIP Belts Disposable x20 S 7072078 Nox RIP Belts Disposable x20 M 7072079 Nox RIP Belts Disposable x20 L 7073504 Nox RIP Belts Disposable x14 XL Disposable adhesive electrodes 631526 Single use snap on electrodes Ambu BlueSensor N 44 8x22 mm EMG PLM x25 7075209 Single use snap on electrodes Ambu Blue...

Page 61: ...sensor for Nonin WristOx2 Large Titration option 7073482 Nox Differential Pressure Sensor Kit 7073740 Pneumoflow Sensor 7073741 Differential Pressure Connector Cable 2 m 7073745 Nox A1 Adaptor Cable for Differential Pressure 30 cm 7073743 Flow Straight Connector transparent part 7073744 Flow Straight Adapter green part 7073746 PT1 Hydrophobic Filters x50 7072092 Mask Tubing 180 cm Spare parts 7072...

Page 62: ... worldwide AirSense AirCurve and S9 are trademarks and or registered trademarks of the ResMed family of companies Nox and SenTec products are distributed by ResMed For information about the manufacturers of Nox and SenTec devices please contact ResMed authorised distributor Product availability may vary across regions Specifications may change without notice 2017 ResMed Ltd 708108 3 2018 07 ...

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