Zimmer A.T.S. 2000, Operators & Service Manual

Page: 11 / 32

9
10. Set the unit to STANDBY by pressing and holding
the ON/STANDBY touch-switch. This switch has
approximately a 2-second delay before allowing
the unit to be set to STANDBY. You must hold the
switch in for the 2-seconds before the unit will be
set to STANDBY.
2.6 DUAL CUFF OPERATION
Operation of the unit is identical to single cuff operation
(see Section 2.5) except for the following points:
1. Both dual port cuffs are connected at the bottom of
the unit.
2. Deflation of one cuff will not be permitted while the
other is inflating.
3. When inflating a second cuff with the other cuff
already inflated, the unit will continuously check the
original cuff to ensure that the pressure is within
allowable limits. The unit will stop its inflation and
maintain the original cuff to within 10 mm Hg of the
set point before returning to the inflating cuff. This
ensures that at least one cuff maintains occlusion
at all times. If there is a significant leak in the origi-
nal cuff, this feature could cause the inflation rate of
the subsequent cuff to be longer and perhaps even
cause the 30-second inflation alarm to sound.
4. At the end of the procedure one cuff, either the
MAIN or SECOND CUFF, may be deflated by
pressing the appropriate deflate touch-switch with-
out the Bier Block Safety Lock Out feature interrupt-
ing. When attempting to deflate the other cuff, an
alarm code “CUFF” “DEFL” will appear. Release the
deflate touch-switch and within 5 seconds of the
alarm discontinuing, press the deflate touch-switch
again.
Immediately upon cuff deflation, the cuff
should be removed from the patient. After the
cuff has been fully deflated and removed from
the patient, the unit can be set to STANDBY.
2.7 BIER BLOCK CUFF OPERATION, (IVRA)
Review Sections 2.5 and 2.6, SINGLE CUFF OPERATION
and DUAL CUFF OPERATION.
1. The following are suggested cuff connections:
a. The proximal cuff connected to the red outlined
MAIN CUFF connectors, using the white/red
cuff tubing;
b. The distal cuff connected to the blue outlined
SECOND CUFF connectors, using the
white/blue cuff tubing.
2. Follow the cuff inflation sequence adopted by your
institution or requested by the surgeon.
3. Deflation of a cuff is not possible while the other is
inflating.
4. At the end of the procedure one cuff, either the
MAIN or SECOND CUFF, may be deflated by
pressing the appropriate deflate touch-switch with-
out the Bier Block Safety Lock Out feature interrupt-
ing. When attempting to deflate the other cuff, an
alarm code “CUFF” “DEFL” will appear. Release the
deflate touch-switch and within 5 seconds of the
alarm discontinuing, press the deflate touch-switch
again. Immediately upon cuff deflation, the cuff
should be removed from the patient. After the
cuff has been fully deflated and removed from
the patient, the unit can be set to STANDBY.
2.8 ALARM CONDITIONS
There are a number of conditions for which the A.T.S.
2000 Tourniquet will produce a visual and/or audible alarm.
Those conditions, indications and appropriate actions are
shown in Table 2.1. The appropriate actions indicated are
based on the most probable causes and should only be
used as a guide. Other causes of alarm conditions may
indicate a need for other actions.
In addition to the conditions shown in Table 2.1, it is con-
ceivable that a malfunction could occur for which the indica-
tions are unintelligible and unpredictable. It is very likely
that the valves will be disabled causing the system to hold
cuff pressure. It is also likely that a high pitched tone will
sound under these conditions.
Most audible alarm tones may be silenced for 30 seconds
by depressing the Alarm Silence switch. The light in the
Alarm Silence switch will normally remain lit until the condi-
tion that created the alarm has been corrected. At the end
of the silenced period, tones will be re-enabled. Depressing
the Alarm Silence switch will cause the alarm tone to be
silenced again.
It is possible for more than one alarm condition to be pres-
ent. In that event, the unit will announce the alarm condi-
tions in sequence. The operator should identify the causes
of the alarms and act on the condition that presents the
most significant risk to the patient first. Note that the Alarm
Silence switch will silence the audible tones associated with
multiple alarm conditions in the same manner that it does
for single alarm conditions.
To minimize nuisance pressure alarms that can be caused
by vigorous movement of the patient’s limbs, a 1.5 sec-
ond delay has been designed into the tone generator. The
Alarm Silence light will still turn on during the 1.5 second
period.
Under certain conditions, such as when a FAIL indication
appears in the TIME display or the information that ap-
pears in the TIME and PRESSURE display is unintelligible,
the operator should conclude that a hardware failure has
occurred, rendering the unit unusable. The appropriate
action is to set the unit to STANDBY by pressing and hold-
ing the ON/STANDBY touch-switch until the unit is set to
STANDBY. Since this removes power from the internal
instrument circuitry and all instrument functions, com-
mands to the valves and pump will cease. This should
cause the cuff to hold pressure (in the absence of
leaks). Clamp the cuff lines with hemostats and replace the
tourniquet. FAIL conditions can only be reset by setting the
unit to STANDBY. In the event that a FAIL shutdown was
caused by transient condition, it may be possible to resume
normal operation by setting the unit to STANDBY then back
on again. Please read the special CAUTION note in Section
2.5
2.8.1 PRESSURE ALARMS
A pressure alarm “LO-P” will occur when the pressure in
a cuff is more than 15 mm Hg from the pressure set point.
A cuff can have a leak that is substantial but which the unit
can compensate for by continual pumping and maintain cuff
pressure within the 15 mm Hg set point window. This type
of leak could be due to a pin hole in a cuff bladder, or loose
pneumatic/hose fitting(s). This type of leak could progress
into a total failure of a cuff if not corrected. The operator is
alerted to a substantial leak by “LEAK” in the cuff pressure
display. Should a “LEAK” be detected, all connections must
be checked for leaks and fixed and/or replaced.