Parks 915-BL Скачать руководство пользователя страница 14 | Manualshive

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Parks Medical Electronics, Inc.

Aloha, Oregon U.S.A.

Diagnostic Procedures

References

The following is a partial listing of standard textbooks which provide more detailed information about the
use of Doppler technology to diagnose vascular disease:

Ali F. Aburahma, John J. Bergan, Editors. Noninvasive Vascular Diagnosis: A Practical Guide to Therapy.
Springer; 2006

C. Rumwell, M. McPharlin. Vascular Technology: An Illustrated Review. Davies Publishing; 2003

Noninvasive Diagnosis of Vascular Disease. Davies, Inc; 1999

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Содержание 915-BL

Страница 1: ...ons and warnings included in this manual The 915 BL Dual Frequency Doppler is two Dopplers in one case The low frequency nominal 2 MHz precordial probe may be used to detect the passage of air emboli in the heart The high frequency nominal 8 9 MHz pencil probe is used for systolic pressures at sites where a stethoscope is not used as well as to detect blood pressures that are too low for a stethos...

Страница 2: ...2 Parks Medical Electronics Inc Aloha Oregon U S A ...

Страница 3: ...ood Pressure BP Measurements 10 Measuring Systolic Pressure 11 Lower Extremity Arterial Evaluation 11 Preoperative and Postoperative Blood Pressure BP Measurements 13 Upper Extremity Arterial Evaluation 13 Venous Evaluation 13 References 14 Maintenance and Service Cleaning the Instrument 15 Cleaning the Probes 15 Tuning 15 Routine Maintenance 15 Replacing the Battery 16 Replacing the Fuse 16 Techn...

Страница 4: ...us situation that if not avoided could result in personal injury or damage to the instrument DANGEROUS VOLTAGE Indicates a potential electrical hazard that if not avoided could result in personal injury or damage to the instrument TYPE B APPLIED PART MEDICAL EQUIPMENT Type B Applied Part complies with degree of protection against electric shock required by IEC 60601 1 Class IIa Equipment This noni...

Страница 5: ...97 DUAL FREQUENCY DOPPLER MODEL 915 BL ALOHA OREGON U S A PARKS MEDICAL ELECTRONICS INC 24 V 0 63 A FLASHING LIGHT INDICATES LOW BATTERY ON OFF ON PROBES CHARGER HEADPHONES VOLUME KEEP ON CHARGE WHEN NOT IN USE TYPE B APPLIED PART MEDICAL EQUIPMENT SUP ON CAUTERY SUPPRESSOR SUP OFF LOW HIGH DUAL FREQUENCY DOPPLER DUAL FREQUENCY DOPPLER MODEL 915 BL MODEL 915 BL SUP OFF HEADPHONE OT IN USE HARGE WH...

Страница 6: ...n the wrist for repeated blood pressure measurements Infant Adult Skinny Pencil Probe optional at additional cost Frequency 8 0 9 9 MHz Specified Diameter 1 4 in Cable length 5 ft standard The smaller probe crystal concentrates power to produce a beam with higher intensity than the standard probe providing better resolution for small vessels Flat Probes an option with kit Frequency 8 0 9 9 MHz Spe...

Страница 7: ...e Doppler in the presence of a cautery can cause interference A cautery generates sound over a wide band of frequencies that cannot be filtered by the Doppler The frequencies close to the probe frequency will be picked up by the probe wires and transmitted to the Doppler speaker Experimenting with placement of the probe cable and the Doppler can minimize cautery interference but not eliminate it T...

Страница 8: ...ical Safety Invert the 2 gel squeeze bottle and shake it downward to get the gel near the bottle opening Squeeze about inch of gel onto the tip of the probe or skin surface making sure there are no 3 air bubbles Turn the volume control all the way down counterclockwise 4 Turn the instrument on setting the control knob to the frequency of the probe 5 For normal operation turn the cautery suppressor...

Страница 9: ... probes Connect the instrument to the 3 battery charger Charging the Battery The 915 BL comes with a 24VDC 0 63 A battery charger The instrument should be connected to the battery charger after the last usage of each day Plug the connector of the battery charger into the battery charger jack on the front of the instrument 1 Plug the charger into an AC outlet use appropriate plug adapter for outlet...

Страница 10: ...space between the fourth and fifth ribs Place the patient in a supine position 1 Place the probe so that the central division of the crystals is centered in the intercostal space 2 parallel to the ribs Centering the first few inches of the probe cable in the intercostal space and taping it in place improves alignment Verify probe placement by listening for venous flow or passage of air embolus 3 A...

Страница 11: ...al and ankle blood pressures BP can be taken The values are used to calculate the ankle brachial index ABI also known as the ankle arm pressure index API The interpretation of the indices varies but the normal ratio is 1 To Obtain Ankle Brachial Indices Obtain bilateral arm blood pressures of brachial or radial artery with the Doppler using the standard 1 pencil probe Place a BP cuff on the right ...

Страница 12: ... Above knee AK using popliteal artery if readings are difficult to obtain with dorsalis pedis or 4 posterior tibial artery High thigh HT using 5 popliteal artery if readings are difficult to obtain with dorsalis pedis or posterior tibial artery Lower Extremity Segmental Pressures After Exercise Doppler segmental pressures are measured after standardized exercise reproduces a patient s ischemic sym...

Страница 13: ...cross the hand this will orient the crystals to point cephalad antegrade Use a Velcro strap or tape to hold the probe in place and anchor the cord at least one place distal 2 to the probe Upper Extremity Segmental Systolic Pressures Doppler segmental pressures are taken with an appropriately sized cuff aligned so the bladder is directly over the artery being measured Bilateral systolic pressures a...

Страница 14: ...ovide more detailed information about the use of Doppler technology to diagnose vascular disease Ali F Aburahma John J Bergan Editors Noninvasive Vascular Diagnosis A Practical Guide to Therapy Springer 2006 C Rumwell M McPharlin Vascular Technology An Illustrated Review Davies Publishing 2003 Noninvasive Diagnosis of Vascular Disease Davies Inc 1999 ...

Страница 15: ...vering over the individual cables and the outer sheath to shrink and crack With a raised temperature a severe loss of sensitivity will occur Autoclaving will void the probe warranty Tuning The Doppler unit is tuned by the manufacturer to match the frequency of the probe and the tuning of the circuit is very stable If sensitivity problems are suspected do not attempt to adjust the instrument contac...

Страница 16: ...anent damage to the instrument Carefully replace the circuit board assembly in the case 9 Replace the four corner screws 10 Replacing the Battery This device uses a 12V 1 2 Ah sealed lead acid rechargeable battery for its power source Replace with Parks Part 854 0017 01 Caution Replace only with the same size sealed lead acid rechargeable battery The use of a larger battery could cause the termina...

Страница 17: ... when connected to charger with Doppler off Battery INDICATOR lamp blinks with Doppler on and charger disconnected after charging for at least 8 hours See Routine Maintenance Replace the battery See Specifications and Replacement Parts 3 0 Hard to hear blood sounds poor signal noise ratio 3 1 Too much noise 3 1 1 Prevent feedback screeching sound Keep the probe against the skin once gel is applied...

Страница 18: ... the flange with your fingers or gently with pliers Make the flange form a smaller circle so that it grips the jacks on the Doppler panel more tightly Check for noise again 5 If there is still noise bend the cable here 6 Send the cable back to the factory for new plugs if the noise originates here Flex the cable near the crystals If the cable 7 is noisy near the transducer it cannot be repaired Re...

Страница 19: ...he speaker If there is sound in the headphones but not in the speaker with the headphones unplugged the inside of the headphone jack is probably bent Unplug the headphones 2 Remove the four screws on the outside 3 corners of the front panel and gently remove the Doppler unit from the case Turn the volume control all the way up and 4 squeeze the contacts on the inside of the headphone jack If you h...

Страница 20: ... Speaker disconnects when headphones are plugged in Parks 915 BL UN Manual Operating manual with maintenance and service section Probes Precordial Probe Low frequency specified 2 1 2 25 MHz double shielded cable 3 4 in diameter circular crystal 5 ft standard cable length Standard Pencil Probe High frequency specified 8 0 9 9 MHz 3 8 in diameter 5 ft standard OR cable length Adult Flat Probe High f...

Страница 21: ...e risk of damage to the retina Environmental Hazards Battery and Instrument Batteries must be recycled or disposed of according to your local ordinances Do not dispose of old instruments or lead acid batteries in land fills Ultrasound Coupling Gel There are no potential environmental hazards from the gels recommended for use with the probes Radio Interference This instrument is intended for use by...

Страница 22: ...been designed to prevent operation while the battery charger is connected to provide protection from electric shock 4 Do not rewire or modify the battery charging circuitry in this Doppler The battery charger must comply with the relevant national requirements EN60601 1 1990 A1 1993 A2 1995 The battery charging input circuitry must not be modified or altered in the field Changing this safety featu...

Страница 23: ... match the tuned frequency of the Doppler Specify frequency MHz when ordering Precordial Probe 19 mm 3 4 in diameter with double shielded cable All probes below are available with double shielded cable Standard Pencil Probe 9 5 mm 3 8 in diameter Skinny Pencil Probe 6 35 mm 1 4 in diameter Adult Flat Probe 15 9 mm 5 8 in x 19 mm 3 4 in Infant Flat Probe 12 7 mm 1 2 in x 15 9 mm 5 8 in Replacement ...

Страница 24: ...24 Parks Medical Electronics Inc Aloha Oregon U S A ...

Страница 25: ...e unit This exhibits an optimal coupling efficiency of 27 for the crystal transducer ONDA report T 4PME02 shows that the maximum global output power was 675 3 mW The maximum allowed by the FDA is 720 mW Parks Medical Electronics Inc is exempt from acoustical output labeling for the US market Parks has decided to provide the output power for each probe type even though it is not required Acoustic O...

Страница 26: ...26 Parks Medical Electronics Inc Aloha Oregon U S A Appendix ...

Страница 27: ...27 915 BL Dual Frequency Doppler Appendix ...

Страница 28: ...28 Parks Medical Electronics Inc Aloha Oregon U S A Appendix ...

Страница 29: ...29 915 BL Dual Frequency Doppler Appendix ...

Страница 30: ... occlusive arterial disease the color and nutrition of the leg and foot appears normal As the ischemic process becomes more severe the skin appears shiny and smooth and hair is often absent from the toes and the dorsal region of the foot Muscle atrophy loss of subcuataneous fat and pallor all indicate a severe degree of ischernia A fairly simple and accurate clinical test that can measure the degr...

Страница 31: ...sis and objective assessment of arterial disease underscores the value of the Doppler ultrasound blood flow detector Although the auscultatory method with a stethoscope is one of the most common blood pressure measurements in clinical medicine it is seldom used in the lower exremity because it is difficult to obtain the Korotkoff sounds in the distal portion of a limb especially when arterial occl...

Страница 32: ... electric voltage emits a continuous wave of ultrasonic energy at a frequency of 5 to 10 MHz which is transmitted through the skin If this sound wave is reflected back from stationary tissue interfaces the frequency of the returned signal received by the second crystal will be the same as the transmitted frequency If the sound wave strikes moving red cells the returned signal will be a different f...

Страница 33: ...he arterial signal can be detected easily 5 after gaining some experience with the instrument An objective and reproducible determination of the extent of the occlusive disease process can be made by measuring the systolic arterial pressure at the ankle 7 Standard blood pressure cuffs are placed around the ankle and the arterial flow signal is monitored in the posterior tibial or dorsalis pedis ar...

Страница 34: ...e pressure returns to normal levels The routine vascular examination should include stressing the patient with some form of exercise and measuring the arm and ankle pressure immediately after the activity using the method previously described The form of exercise which is selected will depend upon the interest requirements and resources of the physician In our clinic all patients have been exercis...

Страница 35: ... of the objective tests proper diagnosis and treatment were begun Doppler survey and ankle pressure measurements not only suggested the correct diagnosis preoperatively but also confirmed the salutory effect of the surgical procedure post operatively Patients with symptoms suggestive of claudication and intact pulses may be mistakenly treated for arthritis neuritis or emotional problems As was sho...

Страница 36: ...tion of the limb are subjective methods of evaluating complaints that may be related to arterial insufficiency Since the physician whose practice includes patients with many varying problems may feel insecure about his ability to evaluate pulses objective testing methods have a real place in the diagnostic armamentarium The Doppler ultrasonic velocity detector may be thought of in the same manner ...

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