Zimmer A.T.S. 1200, Руководство оператора и сервисное руководство

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the default every time the machine is turned on.
2. Default Time Limit
a) The Default Time Limit is selected by pressing and
holding the TIME button for at least 2 seconds.
When the default mode is entered the audible alarm
beeps and a “D” is displayed in the first position on
the TIME display.
b) The Default Time Limit is modified via the
ROTARY knob and can be set between 5 and 240
minutes in increments of 5 minutes.
c) After the correct value is selected, it is saved by
momentarily depressing the TIME button or it will
be saved automatically in 3 seconds.
d) The new default value will be displayed for 1.5
seconds and the audible alarm will beep once
signifying a new default value has been stored.
The new time limit default will be stored and remains
the default every time the machine is turned on.
NOTE:
The elapsed inflation time can be “zeroed” at
any point in the procedure by pressing the TIME and
PRESSURE buttons simultaneously.
2.6 SINGLE CUFF OPERATION
1. Press the ON/STANDBY button to turn the unit on. The
unit will execute a self-check diagnostic test as
described in Section 2.4 of this manual. Successful
completion of the self-check indicates the unit is ready
for use.
CAUTION:
If a connected cuff is pressurized to
50 mm Hg or more during power-up, the A.T.S. 1200
Tourniquet will declare it an abnormal start-up sequence.
It will assume that a surgical procedure is in process,
and will adopt the pressure sensed in the cuff as the
new
set point
. It will automatically go into the regulate mode
on the cuff. To alert the operator of this condition, the
unit will sound a tone and display a “CUFF” “INFL”
alarm. The operator should immediately check the
pressure set point and readjust to the proper set point if
necessary. The alarm will be cleared as soon as the set
point is examined (PRESSURE button pressed).
2. Connect a single port cuff to the unit at the Main cuff
connector (
red port).
3. The default settings for cuff pressure and time limit are
retrieved from the nonvolatile memory during power up.
For each patient, tourniquet pressure required to
occlude blood flow to operative site should be set to the
minimum effective pressure. The minimum effective
pressure should be determined by factors such as:
whether the cuff is to be applied to an upper or lower
limb; whether the limb is normal, hypertrophied, or
obese; the patient’s preoperative systolic pressure; and
the maximum anticipated rise in systolic pressure during
the procedure.
4. Prepare the patient in accordance with your established
procedures and cuff manufacturer’s instructions. The
precautions of Section 1 and the following are offered as
a guide to assist in this process.
In most cases a tourniquet cuff should be applied to
the widest part of the limb to allow as much tissue as
possible to lie between the cuff and any nerves or
vascular structures susceptible to damage. The optimum
positions are the upper arm and the proximal third of the
thigh. In certain cases of fore-foot surgery, the
tourniquet cuff can be applied around the calf or to the
area proximal to the malleoli. For emergency surgery of
the hand, a sufficiently small tourniquet can be fitted
around the wrist.
Apply a leak-free tourniquet cuff smoothly without
wrinkles. The valve port and hose connections should be
placed so that the hose will not be kinked when the limb
is positioned for surgery. The viability of the skin and
deeper tissues should be established prior to
exsanguination of the limb and tourniquet inflation.
Exsanguinate the limb by elevating it for a minimum of
2 minutes and wrapping it, distal to proximal, using an
Esmarch, Martin, or elastic bandage. The bandage
should come up approximately to 1 in. (2.5 cm) from the
edge of the tourniquet cuff. The elastic bandage is
removed following inflation of the cuff. If regional
anesthesia is being used, the anesthetic agent or nerve
block is then administered. The tourniquet time depends
greatly on the patient’s anatomy, age, and absence of
vascular disease. The surgeon will determine:
1) When the tourniquet is to be inflated;
2) What pressure is applied;
3) How long the tourniquet is applied;
4) Whether to allow for intermittent aeration of
tissue by deflating the cuff for 10 to 15
minutes;
5) To what point in the operation the tourniquet
should be released.
In many operating rooms, it is customary to
prominently note the time of inflation, and to warn the
surgeon after a certain time has elapsed. This will allow
the surgeon to assess the need for further tourniquet
time.
There is a general agreement that, for reasonably
healthy adults, 2 hours should not be exceeded without
releasing the tourniquet to allow the underlying tissue to
breathe. During this time, the limb should be elevated to
about 60 degrees, and steady pressure should be applied
to the incision with sterile dressings.
5. The cuff is inflated by pressing the red MAIN CUFF
INFLATE button. The unit will pressurize the Main cuff
to the set pressure and start the time limit (inflation)
clock. The MAIN CUFF INFLATION indicator will
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A.T.S. 1200 TOURNIQUET SYSTEM