Accurate Technology Digi-Stop Manuel d'instructions télécharger pdf (Page 2)

another function is selected. The train-of-four pulses can be repeated as often as one wishes without waiting for ten

seconds. Immediately after the train-of-four pulses, depress the STANDBY button and then the TOF button again.

This cycle can be repeated as often as needed.

3.9 The BATTERY button when depressed will display the voltage of the battery on the digital display. This enables

the user to check the condition of the battery before using the instrument. The instrument will function properly

when the battery voltage is in the range of 7.0 to 9.5 volts.

4.0 INDICATORS

4.1 The Pulse LED will flash RED each time an output stimulus pulse is generated. It is located to the right of the

digital display and is labeled as Pulse.

4.2 An audible click will be heard each time an output stimulus pulse is generated. This enables the user to verify

that the unit is stimulating without observing the Pulse LED.

4.3 The Battery Voltage will be indicated on the digital display when the Battery button is depressed. See Section

6.0 for battery replacement.

4.4 The digital display is a three digit liquid crystal display (LCD) that displays the current delivered to the patient in

milliamperes (mA). Knowing the precise current setting is important in applications such as nerve locating or

detecting fault conditions. Since the digital display measures the actual current delivered to the patient, a number of

fault conditions can be detected by observing the LCD. One fault condition is a broken leadwire. Since current

cannot flow through an open circuit, any leadwire which breaks connection with the patient will cause the digital

display to indicate all zeroes (i.e. no current flowing to the patient). This is an important feature because a total lack

of twitch of the hand due to a broken leadwire could mislead the anesthesiologist to believe that the patient is 100%

blocked. A quick glance at the digital display can confirm what is happening and significantly add to the

anesthesiologist's confidence that a proper connection is made with the patient. A second fault condition is shorted

leadwires. A large increase in the current displayed could indicate that the leadwires are shorted together, possibly

due to the alligator clips touching or the gell from the gelled pads flowing together. A shorted leadwire causes the

current to bypass the patient and even though the current displayed is higher, the patient may not be receiving

sufficient stimulus. The end result of shorted leadwires is the same as broken leadwires which is no or greatly

reduced twitch response.

5.0 OUTPUT JACKS

5.1 There are three output jacks located on the rear panel of the instrument case. Their colors are RED (HI), BLACK

(COM) and YELLOW (LO).

5.2 The common output jack is BLACK (COM). This is the negative output and should always be connected to the

leadwire with the BLACK plug. It is labeled as COM.

5.3 The RED (HI) jack is the high positive output. The leadwire with the RED plug should be connected to the RED

(HI) jack for use with gelled electrodes. This output can deliver (with a fresh battery) approximately 70 mA into a

2000 Ohm load. It is labeled as HI. The HI output should never be used with a needle electrode.

5.4 The YELLOW (LO) jack is the low positive output and is used with a needle electrode when performing nerve

block procedures. The low output can deliver up to approximately 6 mA into a 2000 Ohm load. An important feature

of the low output is that one is able to select precise current settings in 0.1 mA increments. It is labeled as LO.

6.0 BATTERY REPLACEMENT

The battery is easily replaced by turning the instrument over and removing the battery cover, unsnapping the old

battery and snapping in a fresh one. The battery should always be replaced with a 9 volt alkaline battery. Battery

voltage can be monitored by depressing the Battery button on the front panel and observing the voltage indicated on

the digital display. Although the instrument will operate satisfactorily down to approximately 6.5 volts, the stimulus

output current decreases rapidly below this voltage. Therefore, the battery should be replaced at a voltage level no

lower than 6.5 volts.

7.0 APPLICATION NOTES (monitoring of neuromuscular function)

7.1 LEADWIRE ATTACHMENT WHEN USING GELLED ELECTRODES

The leadwire with the BLACK plugs should be plugged into the BLACK (COM) jack located on the rear panel of the

instrument and the leadwire with the RED plugs should be plugged into the RED (HI) jack located adjacent to the

BLACK (COM) jack. Gelled electrodes should be placed in line with and over the ulnar nerve. The distal (negative)

electrode should be placed at the level of the proximal flexor crease of the wrist. The electrode pair should be placed

directly over and parallel to the flexor carpri ulnaris tendon.

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