Mainline Medical TOF-Watch S, Operator'S Manual

Page 1: ...TOF Watch S Organon Ireland Ltd Drynam Road Swords Co Dublin Ireland Operator manual ...

Page 2: ... 23 Bedienungsanleitung Seite 43 Manual del usuario página 63 Registered trademark in one or more countries Scheme of buttons and display symbols Schéma des touches et symboles d affichage Tastaturübersicht und Displaysymbole Esquema de los pulsadores y símbolos ...

Page 3: ...rm position 9 3 8 Connection to stimulator 9 3 9 Skin resistance 9 3 10 Control twitch height 10 3 11 Calibration 10 3 12 Sensitivity 10 3 13 Stimulation units 10 4 Survey of functions 10 4 1 General functions 10 4 1 1 Stop on off button 1 10 4 1 2 Secondary function button 4 11 4 1 3 Calibration button 22 11 4 1 4 mA µC up 21 and down buttons 23 11 4 1 5 Timer function 12 4 2 Primary functions 12...

Page 4: ...7 Further information 18 7 1 Cleaning 18 7 2 Unusual patterns 18 8 Error signals 19 9 Accessories 19 10 Technical specifications 20 11 Symbols 20 12 Warnings 21 4 TOF Watch S Operator manual 33 516 A ...

Page 5: ...rnal error symbol Stimulation beep symbol Acceleration transducer symbol Resistance too high symbol Needle electrode symbol Timer stimulation symbol Stimulation mode indication Frequency symbol Micro coulomb symbol Milli ampères symbol Value for TOF ratio Twitch height PTC or stimulation current Percent symbol used for TOF ratio or Twitch height mA µC up button Calibration button mA µC down button...

Page 6: ...ransmission during surgery or in the intensive care unit by means of acceleromyography The TOF Watch can also be used as a peripheral nerve stimulator Moreover it can be used to localize nerves for loco regional anesthesia The TOF Watch should only be operated by trained medical personnel Before operation please refer to the Warnings in chapter 12 1 3 Actions upon delivery Upon delivery of the TOF...

Page 7: ...s cable is inserted in the TOF Watch the instrument automatically reverts to the loco regional anesthesia mode Since only a visual assessment of the response is needed no responses are shown on the display 1 Connect special stimulation cable to the TOF Watch 2 Place the surface electrode in position 3 Turn TOF Watch on by pressing the button 1 and holding it down for 1 s 4 Start the repetitive 1Hz...

Page 8: ... outlet is not possible because of a mechanical barrier 3 4 Electrodes When monitoring neuromuscular transmission the TOF Watch should always be used with round surface electrodes with snap connection Small pediatric electrodes are advisable to obtain a sufficient current density In order to ensure a steady quality of the test be sure only to use CE marked electrodes 3 5 Electrode placement Accele...

Page 9: ...that the display shows the stop symbol 7 before touching the electrodes The proximal electrode is usually connected to the white Positive clip on the stimulator cable The distal electrode should be connected to the black Negative clip If both electrodes are near the wrist the polarity is less critical The stimulation pulses are monophasic Switching the electrode connection exchanging with may some...

Page 10: ...ch the TOF Watch starts to display the responses 3 13 Stimulation units The TOF Watch can show the strength of the electrical stimulation in both milli ampères mA and micro coulomb µC For routine monitoring the default setting is in mA for use in loco regional anesthesia the default setting is in µC It is possible to change between the two modes in the Set up menu see page 15 4 Survey of functions...

Page 11: ... stimulation When not desired be sure to switch off the stimulation beep in cases where beeps from other operating equipment are more important e g heart monitoring systems 4 1 3 Calibration button 22 long Starts calibration adjust gain to 100 control twitch height or returns to standard gain Notes Calibration is only possible when the symbol is shown in the display If flashes after completion of ...

Page 12: ...t down procedure will be initiated and indicated on the display 4 2 1 Train Of Four stimulation press 3 short Starts one TOF stimulation on demand long Starts repetitive TOF stimulation TOF stimulation occurs in 15 second cycles The numeric display shows the train of four ratio in if all 4 responses were detected When less than four responses are detected or if the first twitch is less than 20 onl...

Page 13: ... the TOF Watch automatically switches to TOF mode after 5 s The TOF Watch automatically prevents the use of the PTC button for 2 minutes after successful operation of PTC If activated before the time out period has expired an information beep will sound PTC will be shown flashing for 5 s if no other test is running and the TOF Watch automatically reverts to its original mode 4 3 Secondary function...

Page 14: ... The TOF Watch automatically prevents the use of DBS and TOF for 20 s after the last DBS 4 3 3 0 1 Hz stimulation button first press 4 then 24 Starts repetitive 0 1 Hz stimulation The third secondary function is the 0 1 Hz stimulation The display shows the twitch height of the last response However this is only valid when the TOF Watch has been calibrated If not the flashes together with and an in...

Page 15: ...ze twitch height percentage manually Sensitivity can be adjusted between 1 and 512 where 512 represents the most sensitive setting Sensitivity setting 157 is the default sensitivity Changing sensitivity invalidates any previous calibration of the TOF Watch 5 Set up menu The set up menu can be activated and manipulated using the buttons described below mA µC up 21 and down buttons 23 Press both mA ...

Page 16: ...e stimulation pulse width can be selected to 200 or 300µs Surface electrode stimulation flashing stimulation size 50 mA Default surface electrode stimulation strength can be adjusted between 0 and 60 mA 0 and 12 18 µC Needle electrode stimulation flashing stimulation units µC Needle stimulation strength shown in micro coulomb mA Needle stimulation strength shown in milli ampères Needle electrode s...

Page 17: ...lectrode 13 flashing Skin resistance too high Set up Indicates set up of stimulation strength for needle electrodes Stimulation in progress 14 Time to next stimulation 14 µs µs used when changing stimulation pulse width 25 Hz Frequency of stimulation pattern 16 µC µC used when changing the stimulation strength DBS LA and if no acceleration transducer is detected 17 mA mA used when changing the sti...

Page 18: ...sive cleaners as these will damage the surface Do not allow liquid to enter the case 7 2 Unusual patterns Persisting responses Direct stimulation If the thumb is influenced by direct stimulation of the muscles under the stimulation electrodes this can result in an apparent response which does not disappear To eliminate this phenomenon the hand must be fixed in such a way that the muscle stimulatio...

Page 19: ...es Skin resistance too high Flashing bad needle electrode connection symbol 13 All modes Missing or bad electrode connection Flashing needle electrode symbol 13 All modes Skin resistance too high Both symbols flashing simultaneously 12 13 All modes No stimulation cable connected to TOF Watch Battery empty symbol 8 All modes Battery empty Internal error symbol 9 All modes Internal error detected 9 ...

Page 20: ...e width Needle electrodes Constant current 0 6 mA or 0 0 24 µC up to 5 kOhm Monophasic 40 µs pulse width Acceleration transducer Acceleration transducer accuracy 5 of full scale value Battery 9V Alkaline or NiCd 6LR61 6AM6 Supply voltage 9V 110 mA max Type BF Weight Approximately 250 gram with battery Dimensions 200 x 90 x 50 mm Safety Complies with IEC601 1 EMC Complies with EMC directive 89 336 ...

Page 21: ...or electrodes and possible damage to the stimulator Operation in close proximity e g 1 m to short wave or micro wave therapy equipment may produce instability in the stimulator output Do not stack the TOF Watch directly on top of other electronic equipment If stacking is necessary observe the TOF Watch to verify normal operation before applying it to the patient Patients with nerve damage Bell s p...