Amrex SynchroSonic US/54 Series User manual

*Federal law (USA) restricts this device to sale by or on the order of a licensed practitioner licensed by the law of the state in which
he practices to use or order the use of this device.
User's Guide
SynchroSonic
US/54*
Amrex
®
electrotherapy equipment
a division of Amrex-Zetron, Inc.

SynchroSonic US/54 User's Guide
Revised February 2014
AMREX®electrotherapy equipment
a division of Amrex-Zetron, Inc.
7034 Jackson Street
Paramount, California 90723
[phone]
Toll Free Customer Service [phone]
Fax [phone]
E-Mail: [email protected]
Web Site: http://www.amrexusa.com
Copyright © Amrex-Zetron, Inc. 1995. All rights reserved.
Printed in the United States of America
The following are registered or trademarked by Amrex:
Amrex®
SynchroSonic®
QuickConnect™
Flextrode®

i
Thank you. . .
for selecting the Amrex SynchroSonic US/54. We believe that you will find this
instrument to be versatile, dependable and user friendly. The SynchroSonic
US/54providestwowidelyusedtherapeuticmodalities:LowVoltAC Stimulation
and Ultrasound. Each modality may be applied separately or the Ultrasound may
becombinedwithLowVoltACStimulationsimultaneouslythroughthe ultrasound
transducer.
Your SynchroSonic US/54 has been manufactured by a group of dedicated, highly
trainedemployeeswhoexemplifytheAmrextradition,since1935,ofmanufacturing
therapeutic equipment of the highest quality while supporting you with prompt,
courteous customer service.
Upon receipt of your SynchroSonic US/54, verify your accessories against the
enclosed check list. Promptly return the postage paid Registration Card toAmrex.
Savetheoriginalshippingcartonandallpackingmaterials.
Please carefully review this User’s Guide prior to operating the SynchroSonic
US/54. Should you have any questions regarding your new purchase, or need
assistance, telephoneAmrex Technical Services at [phone].

ii
Limited Warranty
Amrex-Zetron, Inc. (Manufacturer) warrants each instrument it manufactures to be free from
defects in material and workmanship under normal use and service for a period of two (2) years
from the date of purchase. This two year warranty extends only to the original purchaser and
shall not apply to batteries, fuses, accessories or any instrument which has been subjected to
misuse, neglect, accident or abnormal conditions of operation.
There is a one (1) year warranty on the ultrasound transducer and cable.
The Manufacturer's obligation under this warranty is limited to repairing or replacing, at the
Manufacturer's option, any instrument returned to the factory within two (2) years from the date
of purchase. If the Manufacturer determines that the product fails to conform to this warranty
duetomisuse,alterationorabnormalconditionofoperation,includingevidencethatnonauthorized
personnel have attempted to repair the device, the instrument will be repaired at customers
expense. This warranty is exclusive and in lieu of all other warranties, expressed or implied,
including but not limited to any other warranty of merchantability or fitness for any particular
purpose. Manufacturer shall not be liable for any special, incidental or consequential damages,
whether in contract, tort or otherwise.
Service and Shipping Information
AmrexTechnical Serviceshasarepresentativetoassistyou shouldyourequipmentrequire service
or repair. It is necessary to obtain a Return Merchandise Authorization (RMA) number before
returning equipment to the factory for warranty repair. Call our representative toll free (800) 221-
9069.Damage, resultingfromrepairsmadeoutsidethefactory,is not coveredunder the warranty.
To maintain compliance with FDA, 21 CFR 1050.10 Performance Standards, your Amrex
ultrasound must be calibrated and safety tested on an annual basis. Amrex strongly recommends
that servicing be referred to the factory. Call toll free [phone].
Save the original shipping carton and all packing materials to safely returnAmrex equipment to
the factory for service; repair; annual calibration, electrical and mechanical safety check. All
accessories,includingtheaclinecord,mustbe includedwiththereturnedinstrument.The customer
isresponsiblefor allfreightcharges.The Manufacturershall assumeNOresponsibilityfor damage
in transit.

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Contraindications—Warnings—Precautions
THIS INSTRUMENT OPERATES ON 120 VOLTS AC, 60 Hz. (unless otherwise indicated on the
unit) AND MUST BE PROPERLY GROUNDED FOR SAFETY. The three wire power cord with
"hospitalgrade" plug should be connected to aGROUNDEDAC wall receptacle.Itisthe personal
responsibility and obligation of the user to insure that this instrument is properly connected to
the AC POWER source before use.
Important
AMREX Intensity Reset Circuit: The Amrex Low Volt AC Stimulator modality incorporates a
unique safety reset function as part of the intensity controls. This is to prevent any sudden or
inadvertent stimulation output to the patient in the event that:
•The Low Volt AC Intensity controls are not set to the 0/Reset position enabling the audible
"clicks" at power on, provided the power has been off for more than ten seconds
•The ac power is interrupted for more than ten seconds before power is restored
•The treatment period has ended and more than ten seconds has elapsed before power on
The Low VoltAC Intensity controls must be returned to the 0/Reset position enabling the audible
"clicks" before stimulation output can be activated.
OPTIONAL FEATURE (1.0/3.3) AMREX Ultrasound Intensity Reset Circuit: The Ultrasound
modality incorporates a unique reset circuit feature as a part of the intensity control. The
ultrasound output will be disabled in the event that:
•The Ultrasound Intensity control is not set to the 0position at power on
•The ac power is interrupted
•The treatment period has been completed and the bell has sounded
•Thethe UltrasoundFrequency switch setting is changed during treatment
The Ultrasound Intensity control must be returned to the 0position before ultrasound output
can be activated.
Patient "Treatment Stop" Switch: When the patient "Treatment Stop" switch is activated, stimulator
output will be discontinued immediately. The Stimulator Reset Intensities indicator light will
illuminate. StimulatoroutputcannotberesumeduntiltheLowVoltACIntensitycontrolsforChannel
A and Channel B are returned to the 0/Reset position enabling the audible "clicks" which will
turn off the Stimulator Reset Intensities indicator light. NOW the stimulator output can be activated.
Warning–Risk of burns and fire. DO NOT use near conductive
material such as metal bed parts or innerspring mattresses. Renew
electrode cables upon evidence of deterioration. Use of controls,
adjustment,or performanceofprocedures,otherthan those specified
herein, may result in hazardous exposure to ultrasonic and/or
electrical energy.

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Ultrasound—Contraindications
Ultrasoundshouldnotbeusedinthefollowingareas:transcerebrally;neartheheartor reproductive
organs; over viscera, eyes, ears, the spinal column, malignancies, the joint capsule in arthritic
conditions either acute or subacute, or over total joint replacements. Ultrasound should not be
used in cases of: cardiac pacemakers, pregnancy, implants, malignant or benign tumors, multiple
sclerosis, arteriosclerosis or weakened blood vessels, hemophilia, thrombosis and thrombophle-
bitis either acute or subacute. Neither should ultrasound be used over bone in growing children,
where the skin suffers from any sensory impairment, nor in the area of the carotid sinus nerves,
visceralplexus or large autonomous ganglion.
Ultrasound—Precautions
Excessive doses of ultrasound can cause damage to tissue. Periosteal pain is an indication of
excess intensity. Should this occur, reduce the power and/or move the transducer more quickly
over the area being treated.
Any bleeding tendency is increased by heating because of the increase in blood flow and
vascularity of the heated tissues. Care should be used in treating patients who have bleeding
disorders.

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Electrical Muscle Stimulation—Contraindications
•Contraindicatedforpatientswithcardiacdemandpacemakers
•Should not be used on cancer patients
ElectricalMuscleStimulation—Warnings
•Long term effects of chronic electrical stimulation are unknown
•Safetyhasnot beenestablishedfortheuseofelectricalmusclestimulationduringpregnancy
•Adequateprecautionsshouldbetakeninthecaseofpersons withsuspectedheart problems
•Adequate precautions should be taken in the case of persons with suspected or diagnosed
epilepsy
•Donotstimulateoverthecarotidsinusnerves,especiallyinpatientswithaknownsensitivity
to the carotid sinus reflex
•Severe spasm of the laryngeal and pharyngeal muscles may occur when the electrodes are
positioned over the neck or mouth. The contractions may be strong enough to close the
airwayorcausedifficultyin breathing
•Electrical muscle stimulators should not be applied transcerebrally
•Electrical muscle stimulators should not be used over swollen, infected or inflamed areas
or skin eruptions
•Caution should be used in the transthoracic application of electrical muscle stimulators in
that the introduction of electrical current into the heart may cause arrhythmias
•Electrical muscle stimulators should be kept out of the reach of children
ElectricalMuscleStimulation—Precautions
Precautions should be observed:
•When there is a tendency to hemorrhage following acute trauma or fracture
•Following recent surgical procedures when muscle contraction may disrupt the healing
process
•Over the menstruating uterus
•Where sensory nerve damage is present by a loss of normal skin sensation
Some patients may experience skin irritation or hypersensitivity due to the electrical
stimulation or the conductive medium. The irritation can usually be reduced by use of
an alternate conductive medium or alternate electrode placement
Skinirritationandburnsbeneaththeelectrodeshavebeenreportedwiththeuseof electrical
muscle stimulators

vi

vii
Part 1
Overview ................................................................................................................................. 1
Part 2
Power Section......................................................................................................................... 5
Part 3
Low Volt AC Stimulator Modality ..................................................................................... 9
Part 4
UltrasoundModality .......................................................................................................... 15
Part 5
US/54 General Operation and Application Procedures ................................................. 23
General Operation Ultrasound Modality.............................................................................. 23
Application of Ultrasound .......................................................................................................25
Adverse Effects - Shortwave Diathermy Interference ........................................................26
Ultrasound—Indications ..........................................................................................................27
Ultrasound—Contraindications .............................................................................................28
Ultrasound—Precautions.........................................................................................................28
The Ultrasound Transducer.....................................................................................................29
Transducer Cable Fault Alarm System ..................................................................................29
QuickConnect Transducer Cable System (Optional Feature) ...........................................30
Dual Transducers (Optional Feature) ....................................................................................31
General Operation Low Volt AC Stimulator Modality ....................................................... 32
Application of Electrical Muscle Stimulation .......................................................................34
Adverse Effects - Shortwave Diathermy Interference ........................................................35
Electrical Muscle Stimulation—Indications ..........................................................................36
Electrical Muscle Stimulation—Contraindications..............................................................36
Electrical Muscle Stimulation—Warnings.............................................................................36
Electrical Muscle Stimulation—Precautions .........................................................................37
US/54 Combination Mode ...................................................................................................... 38
Ultrasound Modality Combined With Low Volt AC Stimulator Modality ..................... 38
Control Settings and General Operation .......................................................................38
Appendix A
Specifications ....................................................................................................................... 41
Appendix B
References.............................................................................................................................. 45
Table of Contents

viii

Overview
US/54 User's Guide 1
Part 1
AMREX
The layout of the US/54 panel is logically arranged into three major sections.
These sections are, from left to right: Power, Low Volt AC Stimulator and
Ultrasound.

2US/54 User's Guide
Part 1
In the illustration below, dashed lines surround each of the US/54's sections.
Abrief description of eachsection follows the illustration.Parts 2 through4 of this
User's Guide contain detailed descriptions.

US/54 User's Guide 3
Overview
PowerSection
UsethePowerSectiontoselectthetreatmentmodality,activatethe mainacpower
andsetthetreatmentduration.Thepowerwillshutoffand a bell will sound when
the treatment is complete
Low Volt AC Stimulator Modality Section
Settheintensitiesandmonitortheoutputoflow voltacstimulationwiththe controls
and connectors in this section of the panel. Select either pulsation, tetanize, surge
or reciprocal output using the Output Mode control. Regulate the frequency of
the pulses, or adjust the duration of the surge or reciprocal, with the Pulse/Surge
Rate control.
Ultrasound Modality Section
Set the intensity and monitor the output of ultrasonic energy with the controls,
connectorsandmeterdialinthissectionofthepanel. Selecteither non-interrupted
outputoraspecificinterruptedrateusingtheInterruptedOutputcontrol.Combine
ultrasoundoutputwithlowvoltacstimulationusingthe Combinationswitch.
Optional feature (1.0/3.3): Select either 1.0 MHz or 3.3 MHz output using the
Ultrasound Frequency switch.

4US/54 User's Guide
Part 1

Power Section
US/54 User's Guide 5
In the illustration below, dashed lines surround the US/54's power section.
Part 2
AMREX

6US/54 User's Guide
Part 2
The power section of the US/54 panel is depicted below. Items referenced with
circled numbers (1 – 2) are explained on the following page.

US/54 User's Guide 7
Power Section
1. POWER/TIMER: Controlsthe mainacpoweraswellasthetimerfor treatment.
Rotate the Power / Timer knob clockwise past the 10-minute mark and then set
it to the desired treatment duration. The ac power will shut off and a bell will
sound when treatment is completed. To initiate early shut off, rotate the Power
/ Timer knob counterclockwise to the Off position. The ac power will shut off
and a bell will sound.
2. INTERNAL POWER: (Modality Selections): Controls the secondary ac power
for each of the two modality sections:
•Ultrasound
•Stimulator
•Combination(UltrasoundandStimulatormodalities)
Activate the Ultrasound modality using the Internal Power Ultrasound switch.
The Ultrasound On indicator light (located above the upper left corner of the
Ultrasound meter)willilluminatewhentheUltrasound modalityisactivated.
ActivatetheStimulatormodalityusingtheInternalPowerStimulatorswitch.The
Stimulator On indicator light (located in the upper left corner of the Low Volt
A.C.Stimulatorsection),willilluminatewhentheStimulator modalityisactivated.
Activate the Combination mode using the Internal Power Combination switch.
The Internal Power Ultrasound and Stimulator modalities MUST be activated to
enableCombinationmodetreatment.TheCombinationOnindicatorlight(located
abovethe uppermiddleof the Ultrasound meter)willilluminateiftheUltrasound
modality, Stimulator modality, and Combination mode are activated.
The Combination mode provides for ultrasound and low volt ac stimulation
outputtobeappliedsimultaneouslythroughtheultrasound transducer. When
the Combination mode is NOT activated, only ultrasonic energy is obtained
through the transducer, even if the Ultrasound and Stimulator modalities are
both activated.

8US/54 User's Guide
Part 2

Low Volt AC Stimulator Modality
US/54 User's Guide 9
Intheillustrationbelow,dashedlinessurroundtheUS/54'slowvolt acstimulator
section.
Part 3
AMREX

10 US/54 User's Guide
Part 3
The low volt ac stimulator section of the US/54 panel is depicted below. Items
referenced with circled numbers (3 – 6) are explained on the following page.