ARJO HUNTLEIGH citadel User manual

Citadel Bed Frame System
Instructions for Use
...with people in mind
830.331 Rev A • 08/2016

Design Policy and Copyright
® and ™ are trademarks belonging to the ArjoHuntleigh group of companies
unless otherwise stated.
© ArjoHuntleigh 2015
As our policy is one of continuous improvement, we reserve the right to modify
designs without prior notice. The content of this publication may not be copied
either wholly or in part without the consent of ArjoHuntleigh.

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Citadel Bed Frame System
Table of Contents
General Warnings ...........................................................................................5
•Safety Information ......................................................................................8
Introduction....................................................................................................11
•Product Overview .....................................................................................11
Clinical Applications.......................................................................................14
•Intended Use ............................................................................................14
•Indications ................................................................................................14
•Contraindications......................................................................................14
•General Product Information ....................................................................15
•Precautions...............................................................................................15
Installation .....................................................................................................16
•Weighing System Preparation ..................................................................16
•Electricity Supply ......................................................................................17
•Potential Equalization Terminal.................................................................18
•Electrical Connections .............................................................................18
•Power Cord...............................................................................................18
•Nurse Call and RS232 Connections.........................................................19
•Auxiliary Power Outlet (Optional Feature) ................................................20
•Skin IQ Family Power Cable ....................................................................20
•Skin IQ Installation....................................................................................20
•Citadel Patient Therapy System Connections ..........................................21
•Mattresses ................................................................................................21
•SafeSet™ .................................................................................................22
Operating Instructions ...................................................................................24
•Lifting Pole and Accessory Sockets..........................................................24
•Drainage Bag Rails...................................................................................25
•Bed Length Adjustment ............................................................................25
•Foot Pedal for Adjustment of Bed Height (Optional Feature) ...................27
•Brakes and Steering .................................................................................27
•Side Rails .................................................................................................28
•Head and Foot Boards .............................................................................29
•Patient Restraints .....................................................................................29
•Under Bed Light........................................................................................30
•Backup Battery .........................................................................................31
•Recharging the Backup Battery................................................................32
•Over-Use Lockout.....................................................................................32
•Attendant Control Panel (ACP).................................................................33
•Nurse Control Panel .................................................................................33
•Patient Control Panel................................................................................33
•Patient Handsets (Optional Feature) ........................................................36
•Weigh Scale Panels (With and Without Unit Selection)............................37
•Weighing Accuracy ..................................................................................38

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•Weighing Initialization ..............................................................................39
•Weighing ..................................................................................................39
•Weighing Units .........................................................................................40
•Auto Compensation ..................................................................................40
•Weighing System Error Codes .................................................................41
•Angle Indication ........................................................................................41
•VariZone Patient Movement / Exit Detection ............................................42
•VariZone Operation .................................................................................43
•Anti-Entrapment System...........................................................................44
•SafeSet™ (Optional Feature) ...................................................................45
•RS232 Connection ...................................................................................47
•Controls for Television and Lighting (Optional Feature)............................48
Patient Placement .........................................................................................49
•Power On .................................................................................................49
•Preparation for Patient Placement ...........................................................49
•Completion of Patient Placement .............................................................50
Nursing Care .................................................................................................51
•CPR ..........................................................................................................51
•CPR Backrest Release.............................................................................52
•Patient Bathing .........................................................................................52
•Patient Transfer from the Citadel Bed Frame System ..............................53
•Patient Transport ......................................................................................53
Care and Cleaning.........................................................................................54
•Deck Sections...........................................................................................54
•Decontamination.......................................................................................54
•General Recommendations......................................................................56
•Cleaning the Citadel Bed Frame System While in Use ............................ 56
Preventive Maintenance................................................................................57
•Weighing System......................................................................................58
•Battery Test ..............................................................................................58
Troubleshooting.............................................................................................59
•Error Codes ..............................................................................................60
•Fault Indications .......................................................................................61
•Product Lifetime........................................................................................61
•Accessories ..............................................................................................61
EMC Information............................................................................................62
Warranty and Service ....................................................................................66
Specications ................................................................................................67
Explanation of Symbols Used........................................................................69
Questions and Contact Information...............................................................71

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Citadel Bed Frame System
GENERAL WARNINGS
The following warnings should be considered prior to using this product:
Before using the bed, make sure that the power in rating on the
specication label is compatible with the local electricity supply.
To make sure the patient can use the bed safely, their age and
condition should be assessed by a clinically-qualied person.
The use of head down tilt (Trendelenburg) or foot down tilt
(reverse Trendelenburg) may be contraindicated for certain
medical conditions. The tilt function should only be used under
the guidance of a clinically-qualied person after assessment of
the patient’s condition.
All accessories added to the system reduce the safe working
load of the frame by the same amount.
If the power cord or plug is damaged, the complete assembly
must be replaced by authorized service personnel. Do not
remove the tted plug, or use a rewireable plug or adapter.
Make sure the power cord is not stretched, kinked or crushed.
Do not allow the power cord to trail on the oor where it may
cause a trip hazard.
Make sure the power cord does not become entangled with
moving parts of the bed or trapped between the bed frame and
head board.
Always adjust the bed frame and deck to the same length and
make sure both are latched securely in position.
Always use a mattress of the correct size and type. Incompatible
mattresses can create hazards.
Entrapment hazards may exist when using a very soft mattress,
even if it is the correct size.
The clinically-qualied person responsible should consider the
age, size and condition of the patient before allowing the use of
side rails.
Side rails are not intended to restrain patients who make a
deliberate attempt to exit the bed.
To prevent possible entrapment, make sure the patient’s head
and limbs are clear of the side rails when adjusting the deck.

6Citadel Bed Frame System
Make sure the locking mechanisms are securely engaged when
the side rails are raised.
Prior to engaging any mattress turn feature, make sure that bed
frame has side rails and that all side rails are fully engaged in
their full upright and locked position. Do not activate the turning
feature on any mattress system when patient restraints are in
use.
Patient restraints should be used in compliance with all
applicable local regulations and in accordance with the
healthcare facility’s own policies and procedures.
Patient restraints, even when correctly used, can result in
entrapment or injury, particularly if the patient is disorientated or
restless. The decision to use patient restraints must be made
by the clinician overseeing the care of the individual patient,
following a fully documented risk assessment.
Patient restraints are not intended as substitutes for good
nursing practice. ArjoHuntleigh makes no recommendations
regarding the use of such restraints.
To make sure the battery is kept fully charged and prevent
damage to the battery, the bed should be connected to the
electricity supply at all times during normal use.
The battery is intended for emergency, short term use only. Its
life will be reduced if it is used to power the bed for long periods.
Only connect devices designed to be used with the bed
Connecting devices not designed to be used with the bed may
result in damage to the equipment or to the bed.
At minimum height, clearance underneath the side rails is
reduced. Keep your feet away from the areas below the side
rails and take extra care when using patient hoists or similar
equipment.
The weighing system should only be used by staff trained in the
correct use of the weighing function.
The weighing system should only be used in closely supervised
environments, where factors inuencing patient weight (such
as additions to the bed) can be controlled as described in the
following instructions for use.

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Citadel Bed Frame System
The weighing system MUST be zeroed every time a new patient
is to be placed on the bed.
The weighing system MUST be zeroed every time a mattress is
changed.
The weighing system cannot be zeroed if a mattress or
accessories weighing more than 50 kg (110 lb) are tted.
Data retrieved from the RS232 connection is not intended to be
used to make clinical decisions. All patient diagnosis, treatment
and care should be performed under the supervision of an
appropriate healthcare professional.
The manual CPR release should only be used in an emergency;
repeated everyday use can cause permanent wear.
Disconnect the bed from the mains wall outlet before starting
any cleaning or maintenance activity. The bed will still operate
on battery power if the function has not been locked on the
Attendant Control Panel.
To prevent cross contamination or equipment damage,
ArjoHuntleigh recommends that the Citadel Bed Frame System
be cleaned during use and between patients according to the
Care and Cleaning section in this IFU. Local protocols and
regulations / procedures for blood borne pathogens may be used
provided the manufacturer’s instructions are followed.
Always disconnect the Citadel Bed Frame System from mains
wall outlet before cleaning. Failure to do so could result in
equipment damage and / or electric shock.
Do not allow uids to penetrate the Citadel Bed Frame System
control panels to avoid damage to system.
If the bed is stored for a long time, it should be connected to the
electricity supply for 24 hours every three months to recharge the
backup battery, otherwise it may become unserviceable.

8Citadel Bed Frame System
Safety Information
General Protocols – Follow all applicable safety rules and institution
protocols concerning patient and caregiver safety.
Brakes – Set all caster brakes before transferring patient.
Bed Height – To minimize risk of falls or injury, the bed should always be in
the lowest practical position when the patient is unattended.
Fluids – Avoid spilling uids on unit controls. If spills do occur, unplug unit,
clean uid from unit, wearing rubber gloves to avoid any possibility of shock.
Once uid is removed, check operation of components in area of spill.
Fluids remaining on controls can cause corrosion, which
may cause components to fail or to operate erratically,
possibly producing hazards for patient and staff.
Oxygen Use - Make sure that the unit is not contained in an oxygen
enriched environment. Possible re hazard when bed is used with oxygen
administering equipment other than the nasal prongs, mask or half bed
length tent type. Oxygen tent should not extend below mattress support
level.
Lock-Outs – Lock-outs for bed functions should be used at staff’s discretion
to prevent unintentional operation of bed.
Power Cord – Make sure power cord is kept free from all pinch points,
moving parts and is not trapped under casters. Improper handling of power
cord can cause damage to the cord, which may produce risk of re or electric
shock. Pull the power cord out of the mains wall outlet to remove power from
the unit.
Avoid Fire Hazards – To minimize the risk of re, connect the unit’s power
cord directly into a wall-mounted outlet. Do not use extension cords or
multiple outlet strips. In the US, review and follow FDA’s Safety Tips for
Preventing Hospital Bed Fires. Outside the US, consult the local Competent
Authority or Government Agency for Medical Device Safety for specic local
guidance.
Disposal – At the end of useful life, dispose of waste according to local
requirements or contact the manufacturer for advice. There may be special
requirements for disposal of batteries, leaded foam and / or angle sensors (if
present in this product). Improper disposal of any component may result in
regulatory non-compliance.
Moving Parts - Keep all equipment, tubes and lines, loose clothing, hair and
parts of the body away from moving parts and pinch points.
Patient Entrance / Exit – Caregiver should always aid patient in exiting the
bed. Make sure a capable patient knows how to get out of bed safely (and, if
necessary, how to release the side rails) in case of re or other emergency.
Side Rails / Patient Restraints - Whether and how to use side rails or
restraints is a decision that should be based on each patient’s needs and
should be made by the patient and the patient’s family, physician and

9
Citadel Bed Frame System
caregivers, with facility protocols in mind. Caregivers should assess risks and
benets of side rail / restraint use (including entrapment and patient falls from
bed) in conjunction with individual patient needs, and should discuss use or
non-use with patient and / or family. Consider not only the clinical and other
needs of the patient but also the risks of fatal or serious injury from falling
out of bed and from patient entrapment in or around the side rails, restraints
or other accessories. In the US, for a description of entrapment hazards,
vulnerable patient prole and guidance to further reduce entrapment risks,
refer to FDA’s Hospital Bed System Dimensional and Assessment Guidance
To Reduce Entrapment.
Outside the US, consult the local Competent Authority or Government
Agency for specic local guidance on Medical Device Safety. Consult a care
giver and carefully consider the use of bolsters, positioning aids or oor pads,
especially with confused, restless or agitated patients. It is recommended
that side rails (if used) be locked in the full upright position when the patient
is unattended. Make sure a capable patient knows how to get out of bed
safely (and, if necessary, how to release the side rails) in case of re or other
emergency. Monitor patients frequently to guard against patient entrapment.
When selecting a standard mattress (as dened by IEC 60601-2-52:2009),
make sure the distance between top of side rails (if used) and top of mattress
(without compression) is at least 22 cm (8.66 in) to help prevent inadvertent
bed exit or falls. Consider individual patient size, position (relative to the top
of the side rail) and patient condition in assessing fall risk.
Make sure the distance between top of side rails (if used)
and top of a speciality mattress (as dened by IEC 60601-
2-52:2009) (without compression) is approximately 11.4 cm
(4.5 in) or greater. Consider individual patient size, position
(relative to the top of the side rail) and patient condition in
assessing fall risk.
Skin Care – Monitor skin conditions regularly and consider adjunct or
alternative therapies for high acuity patients. Give extra attention to skin
over any raised side bolster and to any other possible pressure points
and locations where moisture or incontinence may occur or collect. Early
intervention may be essential to preventing skin breakdown.
Maximum Recommended Patient Weight - Total patient weight capacity
should not exceed 227 kg (500 lb). The use of accessories on the bed may
decrease the patient weight capacity of the bed. Contact ArjoHuntleigh
Customer Service for questions concerning the use of accessories and
see the Questions and Contact Information section of this guide for contact
information.
I.V. and Drainage Tubes – Prior to activating any positioning function assess
the security of all invasive lines and tubes to accommodate the desired angle
of articulation and minimize the risk of binding, disconnecting or dislodging.
Tubes and lines should always have sufcient slack for articulation and
patient movement.

10 Citadel Bed Frame System
Turning - Prior to engaging any mattress turn feature, make sure that bed
frame has side rails and that all side rails are fully engaged in their full upright
and locked position. Do not activate the turning feature on any mattress
system when patient restraints are in use.
Scale Readings - Scales / patient weights are for reference only. Scale
readings should not be relied upon for medication dosage. All equipment on
the weighed portion of the unit is included in weight displayed.
Patient Migration – Specialty surfaces have different shear and support
characteristics than conventional surfaces and may increase the risk of
patient movement, sinking and / or migration into hazardous positions of
entrapment and / or inadvertent bed exit. Monitor patients frequently to guard
against patient entrapment.
Skeletal Traction or Unstable Fracture (if not contraindicated) – With
skeletal traction, unstable pelvic fracture or any other unstable fracture (to the
extent not contraindicated), maintain physician directed angle of articulation
and guard against risks of patient migration or inadvertent deation of
surface.
Electromagnetic Interference – Although this equipment conforms with the
intent of electromagnetic compatibility, all electrical equipment may produce
interference. If interference is suspected, move equipment away from
sensitive devices or contact the manufacturer.
Shock Hazard – Electrical shock hazard; do not remove electrical
compartment covers. Refer to qualied service personnel.