ARJO HUNTLEIGH First Step Select User manual

First step select™Mattress
replaceMent systeM
User ManUal
ManUel De l’ UtiltsateUr
ManUal Del UsUariO
215238-AH Rev D • 02/2014
...with people in mind

IMPORTANT INFORMATION FOR USERS
In order for product to perform properly, the manufacturer recommends the following conditions. Failure to comply with these
conditions will void any applicable warranties.
•Use this product only in accordance with these instructions and applicable product labeling.
•WARNING: Assembly, operations, extensions, re-adjustments, modifications, technical maintenance or repairs must be
performed by qualified personnel authorized by the manufacturer. Contact the manufacturer for information regarding
maintenance and repair.
•Ensure the electrical installation of the room complies with the appropriate national electrical wiring standards.
Specific indications, contraindications, warnings, precautions and safety information exist for therapeutic support
surface products. It is important for users to read and familiarize themselves with these instructions and to consult
the treating physician prior to patient placement and product use. Individual patient conditions may vary.
NOTICE
This product has been configured from the manufacturer to meet specific voltage requirements. Refer to the product information
label for specific voltages.

5
Table Of Contents
Introduction ................................................................................................................................................. 9
• Indications............................................................................................................................................................................................................9
• Contraindications.................................................................................................................................................................................................9
• RisksandPrecautions............................................................................................................................................................................................9
• SafetyInformation................................................................................................................................................................................................9
Preparation For Use and Patient Placement .............................................................................................. 11
• UnboxingandInspection......................................................................................................................................................................................11
• UnitSetupandPreparationforPatientPlacement................................................................................................................................................11
PatientTransfertotheFirstStepSelect™MRS...........................................................................................................................12
• AmbulatoryPatientTransfer..................................................................................................................................................................................13
• Non-ambulatoryPatientTransfer...........................................................................................................................................................................13
PatientTransferfromtheFirstStepSelect™Unit........................................................................................................................13
• AmbulatoryPatientTransfer..................................................................................................................................................................................13
• Non-ambulatoryPatientTransfer...........................................................................................................................................................................13
• AirPressureAdjustment........................................................................................................................................................................................13
• PressureAdjustHT/WTMethod.............................................................................................................................................................................14
• PressureAdjustManualMethod...........................................................................................................................................................................14
CompletionofPatientPlacement.................................................................................................................................................15
• HomeDisplay.......................................................................................................................................................................................................15
InstaFlate™InflationFunction(IF)..................................................................................................................................................15
SeatDeflate....................................................................................................................................................................................16
WarmerAdjust................................................................................................................................................................................16
Lock-OutProcedures......................................................................................................................................................................17
• AllButtonLock-out...............................................................................................................................................................................................17
• PressureAdjustButtonLock-out...........................................................................................................................................................................18
Nursing Care................................................................................................................................................. 19
CardioPulmonaryResuscitation(CPR)..........................................................................................................................................19
PatientTransfertotheFirstStepSelect™MRS..............................................................................................................................19
PatientTransfer..............................................................................................................................................................................19
PatientBathing..............................................................................................................................................................................19
BedpanPlacement..........................................................................................................................................................................20
BedpanRemoval.............................................................................................................................................................................20
RepositioningPatientusingDri-Flo™Pads..................................................................................................................................21
Incontinence/Drainage.................................................................................................................................................................21
SkinCare.........................................................................................................................................................................................21
GeneralOperation..........................................................................................................................................................................21
Care and Cleaning........................................................................................................................................ 23
DailyCareandCleaningofFirstStepSelect™MRSWhileinUse.................................................................................................23
WeeklyCareandCleaningofFirstStepSelect™MRSWhileinUse...........................................................................................23
• DisassemblyofFirstStepSelect™MRSandCoverSheetforLaunderingandCleaning..........................................................................................23
InfectionControlProcedures.........................................................................................................................................................23
• In-HomeCleaning(singlepatientuse)...................................................................................................................................................................23
• InfectionControlProtocol.....................................................................................................................................................................................23
• LaunderingProcedureforCoverSheet..................................................................................................................................................................24
• LaunderingProcedureforCushionsandToteBag..................................................................................................................................................24
• CleaningProcedureforTherapyControlUnitandHoses.......................................................................................................................................25

6
• CleaningProcedureforFoamBase........................................................................................................................................................................25
• CleaningProcedureforAirFilter...........................................................................................................................................................................25
• InstitutionalCleaning(DMEsandExtendedCareFacilities)....................................................................................................................................25
• AssemblyoftheFirstStepSelect™MRSafterLaunderingandCleaning...............................................................................................................25
Maintenance................................................................................................................................................. 27
PreventativeMaintenance.............................................................................................................................................................27
UnscheduledMaintenance............................................................................................................................................................27
Troubleshooting........................................................................................................................................... 29
• TroubleshootingChartfortheFirstStepSelect™MRS.........................................................................................................................................29
Replacement Parts ....................................................................................................................................... 31
MajorComponents.........................................................................................................................................................................31
Literature........................................................................................................................................................................................31
Accessories......................................................................................................................................................................................31
Miscellaneous..................................................................................................................................................................................31
Specifications ............................................................................................................................................... 33
Dimensions:.....................................................................................................................................................................................33
Weight:...........................................................................................................................................................................................33
Electrical:........................................................................................................................................................................................33
SymbolsUsed..................................................................................................................................................................................34
Miscellaneous..................................................................................................................................................................................35
• EMC.....................................................................................................................................................................................................................35
• Classification........................................................................................................................................................................................................35
• EnvironmentalStorage/TransitConditions..........................................................................................................................................................35
• EnvironmentalOperatingConditions....................................................................................................................................................................35
• LeakageTestingandGroundContinuityTesting....................................................................................................................................................36
• LeakageTesting....................................................................................................................................................................................................36
• GroundContinuityTesting....................................................................................................................................................................................36
Questions and Information......................................................................................................................... 37

7
Introduction
The First Step Select™Mattress Replacement System (MRS) is a pressure relieving overlay and mattress replacement system
(MRS) designed to suspend the patient on a low air-loss support surface, providing effective pressure redistribution and early
intervention for patients with skin breakdown.
The mattress overlay is constructed of a nylon fabric with moisture vapor permeable backing and is divided into three
sections: HEAD, BODY and LEG. The therapy control unit consists of a single variable speed blower with a warmer to provide air
temperatures that can be adjusted for patient comfort. Each overlay surface can be adjusted for each overlay section to meet
individual patient needs.
Indications
The First Step Select™MRS is indicated for patients who would benefit from a pressure redistribution surface assisting in the early
intervention of skin breakdown.
Contraindications
Patient conditions for which the application of pressure redistributing therapy on the First Step Select™MRS are contraindicated
include:
•Unstable spinal cord injury.
•Unstable vertebral fracture.
•Cervical traction.
Risks and Precautions
•Transfer - Precaution should be taken during patient transfer, including the locking of caster brakes and deflation of overlay
surface. Refer to Patient Transfer sections in the Patient Placement and Nursing Care chapters of this manual.
•Side Rails and Restraints - Use or non-use of restraints, including side rails, can be critical to patient safety. WARNING:
Serious or fatal injury can result from the use (potential entrapment) or non-use (potential patient falls) of side rails or other
restraints. See related Safety Information.
•Patient Migration - WARNING: As with all speciality bed products that are designed to reduce shear and pressure on the
patient’s skin, the risk of gradual movement and / or sinking into hazardous positions of entrapment and / or inadvertent bed
exit may be increased.
•Skeletal Traction or Unstable Fracture (if not contraindicated) - With skeletal traction, unstable pelvic fractures 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 deflation of surface.
•Oxygen Use - Danger: Risk of explosion if used in the presence of flammable anesthetics. Use of this product’s therapy
control unit in an oxygen-enriched environment may produce potential of fire hazard. This equipment is not suitable for use
in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide.
Position therapy control unit only at foot end of bed when using oxygen administering equipment.
•Electromagnetic Interference - Although this equipment conforms with the intent of the directive 89 / 336 / EEC in
relation to 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 cover. Refer to qualified service personnel.
Safety Information
Bed Frame - Always use a standard health care bed frame with side rails and any other safeguards or protocols that may be
appropriate. Frame and side rails (if used - see Risks and Precautions) must be properly sized to eliminate any gaps that might
entrap a patient’s head or body.
Brakes - Caster brakes should always be locked once the bed is in position. Verify wheels are locked before any patient transfer to
or from the bed.

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Bed Height - To minimize the risk of falls or injury the bed should always be in the lowest position when the patient is
unattended.
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 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 profile 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 Medical Device Safety for specific local guidance. Consult a caregiver and carefully consider the use of bolsters, positioning
aids or floor 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 fire or other emergency. Monitor patients frequently to guard against patient
entrapment.
When selecting a standard mattress, ensure the distance between top of side rails (if used) and top of mattress (without
compression) is at least 8.66 in (220 mm) 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.
Skin Care - Monitor skin conditions regularly, especially at bony prominences and areas where moisture or incontinence may
occur or collect, and consider adjunct or alternative therapies for high acuity patients. Early intervention may be essential to
preventing serious skin breakdown.
Fluids- Avoid spilling fluids on the therapy control unit. If spills do occur, unplug the unit, clean fluid from the bed and the
therapy control unit wearing rubber gloves to avoid any possibility of shock. Once fluid is removed, check operation of
components in area of spill.
Fluids remaining on controls can cause corrosion, which may cause components to fail or operate erratically, possibly
producing potential hazards for patient and caregivers.
Lock-Outs - The lock-out feature on the therapy control unit should be used at the caregiver’s discretion to ensure against
unintentional or unauthorized tampering with unit settings.
Avoid Fire Hazards - To minimize risk of fire, connect the unit’s power cord directly to the wall-mounted outlet. Do not use
extension cords or multiple outlet strips.
No Smoking in Bed - Smoking in bed can be dangerous. To avoid the risk of fire, smoking in bed should never be allowed.
Tobacco Smoke - If routine laundering and cleaning procedures as described in the Preventative Maintenance section of
the Maintenance chapter of the First Step Select™MRS Maintenance Manual are not followed, tobacco smoke build-up may
conceivably reduce the amount of air flow through the product. Severe air restrictions (whatever the source) may cause the
therapy control unit to overheat and automatically deactivate.
Power Cord - Ensure power cord is kept free from all pinch points and moving parts and is not trapped under casters. Improper
handling of the power cord can cause damage to the cord, which may possibly produce risk of fire or electrical shock.
General Protocols - Follow all applicable safety rules and institution protocols concerning patient and caregiver safety.
Maximum Patient Weights
•First Step Classic™ Overlay or Mattress Replacement System (MRS): 250 lb.
•First Step Excel™MRS (Mattress Replacement System only): 300 lb.
•First Step Air Rail™ Overlay or Mattress Replacement System: 250 lb.

9
Preparation For Use and Patient Placement
Preparing the First Step Select™ MRS for use entails inspecting the unit for any damaged or unserviceable assemblies as well
as performing the steps outlined in the Unboxing and Inspection procedure below. It is recommended that all sections of
this manual be reviewed prior to product use. Carefully read the Contraindications, Safety Information and Risks and
Precautions sections in the Introduction chapter of this manual prior to placing a patient on the First Step Select™ MRS.
Unboxing and Inspection
1. Open shipping boxes. Do not use sharp instruments to open boxes. Damage to overlay, cover sheet or hoses could
result.
2. Inventory includes all items listed below:
•One tote bag containing First Step Select™ Overlay / MRS.
•Two nylon fabric cover sheets with moisture vapor permeable backing.
•One therapy control unit.
•One set of three hoses (connected together).
•One Quick Reference Guide and one removable cable tie for securing the Quick Reference Guide to therapy control unit
handle.
3. Remove and discard all packing materials.
4. Inspect all components for any visible damage occurring from transport. Contact ArjoHuntleigh immediately if damage is
observed.
Unit Setup and Preparation for Patient Placement
Always use a standard health care bed frame with such safeguards and protocols as may be appropriate.
1. Level bed and lock caster wheel brakes and caster wheel steering.
2. Remove existing mattress if using Mattress Replacement System (MRS).
When selecting a standard mattress, ensure the distance between top of side rails (if used) and top of mattress
(without compression) is at least 8.66 in (220 mm) 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.
3. Install overlay:
•Place tote bag at foot of mattress.
•Open tote bag and remove overlay, air hoses, therapy control unit, sheets, etc.
•Place overlay on mattress with hose connections and tote bag at foot of mattress with elastic harness on underside of
overlay.
•Slide elastic harness over each end of mattress.
•Tuck tote bag under foot end of mattress.
Always ensure bed frame is properly sized. Ensure against any gaps that might entrap the patient’s head or body.
4. Install First Step Select™ MRS Nylon Fabric Cover Sheet:
•Draw sides of sheet down each side of bed and tuck under mattress.
•Secure sheet around hose connections using individual hook and loop strips located on cover sheet.
5. Install therapy control unit on footboard:
•Swing out adjustable hanging arms located on each side of therapy control unit.
•Pull down tilt display bracket located on lower backside of therapy control unit.
•Hang therapy control unit on footboard.
If the arms cannot accommodate a large footboard, a separate hanging bracket is available as an accessory, or the
therapy control unit may be placed on a clean floor.
Verify air intake located on the back face of the therapy control unit is not blocked by a blanket or other obstructions.
The therapy control unit has a thermal cutoff that will, after a period of time, automatically deactivate if the air intake is
blocked.
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10
6. Connect hoses to therapy control unit:
•Locate hose set coupler that holds three hose tab ends together.
•Turn hose set coupler such that hoses are stacked vertically (Fig. 1).
•Insert tab of coupler into horizontal slot on the right side of therapy control unit (Fig. 2).
Ensure hose set is not twisted.
•Pivot coupler downward, placing hose ends over air outlets, until bottom of coupler clicks into locked position (Fig. 3).
7. Attach hoses to overlay connectors:
•Match respective hose end colors to patches at overlay hose connectors.
•Attach hoses snugly by turning them slightly as you push hose end onto the overlay hose
connector.
8. Plug therapy control unit cord into a grounded 115V AC wall outlet.
Be sure power to this outlet is not controlled by a wall switch.
9. Press the power button. Therapy control unit will activate and the First Step Select™MRS will
inflate to provide a firm surface for patient transfer. The home display at right
will appear.
•Soft / rm display is the home display.
Motor will ramp-up, setting pressures during first 25 seconds of operation. After
ramping-up and setting pressures, unit will be noticeably quieter.
•For non-ambulatory patients - Place non-ambulatory patients on a firm surface.
•For ambulatory patients - Place ambulatory patients on a deflated surface.
10. Power down therapy control unit.
•Press green power button to deactivate therapy control unit.
•Unplug therapy control unit from wall outlet.
All settings will be held in memory, and restored when therapy control unit is activated.
Inspect all components for visible damage. Verify basic functionality and inspect all hoses, cords and other
components for visible damage. Discontinue use and immediately contact ArjoHuntleigh if damage is observed.
Patient Transfer to the First Step Select™ MRS
It is recommended that all sections of this manual be reviewed prior to product use. Carefully read the Contraindications,
Safety Information and Risks and Precautions sections in the Introduction chapter of this manual prior to placing a patient
on the First Step Select™ MRS.
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Fig.1
™
Fig.2
™
Fig.3
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11
Ambulatory Patient Transfer
1. If in operation, press green power button to turn OFF therapy control unit. Surface will begin to deflate.
2. Adjust height of both surfaces to comfortable levels for patient transfer.
3. Lower side rails when applicable.
4. Lock caster wheel brakes and caster wheel steering on both surfaces.
5. Assist patient in ambulatory transfer, following all applicable safety rules and institution protocols.
6. Center patient on the First Step Select™ MRS surface.
7. Raise and lock side rails on both sides of bed, if decision has been made to use side rails (refer to the Safety Information
and Risks and Precautions sections in the Introduction chapter of this manual).
8. Press green power button to activate therapy control unit and adjust air pressures. See the Air Pressure Adjustment
section of this chapter.
9. With air pressures adjusted, verify patient comfort.
10. Lower bed height to lowest level.
11. Activate warmer and adjust temperature, if desired.
Non-ambulatory Patient Transfer
1. Press green power button on therapy control unit to activate blower.
2. Press the InstaFlate™ Inflation Function (IF) to fully inflate cushions and create a firm surface for patient transfer.
3. Perform steps 2-7 from Ambulatory Patient Transfer section.
4. Deactivate the InstaFlate™ IF and adjust air pressures. See Air Pressure Adjustment section of this chapter.
5. Perform steps 9-11 of Ambulatory Patient Transfer section.
Patient Transfer from the First Step Select™Unit
Ambulatory Patient Transfer
1. Press green power button to turn OFF therapy control unit. Surface will begin to deflate.
2. Adjust height of bed to same level as surface to which patient is being transferred.
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Lower side rails when applicable.
5. Transfer patient following all applicable safety rules and institution protocols.
Non-ambulatory Patient Transfer
1. Press InstaFlate™ IF to fully inflate cushions and create a firm surface for patient transfer.
2. Perform steps 2-5 from Ambulatory Patient Transfer section.
Air Pressure Adjustment
Use Pressure Adjust button to adjust pressure in each individual section of surface. Air pressures are set by using either HT/WT
pre-set or manual method.
1. Press PRESSURE ADJUST button shown at right.
2. Display shown at right will appear.
PRESSURE
HT/WT
ADJUST
MANUALEXIT

12
Pressure Adjust HT/WT Method
Use HT/WT pre-set method to set an appropriate air pressure based on patient’s height and
weight. HT/WT pre-sets can be adjusted from 2 ft 0 in to 6 ft 8 in by 1-inch increments
and from 50 lb (22 kg) to 300 lb (136 kg) by 5 lb (2 kg) increments.
1. Press left arrow button under HT/WT. The display shown at right will appear.
•Press left arrow button under DECR to decrease height.
•Press right arrow button under INCR to
increase height.
•Press center oval button under ENTER to enter selected weight.
Display shown at right will appear.
•Press left arrow button under DECR to decrease weight.
•Press right arrow button under INCR to increase weight.
•Press center oval button under ENTER to enter selected weight.
•Press center oval under EXIT to return to Home Display.
Pressure Adjust Manual Method
Use manual method to make major adjustments in existing pressures.
1. With Pressure Adjust display showing, press right arrow button under MANUAL. Display
shown at right will appear.
•Press left arrow button to decrease head section pressure.
•Press right arrow button to increase
head pressure.
•Press center oval button to enter selected head section pressure. Display shown at
right will appear.
•Press left arrow button to decrease body section pressure.
•Press right arrow button to increase
body section pressure.
•Press center oval button to enter selected body section pressure. Display shown at
right will appear.
•Press left arrow button to decrease leg section pressure.
•Press right arrow button to increase leg section pressure.
•Press center oval button to enter selected leg section pressure. Display shown at
right will appear.
•Press center oval button under EXIT to return to Home Display.
If HT/WT display is accessed after adjustments have been made using MANUAL, the
MANUAL pressures will automatically be replaced with previous HT/WT pressures.
HEAD SECTION ADJUST
BODY SECTION ADJUST
BODY ADJUSTSECTION
LEG SECTION ADJUST
PRESSURE
HT/WT MANUAL
EXIT
ADJUST
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13
Completion of Patient Placement
Home Display
1. Verify patient comfort.
2. Use Home Display for up to 25% uniform pressure adjustment.
•Press left arrow button under SOFT to decrease uniform pressure.
•Press right arrow button under FIRM to increase uniform pressure.
3. If the decision has been made to use side rails, raise and lock side rails.
Serious injury or death can result from the use (potential entrapment) or non-use (potential patient falls) of side rails
or other restraints.
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 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 profile 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 Medical Device Safety for specific local guidance.
Consult a caregiver and carefully consider the use of bolsters, positioning aids or floor 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 fire or other emergency. Monitor patients frequently to guard against patient
entrapment.
When selecting a standard mattress, ensure the distance between top of side rails (if used) and top of mattress
(without compression) is at least 8.66 in (220 mm) 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.
Adjust bed height to lowest level.
To minimize risks of injury from falls, the bed frame should always be in the lowest possible position when the patient
is unattended.
4. Ensure all brakes are locked.
5. Activate warmer and adjust temperature if desired.
InstaFlate™Inflation Function (IF)
Use InstaFlate to assist patient transfer and bathing by increasing pressure throughout surface. InstaFlatewill automatically
deactivate after 15 minutes. Screen will flash every second in the last 15 seconds before deactivation.
1. Press the INSTAFLATE ON/OFF button shown at right.
Display shown at right will appear and flash until InstaFlate is deactivated.
2. Press the INSTAFLATE ON/OFF button to deactivate InstaFlate.
Display shown at right will appear temporarily and then return to the Home Display.
Pressure and warmer settings will be restored when InstaFlate is deactivated.
INSTAFLATE
INSTAFLATE OFF
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14
Seat Deflate
Use seat deflate to assist patient exit and bedpan placement by lowering pressure in body section. Seat deflate should
automatically deactivate after 15 minutes. Screen will flash every second in the last 15 seconds before deactivation.
1. Press the SEAT DEFLATE ON/OFF button shown at right.
Display shown at right will appear and
flash until seat deflate is deactivated.
2. Press the SEAT DEFLATE ON/OFF button to deactivate seat deate. Display shown at right will appear temporarily and then
return to the home display.
Pressure and warmer settings will be restored when seat deflate is deactivated.
Warmer Adjust
Use warmer adjust to set 3 optional levels of comforting heat when desired. Use only by caregiver under direction of patients
physician.
1. Press WARMER ADJUST button shown at right.
The displays shown at right will appear.
2. Press the right arrow button to activate warmer .
3. To deactivate warmer, press and hold the left arrow button until the display reads
WARMER OFF.
4. The panel displays a sliding scale that identifies level of selected warmth.
5. Use the right and left arrow buttons to increase or decrease warmth.
6. As warmth is increased or decreased, LED readout displays LOW, MEDIUM or HIGH
accordingly.
SEAT DEFLATE
INSTAFLATE
ON/OFF
SEAT
DEFLATE
ON/OFF
WARMER
ADJUST
PRESSURE
ADJUST
FIRMSOFT
WARMER: OFF
PRESS TO TURN ON
WARMER: OFF
PRESS TO TURN ON
LOW MEDIUM HIGH
INSTAFLATE
ON/OFF
SEAT
DEFLATE
ON/OFF
WARMER
ADJUST
PRESSURE
ADJUST
FIRMSOFT
SEAT DEFLATE OFF
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15
Lock-Out Procedures
Use lock-outs to disable buttons on the control panel to ensure against unauthorized tampering after air pressures and warmth
have been adjusted to individual patient needs.
Lock-outs can be activated to disable either the pressure adjust button only, or all buttons on control panel.
All Button Lock-out
1. With home display showing, press and hold PRESSURE ADJUST.
The screen shown at right will appear temporarily.
•Release PRESSURE ADJUST button when Lock-Out Activated display appears.
•Display will return to home display.
2. To deactivate All Button Lock-Out press and hold PRESSURE ADJUST button while each
display shown at right appears temporarily.
•Release PRESSURE ADJUST button when Lock-Out Released display appears.
•Display will return to home display.
PRESSURE
HT/WT
ADJUST
MANUALEXIT
LOCK-OUT ACTIVATED
LOCK-OUT ACTIVATED
LOCK-OUT RELEASED

16
Pressure Adjust Button Lock-out
1. With home display showing, press and hold PRESSURE ADJUST button while each
display shown at right appears temporarily.
•Press INSTAFLATE button when Lock-Out Activated display appears.
Display shown at right appears temporarily.
•Display will return to home display.
2. To deactivate Pressure Adjust Button Locked-Out, press and hold
PRESSURE ADJUST button while each display shown at right appears temporarily.
•Press INSTAFLATE button when Lock-Out Activated display appears.
Display shown at right appears temporarily indicating button released.
•Display will return to home display.
INSTAFLATE
ON/OFF
SEAT
DEFLATE
ON/OFF
WARMER
ADJUST
PRESSURE
ADJUST
FIRMSOFT
HT/WT
PRESSURE ADJUST
MANUALEXIT
BUTTON LOCKED-OUT
LOCK-OUT ACTIVATED
LOCK-OUT ACTIVATED
PRESSURE ADJUST
BUTTON RELEASED
PRESSURE ADJUST
BUTTON LOCKED-OUT
PRESSURE ADJUST
SOFT FIRM

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Nursing Care
It is recommended that all sections of this manual be reviewed prior to product use. Carefully read the Contraindications,
Safety Information and Risks and Precautions sections in the Introduction chapter of this manual prior to performing
nursing care for a patient on the First Step Select™MRS.
Cardio Pulmonary Resuscitation (CPR)
1. Lift up on quick release lever (Fig. 1).
2. Swing hoses up and away from therapy control unit (Fig. 2).
3. Bring bed to a level position.
4. Lower side rails if used.
5. Place back board under patient.
6. Begin CPR. Patient’s body weight and the CPR process will deflate overlay or cushions.
7. After CPR is performed and patient is clinically stable:
•Connect hose set to therapy control unit.
•Return bed to original configuration, considering all applicable safety rules and protocols. If the decision has been
made to use side rails, restraints or other accessories (see related Risks and Precautions and Safety Information in the
Introduction chapter of this manual), then raise and lock the side rails on both sides of the bed and reposition other
restraints and accessories.
Patient Transfer to the First Step Select™MRS
Refer to the Patient Placement chapter of this manual if patient is being transferred to the First Step Select™MRS for the first
time.
Patient Transfer
1. Press the green power button to deactivate therapy control unit. Product will begin to deflate.
Patient will be supported by existing mattress or foam base if using the First Step Select™MRS as a mattress
replacement system.
2. Unplug the power cord from wall outlet.
3. If side rails are present, ensure they are raised and locked.
4. Unlock caster wheel brakes and caster wheel steering.
5. Transport patient following all applicable safety rules and institution protocols.
6. Plug the power cord into a grounded wall outlet when destination is reached.
Be sure power to this outlet is not controlled by a wall switch.
7. When power is resumed, surface will resume previous air pressure settings.
8. Adjust head of bed for patient comfort and return bed to original configuration, considering all applicable safety rules
and protocols. If the decision has been made to use side rails, restraints or other accessories (see related Risks and
Precautions and Safety Information in the Introduction chapter of this manual), then raise and lock side rails on both
sides of the bed and reposition other restraints and accessories.
Patient Bathing
1. When side rails are available, raise the rail on the side of the bed opposite the caregiver to help reduce the risk of patient
fall during bathing.
2. Level bed and adjust bed height to facilitate bathing.
3. Press INSTAFLATE button to provide a firm surface for patient bathing.
4. Bathe and rinse anterior side of patient.
Avoid spilling fluids on bed controls. If spills do occur, clean fluid from surface wearing rubber gloves to avoid any
possibility of shock. Once fluid is removed, check operation of components in area of spill.
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Fig.2
™
QuickReleaseLever
Fig.1

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Fluids remaining on electronic controls can cause corrosion, which may cause the electronic components to fail.
Component failures may cause the unit to operate erratically, possibly producing potential hazards to patient and
caregiver.
To reduce risk of patient falls during bathing, caregiver must never leave patient unattended or turn away during
bathing.
5. Gently log roll patient toward opposite side rail.
6. Bathe and rinse patient’s exposed side and posterior.
7. Wipe cover sheet while bathing patient.
Replace and launder extensively soiled cover sheet and cushions.
8. Dry cover sheet with a towel. Remaining moisture will normally evaporate rapidly with air flow.
9. Log roll patient to clean, dry side of air mattress and repeat steps 4 through 10 for opposite side.
10. Return patient to supine position in center of surface.
11. Press INSTAFLATE button to deactivate InstaFlate and return surface to previous air pressure settings.
12. Adjust warmer and bed height as required.
13. Adjust head of bed for patient comfort and return bed to original configuration, considering all applicable safety rules
and protocols. If the decision has been made to use side rails, restraints or other accessories (see related Risks and
Precautions and Safety Information in the Introduction chapter of this manual), then raise and lock side rails on both
sides of the bed and reposition other restraints and accessories.
Bedpan Placement
1. Level bed.
2. Activate SEAT DEFLATE.
3. Lower side rail (if used) on caregiver’s side.
4. Log roll patient toward opposite side rail.
5. Position bedpan parallel to patient’s buttocks, next to patient and push bedpan down into seat cushion.
6. Log roll patient onto bedpan, keeping one hand on bedpan.
7. Adjust head of bed for patient comfort and return bed to original configuration, considering all applicable safety rules
and protocols. If the decision has been made to use side rails, restraints or other accessories (see related Risks and
Precautions and Safety Information in the Introduction chapter of this manual), then raise and lock side rails on both
sides of the bed and reposition other restraints and accessories.
Bedpan Removal
1. Level bed.
2. Lower side rail (if used) on caregiver’s side.
3. Grasp bedpan firmly with one hand, and turn patient toward opposite side with other hand.
4. Remove bedpan and cleanse patient’s posterior.
5. Return patient to supine position.
6. Press SEAT DEFLATE button to deactivate seat deflate and return body cushion to previous setting.
7. Center patient on air mattress, with patient’s buttocks centered on seat cushion.
8. Adjust head of bed for patient comfort and return bed to original configuration, considering all applicable safety rules
and protocols. If the decision has been made to use side rails, restraints or other accessories (see related Risks and
Precautions and Safety Information in the Introduction chapter of this manual), then raise and lock side rails on both
sides of the bed and reposition other restraints and accessories.
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Repositioning Patient using Dri-Flo™ Pads
1. Adjust bed to lowest height position.
2. Press INSTAFLATE button to activate InstaFlate and create a firm surface for patient repositioning.
3. Lower side rails (if used).
4. Take positions on each side of patient (at least two people will be needed). Roll edges of Dri-Flo™ Pad on each side of
patient to get a firm grip.
5. Use Dri-Flo™ Pad to slightly lift and properly position patient.
6. Press the InstaFlate™ IF button to deactivate the InstaFlate™ IF and return surfaces to previous air pressure settings.
7. Adjust head of bed for patient comfort and return bed to original configuration, considering all applicable safety rules
and protocols. If the decision has been made to use side rails, restraints or other accessories (see related Risks and
Precautions and Safety Information in the Introduction chapter of this manual), then raise and lock side rails on both
sides of the bed and reposition other restraints and accessories.
Incontinence / Drainage
1. A First Step Select™MRS Nylon Fabric cover sheet should be placed over the product.
2. Use moisture-impermeable, breathable underpads for incontinent patients.
Dri-Flo™ Pad breathable underpads are recommended for incontinent patients. They are absorbent and do not block
air flow. Do not use plastic-backed underpads. Plastic may tend to block moisture vapor transmission and air flow from
mattress surface.
3. Watch for incontinence or drainage and provide appropriate skin care following each episode.
Skin Care
1. Remove excess moisture and keep skin dry and clean.
2. Maintain proper air pressures in accordance with the Air Pressure Adjustment section of the Patient Placement
chapter of this manual.
3. Assess patient’s skin regularly, particularly in areas where incontinence and drainage occur.
Monitor skin conditions regularly, especially at bony prominences and areas where moisture or incontinence may
occur or collect, and consider adjunct or alternative therapies for high acuity patients. Early intervention may be
essential to preventing serious skin breakdown.
General Operation
Avoid contact of sharp instruments with the First Step Select™MRS. Punctures, cuts and tears may prevent proper inflation and
air pressure operation.
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