ARJO HUNTLEIGH NIMBUS User manual

Instructions For Use
Product Photo
NIMBUS®PEDIATRIC STSTEM

(i)
Contents
General Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
About this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About the Nimbus®Pediatric System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Contraindications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Product Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Mattress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Preparing the Pump and Mattress Replacement. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Connecting the Tubeset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Disconnecting the Tubeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Inflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Testing the Power Fail Alarm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Deflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
System Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Modes of Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Mode Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CPR Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
To Reset CPR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Patient Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Controls, Indicators and Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Routine Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Nimbus Pediatric System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Mattress Replacement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Technical Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Mattress Size Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Cleaning Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

(ii)

(iii)
GENERAL SAFETY
Before you connect the system pump to a mains socket, read carefully all the installation
instructions contained within this manual.
The system has been designed to comply with regulatory safety standards including:
• EN60601-1:1990/A13:1996 and IEC 60601-1:1988/A2:1995
• UL60601-1, UL2601-1 and CAN/CSA C22.2 No. 601.1-M90
Safety Warnings
• It is the responsibility of the care giver to ensure that the user can use this product
safely.
• Whilst the patient is unattended, safety sides should be used based on clinical
assessment and in line with local policy.
• Alignment of the bed frame, safety sides and the mattress should leave no gap
wide enough to entrap a patient's head or body, or to allow egress to occur in a
hazardous manner where entanglement with the mains power cable and tubeset or
air hoses may result. Care should be exercised to prevent occurrence of gaps by
compression or movement of the mattress. Death or serious injury may occur.
• Make sure that the mains power cable and tubeset or air hoses are positioned to
avoid causing a trip or other hazard, and are clear of moving bed mechanisms or
other possible entrapment areas. Where cable management flaps are provided
along the sides of the mattress, these should be used to cover the mains power
cable.
• Electrical equipment may be hazardous if misused. There are no user-serviceable
parts inside the pump. The pump's case must only be removed by authorised
technical personnel. No modification of this equipment is allowed.
• The mains power socket/plug must be accessible at all times. To disconnect the
pump completely from the electricity supply, remove the plug from the mains
power socket.
• The CPR control and/or the CPR indicator tag must be visible and accessible at all
times.
• Disconnect the pump from the mains power socket before cleaning and inspecting.
• Keep the pump away from sources of liquids and do not immerse in water.
• Do not use the pump in the presence of uncontained flammable liquids or gasses.
• The cover of this product is vapour permeable but not air permeable and may
present a suffocation risk.
• Only the pump and mattress combination as indicated by ArjoHuntleigh should be
used. The correct function of the product cannot be guaranteed if incorrect pump
and mattress combinations are used.
• To avoid the risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.

(iv)
Precautions
For your own safety and the safety of the equipment, always take the following
precautions:
• Placing extra layers between the patient and the mattress potentially reduces the benefits
provided by the mattress and should be avoided or kept to a minimum. As part of sensible
pressure area care, it is advisable to avoid wearing clothing which may cause areas of
localised high pressure due to creases, seams, etc. Placing objects in pockets should be
avoided for the same reason.
• Do not expose the system, especially the mattress, to naked flames, such as cigarettes,
etc.
• In the event of a fire, a leak in the seat or mattress could propagate the fire.
• Do not store the system in direct sunlight.
• Do not use phenol-based solutions to clean the system.
• Make sure the system is clean and dry prior to use or storage.
• Never use sharp objects or electrically heated under blankets on or under the system.
• Store the pump and mattress in the protective bags supplied.
Electromagnetic Compatibility (EMC)
This product complies with the requirements of applicable EMC Standards. Medical electrical
equipment needs special precautions regarding EMC and needs to be installed in accordance
with the following instructions:
• The use of accessories not specified by the manufacturer may result in increased
emissions by, or decreased immunity of, the equipment, affecting its performance.
• Portable and mobile radio frequency (RF) communications equipment (e.g. mobile/cell
phones) can affect medical electrical equipment.
• If this equipment needs to be used adjacent to other electrical equipment, normal
operation must be checked before use.
• For detailed EMC information contact ArjoHuntleigh service personnel.
Environmental Protection
Incorrect disposal of this equipment and its component parts, particularly batteries or other
electrical components, may produce substances that are hazardous to the environment. To
minimise these hazards, contact ArjoHuntleigh for information on correct disposal.
Service Information
ArjoHuntleigh recommend that this system should be serviced every 12 calendar months or,
where applicable, when the service indicator is illuminated.
Design Policy and Copyright
® and ™ are trademarks belonging to the ArjoHuntleigh group of companies. As our policy is
one of continuous improvement, we reserve the right to modify designs without prior notice.
© ArjoHuntleigh 2010.

1
1. Introduction
About this Manual This manual is your introduction to the Nimbus®
Pediatric Mattress Replacement System. Use it initially
to set up the system and keep it handy as a reference for
day-to-day routines and as a guide to maintenance.
About the Nimbus®
Pediatric System Thecompletesystemconsistsofamattressreplacement,
top cover, and pump unit. The system is used for the
prevention and management of pressure ulcers.
The Nimbus Pediatric System incorporates the unique
Auto-Matt®sensor pad which ensures that the patient is
automatically supported at optimum pressures
regardless of size, height, position or weight
distribution.
The mattress replacement is designed for use with the
ArjoHuntleigh ChildMinder or Hi-Lo Crib. Users are
able to employ established practices for moving and
handling patients.
A water resistant, vapor permeable cover is supplied
which enhances patient comfort by preventing heat
build-up while protecting the mattress replacement
interior from contamination. It is simple to clean in situ
but can be easily removed for laundering.
In the event of cardiac arrest, the mattress can be
quickly deflated in approximately 10 seconds to allow
cardiac resuscitation procedures to be performed.
The Nimbus Pediatric System is designed to operate in
3 modes:
•Dynamic mode continuously changes the tissue
pressure points, providing a high degree of
pressure relief.
•Static mode provides constant low pressure
reduction and is used when a moving surface is
contraindicated.
•Autofirm mode provides a stable surface for
nursing procedures, patient transfer and
physiotherapy.
Caution
USA Federal law restricts this device to sale by or on the order of a
physician.

2
2. Clinical Applications
Indications The Nimbus Pediatric systems are indicated for the
prevention and management of all categories1of pressure
ulcer when combined with an individualised monitoring,
repositioning and wound care programme.
The Nimbus Pediatric mattress is designed for patients
weighing between 13 - 55 lb (6 - 25 kg).
Contraindications Do not use Nimbus Pediatric systems for patients with
unstable spinal fractures.
Cautions If patients have other unstable fractures, or conditions
which may be complicated by a soft or moving surface,
advice should be sought from an appropriate clinician
before use.
While the Nimbus Pediatric systems have been designed
to manage patients up to the weightlimitsindicated above,
those approaching this upper limit are likely to have
additional care and mobility needs and may be better
suited to a specialist bariatric system.
Active therapy (alternating) cushions may be unsuitable
for patients with poor sitting posture or pelvic deformity;
advice from a seating specialist should be sought.
The above are guidelines only and should not replace clinical judgement.
The Nimbus Pediatric systems represent one aspect of a pressure ulcer
management strategy; if existing wounds do not improve or the patients
condition changes the overall therapy regimen should be reviewed by the
prescribing clinician.
Mattress and cushion combinations may have different upper weight limits.
Cushions should be used in combination with pressure-redistributing
mattresses to provide 24-hour therapy.
1. NPUAP/EPUAP International Pressure Ulcer Guideline, 2009.

3
3. Product Description
Mattress The Nimbus Pediatric mattress replacement is
comprised of a series of 18 individual cells, all of which
inflate alternately. The best way of describing cell
arrangement is that, if all cells were numbered 1 to 18,
the odd number cells inflate simultaneously while the
even number cells are deflated and then vice versa.
The sequence of dynamic pressure relief is :
• Phase 1 – odd numbered cells inflated for
approximately 4 minutes.
• Phase 2 – total support period where all cells are
inflated (cross-over) for approximately one
minute.
• Phase 3 – even numbered cells inflated for
approximately 4 minutes.
• Phase 4 – as phase 2 (one minute)

4
At the foot end of the mattress replacement a tube-set
serves to inflate and deflate the Nimbus Pediatric
mattress replacement.
To deflate the mattress replacement quickly in the event
of cardiac arrest pull the CPR Tag firmly to remove the
CPR plugs. To reinflate the Nimbus Pediatric mattress
replacement, replace the CPR plugs securely.
Pump
The pump comprises a rugged molded case with non-
slip feet on the base and rear and an integral carry
handle.
The unit has been designed to maintain sustained
operation and to withstand prolonged use in the hospital
environment. Weight has been minimized and is evenly
distributedthroughoutthecase with thecenterof gravity
beneath the carry handle.
The On/Off switch is on the side panel. Other controls
and indicators (lights) are located on the front panel
which is recessed to prevent accidental operation.
New pumps have different icons on the control panel comparedto old pumps.
Refer to “Controls, Indicators and Alarms” on page 14 for the different
icons.
The pump incorporates a sophisticated alarm system
that differentiates between normal operation and
genuine system faults. If an alarm situation is detected a
Wait Indicator
Alarm Indicator Power Indicator
Static
Dynamic
Mode Select
Mute Button / Indicator
On/Off Switch
Autofirm

5
flashing indicator will illuminate and an audible
warning will sound.
Bed Bracket The pump can be fixed to the foot end of the
ArjoHuntleigh ChildMinder or Hi-Lo Crib by the
separate crib bracket which has been designed for
simplicity and ease of use. It features a simple self
adjusting mechanism that clips onto most common crib
frames (18-50 mm wide) and a hook that fits into the
pump handle.
The pump can also be stood on the floor, either
vertically or horizontally.
Tube-Set The tube-set incorporates a flexible, compact anti-kink
tube that is resistant to crushing and the obstruction of
air flow. Incorporated into the tube-set is the facility to
set the mattress to Normal or Transport mode. There is
a quick connect system for connecting the tubeset of the
mattress replacement to the pump. The other end the
tube-set is permanently connected to the mattress.

6
4. Installation
These instructions cover initial set up and operation of
the Nimbus Pediatric System. More detailed
information regarding controls, alarms and indicators is
in Section 5.
Preparing the Pump and Mattress Replacement
Installing the Nimbus
Pediatric Pump 1. Remove the pump from the carton together with the
mattress replacement and cover. You should have
the following items:
• Mattress replacement with cover & tube-set
• Pump and bed bracket
2. The pump can be suspended from the crib foot rail
by means of the hanging device or alternatively
stood upright or on its back on any convenient
horizontal surface.
3. Check there are no protruding springs or similar
sharp objects on the crib base.
4. Place the Nimbus Pediatric mattress replacement
on the crib base with the air feed tubes located near
the pump at the foot of the crib, ensuring that the
Auto-Matt sensor pad is flat.

7
5. Ensure individual cells of the Nimbus Pediatric
mattress replacement are uppermost.
6. Secure the Nimbus Pediatric mattress replacement
by fixing the six straps (three at each end) to the
moveable part of the crib base.
7. Place the protective cover on the mattress
replacement and fix into position with the zips and
velcro provided.
8. Ensure the transport facility on the tubeset is in the
normal mode. Make sure the CPR tag is not tucked
under the mattress and it is routed out of the crib in
an accessible position.
Fixing Straps

8
Connecting the
Tubeset To connect the tubeset to the mattress and pump:
1. Locate the bottom of the tubeset connector onto the
bottom of the pump/mattress connector.
2. Pull the top of the tubeset connector up and over the
top of the pump/mattress connector, until the
tubeset connector “clicks” into position.
3. Make sure both connections are secure.
Disconnecting the
Tubeset To disconnect the tubeset from the mattress and pump:
1. Move the tubeset connector down by pulling the
tubeset extrusion downwards, and then pull the
bottom of the tubeset connector away from the
bottom of the pump/mattress connector.
2. Lift the top of the tubeset connector off the top of
the pump/mattress connector.
1
2
1
2

9
Inflating the Mattress 1. Insert the power plug into the power socket.
2. Switch the pump ON/OFF switch to ON; the ON
light on the front panel should illuminate.
3. The pump will now run a self test for
approximately 3 seconds when all lights will be
illuminated.
4. If the pump detects low pressure it will enter an
inflation sequence with the WAIT message
illuminated.
Once normal operating pressure has been reached, the
WAIT light will switch off. It may take up to 20 minutes
to fully inflate the pediatric mattress replacement.
Testing the Power
Fail Alarm The power fail alarm is powered by a rechargeable
battery.
The duration of the alarm will depend on the level of
charge in the battery.
In use, it may have become discharged or reached the
endof its life.It is thereforerecommendedthat thealarm
be tested before use.
1. Connect the pump to the mains, switch on and
allow to run for 10-15 seconds.
2. Remove the power at the wall socket without
switching the pump off.
3. The alarm should operate within 10 seconds.
4. If the alarm does not operate, run the pump for 4
hours to recharge the battery.
Caution
If the power fail alarm does not operate after this test, only use the
pump under supervision to ensure that the power-on status is
checked at regular intervals.
Route the power cable so that it cannot be damaged or be
hazardous to the caregiver or visitor.

10
5. Retest the alarm after at least 4 hours. Allow the
alarm to operate for 2 minutes to ensure that it has
been adequately recharged.
6. If the alarm does not operate for 2 minutes, call the
service engineer.
Continue to use the pump only under supervision to
ensure that the power-on status is checked at regular
intervals.
All other alarms will continue to function as normal.
Deflating the
Mattress To deflate and store the mattress, switch off the pump
and remove the tube-set at the pump end. Ensure the
transport facility on the tube-set is set to normal mode
and roll up the mattress, starting at the end furthest from
the tube-set.

11
5. Operation
These instructions cover day-to-day operation of the
system. Other operations, such as maintenance and
repair, should only be carried out by suitably qualified
personnel.
System Optimization The Nimbus Pediatric System automatically
compensates for patient weight distribution and
position,optimizing the pressure relieving performance.
To ensure that the pressure relieving properties are not
impaired, the cover must not be pulled tight and any
covering sheets not fitted too tightly. Similarly, any
covering sheets should not be too loose to cause
wrinkling. Always use the Nimbus Pediatric mattress
with the protective top cover.
Placing extra layers and catheter tubes between the patient and the mattress
potentially reduces the benefits provided by the mattress and should be
avoided or kept to minimum.
Modes of Operation The system provides 3 modes of operation:
•Dynamic
• Static
•Autofirm
The pump defaults to Dynamic mode when switched on.
Dynamic Mode Provides the optimum pressure relieving properties and
should be used in most cases.
The support surface beneath the patient will cycle every
10 minutes.
Static Mode Provides a non-moving support surface for instances
where a dynamic support system is contra-indicated.
All cells are equally inflated and remain constant.
Autofirm Mode Provides a non-moving support surface with increased
firmness to assist in the application of certain nursing
procedures (physical therapy, etc).
All cells are equally inflated at an increased pressure for
30 minutes before reverting to dynamic mode.

12
Mode Selection Press the Mode Select button to cycle through the
different modes. An audible tone will sound and a visual
indicator will illuminate to show the selected mode.
Silencing Audible
Alarms Audible alarms can be silenced using the Mute button.
To silence an alarm simply push the Mute button once.
CPR Control To perform CPR, pull the CPR tag firmly up and away
from the mattress. This will disconnect 2 CPR plugs and
rapidly deflate the Nimbus Pediatric System.
On disconection, the mattress replacement will rapidly deflate, sufficient for
CPR procedures to commence.

13
To Reset CPR To reset the Nimbus Pediatric System after the CPR has
been activated:
1. Push the CPR plugs fully into the holes in the side
of the mattress.
2. Close the CPR cover flap using the Velcro
provided.
3. Ensure that the CPR Tag hangs freely from the CPR
cover flap.
Patient Transport The patient may be transported on the Nimbus Pediatric
System as follows:
1. Turn the transport facility on the tube-set to
transport. The pressure in the two sets of cells will
be maintained and the patient will continue to be
supported for up to 12 hours with the patient in the
supine position.
2. Turn the pump off and disconnect the tubeset from
the pump.
To resume normal operation, re-connect the tube-set to
the pump, switch the pump on and turn the transport
knob to normal.
If the tube-set remains connected to the pump when the transport control is
set to transport, the pump will indicate a low pressure fault.
To obtain the maximum use of the transport facility ensure that the patient
remainsin thesupine positionand the mattress is put in transportmode when
all cells are inflated.

14
Controls, Indicators and Alarms
On/Off Switch
(And Alarm Reset) Situated on the side panel of the pump, this switches the
power on and off. It is combined with an internal battery
circuit that will activate the alarm system if the power
supply is interrupted prior to switching off. Examples
are accidental power lead removal or power failure.
Control Panel New pumps have different icons on the control panel
compared to old pumps. For a detailed description of the
controls and indicators, you must refer to the correct
control panel section:
• Old control panel icons for pumps which have a nine
digit serial number starting with a 631 prefix, e.g.
631000001, refer to “Old Control Panel Icons” on
page 14.
• New control panel icons for pumps which have a ten
digit serial number starting with a 09 prefix, e.g.
0900000001, refer to “New Control Panel Icons” on
page 16.
Old Control Panel Icons
Power Indicator A green light on the front panel indicates that the power
is ON.
Wait Indicator If the pump detects low pressure in the mattress
replacement, the WAIT indicator is illuminated and the
pump performs a start up procedure to inflate the
mattress replacement.
Once correct operating pressures have been reached the
WAIT indicator goes out.