ARJO HUNTLEIGH RotoProne User manual

...with people in mind
RotoProne Therapy System
User Manual
208662-AH Rev C • 12/2014
The Indications for Use of the RotoProne Therapy System have recently been updated. The User
Manual provided with the product has the updated Indications for Use included. Please discard any
product manuals within your possession that have revisions prior to those shown below.
User Manual: 208662-AH Rev C
Maintenance Manual: 207562 Rev B
If you would like to obtain additional copies of the product manuals or have any questions related to
the use of the product contact ArjoHuntleigh at 1-800-343-0974.

iii
TABLE OF CONTENTS
DISCLAIMER OF WARRANTY AND LIMITATION OF LIABILITY........................................ vii
Introduction
Indications for Use ....................................................................................................1-1
Contraindications......................................................................................................1-1
Risks and Precautions................................................................................................1-2
Safety Information ....................................................................................................1-3
Operating Instructions
RotoProne Therapy System Overview ........................................................................2-1
Power-Up Procedure ................................................................................................. 2-2
Welcome to RotoProne / New Patient Screen ............................................................2-3
Home Screen ............................................................................................................2-3
• Prone / Supine Button and Prone / Supine Preparation.........................................2-4
- Checklist...........................................................................................................2-5
• Move to Prone / Supine.......................................................................................2-6
• Therapy Settings Selection...................................................................................2-7
- Prone / Supine Settings.....................................................................................2-8
- Therapy Settings Definitions..............................................................................2-8
• Scale...................................................................................................................2-9
- Hold Patient Weight .........................................................................................2-9
- Zero Scale.......................................................................................................2-10
- Display ...........................................................................................................2-10
- Weigh Delay...................................................................................................2-10
- Adjusted Weight.............................................................................................2-11
- Weight Trends ................................................................................................2-11
• Surface Position ................................................................................................2-12
- Surface Height................................................................................................2-12
- Trendelenburg / Reverse Trendelenburg...........................................................2-12
• Park ..................................................................................................................2-13

iv
- Park Positions .................................................................................................2-13
- Therapy Meters...............................................................................................2-14
- Therapy Chart.................................................................................................2-15
Powered CPR ..........................................................................................................2-15
Emergency Release for CPR / Supine Position ..........................................................2-17
Manual Rotation to Prone Instructions ....................................................................2-19
Help........................................................................................................................2-20
Hand Control..........................................................................................................2-20
Alarms and Troubleshooting....................................................................................2-21
Stuck or Jammed Lock Pin Instructions .................................................................... 2-27
Patient Placement
Preparation for Patient Placement .............................................................................3-1
- Therapy Settings Definitions..............................................................................3-4
Patient Transfer to the RotoProne Therapy System...................................................3-10
Pack Installation......................................................................................................3-12
• Leg Abductor Pack............................................................................................3-12
• Side Support Packs............................................................................................3-13
• Proning Packs....................................................................................................3-16
• Assess Patient Position ......................................................................................3-19
• Face Pack..........................................................................................................3-19
• Chest Packs.......................................................................................................3-21
Completion of Patient Placement............................................................................ 3-21
Starting Therapy .....................................................................................................3-23
Prone Therapy.........................................................................................................3-25
Patient Care
Hatches ....................................................................................................................4-1
• Upper Body Hatches............................................................................................4-1
• Hatch Center Bar (X-ray Facilitation).................................................................... 4-1
• Midline Hatch .....................................................................................................4-2
• Lower Body Hatch...............................................................................................4-2
Bathing Patient .........................................................................................................4-3

v
• Supine Bathing....................................................................................................4-3
• Prone Bathing .....................................................................................................4-4
Skin Care ..................................................................................................................4-5
• Face....................................................................................................................4-5
• Axilla...................................................................................................................4-5
• Shoulders and Iliac Crest .....................................................................................4-6
• Feet ....................................................................................................................4-6
Incontinence / Drainage ............................................................................................4-6
Foot Support.............................................................................................................4-6
Side-Lying Head Position ...........................................................................................4-6
Patient Transfer From the RotoProne Therapy System ................................................4-7
Power-Down Procedures
• Power-Down for Intra-Facility Transport / Storage ................................................5-1
• Power-Down for Shipping ...................................................................................5-3
Care and Cleaning
Daily Equipment Check............................................................................................. 6-1
Preventive Maintenance ............................................................................................6-1
Specifications
• Recommended Weight and Height......................................................................7-1
• Dimensions .........................................................................................................7-1
• Articulation.........................................................................................................7-1
• Scale...................................................................................................................7-1
• Electrical .............................................................................................................7-1
• Classification.......................................................................................................7-1
• Environmental Storage / Transit Conditions..........................................................7-2
• Environmental Operating Conditions...................................................................7-2
Symbols Used ...........................................................................................................7-2
Electromagnetic Emissions Information .....................................................................7-4
Questions and Information
Customer Contact Information .................................................................................8-1

vii
DISCLAIMER OF WARRANTY AND LIMITATION OF LIABILITY
ARJOHUNTLEIGH HEREBY DISCLAIMS ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT
LIMITATION ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE,
ON THE ARJOHUNTLEIGH PRODUCT(S) DESCRIBED IN THIS PUBLICATION. ANY WRITTEN WARRANTY
OFFERED BY ARJOHUNTLEIGH SHALL BE EXPRESSLY SET FORTH IN THIS PUBLICATION OR INCLUDED WITH
THE PRODUCT. UNDER NO CIRCUMSTANCES SHALL ARJOHUNTLEIGH BE LIABLE FOR ANY INDIRECT,
INCIDENTAL, OR CONSEQUENTIAL DAMAGES AND EXPENSES, INCLUDING DAMAGES OR INJURY TO
PERSON OR PROPERTY, DUE IN WHOLE OR IN PART TO THE USE OF THE PRODUCT OTHER THAN THOSE FOR
WHICH DISCLAIMER OF WARRANTY OR LIMITATION OF LIABILITY IS EXPRESSLY PROHIBITED BY SPECIFIC,
APPLICABLE LAW. NO PERSON HAS THE AUTHORITY TO BIND ARJOHUNTLEIGH TO ANY REPRESENTATION
OR WARRANTY EXCEPT AS SPECIFICALLY SET FORTH IN THIS PARAGRAPH.
Descriptions or specifications in ArjoHuntleigh printed matter, including this publication, are meant solely
to generally describe the product at the time of manufacture and do not constitute any express warranties,
except as set forth in the written limited warranty included in this publication or with this product.
Information in this publication may be subject to change at any time. Contact ArjoHuntleigh for updates.
IMPORTANT INFORMATION FOR USERS
In order for ArjoHuntleigh products to perform properly, ArjoHuntleigh recommends compliance with 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.
• Assembly, operations, extensions, re-adjustments, modifications, technical maintenance or repairs
must be performed by qualified personnel authorized by ArjoHuntleigh. Contact ArjoHuntleigh 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
ArjoHuntleigh’s 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. Contact your local
ArjoHuntleigh representative for product in-service and training.
NOTICE
This product has been configured from the manufacturer to meet specific voltage requirements. Refer to the
product information label for specific voltage.

1-1
INTRODUCTION
The RotoProne™ Therapy System is a patient care system for the prevention and treatment of complications
associated with immobility.
• Kinetic Therapy™- Allows an immobile patient to be rotated bilaterally up to 62° in the supine
position.
• RotoProne Therapy System - Allows an immobile patient to be moved from the supine to the prone
position in an automated fashion. Additionally, the RotoProne Therapy System provides continuous,
bilateral rotation up to 62° in the prone position.
The RotoProne Therapy System features include rotation that is programmable in one-degree increments
bilaterally, up to 62° in either the prone or supine position.
Additional features include:
• acclimation mode to build patient tolerance to rotation
• pause and hold functions to suspend the patient in a side lying position
• tube management system
• electronically monitored buckles
• ergonomically designed head positioning system
• ability to move a patient quickly from prone to supine or vice-versa
Indications
The RotoProne Therapy System is indicated for prevention and treatment of complications due to immobility:
Contraindications
Patient conditions for which the application of Kinetic Therapy and the RotoProne Therapy System are
contraindicated include:
• unstable cervical, thoracic, lumbar, pelvic, skull* or facial* fractures
• cervical and / or skeletal traction
• uncontrolled Intracranial Pressure (ICP)
• patient weight below 88 lb / 40 kg
• patient weight above 350 lb / 159 kg
• patient height above 6 ft 6 in / 201.18 cm
• patient height below 4 ft 6 in / 140.21 cm
*Only contraindicated for prone therapies.

1-2
Risks and Precautions
The RotoProne Therapy System is typically prescribed for patients suffering from the consequences of
immobility. Although use of the RotoProne Therapy System is thought to help caregivers address potentially
life-threatening conditions, proning itself may present inherent risks of serious injury. For instance, some
studies and caregiver experience have suggested or reported risk of the following in relation to proning in
general:
• skin breakdown and / or pressure necrosis
• wound dehiscence
• cardiac arrest
• loss of invasive lines or tubes or extubation (endotracheal and oral)
• edema and / or swelling
• splenic rupture
• blindness and other consequences of damage to the ocular nerve
• corneal abrasion
• myositis ossification
• venous air embolism
• increased intraorbital pressure
• central retinal artery occlusion
• pain and discomfort
• difficulty performing CPR
Precautions may also need to be taken when using this product with certain patient conditions, including
but not limited to:
• hemodynamic instability
• severe agitation
• uncontrollable claustrophobia or fear of confinement
• uncontrollable diarrhea
• intolerance to face down position
• wounds at risk of dehiscence while in prone position
• patient in the prone position with open sternal wound or thoracic post-surgical incision
• patient in the prone position with open abdomen
• any implant that potentially increases the risk of skin breakdown including, but not limited to, breast
implants or penile prosthesis
• pregnancy
• extensive facial trauma
• any other unstable fracture not listed as a contraindication
• ICP monitoring or intracranial drainage devices
Caregivers should make sure to discuss Safety Information, Risks and Precautions with
the patient (or the patient’s legal guardians) and the patient’s family.

1-3
Safety Information
Skin Care - Fitting the head support, face pack, proning packs or other accessory packs too tightly may
increase pressure points, possibly leading to skin breakdown. Assess skin at frequent intervals depending on
patient condition (at least once every four hours). Give extra attention to skin at pressure points and locations
where moisture or incontinence may occur or collect. Common pressure points include, but are not limited
to, the face, ears, axilla, shoulders, sides and upper and lower extremities. Early intervention may be essential
to preventing serious skin breakdown. Do not leave patient in a stationary position in the supine or prone
position for more than two hours.
Face Pack - Position face pack to ensure visibility of the eyes and to avoid pressure on or around patient’s
eyes, mouth and ears. Remove face pack at regular intervals to assess the eyes, ears and facial skin.
Prolonged, increased intraoccular pressure may cause eye injury, including blindness. Ensure all face pack
buckles are secure before proning patient.
Face pack buckles are not electronically alarmed; manually pull up on face pack to ensure it is
attached securely.
Side Support Packs - Maintain a one-inch clearance (approximately the width of two fingers) between the
end of the side support pack and the patient’s axilla. Never place Side Support Pack snugly against patient’s
axilla, as undue pressure on axillary blood vessels and / or nerve injury may result.
Bed Height - To minimize risk of falls or injury, the unit should always be in the lowest practical position
when the patient is unattended. Make sure area under and around unit frame is clear of objects, persons and
parts of body before adjusting height.
Lock Pin - The lock pin should be fully engaged in the 0° supine position when rotation is stopped. Make
sure area under and around unit frame is clear of objects, persons and parts of body before pulling lock pin
to allow rotation.
Tube and Line Management - Prior to activating rotation, assess the security of all invasive lines and tubes
to accommodate a full 360° of rotation and minimize the risk of binding, disconnecting or dislodging. Tubes
and lines should always have slack for rotation and patient movement. Tubes and lines must always be routed
through and kept within either top frame hoop or the circular opening in the frame at the foot-end of the
unit, just beneath the main display panel. Do not hang or tie any equipment or lines on sides of patient
support frame.
Ventilator Management - Always rotate the patient surface from the supine position to the prone position
toward the ventilator, to reduce risk of extubation.
Hatches - Always make sure hatches are closed and locked in position prior to rotating patient surface from
supine / prone position and vise-versa. Use caution when opening and closing hatches. Keep extremities, hair,
clothing or other objects clear of hatch openings to avoid injury or damage. Unlatched hatches and hatch
center bar may pose risk of injury or damage if allowed to drop freely.

1-4
Moving Parts - Keep all equipment, tubes and lines, loose clothing, hair and parts of the body away from
moving parts and pinch points.
Fluids - Avoid spilling fluids on unit controls. If spills do occur: unplug unit and clean fluid from 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 to
operate erratically, possibly producing hazards for patient and caregiver.
Patient Restraints - Whether and how to use restraints is a decision that should be based on each patient’s
individual needs and should be made by the patient and the patient’s family, physician and caregivers, with
facility protocols in mind. Monitor restrained patients frequently.
CPR and Manual Rotation Features - Caregivers and other hospital personnel are required to become
familiar with the CPR function and the emergency release procedures for automatically or manually rotating
the patient surface, as well as the other procedures required to access the patient in case of an emergency.
Avoid Fire Hazards - To minimize the risk of fire, connect the unit’s power cord directly into a wall-mounted
outlet. Do not use extension cords or multiple outlet strips.
Power Cord - Position power cord to avoid a tripping hazard and / or damage to the 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 produce risk of fire or electric shock.
Brakes - Caster brakes should always be locked once the unit is in position. Verify wheels are locked before
any patient transfer to or from the unit.
Transport - Always use at least two people when transporting unit.
Scale Readings - Scales / patient weights are for reference only. Scale readings should not be relied upon for
medication dosage. All equipment on the unit is included in weight displayed.
General Protocols - Follow all applicable safety rules and institution protocols concerning patient and
caregiver safety.

2-1
OPERATING INSTRUCTIONS
This chapter contains instructions for setting and adjusting functions of the RotoProne Therapy System. It
is recommended that all chapters of this manual be reviewed before operating the unit. Carefully read
the Contraindications, Risks and Precautions and Safety Information sections in the Introduction
chapter as well as the Patient Placement chapter of this manual prior to operating the RotoProne
Therapy System. Contact your local ArjoHuntleigh representative for product in-service and training.
RotoProne Therapy System Overview
The outline below lists the major sections of the Operating Instructions chapter:
• Power-Up Procedure
• Welcome To RotoProne / New Patient screen
• Home screen
• Powered CPR
• Emergency Release for CPR / Supine Position
Prone Lower Leg Pack
Main Display
Foot Hoop
Accessory Rack
Lock Pin
Manual
Rotation
Lever
Manual
Lift Switches
Prone Pack Plunger
Emergency
Release
Handle
Roll Lock Caster
U Frame
Caster Frame
Steer / Roll Lock Caster
Control Handle
Prone Pack Strap
Head Hoop
Prone Chest Pack
Prone Abdominal Pack
Prone Upper Leg Pack
CPR Button
Tube Management System
(See picture on page 3-10)

2-2
• Manual Rotation to Prone Instructions
• Help
• Hand Control
• Alarms
Power-Up Procedure
1. Plug power cord into a properly grounded wall outlet.
2. Press ON / OFF switch located behind power switch door to activate power.
3. The software will boot and a Set Date and Time option will appear on
the main display.
The main display is a touch screen located at the foot of the
RotoProne Unit. It is the primary point of interface for the
caregiver. The caregiver can simply touch the various buttons
shown on the screen to access all RotoProne Unit functions. The
buttons lead to subsequent screens that display therapy and
proning options, settings and configurations.
4. Enter correct date and time if necessary and press either Save New Time or Time is Correct button.
5. A calibration option will appear on the main display. Detailed information regarding the calibration
procedure is outlined in the Patient Placement section of this manual.
Do not calibrate scales. Scale calibration should be performed by trained ArjoHuntleigh personnel.
6. Once calibration is completed, a Notice to Users screen will appear. Please read the Welcome to
RotoProne statement and press the button to indicate you have read and complied with the statement.
The Welcome to RotoProne / New Patient screen will appear.
The following sections illustrate and describe the main screens and sub-screens to which they
provide access. The Help button is present on all screens and may be accessed at any time to
explain a screen’s function or to navigate through various screens. The CPR button is located in the
lower right corner of all screens. Press to activate the CPR function at any time.
1-800-343-0974
Power Switch

2-3
Welcome To RotoProne / New Patient Screen
Use the Welcome To RotoProne / New Patient screen to set up the RotoProne Unit for a new patient or to
access former patient data.
• Press New Patient - Yes button to activate the
RotoProne Set-up Wizard. The Set-up Wizard serves as
a step-by-step guide to all screens required to prepare
for a new patient.
• Press New Patient - No button to restore the data
from most recently-placed patient on the unit.
Home Screen
The Home screen displays the current status of the RotoProne Therapy Unit. Readings on the Home screen
show if the patient is in prone or supine position, how many degrees and to which direction the patient is
rotated, how many degrees (if any) in Trendelenburg / Reverse Trendelenburg a patient is positioned and if
the patient surface is rotating or paused. If the patient surface is not rotating, a message will be included on
the Home screen to pull the lock pin to begin rotation.
Prolonged static positioning may increase risk of skin breakdown.
Use the Home screen to:
• Move the patient to prone or supine
• Access Kinetic Therapy and Prone Therapy settings
• Access scale functions

2-4
• Adjust patient surface position
• Park the patient (hold the patient surface at a desired angle)
• Access therapy meters
• Access Help
• Activate CPR
Prone / Supine Button and Prone / Supine Preparation
Use the Prone / Supine button to access the screens and buttons that will begin Kinetic Therapy in the
desired position.
• With the Home screen showing, press the Prone / Supine button. The Prone or Supine Preparation
screen will appear.
• Press and hold the Rotate and Lower button to move patient surface to 0° and lowest height and
cancel any Trendelenburg position in preparation for rotation. Once patient surface is level and fully
lowered, the Checklist screen will appear.
Make sure area under and around frame is clear of objects before starting movement.
If a change is not made on any screen within approximately five minutes, the display will
automatically revert to the Home screen.

2-5
Checklist
The short Checklist screen appears prior to initiation of supine therapy or when rotating the patient from
prone to supine. It requires assessment of the patient’s invasive lines and tubes, intubation system and
placement in the head support.
The long Checklist screen appears prior to rotating the patient from supine to prone. In addition to assessing
patient’s invasive lines and tubes, intubation system and head placement, it requires assessment of the
patient’s arm and abdominal support.
For detailed information on equipment check and assessment of patient position, refer to the Starting
Therapy and Prone Therapy sections of the Patient Placement chapter of this manual.
1. Assess all invasive lines and tubes. If secure, press Check Tubing button. The arrow will change to a
check mark.
2. Examine patient’s artificial airway system. If secure, press Check Airway button. The arrow will change
to a check mark.
3. Examine patient’s placement in head support assembly. If secure, press Check Head Support button.
The arrow will change to a check mark.
4. Examine placement of patient’s arms in arm supports. If secure, press Check Arm Slings button (long
checklist only). The arrow will change to a check mark.
5. Examine placement of chest and pelvic packs. If secured and positioned properly, press Check Abdomen
Support button (long checklist only). The arrow will change to a check mark.

2-6
6. If you are moving the patient into the prone position, a special
Face Pack Caution screen will appear once the long checklist has
been cleared. Assess position of the face pack, make any necessary
adjustments, then press the Confirm button.
Face pack buckles are not electronically alarmed. Manually
pull up on face pack to ensure it is attached securely.
The special Face Pack Caution screen will not appear if
patient is to be rotated in the supine position.
7. Once all buttons display check marks, the Prone or Supine Rotate screen will appear.
Move To Prone / Supine
Use the Move to Prone or Move to Supine screen to rotate from prone to supine or supine to prone
position.
1. Press and hold the Prone or Supine button until the patient surface rotates to 0°. Once the patient
surface reaches 0° prone or supine, the short Checklist screen reappears.
If for any reason the Prone or Supine button is released before the patient surface reaches 0°,
the Interrupted Rotation screen appears. A Fast or Slow rotation option may be chosen in
this screen. This option only affects the speed at which the patient surface is rotated into initial
placement for therapy, not the speed of rotation during actual Kinetic Therapy and Prone Therapy.
To move the patient surface fast right, press and hold the right double button.
To move the patient surface slow right, press and hold the right single button.
To move the patient surface fast left, press and hold the left double button.
To move the patient surface slow left, press and hold the left single button.
2. Reconfirm the checklist. Once all items are re-checked, the Start Rotation screen will appear.
For detailed information on equipment check and assessment of patient position, refer to the
Starting Therapy and Prone Therapy sections of the Patient Placement chapter of this manual.
3. Press Start Rotation button. Patient surface will begin rotation and the Home screen will appear,
displaying current rotation angle and therapy status.

2-7
Therapy Settings Selection
Use the Therapy Settings Selection screen to select supine or prone settings, direction of rotation and any
acclimation options.
1. With the Home screen showing, press the Therapy Settings button. The Therapy Settings Selection
screen will appear.
2. Press Prone Direction button to select clockwise or counterclockwise rotation.
Use the Prone Direction option to choose which direction the patient surface rotates from supine
to prone. When the patient surface is ready to return to the supine position from the prone
position, it will always rotate in the opposite direction. For example, if clockwise rotation is
selected, the patient surface will rotate from supine to prone in the clockwise direction. When
directed to return back to supine from prone, the patient surface will rotate in the
counterclockwise direction, so as not to tangle endotracheal tubing or patient lines.
Always rotate the patient surface from the supine position toward the ventilator, to reduce risk of
extubation.
3. Press Acclimate button to select the Acclimation option.
NOTE: Use the Acclimation option to help the patient adjust to the target rotation angle by beginning
rotation at a lower degree angle, then increasing the degree of rotation in a series of steps until
the target rotation angle is achieved.
4. Press the Prone Settings or Supine Settings button, according to which therapy will be used. The
Prone or Supine Therapy Settings screen will appear.

2-8
Use the Prone and Supine Therapy Settings screen to select and adjust left, center and right pause times
and left and right rotation angles.
Therapy settings should be determined per physician’s orders.
1. Select the desired setting to change by pressing the corresponding button location; button will turn
yellow when selected.
2. Press the Adjust up or down arrow button to reach the desired setting.
3. Press the Done button to save all settings and return to the Therapy Settings Selection screen.
4. Press the Home button to return to the Home screen.
Therapy Settings Definitions
• Patient Left Pause Time: The amount of time the patient is held in place once the target left rotation
angle is reached. Minimum pause time is one minute; maximum pause time is 30 minutes.
• Patient Center Pause Time: The amount of time the patient is held in a level position after rotating to the
right or left. Minimum pause time is zero; maximum pause time is 30 minutes.
• Patient Right Pause Time: The amount of time the patient is held in place once the target right rotation
angle is reached. Minimum pause time is one minute; maximum pause time is 30 minutes.
• Patient Left Maximum Angle: The target left rotation angle to which the patient will turn during rotation
and left pause.
• Patient Right Maximum Angle: The target right rotation angle to which the patient will turn during
rotation and right pause.
Prone / Supine Settings