Arjo Citadel User manual
Citadel
INSTRUCTIONS FOR USE
830.213-EN Rev G • 09/2019
Bed Frame System
Design Policy and Copyright
® and ™ are trademarks belonging to the Arjo group of companies.
© Arjo 2019
As our policy is one of continuous improvement, we reserve the right to modify designs
without prior notice. The content of this publication may not be copied either wholly or
in part without the consent of Arjo.
3
Citadel Bed Frame System
Table of Contents
General Warnings ...................................................................................................5
•Safety Information ..............................................................................................8
Introduction............................................................................................................ 11
•Product Overview ............................................................................................. 11
Clinical Applications...............................................................................................14
•Intended Use....................................................................................................14
•Indications ........................................................................................................14
•Contraindications..............................................................................................14
•General Product Information ............................................................................15
•Precautions.......................................................................................................15
Installation .............................................................................................................16
•Weighing System Preparation..........................................................................16
•Electricity Supply..............................................................................................17
•Potential Equalization Terminal.........................................................................18
•Electrical Connections .....................................................................................18
•Power Cord.......................................................................................................18
•Nurse Call and RS232 Connections.................................................................19
•Auxiliary Power Outlet (Optional Feature)........................................................20
•Skin IQ Family Power Cable ..........................................................................20
•Skin IQ Installation...........................................................................................20
•Non Powered 5th Wheel Operation (Optional Feature)....................................21
•Citadel Patient Therapy System Connections...............................................22
•Mattresses........................................................................................................22
•SafeSet™.........................................................................................................23
Operating Instructions ...........................................................................................25
•Lifting Pole and Accessory Sockets..................................................................25
•Drainage Bag Rails...........................................................................................26
•Bed Length Adjustment ....................................................................................26
•Foot Pedal for Adjustment of Bed Height (Optional Feature)...........................28
•Brakes and Steering.........................................................................................28
•Side Rails .........................................................................................................29
•Head and Foot Boards .....................................................................................30
•Patient Restraints.............................................................................................30
•Under Bed Light................................................................................................31
•Backup Battery.................................................................................................32
•Recharging the Backup Battery........................................................................32
•Over-Use Lockout.............................................................................................33
•Attendant Control Panel (ACP), Nurse Control Panel and
Patient Control Panel........................................................................................34
•Patient Handsets (Optional Feature)................................................................37
•Weigh Scale Panels (With and Without Unit Selection)....................................38
4Citadel Bed Frame System
•Weighing Accuracy .......................................................................................... 39
•Weighing Initialization ...................................................................................... 40
•Weighing .......................................................................................................... 40
•Weighing Units ................................................................................................. 41
•Auto Compensation.......................................................................................... 41
•Weighing System Error Codes ........................................................................ 42
•Angle Indication................................................................................................ 42
•VariZone Patient Movement / Exit Detection................................................... 43
•VariZone Operation ......................................................................................... 44
•Anti-Entrapment System................................................................................... 45
•SafeSet™ (Optional Feature)........................................................................... 46
•RS232 Connection ........................................................................................... 48
•Controls for Television and Lighting (Optional Feature)....................................49
Patient Placement ................................................................................................. 50
•Power On ......................................................................................................... 50
•Preparation for Patient Placement ................................................................... 50
•Completion of Patient Placement.....................................................................51
Nursing Care ......................................................................................................... 52
•CPR.................................................................................................................. 52
•CPR Backrest Release.....................................................................................53
•Patient Bathing ................................................................................................. 53
•Patient Transfer from the Citadel Bed Frame System ..................................... 54
•Patient Transport.............................................................................................. 54
Care and Cleaning................................................................................................. 55
•Deck Sections................................................................................................... 55
•Decontamination............................................................................................... 55
•General Recommendations.............................................................................. 57
•Cleaning the Citadel Bed Frame System While in Use ...................................57
•Cleaning the Citadel Bed Frame Between Patients.........................................58
Preventive Maintenance........................................................................................ 59
•Weighing System.............................................................................................. 60
•Battery Test ...................................................................................................... 60
Troubleshooting..................................................................................................... 61
•Error Codes ...................................................................................................... 62
•Fault Indications ............................................................................................... 63
•Product Lifetime................................................................................................ 63
•Accessories ...................................................................................................... 63
Electromagnetic Compability (EMC)...................................................................... 64
Warranty and Service............................................................................................ 67
6SHFL¿FDWLRQV ........................................................................................................ 68
Explanation of Symbols Used................................................................................ 70
5
Citadel Bed Frame System
GENERAL WARNINGS
The following warnings should be considered prior to using this product:
Before using the bed, make sure that the power in rating on the
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To make sure the patient can use the bed safely, their age and
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use of head down tilt (Trendelenburg) or foot down tilt (reverse
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The tilt function should only be used under the guidance of a clinically-
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All accessories added to the system reduce the safe working load of
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If the power cord or plug is damaged, the complete assembly must be
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Make sure the power cord does not become entangled with moving
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Always adjust the bed frame and deck to the same length and make
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Entrapment hazards may exist when using a very soft mattress, even
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Side rails are not intended to restrain patients who make a deliberate
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Make sure the locking mechanisms are securely engaged when the
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6Citadel Bed Frame System
Prior to engaging any mattress turn feature, make sure that bed
frame has side rails and that all side rails are fully engaged in their full
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PDWWUHVVV\VWHPZKHQSDWLHQWUHVWUDLQWVDUHLQXVH
Patient restraints should be used in compliance with all applicable
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Patient restraints, even when correctly used, can result in entrapment
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decision to use patient restraints must be made by the clinician
overseeing the care of the individual patient, following a fully
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Patient restraints are not intended as substitutes for good nursing
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To make sure the battery is kept fully charged and prevent damage to
the battery, the bed should be connected to the electricity supply at all
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Only connect devices designed to be used with the bed Connecting
devices not designed to be used with the bed may result in damage to
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Keep your feet away from the areas below the side rails and take
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The weighing system should only be used by staff trained in the
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The weighing system should only be used in closely supervised
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additions to the bed) can be controlled as described in the following
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The weighing system MUST be zeroed every time a new patient is to
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The weighing system MUST be zeroed every time a mattress is
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7
Citadel Bed Frame System
The weighing system cannot be zeroed if a mattress or accessories
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care should be performed under the supervision of an appropriate
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power if the function has not been locked on the Attendant Control
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To prevent cross contamination or equipment damage, Arjo
recommends that the Citadel Bed Frame System be cleaned during
use and between patients according to the Care and Cleaning
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Always disconnect the Citadel Bed Frame System from mains wall
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If the bed is stored for a long time, it should be connected to the
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When the bed is operated, make sure that obstacles such as bedside
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Take care when using equipment that needs to be positioned under
the base frame to ensure there is no contact with any part of the bed
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If a serious incident occurs in relation to this medical device, affecting
the user, or the patient then the user or patient should report the
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In the European Union, the user should also report the serious
incident to the Competent Authority in the member state where they
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8Citadel Bed Frame System
Safety Information
General Protocols – Follow all applicable safety rules and institution protocols
concerning patient and caregiver safety.
Brakes – Set all caster brakes before transferring patient.
Bed Height – To minimize risk of falls or injury, the bed should always be in the
lowest practical position when the patient is unattended.
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is removed, check operation of components in area of spill.
Fluids remaining on controls can cause corrosion, which may
cause components to fail or to operate erratically, possibly
producing hazards for patient and staff.
Oxygen Use - Make sure that the unit is not contained in an oxygen enriched
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equipment other than the nasal prongs, mask or half bed length tent type. Oxygen
tent should not extend below mattress support level.
Lock-Outs – Lock-outs for bed functions should be used at staff’s discretion to
prevent unintentional operation of bed.
Power Cord – Make sure power cord is kept free from all pinch points, moving
parts and is not trapped under casters. Improper handling of power cord can
FDXVHGDPDJHWRWKHFRUGZKLFKPD\SURGXFHULVNRI¿UHRUHOHFWULFVKRFN3XOO
the power cord out of the mains wall outlet to remove power from the unit.
Avoid Fire Hazards±7RPLQLPL]HWKHULVNRI¿UHFRQQHFWWKHXQLW¶VSRZHUFRUG
directly into a wall-mounted outlet. Do not use extension cords or multiple outlet
strips. In the US, review and follow FDA’s Safety Tips for Preventing Hospital
Bed Fires. Outside the US, consult the local Competent Authority or Government
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Disposal – At the end of useful life, dispose of waste according to local
requirements or contact the manufacturer for advice. There may be special
requirements for disposal of batteries, leaded foam and / or angle sensors (if
present in this product). Improper disposal of any component may result in
regulatory non-compliance.
Moving Parts - Keep all equipment, tubes and lines, loose clothing, hair and parts
of the body away from moving parts and pinch points.
Patient Entrance / Exit – Caregiver should always aid patient in exiting the
bed. Make sure a capable patient knows how to get out of bed safely (and, if
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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
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9
Citadel Bed Frame System
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,
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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
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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,
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frequently to guard against patient entrapment.
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sure the distance between top of side rails (if used) and top of mattress (without
compression) is at least 22 cm (8.66 in) to help prevent inadvertent bed exit or
falls. Consider individual patient size, position (relative to the top of the side rail)
and patient condition in assessing fall risk.
Make sure the distance between top of side rails (if used) and
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greater. Consider individual patient size, position (relative to the
top of the side rail) and patient condition in assessing fall risk.
Skin Care – Monitor skin conditions regularly and consider adjunct or alternative
therapies for high acuity patients. Give extra attention to skin over any raised side
bolster and to any other possible pressure points and locations where moisture
or incontinence may occur or collect. Early intervention may be essential to
preventing skin breakdown.
Maximum Recommended Patient Weight - Total patient weight capacity should
not exceed 227 kg (500 lb). The use of accessories on the bed may decrease the
patient weight capacity of the bed. Contact Arjo Customer Service for questions
concerning the use of accessories and see the Questions and Contact Information
section of this guide for contact information.
I.V. and Drainage Tubes – Prior to activating any positioning function assess
the security of all invasive lines and tubes to accommodate the desired angle of
articulation and minimize the risk of binding, disconnecting or dislodging. Tubes and
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Turning - Prior to engaging any mattress turn feature, make sure that bed frame
has side rails and that all side rails are fully engaged in their full upright and locked
position. Do not activate the turning feature on any mattress system when patient
restraints are in use.
10 Citadel Bed Frame System
Scale Readings - Scales / patient weights are for reference only. Scale readings
should not be relied upon for medication dosage. All equipment on the weighed
portion of the unit is included in weight displayed.
Patient Migration – Specialty surfaces have different shear and support
characteristics than conventional surfaces and may increase the risk of patient
movement, sinking and / or migration into hazardous positions of entrapment
and / or inadvertent bed exit. Monitor patients frequently to guard against patient
entrapment.
Skeletal Traction or Unstable Fracture (if not contraindicated) – With skeletal
traction, unstable pelvic fracture or any other unstable fracture (to the extent
not contraindicated), maintain physician directed angle of articulation and guard
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Electromagnetic Interference – Although this equipment conforms with the intent
of electromagnetic compatibility, all electrical equipment may produce interference.
If interference is suspected, move equipment away from sensitive devices or
contact the manufacturer.
Shock Hazard – Electrical shock hazard; do not remove electrical compartment
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11
Citadel Bed Frame System
INTRODUCTION
These instructions contain information for the installation, use and maintenance of the
Arjo Citadel™ Bed Frame System. These beds have multiple functions to provide the
optimum nursing position for both patient and caregiver.
Product Overview
A. Head Board
B. Backrest Section
C. Patient Controls
D. Seat Section
E. Thigh Section
F. Foot Board
G. Extension Locking Handle
H. Accessory Power Outlet
I. Anti-Entrapment Sensor
J. Foot End Brake Pedal
K. Extension Catch Bar
L. CPR Release Handle
M. Weighing / Movement Detection
System Controls
N. Attendant Control Panel (ACP)
O. Side Rail Release Lever
P. Drainage Bag Rail
Q. Caster
R. Roller Buffer
S. Lifting Pole Socket
T. Foot End Side Rail
U. Caregiver Controls
V. Head End Side Rail
*not pictured, optional foot pedal for
adjustment of bed height.
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Citadel Bed Frame System
All Citadel beds have the following standard features:
• Folding split side rails with integrated bed controls
• Electrical adjustment of bed height and leg section elevation
• Electrically operated retracting backrest
• Auto-Chair facility
• Electrical adjustment of head down tilt (Trendelenburg) and foot down tilt
(reverse Trendelenburg)
• Electrical adjustment of calf section vascular position
• Mattress support surface with removable panels
• Adjustable length deck
• Drainage bag rails
• Under bed lights
• 125 mm single wheel casters
• Patient weighing
• VariZone™patient egress detection
• Anti-Entrapment System
The following are optional features:
• IndiGo™ Intuitive Drive Assist
• Non Powered 5th Wheel
• Vertical Height Foot Switch
• One-way nurse call
• Two-way nurse call
• Environmental controls
• RS232 connection allowing transfer of bed status data
• 150 mm (single or dual wheel) casters
• Additional brake pedals at head end
• DIN accessory rails
• Foot pedal for adjustment of bed height
• Patient handset
• Auxiliary power outlet
13
Citadel Bed Frame System
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options are indicated by the equipment model number.
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on the bed frame below the head board.
Before using the bed, make sure that the Power in rating on the
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DUTY10% 2 min ON / 18 min OFF
POWERin 115V~ 9.5 A MAX 60Hz
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ArjoHuntleighAB
HansMichelsensgatan 10
21120 Malmö, SWEDEN
www.arjohuntleigh.com
YYYY-MM-DD
MADEIN POLAND
CitadelBed Frame System 270 kg
595 lb
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Citadel Bed Frame System
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14 Citadel Bed Frame System
CLINICALAPPLICATIONS
To make sure the patient can use the bed safely, their age and
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The use of head down tilt (Trendelenburg) or foot down tilt (reverse
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The tilt function should only be used under the guidance of a clinically-
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Intended Use
The Citadel Bed Frame System is intended for the acute and post-acute care
environments. It is not intended for use in the homecare environment.
The bed is suitable for use in the following situations:
• Intensive / critical care provided in a hospital where 24-hour medical
supervision and constant monitoring is required, e.g. ITU, ICU and CCU.
• Acute care provided in a hospital or other medical facility where medical
supervision and monitoring is required, e.g. general medical and surgical
wards.
• Long term care in a medical area where medical supervision is required and
monitoring is provided if necessary, e.g. nursing homes and geriatric facilities.
Indications
The Citadel Bed Frame System is indicated for medical purposes to aid the patient
and staff during the performance of routine care.
Contraindications
The Citadel Bed Frame System is contraindicated for patients weighing in excess of
227 kg (500 lb). The caregiver should refer to and follow any contraindications in the
product labeling for the pressure redistribution surface being used with the Citadel Bed
Frame System.
The bed is not suitable for patients under 40 kg (88 lb) in weight.
15
Citadel Bed Frame System
General Product Information
All accessories added to the system reduce the safe working load of
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Safe working load (SWL)............................... 270 kg (595 lb)
Maximum patient weight................................ 227 kg (500 lb)
The recommended patient height is between 146 cm (58 in) and 190 cm
(75 in). At the discretion of the caregiver, patients taller than 190 cm (75 in) may be
accommodated by extending the bed - refer to bed length adjustment on page26.
Make sure that the patient’s height does not exceed the in-bed length.
Maximum Patient Weight
:LWKNJDFFHVVRULHVRUPDWWUHVV Without Accessories or mattress
Safe Working Load NJ NJ
Patient Therapy System NJ NJ
Accessories NJ NJ
Maximum allowable patient weight NJ NJ
Precautions
Precautions may need to be taken when using this product with certain patient
conditions, including, but not limited to:
• hemodynamic instability
• severe agitation
• XQFRQWUROODEOHFODXVWURSKRELDRUIHDURIFRQ¿QHPHQW
• uncontrollable diarrhea
• pregnancy
• extensive facial trauma
• any other unstable fracture
• ICP monitoring or intracranial drainage devices
146 cm BMI 17
/1036 lb)
/ 595 lb
/595 lb)
(470 kg
/ 500 lb
832.779
227 kg
(270 kg
/441 lb)
(270 kg
(200 kg
16 Citadel Bed Frame System
INSTALLATION
The following chapter describes how to install the bed.
Weighing System Preparation
To prevent damage to the weighing mechanism, replace the transport
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When replacing the transport locking bolts care must be taken to
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Remove the four transport locking bolts (1) and washers (2); there are two locking
bolts at the head end of the bed and two at the foot end.
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Retain the bolts and washers in case the bed needs to be transported at a later date.
2
1
2
1
17
Citadel Bed Frame System
Electricity Supply
If the power cord or plug is damaged, the complete assembly must be
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SOXJRUXVHDUHZLUHDEOHSOXJRUDGDSWHU
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'RQRWDOORZWKHSRZHUFRUGWRWUDLORQWKHÀRRUZKHUHLWPD\FDXVHD
WULSKD]DUG
Make sure the power cord does not become entangled with moving
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Unplug the power cord from the electricity supply, and store it, before
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connect the bed to the electricity supply for at least 24 hours to allow the backup
battery to recharge fully; failure to do this may reduce the life of the battery. After
charging, check that the battery is fully serviceable by carrying out a battery test as
shown on page 60.
Connect the mains plug to a suitable outlet. Make sure the plug is easily accessible so
it can be unplugged quickly in an emergency.
When the bed is connected to the electricity supply, the Power On Indicator LED will
light on the Attendant Control Panel (see page 34).
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When not in use or before moving the bed, clip the hook onto the head board, coil up
the cable and place it over the hook as shown.
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To isolate the bed from the electricity supply, unplug the mains plug from the outlet.
18 Citadel Bed Frame System
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A potential equalization terminal (Figure 5, item 1) is located at the foot end of the bed.
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When other electrical equipment is within reach of the patient or caregiver, potential
differences between the equipment can be minimized by connecting together their
potential equalization terminals.
Electrical Connections
The Citadel bed contains the following electrical connections.
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• Power Cord • AC Power Connection
• Nurse Call Connector • CPR Switch Connection
• 56&RQQHFWRULIVSHFL¿HG Communication Connection
• Auxiliary Power Outlet
• Skin IQ™Family Power Cable
Power Cord
The power cord is located at the head end of the bed. Make sure power cord is kept
free from all pinch points, moving parts and is not trapped under casters. Improper
KDQGOLQJRISRZHUFRUGFDQFDXVHGDPDJHWRWKHFRUGZKLFKPD\SURGXFHULVNRI¿UH
or electric shock. Pull the power cord out of the mains wall outlet to remove power from
the unit.
19
Citadel Bed Frame System
1XUVH&DOODQG56&RQQHFWLRQV
1. Connect one end of the nurse call cable to the 37-pin D-type outlet, located
below the head end of the bed on the patient's right hand side.
2. Connect the other end of the nurse call cable to a compatible nurse call
system. The type of connector will vary depending on the nurse call system.
3. Connect one end of an RS232 cable to the 9-pin D-type outlet, located below
the head end of the bed on the patient's right hand side.
4. Connect the other end of the RS232 cable to a device capable of receiving
data through an RS232 connection.
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WKHFRUUHFWFDEOHV8VHRIWKHZURQJFDEOHVPD\FDXVHPDOIXQFWLRQRI
WKHEHGRUGHYLFHVFRQQHFWHGWRWKHQXUVHFDOORU56FRQQHFWRUV
Verify correct operation of the nurse call system before placing a
SDWLHQWRQWKHEHG
'RQRWDOORZWKHQXUVHFDOORU56FDEOHVWRWUDLORQWKHÀRRUZKHUH
WKH\PD\FDXVHDWULSKD]DUG8QSOXJERWKFDEOHVEHIRUHPRYLQJWKH
EHG
'RQRWDOORZWKHFDEOHVWRWRXFKWKHEHGIUDPHDVWKLVPD\DIIHFWWKH
DFFXUDF\RIWKHZHLJKLQJV\VWHP
2QO\FRQQHFWGHYLFHVGHVLJQHGWREHXVHGZLWKWKHEHG
Connecting devices not designed to be used with the bed may result
LQGDPDJHWRWKHHTXLSPHQWRUWRWKHEHG
2QO\XVHFDEOHVZLWKDQLQOLQHEUHDNDZD\FRQQHFWRUEHORZ)DLOXUH
to do so could result in damage to the bed or to other hospital
HTXLSPHQW
)LJXUH([DPSOHRIDQLQOLQHEUHDNDZD\FRQQHFWRU
Breakaway
connection
Connect to
bed Connect to
Nurse call system
Citadel Bed Frame System
Auxiliary Power Outlet (Optional Feature)
'RQRWFRQQHFWDQ\FULWLFDORUOLIHVXVWDLQLQJHTXLSPHQWWRDX[LOLDU\
RXWOHW7KHVHGHYLFHVVKRXOGEHFRQQHFWHGWRKRVSLWDORXWOHWV
'HYLFHVFRQQHFWHGWRWKLVRXWOHWVKDOOQRWH[FHHG
• 115 VAC / 7A
• 230 VAC / 4A
This outlet does not remain powered when the bed is on battery
EDFNXS
Auxiliary power outlet is provided as a convenience for powering devices intended to
be placed at or near the foot end of the bed.
Skin IQ Family Power Cable
The cable should only be used to power the Skin IQ Family of
SURGXFWV
Skin IQ Power Cable is provided as a convenience for powering Skin IQ. This feature
remains powered for four hours when the bed is on battery backup. A 12 VDC power
cable is located at the foot end of the bed which provides a connection point for the
Skin IQ of products.
Skin IQ Installation
Refer to Skin IQ Instructions for Use for detailed installation
instructions.
1. Stretch the Skin IQ coverlet over existing surface and use straps to secure to
existing mattress.
2. When using the Skin IQ on the Citadel mattress, the mattress comes already
equipped with straps located mid way under the mattress exclusively for
attaching the tie-down straps from the Skin IQ coverlet.
3. Use the 12 VDC power cable, centered at the foot end of the bed to plug in
the Skin IQ. Cable has a tag indicating it is for Skin IQ use.
)LJXUH$X[LOLDU\SRZHURXWOHWDQGSkin IQ Family power cable
Skin IQ
connection
located behind
foot board
weldment
Auxiliary
power outlet
located on the
under side
of foot board
weldment
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