DARAY V460S Series Installation and operating instructions

V460S Series
Ambulatory NIBP Patient Monitor with SpO2
User Manual & Installation Guide
QAM.V460S.0915.4

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Contents
1. Introduction.................................................................................... 4
1.1 Supported Units .......................................................................... 4
1.2 Specification.............................................................................. 5
1.3 Pre-Operation Responsibilities and component packing list........................ 7
1.4 Packing List ............................................................................... 7
1.5 Safety Information ....................................................................... 7
2. General Operation Guide Section ........................................................... 9
2.1 Product Layout ..........................................................................10
2.2 Pre-Start Checks ........................................................................11
2.3 Battery Installation .....................................................................11
2.4 Operation, Powering On and Menu Functions .......................................11
2.5 Mode Selection, Modes and Backlighting.............................................12
2.5.1 Standard Measurement Screen (the boot-strap menu)...................... 12
2.5.2 Measuring the ambulatory blood pressure function: ........................ 12
3. Alarm Operation..............................................................................13
4. NIBP Operation ...............................................................................14
4.1 Introduction..............................................................................15
4.2 Considerations and Measurement Limitations.......................................15
4.3 Placement and Operation..............................................................16
4.4 Troubleshooting NIBP Messages and Explanations ..................................18
5. SpO2Operation ...............................................................................19
5.2 Considerations and Limits..............................................................21
5.3 Placement and Operation..............................................................22
5.4 Troubleshooting .........................................................................22
6. Software Operation & .......................................................................23
Initial Set-up Guide Section....................................................................23
6.1 Software Requirements ................................................................24
6.2 Installation of the software............................................................24
6.3 Considerations...........................................................................24
6.4 Introduction to the software ..........................................................24
6.4.1 User registration ................................................................. 24
6.4.2 Patient File Path ................................................................. 25
6.4.3 Main Interface .................................................................... 25
6.4.4 Wearing the Monitor ............................................................. 26
6.4.5 Designing the measurement plan .............................................. 26
6.4.6 Data download ................................................................... 27
6.4.7 Choose patient data to edit .................................................... 28
6.4.8 Delete data file .................................................................. 29
6.4.9 Data file backup.................................................................. 29
6.4.10 Edit Blood pressure data....................................................... 30
6.4.11 Trend Editing.................................................................... 30
6.4.12 SpO2Trend Edit ................................................................. 32
6.4.13 Display the statistics information ............................................ 33
6.4.14 Editing diagnosis information ................................................. 33
6.4.15 Sleep period settings........................................................... 33
6.4.16 Blood Pressure Thresholds..................................................... 34
6.4.17 Histogram Report ............................................................... 34
6.4.18 Pie Chart Reports ............................................................... 35
6.4.19 Correlation lines ................................................................ 35
6.4.20 Report Printing.................................................................. 36
6.4.21 Help .............................................................................. 36

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7. First Time Setup and the on-board menu functions .....................................37
7.1 Introduction..............................................................................38
7.2 Main Interface ...........................................................................38
7.3 System Menu.............................................................................38
7.4 System Setup ............................................................................39
7.5 BP SETUP .................................................................................40
7.6 SpO2SETUP...............................................................................40
7.7 Patient Information.....................................................................41
7.8 BP TABLE .................................................................................41
7.9 SpO2TABLE...............................................................................41
7.10 TREND ...................................................................................42
8. Maintenance ..................................................................................43
8.1 Maintenance schedule ..................................................................43
8.2 Safety Precautions ......................................................................43
8.3 Cleaning ..................................................................................44
8.4 Restrictions ..............................................................................44
8.4 Disposal...................................................................................45
8.5 Transportation and Storage............................................................45
9. Troubleshooting Guide ......................................................................46
10. Replacement Parts .........................................................................47
11. Warranty Information ......................................................................48
11.1 Returns Policy ..........................................................................48
11.2 Warranty Details .......................................................................49

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1. Introduction
Thank you for choosing a Daray V460S Ambulatory NIBP Patient Monitor with SpO2.
The V460S monitor is specifically designed to meet the demanding needs of today’s
medical department whilst providing the finest quality design with superior
performance, reliability and value.
The V460S not only measures parameters, it also records them; it integrates
parameter measuring modules into its functions and also allows you to display and
review data from the device.
This user guide has been provided to give detailed descriptions covering the
performance, operation and safety information of the device.
It is recommended that users read through this document before using the device so
they are aware of its complete and proper operation. This includes its features and
optional fixings and is to ensure users are able to operate the monitor appropriately
whilst also ensuring patient and operator safety.
Restrictions and Liabilities
Information in this document is subject to change and does not represent a
commitment by DARAY. Changes made to the information in this document will be
incorporated in new editions of the publication. No responsibility is assumed by DARAY
for the use or reliability of software or equipment that is not supplied by DARAY.
For further information on our product range and find out more about our company
please visit www.daray.co.uk or call 0333 321 0971
This product was designed & manufactured in Great Britain by:
Daray Ltd.
Marquis Drive, Moira
Swadlincote
Derbyshire
DE12 6EJ
1.1 Supported Units
The Following Models are supported in this Manual
V460S
Handheld Ambulatory Patient
Monitor with SpO2

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1.2 Specification
General Information
Display
2.4 inch colour LCD Display (V460S - 64k Colour OLED)
Measuring Parameters
Blood Pressure, PR, Pulse strength/waveform, (V460S - SpO2)
Battery
2 x AA Battery’s and low battery indicators
Alarms
0-100% Adjustable
Data
24 Hour monitoring with automatic power-off function
Connection
Mini USB
Backlight
Yes
Dimensions
63 (H) x 34 (W) x 33 (D) mm
Net Weight
350g (with batteries)
Working Voltage
2.2V DC ~ 3.4 V DC
Power Supply
3 (V) DC Pmax = 2.56VA
Specification
Measurement Method:
Oscillometric
Mode:
Manual, Auto, STAT
Measuring Type:
Systolic (SYS), Diastolic (DIA), Mean (MAP)
Measuring Unit:
mmHg / KPa selectable
Patient Range:
Adult, Paediatric, Neonatal
Over Pressure Protection:
Yes
Cuff Pressure Range
Meets ANSI/AAMI SP10-1992
Pulse Rate Range
30-220
Over Pressure Protection
Independent safety microprocessor monitors cuff pressure,
measurement time as well as the operation of the main
microprocessor
The SYSTOLIC and DIASTOLIC values measured using this device shall be equal to those
measured by trained medical personnel using cuff and stethoscope. The MEAN value measured
using this device is equal to that measured using a blood pressure measurement device.
Blood Pressure Measurement Ranges
Adult
SYS
40-270mmHg
MAP
30-235mmHg
DIA
20-215mmHg
Paediatric
SYS
40-200mmHg
MAP
30-165mmHg
DIA
20-150mmHg
Neonatal
SYS
40-135mmHg
MAP
30-110mmHg
DIA
20-100mmHg
Maximum mean error of measurement:
±5mmHg
Maximum experimental standard
deviation:
8mmHg
Pressure Resolution:
1 mmHg
SpO2 Monitoring (V460S only)
Patient Type
Adult, Paediatric, Neonatal
Range
35 ~ 99%
Resolution
1%
Accuracy
±2% (90%~00%), ±3 % (70%~9%)
Alarm Range
0-100%

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Pulse Rate (V460S only)
Storage and Review
Maximum Data Quantity:
300 records of common user data and 358 Ambulatory BP data
Every record includes the detailed measure time, systolic blood
pressure, diastolic blood pressure, mean blood pressure, pulse
rate, error message and record number, etc.
Operating Environment
Temperature:
5～40 (C) (V460S - 0～40 (C))
Transport and storage
Temperature:
-20～60 (C)
Humidity (noncondensing):
≤ 80 % (V460S –15% ~ 95%)
Transport and Storage Hum
≤ 95 % (V460S –10% ~ 95%)
Altitude:
-500 to 4,600m (-1,600 to 15,000ft) 86 ~ 106 KPa
Transport and Storage Alt
-500 to 13,100m (-1,600 to 43,000ft) 50 ~ 106 KPa
This device has a user friendly operation interface. It integrates data review functions and display
functions which include a large-print single record data review, data list, BP data trends chart,
the current time, data, power, alarm, etc.
Users can power on/off the monitor, start manual measurements, set system parameters, etc.
with the five keys on the front panel. (Please refer to section 1.2 for details).
There are light and sound alarm functions where the audio alarm intermittently beeps and a built
in red light will flash. When a measurement result exceeds the alarm limits, the colour of the
measured result becomes red and an alarm sounds. The user can turn on or off the alarm sound if
necessary.
The cuff socket is located on the top of the device and the USB socket at the bottom of the
device. The stored data can be transferred to a computer via the USB interface, and then various
operations can be performed by using the PC software. (Please refer to "Software Functions"
section for detailed contents)
In the ambulatory measurement mode, the monitor can work for up to 24 hours continuously.
The monitor has the capability of recording up to 4800 measurements, along with displaying a
BP data trends chart.
Measurement Performance in a Weak Filling Condition
A weak filling condition during a measurement will impact the monitor’s performance to some
degree. However, the SpO2and pulse rate can be shown correctly with a pulse filling ratio of
0.4%. During a weak filling measurement the SpO2error is ±4% and the pulse rate error is ±2bpm.
This device is defibrillator protected. Note that no precautions specific to the
device are required during defibrillation, and defibrillation discharge has no effect on the
monitor. The equipment uses a gray silicone airway as a precaution for when a
defibrillation device is used on the patient, this is to protect the equipment from the
effect.
This monitor complies with EN1060 Part 1: General requirements; Part 3: Supplementary
requirements for electro-mechanical blood pressure measuring systems (in course of preparation).
Range
0 ~ 250 bpm
Resolution
1 bpm
Accuracy
±2 bpm

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1.3 Pre-Operation Responsibilities and component packing list
This document is a guide to the steps that need to be performed to correctly operate the V460S
Series Ambulatory patient monitor system. However, any work required for the setup or operation
of the device is the responsibility of the owner or designated operators.
1.4 Packing List
The components supplied by Daray should be the following items in the specified quantities,
unless otherwise arranged.
V500 Packing List
Qty.
V460 Ambulatory Patient Monitor
1
Adult SpO2Finger Sensor
1
Adult NIBP Cuff
1
Carry Case
1
PC Software CD
1
USB cable
1
User Manual
1
Please be aware using un-approved accessories may cause damage to the device.
Please contact Daray for any further information.
1.5 Safety Information
The safety statements presented in this chapter refer to the basic safety information that the
operator of the monitor should pay attention to and abide by. This information may be repeated
within subsequent sections to reiterate our warnings, some sections may also have warnings for
specific operational aspects.
Warnings and Cautions are used throughout this manual to point out hazards and to designate a
degree or level of seriousness, these should be observed at all times and include electrical safety
warnings.
These warnings are used to indicate a potential hazard situation or unsafe practice that, if not
avoided, could result in death or serious injury.
Cautionary notices are used to indicate a potential hazard or unsafe practice that, if not avoided,
could result in minor personal injury or product/property damage.
Considerations
Pre-use
To ensure patient and user safety, its recommended that the device and
its accessories are regularly checked for damage and normal operation
before use; if any damage is found you should immediately stop using
the device and contact your relevant body.
Usage
This monitor is intended only as an adjunct in patient assessment. It
must be used in conjunction with clinical signs and symptoms. It is not
intended as a device used for treatment purposes. This device should
only ever be used on one patient at a time.
Warning: If Luer lock connectors are used in the construction of
tubing, there is a possibility that they might be inadvertently
connected to intravascular fluid systems, allowing air to be pumped
into a blood vessel.
Do not pull or lift the monitor by its connection cables. This may cause
damage to the leads or the stability of the device leading to subsequent
patient injuries
Do not use the monitor when wet, for any internal water damage please
contact daray.

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Please ensure any connecting hardware such as PC’s meet appropriate
compliance requirements for IEC 60950.
The software was developed per IEC60601-1-4. The possibility of hazards
arising from errors in the software program are minimal
Users
This monitor is intended for use only by appropriately trained or
instructed personnel.
Monitoring
Limitations
Ensure that the environment in which the device is operated is not
subject to any sources of strong electromagnetic interference, such as
radio transmitters, mobile telephones, etc. Keep them far away. High
level electromagnetic radiation emitted from such devices may greatly
affect the instrument performance.
When using the monitor in conjunction with electrical surgery
equipment, the user should pay attention to and guarantee safety of the
patient being monitored.
You should refrain from using mobile phones in close proximity to the
monitor as mobiles could cause electromagnetic interference with the
monitor.
Ambulatory Use
and Patient
Movement
Please do not hang the monitor in any way whilst transporting the
patient. The potential for the monitor to swing could cause physical
damage to the patient or the monitor. For information on Mounting
options please contact daray
EXPLOSION
HAZARD
Possible explosion hazard if used in the presence of flammable
anaesthetics or other flammable substances in combination with air,
oxygen-enriched environments, or nitrous oxide.
Transportation and
Storage
Improper storage or transport of the monitor and its accessories can
cause contamination, Please use the recommended cleaning and
disinfecting methods as indicated in this manual before use.
Maintenance
Do not touch, or rub the display screen with abrasive cleaning
compounds, instruments, brushes, rough surfaced materials or make
contact with anything that can scratch the panel. For detailed cleaning
instructions please refer to the maintenance section of this manual.
The Monitor is a Sealed device, however, do not submerge in any liquids
and keep the monitor placed appropriately when in use or storage to
prevent any potential damage from falling, persistent strong vibrations
or other mechanical damage.
Any internal maintenance should only be conducted by a Daray
authorised service centre. For further details please contact Daray.
Standard electrical safety tests should be conducted once every 12
months by qualified personnel
Disposal
Please dispose of the packaging material, observing the applicable
waste control regulations and keeping it out of children’s reach.
At the end of its service life, the product described in this manual, as
well as its accessories, must be disposed of in compliance with the local
governing guidelines regulating the disposal of such products. If you
have questions concerning disposal of the product, please contact one
of your local government representatives.

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2. General Operation Guide Section

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2.1 Product Layout
The V460 Ambulatory NIBP Monitor has a couple of connection points which vary slightly
depending on model (V460 / V460s). Located on the top of the device is a blue plastic cap which
signifies the location of the NIBP nozzle and the SpO2 connector (V460S only).
For the convenience of operation, the different interfaces are on different parts of the monitor.
At the top is the Socket for the SpO2Sensor and socket for NIBP cuff.
At the bottom is the USB socket
Top
Bottom

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2.2 Pre-Start Checks
Please check that the device and its accessories are without visible damage and that
there are no cuts, harsh folds or knots in any part of the equipment or its accessories.
Check that any cables are fully connected to the device and that plugs and connectors
are fully attached.
Do not remove the primary casing or attempt to use the device with the casing
removed or severely damaged.
The Battery discharges even when the device is not in use, when storing the V460
remove the batteries and check the status of both the batteries and the monitor once
a month.
Do not use the monitor in a flammable atmosphere where concentrations of flammable
anaesthetics or other materials may occur.
2.3 Battery Installation
The V460 is powered using AA batteries. It is supplied with two standard 'AA' alkaline high capacity
batteries. Before using the monitor, you must insert these into the battery housing located on the
back of the monitor.
Note: When not using the monitor for an extended period, we recommend you remove the battery
to avoid battery bleeding and corrosion inside the device.
NOTE
Plug in the USB to upload and download data when the battery is low or has no power. The top of
the screen displays a USB symbol when the V460 is successfully connected to the computer. The
NIBP button is unavailable when the USB is being used.
2.4 Operation, Powering On and Menu Functions
All the operations of the V460 Blood Pressure Monitor can be completed with the buttons located
on the front of the monitor. The designation of the buttons are symbolised on each one. They are:
The Power button. Pressing and holding the button will start the system. When turning the
monitor on and off, the red and green lights both flash once to prompt that the on or off
operation is successful. Press it for a short time to return to the primary screen display. Hold the
button for 3 seconds while powered on, and the instrument will turn off.
If power is lower than 2.2V, the instrument will not turn on. When the battery power is low, an
alarm occurs. The battery’s frame becomes red, and will flash.
The OK key is also the main menu key, this corresponds with the text located in the middle
bottom of the screen on the primary screen view. When in any menu system, press this button as
a confirmation key and the system will immediately execute the selected function.
In the primary screen display, this key toggles the silence function on/off. The function of this key
alters depending on what is being displayed. The text in the bottom left of the screen indicates
the current function of the key. Such as: The button is the ‘up’ key in the "SYSTEM MENU", and the
‘left’ key in the "TREND "chart.

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In the primary screen display this key toggles the data review function for the current user. The
function of this key alters depending on what is being displayed. The text in the right bottom of
the screen indicates the function of this key. Such as: being the data review key of the current
user in the primary display screen, the ‘down’ key in the "SYSTEM MENU" and the ‘right’ key in the
"TREND" chart
Start/Stop button. If measuring, press this key to cancel the current measurement
While uploading data via the mini USB connection, all of the buttons are disabled. If
measuring, the measurement will be cancelled.
During measurement, these three buttons are all disabled.
There is a white rectangular mark in the screen that moves with the operation of the left and
right keys - , in the motion of up and down respectively. This rectangle box
surrounds the option and is known as the “cursor”. The operation or menu section that has
the cursor hovering around it, is the section that is selected. When the selection is not
activated, the cursor is white; when selected, the cursor becomes red.
2.5 Mode Selection, Modes and Backlighting
The V460 has a selection of display modes for reviewing data and taking measurements. It also
uses a backlighting system for its display.
After prolonged inactivity the screen will naturally dim, this is based off the Backlight time set in
the system preferences. Interaction with the device should brighten the display again. If there is no
action for 2 minutes after the backlight dims, the device will automatically turn off unless it is in
the Ambulatory Blood Pressure mode; in this mode when the backlight dims, the green indicator
will intermittently flash to prompt you that the device is in a running state.
2.5.1 Standard Measurement Screen (the boot-strap menu)
In the standard function mode of the V460s it stores 300 records of common user data and 358
records of ambulatory Blood Pressure data. Every record includes detailed measurement times,
systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse rate, any error
messages and a record number, etc.
2.5.2 Measuring the ambulatory blood pressure function:
In this mode, the monitor can work for 24 hours continuously. The monitor has the capability of
recording up to 4800 measurements, along with producing a BP data trends chart. The stored
readings in the monitor are downloaded into the computer to store as patient history for later
viewing, or to edit the data. Editing via the computer allows the user to modify the trend graph,
statistics, and the way information is displayed, as well as the editing of diagnostic information,
parameter settings and printing etc. However, this monitor cannot transmit data in real-time
during the process of taking a measurement.
The stored values of SpO2in the monitor can be downloaded into a computer too.

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3. Alarm Operation
The V460 has a selection of adjustable Audio and Visual alarms for monitoring.
During the operation of the monitor, users can turn the alarms on or off using the keys mentioned
in section 7.
While the alarm is on:
The blood pressure alarm is as follows: after the test finishes, it will measure the high pressure,
low pressure and the mean pressure every 4 seconds, until the end of the next test.
The SpO2alarm is as follows: oxygen saturation and pulse rate are displayed circularly for 5 times
in 1 second and then tests the measured value over to see whether it was exceeded or not at the
same time;
The pitch of the alarm for the NIBP and SpO2are the same, the only difference between them is
the interval. The audible alarm is accompanied by a visual alarm in which the main interface turns
red during the alarm situation.
With multiple alarms, there is an alarm priority structure:
Technical alarms (such as low power, probe off) >Physiological alarms (such as over pressure or
SpO2levels outside of the prescribed limits)
Alarm image indicators show the user whether an alarm has been muted or turned off at all:
Mute the sound
Open the alarm sound indication
Close the alarm sound indication

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4. NIBP Operation

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4.1 Introduction
The V460S’s primary function is an ambulatory NIBP monitor. The Non-invasive Blood Pressure
(NIBP) module measures blood pressure by using the oscillometric method.
Warnings
Prolonged Usage
Prolonged non-invasive blood pressure measurements in Auto mode may
be associated with purport, ischemia and neuropathy in the limb wearing
the cuff. When monitoring a patient, examine the extremities of the limb
frequently for normal colour, warmth and sensitivity. If any abnormality is
observed, stop the blood pressure measurements immediately.
Skin and Blood
Disorders
You must not perform NIBP measurements on patients with sickle-cell
disease or under any condition which the skin is damaged or expected to
be damaged.
Thrombasthenia
For a thrombasthenia patient it is important to determine whether
measurement of the blood pressure shall be done automatically. The
determination should be based on a clinical evaluation.
Mode Selection
Ensure that the correct mode setting is selected when performing
measurements on children and new-borns (Refer to measuring mode menu
setting), and use a child or new-born specific cuff. It can be dangerous to
use incorrect patient modes in error as this could cause damage to your
patients and also present incorrect readings because adult blood pressure
levels do not apply to children and new-borns.
catheterisation
and intravenous
infusion
Do not apply the cuff to a limb that is undergoing an intravenous infusion
or has a catheter/cannula in place. This could cause tissue damage around
the catheter/cannula when infusion is slowed or blocked during cuff
inflation.
Cabling
Make sure that the air conduit connecting the blood pressure cuff and the
monitor is neither blocked nor tangled.
Within the NIBP system there are two modes of measurement available: manual and automatic.
Both modes display the systolic, diastolic and mean blood pressures and pulse rates.
In the Manual mode, only one measurement is conducted each time. In the Automatic mode, the
measurement is cycled; you can set the interval time to 5/10/15/20/30/45/60 or 90 minutes.
Depending on the cuff being used, the V460 is applicable for adult, paediatric, and neonatal
usage.
Sizes of reusable cuffs for neonatal/paediatric/adult patients
Patient Type
Limb perimeter
Cuff width
Hose
Infant
10 ~19 cm
8 cm
1.5 m or
3 m
Child
18 ~ 26 cm
10.6 cm
Adult
25 ~ 35 cm
14 cm
Adult XL
33 ~ 47 cm
17 cm
Thigh
46 ~ 66 cm
21 cm
4.2 Considerations and Measurement Limitations
In different patient conditions, the Oscillometric measurement method has certain limitations.
The measurement is in search of a regular arterial pressure pulse. In those circumstances when
the patient's condition makes it difficult to detect, the measurement becomes unreliable and the
measuring time increases.
Users should be aware that the following conditions could interfere with the measurement,
making the measurement unreliable or longer to derive. In some cases, the patient's condition will
make a measurement impossible.
NOTE
For extended use we advise you do not allow the cuff to contact the skin directly, however, any
clothing between the cuff and the patient should be no more than 3 cm thick.

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Limitations
Patient
Movement
Measurements will be unreliable or cannot be taken if the patient is moving,
shivering or having convulsions. These motions may interfere with the detection of
the arterial pressure pulses. In addition, the measurement time will be prolonged.
Cardiac
Arrhythmia's
Measurements will be unreliable and may not be possible if the patient's cardiac
arrhythmia has caused an irregular heartbeat. Thus the measuring time will be
prolonged.
Heart/lung
Machine
Measurements will not be possible if the patient is connected to a heart or lung
machine.
Pressure
Changes
Measurements will be unreliable and may not be possible if the patient's blood
pressure is changing rapidly over the period of time during which the arterial
pressure pulses are being analysed to obtain the measurement.
Severe Shock
If the patient is in severe shock or hypothermia, measurements will be unreliable
since reduced blood flow to the peripheries will cause reduced pulsation of the
arteries.
Heart Rate
Extremes
Measurements cannot be made with a heart rate of less than 40 bpm or greater than
240 bpm.
Larger Patients
Thick layers of body fat will reduce measurement accuracy as this dampens the
compressive shock of the cuff on the bodies arteries
4.3 Placement and Operation
1. Select the correct NIBP Cuff.
Note: The width of the cuff should be either 40% of the limb circumference (50% for
neonates) or 2/3 of the upper arm length. The inflatable part of the cuff should be long
enough to encircle 50-80% of the limb. The wrong size of cuff can cause erroneous readings.
If the cuff size is in question, then use a larger cuff.
2. Connect the cuff to the NIBP extension hose using the bayonet.
The connection used as standard for our BP cuff is a metal, male barbed bayonet valve as pictured
below, this connection allows the BP cuffs to be interchangeable.
Warning - Avoid compression or restriction of pressure tubes, and make sure the tube
between the cuff and the monitor are not kinked or blocked.
3. Once attached you will need to place the cuff snugly around the extremity being used.
Make sure that the cuff edge falls within the range of the marks ‘<->’. If it does not, use a larger
or smaller cuff that fits better.

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4. Ensure the marking indicated on the cuff with the symbol "Φ" is placed over the
brachial artery.
The cuff should not be wrapped too tightly around the limb. Excessive tightness may cause
discoloration and eventual ischemia of the extremities. The tube coming from the cuff should be
immediately to the left or right of the brachial artery to prevent kinking when the elbow is bent.
5. Before starting the test, check that the cuff is 2 to 5 cm (1 to 2 inches) above the
elbow and that the limb chosen for taking the measurement is placed at the same
level as the patient's heart.
If this is not possible you should apply the following corrections to the measured values:
If the cuff is placed higher than the heart level, add 0.75 mmHg (0.10 kPa) for each inch of
difference.
If it is placed lower than the heart level, deduct 0.75 mmHg (0.10 kPa) for each inch of
difference.
Check whether the measure mode is appropriately selected. (the measurement mode is displayed
in the primary screen display information area).
Note –Readings are usually taken from the arms, however, when this is not possible you can also
take readings from the Thigh. All the same instructions apply, you will need to find the artery and
align the cuff’s measurement point with that artery; and then, you will need to ensure that the
cuff is not too tight.
Before starting a measurement, verify that you have selected the setting
appropriate for your patient (adult, paediatric or neonatal).
6. Press button on the front panel to start a measurement. Press this button again to
stop a measurement prematurely.
Auto Measuring
The V460(S) also has an ambulatory auto measuring function, to use this you will need to do the
following: Once all previous parameters have been considered. Access ABPM SETUP menu and pick
the "ASLEEP INTERVAL“ item and "AWAKE INTERVAL" item, in which you, the user, may select the
time interval value for auto measurement. After this; enter the "ABPM" menu and select the
entrance, enter into the ABPM working environment and the system will start its automatic cycle
taking measurements by autonomously inflating in accordance with the time interval settings.
During the idle period of the auto measuring process, you can press the button at any time
to start a manual measurement. Then press button again to stop manual measurement and
the system should continue executing the auto-measuring program.
How to stop auto measuring:
During auto measuring you can stop a reading in progress by pressing the button at any time.
If you are in doubt about the accuracy of any reading(s), check the patient's vital
signs by an alternative method before checking the functionality of the blood
pressure monitor.

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4.4 Troubleshooting NIBP Messages and Explanations
Message
Explanation
Probable Cause
02
Self-test failure
There is a Probe or A/D sampling error.
06
Loose cuff
The Cuff is not connected properly or the connection may be
loose, please check all connections. if the problem persists
please check the Cuff inflation settings
07
Air leakage
There is Air leakage in the valve or airway
08
Atmospheric
pressure error
The valve inside the device cannot open, this could be caused by
kinks and blockages in the
09
The Signal is too
weak
If the pulse is too weak or the cuff is loose you may be presented
with this code. Please check the Patients vitals before attempting
to adjust the device
10
The
measurement is
over range
The blood pressure measurement is outside its standard
measurement range
11
There is
Excessive
movement
When measuring, the device detects the presence of excessive
movement or pseudo-differential interference from the readings.
12
Overpressure in
the BP Cuff
Cuff pressure is over the scope, ADU 290 mmHg, this can be
caused by using the incorrect settings with smaller cuffs
13
Saturated signal
Movement or other factors have produced an excessive signal
amplitude.
14
Air leakage
There is an air leakage in the valve or airway
If the wrong pressure is specified in the settings. For example if
the system tries to fill an adult cuff with a neonatal pressure.
15
System failure
There is an unidentifiable issue with the NIBP module or the
Analogue/Digital sampling of the system has presented an error in
conversion after turning on the device. Please restart the device,
if this problem persists please contact Daray
19
Measurement
Timeout (it took
too long to get a
reading)
The Measurement timeouts after a specific interval. This can be
due to the patient having unidentifiable readings through
movement or incorrect cuff placement, etc.
If the wrong pressure is specified in the settings. The cuff
pressure of an adult cuff is 2KPa (15mmHg) this means it could
take up to 3 minutes to fully inflate, for Neonatal settings, the
cuff has a pressure of 0.67KPa (5mmHg) which can take around 90
seconds.

Page 19 of 49
5. SpO2Operation