Datex-Ohmeda TuffSat User manual
9
Datex-Ohmeda
TuffSat™
Pulse
Oximeter
User’s
Guide
and
Service
Manual
nJeSJJNL
The
instructions
for
using
this
device
are
in
English.
In
Norway,
this
device
Is
to
be
used
only
by
qualified
medical
professionals.
Instruksjoner
for
bruk
av
denne
enheten
er
pa
engelsk.
1
Norge
skal
denne
enheten
kun
benyttes
av
kvalifisert
medisinsk
personeli.
6050
0005
576
Printed
in
USA
O
Datex-Ohmeda
TuffSat™
Pulse
Oximeter
User's
Guide
and
Service
Manual
Sensor
connector
Connect
a
Datex-Ohmeda
sensor
(or
sensor
cable)
approved
for
use
with
the
TuffSat.
_
Oxygen
saturation
%
(Sp02)
Pulse
rate
in
beats
per
minute
Pleth
bar
Segments
flash
to
match
pulse
rate.
Number
of
flashing
segments.
indicates
pulse
strength.
Low
battery
and
print
icons
d
AM
Flashes
on
and
off
when
battery
power
is
low.
[3
Appears
when
the
print
button
Backlight
button
is
pressed
and
while
printing.
Press
to
power
on
the
backlight.
Press again
to
power
it
off.
Print
button
Press
to
start
printing
to
the
optional
printer.
Press
again
to
stop
printing.
On/
off
button
Press
to
power
on
the
oximeter.
Press
again
to
power
it
off.
important
This
manual
is
subject
to
periodic
review,
update,
and
revision.
Customers
are
cautioned
to
verify
that
the
information
in
this
manual
applies
to
the
software
and
hardware
present
in
the
equipment.
A
Attention!
Consult
the
accompanying
instructions
before
using
this
device.
This
device
performs
as
described
in
this
manual,
and
in
accompanying
labels
and
inserts,
when
assembled,
operated,
maintained,
and
repaired
in
accordance
with
the
instructions
provided.
This
device
must
be
cleaned
and
checked
periodically.
Do
not
use
a
defective
device.
Parts
that
are
broken,
missing,
plainly
worn,
distorted,
or
contaminated
should
be
replaced
immediately.
If
repair
or
replacement
becomes
necessary,
request
service
advice
from
Datex-Ohmeda
(information
is
listed
on
the
back
cover).
Do
not
repair
this
device
or
any
of
its
parts
other
than
in
accordance
with
written
instructions
provided
by
Datex-Ohmeda.
The
user
of
this
device
shall
have
the
sole
responsibility
for
any
malfunction
that
results
from
improper
use,
faulty
maintenance,
improper
repair,
unauthorized
service,
damage,
or
alteration
by
anyone
other
than
Datex-Ohmeda.
The
safety,
reliability,
and
performance
of
this
device
can
be
assured
only
under
the
following
conditions:
e
If
it
is
used
according
to
the
accompanying
operating
instructions.
e
If
fittings,
extensions,
changes,
or
repairs
are
carried
out
by
agents
authorized
by
Datex-Ohmeda.
Trademarks
Datex®
and
Ohmeda®
are the
property
of
Instrumentarium
Corp.
or
its
subsidiaries.
|
TuffSat and
TruTrak
are
trademarks
of
Datex-Ohmeda,
Inc.
Hewlett-Packard
and
HP
are
registered
trademarks
of
Hewlett-Packard
Co.
Cidex
is
a
registered
trademark
of
Johnson
&
Johnson.
All
other
product
and
company
names
are the
property
of
their
respective
owners.
Text
revised
June
2000
©
1999,
2000
Datex-Ohmeda,
Inc.
All
rights
reserved.
Table
of
Contents
1/
Overview
Product
description
1-1
Clinical
use
1-1
TruTrak™
data
sampling
system
1-2
Theory
of
operation
1-2
Signal
processing
1-2
Calibration
14
Assumptions
14
Methods
14
Circuit
board
15
Patient
and
operator
safety
1-6
General
16
Electrical
shock
and
flammability
hazard
16
Fire/explosion
hazard
16
Failure
of
operation
16
Data
validity
16
Operator
safety
16
Patient
safety
and
operator
safety
16
Patient
safety
(oximeter)
1-7
Patient
safety
(sensors)
1-7
Cleaning
1-7
Maintenance
and
repair
18
Disposal
18
2/Oximeter
Features
and
Use
Product
information
labels
2-1
Oximeter
features
and
controls
2-2
Top
view
2-3
Checking
normal
operation
2-3
Using
the
oximeter
2-4
Data
validity
and
signal
strength
2-5
Pleth
bar
(pulse
rate
and
strength
indicator)
2-5
3/Maintenance,
Troubleshooting,
and
Service
Oximeter
maintenance.........
3-1
Replacing
oximeter
batteries
31
Cleaning
the
oximeter
3-2
Sensors
3-2
Troubleshooting
3-2
Service
policy
3-4
Ordering
parts
and
obtaining
service
34
Packaging
and
returning
equipment
34
Repair
procedures
3-5
-
Disassembling
the
oximeter
35
Replacing
parts
3-6
Assembling
the
oximeter
3-6
Assembly
drawing
3-7
Parts
list
3-8
Table
of
Contents
4/Compliance
and
Specifications
Electromagnetic
compatibility
(EMC)
4-1
Electromagnetic
effects
41:
EMC
performance
41
Compliance
with
standards
4-2
General
safety
requirements
4-2
Requirements
for
pulse
oximeters
42
Software
safety
checks
42
Performance
specifications
4-3
General
43
SpO2
43
Interfering
substances
43
Sensor
emitter
wavelength
ranges
43
Pulse
rate
43
Alarms
43
Displays
44
Updates
44
Visibility
44
Power
44
Low
battery
indicator
(screen
icon)
44
Environment
44
Dimensions
and
weight
44
Appendix:
Printer
Features
and
Use
Functions
and
features
A-1
How
the
TuffSat
stores
data
A1
Printer
components
A-2
Using
the
printer
A-2
Powering
the
printer
A-2
Positioning
the
oximeter
and
printer
A-3
Printing
data
A-3
Sample
printouts
A-4
Real-time
printout
and
Trend
#1
printout
A4
Trend
#2
printout
A-5
Troubleshooting
A-5
Printer
maintenance
A-6
Replacing
printer
paper
A6
Cleaning
the
printer
A-7
Ordering
the
printer
and
printer
accessories.
A-7
Printer
specifications
A-8
Electromagnetic
compatibility
(EMC)
AS
Print
indicator
(screen
icon)
AS
Power
AS
Environment
AS
Dimensions
AS
Warranty
1/
Overview
This
chapter
contains:
e
A
brief
description
of
the
Datex-Ohmeda
TuffSat"“
Pulse
Oximeter.
e
The
theory
of
operation
for
the
oximeter.
e
A
list
of
the
precautions
you
must
take
when
using
this
device.
Product
description
The
TuffSat
oximeter
is
a
small,
durable,
portable
pulse
oximeter
that
operates
on
battery
power.
These
items
are
included
with
the
oximeter:
e
This
manual,
which
includes
an
insert
that
lists
the
sensors
you
can
use
with
the
oximeter.
e
Four
1.5V
alkaline
AA
batteries.
ο
Neoprene
carrying
case
with
belt
clip.
The TuffSat
oximeter
is
capable
of
printing
data
through
an
infrared
link
to
the
optional
Hewlett-Packard®
Infrared
Printer
(HP
82240B).
For
information
on
ordering
and
using
this
printer
with
the
TuffSat
oximeter,
see the
Appendix:
Printer
Features
and
Use.
Clinical
use
The
TuffSat
oximeter
is
designed
specifically
for
spot-checking
arterial
oxygen
saturation
(SpO2)
and
pulse
rate.
This
easy-to-use
oximeter
is
ideal
for
use
in
the
environments
listed
below:
‧
Respiratory
care
e
Subcritical
care
for
hospital
satellite
locations
e
Home
care
‧
Prehospital/EMS
‧
Rehabilitation
e
Physician's
office
WARNING:
Patient
safety.
The
TuffSat
oximeter
is
not
intended
for
continuous
monitoring.
It
has
no
alarms
(audible
or
visual)
and
no
user-definable
parameters.
1-1
jm.
TuffSat
User's
Guide
and
Service
Manual
TruTrak™
data
sampling
system
The
TruTrak
data
sampling
system,
patented
by
Datex-Ohmeda,
enables
the
TuffSat
oximeter
to
calculate
SpO2
many
times
each
second
through
advanced
statistical
data
processing.
While
other
oximeters
calculate
only
at
the
peak
and
trough
of
each
waveform,
the
TuffSat
assesses
SpO2
continuously.
The
TruTrak
data
sampling
system
provides
reliable
readings
during
times
of
low
perfusion,
motion,
or
electrical
interference.
The TuffSat
oximeter
employs
an
analog/digital
(A/D)
converter
and
maximized
digital
signal
processing
techniques
to
produce
samples
for
the
TruTrak
system
to
process.
The
result
is a
highly
reliable
level
of
oximetry
performance.
Theory
of
operation
The
TuffSat
oximeter
uses
a
two-wavelength
pulsatile
system—red
and
infrared
light—to
distinguish
between
oxygenated
(O2Hb)
and
reduced
(HHb)
hemoglobin,
each
of
which
absorbs
different
amounts
of
light
emitted
from
the
oximeter
sensor.
The
SpO,
and
pulse
rate
are
determined
by the
oximeter
through
sensor
signal
processing
and
microprocessor
calculations.
Signal
processing
Sensor
LED
LB
Photodetector
e
と
ニー
ニー
ニー
ニー
ニー
ニー
ニー
ニー
ニー
ニース
Front
End
Analog
A/D
Digital
Amplifier
B]
Processing
Dİ
Converter
Processing
—P
Display
1
Figure
1-1.
Signal
processing
biock
diagram
The
sensor
contains
a
light
source
and
a
photodetector:
e
The
light
source
consists
of
red
and
infrared
light-emitting
diodes
(LEDs).
e
The
photodetector
is
an
electronic
device
that
produces
an
electrical
current
proportional
to
incident
light
intensity.
The
two
light
wavelengths
generated
by
the
sensor
light
source
{the
red
and
infrared
LEDs)
pass
through
the
tissue
at
the
sensor
site.
The
light
is
partially
absorbed
and
modulated
as
it
passes
through
the
tissue.
Arterial
blood
pulsation
at
the
sensor
site
modulates
transmission
of
the
sensor’s
light.
Since
other
fluids
and
tissues
present
generally
don't
pulsate,
they
don't
modulate
the
light
passing
through
that
location.
The
pulsatile
portion
of
the
incoming
signal
is
used
to
detect
and
isolate the
attenuation
of
light
energy
due
to
arterial
blood
flow.
1-2
1/
Overview
Variable
absorption
(Due
to
arterial
pulse)
Arterial
blood
absorption
a
4
o
Za
2409902004
0897
64
Co
o
o
Pad
ga
9
Venous
blood
absorption
Absorption
Other
tissue
absorption
Time
Figure
1-2.
Comparative
light
absorption
The
sensor's
photodetector
collects
and
converts
the
light
into
an
electronic
signal.
Since
O2Hb
and
HHb
allow
different
amounts
of
light
to
reach
the
photodetector
at
the
selected
wavelengths,
the
electronic
signal
varies
according
to
which
light
source
is
“on”
(red
or
infrared)
and
the
oxygenation
of
the
arterial
hemoglobin.
The
oximeter
uses
this
information
to
calculate
the
relative
percentage
of
O2Hb
and
HHb.
1
(Red)
(Infrared)
660
nm
940
nm
N
<
0
る
=
=
2
È
0。Hb
Sal
HHb
2
i
i
|
|
|
1
1
|
600
700
800
900
1000
Wavelength
(nm)
Figure
1-3.
Extinction
vs.
wavelength
graph
The
photodetector
sends
the
electronic
signal,
which
contains
the
light
intensity
information,
to
the
oximeter.
The
oximeter's
electronic
circuitry
processes
the
electronic
signal,
calculates
the
SpO2
and
pulse
rate
values,
and
displays
them
on
the
screen.
1-3
TuffSat
User's
Guide
and
Service
Manual
1-4
Calibration
Datex-Ohmeda
pulse
oximeters
use
two
wavelength
ranges,
650
nm
to
665
nm
and
930
nm
to
950
nm,
both
with
an
average
power
of
less
than
1
mW.
These
wavelengths
are
used
to
calculate
the
presence
of
oxyhemoglobin
(02Hb)
and
reduced
hemoglobin
(HHb).
A
CO-oximeter
typically
uses
four
or
more
wavelengths
of
light
and
calculates
reduced
hemoglobin
(HHb),
oxyhemoglobin
(02Hb),
carboxyhemoglobin
(COHb),
and
methemoglobin
(MetHb).
Therefore,
pulse
oximetry
readings
and
CO-oximetry
readings
will
differ
in
situations
where
a
patient's
COHb
or
MetHb
are
increased.
Increased
patient
COHb
leads
to
falsely
increased
SpO
in
all
pulse
oximeters.
Assumptions
The
calculation
of
SpO2
assumes
1.6%
carboxyhemoglobin
(COHb),
0.4%
methemoglobin
(MetHb),
and
no
other
pigments.
These
values
are
based
on
the
Datex-Ohmeda
Pulse
Oximeter
Empirical
Calibration
Study.
Appreciable
variation
from
these
values
will
influence
SpO»
accuracy.
Methods
Two
different
methods
of
calibration
are
currently
used
by
manufacturers
of
pulse
oximeters:
fractional
and
functional.
Important:
The
TuffSat
pulse
oximeter
uses
the
functional
calibration
method.
The
user
cannot
change
the
calibration
method
to
fractional.
*
Fractional
saturation
is
represented
mathematically
as
the
percentage
of
the
total
amount
of
hemoglobin
carrying
oxygen.
It
is
determined
by
dividing
the
oxyhemoglobin
by
the
total
hemoglobin.
|
0,Hb
0,Hb
Fractional
Sp0,
=
x
100
=
$
——
==>
)
x
100
HbroraL
O2Hb
+
HHb
+
COHb
+
MetHb
e
Functional
saturation
is
represented
mathematically
as
the
percentage
of
hemoglobin
capable
of
carrying
oxygen
that
is
carrying
oxygen.
-
05Hb
0。Hb
Functional
Sp0,
=
|
——————————
|
x
100
=
|
一 一
一
一
一 |
x100
Hbrora,
-
COHb
-
MetHb
O
Hb
+
HHb
The
functional
calibration
is
obtained
by
multiplying
the
fractional
SpOz
by
a
value
of
1.02.
1/
Overview
Circuit
board
The
circuit
board
contains
all
the
circuitry
for
the
TuffSat
oximeter.
The
functions
performed
by
this
board
are
illustrated
below.
Keys
Backlight
LED
Alphanumeric
LCD
and
LCD
driver
Infrared
(IR)
wireless
transmitter
рн
7
H
1
'
i
:
Power
supply
'
i
;
Power
on/off
control
>
(reset
control)
Ambient
light
»
Processor
detection
Code
memory
and
——>
Data
memory
Watchdog
timer
—>
Timing
Sensor
LED
drive
A/D
converter
Analog
Signal
Path
M
|
1
I
!
!
Analog
1
Sensor
P|
front
end
Figure
1-4.
Circuit
board
block
diagram
1-5
TuffSat
User's
Guide
and
Service
Manual
Patient
and
operator
safety
Warnings
and
cautions
associated
with
following
safe
practices
while
using
the
oximeter
appear
throughout
this
manual.
»
WARNINGS
indicate
potentially
harmful
situations
that
may
cause
injury
to
a
patient
or
operator.
+
CAUTIONS
indicate
conditions
that
may
lead
to
equipment
damage
or
malfunction.
Read
this
section
carefully
before
using
the
oximeter
to
monitor
patients.
General
Caution:
U.S.
Federal
and
Canadian
laws
restrict
this
device
to
sale
by
or
on
the
order
of
a
licensed
medical
practitioner.
Electrical
shock
and
flammability
hazard
Warning:
Power
off
the
oximeter
before
cleaning
or
servicing.
Fire/explosion
hazard
Warning:
Do
not use
the
oximeter
in
the
presence
of
a
flammable
anesthetic
mixture
with
air,
or
with
oxygen
or
nitrous
oxide.
Warning:
Use
only
AA
batteries
in
the
oximeter.
Fallure
of
operation
Warning:
It
is
possible
for
any
device
to
malfunction;
therefore,
always
verify
unusual
data
by
performing
a
formal
patient
assessment.
Warning:
Do
not
use
the
oximeter
if
it
fails
to
function
as
described
or
if
the
validity
of
data
is
questionable.
Refer
to
the
appropriate
sections
of
this
manual
to
identify
and
correct
the
malfunction.
Data
validity
Warning:
To
prevent
erroneous
readings,
do
not
use
an
inflated
blood
pressure
cuff
or
arterial
blood
pressure
measurement
device
on
the
same
limb
as
the
oximeter
sensor.
Warning:
Interfering
substances, excessive
ambient
light,
excessive
motion,
low
perfusion,
low
signal
strength,
incorrect
sensor
placement,
or
electrical
interference
at
the
sensor
site
can
result
in
the
display
of
inaccurate
SpO;
data.
Operator
safety
Warning:
Do
not
handle
hot
or
leaking
batteries.
Patient
safety
and
operator
safety
Warning:
To
protect
against
injury
and
eguipment
damage
from
leaking
batteries,
remove
the
batteries
when
the
oximeter
is
not
to
be
used
for
some
time.
1-6
1/
Overview
Patient
safety
(oximeter)
Warning:
The
TuffSat
oximeter
is
not
intended
for
continuous
monitoring.
It
has
no
alarms
(audible
or
visual)
and
no
user-definable
parameters.
.
Warning:
Never
test
or
perform
maintenance
on
the
oximeter
while
using
it
to
monitor
a
patient.
Warning:
When
the
battery
becomes
depleted,
the
oximeter
shuts
off.
No
alarm
sounds.
Warning:
The
correct
use
of
the
oximeter
is
to
measure
only
arterial
oxygen
saturation
(SpO2)
and
pulse
rate.
A
pulse
oximeter
does
not
measure
respiration
and
should
never
be
used
as
a
substitute
for
an
apnea
monitor.
Warning:
This
device
is
not
intended
for
use
in
a
magnetic
resonance
imaging
(MRI)
environment.
Patient
safety
(sensors)
Warning:
When
the
display
indicates
an
error
condition
or
the
oximeter
appears
to
be
operating
abnormally,
disconnect
the
sensor
immediately.
Warning:
Prolonged
monitoring
or
patient
condition
may
require
you
to
periodically
change
the
sensor
site.
If
there
is
evidence
of
blistering,
skin
erosion,
or
ischemic
skin
necrosis
(such
as
skin
discoloration
or
reddening),
change
the
site
immediately.
Otherwise,
change
the
site
as
specified
in
the
instructions
for
the
sensor.
Warning:
Discard
a
damaged
sensor
immediately.
Do
not
repair
a
damaged
sensor
or
use
a
sensor
repaired
by
others.
Warning:
To
prevent
patient
injury
or
equipment
damage,
use
only
Datex-Ohmeda
sensors
approved
for
use
with
this
oximeter.
For
complete
information
about
the
safe
and
appropriate
use
of
a
sensor,
consult
the
instructions
for
that
sensor.
Cleaning
Caution:
Follow
these
guidelines
when
cleaning
the
oximeter:
e
Do
not
autoclave,
pressure
sterilize,
or
gas sterilize
the
oximeter.
e
Use
cleaning
solution
sparingly.
Do
not
immerse
the
oximeter
in
liquid.
Excessive
solution
can
flow
into
the
oximeter
and
damage
internal
components.
‧
When
cleaning
the
display
lens,
do
not
use
abrasive
cleaning
compounds
or
other
materials
that
could
damage
the lens.
＊
Do
not
use
petroleum-based
solutions
or
solutions
containing
acetone,
freon,
or
harsh
solvents.
These
substances
may
damage
the
oximeter
and
cause
a
malfunction.
Caution:
Disposable
sensors
are
intended
for
single-patient-use
only.
1-7
TuffSat
User's
Guide
and
Service
Manual
Maintenance
and
repair
Caution:
An
operator
may
perform
only
maintenance
procedures
specifically
described
in
this
manual.
Refer
servicing
to
gualified
service
personnel
who
are
trained
in
the
repair
of
this
equipment.
Caution:
Internal
electronic
components
are
susceptible
to
damage
by
electrostatic
discharge.
To
avoid
damage
when
disassembling
the
oximeter,
observe
the
standard
precautions
and
procedures
for
handling
static-sensitive
components.
Disposal
Caution:
When
the
oximeter
has
reached
the
end
of
its
useful
life,
dispose
of
it
in
accordance
with
local
procedures
and
regulations.
1-8
2/Oximeter
Features
and
Use
This
chapter
contains:
Descriptions
of
the
product
information
labels
that
appear
on
the
oximeter.
Descriptions
of
the
oximeter’s
features
and
controls.
Instructions
for
checking
the
operation
of
the
oximeter.
Instructions
for
using
the
oximeter.
Information
to
help
you
determine
the
validity
of
the
SpO2
and
pulse
rate
values
you
see
on
the
oximeter.
Product
information
labels
Labels
on
the
TuffSat
oximeter
provide
product
information.
Agency
and
regulatory
symbols
are
described
in
chapter
4.
x
Not
for
continuous
monitoring.
The
TuffSat
has
no
alarms
(audible
or
spo,
|
Visual).
It
is
to
be
used
only
for
spot-checking
SpOz
and
pulse
rate.
SN
Identifies
the
serial
number
for
this
product
in
the
form:
AAAYwovw.
The
first
three
letters
are
specific
to
the
product.
The
fourth
letter
indicates
the
year
of
manufacture
(B
=
1998,
C
=
1999,
and
so
on.
“I”
and
“O”
are
not
used).
The
last
five
digits
are the
sequential
number
for
the
unit
manufactured
in
the
indicated
year.
(©
Identifies
the
warranty
expiration
date
for
this
product.
2-1
TuffSat
User's
Guide
and
Service
Manual
Oximeter
features
and
controls
Pleth
bar
The
segments
pulsate
(flash
on
and
off)
to
match
the
pulse
rate.
The
number
(or
height)
of
lighted
segments
indicates
the
pulse
strength.
Oxygen
saturation
%
(Sp02)
———_—-
For
more
information,
see
Data
validity
and
signal
strength
later
Pulse
rate
in
beats
per
minute
in
this
chapter.
Low
battery
and
print
icons
LÆ
Flashes
on
and
off
until
the
batteries
are
replaced
or
until
no
power
remains.
"JE
SIML
=
indicates
the
battery
power
is
low
(10
to
60
minutes
for
alkaline
batteries;
not
predictable
for
other
battery
types).
For
more
information,
see
Power
in
chapter
4.
[3
Appears
when
the
print
button
is
pressed
to
start
printing
to
the
optional
printer.
Print
button
Press
to
start
printing
to
the
optional
printer.
Press
again
to
stop
printing.
For
details
about
printing
data,
see
the
Appendix:
Printer
Features
and
Use.
Backlight
button
Press
to
power
on
the
backlight.
Press
again
to
power
it
off.
On/
off
button
Press
to
power
on
the
oximeter.
Press
again
to
power
it
off.
When
you
stop
monitoring,
the
power
is
switched
off
after
5
minutes
to
conserve
battery
power.
All
patient
data
are
erased
from
memory
when
the
oximeter
is
powered
off.
2/Oximeter
Features
and Use
Top
view
T
Sensor
connector
ーーーーー
Receptacle
for
connecting
a
Datex-Ohmeda
sensor
(refer
to
the
instructions
for
the
sensor).
Infrared
(IR)
transmitter
port
Port
through
which
real-time
and
trend
data
are
transmitted
from
the
oximeter
to
the
optional
printer.
Checking
normal
operation
Before
monitoring
a
patient,
always
check
that
the
oximeter
is
operating
normally.
WARNING:
Patient
safety.
Never
test
or
perform
maintenance
on
the
oximeter
while
using
it
to
monitor
a
patient.
WARNING:
Failure
of
operation.
Do
not
use
the
oximeter
if
it
fails
to
function
as
described
or
if
the
validity
of
data
is
questionable.
Refer
to
the
appropriate
sections
of
this
manual
to
identify
and correct
the
malfunction.
It
is
possible
for
any
device
to
malfunction;
therefore,
always
verify
unusual
data
by
performing
a
formal
patient
assessment.
Verify
that
the
four
AA
batteries
are
installed.
For
installation
instructions,
refer
to
chapter
3.
Press
the
on/off
button
to
power
on
the
oximeter.
As
the
oximeter
completes
its
self-test,
verify
the
following:
e
The
backlight
illuminates.
e
All
display
elements
(including
the
printer
and
battery
screen
icons)
illuminate
briefly,
then
all
turn
off.
e
The
backlight
remains
on
until
dashes
(---)
are
displayed
for
the
SpO2
and
pulse
rate
values.
Note:
If
the
low
battery
icon
flashes
on
and
off
continuously,
change
the
batteries
as
instructed
in
chapter
3.
Place
a
sensor
on
your
finger
and
connect
the
sensor
cable
to
the
oximeter.
When
the
SpOz
and
pulse
rate
values
are
displayed,
verify
that
the
lowest
pleth
bar
segment
remains
on
while
one
or
more
of
the
other
segments
flash
on
and
off.
Disconnect
the
sensor
cable
from
the
oximeter.
Verify
that
dashes
are
displayed
in
place
of
the
SpO2
and
pulse
rate
values.
Reconnect
the
sensor
cable
to
the
oximeter.
After
SpO2
and
pulse
rate
values
are
displayed,
remove
the
sensor
from
your
finger
and
verify
that
dashes
are
displayed.
If
the
oximeter
fails
to
function
as
described,
refer
to
Troubleshooting
in
chapter
3.
2-3
v
TuffSat
User's
Guide and
Service
Manual
Using
the
oximeter
WARNING:
Patient
safety.
«
Thisdeviceis
not
intended
for
use
in
a
magnetic
resonance
imaging
(MRI)
environment.
=
To
prevent
patient
injury
or
equipment
damage,
use
only
Datex-Ohmeda
sensors
approved
for
use
with
this
oximeter.
For
complete
information
about
the
safe
and
appropriate
use
of
a
sensor,
consult
the
instructions
for
that
sensor.
WARNING:
Data
validity.
To
prevent
erroneous
readings,
do
not
use
an
inflated
blood
pressure
cuff
or
arterial
blood
pressure
measurement
device
on
the
same
limb
as
the
oximeter
sensor.
1.
Apply
the
sensor
to
the
patient
and
connect
it
to
the
oximeter.
Refer
to
the
instructions
for
the
sensor
you
are
using.
2.
Press
the
on/off
button
to
power
on
the
oximeter.
After
completing
the
brief
self-test,
the
oximeter
detects
the
SpOz
and
pulse
rate
values
and
monitoring
begins.
3.
Verify
that
the
signal
strength
is
adequate
and
that
the
data
agree
with
your
clinical
evaluation
of
the
patient.
See
Data
validity
and
signal
strength
later
in
this
chapter.
If
the
oximeter
fails
to
function
as
described,
refer
to
Troubleshooting
in
chapter
3.
WARNING:
Patient
safety.
e
When
the
display
indicates
an
error
condition
or
the
oximeter
appears
to
be
operating
abnormally,
disconnect
the
sensor
immediately.
e
Prolonged
monitoring
or
patient
condition
may
require
you
to
periodically
change
the
sensor
site.
If
there
is
evidence
of
blistering,
skin
erosion,
or
ischemic
skin
necrosis
(such
as
skin
discoloration
or
reddening),
change
the
site
immediately.
Otherwise,
change
the
site
as
specified
in
the
instructions
for
the
sensor.
*
Discard
a
damaged
sensor
immediately.
Do
not
repair
a
damaged
sensor
or
use
a
sensor
repaired
by
others.
=
When
the
battery
becomes
depleted,
the
oximeter
shuts
off.
No
alarm
sounds.
WARNING:
Data
validity.
interfering
substances,
excessive
ambient
light,
excessive
motion,
low
perfusion,
low
signal
strength,
incorrect
sensor
placement,
or
electrical
interference
at
the
sensor
site
can
result
in
the
display
of
inaccurate
Sp02
data.
WARNING:
Failure
of
operation.
It
is
possible
for
any
device
to
malfunction;
therefore,
always
verify
unusual
data
by
performing
a
formal
patient
assessment.
2/Oximeter
Features
and
Use
Data
validity
and
signal
strength
The
SpO,
and
pulse
rate
data
are
continuously
calculated
as
a
12-second
“moving”
average.
Both
values
are
displayed
when
you
begin
to
monitor
a
patient,
however,
their
display
may
be
delayed
slightly
for
patients
with
lower
pulse
rates.
If
the
displayed
pulse
rate
and
the
patient’s
palpated
pulse
rate
vary
significantly,
motion
artifact
or
other
noise
may
be
affecting
the
accuracy
of
the data.
A
cough
or
other
hemodynamic
pressure
disturbance
can
also
disrupt
the
pulse
rate.
The
stability
of
the
SpO2
readings
is a
good
indicator
of
signal
validity.
Motion
at
the
sensor
site,
low
signal
strength,
incorrect
sensor
placement,
and
electrical
interference
may
affect
the
stability
of
the
readings.
To
ensure
the
validity
of
the
signal:
e
Apply
the
sensor
correctly
to
the
patient
(refer
to
the
instructions
for
the
sensor).
e
Restrict
motion
at
the
sensor
site
or
choose
a
site
where
motion
is
less
likely.
+
If
possible,
remove
sources
of
electrical
interference,
such
as
electrosurgical
and
electrical/electronic
devices.
Pleth
bar
(pulse
rate
and
strength
indicator)
The
pleth
bar—a
column
of
eight
segments—represents
the
plethysmographic
waveform.
During
monitoring,
the
lowest
segment
is
always
on;
the
other
segments
pulsate
(flash
on
and
off).
e
The
rate
at
which
the
segments
pulsate
represents
the
pulse
rate.
e
The
highest
segment
that
pulsates
represents
the
strength
of
the
pulse—as
the
pulse
strength
increases,
the
number
of
pulsating
segments
increases.
If
the
pulse
strength
is
low
(only
the
lower
four
pleth
bar
segments
pulsate),
check
for
the
following:
Poor
alignment
of
sensor
optical
components
Make
sure
the
sensor
light
source
and
sensor
detector
are
directly
opposite
each
other
and
that
the
detector
is
completely
covered
by
the
patient's
skin.
If
the
sensor
site
is
thick,
select
a
site
where
there
is
less
distance
between
the
light
source
and
the
detector.
Low
perfusion
Change
the
sensor
site
or
gently
massage
the
site
to
increase
perfusion.
Artificial
fingernails
or
excessive
fingernail
polish
Select
a
different
site
or
remove
the
artificial
fingernails
or
polish.
2-5
3/Maintenance,
Troubleshooting,
and
Service
This
chapter
contains:
‧
Maintenance
instructions
that
include
replacing
the
batteries
and
cleaning
the
oximeter.
e
Achart
for
troubleshooting
situations
that
may
occur
while
using
the
oximeter.
‧
The
Datex-Ohmeda
service
policy.
e
Repair
procedures
that
may
be
performed
by
qualified
service
personnel.
*
An
illustration
of
the
oximeter
to
help
you
identify
its
parts
and
how
it
is
assembled.
e A
list
of
parts
and
their
order
numbers.
Oximeter
maintenance
WARNING:
Electrical
shock
and
flammability
hazard.
Power
off
the
oximeter
before
cleaning
or
servicing.
WARNING:
Patient
safety
and
operator
safety.
To
protect
against
injury
and
equipment
damage
from
leaking
batteries,
remove
the
batteries
when
the
oximeter
is
not
to
be
used
for
some
time.
Replacing
oximeter
batteries
%
WARNING:
Fire/explosion
hazard.
Use
only
AA
batteries
in
the
oximeter.
WARNING:
Operator
safety.
Do
not
handle
hot
or
leaking
batteries.
1.
Power
off
the
oximeter.
2.
Use
a
flat-blade
screwdriver
or
coin
to
loosen
the
screw
that
secures
the
battery
door
to
the
back
case
of
the
oximeter.
Remove
the
door.
3.
Replace
the
depleted
batteries
with
four
new
(or
recharged)
1.5V
AA
batteries.
Align
the
+
on
each
battery
with
the
+
shown
inside
the
battery
compartment.
4.
Position
the
battery
door
hinges
in
the
slots
on
the
back
case.
Close
the
door
and
tighten
the
screw
that
secures
the
door
to
the
device.
Dispose
of
used
batteries
according
to
the
manufacturer's
instructions
or
your
local
regulations.
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