EasyCare toto User manual

Special Products and Service
User guide
Version 4.0 April 2021
www.easycaresystems.co.uk
pioneering simplicity
User guide
www.frontier-group.co.uk
Toto® Lateral Turning System, with Toto® Touch Control Unit

Version 4.0 April 2021
Easy Care Systems Limited
Units 5 and 6 Lower Vicarage
Road
Southampton
Hampshire
SO19 7RJ
T: 02380 420678
E: [email protected]
W: www.easycaresystems.co.uk
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Toto lateral turning system is covered by UK patent no. GB 2449318
Toto lateral turning system is a registered trade mark of Frontier Therapeutics Ltd
© 2019 Frontier Therapeutics Limited. All rights reserved.
Frontier Therapeutics Limited
Newbridge Road Industrial Estate,
Blackwood, Caerphilly,
NP12 2YN, UK
[phone]
[e-mail]
www.frontier-group.co.uk
E
GP0113_A56_04
2021

User guide
English

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Toto® Lateral Turning System Labelling
65ºc for 10 minutes or
73ºc for 3 minutes
Maximum user
weight
Bleaching agent
allowed
Do not pierce
or cut
Do not iron
Line dry
Refer to user manual CE Mark Type BF applied part
Air leak
Keep dry
Class II electrical
equipment
Air hoses blocked
Disposal: Do not dispose of this
product as unsorted domestic
waste. It must be sent to a separate
collection facility for recovery
and recycling.
Caution symbol Service interval
Interface lock Fragile handle
with care
Audio pause Do not tumble dry
!
250
European Authorised
Representative

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This user guide contains important information on correct usage, handling, cleaning and
decontamination. Please read carefully prior to use.
Kit Contents
Before you start, please ensure that you have all the necessary components listed below. If any
are absent, or in case of doubt, please contact Frontier Therapeutics Ltd Customer Services on
[phone].
Toto Touch Control Unit Labelling
1. Starts, stops and pauses the control unit.
2. Air Cell side selection.
3. Air Cell inflation time.
4. Air Cell rest time.
5. Alarm mute and interface
lock mode.
6. Air leak alarm.
7. Blockage alarm.
8. Service indicator.
9. Interface lock indicator.
Toto Platform
• 1x Platform including a fitted cover.
• 1x CPR deflation valve and tubing set.
• 1x Pair of air cells with quick
connectors.
• 1x Transport Bag.
Toto Touch Control Unit
• 1x Toto Touch control unit.
• 1x Control unit power lead.
• 1x User guide.

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Contents
Kit Contents 5
Product Specifications 7
Intended Purpose 8
Alarms and Alerts 17
CPR Emergency Deflation System 19
Nature and Frequency of Preventative Maintenance 21
Cleaning and Disinfection 21
Cleaning Air Filters 22
Warranty 23
Technical Specification 24

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Product Specifications
Toto Lateral Turning System - Standard: a fully
customisable control unit and patient turning
platform.
Product Depth (flat position - air cells
empty) mm (Inches)
Depth (raised position - air
cells inflated) mm (Inches) CPR Deflation Valve
Standard 35 (1.4) 185 (7.3) Quick Release Pull Tag
Product Weight - kg (lbs) Maximum User Weight - kg
(lbs)
Width - mm (Inches) Length - mm (Inches)
Standard 6.7 (14.7) 250 (551) 745 (29) 1850 (73)
Toto Platform
Toto Touch Control Unit
Specifications
Dimensions (width / depth / height) – mm (inches) 240 (9.5) x 100 (4) x 200 (8)
Weight - kg (lbs) 2.2 (4.8)
Rated voltage – UK & EU 220 ~ 240VAC, 50/60Hz, 0.3A
Rated input power (VAC) 20
Protection class Class 2
Power cord length - meters (Feet) 5 (16.4)
Air output (LPM) 11

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Intended Purpose
Frequent repositioning of individuals with impaired mobility and the use of an appropriate support
surface are the most significant interventions to prevent pressure damage1-3. This is achieved
through individual patient assessment and the implementation of manual turning plans.
Toto® is an automated lateral turning system supporting healthcare professionals in the regular
turning of patients, who are at risk of developing pressure ulcers or injuries.
Extended periods of lying or sitting on a particular part of the body and failure to redistribute the
pressure on the body surface can result in sustained deformation of soft tissues and, ultimately, in
tissue damage4. Repositioning involves changing the position of the lying or seated individual at
regular intervals, with the purpose of relieving or redistributing pressure and enhancing comfort.
The frequency of repositioning is determined by considering the individuals level of activity to
independently reposition5. The 30-degree side lying position is widely accepted as the optimum
position for pressure ulcer or injury reduction6. Toto achieves both objectives by allowing for full
customisation of turning frequency, with a 30-degree angle of tilt.
The Toto® system comprises a user programmable digital control unit, and a multiple patient
use turning platform, which is positioned underneath the patients’ mattress to eectively relieve
pressure over patients’ most vulnerable areas.
The digital control unit provides customised care with a user-determined side selection feature
and accurately timed digital inflation and rest durations, allowing for patient-prescribed turning
intervals. Increased patient safety is achieved, via a sophisticated yet simple to understand system
of integrated alarms and a convenient therapy pause mode, enables patient interaction without
having to stop therapy.
The turning platform operates via discreet air cells which smoothly, gently and consistently turn
the patient laterally via the mattress surface, even when they are asleep. Compatible with profiling
beds and both standard and alternating pressure relieving equipment, the platform provides head
to toe peak pressure redistribution.
The Toto system has a maximum user weight of 250kg meaning management of heavier patients
becomes easier and less onerous on sta. Toto can be used in conjunction with support aids and
sleep systems, an individual assessment must be carried out to assess for suitability.
Bedsides should be used to help prevent patient egress and to increase the feeling of security, see
warnings and precautions for further information.
Toto does not replace pressure relieving and redistribution surfaces and is supplementary to
theiruse.
Indications
Toto is a supplementary device for the prevention of pressure ulcers or injuries for patients:
• Identified as being at moderate to high risk of developing pressure damage.
• Weighing up to 250kg (551lbs).
• That are unable to change their position without assistance.
• Requiring regular turning and who are non-compliant with manual turning schedules.

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Contraindications
• Do not use without a suitable pressure redistribution surface and package of care.
• Do not use with patients with unstable spinal cord injuries or who are undergoing traction.
• Do not use with patients with equilibrium disturbances.
Advice for laypersons
Any change in skin condition that causes concern, should be reported to a healthcare professional.
Warnings and Precautions
Individual patient assessments should be made prior to use and appropriate pressure redistributing
devices put in place. Please note the following:
• Unusual body shapes and postures should be assessed prior to use.
• Caution is advised when using with patients with underlying neurological disorders which may
lead to increased anxiety.
• Other medical devices should be assessed for suitability.
• Ensure the Toto platform is fully deflated before attempting to leave the bed.
•Engage therapy pause mode during hygiene procedures and when over-bed tables are being
used to avoid the risk of spillages.
• When elevating a profiling bed back rest, raise the knee break first.
•Ensure the surface of the bed frame is clear from debris before placing the Toto platform, as this
can damage the coating of the cover.
• The system should not be used without a mattress.
• Do not strap the mattress to the bed frame as this will prevent Toto from operating.
•If mattress overlays are being used, these must be securely fastened to the mattress, not the
Toto platform.
•Toto can be used with positioning systems, bed levers and linen cradles, if their support frame
fits horizontally across the bed. These must be positioned under the Toto platform.
• Evacuation hammocks must be placed between the Toto platform and the mattress.
• If using foot board protectors, assess for compatibility.
•Do not place the control unit directly underneath the bed frame if placing on the floor, to avoid
lowering the bed onto the control unit.
•Use only with the supplied AC power lead and with correct fuse fitted. Should there be a need
to replace the fuse, ensure only the correct fuse rating is used (3A).

• The use of bedsides or bed rails is recommended.
•When Toto is deflated and in the flat position, the distances between the top of the uncompressed
mattress and bed rail should be as follows;
• Top of the bed rail >220mm (Diagram 1)
• Bottom of the bed rail <120mm (Diagram 2)
•When inflated, assess the distance between the tilted side of the mattress and bed rail. This
should be <120mm. (Diagram 3)
• Assess for risk of entrapment
Bed Sides
Mattress / Support Surface
Toto Platform
Bed Frame
DIAGRAM 1. VIEW FROM SIDE
≥ 220mm
Bed Sides
Mattress / Support Surface
Toto Platform
Bed Frame
DIAGRAM 2. VIEW FROM SIDE
≤ 120mm
Bed Sides
Mattress / Support Surface
Toto Platform
Bed Frame
DIAGRAM 3. VIEW FROM HEAD
≤ 120mm
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Patient Target Group
Immobile and less mobile patients who are at risk of developing pressure ulcers or injuries, who
require regular turning and those who may be non-compliant with manual turning schedules.
Intended Users
Intended for use in home and professional healthcare facilities by medically trained and untrained
users. There are no special skills required to operate or use Toto. More information can be found
online at https://www.frontier-group.co.uk.
Instructions for Use
Before use, please read the following instructions. Should you have any queries, please contact
Frontier Therapeutics Ltd. on [phone] or visit our website www.frontiergroup.co.uk.
Platform Installation and Operating Guide
To ensure the system is correctly installed and functions smoothly, follow this step-by-step guide.
1. Remove all items from packaging and inspect for damage.
2. Remove the mattress and place the rolled platform at the foot end of the bed, roll out until it is
fully extended and positioned centrally to the bed frame.
3. Ensure the air cells within the platform are secured in position via the popper fastenings by
unzipping the cover and visually inspecting.
4. If required, re-fit the cover and close the zip ensuring the air cell hoses are fed through the
opening at the foot end of the cover.
Please note: The platform cover should be free to move, allowing each side of the platform
unrestricted room to inflate.
5. Using the quick connectors, connect the air inflation hoses to the air cell hoses - ‘Red to Red’ -
ensuring the hoses are not twisted or kinked.
6. Check the CPR deflation valves are securely in place to ensure no air leaks.
7. Replace the mattress on top of the platform. DO NOT strap or fasten the mattress to the bed
frame.
8. Using the bed hooks, hang the control unit on the bed footboard.
9. Using the quick connectors, connect the air inflation hoses to the control unit - ‘Black to Control
Unit’ - ensuring the hoses are not twisted or kinked.
10. Connect the control unit to mains power via the lead supplied.
A. The platform should be placed directly
onto the bed frame and underneath the
existing mattress.
B. Inspect the platform for visible signs of
damage.
C. Using the quick connectors, connect
the air inflation hoses to the air cell hoses
- 'Red to Red' - ensuring the hoses are
not twisted or kinked.

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G. Connect the control unit to the mains
power via the lead supplied.
Patient Positioning
Position supine patients along the centre line of
the mattress by aligning the patient’s nose with
the centre of the headboard. Ensure the head
and shoulders are supported preventing neck
rolling and pivoting at the hips.
Toto is indicated for side lying if patients can self-
support, and they are in the middle of the bed.
When using bedsides, consider the use of
padding, bumpers ornetinfills.
Centre Line
D. Check the CPR deflation valves are
securely in place to ensure no air leaks.
E. Using the bed hooks, hang the control
unit on the bed footboard.
F. Using the quick connectors, connect
the air inflation hoses to the control unit
- ‘Black to Control Unit’ - ensuring the
hoses are not twisted or kinked.

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L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
touch
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Toto Touch Control Unit Operating Guide
1. Start, stop and pause the control unit.
2. Air cell side selection - Left only, Right only or Both.
3. Air cell inflation time - Length of time the air cell remains inflated; minimum 30 minutes, maximum
240 minutes.
4. Air cell rest time - Length of time the air cells remain deflated and the platform is flat; minimum
30 minutes, maximum 240 minutes.
5. Alarm mute and interface lock mode activation.
Turning the Toto Touch Control Unit On
• Press and hold the start/stop button (1) for three seconds.
• A single beep confirms activation along with default lit LEDs.
• Note the system default settings below; these can be changed as appropriate.
o Air cell side selection - both sides.
o Air cell inflation time - 120 minutes.
o Air cell rest time - 120 minutes.
•The pump automatically inflates the left side of the platform; this can be changed as appropriate.
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
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Air Cell Inflation Selection
• Press the side selection button (2) to scroll through the three available options:
o Left and right air cell (Default).
o Right air cell only.
o Left air cell only.
• Side selection refers to the patient’s side, as standing at the foot end of the bed.
• A single beep confirms activation along with a lit LED.
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Changing the Air Cell Inflation Time
• Press the inflate time button (3) to scroll through the five available options:
o 30 minutes.
o 60 minutes.
o 120 minutes (Default).
o 180 minutes.
o 240 minutes.
• A single beep confirms activation along with the lit option LED’s.
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
touch
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
touch
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Changing the Air Cell Rest Time
• Press the rest time button (4) to scroll through the five available options:
o 30 minutes.
o 60 minutes.
o 120 minutes (Default).
o 180 minutes.
o 240 minutes.
• A single beep confirms activation along with the lit option LED’s.
Once settings have been selected, lock the interface by pressing the interface lock button (5),
confirmed by the padlock LED (9) turning on and a double beep (see Interface Lock).
Therapy Pause Mode
The therapy pause mode temporarily deactivates all control unit functions, returning the platform
to a flat position.
• Press the start/stop button (1) a single beep confirms activation.
• The currently selected side selection, inflate and rest time LEDs flash when active.
•For safety, the alarm activates after 10 minutes. To continue in this mode for another 10 minutes,
press the Alarm Pause button (5), repeat this process until Therapy Pause Mode is no longer
required.
•To deactivate, press the start/stop button (1). A single beep confirms deactivation and the control
unit returns to the previously selected settings.
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
touch
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L
R
L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
touch
5
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Interface Lock
The interface lock prevents any unwanted changes to the control unit settings.
• Press and hold the alarm mute button (5) for four seconds.
• Confirmed by the padlock LED (9) and a double beep.
• When the interface is locked, only the alarm mute button is operational.
• To deactivate, press and hold the alarm mute button (5) for four seconds.
• Deactivation is confirmed by the padlock LED (9) turning o, and a double beep.
Alarm Mute Control Button
When activated, the alarm can be paused for up to 10 minutes while troubleshooting, after which
time, the alarm recommences if the problem remains.
• To mute the alarm, press the alarm mute button (5).
If a new alarm condition occurs when paused, the initial alarm terminates and a new alarm
willactivate.

L
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L & R 60 min
30 min
120 min
180 min
240 min
60 min
30 min
120 min
180 min
240 min
INFLATE TIME
REST TIME
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Alarms and Alerts
The Toto Touch control unit has three integrated alarms and one information alert to ensure patient
safety and ecacy.
The sound pressure level of the alarm audio or the reminder audio signal ranges from 55dB-85dB.
The alarm frequency is 150HZ to 1000HZ.
While troubleshooting, the alarm can be muted for up to 10 minutes. If the fault is not corrected
during this time, the alarm reactivates.
If a new alarm condition occurs within 10 minutes, mute will cease, and the new condition will
generate an alarm.
Please Note:
• The corresponding alarm indication LED remains lit when the alarm is muted.
• If the alarm condition is corrected while muted, the LED and mute will automatically terminate.
•The alarm audio signal comes from a speaker, and the remainder audio signal comes from
abuzzer.
• Alarm activation may take up to two minutes from when the alarm state occurs.
Alarms and Alerts Alarm Condition Indicated by an audible alarm and:
Air Leak Alarm
The pressure in the system
has fallen below the minimum
operational requirements, i.e.
an air leak.
Low priority Air Leak LED permanently lit yellow
(when activated) (6).
Blockage Alarm
Airflow between the control unit
and the platform is prevented, i.e. a
blocked air hose.
Low priority
Blockage LED permanently lit yellow
(when activated) (7).
Service Interval
Service required; default at one-year
use. n/a Service LED permanently lit amber
(8) (NO AUDIBLE alarm).
Power Loss Alarm
Power to the control unit has been
interrupted.
Low priority Audible alarm, no LED lit.
Initialisation Failure
Control unit fails to start n/a All ‘Inflate time LEDs’ and ‘Rest time
LEDs’ flashing (when activated).

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Do not open the control unit. Opening the unit could cause personal injury or equipment damage.
NB. The Toto Touch control unit self calibrates on start up.
System Error Trouble Shooting Guide
Problem Cause Initial Checks / Trouble Shooting
No LEDs lit; no audible
alarm heard.
• Control unit may not
be attached to a power
source.
• The fuse may need
replacing.
1. Check that the mains power outlet is live and active.
2. Check the control unit is switched on.
3. If following points 1 and 2 does not resolve the
problem, switch o and unplug the control unit:
- Check the mains plug fuse (3A).
- Check the control unit fuse (1A).
4. Restart the control unit.
If the problem persists, contact Frontier Therapeutics
Ltd Tel. [phone] for assistance.
Air-leak alarm
LED (6) lit permanently
yellow with an audible
alarm.
• Pressure has fallen below
the minimum operational
requirements.
1. Press the alarm pause button.
2. Check the CPR valve is closed and correct.
3. Check all air cells and hoses for any air leakage.
4. Resolve and wait for the alarm to reset.
If the problem persists, contact Frontier Therapeutics
Ltd Tel. [phone] for assistance.
Blockage alarm
LED (7) lit permanently
yellow with an audible
alarm.
• Airflow obstruction
between the control unit
and the platform.
1. Press the alarm pause button.
2. Check for twists or kinks in the air hoses between
the platform and control unit.
3. Resolve and wait for the alarm to reset.
If the problem persists, contact Frontier Therapeutics
Ltd Tel. [phone] for assistance.
Service LED (8)
permanently lit amber.
• Service required. Please contact Frontier Therapeutics Customer
Services for support Tel. [phone]
The Control Unit continues to function even though
the service LED remains lit.
Interface panel is lit
but unresponsive.
• Interface panel is locked. 1. Check that screen lock LED is lit amber (9).
2. Press and hold the alarm mute button for four
seconds to deactivate.
If the problem persists, contact Frontier Therapeutics
Ltd Tel. [phone] for assistance.
An audible alarm is
sounding; no LEDs lit.
• Loose or absent power
lead.
• Mains power accidentally
turned o
• Mains power failure.
1. Reconnect mains power lead to the control unit.
2. Check the mains power wall switch is turned on.
3. Attempt to restart the control unit.
If the problem persists, contact Frontier Therapeutics
Ltd Tel. [phone] for assistance.

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CPR Emergency Deflation System
The Toto system features a quick release CPR deflation valve which allows for rapid deflation for
emergency procedures.
In the event of an emergency, firmly pull and release the yellow tab.
To re-inflate the system, replace the CPR tag ensuring both sealing connectors are firmly attached
and restart the Toto Touch control unit.
CPR Deflation Valve Closed CPR Deflation Valve Open

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Inspection and Care
The Toto lateral turning system cover, platform assembly, air cells, CPR deflation valve and tubing
set and control unit each have a unique GS1 compliant barcode which should be retained and used
in the event of a warranty claim. NEVER remove these labels.
Cover
Regularly inspect the outer and inner surfaces of the cover for signs of damage.
Report damaged covers to the ward or department manager or appropriate healthcare
professional.
Withdraw damaged covers from service and replace. Check zip fasteners for function
andintegrity.
Platform
Regularly inspect the interior and exterior of the platform, ensuring that the poppers and air cells
are intact.
Ensure the platform has not drifted out of position and the air hoses are not blocked, kinked or
twisted.
Fitting and Replacing Damaged Air Cells
In the event of an air cell puncture or leak, either or both air cells can be replaced. Please contact
Frontier Therapeutics Customer Services for replacement parts Tel: [phone].
1. Switch o the control unit and disconnect from mains power.
2. Disconnect the air hoses from the platform using the quick connectors.
3. Unzip and pull back the cover revealing the platform.
4. Determine the faulty air cell and remove by unfastening the popper fastening.
5. Inspect the platform for other signs of damage, including the potential source of the damage.
6. Fit the new air cell ensuring it is in-line with the correct section and secure in place with the
popper fastening.
7. Replace the cover ensuring correct orientation and feed air cell hoses through the opening
atthe bottom.
8. Reattach the hoses using the quick connectors - ‘Red to Red’ - ensuring they are not twisted or
kinked.