Ferno iNSX Integrated Patient Transport & Loading... User manual

Instructions for Use
December 2022
Pub. No. 234-3622-09
iN∫X®
Integrated Patient Transport & Loading System™
Read this Manual and Retain
for Future Reference

© Ferno / 234-3622-09 / December 2022
2
iN∫X®
Ferno Customer Relations
For ordering assistance or general information:
CANADA AND THE U.S.A.
Telephone (Toll-free) 1.877.733.0911
Telephone [phone]
Fax (Toll-free) 1.888.388.1349
Fax [phone]
Internet www.ferno.com
ALL OTHER LOCATIONS
For assistance or information, please contact your Ferno distributor. If you do not
have a Ferno distributor, please contact Ferno Customer Relations:
Ferno-Washington, Inc., 70 Weil Way
Wilmington, Ohio 45177-9371, U.S.A.
Telephone Country Code +1.937.382.1451
Fax Country Code +1.937.382.6569
Internet www.ferno.com
Disclaimer
This manual contains general instructions for the use, operation and care of this
product. The instructions are not all-inclusive. Safe and proper use of this product
is solely at the discretion of the user. Safety information is included as a service
to the user. All other safety measures taken by the user should be within and
under consideration of applicable regulations and local protocol. Training on
the proper use of this product must be provided before using this product in an
actual situation.
Retain this manual for future reference. Include it with the product in the event
of transfer to new users. Additional free copies are available upon request from
Customer Relations.
Proprietary Notice
The information disclosed in this manual is the property of Ferno-Washington,
Inc., Wilmington, Ohio, USA. Ferno-Washington, Inc. reserves all intellectual
property rights, proprietary design rights, manufacturing rights, reproduction
use rights, and sales use rights thereto, and to any article disclosed therein
except to the extent those rights are expressly granted to others or where not
applicable to vendor proprietary parts.
Limited Warranty Statement
The products sold by Ferno are covered by a limited warranty, which is printed
on all Ferno invoices. The complete terms and conditions of the limited warranty,
and the limitations of liability and disclaimers, are also available upon request by
calling Ferno at 1.800.733.3766 or 1.937.382.1451.
Adverse Event Notice
In the event of an adverse event or serious incident related to the use of this
device, the end user/operator must report the incident to Ferno-Washington,
Inc. at 70 Weil Way, Wilmington, Ohio 45177 USA, 1-877-733-0911, or via email at
[e-mail]. If the incident occurred in the European Union, report
it to Ferno’s Authorized EU Representative and the competent authority of the
Member State in which the end user is established.
Battery Recycling
In the U.S.A., contact TerraCycle Regulated Waste to responsibly recycle and
dispose of the Ferno 36VDC Lithium-iron phosphate battery. Visit https://
tcrwusa.com/.
Outside the U.S.A., contact the government of your country for recycling
information. See“Recycling Notice”on page 39.
USERS’MANUALS
To request additional free users’ manuals,
contact Ferno Customer Relations, your Ferno
distributor, or www.ferno.com.
Unique Device Identication (UDI)
Ferno complies with the United States Food and Drug Administration’s (FDA)
Unique Device Identication (UDI) regulation to identify medical devices.
The UDI label contains information in human- and machine-readable form.
Device information is online at the FDA’s Global Unique Device Identication
Database (GUDID). The public can search and download information at
AccessGUDID at www.fda.gov.
The label is located on the under the battery, on the battery tray.
Ferno-Washington Inc. | Wilmington, Ohio 45177 USA | +1.937.382.1451
Product Name/Model
(01) Global Trade Item Number
(11) Date of Manufacture
(21) Serial Number
Date of Manufacture
SN Serial Number
Manufacturer GS1 Data Matrix
Serial Label

© Ferno / 234-3622-09 / December 2022 3
iN∫X®
Ferno Customer Relations ________________________________ 2
Unique Device Identication (UDI) _________________________ 2
Table of Contents _________________________________________ 3
1 - Safety Information _____________________________________ 4
1.1 Warning__________________________________________ 4
1.2 Notice ___________________________________________ 5
1.3 Bloodborne Disease Notice __________________________ 5
1.4 Symbol Glossary ___________________________________ 5
1.5 Safety and Instruction Labels _________________________ 6
1.6 Compliance: USA Standard SAE J3027__________________ 7
1.7 Compliance: Worldwide _____________________________ 7
2 - Operator Focus ________________________________________ 8
2.1 Operator Training __________________________________ 8
2.2 Operator Height and Strength ________________________ 8
2.3 Daily Operator Duties _______________________________ 8
2.4 No-Lift Loading/Unloading __________________________ 9
2.5 Control the Load ___________________________________ 9
2.6 Using Additional Help______________________________ 10
2.7 Terms ___________________________________________ 11
3 - About the Cot_________________________________________ 12
3.1 Description ______________________________________ 12
3.2 General Specications _____________________________ 12
4 - Features _____________________________________________ 14
4.1 Display__________________________________________ 14
4.2 Power Switch_____________________________________ 14
4.3 Lights___________________________________________ 14
4.4 Display Zones ____________________________________ 15
4.5 Audible Alarm ____________________________________ 15
4.6 Battery__________________________________________ 16
4.7 Battery Charger___________________________________ 17
4.8 Integrated Charging System (ICS®) ___________________ 17
4.9 Extend and Retract Buttons _________________________ 18
4.10 Sleep Mode ______________________________________ 18
4.11 Mode-Select Button _______________________________ 18
4.12 Telescoping Handles_______________________________ 19
4.13 Position Indicator Lights____________________________ 19
4.14 Shock Frame _____________________________________ 19
4.15 Backrest_________________________________________ 20
4.16 Safety-Bar Release Levers___________________________ 20
4.17 Wheel Locks _____________________________________ 20
4.18 Telescoping Frame ________________________________ 21
4.19 Mattress_________________________________________ 21
4.20 Fold-Down Sidearm (Option) ________________________ 22
4.21 SX Surface Xtender (Option) ________________________ 22
4.22 Non-Powered Operation (Manual Mode Handles) _______ 22
4.23 Patient Restraint System____________________________ 23
4.24 Accessory Rail ____________________________________ 23
4.25 Oxygen Cylinder Holder ____________________________ 23
5 - Using the Cot _________________________________________ 24
5.1 Before Placing the Cot in Service _____________________ 24
5.2 General Guidelines for Use__________________________ 24
5.3 One Operator, Empty Cot ___________________________ 25
5.4 Powered Extending/Retracting ______________________ 25
5.5 Transferring the Patient ____________________________ 26
5.6 Transferring the Patient: Chair Position ________________ 27
5.7 Rolling the Cot ___________________________________ 28
5.8 Loading the Cot __________________________________ 29
5.9 Unloading the Cot ________________________________ 30
5.10 Direct Power Modes _______________________________ 31
5.11 Non-Powered Operation: Extending and Retracting _____ 32
5.12 Non-Powered Operation: Loading____________________ 33
5.13 Non-Powered Operation: Unloading __________________ 34
6 - Maintenance _________________________________________ 35
6.1 Maintenance Schedule_____________________________ 35
6.2 Service Life ______________________________________ 35
6.3 Disinfecting /Cleaning Restraints_____________________ 35
6.4 Disinfecting/Cleaning Mattress ______________________ 35
6.5 Disinfecting the Cot _______________________________ 36
6.6 Cleaning the Cot __________________________________ 36
6.7 Pressure-Washing _________________________________ 36
6.8 Inspecting the Cot ________________________________ 37
6.9 Lubricating the Cot________________________________ 38
6.10 Storing the Cot ___________________________________ 39
6.11 Storing the Battery ________________________________ 39
6.12 Recycling Notice __________________________________ 39
6.13 Adjusting Backrest Control Handles __________________ 40
6.14 Adjusting Position Indicator Lights ___________________ 40
6.15 Adjusting Manual Mode Handles_____________________ 41
6.16 Adjusting the Oxygen Cylinder Holder ________________ 42
7 - Initial Setup __________________________________________ 44
7.1 Ambulance Information ____________________________ 44
7.2 Accessories ______________________________________ 44
7.3 Charge and Install the Battery _______________________ 44
7.4 Set the Loading Height_____________________________ 44
8 - Troubleshooting ______________________________________ 45
8.1 General Troubleshooting ___________________________ 45
8.2 Status Indicators __________________________________ 45
9 - Parts and Service______________________________________ 46
9.1 U.S.A. and Canada_________________________________ 46
9.2 Worldwide_______________________________________ 46
10 - Accessories__________________________________________ 46
Training Record__________________________________________ 47
Maintenance Record _____________________________________ 47
TABLE OF CONTENTS
Section Page Section Page

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1.1 Warning
Warning safety alerts indicate a potentially hazardous situation that, if
not avoided, could result in injury or death.
1  SAFETY INFORMATION
WARNING
Untrained helpers can cause injury or be injured. Trained
operators must operate the controls and direct helpers
where to grasp the cot to avoid pinch points.
Improper use of the cot can cause injury. Use the cot only
for the purpose described in this manual.
Improper operation can cause injury. Operate the cot
only as described in this manual.
An unattended patient can be injured. Stay with the
patient at all times.
An unrestrained patient can be injured. Use properly-
installed patient restraints to secure the patient on the
cot.
Rolling the cot above the factory-set maximum transport
height can cause it to tip. Only roll the cot at or below the
factory-set maximum transport height.
Uncontrolled movement can cause injury or damage.
Support and control the cot at all times.
Sheets or other objects can interfere with, or become
entangled in, the actuator or legs, which can cause injury
and/or malfunction, including unexpected retracting
of the cot legs. Tuck sheets between the mattress and
patient surface. Keep other articles above the mattress.
Rolling the cot sideways can cause it to tip and injure the
patient and/or operators. Roll the cot only toward the
control end or loading end.
Pushing the cot by the backrest can cause it to tip and
injure the patient and/or operators. Roll the cot only by
grasping the main frame.
Trained operators must consider the environment and
terrain before rolling. Rolling the cot in a lowered position
will minimize the potential of a cot tip.
Failure to engage the safety hook during loading or
unloading can cause injury. Operators must visually
ensure each safety bar engages the safety hook and the
cot is secure inside the ambulance before extending or
retracting the legs.
A severe angle can injure the patient and/or operators.
Control the cot when using a direct power mode.
Uncontrolled movement can cause injury or damage.
Support the load before using a manual mode handle.
WARNING
A severe angle can injure the patient and/or operators.
Control the cot when operating without power.
Improper maintenance can cause injury and damage.
Maintain the cot and battery only as described in this
manual.
Improper adjustment of the manual mode handle cables
can lead to injury. Adjust cable tension when needed.
The cot can rapidly descend and cause injury if the manual
mode handles are activated while you are adjusting the
cable tension. Use caution when adjusting cable tension.
Attaching improper items to the cot can cause injury. Use
only Ferno-approved items on the cot.
Improper parts and service can cause injury. Use only
Ferno parts and Ferno-approved service on the cot.
Modifying the cot can cause injury and damage. Use the
cot only as designed by Ferno.

© Ferno / 234-3622-09 / December 2022 5
iN∫X®
Symbol Denition
General warning of potential injury
Laser Class 2M Warning: Do Not Stare Into
Light
Pinch point. Keep hands clear
Read the users’manual
Two trained operators required
Lubricate
Do not lubricate
Do Not Open. No user serviceable parts.
Do not push cot by the backrest
Lock
Unlock
700 lb
318 kg
50 st
Load Capacity/Safe Working Load in
pounds, kilograms, stone
OFF
ON
Status Indicator: Low or Medium Priority
Status Indicator: High Priority
1.2 Notice
Notices emphasize important, but not hazard-related information.
Failure to follow Notices could result in product or property damage.
1.3 Bloodborne Disease Notice
To reduce the risk of exposure to blood or other potentially infectious
materials when using the cot, follow the disinfecting and cleaning
instructions in this manual.
Button Denition
Extend Legs
Retract Legs
Scene Lights
Emergency Lights
Chair Position
Battery Check
1.4 Symbol Glossary
The symbols dened here are used on the cot and/or in this’ manual.
Ferno uses symbols recognized by the International Standards
Organization (ISO), American National Standards Institute (ANSI) and
the emergency medical services industry.
NOTICE

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iN∫X®
1.5 Safety and Instruction Labels
Safety and instruction labels place important information from the
users’ manual on the cot. Read and follow label instructions. Replace
worn or damaged labels immediately.
Symbol Denition
A
General injury warning, read the users’
manual, two trained operators required,
load capacity
B Ferno approved battery only
CDo not open: no user-serviceable parts
inside
D Warning: laser emitter
E Regulatory and ratings label
FWarning: do not open controller or stare
into laser light with optical instruments
G Warning: do not push cot by the backrest
H Manual release handle mount
I Manual mode control handle
J Warning: pinch point
AB
DC
FE
JI
HG
700 lb
318 kg
50 st

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iN∫X®
1.7 Compliance: Worldwide
When properly installed and used with appropriate Ferno products,
the iN∫X meets the following standards. Standards and specications
are updated periodically. Current standards are available from these
organizations.
● Alberta: Alberta Health and Wellness Ambulance Vehicle Standard
Code; Section 17.5 Cot Retention System Test
● AMD: Ambulance Manufacturer’s Division (AMD) of the National
Truck Equipment Association Standard 004 Litter Retention System
Static Test.
● AS/NZS 4535:1999: Meets the requirements of Australia/New
Zealand Ambulance Restraint Systems test.
● BCAS: British Columbia Ambulance Service (BCAS) Ambulance
Performance Test Criteria E2 Stretcher Retention
● CAAS: Commission on Accreditation of Ambulance Services Global
Vehicle Standard (GVS)
● CE: Conforms to European standards.
● CSA: Electronic components meet Canadian Standards Association
requirements.
● EN 1789 and EN 1865-3: Vehicle, fastening system, and crash-test
standards.
● IEC 60601-1-2: Electrical and electromagnetic medical equipment.
● IEC 2007/47
● IP56: Ingress Protection rating. Tested in compliance with dust and
water inltration standards.
● KKK-A-1822 (F): Federal Ambulance Specication KKK-A-1822
revision F.
● MDR: Meets the requirements of the European Medical Device
Regulation 2017/745.
● MDD (UK): Meets the requirements of the European Medical Device
Directive 93/42/EEC.
● NFPA: National Fire Protection Association standard NFPA 1917.
● Ontario: Ontario Land Ambulance Standard, Version 5.0, Section
20.1 Main Cot Retention
● SAE J3027:2016: Society of Automotive Engineers Recommended
Practice, Ambulance Litter Integrity, Retention, and Patient
Restraint
1.6 Compliance: USA Standard SAE J3027
The iN∫X® is compatible with SAE J3027 Recommended Practice (USA),
when used with a compliant fastening system (Ferno® iN∫LINE®), and
transport restraint system (Ferno Model 417-3 Restraint System).

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iN∫X®
2.3 Daily Operator Duties
It is good practice for operators to check equipment at the start of each
work shift.To check the cot prior to use, follow the procedures described
in this manual:
● Unload the cot from the ambulance.
● Retract the cot to the oor or ground.
● Extend the cot to the recommended rolling height.
● Rotate the cot in a circle to verify it rolls easily.
● Visually inspect the cot for readiness (page 37).
● Load the cot into ambulance and secure it in the iN∫LINE fastening
system.
● If equipped, verify the cot is being charged by the ICS (page 17,
or see the ICS users’manual).
2  OPERATOR FOCUS
2.1 Operator Training
Operator using the cot:
● must read and understand this manual.
● must have training on proper use of the cot.
● musthaveatraining on emergency-medicalserviceandemergency
patient-handling procedures.
● must have the physical ability to assist the patient.
● must practice with the cot before using it with a patient.
● must keep training records. For a sample, see page 47.
WARNING
Untrained helpers can cause injury or be injured. Trained
operators must operate the controls and direct helpers
where to grasp the cot to avoid pinch points.
2.2 Operator Height and Strength
The cot is designed to minimize the need for lifting. Whenever possible,
use the powered hydraulic system to:
● Extend and retract the legs.
● Load the cot into and unload it from an ambulance.
● Transition between surfaces of varying levels.
● Place the cot at good height to establish a proper, ergonomic
grasping position for the operators.
An excessive load (exceeding the 700 lb/318 kg load capacity) or non-
powered operation may require the operators to lift a portion of the
load. Use additional help as needed (page 10).
NOTICE
If the ambulance is parked on an uneven surface, the
operators (and any helpers) may need to extend the legs
higher than the user-set loading height to allow the cot to roll
into the ambulance.

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iN∫X®
2.5 Control the Load
At all times during rolling, both operators (and any helpers) keep both
hands on the main frame (or guide bar), support and balance the load,
and maintain control of the cot. Use care on rough or uneven terrain.
Roll the cot only at, or below, the maximum transport height. This
height is programmed into the cot. See “Rolling the iN∫X”on page 28.
2.4 No-Lift Loading/Unloading
The iN∫LINE fastening system holds the cot level with the patient oor
as the operators load it into the ambulance (Figure 1), or unload it from
the ambulance (Figure 2). During the loading and unloading process:
● Do not lift the cot. Allow the legs to support the load.
● Both operators work together to guide the cot into the iN∫LINE.
● The Control-end Operator conrms each cot safety bar engages
the iN∫LINE safety hook.
● Conrm the legs have clearance before extending or retracting.
Look for obstructions such as the ambulance bumper.
● Follow the loading and unloading procedures in this manual.
● Use additional help as needed (page 10). 1
2

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Heavy Patients (95th Percentile Male and Heavier), Ferno Recommends:
Extend/Retract Rolling Loading/Unloading
Key: O = Operator H = Helper
O
OO
O
Extend/Retract Rolling Loading/Unloading
2.6 Using Additional Help
Operating the cot requires a minimum of two trained operators. They
may need additional trained help when working with heavy loads
(patient plus equipment), or when operating the cot manually.
● Two trained operators stand at the loading end and control end of
the cot, maintain control of the cot, operate the controls, and direct
helpers on where to stand and how to grasp the cot.
● Side helpers may need to walk sideways under some circumstances.
Follow local protocols.
● Ferno recommends that helpers work in pairs to help maintain cot
balance.
● For heavy loads (patient weight exceeding 95th percentile male
and heavier), Ferno recommends a minimum of two trained
operators and two helpers.
● Use special techniques when operating the cot without power.
Refer to the non-powered operation instructions in this manual.
● Refer to the chart for suggested placement for operators and
helpers.
LOAD CAPACITY
Inspect the cot if the load capacity has
been exceeded (page 37).
700 lb
318 kg
50 st
WARNING
Untrained helpers can cause injury or be injured. Trained
operators must operate the controls and direct helpers
where to grasp the cot to avoid pinch points.