Getinge Arjohuntleigh Citadel Plus User manual
Citadel Plus
Bariatric Care System
Instructions for Use
...with people in mind
831.484 Rev B • 12/2018
Design Policy and Copyright
® and ™ are trademarks belonging to the ArjoHuntleigh group of companies unless
otherwise stated.
© ArjoHuntleigh 2017
As our policy is one of continuous improvement, we reserve the right to modify designs
without prior notice. The content of this publication may not be copied either wholly or
in part without the consent of ArjoHuntleigh.
3Citadel Plus Bariatric Care System
Table of Contents
General Warnings ..................................................................................................................5
• Safety Information.............................................................................................................8
• Power Drive System Safety Information ........................................................................10
Introduction...........................................................................................................................12
• Product Overview............................................................................................................12
• Optional features.............................................................................................................13
• Clinical Applications ........................................................................................................15
• Intended Use...................................................................................................................15
• Indications.......................................................................................................................15
• Contraindications ............................................................................................................15
• General Product Information...........................................................................................16
Installation ............................................................................................................................17
• Weighing System Preparation.........................................................................................17
• Power Drive Shipping Pin Removal ................................................................................17
• Electricity Supply.............................................................................................................18
• Potential Equalization Terminal .......................................................................................19
• Electrical Connections ....................................................................................................19
• Power Cord .....................................................................................................................19
• Nurse Call and RS232 Connections ...............................................................................19
• Auxiliary Power Outlet.....................................................................................................20
• Skin IQ Family Power Cable ..........................................................................................21
• Skin IQ Installation ..........................................................................................................21
• Mattresses.......................................................................................................................21
Operating Instructions ..........................................................................................................23
• Lifting Pole and Accessory Sockets ................................................................................23
• Drainage Bag Rails .........................................................................................................24
• Bed Length Adjustment...................................................................................................24
• Bed Width Adjustment.....................................................................................................26
• Foot Pedal for Adjustment of Bed Height ........................................................................27
• Brakes and Steering........................................................................................................27
• Side Rails........................................................................................................................28
• Head and Foot Boards....................................................................................................29
• Patient Restraints............................................................................................................29
• Under Bed Light ..............................................................................................................30
• Backup Battery................................................................................................................31
• Recharging the Backup Battery ......................................................................................32
• Over-Use Lockout ...........................................................................................................32
• Attendant Control Panel, Nurse Control Panel and Patient Control Panel .....................33
• Patient Handset (Optional Feature) ................................................................................36
• Weigh Scale Panels (With and Without Unit Selection)..................................................37
• Weighing Accuracy .........................................................................................................38
• Weighing Initialization ....................................................................................................39
4Citadel Plus Bariatric Care System
• Weighing ........................................................................................................................39
• Weighing Units ...............................................................................................................40
• Auto Compensation.........................................................................................................40
• Weighing System Error Codes .......................................................................................41
• Angle Indication...............................................................................................................41
• VariZone Patient Movement / Exit Detection ..................................................................42
• VariZone Operation ........................................................................................................43
• Anti-Entrapment System .................................................................................................44
• RS232 Connection..........................................................................................................45
• Controls for Television and Lighting ................................................................................46
Power Drive..........................................................................................................................47
• Preparation for Transport ................................................................................................47
• Power Drive LEDs...........................................................................................................47
• Operating Power Drive....................................................................................................48
Patient Placement ................................................................................................................50
• Power On .......................................................................................................................50
• Preparation for Patient Placement .................................................................................50
• Completion of Patient Placement....................................................................................51
Nursing Care ........................................................................................................................52
• CPR.................................................................................................................................52
• CPR Backrest Release ...................................................................................................53
• Patient Bathing................................................................................................................53
• Patient Transfer from the Citadel Plus Bariatric Bed Frame System ..............................54
• Patient Transport.............................................................................................................54
Care and Cleaning................................................................................................................55
• Deck Sections .................................................................................................................55
• Decontamination .............................................................................................................55
• General Recommendations ............................................................................................57
• Cleaning the Citadel Plus Bariatric Bed Frame System While in Use.............................57
Preventive Maintenance.......................................................................................................58
• Weighing System ............................................................................................................59
• Battery Test ....................................................................................................................59
Troubleshooting....................................................................................................................60
• Error Codes.....................................................................................................................61
• Fault Indications..............................................................................................................62
• Product Lifetime ..............................................................................................................62
Accessories ..........................................................................................................................62
Electromagnetic Compability (EMC).....................................................................................63
Warranty and Service ...........................................................................................................66
6SHFL¿FDWLRQV .......................................................................................................................67
Explanation of Symbols Used...............................................................................................69
5Citadel Plus Bariatric Care System
GENERAL WARNINGS
The following warnings should be considered prior to using this product:
Before using the bed, make sure that the Power in rating on the
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To make sure the patient can use the bed safely, their age and condition
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down tilt (Trendelenburg) or foot down tilt (reverse Trendelenburg) may
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All accessories added to the system reduce the safe working load of the
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If the power cord or plug is damaged, the complete assembly must be
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Make sure the power cord does not become entangled with moving
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Always adjust the bed frame and deck to the same length and make
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Entrapment hazards may exist when using a very soft mattress, even if
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Side rails are not intended to restrain patients who make a deliberate
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To prevent possible entrapment, make sure the patient’s head and limbs
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Make sure the locking mechanism is securely engaged when the side
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6Citadel Plus Bariatric Care System
Prior to engaging any mattress turn feature, make sure that bed frame
has side rails and that all side rails are fully engaged in their full upright
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V\VWHPZKHQSDWLHQWUHVWUDLQWVDUHLQXVH
Patient restraints should be used in compliance with all applicable
federal and state regulations and in accordance with the healthcare
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Patient restraints, even when correctly used, can result in entrapment or
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to use patient restraints must be made by the clinician overseeing
the care of the individual patient, following a fully documented risk
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Patient restraints are not intended as substitutes for good nursing
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To make sure the battery is kept fully charged and prevent damage to
the battery, the bed should be connected to the electricity supply at all
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Connecting devices not designed to be used with the bed may result in
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Keep your feet away from the areas below the side rails and take extra
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The weighing system should only be used by staff trained in the correct
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The weighing system should only be used in closely supervised
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additions to the bed) can be controlled as described in the following
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The weighing system MUST be zeroed every time a new patient is to be
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The weighing system MUST be zeroed every time a mattress is
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7Citadel Plus Bariatric Care System
The weighing system cannot be zeroed if a mattress or accessories
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should be performed under the supervision of an appropriate healthcare
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The manual CPR release should only be used in an emergency;
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power if the function has not been locked on the Attendant Control
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recommends that the Citadel Plus Bariatric Care System be cleaned
during use and between patients according to the Care and Cleaning
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blood borne pathogens may be used provided the manufacturer’s
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Always disconnect the Citadel Plus Bariatric Care System from mains
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If the bed is stored for a long time, it should be connected to the
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Multiple people may be required to manually transport the bed
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The nurse call button on Citadel Plus has not been evaluated for the
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responsible to determine the operability of the nurse call button with all
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8Citadel Plus Bariatric Care System
Safety Information
General Protocols – Follow all applicable safety rules and institution protocols
concerning patient and caregiver safety.
Brakes – Set all caster brakes before transferring patient.
Bed Height – To minimize risk of falls or injury, the bed should always be in the
lowest practical position when the patient is unattended.
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is removed, check operation of components in area of spill.
Fluids remaining on controls can cause corrosion, which may
cause components to fail or to operate erratically, possibly
producing hazards for patient and staff.
Oxygen Use - Make sure that the unit is not contained in an oxygen enriched
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equipment other than the nasal prongs, mask or half bed length tent type. Oxygen
tent should not extend below mattress support level.
Lock-Outs – Lock-outs for bed functions should be used at staff’s discretion to
prevent unintentional operation of bed.
Power Cord – Make sure power cord is kept free from all pinch points, moving
parts and is not trapped under casters. Improper handling of power cord can
FDXVHGDPDJHWRWKHFRUGZKLFKPD\SURGXFHULVNRI¿UHRUHOHFWULFVKRFN3XOO
the power cord out of the mains wall outlet to remove power from the unit.
Avoid Fire Hazards±7RPLQLPL]HWKHULVNRI¿UHFRQQHFWWKHXQLW¶VSRZHUFRUG
directly into a wall-mounted outlet. Do not use extension cords or multiple outlet
strips. In the US, review and follow FDA’s Safety Tips for Preventing Hospital
Bed Fires. Outside the US, consult the local Competent Authority or Government
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Disposal – At the end of useful life, dispose of waste according to local
requirements or contact the manufacturer for advice. There may be special
requirements for disposal of batteries, leaded foam and / or angle sensors (if
present in this product). Improper disposal of any component may result in
regulatory non-compliance.
Moving Parts - Keep all equipment, tubes and lines, loose clothing, hair and parts
of the body away from moving parts and pinch points.
Patient Entrance / Exit – Caregiver should always aid patient in exiting the bed.
Make sure a capable patient knows how to get out of bed safely (and, if necessary,
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Side Rails / Patient Restraints - Whether and how to use side rails or restraints
is a decision that should be based on each patient’s needs and should be made by
the patient and the patient’s family, physician and caregivers, with facility protocols
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(including entrapment and patient falls from bed) in conjunction with individual
Citadel Plus Bariatric Care System
patient needs, and should discuss use or non-use with patient and / or family.
Consider not only the clinical and other needs of the patient but also the risks of
fatal or serious injury from falling out of bed and from patient entrapment in or
around the side rails, restraints or other accessories. In the US, for a description
RIHQWUDSPHQWKD]DUGVYXOQHUDEOHSDWLHQWSUR¿OHDQGJXLGDQFHWRIXUWKHU
reduce entrapment risks, refer to FDA’s Hospital Bed System Dimensional and
Assessment Guidance To Reduce Entrapment.
Outside the US, consult the local Competent Authority or Government Agency
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with confused, restless or agitated patients. It is recommended that side rails (if
used) be locked in the full upright position when the patient is unattended. Make
sure a capable patient knows how to get out of bed safely (and, if necessary,
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frequently to guard against patient entrapment.
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sure the distance between top of side rails (if used) and top of mattress (without
compression) is at least 22 cm (8.66 in) to help prevent inadvertent bed exit or
falls. Consider individual patient size, position (relative to the top of the side rail)
and patient condition in assessing fall risk.
Make sure the distance between top of side rails (if used) and
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greater. Consider individual patient size, position (relative to the
top of the side rail) and patient condition in assessing fall risk.
Skin Care – Monitor skin conditions regularly and consider adjunct or alternative
therapies for high acuity patients. Give extra attention to skin over any raised side
bolster and to any other possible pressure points and locations where moisture
or incontinence may occur or collect. Early intervention may be essential to
preventing skin breakdown.
Maximum Recommended Patient Weight - Total patient weight capacity should
not exceed 454 kg (1000 lb). The use of accessories on the bed may decrease
the patient weight capacity of the bed. Contact ArjoHuntleigh Customer Service for
questions concerning the use of accessories and see the Questions and Contact
Information section of this guide for contact information.
I.V. and Drainage Tubes – Prior to activating any positioning function assess
the security of all invasive lines and tubes to accommodate the desired angle
of articulation and minimize the risk of binding, disconnecting or dislodging.
7XEHVDQGOLQHVVKRXOGDOZD\VKDYHVXI¿FLHQWVODFNIRUDUWLFXODWLRQDQGSDWLHQW
movement.
10 Citadel Plus Bariatric Care System
Turning - Prior to engaging any mattress turn feature, make sure that bed frame
has side rails and that all side rails are fully engaged in their full upright and locked
position. Do not activate the turning feature on any mattress system when patient
restraints are in use.
Scale Readings - Scales / patient weights are for reference only. Scale readings
should not be relied upon for medication dosage. All equipment on the weighed
portion of the unit is included in weight displayed.
Patient Migration – Specialty surfaces have different shear and support
characteristics than conventional surfaces and may increase the risk of patient
movement, sinking and / or migration into hazardous positions of entrapment
and / or inadvertent bed exit. Monitor patients frequently to guard against patient
entrapment.
Skeletal Traction or Unstable Fracture (if not contraindicated) – With skeletal
traction, unstable pelvic fracture or any other unstable fracture (to the extent
not contraindicated), maintain physician directed angle of articulation and guard
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Electromagnetic Interference – Although this equipment conforms with the intent
of electromagnetic compatibility, all electrical equipment may produce interference.
If interference is suspected, move equipment away from sensitive devices or
contact the manufacturer.
Shock Hazard – Electrical shock hazard; do not remove electrical compartment
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Power Drive System Safety Information
To minimize the risk of serious injury, carefully read and follow all Safety
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Steep Slopes - When operating on slopes, always use slow speed. Do not
operate on slopes in excess of > 7°.
Wet Surfaces - Do not operate power drive system on wet surfaces.
Indoor Use Only - Do not operate power drive on outside walkways, outside
ramps or parking lots.
Unplug - Ensure power cord is unplugged from wall and properly stored before
transport.
Clear Area - Ensure area beneath power drive system is clear before engaging
drive system.
Clear Path - Ensure pathway is clear of cords, hoses and obstacles before driving
bed forward or backwards.
11Citadel Plus Bariatric Care System
Avoid Trapping People - Ensure there is space to operate before forward or
reverse movement. Take caution in crowded areas to prevent trapping a patient or
caretaker between bed frame and wall, furniture, equipment or other objects.
Crowded Areas - Operate with caution in crowded hallways, elevators and rooms.
Navigate Slowly - Use slow speed when moving bed around corners and through
elevators and rooms.
Limited Space Maneuvering - To maneuver the bed in small or tight areas,
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desired direction.
Automatic Brakes - When the Forward or Reverse switch is released, the power
drive system will stop; brakes are automatically engaged to prevent continued
movement.
Citadel Plus Bariatric Care System
INTRODUCTION
These instructions contain information for the installation, use and maintenance of
the ArjoHuntleigh Citadel™Plus Bariatric Care System. These beds have multiple
functions to help provide optimal care and safety for both patient and care giver.
Product Overview
Figure 1: Product overview
A. Foot Board
B. Foot End Side Rail
C. Thigh Section
D. Seat Section
E. Backrest Section
F. Patient Controls
G. Head End Side Rail
H. Power Drive Controls (see page 48)
I. Head Board
J. Accessory Socket
K. Anti-Entrapment Sensor
L. Caster
M. Lifting Pole Socket
N. Side Rail Release Lever
O. Weighing / Movement Detection System
Controls
ABC
D
E
FG
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
P. Power Drive Lift Pedal
Q. Power Drive
R. Drainage Bag Rail
S. Attendant Control Panel (ACP)
T. Foot End Brake Pedal
U. CPR Release Handle
V. Width Extensions (total of eight
see page 26)
W. Care Giver Controls
X. Roller Buffer
Not shown in this view:
Y. Leg Extension Latch
(see page 25)
Z. Blue Extension Locking Handle
(see page 25)
X
13Citadel Plus Bariatric Care System
All Citadel Plus beds have the following standard features:
• Folding split side rails with integrated bed controls
• Electrical adjustment of bed height and leg section elevation
• Electrically operated retracting backrest
• Auto-Chair facility
• Electrical adjustment of head down tilt (Trendelenburg) and foot down tilt
(reverse Trendelenburg)
• Electrical adjustment of calf section vascular position
• Mattress support surface with removable panels
• Adjustable length mattress support surface
• Drainage bag rails
• Under bed lights
• 150 mm dual casters
• Patient weighing and VariZone™patient egress detection
• Anti-Entrapment System
• Width extension (adjustable width mattress support surface)
Optional features
• One-way nurse call
• Two-way nurse call
• Environmental controls
• RS232 connection allowing transfer of bed status data
• DIN accessory rails
• Foot pedal for adjustment of bed height
• Patient handset
• Power Drive
• Hinged power drive handles
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options are indicated by the equipment model number.
14 Citadel Plus Bariatric Care System
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located on the bed frame below the head board.
Before using the bed, make sure that the power-in rating on the
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Citadel Bariatric Care System
DUTY10% 2 min ON / 18 min OFF
POWERin 115V~ 9.5 A MAX 60Hz
ArjoHuntleighAB
HansMichelsensgatan 10
21120 Malmö, SWEDEN
www.arjohuntleigh.com
YYYY-MM-DD
MADEIN POLAND
Citadel Bariatric CareSystem
IPX4
E348583
0086
522 kg
1150 lb
)LJXUH6SHFL¿FDWLRQODEHO
15Citadel Plus Bariatric Care System
CLINICAL APPLICATIONS
Intended Use
The Citadel Plus Bariatric Care System is intended for the acute and post-acute care
environments. It is not intended for use in the home care environment.
The bed is suitable for use in the following situations:
• Intensive / critical care provided in a hospital where 24-hour medical
supervision and constant monitoring is required, e.g. ITU, ICU and CCU.
• Acute care provided in a hospital or other medical facility where medical
supervision and monitoring is required, e.g. general medical and surgical
wards.
• Long term care in a medical area where medical supervision is required and
monitoring is provided if necessary, e.g. nursing homes and geriatric facilities.
Indications
The Citadel Plus Bariatric Care System is indicated for medical purposes to aid
the patient and staff during the performance of routine care.
Contraindications
The Citadel Plus Bariatric Care System is contraindicated for patients weighing
in excess of 454 kg (1000 lb). The care giver should refer to and follow any
contraindications in the product labeling for the pressure redistribution surface being
used with the Citadel Plus Bariatric Care System.
Width extensions retracted: The bed is not suitable for patients under 45 kg (100 lb) in
weight.
Width extensions expanded: The bed is not suitable for patients with a Body Mass
Index (BMI) <30.
To make sure the patient can use the bed safely, their age and condition
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The use of head down tilt (Trendelenburg) or foot down tilt (reverse
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The tilt function should only be used under the guidance of a clinically
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16 Citadel Plus Bariatric Care System
General Product Information
Safe working load (SWL)............................... 522 kg (1150 lb)
Maximum patient weight................................ 454 kg (1000 lb)
The recommended patient height is between 146 cm (58 in) and 190 cm
(75 in). At the discretion of the care giver, patients taller than 190 cm (75 in) may be
accommodated by extending the bed - refer to bed length adjustment on page 24.
Make sure that the patient’s height does not exceed the in-bed length.
All accessories added to the system reduce the safe working load of the
IUDPHE\WKHVDPHDPRXQW
Figure 3: Recommended Patient Height and Weight
17Citadel Plus Bariatric Care System
INSTALLATION
The following chapter describes how to install the bed.
Weighing System Preparation
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Remove the four transport locking bolts (1) and washers (2); there are two locking bolts
at the head end of the bed and two at the foot end.
Figure 4: Removing the transport bolts
Retain the bolts and washers in case the bed needs to be transported at a later date.
To prevent damage to the weighing mechanism, replace the transport
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QHFHVVDU\ZKHQPRYLQJWKHEHGVKRUWGLVWDQFHV
When replacing the transport locking bolts care must be taken to avoid
WUDSSLQJRUGDPDJLQJDQ\FDEOHV
Power Drive Shipping Pin Removal
'RQRWORZHUSRZHUGULYHZKHHOVZLWKRXWUHPRYLQJVKLSSLQJSLQ
If transporting frame to a new facility, insert shipping pin to lock the
SRZHUGULYHSHGDO
Before attempting to lower power drive wheels, remove the shipping pin (1) and store
(2).
Figure 5: Removing the shipping pin
2
1
2
1
CPR
.
Max522kg
(1150lb)
2
1
18 Citadel Plus Bariatric Care System
Electricity Supply
%HIRUHWKH¿UVWXVHRULIWKHEHGKDVEHHQXQXVHGIRUPRUHWKDQWKUHHPRQWKV
connect the bed to the electricity supply for at least 24 hours to allow the backup
battery to recharge fully; failure to do this may reduce the life of the battery. After
charging, check that the battery is fully serviceable by carrying out a battery test as
shown on page 59.
Connect the mains plug to a suitable outlet. Make sure the plug is easily accessible so
it can be unplugged quickly in an emergency.
When the bed is connected to the electricity supply, the Power On Indicator LED will
light on the Attendant Control Panel (see page 33).
7KHIRRWERDUGLV¿WWHGZLWKDSODVWLFKRRN
When not in use or before moving the bed, clip the hook onto the head board, coil up
the cable and place it over the hook as shown.
Figure 6: Power supply cord and potential equalization terminal
To isolate the bed from the electricity supply, unplug the mains plug from the outlet.
If the power cord or plug is damaged, the complete assembly must be
UHSODFHGE\DXWKRUL]HGVHUYLFHSHUVRQQHO'RQRWUHPRYHWKH¿WWHG
SOXJRUXVHDUHZLUHDEOHSOXJRUDGDSWHU
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'RQRWDOORZWKHSRZHUFRUGWRWUDLORQWKHÀRRUZKHUHLWPD\FDXVHD
WULSKD]DUG
Make sure the power cord does not become entangled with moving
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Unplug the power cord from the electricity supply, and store it, before
PRYLQJWKHEHG
1
2
3
Citadel Plus Bariatric Care System
Potential Equalization Terminal
A potential equalization terminal (Figure 6, item 3) is located at the head end of the
bed.
When other electrical equipment is within reach of the patient or care giver, potential
differences between the equipment can be minimized by connecting together their
potential equalization terminals.
Electrical Connections
The Citadel Plus Bariatric Care System contains the following electrical connections.
)UDPH
• Power Cord
• Nurse Call Connector
• 56&RQQHFWRULIVSHFL¿HG
• Auxiliary Power Outlet
• Skin IQ™Family Power Cable
Power Cord
The power cord is located at the head end of the bed. Make sure power cord is kept
free from all pinch points, moving parts and is not trapped under casters. Improper
KDQGOLQJRISRZHUFRUGFDQFDXVHGDPDJHWRWKHFRUGZKLFKPD\SURGXFHULVNRI¿UH
or electric shock. Pull the power cord out of the mains wall outlet to remove power from
the unit.
1XUVH&DOODQG56&RQQHFWLRQV
1. Connect one end of the nurse call cable to the 37-pin D-type outlet,
located below the head end of the bed on the patient's right hand side.
2. Connect the other end of the nurse call cable to a compatible nurse call
system. The type of connector will vary depending on the nurse call
system.
3. Connect one end of an RS232 cable to the 9-pin D-type outlet, located
below the head end of the bed on the patient's right hand side.
4. Connect the other end of the RS232 cable to a device capable of
receiving data through an RS232 connection.
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WKHFRUUHFWFDEOHV8VHRIWKHZURQJFDEOHVPD\FDXVHPDOIXQFWLRQRI
WKHEHGRUGHYLFHVFRQQHFWHGWRWKHQXUVHFDOORU56FRQQHFWRUV
Citadel Plus Bariatric Care System
Verify correct operation of the nurse call system before placing a
SDWLHQWRQWKHEHG
'RQRWDOORZWKHQXUVHFDOORU56FDEOHVWRWUDLORQWKHÀRRUZKHUH
WKH\PD\FDXVHDWULSKD]DUG8QSOXJERWKFDEOHVEHIRUHPRYLQJWKH
EHG
'RQRWDOORZWKHFDEOHVWRWRXFKWKHEHGIUDPHDVWKLVPD\DIIHFWWKH
DFFXUDF\RIWKHZHLJKLQJV\VWHP
2QO\FRQQHFWGHYLFHVGHVLJQHGWREHXVHGZLWKWKHEHG
Connecting devices not designed to be used with the bed may result
LQGDPDJHWRWKHHTXLSPHQWRUWRWKHEHG
2QO\XVHFDEOHVZLWKDQLQOLQHEUHDNDZD\FRQQHFWRUEHORZ)DLOXUH
to do so could result in damage to the bed or to other hospital
HTXLSPHQW
Figure 7: Example of an in-line breakaway connector
Auxiliary Power Outlet (Optional Feature)
Auxiliary power outlet is provided as a convenience for powering devices intended to
be placed at or near the foot end of the bed.
'RQRWFRQQHFWDQ\FULWLFDORUOLIHVXVWDLQLQJHTXLSPHQWWRDX[LOLDU\
RXWOHW7KHVHGHYLFHVVKRXOGEHFRQQHFWHGWRKRVSLWDORXWOHWV
'HYLFHVFRQQHFWHGWRWKLVRXWOHWVKDOOQRWH[FHHG
• 115 VAC / 15A
• 9$&$
This outlet does not remain powered when the bed is on battery
EDFNXS
Breakaway
connection
Connect to
bed
Connect to
Nurse call system
Table of contents
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