KCI FIRST STEP Plus User manual

KCI-USAInc.
San Antonio, Texas 78265-9508
Call Toll Free 1-800-275-4524
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www.kci1.com
P. O. Box 659508
1-800-275-3417
®
R
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Plus

First Step®Plus™ Operations Manual
®
CAUTION
Federal law restricts this device to sale or rental by or on the
order of a physician.
This First Step®Plus™ Operations Manual is not a guarantee or warranty as to this product. It is intended only as a
service guide. For additional information or for specific questions please contact KCI®Customer Service.
In order for KCI products to perform properly, the following conditions must be met. Failure to comply with these
conditions will void any pertinent warranties.
•All assembly, operation, adjustment, modification, maintenance and/or repair be carried out only by qualified
personnel authorized by KCI.
•The electrical installation of the room must comply with the appropriate electrical wiring standards.
•The product must be used in accordance with this manual, this product’s Maintenance Manual and Quick
Reference Guide, and all applicable labeling.
The only servicing to be carried out by the user is described in the Maintenance Chapter of the First Step®Plus™
Maintenance Manual.
Upon customer request and execution of any required confidentiality agreement, KCI will make available, circuit
wiring diagrams, component parts lists, descriptions, calibration instructions, or other information which assist the
user’s appropriately qualified personnel to repair those parts of the equipment designated by the manufacturer as
repairable.
Rev. B 05/05

First Step®Plus™ Operations Manual
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First Step®Plus™ Operations Manual i Table of Contents
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INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Risks and Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Maximum Patient Weights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Safety Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
PATIENT PLACEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Preparing For Patient Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Patient Transfer To First Step®Plus™ Product. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Non Ambulatory Patient Transfer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Air Pressure Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Completion Of Patient Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
NURSING CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
CPR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transfer To First Step®Plus™Product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transfer From First Step®Plus™ Product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Non-Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Patient Bathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Bedpan Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Bedpan Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Repositioning Patient Using Dri-flo®Underpads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Incontinence / Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Skin Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
General Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
CARE AND CLEANING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Daily Care And Cleaning Of First Step®Plus™ Product While In Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Weekly Care And Cleaning Of First Step®Plus™ Product While In Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
OPERATING INSTRUCTIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Power Up Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Pressure Adjust. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Warmer Adjust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
SPECIFICATIONS* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
QUESTIONS AND INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Rev. B 05/05
TABLE OF CONTENTS

Table of Contents ii First Step®Plus™ Operations Manual
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First Step®Plus™ Operations Manual 1-1 Introduction
1
INTRODUCTION
The First Step®Plus™product is a pressure relieving mattress overlay designed to suspend the patient on a low-
air-loss support surface, providing effective pressure relief and early intervention for patients with skin breakdown.
The mattress overlay is constructed of Gore-Tex®fabric and is divided into three sections: HEAD, BODY and
FEET. The air supply unit consists of a single constant speed blower with a warmer to provide air temperatures
that can be adjusted for patient comfort. Each overlay section can be adjusted to meet individual patient needs.
INDICATIONS
The First Step®Plus™product is indicated for patients who would benefit from a pressure relief surface assisting
in the early intervention of skin breakdown.
CONTRAINDICATIONS
Patient conditions for which the application of pressure relieving therapy on the First Step®Plus™product are
contraindicated include:
•Unstable Spinal Cord Injury.
•Unstable Vertebral Fracture.
•Cervical Traction.
RISKS AND PRECAUTIONS
•Transfer – Precaution should be taken during patient transfer, including the locking of caster brakes and
deflation of overlay surface. Refer to Patient Transfer sections in the Patient Placement and Nursing Care
chapters of this manual.
•Side Rails and Restraints – Use or non-use of restraints, including Side Rails, can be critical to patient safety.
WARNING: Serious injury or death can result from the use (potential entrapment) or non-use (potential
patient falls) of Side Rails or other restraints. See related Safety Tips section.
•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 may be increased.
•Skeletal Traction or Unstable Fracture (if not contraindicated) –With Unstable Fractures or Skeletal
Traction, if not contraindicated, maintain physician-directed angle of articulation, and use care to guard
against risk of patient migration or inadvertent deflation of air surface.
•Oxygen Use – DANGER: Risk of explosion if used in the presence of Flammable Anesthetics. Use of this
product’s Air Supply Unit in an oxygen-enriched environment may produce potential of fire hazard. This
equipment is not suitable for use in the presence of a flammable anaesthetic mixture with air or with oxygen or
nitrous oxide.
CAUTION: Position Air Supply Unit only at foot end of bed when using Oxygen Administering Equipment.
•Electromagnetic Interference – Although this equipment conforms with the intent of the directive 89/336/
EEC in relation to 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 cover. Refer to Qualified Service Personnel.
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Introduction 1-2 First Step®Plus™ Operations Manual
MAXIMUM PATIENT WEIGHTS
•Maximum Patient Weight: 250 lbs. (114 kg.).
SAFETY TIPS
Bed Frame – Always use a standard healthcare bed frame with Side Rails and any other safeguards or protocols
that may be appropriate. Frame and Side Rails must be properly sized to eliminate any gaps that might entrap a
patient’s head or body.
Brakes – Caster brakes should always be locked once the bed is in position. Verify wheels are locked before any
patient transfer to or from the bed.
Bed Height – To minimize the risk of falls or injury the bed should always be in the lowest possible position when
the patient is unattended.
Side Rails/Patient Restraints – Whether and how to use Side Rails 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 in mind. Consider not only the clinical and other needs of the patient but also the risks of death or
serious injury from falling out of bed and from patient entrapment in or around the Side Rails, restraints or other
accessories. For a description of entrapment hazards, refer to FDA Safety Alert dated August 23, 1995, the
JCAHO Sentinel Event Alert #27, dated September 6, 2002, and other information referenced at http://
www.kci1.com/products/FDASafetyAlert. Consult a caregiver and carefully consider the use of bolsters,
positioning aids, floor pads or KCI®Padded Side Rail Accessories, especially 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 how to release the
Side Rails) in case of fire or other emergency. Monitor patients frequently to guard against patient
entrapment.
Skin Care - Monitor skin conditions regularly, especially at bony prominences and areas where moisture or
incontinence may occur or collect, and consider adjunct or alternative therapies for high acuity patients. Early
intervention may be essential to preventing serious skin breakdown.
Fluids – Avoid spilling fluids on Air Supply Unit. If spills do occur clean fluids from bed and Air Supply Unit
wearing rubber gloves to avoid any possibility of shock. Once fluid is removed, check operation of components in
area of spill.
NOTE: Fluids remaining on the controls can cause corrosion, which may cause components to fail or operate
erratically, possibly producing potential hazards to patient and caregivers.
Lock-Outs – The Lock-Out feature on the Air Supply Unit should be used at the caregivers discretion to ensure
against unintentional or unauthorized tampering with unit settings.
Avoid Fire Hazards – To minimize risk of fire, connect the bed’s power cord directly into a wall-mounted outlet.
Do not use extension cords or multiple outlet strips. Review and follow FDA’s Safety Tips for Preventing Hospital
Bed Fires (dated 12/18/03) and other information referenced at http://www.kci1.com/products/FDASafetyAlert.
No Smoking in Bed – Smoking in bed can be dangerous. To avoid the risk of fire, smoking in bed should never
be allowed.
Tobacco Smoke – If routine laundering and cleaning procedures as described in the Preventive Maintenance
section of the Maintenance chapter of the First Step®Select™ Maintenance Manual are not followed, tobacco
smoke build-up may conceivably reduce the amount of air flow through the product. Severe air restrictions
(whatever the source) may cause the Air Supply Unit to overheat and automatically deactivate.
Power Cord – Ensure power cord is kept free from all pinch points and moving parts and is not trapped under
casters. Improper handling of the power cord can cause damage to the cord, which may possibly produce risk of
fire or electrical shock.
General Protocols –Follow all applicable safety rules and institution protocols concerning patient and caregiver
safety.
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First Step®Plus™ Operations Manual 2-1 Patient Placement
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2
PATIENT PLACEMENT
It is recommended that all sections of this manual be reviewed prior to product use. Carefully read the
Contraindications, Risks and Precautions and Safety Tips Sections in the Introduction chapter of this manual
prior to performing patient placement on the First Step®Plus™ product.
PREPARING FOR PATIENT PLACEMENT
1. Level bed and lock caster wheel brakes and caster wheel steering.
NOTE: Always use a standard hospital bed frame and any other safeguards that may be appropriate. Side
Rails should be locked in their full upright position whenever a patient is left unattended.
2. Install Overlay:
•Place tote bag at foot of mattress.
•Open tote bag and remove overlay, Air Hoses, Air Supply Unit, Sheets etc.
•Place overlay on mattress with hose connections and tote bag at foot of mattress with elastic harness on
underside of overlay.
•Slide elastic harness over each end of mattress.
•Tuck tote bag under foot end of mattress.
•Wrap elastic halter straps (located at each end of overlay) under and around end of bed mattress.
3. Install First Step®Plus™ GORE-TEX®Cover Sheet:
•Draw sides of sheet down each side of bed and tuck under mattress.
•Secure sheet around hose connections using individual hook and loop strips located on Cover Sheet.
4. Install Air Supply Unit:
•Swing out adjustable hanging arms located on each side of Air Supply Unit.
•Pull down Tilt Display Bracket located on lower backside of Air Supply Unit.
•Hang Air Supply Unit on footboard of bed.
NOTE: Verify air intake located on the back face of the Air Supply Unit is not blocked by a blanket or
other obstructions. The Air Supply Unit has a thermal cutoff that will, after a period of time,
automatically deactivate unit if the air intake is blocked.
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First Step®Plus™ Operations Manual 2-2 Patient Placement
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5. Attach hoses to Air Supply Unit:
•Locate Hose Set Coupler that holds three hose ends together.
•Turn hose set coupler such that hoses are stacked vertically and the blue
HEAD hose is on top.
• Insert top tab of coupler into horizontal slot on the right side of the air
supply unit. Pivot coupler downward, placing hose ends over air outlets
until bottom of coupler clicks into locked position.
NOTE: Ensure hose set is not twisted.
6. Attach hoses to Air Cushion.
•Match color-coded hose ends to their respective patches on air cushions.
•Attach hoses snugly by slightly turning while pushing hose end onto overlay hose connectors.
7. Plug Air Supply Unit into a 115 VAC wall outlet.
NOTE: Be sure power to this outlet is not controlled by a wall switch.
8. Activate Air Supply Unit by depressing green Power Switch.
9. Adjust Head, Body and Foot airflow control knobs, located on front of air supply unit to a low setting.
10. Transfer patient as described below:
PATIENT TRANSFER TO FIRST STEP®PLUS™ PRODUCT
Ambulatory Patient Transfer
1. Adjust height of both surfaces to comfortable levels for patient ingress and egress.
2. Lower Side Rails (when applicable).
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Assist patient in ambulatory transfer, following all applicable safety rules and institution protocols.
5. Center patient side-to-side on surface. Patients sacrum should be centered head-foot on seat section
cushion.
6. Raise and lock Side Rails on both sides of bed. If decision has been made to use Side Rails (Refer to Risks
and Precautions and Safety Tips section in the Introduction chapter of this manual).
7. Adjust air flow control knobs to the proper inflation for individual patient. See Air Pressure Adjustment section
below.
8. Check for good placement, slide hand flat between bottom of underlying surface and patients buttocks. There
should be 1" to 1 1/2" between patient and underlying surface.
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First Step®Plus™ Operations Manual 2-3 Patient Placement
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9. With air pressures set, verify patient comfort.
10. Lower bed height to lowest level.
11. Activate warmer and adjust temperature, if desired.
Non Ambulatory Patient Transfer
1. Press green Power Button on Air Supply Unit to activate blower.
2. Adjust air flow control knobs to fully inflate each individual cushion. See Air Pressure Adjustment section
below.
3. Adjust height of bed to same level as surface from which patient is being transferred.
4. Lock caster wheel brakes and caster wheel steering on both surfaces.
5. Lower Side Rails (when applicable).
6. Transfer patient following all applicable safety rules and institution protocols.
7. Center patient side-to-side on First Step®Plus™ surface. Patients sacrum should be centered head-foot on
seat section cushion.
8. Adjust air flow control knobs to the proper inflation for individual patient. See Air Pressure Adjustment section
below.
9. Raise and lock Side Rails on both sides of bed. If decision has been made to use Side Rails (Refer to Risks
and Precautions and Safety Tips section in the Introduction chapter of this manual).
10. With air pressures set, verify patient comfort.
11. Lower bed height to lowest level.
12. Activate warmer and adjust temperature, if desired.
AIR PRESSURE ADJUSTMENT
1. Adjust air flow to each section; HEAD, BODY and FEET; by turning air flow
control knobs for each corresponding section. The knobs are labeled and
color coded.
NOTE: The air supply unit has a thermal cutoff that will automatically
deactivate the unit after a period of time if the air intake is blocked or if
the unit is operated with all three airflow control knobs in the OFF
position. If a temporary discontinuance of airflow is desired, the green
power button should be used.
NOTE: Large adjustments in air pressure to one section of the mattress
overlay may prompt re-adjust to another section of the overlay.
Head
(Blue)
Body
(Green)
Feet
(Red)
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First Step®Plus™ Operations Manual 2-4 Patient Placement
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2. To assist in patient comfort, allow a ‘‘cradling’’ effect or slight depression in
the overlay where the patient lies.
3. A positive check for good placement is to slide your hand flat between First
Step®Plus™ and bed mattress, under the patient’s buttocks. There should be
a space of 1" to 1 1/2" (2 1/2 to 4 cm) of inflated overlay between patient and
bed mattress.
4. If head of bed is to be elevated, it may be necessary to increase air flow to
the BODY section to ensure proper support for that section.
COMPLETION OF PATIENT PLACEMENT
1. Adjust head of bed for patient comfort.
2. With air pressures set, verify patient comfort.
3. Lower bed height to lowest level.
4. Activate Warmer and adjust temperature, if desired.
5. Verify caster wheel brakes and caster wheel steering is locked.
6. Assess entrapment and fall hazards and carefully consider the use of bolsters, positioning aids, low beds,
floor pads or padded side rail accessories when appropriate, especially with confused, restless or agitated
patients.(Refer to Risks and Precautions and Safety Tips section of the Introduction chapter of this
manual).
NOTE: It is advised that capable patients are instructed on how to release Side Rails and exit bed in the event
of an emergency.
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First Step®Plus™ Operations Manual 3-1 Nursing Care
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3
NURSING CARE
Before beginning nursing care on First Step®Plus™ product, it is recommended that all sections of this manual be
reviewed prior to product use. Carefully read the Contraindications, Risks and Precautions and Safety Tips
sections in the Introduction chapter of this manual prior to performing nursing care for a patient on the First Step®
Plus™ product.
CPR
In The Event CPR Procedures Are Required:
1. Lift up on Quick Release lever.
2. Swing Hoses away from Air Supply Unit.
3. Bring bed to a level position. Lower Side Rails.
4. Place back board under patient.
5. Begin CPR. Patient’s body weight and the CPR process will deflate mattress
overlay.
6. After CPR is performed and patient is clinically stable:
•Return Side Rails, restraints and other accessories (if used, refer to Safety Tips) to their original position.
PATIENT TRANSFER TO FIRST STEP®PLUS™ PRODUCT
Refer to Patient Placement chapter of this manual if patient is being transferred to First Step®Plus™ product for
the first time.
PATIENT TRANSFER FROM FIRST STEP®PLUS™ PRODUCT
Ambulatory Patient Transfer
1. Press green Power Button to turn Off Air Supply Unit. Surface will begin to deflate.
2. Adjust height of bed to same level as surface to which patient is being transferred.
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Lower Side Rails.
5. Transfer patient following all applicable safety rules and institution protocols.
Non-Ambulatory Patient Transfer
1. Adjust all three air flow control knobs to increase pressure in cushions to create a firm surface for patient
transfer.
2. Adjust height of bed to same level as surface to which patient is being transferred.
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
Quick Release Lever
R
TM
R
TM
1
2
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First Step®Plus™ Operations Manual 3-2 Nursing Care
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4. Lower Side Rails.
5. Transfer patient following all applicable safety rules and institution protocols.
PATIENT TRANSPORT
1. Press green Power Button to turn Off Air Supply Unit. Mattress overlay will begin to deflate.
2. Unplug Power Cord from wall outlet.
3. Unlock caster wheel brakes and caster wheel steering.
4. Transport patient following all applicable safety rules and institution protocols.
5. Plug Power Cord into an 115 VAC 15 Amp grounded wall outlet when destination is reached.
NOTE: Verify that power to this outlet Is Not controlled by a wall switch.
6. Press green Power Button to turn On Air Supply Unit. Adjust surface pressures for patient comfort.
PATIENT BATHING
1. When Side Rails are available, raise Side Rails on side of bed opposite caregiver to help reduce the risk of
patient fall during bathing.
2. Adjust bed height and level bed to facilitate bathing.
3. Set air pressures in mattress overlay to maximum by turning all three air flow control knobs to a high setting to
provide a firm surface for patient bathing.
4. Lower Side Rail on caregivers side.
CAUTION
To reduce risk of patient falls during bathing, caregiver must
never leave patient unattended or turn away during bathing.
5. Gently log roll patient toward opposite Side Rail.
6. Bathe and rinse patient’s exposed side and posterior.
NOTE: Avoid spilling fluids on any part of the Air Supply Unit. Fluids remaining on controls can cause
corrosion, which may cause the components to fail. Component failures may cause the Air Supply Unit
to operate erratically possibly producing a potential hazard to patient or staff.
7. Wipe Cover Sheet while bathing patient. The Cover Sheet will dry quickly from airflow through fabric.
NOTE: Replace and launder extensively soiled Cover Sheet and Cushions.
8. Return patient to supine position in center of surface.
9. Raise and lock Side Rail. If decision has been made to use Side Rails (Refer to Risks and Precautions and
Safety Tips section in the Introduction chapter of this manual).
10. Repeat Steps 4 through 9 for other side of patient.
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First Step®Plus™ Operations Manual 3-3 Nursing Care
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11. Adjust all three air flow control knobs to return surface to previous air pressure settings.
12. Adjust head and foot of bed for patient comfort.
13. Adjust Warmer and bed height as required.
BEDPAN PLACEMENT
1. Adjust bed height and level bed to facilitate bedpan placement.
2. Reduce pressure in center cushion.
3. Lower Side Rail on caregiver’s side of bed.
4. When Side Rails are available, raise Side Rail on side of bed opposite caregiver to help reduce the risk of
patient fall during bedpan placement.
5. Gently log roll patient toward opposite side of bed.
6. Position bedpan underneath patient by pushing bedpan down into surface.
7. Gently roll patient onto bedpan, keeping one hand on bedpan until patient is in position.
8. Raise and lock Side Rails. If decision has been made to use Side Rails (Refer to Risks and Precautions and
Safety Tips section in the Introduction chapter of this manual).
9. Adjust head of bed for patient comfort and return bed and accessories to original configuration.
BEDPAN REMOVAL
1. Lower head of bed to a level position.
2. Lower Side Rail on caregivers side.
3. Grasp bedpan firmly with one hand, using other hand gently roll patient toward opposite side of bed.
4. Remove bedpan by pushing bedpan down into surface and slide away from patient.
5. Cleanse and dry patient’s skin.
6. Return patient to proper placement on mattress.
7. Raise and lock Side Rail. If decision has been made to use Side Rails (Refer to Risks and Precautions and
Safety Tips section in the Introduction chapter of this manual).
8. Return pressure in center cushion to previous setting.
9. Adjust head of bed for patient comfort and return bed and accessories to original configuration.
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First Step®Plus™ Operations Manual 3-4 Nursing Care
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REPOSITIONING PATIENT USING DRI-FLO®UNDERPADS
1. Adjust bed to lowest height position.
2. Adjust all three air flow control knobs to increase pressure in cushions to create a firm surface for patient
repositioning.
3. When Side Rails are available, lower Side Rail on caregivers side.
4. Position a person on each side of patient (at least two people will be needed). Roll edges of Dri-Flo®on each
side of patient to provide a firm grip.
5. Use Dri-Flo®pad to lift and reposition patient.
6. Raise and lock Side Rail. If decision has been made to use Side Rails (Refer to Risks and Precautions and
Safety Tips section in the Introduction chapter of this manual).
7. Adjust all three air flow control knobs to return surfaces to previous air pressure settings.
8. Adjust head of bed for patient comfort and return bed and accessories to original configuration.
INCONTINENCE / DRAINAGE
1. First Step®Plus™ Gore-Tex®cover sheet should be placed over mattress overlay.
2. Dri-Flo® breathable underpads are recommended for incontinent patients.
NOTE: Do not use plastic-backed underpads. Plastic will block moisture vapor transmission and air flow from
mattress overlay. Dri-Flo®breathable underpads are absorbent and do not block air flow.
3. Watch for incontinence or drainage and provide meticulous skin care following each episode.
SKIN CARE
1. Remove excess moisture and keep patient's skin clean and dry.
2. Maintain proper air pressures in accordance with the Air Pressure Adjustment section of the Patient
Placement chapter of this manual.
3. Monitor patient's skin condition regularly, especially at bony prominences and in areas where incontinence
and drainage occur and collect.
4. Consider adjunct or alternative therapies for high acuity patients.
GENERAL OPERATION
Avoid contact of sharp instruments with the First Step®Plus™.
Punctures, cuts and tears may prevent proper inflation and air pressure operation.
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First Step®Plus™ Operations Manual 4-1 Care and Cleaning
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4
CARE AND CLEANING
The following are the KCI recommended daily and weekly cleaning and infection control procedures for the First
Step®Plus™Therapeutic Mattress Support System while it is in use. If this product is to be purchased, or utilized
for long term rentals, it is recommended that KCI be contacted for recommended Infection Control Procedures to
be utilized by the facility.
It is recommended that all chapters of this manual be reviewed prior to product use. Carefully read the
Contraindications, Risks and Precautions and Safety Tips section in the Introduction chapter of this manual
prior to performing care and cleaning procedures on the First Step®Plus™Therapeutic Mattress Support System.
Follow all regulations outlined in OSHA Occupational Exposure to Bloodborne Pathogens 29 CFR 1910.1030
regarding Infection Control Procedures to be used when cleaning First Step®Plus™.
DAILY CARE AND CLEANING OF FIRST STEP®PLUS™ PRODUCT
WHILE IN USE
NOTE: The patient need not be removed from First Step®Plus™product when performing daily cleaning
procedures. The patient may be bathed as patient support surface is being cleaned.
1. If Side Rails are used (refer to Risks and Precautions and Safety Tips in the Introduction Chapter of this
manual). Verify Side Rails on both sides of bed are up and locked.
2. Inflate surface fully by adjusting all three air flow control knobs to their highest setting.
3. If Side Rails are used, lower Side Rail only on Caregiver's side of bed.
4. Log roll patient to opposite side of surface.
5. Clean patient as required.
NOTE: Avoid spilling fluids on any part of the air supply unit. Fluids remaining on the electronic controls can
cause corrosion which may cause the electronic components to fail. Component failures may cause
the air supply unit to operate erratically possibly producing a potential hazard to patient or staff.
6. Wipe Cover Sheet as required with soap and water or approved hospital germicide.
7. Move cover sheet for access and wipe soiled mattress overlay as required. Replace and launder extensively
soiled cover sheet or mattress overlay.
8. Dry surface and cover sheet with towel. Remaining moisture will evaporate rapidly with air flow.
9. Move cover sheet back into position.
10. Move patient to clean, dry side of surface and repeat Steps 4 through 11 on the opposite side.
11. Return patient to center of surface.
12. Return surface to previous air pressure settings.
WEEKLY CARE AND CLEANING OF FIRST STEP®PLUS™
PRODUCT WHILE IN USE
In addition to the daily care and cleaning described above, the First Step®Plus™cover sheet should be replaced
weekly or more often as needed. Excessively soiled mattress overlays and cover sheets should be replaced and
laundered as described in the Infection Control section of the Preparation for Use chapter of the First Step®
Plus™Maintenance Manual.
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First Step®Plus™ Operations Manual 4-2 Care and Cleaning
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First Step®Plus™ Operations Manual 5-1 Operating Instructions
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5
OPERATING INSTRUCTIONS
Review Safety Tips section in the Introduction Chapter and Preparing for Patient Placement section in the
Patient Placement Chapter of this manual before beginning operation of the First Step®Plus™ Mattress Overlay.
POWER UP PROCEDURE
1. Plug Air Supply Unit into a 115 VAC wall outlet.
NOTE: Be sure power to this outlet IS NOT controlled by a wall switch.
2. Press green Power Button to activate Air Supply Unit.
NOTE: Motor will "ramp-up", setting pressures during first 25 seconds of
operation. After ramping up and setting pressures, unit will be
noticeably quieter.
PRESSURE ADJUST
1. Adjust air flow to each surface: Head, Body and Feet, by turning the
respective control knob. The knobs are labeled and color coded.
2. Adjust each surface control knob until optimum pressures and patient
comfort has been obtained.
3. Adjust air flow so patient is "cradled" in a slight depression.
NOTE: The Air Supply Unit has a thermal cutoff that will automatically
deactivated the unit after a period of time if the air intake is blocked
or if the unit is operated with all 3 airflow control knobs in the OFF
position.
4. If temporary discontinuance of airflow is desired, the green Power Button
should be used.
WARMER ADJUST
1. Patient warming is controlled by the warmer control knob located on the top
of the Air Supply Unit.
2. Turn warmer control knob clockwise to increase warmer setting.
NOTE: Do not us warmer with all three air flow control knobs in the off
position.
3. If warmer is used, speed patient warming by temporarily increasing air flow
to the Feet section.
Power Switch
TM
R
Head
(Blue)
Body
(Green)
Feet
(Red)
Rev. B 05/05

First Step®Plus™ Operations Manual 5-2 Operating Instructions
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