laerdal VitalSim Manual

VitalSim
Directions for Use
Instrucciones de uso
Mode d'emploi
Istruzioni per l’uso
www.laerdal.com
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Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Important Information . . . . . . . . . . . . . . . . . . . . . . . . . 4
Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Programming ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Sounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Blood Pressure and Pulse . . . . . . . . . . . . . . . . . . . . . . 13
Breathing Rate
- Breathing/ Airway Control (ALS Simulator) . . . . . . 14
Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Scenario . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Set up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
PC Software Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
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Introduction and Intended Use
VitalSim is designed to be used for realistic medical
training within emergency care and nursing. It can be
used with different types of manikins to simulate vital
signs such as breathing, pulse, blood pressure, ECG,
heart, lung and bowelsounds.Vocal (spoken sounds)
are also generated.
TheVitalSim base unit performs all simulations and
connects to the manikin.The base unit can be battery
operated, allowing simulations to be performed any-
where.The operator controls the simulations with a
user-friendly remote control, communicating with the
base unit through radio frequency (RF) communication.
RF communication allows the operator to move freely
around the scene up to a distance of 10 meters (30 ft.)
from the base unit.
Included in the system is a PC-based Scenario Builder
program, allowing the user to preprogram scenarios.
These custom built scenarios may then be downloaded
and run byVitalSim. Scenarios can control all output
parameters of the VitalSim and make parameters
change based on certain events. The VitalSim will also
generate logs that can be uploaded to a PC for review
and printing.
Important Information
This device complies with Part 15 of the FCC Rules.
Operation is subject to the following two conditions:
(1) this device may not cause harmful interference, and
(2) this device must accept any interference received,
including interference that may cause undesired op-
eration.
NOTE:This equipment has been tested and found to
comply with the limits for a Class B digital device,
pursuant to Part 15 of the FCC Rules.These limits are
designed to provide reasonable protection against
harmful interference in a residential installation.This
equipment generates, uses and can radiate radio frequ-
ency energy and, if not installed and used in accordance
with the instructions, may cause harmful interference to
radio communications. However, there is no guarantee
that interference will not occur in a particular in-
stallation. If this equipment does cause harmful interfer-
ence to radio or television reception, which can be de-
termined by turning the equipment off and on, the user
is encouraged to try to correct the interference by one
or more of the following measures:
- Reorient or relocate the receiving antenna.
- Consult the dealer or an experienced radio/TV
technician for help.
- Increase the separation between the equipment
and receiver.
- Connect the equipment into an outlet on
a circuit different from that to which the receiver
is connected.
- Consult the dealer or an experienced
radio/TV technician for help.
Caution: Changes or modifications not expressly approved
by Laerdal could void the user's authority to operate this
equipment.
Hereby, Laerdal Medical declares that when
carrying the CE-mark, the VitalSim product
is in compliance with the essential
requirements and other relevant provisions
of Directive 1999/5/EC.
MegaCode Kelly MegaCode Kid
Nursing Anne
Nursing Baby
Nursing Kid
VitalSimTaskTrainers
Nursing Kelly
ALS Simulator
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VitalSim package contents:
- Carry case
- Base unit including battery case and batteries
(6 C-cell)
- Remote control including batteries (4 AA-cell)
- Remote control to base unit connection cable
- USB cable for connection to PC
- DC power supply
- Direction for Use
- Operating software on CD-ROM
Use with Laerdal Manikins
VitalSim is designed to work with a variety of manikins
manufactured by Laerdal.VitalSim will automatically
detect which type of manikin is connected (adult male
simulator, adult male, adult female, child or infant) and
adjust physiological and menu functions accordingly.
Refer to the specifications chapter for details on the
different manikin parameters. Manikin selection may be
manually overridden from the Setup Menu.
NOTE: The ALS Simulator requires VitalSim Software
version 3.0 or higher.
Features
ECG, Defibrillation and Pacing
- Extensive ECG library
- External defibrillation (10-360 J)
- Automatic rhythm change after defibrillation
- Responds to external pacing with settable pacing
threshold 20 – 200 mA
Heart, Lung, Bowel and Spoken Sounds
- Extensive sounds libraries
- Volume of each sound can be adjusted individually
- Heart sounds synchronized with ECG
- Lung sounds synchronized with adjustable breathing
rate, 0 – 60 BPM
- Individual lung or bilateral sound selection
- Normal and abnormal bowel sounds
- Fetal heart sounds for female manikins
- Synthesised vocal sounds such asVomit, Cry, Moan
- Voice input via microphone
Airway Control (ALS Simulator)
- Spontaneous respirations
- Breathing rate
- Left, right or both lung blockage
Blood Pressure
- Auscultated and palpated blood pressure simulation
- Korotkoff sounds synchronized with ECG
- Systolic and diastolic pressure individually settable
in steps of 2 mmHg up to 300 mmHg
- Auscultatory gap, on or off
- Blood pressure can be palpated at radial pulse
Pulses
- Brachial, radial, and carotid pulses
- Pulses synchronized with ECG
- Pulse strength settable to weak, normal or strong
- Pulse strengths dependent on blood pressure
Scenario Function
- Pre-programmed scenarios eases operation
and simulations
- PC Scenario builder program
- Up to 10 scenarios can be stored in base unit
Logging
- Save logs for after action review.
- User definable events
- Log(s) can be retrieved by a PC through
the USB connection
- Up to 25 logs can be stored in base unit
RF Communication
Communication between the remote control and base
unit is based on low power radio frequency communi-
cation.The equipment meets the standards and
requirements of FCC and EC. If VitalSim is used in
an environment where RF communication is not
desirable, or where interference from other sources
makesVitalSim inoperable, it is recommended to use
cable connection between the remote control and
the base unit. Using the direct cable connection
disables the RF circuits in both units.
The cable is included in theVitalSim package.
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Overview
A. On/Off button and Indicator.
Press once to turn the unit on.
Press again to turn the unit off.
The indicator is steady green if the base unit has contact
with the remote control. If there is no contact with the remote
control the indicator will be blinking green.
If battery needs to be replaced, the indicator will blink,
alternating between green and orange.
B DC power supply input: Used for stationary training and to limit
battery consumption.
C Manikin Connector: Connects the base unit to the manikin.
D Microphone input: External microphone attachment.
Wireless microphone is sold separately.
E USB port: For connection to PC. Used for transfer
of scenarios and logs.
F Remote connector: Used for direct connection
with the remote control. RF communication is disabled
when the units are connected via cable.
G Blood Pressure connector: Connects the tube from
the blood pressure cuff.
H Battery: Holds 6 replaceable C-cell batteries.
I LCD display: Displays status and operation information.
J Quick execution buttons: Function keys.The function of each
button is labelled on the display above the button.
K Navigation keys: Use keys to navigate and select functions
on the display.
L OK / Select key: Use this key to activate selected functions.
M Cancel / Back key: Go back from sub menus without any changes.
N Numerical keys: Use these keys to enter numerical data
or to select numbered parameters.
Can also be used as alphanumerical keys to enter file-
and event-names
O Menu/Setup: Enter Setup Menu.
P Scenario: Use this button to start a scenario.
Q Shift key
R On/Off key: Press once to turn the unit on.
Press again to turn the unit off.
Q
P
O
J
K
L
M
N
R
I
H
G
B
C
DEF
A
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Start
Once your manikin has been connected to theVitalSim,
turn the base unit and remote control on.
TheVitalSim will automatically detect the connected
manikin and set the initial parameters accordingly.
Main Display
The main display screen shows the current status, and allows
for modifying some parameters directly using the quick
execution buttons.
The main display is divided into five functional areas and a quick
execution area.
1. The upper area is the Logging and Scenario status area.
The log status and clock are presented here together with
the remote control battery status and a radio reception
indicator.
2. The ECG section is indicating Running Rhythm on the first
line,Waiting Rhythm on the second line.
”Defib. Enabled” allows change to Waiting Rhythm
when a defibrillatory shock is given.
Pacing capture can be enabled / disabled and if enabled
the threshold for capture can be set.
3. The sounds section controls the selected Lung, Heart,
Bowel and Vocal (spoken) sounds.
Volume for each sound can be controlled individually.
4. The Blood Pressure (BP) section shows the set BP,
Pulse Strength and the Korotkoff sound volume.
5. The Breathing rate section shows the set breathing rate.
The Airway section shows the set breathing rate, airway
blockage (ALS Simulator only) and chest rise/fall
(ALS Simulator only).
At the bottom of the display are the quick execution button
menus.The functions of the buttons will change with the
selected function area.
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4
2 3
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Operation
Using left / right navigation buttons, tab over to the desired
functional area of the display. Once the desired area is high-
lighted, use the up / down navigation buttons to scroll through
to the desired selection.
When the desired functional area is highlighted, press OK to
edit the settings. (For example, to set the rhythm, highlight the
ECG functional area and push the OK button.)
When the selection is complete, press OK to implement
the new selection and return to the main display.
To cancel the selection, press C and return to the main
display with the previous setting unchanged.
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Programming ECG
Set Running Rhythm
On the main display, using the left / right navigation buttons, hig-
hlight the ECG functional area and press OK to edit
the functions.
Note: Some functions may be changed directly from the main
display using the quick execution buttons.
•HR+ and HR– Changes the heart rate up and down.
•Extrasyst. generates an extrasystole of the selected kind
(on Sinus rhythms only), immediately after the button
is pushed. If no extrasystole is selected, a Unifocal PVC will
be generated.
Selecting Rhythm
Using the navigation buttons, highlight the desired rhythm
and press OK.
Rate and QRS type can be modified using
the quick execution buttons,
OR
By highlighting the QRS or Rate area using the left / right
navigation buttons and then use the numeric pad or up/
down buttons.
QRS types can be set to A through G:
Available rates are dependent on the selected rhythm.
Setting PEA sets the BP to 0.
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Set Waiting Rhythm
From the main display use the left / right navigation buttons to
highlight the ECG functional area. Scroll down to Waiting rhyt-
hm. Press OK to edit the selection.
Select a Waiting rhythm in the same way
as the Running rhythm.
When a Waiting rhythm is selected, two additional quick
execution buttons appear in the quick execution area:
• Activate Activates the Waiting rhythm, substituting
the Running with the Waiting.
• Parox. Activates the Waiting rhythm, and exchanges
the Waiting and Running rhythm.
Set Defibrillation Enabled / Disabled
When Defib. Enabled is selected the Waiting rhythm will
be automatically activated and replace the Running rhythm
when a shock is delivered to the manikin.
Enable /Disable is selected by toggling OK or
the quick execution button labeled Disable / Enable
Pacing Threshold
If pacing is enabled pacing pulses on the manikin with a current
higher or equal to the set threshold will activate heartbeats.
Pacing threshold can be adjusted directly from the main display
using the Thres. +/- quick execution buttons when the Pacing
field is selected.
Press OK to set the pacing threshold in a sub menu.
Threshold can be adjusted using the up/ down navigation
buttons, the Thres.+/- keys (steps of 10) or entered directly
using the numeric buttons.
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Sounds
On the main display, using the left / right navigation buttons hig-
hlight the sounds functional area.
The sound volume for the selected highlighted sound can
be set directly from the main display using the -and +quick
execution buttons.
The selectedVocal sound can be activated using the quick
execution button.(When ”Cough” is the selected vocal sound,
the button will be labeled Cough.)
The Recall quick execution button reactivates the previously
selected sound for the highlighted sound type.
Set Lung Sounds
Normally Right and Left lung sounds are highlighted together
indicating that the sound for the right and left lung is set the
same (bilateral).
To set Right and Left sounds individually, press the Set Unilat.
quick execution button.
When the sounds are later reset to bilateral, the sound in
the right lung will be used for both lungs.
To alter a lung sound, highlight the sound and press OK.
This will activate the sound selection sub-menu.
The sounds can be selected using the up / down navigation
buttons or using the numeric buttons.
The arrow on the bottom right of the selection field indicates
that there are more selections than presented on the screen.
Volumes can be adjusted using the +/ -quick execution
buttons, or by highlighting the volume field and then use the
up / down navigation buttons or the numeric buttons.
Set LL and Set RL quick execution buttons are alternative ways
to select individual (unilateral) lung sounds.
Press OK to implement the new selection and return
to the main screen.
Press Cto return without any changes.
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Set Heart Sounds
Heart sounds are set in the same manner as Lung sounds.
On the main display, using the left / right navigation buttons hig-
hlight the sounds functional area. Scroll down to the Heart
sound.
Use the +/ -quick execution buttons to alter volume directly,
or Recall to recall the previously selected Heart sound.
Press OK to get to the Heart sounds selection menu.
Set Bowel Sounds
Bowel sounds are set in the same manner as Lung and Heart
sounds.
On the main display, using the left / right navigation buttons hig-
hlight the sounds functional area. Scroll down to the Bowel
sound.
Use the +/ -quick execution buttons to alter volume directly,
or Recall to recall the previously selected Bowel sound.
Press OK to get to the Bowel sounds selection menu.
Set Vocal Sounds
On the main display, using the left / right navigation keys high-
light the Sounds functional area.
Notice that whenever the Sounds area is selected, the selected
Vocal sound can be activated using the quick execution button.
Most sounds are activated once.The continuous sounds are
toggled on / off.
To alter theVocal sound, scroll down and highlight Vocal.
Note that whenVocal is selected, the three last used sounds
are available as quick execution buttons.
Use the quick execution buttons to activate a new sound
directly or press OK to get to theVocal sounds selection menu.
Some vocal sounds are continuous.A continuous sound will be
repeated until the sound is selected again or another sound is
activated.
Use the +/ -keys to alter volume directly.
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Using the BP+/- buttons
When both systolic and diastolic are
highlighted, both pressures will change
and maintain the difference.
When systolic is highlighted, only systolic
will change, but diastolic will be kept at
least 10 mmHg below systolic.
When diastolic is highlighted, only diastolic
will change, but systolic will be kept at
least 10 mmHg above diastolic.
Set BP menu:
Use left / right navigation buttons to select function.
Systolic and Diastolic BP can be adjusted using the up / down
buttons, the BP +/- quick execution buttons or entered directly
by using the numeric buttons.
If the running rhythm isVF or Asystole, BP cannot be set.
Volume can be adjusted using the +/ -or the up / down
buttons or directly through the numeric buttons.
Auscultatory Gap (Korotkoff sound disappears in part
of Phase II) can be toggled on / off using the up / down
buttons.
Pulse strength can be adjusted using the up / down buttons.
Blood Pressure and Pulse
The set blood pressure (BP) affects the pulse strength as described in the specifications chapter.
The Normal pulse can be adjusted to three levels,Weak, Normal or Strong. If the pulse is set to be normally
weak, a weak pulse because of low BP will be almost impossible to detect.
If the Running rhythm is a rhythm with no BP, i.e.VF or Asytole, BP will automatically be set to 0/0.
The BP is not automatically set back to normal if a perfusing rhythm is chosen.
Set Blood Pressure
On the main display, using the left / right navigation buttons highlight the Blood Pressure functional area.
Press OK to activate the BP menu or adjuste BP directly using the BP +/- quick execution buttons
The up / down navigation buttons are used to change selection.
Set PEA quick execution button will set BP to 0/0. Reset PEA will set the BP back to what it was
before Set PEA was selected.
Use the +/ -quick execution buttons to alter volume of Korotkoff sounds directly.
Pulse strength is indicated as P:N (Normal), P:W (Weak) or P:S (Strong)
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Breathing Rate/Airway Control (ALS Simulator)
Breathing rate is automatically set to 0 if BP is 0.The breathing rate
is not automatically set back to normal if a BP is set.
Breathing rate can be adjusted between 0 and 60 breaths
per minute.
Set Breathing Rate
On the main display, using the left / right navigation buttons, high-
light the Breathing rate functional area.
Press OK to activate the Breathing rate menu or adjust BR
directly using the BR + / - quick execution buttons.
Set Apnea will set breathing rate to 0. Reset Apnea will
restore the previously set breathing rate.
When Breathing rate is 0, the quick execution button
1 Breath becomes available.This function will activate one
breath cycle, allowing for generating breath sounds on
the manikin in synchronism with forced ventilations.
Breathing rate can be adjusted using the up / down navigation
buttons, the BR + / - quick execution buttons (steps of 5)
or entered directly using the numeric buttons.
Chest rise and fall (ALS Simulator only)
Chest rise is default off. However the lungs sounds and breathing
rate will default to normal when the unit is turned on.
To set the chest rise
- On the main display, highlight the Airway functional area.
- Press OK to activate the Airway menu or turn the chest rise
on or off using the quick execution buttons.
- "Set apnea" will set breathing rate to 0 and allow no chest
rise.
- When breathing rate is 0 there will be no chest rise.
- To control the rate of chest rise set the breathing rate by
using the up/down navigation buttons, the BR +/- quick
execution buttons (steps of 5) or by entering the rate
directly using the numeric buttons.
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Log
The top section of the main functional area controls log and
scenario.
TheVitalSim automatically generates a log of events from the
moment the unit is turned on. Elapsed time and name for the
current log is displayed in the upper left corner of the display.
Unless saved, the log will be erased when the base unit is
turned off. The Log / Scenario section have controls for Pause
and Resume, Restart and Save logs. In addition it is possible to
log manual events from the remote control.
Saved logs can be retrieved later using theVitalSim PC utility
program. Logs can be transferred to the PC for permanent
storage, additional comments and printing.
Log Controls
On the main display; using the left / right navigation buttons hig-
hlight the Log functional area.
Press OK to activate the Log Control menu or select functions
directly from quick execution buttons.
Pause: Stops the clock. Any events or changes in settings
will not be logged. Resume logging and clock.
Restart: Restart the log. Erase current log.
Save Log. Saves the current log. Log is given a default name by
VitalSim, Logxx, where xx is a sequential number.This name can
be modified, using the backspace quick execution
button and the alphanumeric buttons.
Up to 25 logs can be saved. Logs are erased when
transferred to a PC, or they can be erased using
the Clear All Logs function.
Set lung blockage
- On the main display highlight the airway functional area
and then the desired function.
- Press OK to activate the Airway menu or select the desired
airway open, left/right or both lungs blocked using the quick
execution buttons.
- When both lungs are blocked the breathing rate will set to 0.
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Log Events
The Event function allows for entering an event into the log.
The events are chosen from a list of up to 14 that are stored
in the remote control.
To log an event, select the event using the navigation buttons,
and press OK.
The first seven events are preprogrammed. They can be
deleted using the Delete quick execution button and then
be reprogrammed by the user.
The Default quick execution button restores the factory
setting of preprogrammed events.
The last seven events are left open (“---“) for the user
to program.
To program an empty event, highlight the event and press the
Add quick execution button.
Enter the event name using the alphanumeric buttons and the
backspace quick execution button. The shift key is
functional for upper or lower case characters. Up to 13
characters can be used for the event name.
Scenario
TheVitalSim can run preprogrammed scenarios, generated
on a PC-based scenario builder program.These scenarios can
be transferred to the base unit using theVitalSim PC utility
program.
Execution of a scenario is started using the Scen button
on the remote control.
Logs and scenarios are synchronized in the following manner:
•A new log is started when a scenario is started.
•Pause and Resume affects both scenario and log.
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To start a scenario, press the Scen button.
Note: It usually takes a little time to transfer all of the scenario
information to the remote control.
Select the desired scenario and press OK.
The scenario will start with the clock set to 0 and a new log
will begin.The current log will be erased, unless it is saved
before the scenario is started.
When running a scenario the top line of the main display
shows the scenario name and number of the current frame.
Pause. Stops the clock and scenario execution.Any events
or changes in settings will not be logged or affect the scenario.
Resume logging and scenario execution.
Restart the scenario. Erase current log and restart logging.
Stop scenario execution. Logging and clock will continue in
normal operation.
Scenario Events
When running a scenario, the Log Events are replaced with
Scenario Events that are programmed individually for each
scenario. Scenario Events are programmed in the PC Scenario
Builder program.
Selected events will go into the log, and can also be used as
events in the scenario, bringing the scenario from one frame
to the next.
To select a Scenario Event, press the Event quick execution
button. Select the event from the menu using the arrow
buttons, and press OK.
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Setup
To activate the Setup Menu, press the Menu button.
Use the navigation buttons to select function. Use quick
execution buttons or the navigation buttons to make a
selection. Press OK to save.
Display backlight can be turned on or off. Unless used in a
dark room, it is recommended to have the backlight off
to preserve batteries.
Factory setting is off.
Display Contrast can be adjusted between 9 (darker)
and 1 (lighter).
Factory setting is 5.
To preserve batteries, the Autopower off function turns off the
remote control if there has been no keyboard activity for the
set number of minutes.A warning will be given one minute be-
fore the unit turns off.
Factory setting is 15 minutes.
The base unit has no autopower off function. System status is
stored in the base unit, so turning the remote control off will
not affect it’s operation or settings.
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Com. Channel
To be able to operate several VitalSim units in the same vicinity,
it is possible to select 5 different communication channels.
Factory setting is channel 1.
Communication channels can only be changed if the remote
control and base unit are connected via cable.
Calibrate BP
To ensure correct measurements of simulated BP,
the sphygmomanometer used with the cuff needs to be
calibrated to the pressure sensor in the VitalSim.
This is done by selecting the Calibrate BP function, inflating
the cuff to 100 mmHg and pressing the Calibrate quick
execution button as the pressure is held at exactly 100 mmHg.
Language
One of several languages can be selected. Language selection
affects the texts on the remote control display. Selection of a
new language will also affect the “Yes” and “No” vocal sounds.
Factory setting is English
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Battery Status
The battery status in the remote control is indicated in the
upper right corner of the display. Batteries should be replaced
immediately when battery empty is indicated.
When the battery is totally empty, the remote control will
turn itself off without any warning.
Replace the remote control batteries with 4 AA size alkaline
batteries.
The battery status for the base unit is not continuously
indicated, as it is for the remote control.
When the battery has reached a state where less than 20%
capacity is remaining, a “Battery low” message will be displayed
by the remote control.
When the remaining capacity in the base unit battery is less
than 10%, a “Replace battery” warning will by given on the
remote control, and the indicator in the base unit will be
flashing alternating between orange and green.
When the battery is totally empty, the base unit will turn itself
off without any warning.
Replace the batteries in the base unit battery case wit 6 C-cell
alkaline batteries.
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