laerdal Heartsim 200 Manual

Heartsim®200
–Directions for Use
Page 2 - 15
–Gebrauchsanweisung
Seite 16 - 29
–Mode d'emploi
Page 30 - 43
–Instrucciones de utilización
Páginas 44 - 57
–Istruzioni per l'Uso
Pagine 58 - 71
–Handleiding
Blz. 72 - 85
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Limited Warranty ............................................ 2
Cautions and Warnings ................................ 3
1. Introduction ............................................. 4
2. Description .............................................. 4
3. Getting Started ........................................ 5
3.1 Unpacking........................................ 5
3.2 Connecting the Heartsim 200 .......... 5
4. Operation ................................................ 6
4.1 General ............................................ 6
4.2 ECG Rhythms .................................. 7
4.3 Activation of a New Rhythm ............. 10
4.4 Ignore Shock Function .................... 11
4.5 Pulse Function ................................. 12
5. Maintenance ........................................... 13
5.1 Trouble Shooting ............................. 13
5.2 Servicing ......................................... 13
5.3 Cleaning .......................................... 13
6. Parts List ................................................. 14
7. Technical Data ....................................... 15
Laerdal warrants to the purchaser that its product(s) is/are free
from defects in material and workmanship for a period of one (1)
year from the date of purchase by the original user. During the
designated one (1) year period, Laerdal will, upon receipt of a
product found to be defective due to materials or workmanship
from the purchaser and notification in writing of the defect at its
option repair or replace any parts found to be defective or the
entire product.
Products found to be defective and notification of defects may also
be sent to the authorized Laerdal dealer from whom the product
was purchased. All postage, shipping, or handling charges shall be
the sole responsibility of the purchaser.
2
Contents
Limited Warranty
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ENGLISH
3
Laerdal is responsible for the effects of safety, reliability and
performance of its product(s) only if:
– Service, repair, readjustment or modification is carried out by
Laerdal or persons authorized by Laerdal.
–The electrical installation of the room where the product is used
complies with pertinent national requirements.
–The product is used in the proper manner in strict compliance
with its Directions for Use.
Laerdal shall not be liable under this warranty for incidental or
consequential damages or in the event any unauthorized repairs or
modifications have been made or attempted or when the product,
or any part thereof, has been damaged by accident, misuse or
abuse. This warranty does not cover batteries, fuses, normal wear
and tear, staining, discoloration or other cosmetic irregularity which
does not impede or degrade product performance.
Some states in the USA do not allow the exclusion or limitation of
incidental or consequential damages, so those limitations or
exclusions may not apply to you.
There are no other express or implied warranties, whether of
merchantability, fitness or purpose, or otherwise, on the product, its
parts and accessories.
When using the Heartsim 200 together with a training manikin and
defibrillator, the warnings and cautions given in their respective
Directions for Use must be followed.
Do not open the Heartsim 200 case, there are no user serviceable
parts. Refer the unit to a qualified service technician.
This device generates, uses and can radiate radio frequency
energy. If it is not installed and used in accordance with the
instructions, it may cause harmful interference to radio
communications. In that case the user is encouraged to try to
correct the interference by:
-Reorienting or relocating the receiving antenna.
-Increasing the distance between the device and the receiver.
-Connecting the device into an outlet on a circuit different from
that to which the receiver is connected.
-Consulting the dealer or an experienced radio/TV technician
for help.
Cautions and Warnings
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4
The Heartsim 200 is a battery powered ECG rhythm simulator
which provides simulation of basic, modified and pediatric
rhythms with the applicable pulse rate and strength. Dedicated
controls and indicators for each function make the Heartsim 200
simple to use.
The Heartsim 200 has been designed to be used with the ALS
Skilltrainer and ALS Baby Trainer. However, by using the Heartsim
200 link cable (cat. No. 29 20 21) the following manikins can also
be used with the Heartsim 200, although no pulse is generated:
-Skillmeter Arrhythmia Trainer
-Early Defibrillation Trainer
-Basic ALS Trainer.
The Heartsim 200 can also be used as a stand-alone unit to provide
ECG signals for display on any standard 3-lead ECG monitor.
This Directions for Use provides all the information to fully utilise
the Heartsim 200 but does not aim to provide related medical
knowledge.
Note: The training manikins are supplied with their own
Directions for Use.
The Heartsim 200 is a hand held unit with the function keys
incorporated on the top panel. Every key (with the exception of the
Paroxysmal and Change rhythm keys) has an associated LED to
indicate the status of its function. The unit connects to the manikin
by plugging the cable into the top end of the unit or via the ECG
mounts on the top of the control panel.
The rear of the unit contains the battery compartment.
1.Introduction
2.Description
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ENGLISH
5
3.1 Unpacking
Remove the Heartsim 200 from its packaging.
If there is any obvious sign of damage, immediately notify
Laerdal Medical and the carrier. Remove the battery cover
and then remove the battery tag that is temporarily installed
to prevent discharge of the batteries.
3.2 Connecting the Heartsim 200
3.2.1 Connecting the Manikin
To connect the ALS Skilltrainer to the Heartsim 200, connect the
cable from the side of the
manikin to the connector on the top end
of the Heartsim 200. This port also accepts the Heartsim 200 link
cable plug.
Note: The plug will only enter the receptacle
with the correct orientation.
3.2.2 Connecting the ALS Baby Trainer
Connect the manikin's three connectors onto the ECG mounts on
the top of the control panel. These mounts can also connect directly
to an ECG monitor for rhythm recognition training.
3.Getting Started
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4.1 General
4.1.1 Power On/Off
To switch on the Heartsim 200, simply press the On/Off key.
To switch off the Heartsim 200, press the On/Off key a second time.
To conserve battery power, the Heartsim 200 automatically
switches off after approximately 10 minutes if there has been
no user activity.
4.1.2 Battery Low Indication
The yellow Battery low LED switches on to indicate that battery
power is low and that the batteries should be replaced. See
section 5.2.1 for battery removal/replacement. The Heartsim 200
will operate after the battery low LED is lit, but when the battery
voltage is too low, the unit will switch automatically off.
Note: The amplitude of the ECG and pulse strength may be
affected when the Battery low LED is lit.
6
4.Operation
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
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ENGLISH
7
4.2 ECG Rhythms
The ECG rhythms can be selected from their own dedicated
controls on the keyboard. Each rhythm has its own key and green
LED indicator that tells you which rhythm has been selected and
its status. The Heartsim 200 has keys for the following rhythms:
Basic Rhythms
Key Marking Rate Descriptive Name
Sinus 80 Normal Sinus Rhythm (NSR)
VT slow 120 Ventricular Tachycardia, slow
VT fast 220 Ventricular Tachycardia, fast
VF coarse - Ventricular Fibrillation, coarse
VF fine - Ventricular Fibrillation, fine
Asystole - Asystole.
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
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8
Modified Rhythms
Key Marking Rate Descriptive Name
Sin. Brad 40 Sinus Bradycardia
Sin. Tach 140 Sinus Tachycardia
Torsade - Torsade des Pointes
Atr. Flutt 150 Atrial Flutter
Atr. Fibr 140 Atrial Fibrillation
Atr. Tach 210 Atrial Tachycardia
1°AVB 60 1st Degr. AV Block
2°AVB #1 80, 4:3 2nd Degr. AV Block #1
2°AVB #2 80, 2:1/3:1 2nd Degr. AV Block #2
3°AVB 50 3rd Degr. AV Block
Junctional 50 Junctional Rhythm
Junc. Tach 120 Junctional Tachycardia
Unif. PVC 80 NSR with Unifocal PVCs
Multif. PVC 80 NSR with Multifocal PVCs
Coupl. PVC 80 Sinus with Coupled PVCs
PAC 80 Sinus with PACs
(Premature Atrial Complex)
PJC 80 Sinus with PJCs
(Premature Junctional Complex)
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
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ENGLISH
9
Infant Rhythms
Key Marking Rate Descriptive Name
Sinus 130 Normal Sinus Rhythm (NSR)
Sin. Brad 80 Sinus Bradycardia
Sin. Tach 180 Sinus Tachycardia
SVT 280 Supraventricular Tachycardia
VT 210 Ventricular Tachycardia
VF - Ventricular Fibrillation
Asystole - Asystole
4.2.1 Running/Waiting Rhythm Indication
The green LED indicator next to the key shows you which
rhythm has been selected and its status. A flashing LED denotes
a waiting rhythm and a steady LED denotes a running rhythm.
4.2.2 Default Rhythm
The default running rhythm when you switch on the Heartsim 200
is the Normal Sinus Rhythm (NSR).
4.2.3 Selecting a New Rhythm
To select a new rhythm simply press the key of the new rhythm
you require. Your new selection is indicated as a waiting rhythm.
To activate, see next page.
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
HS 200 DfU 02-15EN.qxd 12.11.03 13:25 Page 9

10
4.3 Activation of a New Rhythm
There are three methods to activate a new rhythm:
4.3.1 Use the Change Rhythm Key
When you push the Change rhythm key the present selected
running rhythm is deactivated and the selected waiting rhythm
becomes the new running rhythm.
4.3.2 Defibrillation of the Manikin
Defibrillation of the manikin deactivates the selected running
rhythm and the selected waiting rhythm becomes the new running
rhythm, unless the Ignore Shock button is on.
4.3.3 Paroxysmal Function
When you push the Paroxysmal Function key you can alternate
between a running rhythm and a waiting rhythm.
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
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ENGLISH
11
4.4 Ignore Shock Function
When you push the Ignore shock key, the detection of the shock
is ignored and the status of the ECG rhythm stays the same. This
function is engaged until you push the Ignore shock key again.
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
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12
4.5 Pulse Function
4.5.1 Default Pulse Strength
The default pulse strength when you switch on the Heartsim 200 is
Normal. Since the default rythm is NSR, the pulse strength that will
be felt on the manikin will be similar to the normal pulse on a
healthy individual.
4.5.2 Pulse Strength Selection
You can select three different pulse strengths:
- Normal
- Weak
- Absent.
A single push of the Pulse key changes the pulse strength
selection from the default strength (Normal) to Absent. The next
push changes the pulse strength to Weak, and the next returns it
to Normal. Further pushes of the Pulse key change the selection
sequentially. The pulse rates simulated in the Normal and Weak
settings will depend upon selected rhythm.
4.5.3 Indication
Each pulse strength has its own green LED that comes on to show
you which pulse strength has been selected.
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
Note: The ALS Baby Trainer has a manually operated pulse.
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ENGLISH
5.1 Trouble Shooting
The Heartsim 200 is designed to be a reliable unit requiring a
minimum of maintenance. With this in mind, there are only a few
faults the user can rectify. In all other cases contact Laerdal
Medical, or your Laerdal dealer for authorized servicing or repair.
Problem Correction
Battery Low LED is on - Replace batteries
No ECG signals displayed - Check all connections
No pulse simulation - Check to see if battery
low LED is on.
-Check manikin cable
connection.
-Check type of manikin
(see page 4).
-ALS Skilltrainer only:
Pulse is pressed down on
both sides simultaneously.
5.2 Servicing
5.2.1 Battery Removal/Replacement
To remove and replace the batteries:
-Remove the battery cover on the rear of the Heartsim 200.
-Remove and safely discard the old batteries.
-Install the new batteries, AA size (R6) 1.5V, in the correct
orientation as shown on the cabinet bottom.
-Re-fit the battery cover.
5.3 Cleaning
5.3.1 General
Cleaning of the Heartsim 200 is restricted to general cleaning of
the keyboard and case:
-Moisten a cloth with a suitable cleaning agent. Use a mild soap
or cleaner.
-Gently wipe the surface of the keyboard and case.
-Remove any excess liquid with a dry cloth.
-Do not immerse the unit in water.
13
5.Maintenance
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26 00 10 Heartsim 200
26 10 00 Soft pack
26 10 20 Battery case lid
26 04 20 Directions for use Heartsim 200
Extra Equipment
29 20 21 Heartsim 200 link cable
If increased battery life is needed, there is an extra battery pack
available which is mounted in ALS Skilltrainer.
See ALS Skilltrainer Directions for Use.
Product specifications are subject to change without notice.
14
6.Parts List
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ENGLISH
Environmental Data
-Temperature 10°C to 40°C
-Humidity 15 to 90% RH (non - condensing)
-Atmospheric pressure 70 kPa to 106 kPa
Power Supplies
-Power supply 9V from internal batteries
-Batteries AA size (R6) 1.5V
-Number of batteries 6
-Capacity 2500 mAh
-Battery life time Approx. 12.5 hours until the
unit switches automatically off.
This is under the following
conditions:
Normal Sinus Rhythm
Pulse active max. 10 sec./min.
20°C
-Battery low indicator operation 6.6 +/- 0.2 VDC
Storage
-Temperature - 15 to + 50°C
-Humidity 15 to 90% RH (non - condensing)
Physical Dimensions
-Size 233 x 132 x 63 mm
-Weight incl. batteries 0.5 kg
Symbols used
Type B in accordance with IEC-601.
Standards/Approvals
The product is in compliance with essential requirements
of council directive 89 / 366 / EEC; EMC - directive.
Limit B of EN 55011/1991 (CISPR 11/1990)
Limit B of VDE 0871 / 6.78 with amendments of Amtsblatt
no 163 / 1984 Vfg. 1046
Limit B of FCC rules and regulations part 15, subpart B.
EN 50082 -1 / 1992 (IEC 801-2, -3, -4).
IEC 601-1
15
7.Technical Data
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Garantie ........................................................ 17
Sicherheitshinweise ...................................... 17
1. Einleitung ................................................ 18
2. Beschreibung ......................................... 18
3. Vorbereitung zur Inbetriebnahme .......... 19
3.1 Auspacken ........................................ 19
3.2 Anschlüsse ....................................... 19
4. Bedienung .............................................. 20
4.1 Allgemeines ...................................... 20
4.2 EKG Rhythmen ................................ 21
4.3 EKG-Rhythmus aktivieren ................. 24
4.4 Funktion "Schock ignorieren" ............ 25
4.5 Puls .................................................... 26
5. Wartung................................................... 27
5.1 Fehlerbehebung ............................... 27
5.2 Service .............................................. 27
5.3 Reinigung .......................................... 27
6. Teileliste .................................................. 28
7. Technische Daten .................................. 29
16
Inhalt
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DEUTSCH
17
Die Gewährleistungsfrist beträgt 12 Monate und beginnt mit dem
Datum der Lieferung. Die Haftung gilt nicht für normale Abnutzung,
Batterien und Sicherungen.
Laerdal betrachtet sich nur dann für die Auswirkungen auf
Sicherheit, Zuverlässigkeit und Leistung des Gerätes als verant-
wortlich, wenn:
– Montage
– Erweiterungen
– Neueinstellungen
– Änderungen
– Reparaturen
– Wartung
nur von Laerdal oder von Laerdal autorisierten Personen ausgeführt
werden und das Gerät in Übereinstimmung mit der Gebrauchs-
anweisung verwendet wird. Desweiteren gelten unsere "Allgemeinen
Geschäftsbedingungen" ( siehe dort § 6, Gewährleistung und Haftung).
Beim Gebrauch von Heartsim 200 zusammen mit einer Übungs-
puppe und einem Defibrillator sind die Sicherheitshinweise und
Vorsichtsmaßnahmen in den entsprechenden Gebrauchs-
anweisungen dieser Geräte zu beachten.
Öffnen Sie Heartsim 200 nicht. Erforderliche Reparaturen können
nur von Laerdal oder von Laerdal autorisierten Personen durch-
geführt werden.
Dieses Gerät erzeugt und arbeitet mit Radiofrequenzen. Wenn es
nicht entsprechend der Gebrauchsanweisung verwendet wird,
kann es zu Interferenzstörungen in Kommunikationsanlagen führen.
In diesen Fällen beachten Sie bitte:
-Empfangsantennen entsprechend ausrichten bzw. aufstellen.
-Abstand zwischen Heartsim 200 und Empfangsanlage
vergrößern.
-Im Zweifelsfalle kontaktieren Sie einen Radio-/Fernsehtechniker.
Garantie
Sicherheitshinweise
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18
Heartsim 200 ist ein batteriebetriebener EKG-Rhythmus-Simulator,
mit dem Basisrhythmen mit deren Modifikationen sowie pädia-
trische Rhythmen mit entsprechenden Pulsfrequenzen simuliert
werden können. Übersichtliche Bedien - und Anzeigeelemente
machen die Bedienung von Heartsim 200 sehr einfach.
Heartsim 200 ist vorgesehen zur Verwendung mit Megacode
Trainer Standard und Megacode Baby. Mit einem speziellen
Verbindungskabel, Kat.-Nr. 29 20 21, kann Heartsim 200 auch
mit den nachfolgend aufgeführten Übungsgeräten verwendet
werden, jedoch ohne Pulssimulation:
-Skillmeter Arrhythmia Trainer
-Frühdefibrillations-Trainer
-Megacode Trainer Basis
Heartsim 200 kann auch alleine als EKG-Simulator zur Darstellung
von EKG-Rhythmen auf jedem Standard-EKG-Monitor (3 Ablei-
tungen) verwendet werden.
Diese Gebrauchsanweisung enthält Informationen, um alle
Möglichkeiten von Heartsim 200 optimal nutzen zu können. Sie ist
jedoch kein Lehrmittel zur Vermittlung von medizinischem Wissen.
Anmerkung: Die Übungspuppen selbst sind mit deren
Gebrauchsanweisungen ausgestattet.
Heartsim 200 ist ein handliches Gerät, die Bedien- und Anzeige-
elemente befinden sich auf der Oberseite des Gerätes. Jedem
Taster ist eine LED (Leuchtdiode) zugeordnet (außer paroxys-
maler Rhythmus und Rhythmuswechsel), die den Status der
entsprechenden Funktion anzeigt. Der Anschluß für das Ver-
bindungskabel zur Übungspuppe befindet sich am oberen Ende
des Gerätes, die Anschlüsse zu einem EKG-Monitor befinden sich
am oberen Ende der Frontplatte. An der Unterseite des Gerätes
befindet sich der Batterieschacht.
1.Einleitung
2.Beschreibung
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DEUTSCH
19
3.1 Auspacken
Heartsim 200 der Verpackung entnehmen. Sollten Sie
Beschädigungen feststellen, wenden Sie sich bitte sofort an
Laerdal. Batteriedeckel an der Geräteunterseite abnehmen
und Isolierstreifen entnehmen.
3.2 Heartsim 200 anschließen
3.2.1 Übungspuppe anschließen
Kabel vom Megacode-Trainer Standard am oberen Ende des Gerätes
anschließen. An diesem Anschluß kann auch das Verbindungskabel
29 20 21 angeschlossen werden.
Anmerkung: Achten Sie bitte auf korrekte Ausrichtung
des Steckers.
3.2.2 Megacode Trainer Baby anschließen
Das 3-polige Kabel der Übungspuppe wird an den oberen Druck-
knopfanschlüssen angeschlossen, ebenso 3-polige Standard EKG-
Kabel zu einem EKG-Monitor.
3.Vorbereiten zur Inbetriebnahme
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4.1 Allgemeines
4.1.1 Ein-/Ausschalten (ON/OFF)
Zum Einschalten ON/OFF-Taste drücken. Zum Ausschalten die
ON/OFF-Taste erneut drücken.
Um die Batterien zu schonen, schaltet das Gerät automatisch
nach ca. 10 Minuten ab, wenn innerhalb dieser Zeit keine
Aktivitäten erfolgen.
4.1.2 Batterie schwach - Anzeige
Die gelbe Batterie schwach - LED zeigt an, daß die Batterie-
kapazität zu niedrig ist und ein Batteriewechsel erforderlich ist.
Siehe Abschnitt 5.2.1 für Batteriewechsel. Heartsim 200 arbeitet
zwar noch nach dem ersten Aufleuchten der Batterie schwach -
LED, wenn jedoch die Batteriespannung zu niedrig wird,
schaltet das Gerät ab.
Anmerkung: Die EKG-Amplitude sowie die Pulsfunktion kann be-
einträchtigt werden, wenn die Batterie schwach LED aufleuchtet.
20
4.Bedienung
Sinus VTslow VTfast VFcoarse VFfine Asystole
Sin.Brad Sin.Tach Torsade Atr.Flutt. Atr.Fibr. Atr.Tach
1°AVB 2°AVB#1 2°AVB#2 3°AVB Junctional Junc.Tach
Unif.PVC Multif.PVC Coupl.PVC PAC PJC
Sinus Sin.Brad Sin.Tach SVT VT VF
Ignore Change
Battery low
Asystole
INFANT RHYTHMS
ON/Off shock Pulse Paroxysmal rhythm
normal
weak
absent
HEARTSIM
2 00
HEARTSIM
®
6427 rev A
HS 200 DfU 16-29GE.qxd 12.11.03 13:28 Page 20