MD Diagnostics RP Check User manual

RP Check
Operating Manual
MD Diagnostics Ltd
15 Hollingworth Court
Turkey Mill
Ashford Road
Maidstone
Kent ME14 5PP
UK
Tel: + 44 (0) 1622 682686
Fax: + 44 (0) 1622 681693
Email: [email protected]
www.mdd.org.uk
Revision 1.1 March 2019

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CONTENTS
Package Contents ........................................................................................2
Overview.......................................................................................................3
Intended Use ……………………………………………………………………..3
Contraindications ………………………………………………………………...4
Operation………………………………………………………………………….4
MIP Test .......................................................................................................6
MEP Test......................................................................................................9
SNIP Test ……………………………………………………………………… 11
Indices ........................................................................................................13
Ppeak –Peak maximum Pressure .........................................................13
MEP - Maximal Expiratory Pressure.......................................................13
MIP –Maximal Inspiratory Pressure.......................................................13
MRPD –Maximum Rate of Pressure Development ...............................13
MRR –Maximum Relaxation Rate..........................................................13
PC Installation and Report..........................................................................14
Calibration...................................................................................................18
Battery Life..................................................................................................18
Cleaning......................................................................................................18
Servicing.....................................................................................................19
Spares ........................................................................................................19
Specifications..............................................................................................20
Symbols......................................................................................................21
Environment................................................................................................21
Caution: Federal Law restricts this device to sale by or on the order of a
physician (or licenced practitioner)
0120

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Package Contents
The RPCheck is supplied in a hard-shell carry case containing:
1. RPCheck
2. 2 x Pink Inspiratory Test valves with integral bacterial/viral filter
(Single patient use only)
3. 2 x Blue Expiratory Test valves with integral bacterial/vial filter
(Single patient use only)
4. 4 x Flanged mouthpiece (Single patient use only)
5. PP3 Battery
6. 3 sizes of nasal probe (single patient use)
7. Operating Manual
8. Nasal probe adaptor
9. USB cable
10.USB stick containing RP Check PC software

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Overview
The RP Check is a handheld, portable, battery-operated device used for
rapid assessment of respiratory muscle strength. The unit can measure
mouth pressures - maximum inspiratory (MIP); maximum expiratory (MEP)
pressures and sniff nasal inspiratory pressure (SNIP). The unit measures
the pressures generated in cmH2O, and these are displayed on the backlit
display.
After either the inspiratory or expiratory mouth pressure manoeuvre, the
unit will display the maximum average pressure over one second in
cmH2O. To repeat the test, press the select key and keep it depressed
until the blow icon appears. Additional indices and the pressure/time curve
can be viewed by pressing the select key momentarily.
After a sniff nasal pressure, the unit will display the peak pressure obtained
in cmH2O for the manoeuvre to repeat the test press the select key and
keep it depressed until the sniff icon appears. The pressure/time curve can
be viewed by pressing the select key momentarily.
A Maximum of 10 tests are recorded for reviewing on the display along with
the corresponding pressure time curves. For mouth pressure
measurements (MIP and MEP) the variation from the best test obtained is
also shown and guidance that the ATS/ERS (American Thoracic Society)
reproducibility criteria has been met.
Once the patient has been tested the results may be uploaded to the PC
software using the USB cable provided, alternatively the unit can be
connected to the PC to allow tests to be performed and the results instantly
displayed on the PC screen –please see section on PC connectivity.
The unit does not require any form of calibration and is restricted to use in a
physician’s office or medical healthcare facility.
The device should be used under the guidance of a healthcare
professional.
Intended Use
The RP Check is intended to measure both inspiratory (MIP) and expiratory
(MEP) mouth pressures and Sniff nasal pressures (SNIP) generated by a
patient after being trained in the technique by a qualified healthcare
professional. The RP Check is suitable for both adult and paediatric

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patients from 6 years and older, there is no upper age limit providing the
patient can comply and perform the test as instructed. Interpretation of the
values obtained should only be performed by an appropriate healthcare
professional.
Contraindications
Mouth or nasal pressure testing should be avoided in patients with:
- Aneurisms
- Uncontrolled hypertension
- Urinary incontinence
T. Trooster et al, Eur Respir Mon, 2005, 31, 57–71
Operation
Insert the 9V PP3 battery [6LR61] (supplied) by removing the battery
cover and clipping the battery in place, replace the battery cover. The unit
will switch ON when the battery is connected. The initial displayed screen is
the MD Diagnostics logo along with the version of RP Check.
The display will then change to the below screen requiring the user to select
the test type: MIP, MEP or SNIP.
To select the desired test, press the ENTER key holding it down on the
highlighted test type and the display will change to show the appropriate
manoeuvre. To scroll to a different test type, press the ENTER key to move
the cursor to the next option, once the test has been selected and
highlighted keep the ENTER key depressed to select that option.
A maximum of 10 of each test type can be performed.
SELECT
TEST TYPE
MIP
MEP
SNIP

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If a patient has previously been tested, then the results are stored on the
device along with the corresponding mouth or nasal pressure graphs. The
options available will then be displayed:
The three options available are:
YES –to Upload the current test records to the PC software, to perform this
please see section on PC Report.
NO –selecting this will change the screen to the test type option.
NOTE: If NO is selected, the previous patients’ tests will be over written,
the device only keeps the last test results in the memory.
CONTINUE TESTING –the display will change the display back to the test
screen with the last graph displayed, pressing the ENTER key will change
back to the test icon and allow tests to be performed.
NOTE: The continue testing option allows the previous test type to
continue, there is not an option to change the test type –for example if the
patient was performing MIP tests and needed a rest and the device turned
OFF due to timing out or was turned OFF, the results and graphs are saved
on the device and MIP testing will be resumed if the Continue Testing
option is chosen.
NOTE: Once a test type has been selected the unit will continue giving an
audible beep to advise the operator that no flow is currently detected
through the unit. Once the patient begins the manoeuvre the audible beep
will be longer, to signify the start of the test.
UPLOAD LAST TEST
TO COMPUTER?
YES
NO
CONTINUE TESTING

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A total of 10 tests can be performed and stored on the RP Check, as tests
are performed the storage bar in the top left of the display will slowly
become shaded to signify that tests are being stored.
For mouth pressures MIP and MEP tests, if the reproducibility criteria have
been met –(3 tests performed and the highest 2 tests are within 20% of
each other), a flag will be displayed in the top bar of the display between the
test storage icon and the battery icon.
Switch OFF the unit by pressing the power button and keeping it
depressed for 3 seconds, the display will show the symbol and switch
off.
NOTE: If the RP Check has been left without being used for 5 minutes then
then it will turn itself OFF to save the battery power.
MIP Test
Insert the pink inspiratory disposable T piece valve. Connect the flanged
mouthpiece to the valve.
The valves are colour coded and are single patient use and should be
disposed of after each patient in accordance with your local infection control
policies. The inspiratory T piece valve have a proven bacterial and viral
efficacy >99% and offer protection to both patient and device. The flanged
mouthpiece is also a single patient use accessory. Failure to dispose of the
inspiratory T piece valve and flanged mouthpiece after each patient may
lead to cross infection between patients.

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Switch the unit ON and select the MIP test, wait for an exhale icon to
appear.
Request the subject to insert the mouthpiece into their mouth, ensuring the
flange is positioned over the gums and inside the lips, whilst the ‘bite
blocks’ are between the teeth. The subject should exhale as much air as
possible to empty their lungs, to residual volume (RV) and then inhale with

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as much effort and for as long as possible (minimum 1.5 seconds). If no
inhalation has occurred the alarm will constantly make an audible beep
indicating it is waiting for a test to be performed, when inhalation starts a
longer audible beep will be heard.
The display will show maximum average inspiratory pressure sustained
over a one second period of the test - MIP. If the manoeuvre was less than
1.5 seconds, the unit will beep and a stopwatch with an exclamation mark
will be displayed indicating that the expiration needs to be longer. When 2
seconds exhalation has occurred, an audible noise will be made indicating
the acceptable time period has been met. After each manoeuvre has been
performed pressing the select key momentarily will allow the operator to
view the Pressure time trace and the additional indices PMax, PAv, MRPD,
and MRR.
Pressing the select key and keeping it held down will change the display
back to the MIP blow icon.
It is recommended to perform three good tests and use the best result as
the maximum achievable MIP, MEP or SNIP. The ATS recommends for
reproducibility that the three tests performed should be within 20% of the
highest MIP pressure obtained. As tests are performed the highest value
acceptable test (over 1.5 seconds) will be displayed along with a cup to
indicate the best test, if subsequent tests are within 20% they will be shown
with a smiley face and if not within the 20% reproducibility a sad face will be
displayed, indicating further testing should be performed.
NOTE: Once three acceptable tests have been performed a flag will be
shown at the top of the display to indicate the reproducibility criteria has
been met.
The maximum reading the RPCheck can measure is equivalent to
300 cmH2O. Any reading above that will be displayed as ---
(overflow).
NOTE: If the patient does not inhale for the minimum period of 1.5 seconds
the display will show the stopwatch icon pressing the select key will
display the test icon so testing can be repeated

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MEP Test
Insert the blue expiratory disposable T piece valve. Connect the flanged
mouthpiece to the valve.
The valves are colour coded and are single patient use and should be
disposed of after each patient in accordance with your local infection control
policies. The expiratory T piece valves have a proven bacterial and viral
efficacy >99% and offer protection to both patient and device. The flanged
mouthpiece is also a single patient use accessory. Failure to dispose of the
expiratory T piece valve and flanged mouthpiece after each patient may
lead to cross infection between patients.
Switch the unit ON the unit and select the MEP test, wait for the exhale icon
to appear.