Mindray Accutorr 3 User manual

Accutorr®
Quick Reference Guide

Note: The Accutorr 3 Quick Reference Guide is not
intended as a replacement to the Operating Instructions.
Prior to operating the equipment, the user must be
familiar with the Operating Instructions Manual contents.
This document is a guideline only to be used as an aid to
comprehensive Inservice Training.

Keys ...............................................................1
Patient Size ........................................................1
NIBP ...............................................................2
Factors that Affect Blood Pressure Measurement Accuracy..................2
Initiate/Stop A Non-Invasive Blood Pressure Measurement (NIBP) ...........4
Alternate Operating Modes .........................................4
Measurement Mode.......................................................4
Parameter Setup Mode ....................................................4
Standby Mode ............................................................4
Load Default (Preset) Settings.......................................4
Cleaning/Disinfecting ..............................................5
Cleaning ..................................................................5
Disinfecting...............................................................6
Sterilization ........................................................6
Error Code .........................................................7
Table of Contents

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Accutorr®Quick Reference Guide
KEYS
Power ON/OFF Switch
•Press this key to turn the monitor on.
•If no parameter is being measured, press this key to enter
Standby mode.
•When the monitor is on, press and hold this key for more than 2
seconds to turn the monitor o.
An indicator is built into this switch. It turns green when the
monitor is on, it turns yellow when the monitor enters Standby
mode, and it turns off when the monitor is off.
Clear Key
•In the Measurement mode, press this key to clear current
parameter value and error codes.
•In the Measurement mode, press and hold this key for more
than 2 seconds to access Parameter Setup mode.
•To enter the Maintenance mode, turn the power on. At the rst
audible beep, press and hold the Clear key.
NIBP Start/Stop Key
•In the Measurement mode, press this button to start or stop
NIBP measurement.
Patient Category Key
•In the Measurement mode, press this key to toggle between
adult, pediatric and neonate.
PATIENT SIZE
The Accutorr 3 monitor allows the clinician to adjust patient size.
To adjust patient size, press the hardkey.
Note:
Adjusting patient size restores the monitor to the default (preconfigured) settings
but does not clear patient information or data.

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Accutorr®Quick Reference Guide
NIBP
Factors that Affect Blood Pressure Measurement Accuracy
The accuracy of non-invasive blood pressure (BP) measurement has been shown
to be affected by numerous factors. Some of the more important aspects (based
on published literature) to consider while measuring BP are:
  • Thecuffshouldfitsnugly,butwithenoughroomfortwofingerstobe
placed between the cuff and the patient’s arm (on adults), and loosely on
neonates with little or no air present within the cuff.
  • UsetheGuidanceTableprovidedtoselectthepropersizecuff.Toosmall
a cuff has been shown to result in the overestimation of BP (systolic and
diastolic) while too large a cuff results in the underestimation of BP. Errors
in the 10 to 40 mmHg range can occur.
Ensure that the cuff is wrapped directly over the patient’s skin. BP measurement
could be 10 to 40 mmHg higher or lower than actual when the cuff is applied
over clothing.
  • Thecuffshouldbeappliedsothatthecenterofthebladderinthecuffis
overthebrachialartery.Usethereferencemarkerforthis.
  • Forbestresults,thecuffshouldbeplacedonthearmatheartleveland
the lower arm supported passively. Published data indicates that BP can
increase about 2 mmHg for every inch that the cuff is below heart level
and decrease by the same amount if above heart level.
  • Avoidcompressionorrestrictionofthepressurehose.Donotplacethe
NIBP cuff on a limb that is being utilized for any other medical procedure,
for example, an I.V. catheter.
  • HavethepatientsitquietlyforseveralminutesbeforeBPmeasurement
and remain still during measurement to avoid unnecessary motion
artifact. If the patient has not rested before measurement, BP could be
elevated by 10 to 20 mmHg.
  • DonottalktothepatientduringBPmeasurementastalkinghasbeen
shown to result in a 10 to 15 mmHg overestimation of BP.
  • Thepatient’sbackandfeetshouldbeproperlysupportedwiththelegs
keptuncrossed.UnsupportedbackandfeetcouldincreaseBPbyupto15
mmHg, while crossed legs could result in a 4 to 12 mmHg increase.

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Accutorr®Quick Reference Guide
  • OtherfactorsthathavebeenshowntoresultinanoverestimationofBP
are labored breathing (5 to 8 mmHg), full bladder (10 to 15 mmHg), pain
(10 to 30 mmHg).
Guidance Table
Cuff Description Limb Circumference
Child 10 - 19 cm
Small Adult 18 - 26 cm
Adult 25 - 35 cm
Large Adult 33 - 47 cm
Thigh 46 - 66 cm
Adult Long 25 - 35 cm
Large Adult Long 33 - 47 cm
References:
1. American Association on Critical-Care Nurses (AACN): Practice Alert,
Non-Invasive Blood Pressure Monitoring (April 2010)- http://www.
aacn.org/wd/practice/docs/practicealerts/non-invasive-bp-monitoring.
pdf?menu=aboutus
2. Pickering Thomas G, Hall John E, Appel Lawrence J, Falkner Bonita E, Graves
John, Hill Martha N, Jones Daniel W, Kurtz Theodore, Sheps Sheldon G,
Roccella Edward J. Recommendations for blood pressure measurement in
humans and experimental animals: Part 1: Blood pressure measurement
in humans: A statement for professionals from the Subcommittee of
Professional and Public Education of the American Heart Association
Council on High Blood Pressure Research. J Hypertens 2005; 45: 142-161.
3. O’Brien Eoin, Asmar Roland, Beilin Lawrie, Imai Yutaka, Mallion Jean-
Michel, Mancia Giuseppe, Mengden Thomas, Myers Martin, Padfield
Paul, Palatini Paolo, Parati Gianfranco, Pickering Thomas, Redon Josep,
Staessen Jan, Stergiou George, Verdecchia Paolo. European Society of
Hypertension recommendations for conventional, ambulatory and
home blood pressure measurement. J Hypertens 2003; 21: 821-848.

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Accutorr®Quick Reference Guide
Initiate/Stop A Non-Invasive Blood Pressure Measurement (NIBP)
To initiate or stop a NIBP measurement on a patient on the Accutorr 3 monitor,
press the hardkey on the monitor's front panel.
ALTERNATE OPERATING MODES
The Accutorr 3 has different operating modes.
Measurement Mode
The monitor will automatically enter measurement mode after power on. Monitor
mode is intended for continuously monitoring vital signs.
Parameter Setup Mode
The Parameter Setup mode is intended for adjusting monitor settings.
To enter the Parameter Setup mode on the Accutorr 3 monitor, press and hold the
hardkey for more than 2 seconds.
To resume monitoring on the Accutorr 3 monitor, press and hold the
hardkey for more than 2 seconds.
Standby Mode
In Standby mode, monitoring for current patient is paused, but the monitor is still
powered on.
To enter the Standby mode on the Accutorr 3 monitor:
a. Press the hardkey.
b. Select Yes to confirm.
To resume monitoring on the Accutorr 3 monitor, select any key on the Accutorr 3
monitor.
LOAD DEFAULT (PRESET) SETTINGS
The Accutorr 3 monitors settings are automatically restored when the patient size
is adjusted.
A clinician may restore default settings on a patient currently being monitored on
the Accutorr 3 monitor by:
a. Enter Maintenance mode.
b. Press the hardkey to access the default factory setup screen.

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Accutorr®Quick Reference Guide
c. Press the hardkey to switch between ON or OFF.
  • ON – to load the default settings.
  • OFF – to retain the current settings.
CLEANING/DISINFECTING
Cleaning
Clean your equipment on a regular basis. Before cleaning, consult your hospital's
regulations for cleaning the equipment.
The following table lists approved cleaning agents.
Product Name Product Type Ingredients
Sodium hypochlorite bleach Liquid Sodium hypochlorite 10%
Isopropanol Liquid Isopropanol 70%
Note:
1. Refer to the Operating Instructions for important notes about cleaning.
2. The "*" symbol indicates a cleaning solution should be prepared
according to the concentration directed by the accompanying
instructions for use.
To clean the equipment:
a. Shut down the monitor and disconnect it from AC power.
b. Clean the display screen using a soft, clean cloth dampened with a
cleaning agent.
c. Clean the exterior surface of the equipment using a soft cloth
dampened with a cleaning agent.
d. Wipe off all the cleaning solution with a dry cloth after cleaning if
necessary.
e. Dry your equipment in a ventilated, cool place.

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Accutorr®Quick Reference Guide
Disinfecting
Disinfect your equipment as required in your hospital's servicing schedule.
Cleaning equipment before disinfecting is recommended.
The following table lists approved disinfectants.
Product Name Product Type Ingredients
Sodium hypochlorite bleach Liquid Sodium hypochlorite 10%
Isopropanol Liquid Isopropanol 70%
Perform® Powder Usedas1%solution*
100g contains 45g
Pentapotassium bis
(peroxymonosulphate) bis
(sulphate).
5 % to 15% anionic surfactants;
<5% non-ionic surfactants;
<5% soap and phosphonates,
perfumes
Note:
1. Refer to the Operating Instructions for important notes about disinfecting.
2. The "*" symbol indicates a disinfectant should be prepared according to the
concentration directed by the accompanying instructions for use.
STERILIZATION
Sterilization is not recommended for this equipment, related products,
accessories,orsuppliesunlessotherwiseindicatedintheInstructionsforUsethat
accompany the products, accessories or supplies.

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Accutorr®Quick Reference Guide
ERROR CODE
Code Description Solution
01 NIBP overrange Contact Mindray's Technical Service department.
02 NIBP module error Restart the monitor. If the error persists, contact
Mindray's Technical Service department.
03 NIBP comm. error
04 NIBP air pressure error
Check for loose cu or pinched hose. Restart the
monitor and retry. If the error persists, contact
Mindray's Technical Service department.
05 NIBP weak signal
Check the patient’s condition and change the
cu application site. If the error persists, replace
the cu.
06 NIBP excessive motion Check the patient’s condition and reduce patient
motion.
07 NIBP cu overpressure Check for kinked hose or excessive patient
movement. Restart the monitor and try again.
08 NIBP illegally reset Contact Mindray's Technical Service department.
09 NIBP timeout Check the patient’s condition and NIBP
connections, or replace the cu.
10 NIBP cu type wrong Verify the patient size and use the appropriate
cu.
11 NIBP air leak
Ensure the cu is applied correctly and check the
ttings for leaks. If the problem persists, contact
Mindray's Technical Service department.
17 SpO2 board fault
(Masimo)
Discontinue monitoring SpO2and contact
Mindray's Technical Service department.
18 SpO2 module error Restart the monitor. If the error persists, contact
Mindray's Technical Service department.
19 PR overrange Contact Mindray's Technical Service department.
20 SpO2 low perfusion Move the sensor to a site with better perfusion.