otometrics ICS NCA-200 User manual

AIR CALORIC STIMULATOR
User Manual
Doc no. 920001301-EN/06
Part no. 920001301-EN

FM template version: 01-02-2010
Copyright notice
No part of this Manual or program may be reproduced, stored in a retrieval system, or transmitted, in any form
or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written con-
sent of GN Otometrics A/S.
Copyright©2011, GN Otometrics A/S
Printed in Denmark by GN Otometrics A/S, Denmark
All information, illustrations, and specifications in this manual are based on the latest product information
available at the time of publication. GN Otometrics A/S reserves the right to make changes at any time with-
out notice.
GN Otometrics A/S
GN Otometrics North America
50 Commerce Drive, Suite 180
Schaumburg, IL 60173-5329
USA
Phone: [phone] Fax: [phone]
www.otometrics.com
Version release date
5. December 2011
Trademarks
The GN Otometrics logo is a trademark of GN Otometrics
CHARTR is a trademark of GN Otometrics
Technical support
Please contact your supplier.

FORWARD
Otometrics specializes in the manufacture of instruments for electro-oculography,
electronystagmography and videonystagmography. Our products are of high quality
and can be expected to provide excellent diagnostic information for many years. We
back these instruments with a warranty and service commitment. Please contact
Otometrics or an authorized distributor should you require assistance.

TABLE OF CONTENTS
Section Page
I. Introduction .… . . ..........................................................................1
II. Installation .. . . . . . ..........................................................................2
III. Operation .... . . . . . ..........................................................................4
A) Front Panel Controls.............................................................4
B) Rear Panel Connectors .........................................................9
C) The Delivery Head Controls...............................................11
D) Charging the Memory Backup Capacitor...........................12
IV. Operating Procedures ....................................................................14
A) Preparation for Testing.......................................................14
B) Testing Procedure...............................................................15
V. Safety Features . . . ........................................................................16
VI. Cleaning and Maintenance ............................................................18
NCA-200 Coolant Refill Procedure ...................................18
VII. Warranty..... . . . . . ........................................................................20
VIII. Specifications . . . . ........................................................................21

1
I. INTRODUCTION
The NCA-200 Air Caloric Stimulator is a convenient and accurate instrument to be used for
evoking eye movement responses (nystagmus) during VNG/ENG examinations. The system
provides thermal stimulation through the use of a carefully controlled flow of air. The air
temperature is adjustable from 12°C to 50°C. The system provides for presetting two
temperatures -- one for the warm and one for the cool caloric stimulation. Precise
temperature control is maintained through the use of a thermistor located within 60 mm of
the point of airflow delivery. The innovative design of the otoscopic delivery head allows
observation of the point of stimulation, assuring valid and repeatable responses.
Intended Use:
An air caloric stimulator is a device that delivers a stream of air to the ear canal at
controlled rates of flow and temperature and that is intended for vestibular function
testing of a patient’s body balance system. The vestibular stimulation of the semicircular
canals produce involuntary eye movements that are measured and recorded by a
nystagmograph.
Caution:
This device should be used by a trained professional.

2
II. INSTALLATION
After unpacking the instrument, remove any packing debris from around the control console
and the delivery head. Make certain that the delivery cable has not been twisted or kinked.
The system is designed to be used at any convenient level such as a table, cart or bench
surface. A clear 18" x 18" area is required. Figure 1 shows a typical VNG/ENG examination
room layout.
Connections to the computer-based CHARTR 200 VNG/ENG can be made. In order to
understand how these connections are made, please refer to section IIIB (Rear Panel
Connectors).
The capacitor that provides power to maintain the temperature and time setpoints on the unit
may need to be recharged prior to the unit being used. Please refer to section IIID for
instructions on how to do this.
NOTE: Before applying line power to the NCA-200, verify that the unit is set up for the
appropriate line voltage. Please refer to section IIIB (Rear Panel Connectors).

3
Figure1: Typical room layout for performing the VNG/ENG test
VNG/ENG System

4
III. OPERATION
A. Front Panel Controls
This section describes all operational controls located on the front panel of
the NCA-200 (Figure 2).
1. Power Switch
This is a push on/push off switch that applies line power to the unit.
Power-on is indicated by the illumination of the digital display.
2. Digital Display
When setting temperature with the Warm Temp/Cool Temp set controls,
the display indicates temperature with a "C" to indicate degrees Celsius.
"S" indicates time in seconds, presented when the flow time is being
displayed. The default settings on power-up provide selection of the
cool stimulus and display of the cool stimulus temperature.
3. Warm (orange) or Cool (blue) Temperature Select Controls
The warm or cool temperature select buttons allow the operator to select
the stimulus (warm or cool) by depressing the associated pushbutton.
Temperature selection will be indicated by the illumination of a green
light adjacent to the temperature select button. The digital display will
present the actual corresponding temperature. Once a temperature has
been selected, it takes no more than 60 seconds for the system to come
to equilibrium at the new temperature.

5
Figure 2: Front view of the NCA-200 showing panel controls.
POWER SWITCH
FLOW METER
DIGITAL DISPLAY
UP/DOWN (arrow) CONTROLS
COOL TEMP SET CONTROL
WARM TEMP SET CONTROL
FLOW TIME SET CONTROL
COOL (blue) TEMP SELECT CONTROL
WARM (orange) TEMP SELECT CONTROL
BATH SELECT LED'S
medical
air caloric stimulator NCA-200
FLOW ON/OFF SWITCH
0
1
COOL TEMP
WARM TEMP
FLOW TIME

6
Selections made with these buttons can be used to override computer
selections.
4. Warm Temp/Cool Temp Set Controls
These buttons provide a display of the “set” temperature and allow it to
be changed. Pressing the Warm Temp button causes the set temperature
for the warm stimulus to be displayed. The Cool Temp button presents
the set temperature for the cool stimulus. Five seconds after pressing
the button or after making the last changes (see point 6 below), the
display returns to the temperature of the selected stimulus.
5. Flow Time Set Control
This provides a display of the period of time for stimulation and allows
it to be changed. By pressing the button marked Flow Time, the display
changes to the current setting for flow time in seconds. Five seconds
after pressing the Warm Temp or Cool Temp or Flow Time button, or
making the last changes to set temperatures (see point 6 below), the
display returns to the temperature of the selected stimulus.

7
6. Up or down (arrow) controls
Immediately after selecting the Warm Temp, Cool Temp, or Flow Time
controls, the up or down (arrow) controls can be used to adjust the
set temperature or the flow time. A single push of either the up or down
button will increase or decrease the temperature by 0.1°C or the flow
time by one second (the available time range is from 1 to 99 seconds).
By holding the up or down button for more than 3/4 of a second, the
temperature or the flow time will change at the rate of 3 units a second
in the selected direction.
Once set, the operating parameters will be stored in memory registers so
they will not need to be re-entered each time the unit is turned on. The
display will automatically return to the temperature of the selected
stimulus 5 seconds after the last push of a button. Tapping either
stimulus select button (the blue or orange buttons) will immediately
switch the display to the selected stimulus temperature.
The standard temperatures used are usually 24°C (cool) and 50°C
(warm).

8
7. Flow Meter
The flow rate can be adjusted by using the control at the base of the flow
meter. The flow meter is usually set to deliver 8 LPM of air.
8. Flow on/off switch
This switch enables the user to start or stop the airflow to the delivery
head. With the air flow turned off, the delivery head may be used as an
otoscope.

9
B. Rear Panel Connectors
The rear panel is the location of connectors to external control or recording
devices (Figure 3).
Figure 3: Rear panel view of the NCA-200 with connectors.
115
REMOTE CONTROL
COMPUTER CONNECTION
POWER LINE VOLTAGE SELECTOR
POWER INPUT & FUSES

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1. Computer Connection
The stimulator cable connector goes to the computer connection on the
rear panel of the stimulator. Through this connection to the computer,
the computer is able to select stimulus temperature through the software.
NOTE: This selection can be made on the unit's front panel (the orange
and blue temperature select controls).
2. Remote Footswitch Connection
A footswitch can be connected to the remote control connector at the
rear of the stimulator. This would be used to activate the flow timer. If
a computer is connected and a caloric test has been selected in the
software, the first depression of the footswitch will initiate the flow
timer and the recording; subsequent depressions will center the tracing
(ENG/VNG) or start the video recording (VNG only). If the computer is
turned on but the software is not running, flow time may be activated by
holding down the flow time activation switch or the footswitch for 5
seconds. The functions of the footswitch operate in parallel with the
flow time activation switch on the delivery head.

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3. 115 VAC/230 VAC Operation
If the NCA-200 is to be operated on 115VAC line voltage, the "input
voltage" switch must be set to "115" and the line fuses in the power
input module must be 5Amp, Slo-Blo, type 3AG fuses. If the NCA-200
is to be operated on 230 VAC line voltage, the "input voltage" switch
must be set to "230", and the line fuses in the power input module must
be 3 Amp, Time Delay, 5x20 mm fuses.
C. The Delivery Head Controls
The delivery head (Figure 4) can be held in any way that is comfortable for
the user. Flow time activation is provided with a trigger button located on the
delivery head. The otoscope light can be turned on and off using the button
located on the back of the handle below the lens.
NOTE: Turn light off when not in use.

12
D. Charging the Memory Backup Capacitor
The NCA-200 incorporates a large capacitor to provide power to maintain the
temperature and time setpoints while the unit is turned off. The operation of
this capacitor is similar to that of a rechargeable battery.
1. Before the NCA-200 is placed in service
Although the capacitor is fully charged at the factory, considerable time
may elapse before the unit is actually placed in service. Therefore, it is
recommended that the following procedure be followed before the unit
is placed in service.
Turn the NCA-200 on. The air pump may be turned off for quieter
operation. Leave the NCA-200 turned on for at least 12 hours to fully
charge the capacitor. The capacitor cannot be overcharged. A fully
charged capacitor is expected to maintain the setpoints for two weeks or
more.
2. During routine use of the NCA-200
The capacitor automatically charges whenever the unit is turned on. A
couple of hours per day of routine use should be sufficient to keep the
capacitor charged.

13
3. After prolonged interruption of use
If the NCA-200 is out of service for a week or more, follow the
procedure for initial charging of the capacitor as described in point 1
above.
Figure 4: Front and Back views of the NCA-200A delivery head and controls.
Inner Speculum
Note: Warning Symbol
indicates that the
inner speculum
should never be
placed in the ear
without an Outer
Disposable Speculum
attached to it.
Flow Time
Activation
Trigger Button
Full View
Otoscope Lens
Light On/Off
Button

14
If the computer is turned on but the software is not running, flow time may be
activated by holding down the flow time activation switch or the footswitch
for 5 seconds.
IV. OPERATING PROCEDURES
A. Preparation for Testing
Turn the unit on by pressing the green power switch at the top left of the front
panel. The cool temperature will automatically be selected as indicated by
the illumination of the green LED next to the blue temperature select control.
Press the orange temperature select button if the warm temperature is to be
selected. The digital display will flash until the set temperature is reached. It
takes approximately 60 seconds for set temperatures to be reached when the
unit is first turned on. When the set temperature is reached (±0.5°C), the
temperature display will stop flashing and illuminate steadily. Note that the
flashing display does not preclude the user from stimulating the ear. If the set
temperature or flow time needs to be changed, see section IIIA for
instructions on how to use the front panel controls.

15
B. Testing Procedure
Using a regular otoscope or the delivery head with air flow turned off,
examine the ear canal for the presence of cerumen and also to determine how
best to direct the NCA-200 airstream. The ear canal should be essentially
free of cerumen. If it is not, this must be removed prior to stimulating. After
selecting the proper temperature and the standard 60 second time for caloric
stimulation, start the flow of air and then place the speculum of the otoscopic
air delivery head directly into the ear and direct the flow of air onto the
tympanic membrane.
Momentarily depress the flow time activation trigger button on the delivery
head. If the NCA-200 is connected to the CHARTR 200 VNG/ENG or
CHARTR VNG/ENG system, subsequent depressions of the flow time
activation switch will center the tracing for VNG/ENG or start the video
recording for VNG. (If installed, the footswitch will also serve to start and
center tracings or start the video recording.) After the selected time interval
has elapsed, a beep indicates when the otoscopic air delivery head should be
removed. After stimulation, remove the speculum from the ear, dispose of
the speculum and carefully place the delivery head in a safe location. Be sure
to utilize alerting tasks as the eye movements are being recorded.

16
V. SAFETY FEATURES
Patient and operator safety are insured by the incorporation of an isolation transformer. Also
a heavy duty, three-wire AC line cord and a "Hospital Grade" plug have been provided. It is
imperative that the plug be connected to a "Hospital Grade" receptacle in order to
insure a reliable ground. (In regions outside of the United States of America, the "Hospital
Grade" plug will probably be removed from the line cord. In this event it is important to
insure that the ground wire of the line cord is reliably connected to an appropriate ground.)
Overtemperature protection is assured through the use of a special secondary sensor that
backs up the thermoelectric control unit. In the event of an overtemperature situation, all
current to the heating devices is shut off and the unit will beep to alert the user.
Warning Symbols
The NCA-200 is marked with this symbol to indicate compliance with Type
BF of the safety standard EN 60601-1.
The NCA-200 is marked with this symbol it is important that the user refer to
associated information given in this manual.