ResMed Nox A1 Operating instructions

ResMed.com/NoxA1
How to use
your Nox A1™
ambulatory recordings
Noxturnal version 5.1

2
Contents
Nox A1 system …………………………………………………………………………………………………………………………………… page 3
Configure a recording……………………………………………………………………………………………………………………………… page 7
Patient hook-up …………………………………………………………………………………………………………………………………… page 14
Check signals ……………………………………………………………………………………………………………………………………… page 26
Clean devices and accessories ………………………………………………………………………………………………………………… page 38
Score a recording
Download data …………………………………………………………………………………………………………………………………… page 41
Analyse data ……………………………………………………………………………………………………………………………………… page 42
Generate a report ………………………………………………………………………………………………………………………………… page 51
Open an existing recording ……………………………………………………………………………………………………………………… page 53
Troubleshooting …………………………………………………………………………………………………………………………………… page 54
Consumables and accessories …………………………………………………………………………………………………………………… page 59
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3
Nox A1 system
Accessories Devices Consumables
Abdomen cable Nasal cannula with filter x2
Disposable RIP belts
(Sizes: XSx1, Sx1, Mx1, Lx1, XLx1)
Battery 1.5V AA x2
Battery 1.5V AAA x4
Nox A1 Recorder
Nonin 3150 oximeter
and SpO2sensor size M
Noxturnal software CDEEG 5 lead gold
electrode cable x2
USB cable
EKG and PLM cables EEG head cable

4
NUMBER FUNCTION
1 Display
2 Push button -
Turn on the device
3 Push button - Forward
4 Push button - Backward
5 Clip strap loops
6 Microphone and light sensor -
Records respiratory
sounds and light
7 Device status indicator light
8 Pressure lock -
Connects to external nasal cannula/
mask pressure tube
9 Unipolar input - EEG channels
10 Reference ground input
11 Bipolar inputs -
EKG and PLM inputs
12 Battery lid -
Covers the battery and the USB connector
13 Battery lid pin - Keeps battery compartment closed
14 Metal snaps - Connect to thorax RIP belt
15 Metal snaps -
Connect to abdomen cable
Nox A1 system
5 6 5
7
14
13
9
8
11
10 12
15 14
1
4 2 3

5
Nox A1 system
• Options available
The Nox A1 device can be used with the following external devices.
Device Function Part number
Bluetooth Nox W7 Link Kit - A
Enables data transfer between the Nox A1 and ResMed AirSense™10 / AirCurve™10
therapy devices. Can be connected to AirSense/AirCurve devices via an adapter.
Signals available: Flow, Pressure, Leak.
7075367
Bluetooth Nox W7 Link Kit - R
Enables data transfer between the Nox A1 and ResMed S9™therapy devices or between
the Nox A1 and selected Radiometer™devices (TCM4 and TCM40). Can be connected to
S9 devices via an adapter. Can be connected to Radiometer devices via an extension cable.
Signals available with the ResMed S9: Flow, Pressure, Leak.
Signals available with the Radiometer: ptCO2, SpO2, Pulse.
7073481
Bluetooth Nox W7 Link Kit - S
Enables data transfer between the Nox A1 and SenTec™Digital Monitor. Can be connected
to the serial port of the SenTec monitor.
Signals available with the SenTec: ptCO2, SpO2, Pulse, Pulsation Index.
7073480
Differential pressure sensor Braebon™PT1 0580
Can be connected to one of the bipolar inputs of the Nox A1. Records patient flow when
using a therapy device. For pressures up to 20 cmH2O.
7073482
Differential pressure sensor Braebon 0580PES
Can be connected to one of the bipolar inputs of the Nox A1. Records patient flow when
using a therapy device. For pressures up to 50 cmH2O.
7075368
Contact your ResMed representative for more details.

6
Nox A1 system
Configure
a recording
Insert
batteries
Patient
hook-up
Check
signals
Clean
devices and
accessories
Download
data
• Ambulatory study

7
Congure a recording

8
• Connect the Nox A1
Open Noxturnal software on your computer.
Open the battery lid of the Nox A1 using the opening tool
provided and connect the device to the USB port of the computer.
Congure a recording
In Noxturnal software, click on Recording >
Configure device to open the configuration
wizard.

9
• Step 1: Select a recording type
Choose a suitable recording type from the drop-down list.
Enter the BDA number shown on the
back of your oximeter.
Congure a recording
Click on Next to continue.

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Congure a recording
• Step 2: Schedule recording
“Start Recording At” option is recommended.
Select
1The number of nights
2The start time
3The date
4The duration
Click on Next to continue.
1
2
3
4

11
Congure a recording
• Step 3: Enter patient information
Add information on the patient’s identity and physical characteristics.
Add at least patient’s First and Last names or
patient ID before finishing.
The Tags fields can be used to link keywords to
the patient in order to easily find him later in the
recordings library.
Use the Edit... button to enter more detailed
information about your patient before the hookup.
Click on Finish.

12
• End configuration
Click on Finish to close this window
and disconnect the device.
Congure a recording

13
• Insert batteries
Insert a new lithium battery or a fully recharged NiMh battery into the Nox A1 device.
For the Nox A1: 1 AA battery
• Lithium batteries are recommended. They last for up to 15h of
recording. Replace them after each recording.
• NiMh batteries that are recommended for the Nox A1 device
are 2700mAh Powerex or 2500mAh Panasonic Eneloop pro.
They last for 8 to 10 hours of recording.
Alkaline batteries are not compatible with the Nox A1
device.
For the Nonin 3150 oximeter: 2 AAA batteries
• Alkaline batteries last for up to 24h. It is recommended
that they are replaced every 2 recordings.
• Rechargeable batteries should be recharged completely
before every recording.
Congure a recording

14
Patient hook-up

15
Patient hook-up
•Attach the device and the belts
1
2
3
1 - Clip the abdomen cable to the back
of the device and snap the clips
onto the patient’s pyjamas.
2 - Wrap the RIP belt around the patient’s
thorax and snap it at the back of the
device.
3 - Repeat this for the abdomen belt and
snap it to the cable.

16
Patient hook-up
EKG snap-on lead wire - Orange (PN 7072172)
Electrode site:
Connection to the Nox A1:
2 disposable adhesive electrodes (PN 7075209)
The EKG cable must be plugged into the bipolar
EKG channel.
Scrub the patient’s skin with NuPrep before
placing the adhesive electrodes.
Under the right clavicle.
On the 7th left rib.
• Place the EKG cable
Equipment needed:

17
Patient hook-up
PLM snap-on lead wire
Grey (PN 7073438)
Electrode site:
Connection to the Nox A1:
PLM snap-on lead wire
Black (PN 7073439)
4 disposable adhesive electrodes
(PN 631526)
Scrub the patient’s skin with NuPrep before placing
the adhesive electrodes.
Electrodes must be placed on the tibialis anterior muscle.
If needed, secure the electrodes with tape and/or a Surgilast net.
• Place the PLM cables
Equipment needed:
Connect the black cable (left leg) to the LM1 bipolar input and
the grey cable (right leg) to the LM2 bipolar input.

18
Patient hook-up
3 disposable adhesive electrodes (PN 7073775)
Electrode site:
Connection to the Nox A1:
Scrub the patient’s skin with NuPrep before placing the adhesive
electrodes.
F- On the midline and 1 cm above the inferior border of the mandible.
1 - 2 cm below the inferior border of the mandible and 2 cm right
of the midline.
2- 2 cm below the inferior border of the mandible and 2 cm left
of the midline.
• Place the chin EMG electrodes
Equipment needed:
Connect corresponding electrodes to the inputs F, 1 and 2.

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Patient hook-up
1 - Choose a snap-on electrode and place
the EEG head cable as shown below:
2 - Scrub the patient’s forehead with
NuPrep and attach the electrode to
the forehead by gently pressing on the
white ring of the electrode.
3 - Connect the 2 EEG lead cables as
shown below:
4 - Pre-position the cups on the head.
• Place the EEG head cable
Before attaching the electrodes, it is important to properly position the ground reference
of the EEG head cable.

20
Patient hook-up
E1 and E2 are respectively 1 cm below the left eye and 1 cm above the right eye.
O1 and O2 are 3 cm below the occipital protuberance and 3 cm from the midline.
C3 and C4 are on the pre-auricular points axis and 7 cm from the midline.
M1 and M2 are respectively on the left and the right mastoids behind the ear.
F3 and F4 are 1 cm before the hair line and 4 cm from the midline.
• Place the electrodes (10/20 system)