ResMed Nox A1s User manual

ResMed.com/NoxA1s
How to use
your Nox A1s™
online recordings
Noxturnal version 6.2

2
Contents
Nox A1s system …………………………………………………………………………………………………………………………………… page 3
Patient hook-up …………………………………………………………………………………………………………………………………… page 6
Make a new recording
Start a recording …………………………………………………………………………………………………………………………………… page 20
Check signals with a PC (option 1) ……………………………………………………………………………………………………………… page 23
Check signals with a tablet (option 2)…………………………………………………………………………………………………………… page 26
End the recording ………………………………………………………………………………………………………………………………… page 35
Clean devices and accessories…………………………………………………………………………………………………………………… page 36
Score a recording
Open an existing recording ……………………………………………………………………………………………………………………… page 43
Analyse data ……………………………………………………………………………………………………………………………………… page 44
Generate a report ………………………………………………………………………………………………………………………………… page 54
Troubleshooting …………………………………………………………………………………………………………………………………… page 56
Consumables and accessories …………………………………………………………………………………………………………………… page 62
2

3
NUMBER FUNCTION
1 Display
2 Push button
3 2 Clip strap loops
4 Microphone - Records respiratory
sounds
51 Pressure lock - Connects to
nasal cannula/mask pressure
tube
6 13 Unipolar touch proof inputs - 10
EEG/EOG, 3 chin EMG
71 Reference ground input
84 Bipolar touch proof inputs
9 Battery lid - Covers the battery
and the USB connector
10 Battery lid pin
11 2 Metal snaps - Connects to
thorax RIP belt
12 2 Metal snaps - Connects to
abdomen cable
Nox A1s system
3 34
2
1
5
7
86
1111 12
9
10

4
Nox A1s system
• Options available
The Nox A1s device can be used with the following external devices.
Device Function Part number
Static IP camera with infrared light
Records video and transfers it directly to Noxturnal software via ethernet. 7076308
ResMed TxLink
Enables remote control of ResMed therapy devices. It also transfers data from the
therapy device to Noxturnal via ethernet.
6 signals available among: Flow, I:E, Leak, Minute Ventilation, Pressure, Resp Rate,
Tidal Volume, Ti, Target Ventilation.
25101
SenTec™capnograph
Measures and records capnography data. Capnography data can be transfered directly to
Noxturnal software via ethernet. Signals available: TcCO2, Pulse, SpO2, Pulsation Index.
7073370
Contact your ResMed representative for more details.

5
Nox A1s system
Insert
batteries
Patient
hook-up
Start a
recording
Check
signals
View online
signals
Clean
devices and
accessories
• Online study

6
Patient hook-up

7
• Insert batteries
Before you start a recording, you should make sure that the Nox A1s recorder has a new or fully charged battery.
For the Nox A1s: 1 AA battery
• Alkaline batteries can last for 10 to 12 hours of recording.
Replace them after each recording.
• Lithium batteries can last for 20 to 30 hours of recording.
• Rechargeable NiMH batteries can be used to record for 1 hour
to 1.5 hours per 200 mAh capacity. NiMH batteries that are
recommended for the Nox A1s device are 2700mAh Powerex
or 2500mAh Panasonic Eneloop pro. Thus, they can last for 12
to 18 hours of recording.
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.
Patient hook-up

8
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.

9
Patient hook-up
EKG snap-on lead wire - Orange (PN 7072172)
Electrode site:
Connection to the Nox A1s:
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.
Remove excess gel with a gauze.
Under the right clavicle.
On the 7th left rib.
• Place the EKG cable
Equipment needed:

10
Patient hook-up
PLM snap-on lead wire
Grey (PN 7073438)
Electrode site:
Connection to the Nox A1s:
PLM snap-on lead wire
Black (PN 7073439)
4 disposable adhesive electrodes
(PN 631526)
Connect the black cable (left leg) to the LM1 bipolar input and
the grey cable (right leg) to the LM2 bipolar input.
Scrub the patient’s skin with NuPrep before placing
the adhesive electrodes. Remove excess gel with a gauze.
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:

11
Patient hook-up
3 disposable adhesive electrodes (PN 7073775)
Electrode site:
Connection to the Nox A1s:
Connect corresponding electrodes to the inputs F, 1 and 2.
Scrub the patient’s skin with NuPrep before placing the adhesive
electrodes. Remove excess gel with a gauze.
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:

12
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 remove excess gel with
a gauze. 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.

13
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)

14
Patient hook-up
Equipment needed:
NuPrep abrasive gel
(PN 7073511)
1 - Scrub the different electrode sites with NuPrep and a cotton bud.
Remove excess gel with gauze.
Ten20 conductive paste
(PN 7073512)
2 - Fill the cups with Ten20 conductive paste and place them
on the correct spots.
3 - Place a small amount of electrode cream or gel on a piece
of gauze. Place the gauze over the cup and onto the patient’s
scalp so the cup stays in place.
Cotton bud and gauze
• Attach the EEG electrodes
Electrode cream e.g.
Tensive adhesive gel
(PN 7072173)
or
Lic2 electrode cream
(PN 7078727)

15
Patient hook-up
Gently position the nasal
cannula in the nostrils with
the prongs facing inwards.
Pull the cannula tubing over
the ears.
Slide the bolo up under the
chin so it is snug but not too
tight.
• Attach the nasal cannula
• Connect the nasal cannula with the filter to the pressure input of the Nox A1s.
You can put a little piece of tape on the cannula on either cheek to hold it securely in place.

16
Patient hook-up
• Attach the oximeter
1 - Place the oximeter on the patient’s left wrist if they
are right-handed or on their right wrist if they are
left-handed.
2 - Then place the probe on the index finger. The
fingertip should reach the end of the probe but
should not go past it.
3 - Wrap tape around the finger to secure
the sensor cable.
1
2
3

17
Patient hook-up
• Therapy device option: pressure tubing installation
Make sure you use an appropriate recording type.
Equipment needed:
- Pressure tubing (PN 7072092)
- Nasal cannula filter (PN 7072097)
- Mask adapter (PN 26915)
Connect the pressure tubing to the mask and the Nox A1s:
1 - Insert a filter into the pressure input of the Nox A1s, where you would usually insert the nasal cannula.
2 - Screw the male luer-lock connector of the pressure tubing into the filter.
3 - Connect the female luer-lock connector of the tubing to the pressure port of the mask adapter.
Set-up picture:
1
2
3

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Patient hook-up
• Therapy device option: installation of the Nox C1 differential pressure sensor
Make sure you use an appropriate recording type.
Equipment needed:
- Flow sensor (PN 7073740)
- 2 mask tubing 180 cm (PN 7072092)
- 2 Nox filters (PN 7072097)
Install the differential pressure sensor:
1 - Insert two Nox filters into the PRES + and - sockets of the Nox C1.
2 - Plug the flow sensor into the filters using the two mask tubings.
3 - Place the flow sensor between the patient tubing and the mask or the therapy device, depending on the situation.
Set-up picture:

19
Make a new recording

20
Start a recording
• Open the software
Click on the Noxturnal icon on your computer desktop. Go to the Recording tab and click on Configure Recording.