Ultimate Healthcare Heritage II Bariatric User manual

Heritage II Bariatric
Bariatric Dynamic Mattress Replacement System
UPRA4878-2
User Manual
Issue 5: 12/12/2018
UPRA4878-2.UM-5

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Contents
1. Introduction ...................................................................................................................................... 5
2. Intended Use.................................................................................................................................... 5
2.1 Contraindications ..................................................................................................................... 5
3. About the Product ............................................................................................................................ 5
4. Symbols and Statements................................................................................................................. 7
5. Important Safety Information ........................................................................................................... 8
6. Technical Specification .................................................................................................................... 9
6.1 Power unit................................................................................................................................ 9
6.2 Mattress ................................................................................................................................... 9
7. Installation and Set-Up................................................................................................................... 10
7.1 Setting up mattress................................................................................................................10
7.2 Setting up power unit .............................................................................................................10
7.3 Cable management system ................................................................................................... 11
7.4 Connecting mattress to the power unit ..................................................................................11
8. Control Panel Operation Guide......................................................................................................12
8.1 Operate / standby .................................................................................................................. 12
8.2 Comfort level..........................................................................................................................13
8.3 Auto detection........................................................................................................................13
8.4 Control panel lockout .............................................................................................................13
8.5 Function mode switch ............................................................................................................14
8.5.1 Alternate ...................................................................................................................... 14
8.5.2 Static............................................................................................................................14
8.5.3 Constant Low Pressure (CLP).....................................................................................14
8.6 Auto-Firm ............................................................................................................................... 14
8.7 Alternate cycle time selection ................................................................................................ 14
8.8 Alarm mute ............................................................................................................................ 14
9. Backrest Mode ...............................................................................................................................15
10. CPR Mode .....................................................................................................................................15
11. Transport Mode..............................................................................................................................15
12. Alarms & Fault Findings................................................................................................................. 16
12.1 Low pressure alarm ...............................................................................................................16
12.2 Power failure alarm................................................................................................................16
12.3 Service (alternating failure alarm)..........................................................................................16
12.4 Annual Service Indicator........................................................................................................16
13. Troubleshooting ............................................................................................................................. 18
14. Cleaning and Decontamination...................................................................................................... 19
14.1 Basic cleaning information..................................................................................................... 19
14.2 Mattress and cover disinfection ............................................................................................. 19
14.3 Power unit disinfection...........................................................................................................20
14.4 Cover laundering ...................................................................................................................20
15. Storage .......................................................................................................................................... 20

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16. Service and Maintenance ..............................................................................................................21
16.1 General ..................................................................................................................................21
16.2 Fuse replacement ..................................................................................................................21
16.3 Air filter replacement..............................................................................................................21
17. EMC Information ............................................................................................................................22

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1. Introduction
This User Manual contains instructions for the installation, use and maintenance of the Ultimate
Healthcare Heritage II Bariatric dynamic mattress replacement system. You must read and fully
understand this manual before using the system.
Caution: Ultimate Healthcare shall not be liable for any damage or injury caused by
failure to follow the proper instructions as described in this User Manual.
Caution: Before using the dynamic mattress replacement system all staff must
familiarise themselves thoroughly with the various parts and controls as detailed in
this User Manual.
Note: Ultimate Healthcare reserves the right to modify the information in this User Manual at any time.
The information in this User Manual may vary slightly with respect to the basic design of the product.
2. Intended Use
The intended use of this product is to prevent and/or manage pressure ulcers while optimising comfort
for larger patients who weight up to 350kg / 55 stone.
2.1 Contraindications
The mattress is not intended to be used by anyone under 12 years of age.
The mattress is not suitable for use on patients with unstable fractures.
The mattress is not intended for use by patients with a BMI (Body Mass Index) of less than
30.
3. About the Product
The Heritage II Bariatric dynamic mattress replacement provides optimal care for patients weighing up
to 350kg / 55 stone. With a 1200mm width surface and comfort control features the Heritage II
Bariatric provides comfortable care options for larger patients considered to be at High to Very High
Risk of pressure damage.
At 1200mm wide the Heritage II Bariatric features a full width deep 8” alternating cell design to
provide optimum support and pressure care for larger patients. Automatic features optimise pressure
area care and patient protection whilst reducing the burden on nursing staff.
Features such as the Backrest feature automatically adjust internal cell pressures to match the
patient’s weight and position ensuring that they receive optimised care.
Powered by a dual compressor the system is able to provide a range of therapies and care for the
larger patient. An active 2-cell cycle Dynamic mode provides pressure redistribution for the
prevention and treatment of pressure ulcers. Constant Low Pressure mode allows the mattress to

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conform closely a patient’s body and redistribute body weight over a wider area; this greater patient
immersion delivers optimum constant levels of pressure redistribution.
Mattress Replacement
Power Unit
CPR Tag
Cable Management Fixings
Air Pipe Connector
3 x Static Head Cells (TPU)
11 x Standard Cells (TPU)
Removable Cover
4 x Smaller Lower Legs Cells (TPU)
1 x Standard Cell (TPU)
Knitted Cell Retention Bands
FOOT END
HEAD END
Air Pipe
Connection Point
ON/OFF Switch
Carry Handle
Swing Out
Hanging Hooks
Control Panel
Power Connection

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4. Symbols and Statements
Note: Indicates tips and advice for the correct use of this product.
Caution: Indicates correct operating or maintenance procedures in order to
prevent damage to or destruction of the product or other property.
Warning: Indicates potential danger that requires correct procedures or practises
in order to prevent personal injury.
BF symbol, indicates this product is according to degree of protection against
electric shock for type BF equipment
The operator must read this document (User Manual) before use.
IP21
Water and dust protection classification.
Disposal of electrical and electronic equipment (WEEE): This product should be
handed over to an applicable collection point for the recycling of electrical and
electronic equipment.
0086
CE certified.

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5. Important Safety Information
Please read all instructions prior to using any Ultimate Healthcare supplied product. The Heritage II
Bariatric dynamic mattress replacement system must be used in accordance with this User Manual.
The mattress must only be operated by personnel who have been properly trained or have
suitable experience with products of this nature.
Ensure a clinical Risk Assessment is conducted, which should take account of the suitability of
use of this product, patient’s condition, any ancillary equipment in use and the surrounding
environment. This should include assessing the use of side rails, head and footboards etc.
Pressure settings should be advised or prescribed by a medical practitioner.
Only personnel trained or formally approved by Ultimate Healthcare in operation and
maintenance of Ultimate Healthcare products may perform maintenance; modification or repair
work on any Ultimate Healthcare supplied product.
Ensure the power cable is not trapped or twisted and is routed suitably to avoid crushing or
entrapment when connected to the product.
Do not use your mattress system power unit in the presence of flammable gases. This excludes
oxygen cylinders.
Avoid hazards caused by inappropriate handling of the power cable e.g. by kinking, shearing or
other mechanical damages.
The power cable for this product must be unplugged from the mains power outlet socket and
suitably stowed before moving, cleaning or maintenance activities.
Do not secure mattress straps to removable head or footboards or any fixed (non-moving) parts
of a profiling bedframe.
Disconnect from mains (power supply) before cleaning the power unit.
When cleaning do not immerse the power unit in water.
Use only the cleaning and disinfectant agents recommended in this User Manual.
When connecting product after transportation or storage, inspect the power cable visually for any
signs of damage. If evident, do not use product and contact Ultimate Healthcare or your local
distributor for repair.
When storing, ensure the product is stored away from direct sunlight and extreme cold conditions.
Never block the air openings of this product or place it on a soft surface, such as a bed or couch,
where their openings may be blocked. Keep the air opening free of lint, hair, and other similar
particles. Air ventilation through the power unit is vital for correct and safe operation.
If this product is used for any activity other than detailed within this User Manual then personal
risk to the end user or patient may occur. Ultimate Healthcare shall not be held liable/responsible
for such an event.
Do not smoke, or allow the patient to smoke when using this product. Keep all possible ignition
sources clear of this product

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6. Technical Specification
6.2 Power unit
Dimensions:
130mm x 360mm x 230mm (D x W X H)
Weight:
4.6 kg
Alternating cycle time:
10 / 15 / 20 / 25 / 30 mins
Output pressure range:
25 to 60mmHg (+/-2)
Power supply:
AC 230V 50 Hz
Current:
0.12 A
Classification:
Class II, Type BF
Warranty:
2 years
Operation environment:
50C to 400C 15%RH ~ 93%RH (no condensation)
Storage environment:
-25℃~70℃≦93%RH (no condensation)
Environment pressure:
70 kPa-101.3 kPa
Water & dust protection
classification:
IP21
6.3 Mattress
Dimensions:
2000mm x 1200mm x 200mm (L x W X H)
Weight:
10.9 kg
No of cells:
19
Cover material:
1 way stretch polyester with PU Coated
Bottom material:
PU coated polyester
Max user weight:
350 kg / 55 stone

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7. Installation and Set-Up
7.1 Setting up mattress
For the comfort and safety of the patient do not put them onto the mattress until you are sure that the
mattress is properly secured and the system indicates that it is fully inflated. The mattress is designed
to completely replace any existing mattress which may be in use on a bed.
Remove any existing mattress and ensure that there are no protruding parts or sharp objects on the
bed which could cause damage to the mattress. Lay the mattress on the bed patient surface ensuring
that the air pipe connector is situated on the bottom left hand side of the bed foot end (as viewed from
the foot of the bed).
There are security straps fitted to the base cover of the mattress which should be fastened loosely to
convenient points on the bedframe patient surface.
Caution: Ensure when fixing the mattress to the bed the security straps are only
fitted to the moving parts of the mattress platform. Straps secured to the fixed parts
of the mattress platform will damage the bed/mattress when operated.
7.2 Setting up power unit
Whilst holding the power unit, unfold the hanging hooks on the rear of the power unit and hang it from
the beds footboard. If required the power unit can be placed on the floor at the foot of the bed.
Caution: Ensure that the power cable is routed in such a manner so that it cannot
be twisted, trapped, crushed or stressed.
Pump Unit
Mattress
CPR Tag
Air Pipe Connector
FOOT END
HEAD END

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7.3 Cable management system
Cable management fixings are located on each side of the mattress underneath the flap of the cover.
The mains power cable should be secured through the cable management fixing as follows:
Locate each cable management fixing.
If necessary, open the press studs.
Run the mains power cable along the side of the mattress securing each fixing loop around
the cable using the press studs.
7.4 Connecting mattress to the power unit
Remove the cover of the air pipe connector and connect the air
pipe connector to the power unit and then ensure that the air tubes
are free from any kind of obstruction, and are not kinked.
Plug the power cable into a suitable electrical socket and switch
‘ON’ using mains power switch found at the side of the power unit.
All indicators on the control panel will light up. The Standby
indicator on the control panel will light up.
Push the Operate button and the system will start inflation and the
Auto-Firm indicator will flash.
Once the mattress is fully inflated, you can then set the mattress to
the appropriate setting suitable for the patient.
Caution: The power unit must only be connected to the mattress recommended by
the manufacturer. Do not use it for any other purpose.
Note: Ensure that the CPR valve is in the closed position.

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8 Control Panel Operation Guide
The Control Panel of the power unit is used to make adjustments to the mattress and also indicates
fault conditions/service requirements. These are either visual (indicator lights) or audible.
When the incorrect button is pressed a buzzer will sound to indicated that the pump is responsive.
1
Auto detection
6
Auto-Firm & Indicator
2
Comfort Control Buttons
7
Operate / Standby Button & Indicators
3
Comfort Setting Indicators
8
Cycle Time Selection Button (Alternate)
4
Control Panel Lockout Button & Indicator
9
Cycle Time/ warning code display
5
Function Mode Selection Button
Alternate, Static and constant low pressure (CLP)
10
Alarm Mute Button & Indicators
8.1 Operate / standby
Press the Operate / Standby button to turn the power unit ON. Press again to turn
OFF/Standby the power unit.
Note: The power switch on the side of the power unit must be turned ON.
8
9
2
3
10
1
4
5
6
7

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8.2 Comfort level
The Soft and Firm buttons allow carers to adjust pressures within a safe pre-set range
to provide patients with enhanced comfort or support whilst maintaining a very good
level of protection and therapy. Qualified clinical advice must always be taken before
adjusting mattress pressures.
The required pressure is selected using the Soft and Firm buttons to move the pressure
by one step at a time.
When pressing the Firm button, the output pressure will increase to provide a higher
pressure output and thus increased support.
When pressing the Soft button, the output pressure will be decreased to provider a
lower pressure output and thus increased comfort.
To check if the pressure is adequately supporting the patient, slide one hand between
the air mattress and bed frame to feel under the patient’s bottom. You should be able to
slide the hand in-between and an acceptable range is approximately 25 to 40 mm (1” to
1-1/2”) to ensure the patient Is not bottoming out.
8.3 Auto-detection
Simultaneously pressing the Soft and Firm buttons on the control panel will
activate Auto-Detection. Once activated the indicator will flash and the
system will start detecting and will set the internal pressure for the
appropriately. The indicator light will flash until the patient’s weight and
position has been detected then the light will extinguish. Auto-Detection
sets the internal pressure for the patient so there is no requirement to input
the patient’s weight, the internal pressure setting will vary slightly depending
on BMI. For example if you had two people weighting 65kg one tall and thin
the other shorter and thicker set, the first patient may auto-detect to 50kg
whilst the second to 75kg, this is due the difference in their BMI. The Auto-
Detection will repeat every 2 hours to allow the system to adjust the
pressure according to the patient’s position.
To turn off the Auto-Detection simply press the Soft and Firm buttons
again simultaneously.
8.4 Control panel lockout
If the control panel is not used for a period of 30 seconds it will lock out and inhibit the
use of the functions. Additionally, if you wish to lock out the control panel press the Lock
Out button, the button will flash and all functions will be locked. This is to prevent the
system being altered accidently.
In order to unlock the control panel, simply press and hold the Lock Out button for 3
seconds, the control panel will now be active for use.
+

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8.5 Function mode switch
8.5.1 Alternate
Alternating mode is the default mode for the system. Within this mode the mattress will
operate in an alternating 1-in-2 cell cycle. The alternating cycle will continue at the
selected cycle time until another mode is selected.
8.5.2 Static
Pressing the Function Mode Selection button until the Static indicator illuminates puts
the system into Static mode.
Within this mode the mattress will maintain a selected constant pressure. After 30
minutes the system will automatically revert back to Alternating mode.
8.5.3 Constant Low Pressure (CLP)
Pressing the Function Mode Selection button until the CLP indicator illuminates puts
the system into Constant Low Pressure (CLP) mode.
Within this mode the internal cell pressures within the mattress will be reduced by 50%
and the mattress will provide a comfortable static surface.
8.6 Auto-Firm
Auto-Firm mode can be selected by pressing the Auto-Firm button. In this mode all cells
inflate to a single pressure setting to provide a firm and stable surface for nursing
procedures or for patient ingress/egress. The system will automatically return to
Alternating mode at the previously selected comfort level after 20 minutes.
8.7 Alternate cycle time selection
The alternating cycle times can be selected to provide an individualised care program for
each patient.
Within Alternating mode the alternating cycle time can be selected by pressing the
Cycle button. Selections can be made from 10-30 minutes at 5 minute intervals. The
cycle time will be displayed in the LCD screen.
8.8 Alarm mute
The Alarm Mute button temporarily resets the audible Low Pressure/Power
Failure/Service alarms. Should the situation not be resolved and the fault condition
continues the alarm will resume notifying carer.

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9 Backrest Mode
If the backrest on the bed is raised, with the patient in a semi-recumbent position, the system detects
the new position and automatically adjusts internal cell pressures to provide optimal pressure
redistribution and additional support.
When the backrest is lowered the system detects this and automatically adjusts internal cell pressures
to return to the previous setting.
10 CPR Mode
CPR (Cardio Pulmonary Resuscitation) can be performed using the
red CPR valve which is situated at the head end on the left hand
side of the mattress.
For rapid deflation gently pull and rotate the dial of the CPR valve
to ‘click’ into the OPEN position. At the same time, disconnect the
air pipe connector from the power unit to speed up the air
release.
If re-inflating the mattress, ensure the dial of the CPR attachment
is rotated until it ‘clicks’ into the CLOSED position.
11 Transport Mode
If the patient is being moved on the mattress, or there is a power cut,
general pressure can be maintained in the system for an adequate period
of time whilst disconnected from the mains.
Simply disconnect air pipe connector and place the connector cover over it.
The air pressures in the mattress will now equalise, but maintain a degree
of comfort. This will maintain the cells in their present state for
approximately 48 hours.
It is important to restore the Heritage II Bariatric mattress as quickly as
possible by reconnecting the supply tubes to the power unit.
Pull out and
rotate for CPR

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12 Alarms & Fault Findings
The Heritage II Bariatric is equipped with audible and visual alarm indicators. These alert the user to
the status of the available mains supply and any mattress defect.
12.1 Low pressure alarm
Upon detection of low pressure, an audible alarm will be heard and the Low Pressure indicator will
illuminate. The audible alarm may be cancelled by pressing the Alarm Mute button. The Low
Pressure indicator will continuously illuminate until the low pressure fault condition is resolved.
This condition could be caused, for example, by incorrect fitting of the air pipe connector, opening of
the CPR valve or a leak in the mattress due to a cut or puncture.
12.2 Power failure alarm
If at any time the mains power should be removed from the power unit or the power cable is
unplugged without turning the power unit OFF, an audible alarm will be heard and the Power Failure
indicator will illuminate. The audible alarm may be cancelled by pressing the Alarm Mute button.
Note: When the power unit has not been used for more than 3 months, it might
require 60 minutes operating time (or more) for the Alarm to function correctly.
12.3 Service (alternating failure alarm)
Should your system develop a fault condition whilst in use, an audible alarm will be heard and the
Service indicator will illuminate. Please refer to Table 1 for error codes and call Ultimate Healthcare or
your local distributor.
12.4 Annual Service Indicator
A dedicated Annual Service indicator on the control panel will illuminate and stay ON to alert nursing
staff of the need for the system to be professionally serviced.
The Annual Service indicator will illuminate after 365 days of use and the indicator light can only be
extinguished by a professional service technician once the required service has been conducted.

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Table 1: Alert/Error Code Reference Table
Priority
High
↓
Low
Warning
Code
Indicator
LED
Audible
Output Mode
Condition of
Output
Warning Description
Remarks
0
N/A
N/A
ONCE
Not in System
Shutdown
Key Tone
Key Tone from
Functional Button
1
Power
Failure
ONCE
Power-Off
System Shutdown
Shutdown
2
ALL LED
ONCE
Operate or
Standby
Power-On
All Indicators
Light On
3
N/A
N/A
ONCE
Operate or
Standby
State / Mode
Switching
No Display
4
Auto-Firm
ONCE
Operate
Mattress Inflation
Completion
Inflation Ended
5
Auto-Firm
ONCE
Operate
Auto-Firm Completion
Auto-Firm Ended
6
Static
ONCE
Operate
Static Completion
Static Ended
7
N/A
Power
Failure
REPEAT
(Cycle 4 sec.)
Power-Off
Power Failure Alarm
No Display
8
Low
Pressure
REPEAT
(Cycle 4 sec)
Operate or
Standby
Power-On Inflation
Failure Alarm
Inflate Failure
9
Low
Pressure
REPEAT
(Cycle 4 sec)
Operate or
Standby
Auto-Firm
Failure Alarm
Auto-Firm Failure
10
Low
Pressure
REPEAT
(Cycle 4 sec)
Operate or
Standby
Low Pressure
Overtime Alarm
Low Pressure
11
Service
REPEAT
(Cycle 4.5 sec)
Operate or
Standby
High Pressure
Overtime Alarm
High Pressure
12
Service
REPEAT
(Cycle 4.5 sec)
Operate or
Standby
High Ambient
Temperature Alarm
High Temperature
13
Service
REPEAT
(Cycle 4.5 sec)
Operate or
Standby
Air Valve 1 Positioning
Failure Alarm
Air Valve 1 failure
14
Service
REPEAT
(Cycle 4.5 sec)
Operate or
Standby
Air Valve 2 Positioning
Failure Alarm
Air Valve 2 failure
15
Service
REPEAT
(Cycle 15 sec)
Operate or
Standby
Battery Low Alarm
Battery would need
to be replaced
16
NONE
NONE
Factory
Calibration
Mode
Calibration Not
Completed
Calibration
Unfinished
17
NONE
NONE
Factory
Calibration
Mode
Calibration
Completed
Calibration
Completed

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13 Troubleshooting
PROBLEM
SOLUTION
No lights on power unit
Check the power unit is connected to the mains power
supply and that the mains switch is turned ON.
Check power unit for any blown fuses.
Low Pressure indicator is flashing
and sounding
Check to ensure that the CPR tag is securely fitted in
place.
Check whether power was suddenly shut down.
Check that the connection between air tube and power
unit is tightly secured.
Check that all tubing connections along the mattress
are secured.
If all of above steps have been checked. Press “Alarm
Mute” for system to be verified again.
Power Failure Alarm Indicator is
flashing and sounding
Check the power unit is connected to the mains power
supply and that the mains switch is turned ON.
Patient is bottoming out (without
alarm being triggered)
Pressure setting might be inadequate for the patient,
adjust comfort level to Firm and wait for a few minutes
for a better comfort.
Power unit is noisy
Ensure that the power unit is resting against a solid
surface.
Service indicator remains
illuminated
Indicates that system is scheduled for an annual
service. Please contact Ultimate Healthcare or your
local dealer to arrange.
If the problem persists, contact Ultimate Healthcare or your local service provider.

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14 Cleaning and Decontamination
The following processes are recommended, but should be adapted to comply with the local or
national guidelines (Decontamination of Medical Devices) which may apply within the Healthcare
Facility of use.
The Heritage II Bariatric system should be routinely decontaminated between patients and at regular
intervals while in use; as is good practice for all reusable medical devices.
Warning: Disconnect the power unit from the electricity supply before carrying out
cleaning/decontamination procedures.
Do not immerse or soak power unit.
14.1 Basic cleaning information
Caution: Only use disinfectants designed for cleaning healthcare equipment i.e.
Sodium Hypochlorite or similar (up to 10,000 ppm available chlorine).
Caution: Do not use abrasives (scouring powder), scourers or other
materials/agents which could damage the mattress system.
Caution: Do not use hyper carbonate or phenol based solutions.
Caution: Do not immerse the power unit in water.
Caution: When cleaning/disinfecting, ensure that only a damp cloth is used.
Caution: After cleaning, dry the mattress out of direct exposure to sunlight.
Caution: Using inappropriate detergents or disinfectants and not observing the
manufacturer’s guidelines may result in damage to the mattress which Ultimate
Healthcare cannot be held liable for.
Caution: The appropriate qualified staff must be consulted when specifying a
suitable cleaning fluid. Ultimate Healthcare shall not be liable for any damages
caused by the use of inappropriate detergents or disinfectants.
14.2 Mattress and cover disinfection
The Heritage II Bariatric mattress, mattress cover and air pipe cover can be cleaned using the
following simple procedures in accordance with your Local Infection Control Policy:
Liberally swabbing with a damp cloth pre-soaked with hot water at 60°C containing detergent,
and then drying.
Swabbing with a solution of sodium hypochlorite (up to 10,000 parts per million available
chlorine) and then drying.
Caution: Frequent or prolonged exposure to higher concentration disinfectant
solutions may prematurely age the fabric cover of mattresses. Surfaces must be
protected during use and rinsed and thoroughly dried after application of a
disinfectant.

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14.3 Power unit disinfection
The power unit can be cleaned by wiping down with a cloth dampened with hot water at 600C
containing detergent or with sodium hypochlorite (up to 10,000 parts per million available chlorine).
14.4 Cover laundering
The mattress cover and air pipe cover can also be machine washed. Mattress covers and air pipe
cover should be completely removed prior to laundering.
Where required mattress covers can be laundered in a pre-wash at 600C for up to 15 minutes and in a
main wash at 600C for up to 15 minutes. This should be followed by a cold rinse and extraction.
However it is recommended that you check your local policy to determine the time/temperature ratio
required to achieve thermal disinfection.
Mattress covers may be tumble dried or air dried. They may be tumble dried on a low heat for up to
90 minutes. Drying temperature must not exceed 400C.
The mattress cover and mattress must be dry prior to refitting.
Caution: Exceeding the temperature can cause significant damage to the mattress
cover.
15 Storage
The mattress should be loosely rolled lengthwise with the cover innermost, taking care not to strain
the air pipe. It should then be placed in in a suitable protective cover with the power unit and stored in
an area appropriate for electronic medical devices.
To quickly extract air out from mattress for storage, pull the CPR tag to remove the CPR
plugs and disconnect the air hose connector to release the air.
Lay the mattress out flat.
Roll from the head end towards the foot end.
The foot end strap can then be stretched around the rolled mattress to prevent unrolling.
The power cord could be wrapped around the power unit bumper or disconnected for storage.
Caution: Do not fold, crease or stack mattresses