Welch Allyn Schiller AT-2plus User manual

i
i
AT-2plus
Spiro Option
AT-2plus
Spiro Option
Schiller Menu
Manuals

ii
ii
AT-2plus Spiro Option User Guide
Article Number 2. 510339wa
Welch Allyn Inc.
7420 Carroll Road
San Diego, CA 92121
Phone: [phone]
Fax: [phone]
www.welchallyn.com
United Kingdom: Canada:
Welch Allyn UK Ltd Welch Allyn Canada Ltd
Cubblington Road 160 Matheson Blvd. East, Unit #2
Aston Abbotts HP22 4ND Mississauga, Ontario L4Z 1V4
United Kingdom Canada
Tel: [phone] Tel: [phone]
Fax: [phone] Fax: [phone]
Copyright © 1999 by Welch Allyn Schiller
AT-2plus Spiro Option User Guide
Article Number 2. 510339wa
Welch Allyn Inc.
7420 Carroll Road
San Diego, CA 92121
Phone: [phone]
Fax: [phone]
www.welchallyn.com
United Kingdom: Canada:
Welch Allyn UK Ltd Welch Allyn Canada Ltd
Cubblington Road 160 Matheson Blvd. East, Unit #2
Aston Abbotts HP22 4ND Mississauga, Ontario L4Z 1V4
United Kingdom Canada
Tel: [phone] Tel: [phone]
Fax: [phone] Fax: [phone]
Copyright © 1999 by Welch Allyn Schiller

iii
iii
Disclaimer
The Information in this guide has been carefully checked for reliability; however no guarantee is given as to the correctness of the
contents and WELCH ALLYN SCHILLER makes no representations or warranties regarding the contents of this manual. We reserve
the right to revise this document and make changes in the specification of the product described within at any time without obligation
to notify any person of such revision or change.
Trademarks
WELCH ALLYN SCHILLER and AT-2plus are registered trademarks of WELCH ALLYN SCHILLER. All trademarks are the
property of their owners.
Copyright Notice
© Copyright 1999 by WELCH ALLYN SCHILLER. All rights reserved. You may not reproduce, transmit, transcribe, store in a
retrieval system or translate into any language, in any form or by any means, electronic, mechanical, magnetic, optical, chemical,
manual or otherwise, any part of this publication without express written permission of WELCH ALLYN SCHILLER.
Terms of Warranty
WELCHALLYN SCHILLER warrants the AT-2plus Electrocardiograph, when new, to be free of defects in material and workmanship
and to perform in accordance with manufacturer`s specifications for the period of three (3) years from the date of purchase from
Welch Allyn or it`s authorized distributors or agents. Accessory items such as electrodes, batteries and cables are limited to a
warranty of 90 days from the date of purchase from Welch Allyn or its authorized distributors or agents. Welch Allyn will repair
or replace any components found to be defective or at variance from manufacturer`s specifications within this time at no cost to the
customer. It shall be the purchasers responsibility to return the instrument to Welch Allyn or an authorized distributer, agent or service
representative. This warranty does not include breakage or failure due to tampering, misuse, neglect, accidents, modifications or
shipping. This warranty is also void if the instrument is not used in accordance with manufacturer`s recommendations or if repaired
by other than Welch Allyn or an authorized agent. Purchase date determines warranty requirements. No other express warranty
is given.
Disclaimer
The Information in this guide has been carefully checked for reliability; however no guarantee is given as to the correctness of the
contents and WELCH ALLYN SCHILLER makes no representations or warranties regarding the contents of this manual. We reserve
the right to revise this document and make changes in the specification of the product described within at any time without obligation
to notify any person of such revision or change.
Trademarks
WELCH ALLYN SCHILLER and AT-2plus are registered trademarks of WELCH ALLYN SCHILLER. All trademarks are the
property of their owners.
Copyright Notice
© Copyright 1999 by WELCH ALLYN SCHILLER. All rights reserved. You may not reproduce, transmit, transcribe, store in a
retrieval system or translate into any language, in any form or by any means, electronic, mechanical, magnetic, optical, chemical,
manual or otherwise, any part of this publication without express written permission of WELCH ALLYN SCHILLER.
Terms of Warranty
WELCHALLYN SCHILLER warrants the AT-2plus Electrocardiograph, when new, to be free of defects in material and workmanship
and to perform in accordance with manufacturer`s specifications for the period of three (3) years from the date of purchase from
Welch Allyn or it`s authorized distributors or agents. Accessory items such as electrodes, batteries and cables are limited to a
warranty of 90 days from the date of purchase from Welch Allyn or its authorized distributors or agents. Welch Allyn will repair
or replace any components found to be defective or at variance from manufacturer`s specifications within this time at no cost to the
customer. It shall be the purchasers responsibility to return the instrument to Welch Allyn or an authorized distributer, agent or service
representative. This warranty does not include breakage or failure due to tampering, misuse, neglect, accidents, modifications or
shipping. This warranty is also void if the instrument is not used in accordance with manufacturer`s recommendations or if repaired
by other than Welch Allyn or an authorized agent. Purchase date determines warranty requirements. No other express warranty
is given.

iv
iv
This equipment has been tested and found to comply with the limits for a class A digital device, pursuant to both Part
15 of the FCC (Federal Communications Commision) Rules and the radio interference regulations of the Canadian
DepartmentofCommunications.Theselimitsaredesignedtoprovidereasonableprotectionagainstharmfulinterference
when the equipment is operated in a commercial environment. This equipment generates, uses and can radiate radio
frequency energy and, if not installed and used in accordance with this instruction manual, may cause harmful
interference to radio communications. Operation of this equipment in a residential area is likely to cause harmful
interference in which case the user will be required to correct the interference at his own expense.
DisposalInstructions
andBatteryCare
ÆÊ
ÇÃ
°DO NOT DISPOSE OF THE BATTERYBY FIRE OR INCINERATOR -
DANGER OF EXPLOSION
°DO NOT ATTEMPT TO RECHARGE THE BATTERY- DANGER OF
EXPLOSION
°DO NOT OPEN THE BATTERYCASING - DANGER OF ACID BURN
Only dispose of the battery in official recycling centres or municipally approved
areas. Alternatively used batteries can be returned to Schiller AG for disposal.
UnitDisposal Instructions
Unitsnolongerrequiredcan be returned to Schiller AG for disposal.Alternatively
dispose of the unit in municipally approved recycling centres.
This equipment has been tested and found to comply with the limits for a class A digital device, pursuant to both Part
15 of the FCC (Federal Communications Commision) Rules and the radio interference regulations of the Canadian
DepartmentofCommunications.Theselimitsaredesignedtoprovidereasonableprotectionagainstharmfulinterference
when the equipment is operated in a commercial environment. This equipment generates, uses and can radiate radio
frequency energy and, if not installed and used in accordance with this instruction manual, may cause harmful
interference to radio communications. Operation of this equipment in a residential area is likely to cause harmful
interference in which case the user will be required to correct the interference at his own expense.
DisposalInstructions
andBatteryCare
ÆÊ
ÇÃ
°DO NOT DISPOSE OF THE BATTERYBY FIRE OR INCINERATOR -
DANGER OF EXPLOSION
°DO NOT ATTEMPT TO RECHARGE THE BATTERY- DANGER OF
EXPLOSION
°DO NOT OPEN THE BATTERYCASING - DANGER OF ACID BURN
Only dispose of the battery in official recycling centres or municipally approved
areas. Alternatively used batteries can be returned to Schiller AG for disposal.
UnitDisposal Instructions
Unitsnolongerrequiredcan be returned to Schiller AG for disposal.Alternatively
dispose of the unit in municipally approved recycling centres.

v
v
Power Supply
The mains connection is on the rear of the unit.
The power supply voltage is set by the factory for100-115V(nom. 110V) or 220-240V
(nom. 230V) working. The setting is indicated by the indented metal strip on the fuse
panel. Contact your dealer if the voltage needs to be changed.
The mains indicator lamp on the keyboard is always lit when the unit is connected to the mains
supply. The unit can either be operated from the mains supply or from the built-in recharge-
able battery. The power source is indicted on the top line of the LCD.
Changing a Mains Fuse
If it is necessary to change a fuse, always replace with the correct rating i.e 2x200mAT
for 230V, or 2x315mAT for 110V .
To change a fuse press the two retaining lugs on side of the fuse panel (situated below the mains
connector on the back panel. Remove the fuse panel and replace the fuse(s). Click back the fuse
panel.
Power Supply
The mains connection is on the rear of the unit.
The power supply voltage is set by the factory for100-115V(nom. 110V) or 220-240V
(nom. 230V) working. The setting is indicated by the indented metal strip on the fuse
panel. Contact your dealer if the voltage needs to be changed.
The mains indicator lamp on the keyboard is always lit when the unit is connected to the mains
supply. The unit can either be operated from the mains supply or from the built-in recharge-
able battery. The power source is indicted on the top line of the LCD.
Changing a Mains Fuse
If it is necessary to change a fuse, always replace with the correct rating i.e 2x200mAT
for 230V, or 2x315mAT for 110V .
To change a fuse press the two retaining lugs on side of the fuse panel (situated below the mains
connector on the back panel. Remove the fuse panel and replace the fuse(s). Click back the fuse
panel.

vi
vi
PHYSICIAN‘S RESPONSIBILITY
THE AT-2PLUS AND SP-250 SENSORARE PROVIDED FOR THE EXCLUSIVE USE
OF QUALIFIED PHYSICIANS OR PERSONNEL UNDER THEIR DIRECT
SUPERVISION. THE NUMERICAL AND GRAPHICAL RESULTS FROM A
RECORDING MUST BE EXAMINED WITH RESPECT TO THE PATIENTS
OVERALL CLINICAL CONDITION. THE RECORDING PREPARATION QUALITY
AND THE GENERAL RECORDED DATAQUALITY, WHICH COULD EFFECT THE
REPORTDATAACCURACY, MUST ALSO BE TAKEN INTO ACCOUNT.
IT IS THE PHYSICIANS RESPONSIBILITY TO MAKE THE DIAGNOSIS OR TO
OBTAIN EXPERTOPINION ON THE RESULTS, AND TO INSTITUTE CORRECT
TREATMENT IF INDICATED.
FEDERAL LAWIN THE USA RESTRICTS THIS DEVICE TO SALE BY OR ON THE
ORDER OF APHYSICIAN
PHYSICIAN‘S RESPONSIBILITY
THEAT-2PLUS AND THE SP-250 SENSOR ARE PROVIDED FOR THE EXCLUSIVE
USE OF QUALIFIED PHYSICIANS OR PERSONNEL UNDER THEIR DIRECT
SUPERVISION. THE NUMERICAL AND GRAPHICAL RESULTS FROM A
RECORDING MUST BE EXAMINED WITH RESPECT TO THE PATIENTS
OVERALL CLINICAL CONDITION. THE RECORDING PREPARATION QUALITY
AND THE GENERAL RECORDED DATAQUALITY, WHICH COULD EFFECT THE
REPORTDATAACCURACY, MUST ALSO BE TAKEN INTO ACCOUNT.
IT IS THE PHYSICIANS RESPONSIBILITY TO MAKE THE DIAGNOSIS OR TO
OBTAIN EXPERTOPINION ON THE RESULTS, AND TO INSTITUTE CORRECT
TREATMENT IF INDICATED.
FEDERAL LAWIN THE USA RESTRICTS THIS DEVICE TO SALE BY OR ON THE
ORDER OF APHYSICIAN

vii
vii
Safety Notices
TO PREVENT ELECTRIC SHOCK DO NOT DISASSEMBLE THE UNIT. NO SERVICEABLE PARTS INSIDE. REFER SERVICING
TO QUALIFIED PERSONNEL ONLY.
DO NOT USE THIS UNIT IN AREAS WHERE THERE IS ANY DANGER OF EXPLOSION OR THE PRESENCE OF FLAMMABLE
GASES SUCH AS ANAESTHETIC AGENTS.
THIS PRODUCT IS NOT DESIGNED FOR STERILE USE.
THIS PRODUCT IS NOT DESIGNED FOR OUTDOOR USE.
SWITCH THE UNIT OFF BEFORE CLEANING AND DISCONNECT FROM THE MAINS.
DO NOT, UNDER ANY CIRCUMSTANCES, IMMERSE THE UNIT OR CABLE ASSEMBLIES IN LIQUID.
THE DEVICE MUST ONLYBE OPERATED USING BATTERYPOWER IF THE EARTH CONNECTION IS SUSPECT OR IF
THE MAINS LEAD IS DAMAGED OR SUSPECTED OF BEING DAMAGED.
DO NOT USE HIGH TEMPERATURE STERILISATION PROCESSES (SUCH AS AUTOCLAVING). DO NOT USE E-BEAM OR
GAMMA RADIATION STERILISATION.
DO NOT USE SOLVENT CLEANERS
USE ONLYACCESSORIES AND OTHER PARTS RECOMMENDED OR SUPPLIED BY SCHILLER. USE OF OTHER THAN
RECOMMENDED OR SUPPLIED PARTS MAYRESULTIN INJURYINACCURATE INFORMATION AND/ OR DAMAGE TO
THE UNIT.
THE AT-2PLUS AND THE SP-250 SENSOR COMPLYWITH EMC REGULATIONS FOR MEDICAL PRODUCTS WHICH
AFFORDS PROTECTION AGAINST EMISSIONS AND ELECTRICAL INTERFERENCE. HOWEVER SPECIAL CARE MUST
BE EXERCISED WHEN THE UNIT IS USED WITH HIGH FREQUENCY EQUIPMENT.
IT MUST BE ENSURED THATNEITHER THE PATIENT NOR THE ELECTRODES (INCLUDING THE NEUTRAL
ELECTRODE) COME INTO CONTACT WITH OTHER PERSONS OR CONDUCTING OBJECTS (EVEN IF THESE ARE
EARTHED).
THIS UNIT IS BF CLASSIFIED ACCORDING TO IEC 601-1.
IF SEVERAL UNITS ARE COUPLED THERE IS ADANGER OF SUMMATION OF LEAKAGE CURRENT
THE DISPOSABLE MOUTHPIECE IS DESIGNED FOR ONE-TIME USE TO ELIMINATE THE DANGER OF CROSS
CONTAMINATION - DO NOT USE THE MOUTHPIECE FOR MORE THAN ONE PATIENT.
Safety Notices
TO PREVENT ELECTRIC SHOCK DO NOT DISASSEMBLE THE UNIT. NO SERVICEABLE PARTS INSIDE. REFER SERVICING
TO QUALIFIED PERSONNEL ONLY.
DO NOT USE THIS UNIT IN AREAS WHERE THERE IS ANY DANGER OF EXPLOSION OR THE PRESENCE OF FLAMMABLE
GASES SUCH AS ANAESTHETIC AGENTS.
THIS PRODUCT IS NOT DESIGNED FOR STERILE USE.
THIS PRODUCT IS NOT DESIGNED FOR OUTDOOR USE.
SWITCH THE UNIT OFF BEFORE CLEANING AND DISCONNECT FROM THE MAINS.
DO NOT, UNDER ANY CIRCUMSTANCES, IMMERSE THE UNIT OR CABLE ASSEMBLIES IN LIQUID.
THE DEVICE MUST ONLYBE OPERATED USING BATTERYPOWER IF THE EARTH CONNECTION IS SUSPECT OR IF
THE MAINS LEAD IS DAMAGED OR SUSPECTED OF BEING DAMAGED.
DO NOT USE HIGH TEMPERATURE STERILISATION PROCESSES (SUCH AS AUTOCLAVING). DO NOT USE E-BEAM OR
GAMMA RADIATION STERILISATION.
DO NOT USE SOLVENT CLEANERS
USE ONLYACCESSORIES AND OTHER PARTS RECOMMENDED OR SUPPLIED BY SCHILLER. USE OF OTHER THAN
RECOMMENDED OR SUPPLIED PARTS MAYRESULTIN INJURYINACCURATE INFORMATION AND/ OR DAMAGE TO
THE UNIT.
THE AT-2PLUS AND THE SP-250 SENSOR COMPLYWITH EMC REGULATIONS FOR MEDICAL PRODUCTS WHICH
AFFORDS PROTECTION AGAINST EMISSIONS AND ELECTRICAL INTERFERENCE. HOWEVER SPECIAL CARE MUST
BE EXERCISED WHEN THE UNIT IS USED WITH HIGH FREQUENCY EQUIPMENT.
IT MUST BE ENSURED THATNEITHER THE PATIENT NOR THE ELECTRODES (INCLUDING THE NEUTRAL
ELECTRODE) COME INTO CONTACT WITH OTHER PERSONS OR CONDUCTING OBJECTS (EVEN IF THESE ARE
EARTHED).
THIS UNIT IS BF CLASSIFIED ACCORDING TO IEC 601-1.
IF SEVERAL UNITS ARE COUPLED THERE IS ADANGER OF SUMMATION OF LEAKAGE CURRENT
THE DISPOSABLE MOUTHPIECE IS DESIGNED FOR ONE-TIME USE TO ELIMINATE THE DANGER OF CROSS
CONTAMINATION - DO NOT USE THE MOUTHPIECE FOR MORE THAN ONE PATIENT.

viii
viii
Intended Use
TheAT-2plus with Spiro Option can be used to measure Forced Vital Capacity (FVC), Forced Expiratory
Volume in one second (FEV1), FEV1.0 / FVC, FEF0.2-1.2, FEF 25-75%, FEF 75-85% , PEF, FEF 25%, FEF 50%, FEF
75%, FIVC, FIV 1.0, FIV 1.0 / FIVC, PIF, FIF 50%, SVC, ERV, IRV, TV, MVV, MV, RR, TV, in patients 6 years
of age or older.
AT-2plus Spiro Option User`s Guide
This User`s Guide gives instructions on how to operate the Spirometry option of the AT-2plus and provides an
overview of all the basic functions in an easy and simple to use format. The procedures are presented in a logical,
step-by step way to enable the user to quickly and easily familiarise themselves with unit operation. Detailed
medical information is excluded from this guide except where necessary to operate the unit or understand the
results.
Intended Use
TheAT-2plus and the SP-250 sensor can be used to measure Forced Vital Capacity (FVC), Forced Expira-
tory Volume in one second (FEV1), FEV1.0 / FVC, FEF 0.2-1.2, FEF 25-75%, FEF 75-85% , PEF, FEF 25%, FEF50%,
FEF 75%, FIVC, FIV 1.0, FIV 1.0 / FIVC, PIF, FIF 50%, SVC, ERV, IRV, TV, MVV, MV, RR, TV, in patients 6
years of age or older.
AT-2plus Spiro Option User`s Guide
This User`s Guide gives instructions on how to operate the Spirometry option of the AT-2plus and provides an
overview of all the basic functions in an easy and simple to use format. The procedures are presented in a logical,
step-by step way to enable the user to quickly and easily familiarise themselves with unit operation. Detailed
medical information is excluded from this guide except where necessary to operate the unit or understand the
results.

ix
ix

x
x

AT-2plus User Guide Spirometry Supplement Page 1
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 1
Art. No. 2. 510339wa ©1999
Contents
CONTENTS --------------------------------------------------------------------- 1
INTRODUCTION ---------------------------------------------------------------- 2
PROCEDURE OVERVIEW ------------------------------------------------------ 3
Forced Vital Capacity (FVC) Test---------------------------------------------- 6
Slow Vital Capacity (SVC) Test ------------------------------------------------- 7
MVV Test ----------------------------------------------------------------------------- 7
MV Test ------------------------------------------------------------------------------- 7
Screen Information ---------------------------------------------------------------- 8
Post-Medication Tests ------------------------------------------------------------ 9
DEFINITION OF BEST ---------------------------------------------------------10
ENTERING PATIENT DATA---------------------------------------------------- 11
RACE INFLUENCES ON NORM VALUES ---------------------------------------14
PRINTOUT --------------------------------------------------------------------15
SPIRO SETTINGS -------------------------------------------------------------16
Printout Graph Setup - Spirometry ------------------------------------------16
Printout Graph Setup - Miscellaneous ---------------------------------------17
Normals ------------------------------------------------------------------------------18
Measurement/ Report setup ----------------------------------------------------19
American and Standard English -----------------------------------------------20
CALIBRATION ----------------------------------------------------------------21
Calibration Procedure ------------------------------------------------------------23
EXPLANATION OF MEASURED VALUES ---------------------------------------24
DIAGNOSIS -------------------------------------------------------------------26
Diagnosis Setting `International` --------------------------------------------- 26
Diagnosis Setting `American` --------------------------------------------------27
NORM VALUES ---------------------------------------------------------------28
Norm Values for Countries Outside the USA ------------------------------ 29
ECCSValues ------------------------------------------------------------------------- 29
Quanjer & Tammeling Comparisons -----------------------------------------30
Austrian Standard Values (österreich) ----------------------------------------31
Swedish Standards (Berglund) ---------------------------------------------------32
Finnish Standards ------------------------------------------------------------------33
Indian Equations -------------------------------------------------------------------34
NORM VALUES FOR USA AND CANADA ------------------------------------35
Morris Norm Values --------------------------------------------------------------35
Crapo Norm Values ---------------------------------------------------------------36
Morris and Crapo Norm Values for Children ------------------------------37
Knudson Norm Values ------------------------------------------------------------38
Knudson 76 Norm Values -------------------------------------------------------39
Composite Norm Values ---------------------------------------------------------40
Polgar Norm Values ---------------------------------------------------------------41
CHANGING THE FLOW SENSOR SP-250 (RS-232) ------------------------42
CARE &MAINTENANCE -----------------------------------------------------44
Self-test ------------------------------------------------------------------------------44
12 Monthly Check----------------------------------------------------------------44
Lifed Items --------------------------------------------------------------------------44
Cleaning the Sensor Assembly -------------------------------------------------45
Cleaning the Sensor Cable-------------------------------------------------------45
Cleaning the Thermal Print Head -------------------------------------------- 45
REPLACING THE RECORDING PAPER ----------------------------------------46
Thermal Paper Handling --------------------------------------------------------47
TECHNICAL DATA------------------------------------------------------------48
ACCESSORIES &ORDERING -------------------------------------------------49
SPIROMETRYTIPS -HOW TODOITAND COMMON PITFALLS AND PROBLEMS
How to Do It -----------------------------------------------------------------------50
FVC ------------------------------------------------------------------------------------51
FEV1 ----------------------------------------------------------------------------------52
Patient-Related Problems -------------------------------------------------------53
INDEX -------------------------------------------------------------------------54
Contents
CONTENTS --------------------------------------------------------------------- 1
INTRODUCTION ---------------------------------------------------------------- 2
PROCEDURE OVERVIEW ------------------------------------------------------ 3
Forced Vital Capacity (FVC) Test---------------------------------------------- 6
Slow Vital Capacity (SVC) Test ------------------------------------------------- 7
MVV Test ----------------------------------------------------------------------------- 7
MV Test ------------------------------------------------------------------------------- 7
Screen Information ---------------------------------------------------------------- 8
Post-Medication Tests ------------------------------------------------------------ 9
DEFINITION OF BEST ---------------------------------------------------------10
ENTERING PATIENT DATA---------------------------------------------------- 11
RACE INFLUENCES ON NORM VALUES ---------------------------------------14
PRINTOUT --------------------------------------------------------------------15
SPIRO SETTINGS -------------------------------------------------------------16
Printout Graph Setup - Spirometry ------------------------------------------16
Printout Graph Setup - Miscellaneous ---------------------------------------17
Normals ------------------------------------------------------------------------------18
Measurement/ Report setup ----------------------------------------------------19
American and Standard English -----------------------------------------------20
CALIBRATION ----------------------------------------------------------------21
Calibration Procedure ------------------------------------------------------------23
EXPLANATION OF MEASURED VALUES ---------------------------------------24
DIAGNOSIS -------------------------------------------------------------------26
Diagnosis Setting `International` --------------------------------------------- 26
Diagnosis Setting `American` --------------------------------------------------27
NORM VALUES ---------------------------------------------------------------28
Norm Values for Countries Outside the USA ------------------------------ 29
ECCSValues ------------------------------------------------------------------------- 29
Quanjer & Tammeling Comparisons -----------------------------------------30
Austrian Standard Values (österreich) ----------------------------------------31
Swedish Standards (Berglund) ---------------------------------------------------32
Finnish Standards ------------------------------------------------------------------33
Indian Equations -------------------------------------------------------------------34
NORM VALUES FOR USA AND CANADA ------------------------------------35
Morris Norm Values --------------------------------------------------------------35
Crapo Norm Values ---------------------------------------------------------------36
Morris and Crapo Norm Values for Children ------------------------------ 37
Knudson Norm Values ------------------------------------------------------------38
Knudson 76 Norm Values -------------------------------------------------------39
Composite Norm Values ---------------------------------------------------------40
Polgar Norm Values ---------------------------------------------------------------41
CHANGING THE FLOW SENSOR SP-250 (RS-232) ------------------------42
CARE &MAINTENANCE -----------------------------------------------------44
Self-test ------------------------------------------------------------------------------44
12 Monthly Check----------------------------------------------------------------44
Lifed Items --------------------------------------------------------------------------44
Cleaning the Sensor Assembly -------------------------------------------------45
Cleaning the Sensor Cable------------------------------------------------------- 45
Cleaning the Thermal Print Head --------------------------------------------45
REPLACING THE RECORDING PAPER ----------------------------------------46
Thermal Paper Handling --------------------------------------------------------47
TECHNICAL DATA------------------------------------------------------------48
ACCESSORIES &ORDERING -------------------------------------------------49
SPIROMETRYTIPS -HOW TODOITAND COMMON PITFALLS AND PROBLEMS
How to Do It -----------------------------------------------------------------------50
FVC ------------------------------------------------------------------------------------51
FEV1 ----------------------------------------------------------------------------------52
Patient-Related Problems -------------------------------------------------------53
INDEX -------------------------------------------------------------------------54

AT-2plus User Guide Spirometry Supplement Page 2
AT-2plus Spirometry Supplement Page 2
Introduction
The Spirometry function of the SCHILLERAT-2PLUS is automatically available when the SP-250 sensor
is plugged into the RS-232 connector on the left hand side of the unit.
It features 4 pulmonary function testing modes for the measurement of inspiratory and expiratory
values. The large LCD screen instantly show pulmonary test results along with the normal ECG results
and provide a clear and comprehensive result analysis in a number of different formats. All tests and
settings are initiated via an easy to use interface with dedicated menu options.
Measurements are made with a lightweight and hygienic open pneumotacho sensor - the SP-250
sensor. This sensor has a disposable, single patient sensor/filter assembly eliminating the need to clean
the sensor after each use.
Direct function icons are displayed for measuring the following:
°FVC ForcedVital Capacity
°SVC SlowVital Capacity
°MVV MaximumVoluntaryVentilation
°MV Expired or Minute Ventilation
CAUTIONS
Connectordisconnect the flowsensoronly whentheunitis turnedoff.Insert the plugintothe socket
marked'RS-232' onthe sideof the unit.Ensure thatthe connectioncable isnot tobe exposed toany
mechanicalstress.Whenever disconnectingthesensor, hold the plug andnot thecable.
Theflowsensor contains asensitivemeasuring device andmustalways behandledwithcare. Donot
allowthesensorto be droppedorsubjectedto any suddenblows.
Introduction
The Spirometry function of the SCHILLERAT-2PLUS is automatically available when the SP-250 sensor
is plugged into the RS-232 connector on the left hand side of the unit.
It features 4 pulmonary function testing modes for the measurement of inspiratory and expiratory
values. The large LCD screen instantly show pulmonary test results along with the normal ECG results
and provide a clear and comprehensive result analysis in a number of different formats. All tests and
settings are initiated via an easy to use interface with dedicated menu options.
Measurements are made with a lightweight and hygienic open pneumotacho sensor - the SP-250
sensor. This sensor has a disposable, single patient sensor/filter assembly eliminating the need to clean
the sensor after each use.
Direct function icons are displayed for measuring the following:
°FVC ForcedVital Capacity
°SVC SlowVital Capacity
°MVV MaximumVoluntaryVentilation
°MV Expired or Minute Ventilation
CAUTIONS
Connectordisconnect the flowsensoronly whentheunitis turnedoff.Insert the plugintothe socket
marked'RS-232' onthe sideof the unit.Ensure thatthe connectioncable isnot tobe exposed toany
mechanicalstress.Whenever disconnectingthesensor, hold the plug andnot thecable.
Theflowsensor contains asensitivemeasuring device andmustalways behandledwithcare. Donot
allowthesensorto be droppedorsubjectedto any suddenblows.

AT-2plus User Guide Spirometry Supplement Page 3
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 3
Art. No. 2. 510339wa ©1999
Procedure Overview
WARNING
FALSE MEASUREMENTS CAN RESULTWHEN THE SENSOR IS NOT HELD VERTICALLY- ALWAYS
ENSURE THATTHE SESOR IS HELD UPRIGHT ATALL TIMES.
1. Switchunit on,pressON, theintroductory screenis displayed:
2. Presskey`ALT` and`P` toenterthe SpiroMode
3. Pressthe Patientkey andenter patientdata - see page 11.
4. PresstheALT Keyto display themenu options.
The pulmonary menu is displayed:
SP-250
ALT + C = ECG ALT + P = SPIRO
ALT
Procedure Overview
WARNING
FALSE MEASUREMENTS CAN RESULTWHEN THE SENSOR IS NOT HELD VERTICALLY- ALWAYS
ENSURE THATTHE SESOR IS HELD UPRIGHT ATALL TIMES.
1. Switchunit on,pressON, theintroductory screenis displayed:
2. Presskey`ALT` and`P` toenterthe SpiroMode
3. Pressthe Patientkey andenter patientdata - see page 11.
4. PresstheALT Keyto display themenu options.
The pulmonary menu is displayed:
SP-250
ALT + C = ECG ALT + P = SPIRO
ALT

AT-2plus User Guide Spirometry Supplement Page 4
AT-2plus Spirometry Supplement Page 4
Procedure Overview
Key '1' 1FVCtest
Key '2' 2SVC test
Key '3' 3
AUTO MVVtest
Key '4' 4
5MVtest
Key '6' 6
20 Results
Key '7' 7
5/10 Pre / Post
Key '8' 8
25 Calibration
Key '0' 0
1mV Settings
'M' Memory
'C' ECG
Procedure Overview
Key '1' 1FVCtest
Key '2' 2SVC test
Key '3' 3
AUTO MVVtest
Key '4' 4
5MVtest
Key '6' 6
20 Results
Key '7' 7
5/10 Pre / Post
Key '8' 8
25 Calibration
Key '0' 0
1mV Settings
'M' Memory
'C' ECG

AT-2plus User Guide Spirometry Supplement Page 5
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 5
Art. No. 2. 510339wa ©1999
Procedure Overview
5. Ifusing theoption forthe firsttime selectthe requiredspiro settings and Spiro Standard.
Press '0' 0
1mV to display the Spiro settings - details of all spiro settings are given on the
followingpages.
All these settings are stored when the unit is switched off.
6. Insertnew disposablesensor (SP-250).
See page 42
WARNING
THE DISPOSABLE MOUTHPIECE IS DESIGNED FOR ONE-TIME USE TO ELIMINATE THE DANGER OF CROSS
CONTAMINATION - DO NOT USE THE MOUTHPIECE FOR MORE THAN ONE PATIENT.
7. CalibrateUnit (printcalibration report) -Press key'8' 8
25
Theunitmust becalibrated
°Atthebeginning ofeachday
°If the sensor is changed
°Whena significant temperatureor pressuredifference occurs
The calibration procedure is detailed on page 21.
Procedure Overview
5. Ifusing theoption forthe firsttime selectthe requiredspiro settings and Spiro Standard.
Press '0' 0
1mV to display the Spiro settings - details of all spiro settings are given on the
followingpages.
All these settings are stored when the unit is switched off.
6. Insertnew disposablesensor (SP-250).
See page 42
WARNING
THE DISPOSABLE MOUTHPIECE IS DESIGNED FOR ONE-TIME USE TO ELIMINATE THE DANGER OF CROSS
CONTAMINATION - DO NOT USE THE MOUTHPIECE FOR MORE THAN ONE PATIENT.
7. CalibrateUnit (printcalibration report) -Press key'8' 8
25
Theunitmust becalibrated
°Atthebeginning ofeachday
°If the sensor is changed
°Whena significant temperatureor pressuredifference occurs
The calibration procedure is detailed on page 21.

AT-2plus User Guide Spirometry Supplement Page 6
AT-2plus Spirometry Supplement Page 6
Procedure Overview
8. Select test:
ForcedVitalCapacity (FVC)Test
KEY 1
For this test the patient must exhale as quickly as possible from the time of starting
the test.
Note: The FVC test employs the `Back extrapolation` method. If the
extrapolatedvolumeistoo large (>0.15litresor5% of FVC),then
awarningappearsonthedisplay
To carry out the test for Forced Vital Capacity (FVC), press key `1` and the
corresponding coordinate presentation appears on the display.
The patient must exhale as quickly as possible from the time of starting the test so
be sure that he understands what is required of him. If inspiratory measurements
arerequired, the exhalationcan be immediatelyfollowed by amaximum inhalation.
The inspiration results will be given on the printout.
The coordinates represent the graph on which the curve will be drawn with the
respiratory volume in litres being represented on the vertical axis and the time in
seconds on the horizontal axis.
ALSOSEE `SPIROMETRYTIPS` AT THE END OFTHIS BOOK
Procedure Overview
8. Select test:
ForcedVitalCapacity (FVC)Test
KEY 1
For this test the patient must exhale as quickly as possible from the time of starting
the test.
Note: The FVC test employs the `Back extrapolation` method. If the
extrapolatedvolumeistoo large (>0.15litresor5% of FVC),then
awarningappearsonthedisplay
To carry out the test for Forced Vital Capacity (FVC), press key `1` and the
corresponding coordinate presentation appears on the display.
The patient must exhale as quickly as possible from the time of starting the test so
be sure that he understands what is required of him. If inspiratory measurements
arerequired, the exhalationcan be immediatelyfollowed by amaximum inhalation.
The inspiration results will be given on the printout.
The coordinates represent the graph on which the curve will be drawn with the
respiratory volume in litres being represented on the vertical axis and the time in
seconds on the horizontal axis.
ALSOSEE `SPIROMETRYTIPS` AT THE END OFTHIS BOOK

AT-2plus User Guide Spirometry Supplement Page 7
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 7
Art. No. 2. 510339wa ©1999
Procedure Overview
MVV Test
KEY 3
AUTO
The patient should breathe as deeply and as rapidly as possible
over a period of 6 to 12 seconds.
WARNING EXTREMECARE SHOULD BEEXERCISED
WHENPERFORMINGTHISTESTASTHEREIS
ADANGEROFHYPERVENTILATION.ENSURE
THATTHEPATIENTISSITTINGDOWN.
MV Test
KEY 4
5
The patient should breathe as normally as possible for up to 60
seconds, but for at least 20 seconds.
SlowVitalCapacity (SVC)Test
KEY 2
The patient should breathe normally 3 times and then
inhale maximally to total lung capacity and then expire
maximally. Make sure that the patient understands what
is required of him.
Procedure Overview
MVV Test
KEY 3
AUTO
The patient should breathe as deeply and as rapidly as possible
over a period of 6 to 12 seconds.
WARNING EXTREMECARE SHOULD BEEXERCISED
WHENPERFORMINGTHISTESTASTHEREIS
ADANGEROFHYPERVENTILATION.ENSURE
THATTHEPATIENTISSITTINGDOWN.
MV Test
KEY 4
5
The patient should breathe as normally as possible for up to 60
seconds, but for at least 20 seconds.
SlowVitalCapacity (SVC)Test
KEY 2
The patient should breathe normally 3 times and then
inhale maximally to total lung capacity and then expire
maximally. Make sure that the patient understands what
is required of him.

AT-2plus User Guide Spirometry Supplement Page 8
AT-2plus Spirometry Supplement Page 8
Procedure Overview
9. ClicktheAuto(START)key .
The flow sensor must be held quite still and no air should be breathed into the device for at least one second
before and after the START key is pressed.
Themessage‘’READYFORMEASUREMENT’’appearsonthedisplaytogetherwithavolumecountergraph
for the value. As soon as the patient starts to breathe into the flow sensor, the unit begins to record the
expiratoryflow.Thecorrespondingcurveis representedonthedisplay.Thebreak-offpointfortheexpiration
measurementis reachedautomatically (orthe Stop key is pressed).
10. Pressthe STOP keyon completionof thetest.
ScreenInformation
Once the test is completed, the measurement results are calculated and given on the display. When subsequent tests
are made, the result with the highest FVC + FEV1value will always be saved and given in the column MEAS 1.
The result with the lowest FVC + FEV1value of the tests already made and stored will be overwritten.
NOTE:The marked results correspond to the displayed test curve.
Procedure Overview
9. ClicktheAuto(START)key .
The flow sensor must be held quite still and no air should be breathed into the device for at least one second
before and after the START key is pressed.
Themessage‘’READYFORMEASUREMENT’’appearsonthedisplaytogetherwithavolumecountergraph
for the value. As soon as the patient starts to breathe into the flow sensor, the unit begins to record the
expiratoryflow.Thecorrespondingcurveis representedonthedisplay.Thebreak-offpointfortheexpiration
measurementis reachedautomatically (orthe Stop key is pressed).
10. Pressthe STOP keyon completionof thetest.
ScreenInformation
Once the test is completed, the measurement results are calculated and given on the display. When subsequent tests
are made, the result with the highest FVC + FEV1value will always be saved and given in the column MEAS 1.
The result with the lowest FVC + FEV1value of the tests already made and stored will be overwritten.
NOTE:The marked results correspond to the displayed test curve.

AT-2plus User Guide Spirometry Supplement Page 9
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 9
Art. No. 2. 510339wa ©1999
Procedure Overview
11. Repeatasmany timesasrequired (Best,orMeas. 1).
Repeatsteps 8and9 untilthree measurementshave been taken.
Note: If the Start key is again pressed (a fourth or more times), only the best three measurements are stored.
WhenAmerican standards arestipulated, the message‚`ATS criteria met` appears on the printout if the deviation (as stipulated
by the American Thoracic Society) between the best and second best measurements is not greater than 200ml.
Following a series of patient measurements the best two results are recorded and stored along with the last test made (which
may or may not be one of the best three). These three results can then be printed graphical along with a table of the best
individual measurements (from these three results). The table of the best measurements can also be displayed on the screen.
12. Dispose of the mouthpiece immediately after completing the tests (page 42) to eliminate the danger of
cross infection.
Post-Medication Tests
In order to carry out post-medication tests for comparison, press key '7' 7
5/10
The post-medication tests are carried out in the same way as the premedication tests (three measurements stored). The printout
following post-medication tests will give the curves of both pre and post-medication tests (the premedication curve is bold). The
measurement results are shown as the best results (pre/post), results as a percentage of those predicted, (both pre and post) and the
percentage change (i.e. difference) between pre and post-medication results.
The diagnosis resulting from the premedication test is also given on this printout.
Procedure Overview
11. Repeatasmany timesasrequired (Best,orMeas. 1).
Repeatsteps 8and9 untilthree measurementshave been taken.
Note: If the Start key is again pressed (a fourth or more times), only the best three measurements are stored.
WhenAmerican standards arestipulated, the message‚`ATS criteria met` appears on the printout if the deviation (as stipulated
by the American Thoracic Society) between the best and second best measurements is not greater than 200ml.
Following a series of patient measurements the best two results are recorded and stored along with the last test made (which
may or may not be one of the best three). These three results can then be printed graphical along with a table of the best
individual measurements (from these three results). The table of the best measurements can also be displayed on the screen.
12. Dispose of the mouthpiece immediately after completing the tests (page 42) to eliminate the danger of
cross infection.
Post-Medication Tests
In order to carry out post-medication tests for comparison, press key '7' 7
5/10
The post-medication tests are carried out in the same way as the premedication tests (three measurements stored). The printout
following post-medication tests will give the curves of both pre and post-medication tests (the premedication curve is bold). The
measurement results are shown as the best results (pre/post), results as a percentage of those predicted, (both pre and post) and the
percentage change (i.e. difference) between pre and post-medication results.
The diagnosis resulting from the premedication test is also given on this printout.

AT-2plus User Guide Spirometry Supplement Page 10
AT-2plus Spirometry Supplement Page 10
Definition of Best
Inaccordance with the ATS Spirometry Standard (11 November 1994), the best recordings are defined as
the highest value from the calculation:
Best=FVC+ FEV1
The measurement table (on the printout and on the display) gives the highest individual measurements
(e.g. FVC, FEV1, SVC, MVV etc.) from the best three recordings as defined above. This is true for all
parameters except the following which are based solely on the highest FVC + FEV1 value:
°FEF0.2 - 1.2
°FEF25% - 75%
°FEF75% - 85%
°FEF25%
°FEF50%
°FEF75%
°FIF50%
Definition of Best
Inaccordance with the ATS Spirometry Standard (11 November 1994), the best recordings are defined as
the highest value from the calculation:
Best=FVC+ FEV1
The measurement table (on the printout and on the display) gives the highest individual measurements
(e.g. FVC, FEV1, SVC, MVV etc.) from the best three recordings as defined above. This is true for all
parameters except the following which are based solely on the highest FVC + FEV1 value:
°FEF0.2 - 1.2
°FEF25% - 75%
°FEF75% - 85%
°FEF25%
°FEF50%
°FEF75%
°FIF50%