WARRANTY LIMITED ONE YEAR WARRANTY INSIDE U.S.A. SCOPE OF LIMITED WARRANTY Zimmer, Inc. warrants the Product (A.T.S. 2200TS Tourniquet System) for one year from date of purchase. During the warranty period, Zimmer will repair or replace, at its option, any product which is defective in materials or workmanship or which fails to meet the published specification for that model. This Limited Warranty is made only to the original purchaser of the product and is non‐transferable. The remedies described in this Limited Warranty are the exclusive remedies for breach of warranty. THIS WARRANTY SHALL NOT APPLY TO ANY PRODUCT WHICH HAS BEEN ALTERED OR MODIFIED IN ANY WAY, OR WHICH HAS BEEN SUBJECTED TO MISUSE OR ABUSE. DISCLAIMER OF IMPLIED WARRANTIES The forgoing of Express Limited Warranty is given in lieu of any and all other express or implied warranties. ZIMMER MAKES NO OTHER WARRANTIES INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. LIMITATION OF REMEDIES In no case shall Zimmer, Inc. be liable for any special, incidental, or consequential damages whether based on breach of warranty or other legal theory whether or not such damages are foreseeable. Some states do not allow limitations on warranties or on remedies for breach in certain transactions. In such states, the limits in this paragraph and the preceding paragraph do not apply. WARRANTY CLAIMS In the event of a warranty claim within the warranty period please take the following steps: Notify Customer Service Department, Zimmer Surgical, at 1‐800‐348‐2759 or contact your local Zimmer representative. Please provide details about the nature of the problem and include the product serial number. Upon receipt of this information, Zimmer will provide a date for service or a return shipping authorization. Upon receipt of the shipping authorization, forward the equipment, freight prepaid, to the location specified in the shipping authorization. Your compliance with these steps will help assure that you receive prompt warranty service for your product. WARRANTY OUTSIDE U.S.A. SCOPE OF WARRANTY Please contact your local Zimmer Representative for warranty information. ...
INSTALLATION AND OPERATING INSTRUCTIONS GENERAL INFORMATION APPLICATION SPECIFICATION The application specification for the A.T.S. 2200TS including characteristics related to the use of the device, intended use, intended patient population, intended part of the body, intended user profile, intended conditions of use and operating principles is contained in this manual. INTENDED USE The A.T.S. 2200TS Tourniquet System is intended to be used by qualified medical professionals to temporarily occlude blood flow in a patient’s extremities during surgical procedures on those extremities. Tourniquets have been found useful in producing a bloodless operation field in surgical procedures involving the extremities including: Reduction of certain fractures. Kirschner wire removal. Subcutaneous fasciotomy. Nerve injuries. Bone grafts. Total wrist joint replacement. Knee joint replacements. Amputations. Tumor and cyst excisions. Tendon repair. Replacement of joints in the fingers. Replantations. WARNING: Do not use Tourniquet cuffs to control the distal flow of CO or any other gases used ...
INSTALLATION AND OPERATING INSTRUCTIONS CAUTION: In every case, the final decision whether to use a Tourniquet rests with the attending physician. A Tourniquet should also be avoided in patients who are undergoing secondary or delayed procedures after immobilization. PRECAUTIONS IN USE Not for use in an oxygen rich environment with an oxygen concentration greater than 25% for ambient pressures up to 110 kPa or the partial pressure of oxygen is greater than 27.5 kPa at ambient pressures exceeding 110 kPa. Normal operation has the A.T.S. 2200TS running on ~ AC Power Mains via its power cord. The backup battery is intended for emergency power or transport. The Tourniquet system must be kept well calibrated and in operable condition. Accessories should be checked regularly for leaks and other defects. The Tourniquet cuff must never be punctured; therefore towel clips used near the system must be handled with special care. Cuffs with inner rubber bladders must be completely enclosed by the outer envelope to preclude ballooning and possible rupture of the bladder. Cleaning and assembly instructions of the cuff manufacturer should be followed carefully. Do not use an elastic bandage for exsanguination in cases where this will cause bacteria, exotoxins, or malignant cells to spread to the general circulation, or where it could dislodge thromboemboli that may have formed in the vessels. The Tourniquet cuff must be applied in the proper location on the limb, for a “safe” period of time, and within an appropriate pressure range. Never apply a Tourniquet over the area of the peroneal nerve or over the knee or ankle. Do not readjust an already inflated cuff by rotating it because this produces shearing forces which may damage the underlying tissue. Prolonged ischemia may lead to temporary or permanent damage to tissues, blood vessels, and nerves. Tourniquet paralysis may result from excessive pressure. Insufficient pressure may result in passive congestion of the limb with possible irreversible functional loss. Prolonged Tourniquet time can also produce changes in the coagulability of the blood with increased clotting time. Inflation should be done rapidly to occlude arteries and veins as near simultaneously as possible. ...
INSTALLATION AND OPERATING INSTRUCTIONS on the limb. The skin under the Tourniquet cuff must be protected from mechanical injury by smooth, wrinkle‐free application of the cuff. If the Tourniquet cuff is applied over any material that may shed loose fibers (such as Webril) the fibers may become embedded in the contact closures and reduce their effectiveness. As an under padding, a section of stockinette may be used. The deflated cuff and any underlying bandage or protective sleeve should be completely removed as soon as Tourniquet pressure is released. After the cuff has been fully deflated and removed from the patient, the unit can be set to STANDBY. Even the slightest impedance of venous return may lead to congestion and pooling of blood in the operative field. If skin preparations are used preoperatively, they should not be allowed to flow and collect under the cuff where they may cause chemical burns. Whenever the Tourniquet cuff pressure is released, the wound should be protected from blood surging back by applying pressure dressings and, if necessary, elevating the limb. Transient pain upon Tourniquet pressure release can be lessened by elevation of the limb. If full color does not return within 3 to 4 minutes after release, the limb should be placed in a position slightly below body level. Whenever IVRA (Bier Block anesthesia), is used, it is recommended that the Tourniquet remain inflated for at least 20 minutes from the time of injection. WARNING: Cuffs will not deflate in STANDBY mode. Ensure cuffs are fully deflated before setting the unit to STANDBY. ADVERSE EFFECTS A dull aching pain (Tourniquet pain) may develop throughout the limb following use. Pathophysiologic changes due to pressure, hypoxia, hypercarbia, and acidosis of the tissues occur and become significant after about 1 1/2 hours of Tourniquet use. Symptoms of Tourniquet paralysis are motor paralysis and loss of sense of touch, pressure, and proprioceptive responses. Intraoperative bleeding may be caused by: The slight impeding effect exerted by an unpressurized cuff (and its padding, if used), which prevents venous return at the beginning of the operation. Blood remaining in the limb because of insufficient exsanguination. Inadequate Tourniquet pressure (between systolic and diastolic blood pressure of the patient), or slow inflation and deflation, all of which allow arterial blood to enter while preventing venous return. ...
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±5 mmHg of set‐point (10 second average under non‐transient conditions without external leaks). Maximum Pressure 400 mmHg per cuff. 600 mmHg per cuff in extended pressure range. Time Alarm Set Range 1–240 minutes; 1 minute increments. Timer Accuracy 0.25% of elapsed time. Internal Diagnostics Program, memory, watchdog timer, transducer calibration, improper valve actuation, touch‐screen, backlight, LCD. Size Height: 11.6 in. (29.5 cm). Width: 8.1 in. (20.6 cm). Depth: 10.0 in. (25.4 cm) (including clamp). Weight: 11.5 lbs. (5.2 Kg) (including power cord). Displays The A.T.S. 2200TS uses a 7.0” WVGA LED backlit LCD panel. Pressure Display: Displays pressure setting, sensed cuff pressure, and other messages. Time Display: Displays time alarm set‐point and elapsed time. IV Pole Height: sufficient to mount unit at ≤ 50 inches (127 cm) from floor to base of ATS unit. Pole Diameter: 0.872 to 1.125 inches. Base Diameter: ≥27.56 inches (70 cm). Page 8 of 68 ...
IPX0 Classification according to the degree IPX0 (Ordinary equipment). of protection against ingress of water Mode of operation Continuous operation. *When the unit is operating on backup battery, the type of protection against electric shock changes to internally powered equipment. EMISSIONS/IMMUNITY The A.T.S. 2200TS Tourniquet System complies with EMC criteria set forth in IEC 60601‐1‐2. The user of this device should be aware that precautions should be taken in regards to EMC. The device should be installed and used according to the EMC information provided in the instructions for use. See EMC Guidance Tables included in this manual. WARNING: The A.T.S. 2200TS Tourniquet System should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the A.T.S. 2200TS Tourniquet System should be observed to verify it is functioning normally. Cable Maximum length ~ AC Power Mains power cord 170 inches (432 cm). WARNING: use of an ~ AC Power Mains power cord with a length other than those specified may result in increased emissions and decreased immunity. INSTALLATION AND OPERATING INSTRUCTIONS INITIAL VISUAL INSPECTION Unpack the A.T.S. 2200TS Tourniquet upon receipt and inspect the unit for any obvious damage that may have occurred during shipment including damage to any accessories. . We recommend that this inspection be performed by a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices. If the unit is damaged, notify the carrier and your Zimmer representative immediately. If the initial inspection results are satisfactory, a functional and calibration check should be performed after a 10‐hour charge. CAUTION: The A.T.S. 2200TS Tourniquet System is intended to be used outside the sterile field. Page 9 of 68 ...
INST TALLATIO ON AND RATING I INSTRUCT TIONS FEAT TURES AND D OPERATI NG PRINC CIPLES The A.T T.S.2200TS has s a variety of fe eatures and ph hysical characte eristics as desc cribed below. BUTTO ONS AND IC CONS Various s colored butto ons and icons a are used in the e A.T.S. 2200TS S and described d below. Pleas se refer to Touchs screen GUI bel ow for details on what the co olors mean. Button n/Icon Title What it m means Power ON/STANDBY Y ...
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INST TALLATIO ON AND RATING I INSTRUCT TIONS Button n/Icon Title What it m means Check Cuff Icon Indicates t that the Tourn niquet system has detected a a connectio on or inflation p problem with t the Tourniquet t cuff attached t to the Main Cu uff Ports when attempting to o leak‐test the cuff. INFLAT TE Button Controls i nflation of the e respective cu ff. The Main C uff and (INFL) Second Cu uff have separa ate INFLATE bu uttons. ...
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INSTALLATION AND OPERATING INSTRUCTIONS Button/Icon Title What it means Documentation Allows access to quick‐reference documentation. Button Stats Button Allows viewing and re‐setting of end‐of‐procedure information. Volume Icon Appears in the system Settings when adjusting Alarm volume. Battery Status Icon Indicates that the system is running on backup battery and at (critically low capacity) critically low capacity. The system should be plugged into ~ AC Power Mains immediately. Medium priority alarm active. Battery Status Icon Indicates that the system is running on backup battery, (25% capacity) currently at 25% of full capacity. Low priority alarm active. ~ AC Power Mains Icon Indicates that the system is running on ~ AC Power Mains and (25% charge) charging the battery, which is currently at 25% of full charge. Battery Status Icon Indicates that the system is running on backup battery, ...
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INSTALLATION AND OPERATING INSTRUCTIONS Feature What it does Carrying Handle Handle for carrying or holding the Tourniquet system. 1 Touch Screen GUI Touch‐screen based graphical user interface (GUI) for interacting with and 2 controlling most of the Tourniquet system functions. Power ON/STANDBY Turns the unit ON or sets the unit to STANDBY. 3 Button The illuminated green AC INDICATOR indicates that the unit is plugged in and is being powered by ~ AC Power Mains. This is the normal means of operation (battery power is only intended for emergency power loss or patient transport). CAUTION: Ensure both cuffs are fully deflated and have been removed from the patient as well as all underlying bandages or protective sleeve prior to setting the unit to STANDBY. CAUTION: This button will not set the unit to STANDBY when the cuff pressure is at a non‐zero value. During STANDBY, the power to the A.T.S. 2200TS instrument and all instrument functions (i.e. inflation, deflation, etc.) are OFF but power continues to supply the battery charging circuitry anytime ~ AC Power Mains is present. Alarm Silence Button Will silence most audible alarms for 30 seconds after the button is pressed. ...
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2200TS. Second Cuff Port Connector port used to connect the Tourniquet system to the Second Cuff 6 hose. The Second Cuff Port is controlled by the right side BLUE GUI controls. CAUTION: The A.T.S. 2200TS is designed and tested for use with Zimmer single port cuffs. Zimmer does not recommend the use of any cuff other than Zimmer single port cuffs. Do not use dual port cuffs with the A.T.S. 2200TS. Pole Clamp The Pole clamp is used to mount the unit on an I.V. pole. See Specifications 7 section above for details. CAUTION: Do not hang articles on the Tourniquet pole that are not related to Tourniquet use. For stability reasons, do not use an I.V. Pole with a base less than ≥27.56 inches (70 cm) in diameter. Hose Hangers The A.T.S. 2200TS is equipped with hose hangers at the back of its case. The 8 cuff hoses can be temporarily hung on the hangers for transport or when disconnecting from the cuff. CAUTION: Cuff hoses should be the only items to utilize the hose hangers. Do not hang articles on the Tourniquet’s hose hangers that may cause the Tourniquet to become unstable. 9 Power Cord Connects to IEC320 appliance inlet on the Tourniquet system. See (not shown) Specifications section above for details. ~ AC Power Mains Contains ~ AC Power Mains Fuses. Fuse drawer is a 2‐pole holder for 5x20mm 10 ...
INSTALLATION AND OPERATING INSTRUCTIONS Feature What it does Battery Compartment Compartment that holds the A.T.S. 2200TS’s backup battery. 14 15 Alarm/Warning Light Alarm priority indicator. This light will flash and change color to yellow or red depending on the alarm priority (see Alarm Conditions section for details). TOUCH SCREEN GUI The A.T.S. 2200TS Graphical User Interface (GUI) consists of RED Main Cuff displays and controls on the left side and otherwise identical BLUE Second Cuff displays and controls on the right side. Additionally, GRAY general System functions are located on the bottom center of the screen. GUI function details: Second Cuff Main Cuff Status Display Status Display Second Cuff Main Cuff Pressure Pressure Display Tile Display Tile Second Cuff Main Cuff Controls Controls Second Cuff Main Cuff ...
INSTALLATION AND OPERATING INSTRUCTIONS GUI Component What it means System Functions Settings button , documentation button , and power status (Backup Menu Battery or ~ AC Power Mains – see Buttons and Icons section above). Cuff Pressure Display Touch to modify set pressure. Tiles During normal operation with no buttons being touched, each of the independent PRESSURE display areas will show the actual cuff pressure as well as the set‐point in smaller digits at the lower right side of a tile. At other times, depending on alarm conditions and buttons touched, the display may communicate other information such as alarm messages, set pressure, or end of procedure Stats. Cuff Time Display Tiles Touch to modify set time. During normal operation with no buttons being touched, each of the independent TIME display areas will show elapsed inflation time of each cuff as well as the set‐point in smaller digits at the lower right side of a tile. At other times the display will communicate time alarm messages. CAUTION: To prevent accidental timer reset, the elapsed inflation time can only be “zeroed” when the cuff is fully deflated or reset in the Stats feature. Additional time can be added to clear a time alarm. INITIAL SETUP WARNING: To avoid the RISK of electric shock, this equipment must only be connected to an ~ AC Power Mains with protective earth. The A.T.S. 2200TS should be plugged into ~ AC Power Mains for 10 hours before initial setup to ensure the backup battery is fully charged. During shipping and storage, the unit’s battery could become weak. Always charge the system 10 hours before initial setup, including calibration checking procedures, initial checks, tests and any institution‐performed biomedical evaluations. ...
INST TALLATIO ON AND RATING I INSTRUCT TIONS e Zimmer circl e “Z” icon and an animat ted Progress ic con appear r on the LCD di isplay. e unit displays s “A.T.S. 2200T TS”. The unit is self‐testing sp pecific system h hardware and software. e animated Pr ogress icon is replaced b by the text “DIA AGNOSTIC OKA AY.” “C ALIBRATION” a and an animat ed Progress ico on are disp played during t...
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INST TALLATIO ON AND RATING I INSTRUCT TIONS e PRESSURE d isplay should r read “250” (the e factory defau ult set‐point). T The tile will tomatically clo ose in approxim mately 5 secon nds. ithin the 5 seco ond time fram e, touch the ne egative left‐ar row button to decrease or positive ght‐arrow butto on + to incre ease the PRESS SURE set‐point t. The set pres ssure can be m aintained betw ween 50 mmHg g and 400 mm Hg in increme nts of 1 mmHg. If an arrow b button is conti nuously held, t...
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INSTALLATION AND OPERATING INSTRUCTIONS The main TIME display should read “60” (the factory default set‐point). The tile will automatically close in approximately 5 seconds. Within the 5 second time frame, touch the negative left‐arrow button to decrease or positive right‐arrow button + to increase the TIME set‐point. The set time can be maintained between 5 and 240 minutes in increments of 1 minute. If an arrow button is continuously held, the increments will change by 5 minutes. Touch the Okay button to immediately remove the displayed tile or wait approximately 5 seconds and it will automatically close. Repeat TIME set‐point system test for the blue Second Cuff TIME set‐point. CAUTION: Anytime an asterisk (*) appears below the TIME value in the TIME tile, the data displayed is the set‐point. Set time will revert back to the default time setting when the unit is set to STANDBY. Low Pressure Alarm Check Connect a cuff and standard length hose set to the Main Cuff ports. Touch the INFLATE (INFL) button to inflate the cuff to the set‐point of 250 mmHg: Create a leak in the cuff by partially detaching the hose (either port) from the unit while a cuff is inflated. Make the leak large enough that the pressure drops more than 15 mmHg below set‐point. Observe: Page 19 of 68 ...
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INST TALLATIO ON AND RATING I INSTRUCT TIONS A short dela y is instituted t to reduce nuis sance alarms. An audible t one will sound d and a red ala rm indicator w will flash annou uncing the alar m condition. A yellow Wa arning tile drop ps over the PRE ESSURE display y and indicates s “LOW PRESSU URE” as well as the m monitored pres ssure: If a substant tial leak has be een present for r more than an n extended tim me, the “LOW P PRESSURE” text will cha nge to “CUFF L LEAK.” ...
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INSTALLATION AND OPERATING INSTRUCTIONS Touch the Stats button to reveal and review statistics of the previous pressure cycle: The Pressure icon with right arrow FROM vertical bar indicates the start pressure. The Pressure icon with right arrow TO vertical bar indicates the ending pressure if the pressure was adjusted during the procedure. The Time icon indicates the total time the cuff was inflated. Touch the Okay button to make no changes and return to the previous view. Touch the Reset button to reset the Stats to default. A confirmation menu appears: Touch Cancel button to make no changes and return to the Stats menu. Touch the Okay button to confirm reset and return to the default GUI. Page 21 of 68 ...
INSTALLATION AND OPERATING INSTRUCTIONS Repeat this procedure with the Second Cuff ports. CAUTION: If Advanced Leak Detection detected an excessive cuff leak during the inflation period, the system will indicate “LEAK DETECTED.” Resetting the Stats also resets the cuff timer. After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. SYSTEM FUNCTIONS SETTINGS Settings options include Defaults, Preferences, Cuff Test, and Service. The Service option is grayed out by default but may be accessed by a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization through the unlock sequence described in the Maintenance section. To modify the system Settings, perform the following steps. Touch the Settings button and the Settings tool tray will slide up, revealing the Settings options: If desired, touch the Cancel button to make no changes and return to the default GUI view. CAUTION: After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. DEFAULTS Defaults options include changing Pressure and Time settings. To change any Default setting, perform the following steps. To modify the default pressure or time settings for either cuff, follow the following steps. Touch the Defaults menu button. The settings for Pressure and Time appear: Page 22 of 68 ...
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INST TALLATIO ON AND RATING I INSTRUCT TIONS Touch t the cuff‐toggle e button to switch between Main n and Second C Cuff. on ‐ to decre button + to Touch t the negative le eft‐arrow butto ease or positiv ve right‐arrow o increase the Def fault Pressure or Time. efault Pressure can be set bet tween 50 and 400 mmHg in increments of 1 mmHg. efault Time can n be set betwe en 1 and 240 m minutes in incr rements of 1 m minute. ...
INSTALLATION AND OPERATING INSTRUCTIONS VOLUME SETTING The Volume can be changed to accommodate different environmental conditions so that the audio alarm can be reliably detected without being too intrusive in most situations. The A.T.S. 2200TS has nine Volume levels ranging from approximately 50 dB to 70 dB when measured at 1 meter from the center of the touch screen. To change the speaker Volume, enter the Preferences menu and perform the following steps: Touch the Volume button. The Volume menu appears: Touch the negative left‐arrow button ‐ to decrease, or positive right‐arrow button + to increase, the Alarm Volume. Increments or decrements immediately take place and are automatically accepted and saved. With every increment or decrement the speaker will sound to give the user feedback of the Volume level setting selected. Press the Okay button to close the menu and return to the Settings menu. CAUTION: Changes in Volume will be automatically accepted. After approximately 5 seconds of inactivity, the system will automatically accept any changes in Volume, close open menus, and return to its normal mode of operation. BRIGHTNESS SETTING To change the display Brightness, enter the Preferences menu and perform the following steps: Touch the Brightness button. The Brightness menu appears: Touch the negative left‐arrow button ‐ to decrease, or positive right‐arrow button + to increase, ...
INSTALLATION AND OPERATING INSTRUCTIONS CAUTION: Changes in Brightness will be automatically accepted. After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. Changes in Brightness will be automatically accepted. LANGUAGE SETTING To change the displayed Language, enter the Preferences menu and perform the following steps: Touch the Language button. The Language menu appears: Touch the up and down arrows to scroll to the preferred Language. Select the desired language and touch the Okay button to accept and save the new Language setting. Touch the Cancel button to ignore any changes. CAUTION: No Language change will be saved unless the Okay button is touched to approve. After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. CUFF TEST To test a Cuff for leaks, perform the following steps. Connect the Cuff to be tested with standard length hose set to the Main Cuff ports. Open the Cuff and lay it flat. Touch the Cuff test menu button. The Cuff test menu appears: If desired, touch the Cancel button to cancel the Cuff test and return to the Settings menu. Page 25 of 68 ...
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INSTALLATION AND OPERATING INSTRUCTIONS Press the Next button to begin the Cuff test. A testing view appears showing an animated progress bar and button: If desired, touch the Cancel button at any time to cancel the Cuff test. A passing test shows the following view: Touch the Cancel button to return to the Settings menu. A leak during the test shows the following view: Touch the Cancel button to cancel the test and return to the Settings menu. An error in the test shows the following view: Page 26 of 68 ...
INSTALLATION AND OPERATING INSTRUCTIONS A test error also briefly causes a yellow “LOW PRESSURE” warning tile to appear as well as the cuff status bar changing yellow. These warnings close after the Error view appears. Correct the error and touch the Retry button to try again or the Cancel button to return to the Settings menu tile. The cuff automatically deflates at the end of the test. CAUTION: After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. DOCUMENTATION Documentation options include Single Cuff, Dual Cuff, and Alarm/Error. To view system Documentation, perform the following steps. Touch the Documentation button in System Functions. The Documentation menu tile will slide up revealing the Documentation options: If desired, touch the cancel button to return to the default GUI. To view particular documentation, perform the following steps. Touch the Single Cuff, Dual Cuff, or Alarm/Error menu button. A new menu tile appears revealing documentation text as well as up/down arrows for scrolling and a cancel button. Touch the up or down arrow in the menu tile to scroll through the revealed text. If desired, touch the menu tile Cancel button to return to the Documentation tile. Touch the Documentation menu tile Cancel button to return to the default GUI view. CAUTION: After approximately 5 seconds of inactivity the system will automatically close open menus and return to its normal mode of operation. Page 27 of 68 ...
INSTALLATION AND OPERATING INSTRUCTIONS OPERATION WARNING: To isolate the device from ~ AC Power Mains in case of an emergency, disconnect the power cord from the wall outlet or from the appliance inlet at the rear of the device. Do not position the device in such a way that obstructs the access to the wall outlet or appliance inlet. Refer to Cuff Operation below for how to apply and use Single, Dual or IVRA (Bier Block) cuffs with the A.T.S. 2200TS. SURGEON DECISIONS The surgeon's discretion will be used to determine the following: What pressure to apply Refer to PRESSURE set‐point system test under the Manual Tests and Checks section for how to set the target pressure set‐point. For each patient, the surgeon will determine the Tourniquet pressure required to occlude blood flow to the operative site. When to inflate the Tourniquet How long to apply the Tourniquet Refer to TIME set‐point system test under the Manual Tests and Checks section for how to set the target cuff inflation time set‐point. The Tourniquet time depends greatly on the patient’s anatomy, age, and absence of vascular disease. In many operating rooms, it is customary to prominently note the time of inflation, and to warn the surgeon after a certain time has elapsed. This will allow the surgeon to assess the need for further Tourniquet time. Whether and when to allow for intermittent aeration of tissue by deflating the cuff for 10 to 15 minutes. There is a general medical practice that, for reasonably healthy adults, 2 hours should not be exceeded without releasing the Tourniquet to allow the underlying tissue to breathe. During this time, the limb should be elevated to about 60 degrees, and steady pressure should be applied to the incision with sterile dressings When to release the Tourniquet in an operative procedure. PATIENT PREPARATION Prepare the patient in accordance with your established procedures and cuff instructions. The Precautions In Use detailed above under General Information, as well as the following, are offered as a guide to assist in this process. In most cases, a Tourniquet cuff should be applied to the widest part of the limb to allow as much tissue as possible to lie between the cuff and any nerves or vascular structures susceptible ...
INSTALLATION AND OPERATING INSTRUCTIONS CUFF OPERATION This section describes operation of the A.T.S. 2200TS Tourniquet Cuff functionality. See below for details of: Single Cuff Operation, Dual Cuff Operation, and Bier Block (IVRA) Cuff Operation. SINGLE CUFF OPERATION Press the button to turn the unit ON. The unit will execute a diagnostic and calibration self‐check test. After successful completion of the self‐check test, the A.T.S. 2200TS unit is ready for use. The default settings for cuff pressure and time limit are retrieved during power‐up. CAUTION: If a connected cuff is pressurized to 50 mmHg or more during power‐up, the A.T.S. 2200TS Tourniquet will declare it an abnormal start‐up sequence. It will assume that a surgical procedure is in process, and will adopt the pressure sensed in the cuff as the new set‐point. It will automatically go into the regulate mode on the cuff. To alert the operator of this condition, the unit will sound a tone and display a “CUFF INFLATED” alarm. The operator should immediately check the pressure set‐point by touching the corresponding pressure tile and readjust to the proper set‐point if necessary. The alarm will be cleared as soon as the cuff set‐point is examined. Prepare patient according to guidelines in Patient Preparation above. Establish the viability of the skin and deeper tissues prior to exsanguination of the limb and Tourniquet inflation. The surgeon determines Tourniquet use‐parameters as discussed above in Surgeon Decisions. Exsanguinate the limb. Elevate the limb for a minimum of 2 minutes. Page 29 of 68 ...
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INSTALLATION AND OPERATING INSTRUCTIONS Wrap the limb from distal to proximal with an Esmarch, Martin, or elastic exsanguinating bandage. Apply a leak‐free single‐port Tourniquet cuff smoothly without wrinkles. Apply a Zimmer protective sleeve or other padding to the limb. Position the Tourniquet cuff so that its distal edge is located approximately 1 in. (2.5 cm) from the proximal edge of the exsanguinating bandage. Place the valve port and hose connections so that the hose will not be kinked when the limb is positioned for surgery. Connect the single port cuff hose to the unit at the Main Cuff connector (Red port). Set target PRESSURE and TIME set‐points. Refer to PRESSURE and TIME set‐point system tests under the Manual Tests and Checks section for how to set target PRESSURE and TIME set‐points. Touch the INFLATE (INFL) button to inflate the cuff to the PRESSURE set‐point: The Main Cuff inflation information will be displayed on the PRESSURE display and the TIME display will track elapsed inflation time. CAUTION: An alarm condition will begin if the cuff inflation TIME set‐point is exceeded. If the unit cannot pressurize the cuff to within 15 mmHg of the set‐point in less than 30 seconds, a leak alarm will be sounded. See Alarm Conditions section for information about possible alarm conditions. Remove the exsanguinating bandage. Administer the anesthetic agent or nerve block if regional anesthesia is being used. Perform the surgical procedure. At the end of the procedure, deflate cuff by TOUCH, SLIDE and HOLDING the DEFLATE (DEFL) button until deflation begins: Page 30 of 68 ...
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INST TALLATIO ON AND RATING I INSTRUCT TIONS The Ma ain Cuff PRESS URE display wi ill show the de eflation of the c cuff and the TI ME display ela apsed inflatio on time alarm c clock will stop. Once th he cuff fully de eflates, the Sta ts button appears on th he Main Cuff Co ontrols: age 31 of 68 ...
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INSTALLATION AND OPERATING INSTRUCTIONS Touch the Stats button to reveal and review statistics of the previous pressure cycle: The Pressure icon with right arrow FROM vertical bar indicates the start pressure. The Pressure icon with right arrow TO vertical bar indicates the ending pressure if the pressure was adjusted during the procedure. The Time icon indicates the total time the cuff was inflated. Touch the Okay button to make no changes and return to the previous view. Touch the Reset button to reset the Stats to default. A confirmation menu appears: Touch Cancel button to make no changes and return to the Stats menu. Touch the Okay button to confirm reset and return to the default GUI. CAUTION: If Advanced Leak Detection detected a cuff leak during the inflation period, the system will indicate “LEAK DETECTED.” Resetting the Stats also resets the cuff timer. After approximately 5 seconds of inactivity the system will automatically close open menus ...
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INSTALLATION AND OPERATING INSTRUCTIONS Disconnect the cuff from the A.T.S. 2200TS unit. If desired, touch the Power button to set the A.T.S. 2200TS unit to STANDBY. CAUTION: The elapsed inflation time can be “zeroed” after the cuff has been deflated in the Time tile or by resetting the Stats. During normal use, the A.T.S. 2200TS should not be set to STANDBY if pressure is present in either cuff. Once the cuff has been properly deflated, removed from the patient, and disconnected from the A.T.S. 2200TS, the unit can be set to STANDBY. DUAL CUFF OPERATION Operation of the unit is identical to Single Cuff Operation above, except for the following points: Two single port cuffs are connected to the unit (Reminder: Main Cuff is the Red port, Second Cuff is the Blue port). The Main and Second Pressure and Time tiles will display inflation information and begin timing the cuff inflation. Deflation of one cuff will not be permitted while the other cuff is inflating. When inflating a second cuff with the other cuff already inflated, the unit will continuously check the original cuff to ensure that the pressure is within allowable limits. The unit will stop its inflation and maintain the original cuff to within 10 mmHg of the set‐point before returning to the inflating cuff. This ensures that at least one cuff maintains occlusion at all times. If there is a significant leak in the original cuff, this feature could cause the inflation rate of the subsequent cuff to be longer and perhaps even cause the 30‐second inflation alarm to sound. When both cuffs are inflated, the PRESSURE and TIME tiles display independent information for each cuff. That is, the PRESSURE and TIME tiles are independently operated and controlled for each cuff. CAUTION: In order to deflate the final cuff, a sequence must be followed to prevent accidental deflation: TOUCH, SLIDE and HOLD the DEFLATE (DEFL) button on the final cuff. The opposite cuff will alarm “CUFF DEFLATED” to indicate the first cuff is deflated. ...
INSTALLATION AND OPERATING INSTRUCTIONS CAUTION: In order to deflate the final cuff, a sequence must be followed to prevent accidental deflation: TOUCH, SLIDE and HOLD the DEFLATE (DEFL) button on the final cuff. The opposite cuff will alarm “CUFF DEFLATED” to indicate the first cuff is deflated. A pop‐up window will appear on the final cuff’s display area asking for deflation confirmation. Touch the Cancel button to cancel the deflation or the Okay button to confirm the deflation. The cuff will deflate. CAUTION: Deflation of a cuff is not possible while the other is inflating. For Bier Block procedures follow the cuff inflation/ deflation sequence adopted by your institution or requested by the surgeon. ALARM CONDITIONS There are a number of conditions for which the A.T.S. 2200TS Tourniquet will produce a visual and/or audible alarm. The appropriate actions indicated are based on the most probable causes and should only be used as a guide. Other causes of alarm conditions may indicate a need for other actions. Most audible alarm tones (non‐technical failures) may be silenced for 30 seconds by pressing the ALARM SILENCE button. The tone will be re‐enabled at the end of the silenced period. Pressing the ALARM SILENCE button will cause the alarm tone to be silenced again. To minimize nuisance alarms that can be caused by range‐of‐motion movement of the patient’s limbs, a 1.5‐second delay has been designed into the alarm actuation. The alarm conditions, indications, and appropriate actions are shown in the ALARM CONDITIONS table. In addition to the alarm conditions shown, it is conceivable that a technical failure could occur for which the indications are unintelligible and unpredictable. In this situation, the A.T.S. 2200TS is designed to close the valves, causing the system to hold cuff pressure and alarm a constant tone. The A.T.S. 2200TS Tourniquet will also provide Error Code information for technical failure alarms as shown in the ERROR CODES table. ...
INSTALLATION AND OPERATING INSTRUCTIONS This type of leak could progress into a total failure of a cuff to hold pressure. To alert the operator that a substantial leak is present, a pressure alarm is declared when this type of leak is detected. If a pressure alarm occurs, and the displayed pressure is not more than 15 mmHg from the set‐point, then this type of substantial leak has been detected and all cuffs and pneumatic fittings should be checked for leaks. ADVANCED LEAK DETECTION The A.T.S. 2200TS has an Advanced Leak Detection feature that automatically monitors an inflated cuff in real‐time and observes potential leaks that may be occurring in the cuff or hoses. Advanced Leak Detection determines the magnitude of the leak. During cuff regulation, pressure is maintained within the set‐point limits and the system’s leak detector will monitor the rate of air flow into the cuff. The rate of air flow to the cuff is monitored for a period of time which takes into account normal transient pressure disruptions such as range‐of‐motion checks. A determination of the magnitude of leakage, that disregards transient disruptions, is produced by the Advanced Leak Detector. Any leakage of air from either cuff or the connection between cuff and device will cause a reduction in cuff pressure. The system will maintain the cuff set‐point pressure automatically. The rate at which the system must replenish air lost due to leakage in order to maintain the cuff pressure at the set‐ point is proportional to the magnitude of the leak. Advanced Leak Detection determines the magnitude of leakage by monitoring the level of the pressure increase signals during the cuff inflation period and then estimating the magnitude of leakage as a function of the level of the pressure increase control signal throughout the inflation time period. The magnitude of leakage determined by Advanced Leak Detection is indicated to the user in the Stats report as “LEAK DETECTED.” Advanced Leak Detection is capable of differentiating between the transient, such as range‐of‐motion checks, and the sustained activation of valves caused by a leak. Advanced Leak Detection can detect low leak. This type of leak is unlikely to trigger an alarm, but is indicative of a potential problem with a cuff, hoses, or the pneumatic connection between a cuff and device. Advanced Leak Detection won’t trigger an alarm, but rather report the potential problem in the Stats report. If Advanced Leak Detection has indicated a leak, the user should take action by leak testing the cuff ...
INSTALLATION AND OPERATING INSTRUCTIONS ALARM/WARNING COLORS AND AUDIBLE TONES During the course of operation, the A.T.S. 2200TS may display a flashing red or yellow light and yellow warning tiles containing Alarm Condition messages. For a technical failure, it will also display warning messages accompanied by Error Codes and a yellow exclamation point graphic. VISUAL AND AUDITORY ALARM PRIORITY Visual Auditory Auditory Comments Indicator Light Priority Tone Pulse Pattern Constant Red Technical Constant tone Constant tone indicating technical failure. Flashing Red High 10 tone pulses per burst, each Indicates immediate operator response is required. repeating two identical groups of 5 Fastest auditory indicator tone pulse at less than tone pulses with a pause between half the duration of Medium priority. each group. Flashing Yellow Medium 3 tone pulses per burst. Indicates prompt operator response is required. Baseline auditory indicator tone pulse speed. Constant Low 1 tone pulse per burst. Indicates operator awareness is required. The ...
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INSTALLATION AND OPERATING INSTRUCTIONS Warning Indicator Priority Condition, Remarks and Appropriate Action Message Light Tone not plugged in, a battery fail condition will occur and the unit will shut down in a fail safe mode closing all cuff valves. While running with a Low Battery Voltage Alarm Condition, other alarm conditions cannot be guaranteed. BATTERY IS Flashing Medium Condition: Battery is low (medium). LOW Yellow Battery charge is below 20% capacity. Plug unit into ~ AC Power Mains. If the unit is not plugged in, a battery fail condition will occur and the unit will shut down in a fail safe mode closing all cuff valves. While running with a Low Battery Voltage Alarm Condition, other alarm conditions cannot be guaranteed. CUFF NOT Flashing Medium Condition: Power switch was activated with cuff pressure. DEFLATED Yellow Cuff pressure greater than zero when ON/STANDBY button pressed. The system assumes that a procedure is in progress and prevents activation of STANDBY mode. CUFF INFLATED Flashing Medium Condition: A cuff was found pressurized during power up. Yellow Cuff pressure is 50 mmHg or greater at system power‐up. The system assumes that a procedure is in progress and adopts the sensed pressure as the new set‐point. The operator should immediately check the set value to determine if it needs reset. CUFF INFLATED Constant Condition: Cuff pressurization issues.
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INSTALLATION AND OPERATING INSTRUCTIONS ERROR CODES SYSTEM FAILURE DETECTED, CALIBRATION ERROR DETECTED and BATTERY ERROR DETECTED warning messages accompany one or more Error Codes. See ALARM CONDITIONS table for what the warning messages mean. Error Warning Indicator Priority Explanation / Appropriate Actions Code Message Light Tone E0001 SYSTEM Constant Technical Condition: EEPROM/ROM fail detected. XXXX FAILURE Red Failure Specification: The EEPROM/ROM access was attempted or R/W error DETECTED Constant tone occurred. The unit has shut down in a safe state. Explanation/Action: Microprocessor failed a ROM memory check. An attempt was made to access or R/W to ROM (non‐volatile memory) and the values were lost. Cycle the ON/ STANDBY button. If problem persists, note error code and contact manufacturer. If problem persists, service the unit. E0002 SYSTEM Constant Technical Condition: Valve fail detected. FAILURE ...
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Condition: Battery failed/error. ERROR Red Failure Specification: The unit has detected that the battery is missing or DETECTED Constant tone internal fuse blown. The unit has shut down in a safe state. Explanation/Action: Verify a battery is connected and cycle the ON/STANDBY button. If problem persists, note error code and contact manufacturer. E0015 BATTERY Constant Technical Condition: Battery failed/error. ERROR Red Failure Specification: The unit has detected a non‐Zimmer battery was installed DETECTED Constant tone or the battery is no longer responding to commands. The unit has shut down in a safe state. Explanation/Action: Verify a battery is connected and is a Zimmer battery. Cycle the ON/STANDBY button. If problem persists, note error code and contact manufacturer. E0016 BATTERY Constant Technical Condition: Battery failed/error. ERROR Red Failure Specification: The unit has received a signal from the battery pack that DETECTED Constant tone ...
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INSTALLATION AND OPERATING INSTRUCTIONS Error Warning Indicator Priority Explanation / Appropriate Actions Code Message Light Tone Explanation/Action: Replace the battery with a new Zimmer battery pack. Cycle the ON/STANDBY button. If problem persists, note error code and contact manufacturer. E0024 SYSTEM Constant Technical Condition: Software has detected the potential for instability. XXXX FAILURE Red Failure Specifications: Internal system diagnostics feature has detected an DETECTED Constant tone error. The unit has shut down in a safe state. Explanation/Action: Cycle the ON/STANDBY Button. If problem persists, note error code and contact manufacturer. E0025 SYSTEM Constant Technical Condition: Amplifier voltage failure detected. XXXX FAILURE ...
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INSTALLATION AND OPERATING INSTRUCTIONS Error Warning Indicator Priority Explanation / Appropriate Actions Code Message Light Tone DETECTED Constant tone Specifications: Internal system diagnostics feature has detected a speaker error. The unit has shut down in a safe state. Explanation/Action: Speaker not detected. Cycle the ON/STANDBY button. If problem persists, note error code and contact manufacturer. E0033 SYSTEM Constant Technical Condition: Watch dog timer safety circuit failure detected an audio XXXX FAILURE Red Failure circuit failure. The unit has shut down in a safe state. DETECTED Constant tone Specifications: Internal system diagnostics feature has detected an error. Explanation/Action: Audio tone generation not detected. Cycle the ON/STANDBY button. If problem persists, note error code and contact manufacturer. E0034 SYSTEM Constant Technical Condition: Primary power supply rails out of specification.
Explanation/Action: The system has detected an occurrence of an illegal program execution event or data values. If problem persists, note error code and contact manufacturer. Some Error Codes are followed by a four‐digit numeric code. This code represents detailed information related to the failure. Contact the manufacturer for information concerning those specific codes. ELECTROMAGNETIC COMPATIBILITY (EMC) GUIDANCE TABLES The following tables provide guidance on needs and installation of the A.T.S. 2200TS regarding electromagnetic compatibility. EMC GUIDANCE AND DECLARATION ‐ EM EMISSIONS Guidance and manufacturer’s declaration – electromagnetic emissions. The A.T.S. 2200TS is intended for use in the electromagnetic environments specified below. The customer or the user of the A.T.S. 2200TS should assure that it is used in such an environment. EMISSIONS TEST COMPLIANCE ELECTROMAGNETIC ENVIRONMENT ‐ GUIDANCE RF emissions Group 1 The A.T.S. 2200TS uses RF energy only for its internal function. CISPR 11 Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment. RF emissions Class A CISPR 11 The A.T.S. 2200TS is suitable for use in all establishments other Harmonic emissions Class A than domestic and those directly connected to the public low‐ IEC 61000‐3‐2 voltage power supply network that supplies buildings used for domestic purposes. Voltage fluctuations/ Flicker Complies emissions IEC 61000‐3‐3 ...
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INSTALLATION AND OPERATING INSTRUCTIONS EMC GUIDANCE AND DECLARATION ‐ EM IMMUNITY/DISTURBANCES Guidance and manufacturer’s declaration – electromagnetic immunity The A.T.S. 2200TS is intended for use in the electromagnetic environments specified below. The customer or the user of the A.T.S. 2200TS should assure that it is used in such an environment. IMMUNITY IEC 60601 TEST LEVEL COMPLIANCE LEVEL ELECTROMAGNETIC ENVIRONMENT – TEST GUIDANCE Electrostatic ± 6 kV contact ± 6 kV contact (230 Vac 50 Hz / Floors should be wood, concrete or discharge battery) ceramic tile. (ESD) If floors are covered with synthetic ± 8 kV air ± 8 kV air (230 Vac/ battery) IEC 61000‐4‐2 materials, the relative humidity should be at least 30% Electrical fast ± 2 kV for power supply ± 2 kV for power supply lines (120 ~ AC Power Mains power quality transient/burst lines Vac 60 Hz / 230 Vac 50 Hz) should be that of a typical commercial IEC 61000‐4‐4 or hospital environment. ± 1 kV for input/output ± 1 kV for input/output lines lines Surge ...
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INSTALLATION AND OPERATING INSTRUCTIONS EMC GUIDANCE AND DECLARATION ‐ EM EMISSIONS/RF Guidance and manufacturer’s declaration – electromagnetic immunity. The A.T.S. 2200TS is intended for use in the electromagnetic environments specified below. The customer or the user of the A.T.S. 2200TS should assure that it is used in such an environment. Immunity IEC 60601 Compliance Electromagnetic environment ‐ guidance Test test level level Portable and mobile RF communications equipment should be used no closer to any part of the A.T.S. 2200TS, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter. 3 Vrms Conducted RF Recommended separation distance 150 kHz to 80 3V IEC 61000‐4‐6 MHz d = 1.2√P d = 1.2√P 80 MHz to 800 MHz d = 2.3√P 800 MHz to 2.5 GHz where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m). Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey, should be less than the compliance 3 V/m ...
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INSTALLATION AND OPERATING INSTRUCTIONS EMC GUIDANCE AND DECLARATION – IMMUNITY/SEPARATION DISTANCES Recommended separation distances between portable and mobile RF communication equipment and the A.T.S. 2200TS The A.T.S. 2200TS is intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the A.T.S. 2200TS can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the A.T.S. 2200TS as recommended below, according to the maximum output power of the communications equipment. Rated maximum Separation distance according to frequency transmitter in output power of Meters (m) transmitter in 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz Watts (W) d = 1.2√P d = 1.2√P d = 2.3√P 0.01 0.12 0.12 0.23 0.1 0.38 0.38 0.73 1 10 100 12 12 23 For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer. NOTES: ...
MAINTENANCE GENERAL MAINTENANCE INFORMATION While the A.T.S. 2200TS Tourniquet has been designed and manufactured to high industry standards, it is recommended that regular inspection and calibration be performed to ensure continual safe and effective operation. This section contains information to assist in the effort as well as serve as a guide to expediting unscheduled maintenance. WARNING: No modification of this equipment is allowed. CAUTION: The A.T.S. 2200TS Tourniquet contains no user‐serviceable parts inside. All internal parts and components must be serviced by an authorized and qualified biomedical engineer or other person thoroughly familiar with electronic medical devices. Do not attempt to dismantle, modify or repair internal components. When testing, it is the user’s responsibility to ensure that the appropriate and proper measuring equipment is used. Improper or poorly maintained equipment may result in incorrect or misleading results. PERIODIC MAINTENANCE This manual includes a blank Test and Analysis form. This is provided at the back of this manual. This form may be photocopied and used to document the visual, electrical safety and functional tests. Cleaning The exterior of the unit, including the touch screen, may be cleaned with a cloth that has been dampened (not dripping) using a mild detergent solution with a neutral PH or isopropyl alcohol. The exterior of the cuff hose may be cleaned using a mild detergent solution with a neutral PH or isopropyl alcohol. Reusable tourniquet cuffs should be cleaned in accordance with their cuff package insert instructions. External Visual Inspection The unit should be inspected at regular intervals. It is recommended that a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization perform a visual inspection at least once every six months. Significant inspection points are: External housing, touch screen, buttons, pole clamp, missing/loose hardware, cuff ports, fuses (correct fuses used per labeling), labels (legible and complete). If any damage is discovered, the system should be removed from service immediately along with all accessories and reported to the designated individual responsible for equipment maintenance within the healthcare organization. Functional and Calibration Check It is recommended that the functional and calibration check described in the Tests and Checks section under the Installation and Operating Instructions section are performed at least once every three months. A Test and Analysis form is provided at the back of this manual. SERVICING The A.T.S. 2200TS system has several built‐in maintenance/service functions available through a Service menu, including Calibrate, Leak test, Unit Info, Burn mode, and Touch test. SERVICE MENU ACCESS To access the Service menu: ...
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Touch t the Settings bu utton on th he Systems Fun nction Menu. T The Settings m menu tile is disp played: Touch and hold the c enter of the la arge Settings ge ear symbol firs st and while co ontinuing to ho old the center of the gear, to ouch and hold t the padlock ico on . Continu e to hold un ntil the system unlocks the p adlock and the e Service menu u is display yed, revealing t the Calibrate, L Leak test, Unit t Info, Burn mo ode, ...
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Calibra ation Hose Kit Routes air r pressure betw ween a regulat ted pressure su upply to a (Provid ded) pressure m meter and the A.T.S. 2200TS unit’s cuff por rts. The Calibr ration Hose Kit t is supplied by y Zimmer and i ncluded with the u unit. CAUTION : The clamps o on the calibrat tion hose rema ain opened (n not clamped) d during calibrat tion. CAUTIO ON: All calibra tion steps mus st be taken in the exact orde er to calibrate the unit. Failu ure to do ...
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CUFF A AND RESERVOI R CALIBRATIO ON Below is a step‐by‐ste ep procedure f for calibrating both cuff tran sducers as wel ll as the reserv voir transdu ucer. The calib ration procedu ure will not be complete unt il both cuff tra nsducers and t the reservo oir transducer are calibrated in the exact se equence below w: Access the Service m enu as describ bed in the Serv vice Menu Acce ess section abo ove. Touch t the Calibrate b button to acce ss the Calibrat tion function in nterface. ...
The system will be looking for 250 mmHg to be applied to the cuff pressure transducers. The pinwheel will be rotating at the 250 numerical value waiting for the pressure to be applied. Once the pressure has been applied and is stable, touch the ‐250‐ button to calibrate the cuff transducers at the 250 mmHg point. A correct input will cause the system to play the confirmation tone and place a checkmark beside the numeric input value. Touch the Next button to continue to the next calibration point. The system will be looking for 475 mmHg to be applied to the cuff pressure transducers. The pinwheel will be rotating at the 475 numerical value waiting for the pressure to be applied. Once the pressure has been applied and is stable, touch the ‐475‐ button to calibrate the cuff transducers at the 475 mmHg point. A correct input will cause the system to play the confirmation tone and place a checkmark beside the numeric input value. Touch the Next button to continue to the next calibration point. The system will be looking for 600 mmHg to be applied to the cuff pressure transducers. The pinwheel will be rotating at the 600 numerical value waiting for the pressure to be applied. Once the pressure has been applied and is stable, touch the ‐600‐ button to calibrate the cuff transducers at the 600 mmHg point. A correct input will cause the system to play the confirmation tone and place a checkmark beside the numeric input value. Once all the cuff transducer values have been calibrated, the list of values will be shown with checkmarks beside each increment. The system is now ready to enter the reservoir calibration. Touch the Next button to continue to the reservoir calibration. The system will dump the reservoir pressure immediately once the Next button has been pressed; this is normal and is expected with a full reservoir. Disconnect the calibration hoses from the cuff transducer ports to allow the pressure to vent. Pressure will be exhausted when the calibration hoses are ...
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confirm mation tone an nd place a chec ckmark beside the numeric in nput value. Tou uch the Next b button o continue to th he next calibra tion point. The sys stem will be lo oking for 250 m mmHg to be ap pplied to the re eservoir pressu ure transducer r. The pinwhe eel will be rota ting at the 250 0 numerical va lue waiting for r the pressure to be applied. Once the pressu re has been ap pplied and is st able, touch the e ‐250‐ button n to calibrate th he reservoir tra ansducers at the 2 250 mmHg poi int. A correct in nput will cause e the system to...
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CALIBR RATION CHECK K Below is a step‐by‐ste ep procedure f for checking th he calibration o of the cuff tran nsducers. If the e calibrat tion is suspect ed of being ou ut of specificati ion, complete the calibration n per the CUFF and RESERV VOIR CALIBRAT TION section. T This section w ill allow the cu uff transducers s to be checked d without changin ng or modifyin ng the saved ca alibration. If the s ystem is not p owered ON, pr ress the Power r ON/STANDBY Y button an nd allow the sy ystem to ...
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Exit the e calibration by y pressing the Cancel button . Cuff trans sducer calibrat tion check is co omplete and the e calibration ho ose can be disc connected. Th e alarm will au utomatically di scontinue whe en pressu re is removed from the cuff p ports. ATS LE EAK TESTING G The A.T T.S. 2200TS To urniquet is cap pable of mainta aining the cuff f pressure set‐p point with an i nternal or exte ernal leak. Natu urally it is desir rable to keep p plumbing leaks s to an absolut e minimum. Fo or this ...
UNIT INFORMATION ACCESS The system contains an information block that will allow a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization the ability to check on key system elements that help track usage. This function is located in the SERVICE menu. To access this information perform the following steps: Access the Service menu as described in the Service Menu Access section above. Touch the Unit Info button to access the Unit Information function interface. Once opened the system will display information about the system that may be helpful for periodic maintenance. UNIT INFO What it indicates Software Version Displays the current version of software installed. 1 Total Cuff Runtime Total time in minutes a cuff has been inflated. This timer counts when either 2 cuff is inflated. 3 Total Successful Total time the system has been successfully calibrated in its life. Calibrations Total Time Used in Total time in minutes the system has been used in backup battery mode. 4 Backup Battery 5 Battery Health Health state of the battery expressed in percent (%). Last 3 Error Codes Displays the last error codes encountered. This may initially include error 6 codes that was intentionally generated during the factory testing. CAUTION: If the button combination was not correctly touched and held, the Systems Function Menu will not allow access and automatically close the menu due to inactivity. While in the Service mode, the system will keep the function running without automatically closing. ...
Touch the Burn Mode button to access the Burn Mode function interface. Attach a leak‐free cuff and hoses to both the Main and Second Cuff ports. These cuffs will be used as the cuffs to inflate and deflate as the Burn Mode exercises the pneumatic circuit. Once the cuffs and hoses are attached, press the Next button to start the Burn Mode. If the cuffs and hoses were not properly attached or have a significant leak, the system will issue an alarm. The Burn Mode will make additional attempts to start during the alarm period. The Burn Mode will successfully start once the cuffs and hoses are attached properly. The Burn Mode will start a countdown timer as soon as the Burn Mode is started. The Burn Mode does not have a pass or fail criteria. Rather, the Burn Mode will run for the time indicated and conclude. At any point in the Burn Mode, the function may be stopped by touching the Cancel button and return to the SERVICE main menu. CAUTION: The Burn Mode is only intended to be used as a method to exercise the pneumatic system after a significant service that includes replacement of parts. This function will be primarily useful to a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization. TOUCH TEST The system contains a feature that will allow a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization the ability to perform a touch screen test. The touch screen in the system is pre‐tuned and does not require any calibration. The Touch Test allows the touch screen to be exercised in the X and Y direction to ensure proper function. This function is located in the SERVICE menu. To access this information perform the following steps: Access the Service menu as described in the Service Menu Access section above. Touch the Touch Test button to access the Touch Test function interface. Press the Next button to start the Touch Test. An animated icon will appear on the screen showing the process for testing the touch screen. Once the animation is complete, start the Touch Test by touching and slowly dragging the red ball over the line. The line will be erased by the red ball. If sections are missed, drag the red ball back over the sections to erase. ...
equipment repair within the healthcare organization. The system should be returned to Zimmer for repair. PROTECTIVE EARTH RESISTANCE TESTING CAUTION: The A.T.S. 2200TS System must meet the protective earth resistance requirements before performing any additional electrical safety checks. The protective earth resistance measurement should be conducted with the power cord attached to appliance inlet. The test equipment used must be able to deliver at least 200mA into 500mΩ. The open circuit voltage shall not exceed 24V. Consult the test equipment manufacturer to ensure these specifications are met. Measure the protective earth resistance between the protective earth pin (ground pin) of the power cord and the exposed aluminum chassis at the back of the device. The resistance reading should not exceed 300mΩ. The integrity of the earth conductor of the power cord should be performed during normal maintenance intervals. During the protective earth resistance testing, the power cord should be flexed along its entire length. If during flexing, changes in resistance are observed, the power cord’s protective earth conductor is presumed to be damaged and the power cord should be immediately replaced. EARTH (EQUIPMENT) LEAKAGE CURRENT TESTING The earth (equipment) leakage current is the recommended leakage current test. The applied parts of the A.T.S. 2200TS are electrically insulated from the user/patient and are constructed from a non‐ conductive material. The maximum allowable leakage current is 500A in a single fault condition. INSULATION RESISTANCE TESTING CAUTION: The A.T.S. 2200TS System must be disconnected from supply mains when measuring the insulation resistance. The insulation resistance testing is conducted by measuring the Mains Part to the Protective Earth ground. The test equipment used shall be capable of performing the measurements with 500VDC. The insulation resistance will be a very high level since the insulation is intended to provide no means for electrical conductivity. Therefore, values >50MΩ will be considered acceptable reference value. Measurements that show a significant decrease from the previous measured value indicates a problem. BACKUP BATTERY SERVICE The A.T.S. 2200TS System is equipped with a Lithium Ion backup battery. The battery is designed to last for years when properly maintained. The system has a built‐in battery charger that maintains the battery power as long as ~ AC Power Mains is present. Continuous cycles of deep discharge and/or storage in a high temperature environment will shorten the life of the battery. Infrequent short‐term ...
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Using n needle‐nose pl iers, carefully unplug the bat ttery clip from the system by y lifting the tab b and pulling free. Replace e with a new Z Zimmer battery y and re‐install l the battery co ompartment c over. The A.T T.S. 2200TS Sys stem will imme ediately evalua ate the new ba attery and beg in charging. CAUTIO ON: The A.T.S. 2200TS Syste m is designed to use Zimme er batteries on ly. Do not use ...
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may not be ex xecuting reliab ble instructions s and is not abl le to display y the correct fa ilure message . The system sh hould be remo oved from serv vice immediate ely along with al l accessories a nd reported to o the designate ed individual re esponsible for equipment re pair within the hea althcare organ ization. The sy ystem should b be returned to Zimmer for re pair. age 58 of 68 ...
TROUBLE SHOOTING GUIDE To aid in unscheduled maintenance, the TROUBLESHOOTING table delineates a number of possible malfunctions that could occur with the unit. The most likely causes are shown for each symptom. While it is not practical to enumerate every conceivable malfunction and all possible causes, the table will assist in isolating the most common problems. TROUBLESHOOTING SYMPTOM POSSIBLE CAUSES Main Cuff or Second Cuff will not inflate Touch screen damaged and not accepting input. Multiple or large unexpected touch being detected. Tubing inside unit may be pinched or improperly connected. Deflate valve is stuck open. Pump not properly plugged in. Pump’s electrical harness damaged. Valve’s electrical harness damaged. Defective valve driver circuitry. Main Cuff or Second Cuff will not deflate. Touch screen damaged and not accepting input. Multiple or large unexpected touch being detected. Deflate function not being used properly. TOUCH, SLIDE and HOLD the button until deflation starts. ...
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Defective battery. Defective battery charging circuitry. Poor battery health. SYSTEM FAILURE DETECTED alarm. Multiple possible causes. See Alarm Conditions section for solutions. Unit cannot be set to STANDBY. ON/STANDBY Membrane not properly plugged in. Pressure sensed in the Main or Second Cuff (unit will alarm “CUFF NOT DEFLATED”) ON/STANDBY not fully pressed. ON/STANDBY button defective. Unit does not turn ON. Membrane panel not properly plugged in. ON/STANDBY button defective. Blown Fuse(s). Unit not plugged in and battery fully depleted. CAUTION ‐ HIGH VOLTAGE ELECTRICAL HAZARD: High voltage will be present on the power input module and control board. All service work must be completed by Zimmer or a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization. Page 60 of 68 ...
REPLACEMENT PARTS The following is a list of field replacement parts that can be ordered from Zimmer: PARTS LIST PART NUMBER DESCRIPTION 62800000130 Replacement Fuses (5‐Pack) 62800011380 Replacement Fuse Drawers (5‐Pack) 60220001455 Calibration Hose Assembly Kit 60220070200 Replacement Battery 62120080019 Power Cord Clip (5‐Pack) 60220021317 Replacement Battery Door 60220090773 Battery Door #8‐18 Screw (20‐Pack) 60236000100 Pole Clamp Knob 62800011340 ATS Foot Pads (20‐Pack) 60279000100 Single Cuff Hose Red 60279000200 Single Cuff Hose Blue 602200049EN Operator & Service Manual, English 602200049DA Operator & Service Manual, Danish 602200049NL Operator & Service Manual, Dutch 602200049FI Operator & Service Manual, Finnish 602200049FR Operator & Service Manual, French 602200049DE Operator & Service Manual, German ...
ORDER INFORMATION To ensure prompt service, please include the following information with your order: Model Number Shipping Means (if any). Shipping Address Description of Part Serial Number Quantity Desired Part Number (if known) CAUTION: We strongly recommend that all repairs be done by Zimmer or a qualified biomedical engineer or other person thoroughly familiar with electronic medical devices within the healthcare organization. CONTACT INFORMATION To obtain part or additional information regarding your unit, contact your Zimmer distributor or write or phone: MAIL TELEPHONE Zimmer Surgical 1‐330‐343‐8801 (local) 200 West Ohio Avenue 1‐800‐830‐0970 (toll‐free) Dover, Ohio 44622 U.S.A. Page 62 of 68 ...
ENVIRONMENTAL CONDITIONS The following are environmental conditions for operation of the A.T.S. 2200TS unit: CONDITION OPERATION Ambient temperature 68 F (20˚C) to 73˚F (23˚C) Typical 50˚F (10˚C) to 100˚F (38˚C) Maximum Relative humidity 30% to 60% Altitude ≤2,000 m – Not intended for high altitude environments Pollution Degree Pollution degree 2 There are no special requirements for transport or storage. Transport or store in an environment that limits exposure to dust, moisture and temperature extremes. See Backup Battery Service for battery recommendations on long‐term storage. WARNINGS, CAUTIONS & SYMBOLOGY Below are graphical Warning, Caution and other Symbols indicated on the A.T.S. 2200TS system and within this manual. Graphic What it means The tourniquet system shall be placed no higher than 50 inches (127 cm) from the floor when mounted to an IV pole and on a pole base diameter of at least 27.56 inches (70 cm) to maintain stability. Signifies to follow instructions for use (IFU). Replace fuse as marked. ...
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Graphic What it m means dical – General Medical Equip pment as to Ele ectric Shock, Fi ire and hanical Hazard ds Only, in Acco ordance with A ANSI/AAMI ES6 60601‐1 (200 5, 3rd Ed.) and d CAN/CSA‐C22 2.2 NO. 60601‐ ‐1. This prod uct contains o ne or more tox xic or hazardou us substances or elements . The Environm mental Protect ion Use Period d on the logo re efers to the period d in years whic ch toxic or haz ardous substa nces or eleme nts contained d in the produc ct will not leak k or mutate und...
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Graphic What it m means Potential equalization c connection. Ide entifies the ter rminals which, when connecte d together, bri ing the various s parts of an eq quipment or of f a system to the sam me potential, n not necessarily y being the ear rth (ground) po otential, e.g. for lo ocal bonding. Indicates hazards arising g from danger rous voltages. Signifies a a general warn ning. Used to d distinguish betw ween identical l or similar dev vices sold in bo oth sterile and nonst terile condition ns. ...
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Graphic What it m means Indicates suitability for alternating cu rrent only. Indicates suitability for direct current only. Indicates equipment or systems in the e medical elect trical area that t include RF transm mitters or that intentionally a apply RF electro omagnetic ene ergy for diagnosis or treatment. ...
TEST AND EVALUATION REPORT Test before putting into service (reference value) Testing Organization: _________________________________ Recurrent test Test after repair Name of Testing Person: ______________________________ Responsible Organization: ______________________________________________________________________________ Equipment: ________________________________________ ID – Number: __________________________________ Type: _____________________________________________ Serial Number: _________________________________ Manufacturer: Zimmer Class of Protection: Class I Class II Battery Applied Part Type: Mains Connection : Permanently Installed Non‐detachable Power Cord Detachable Power Cord 0 B BF CF Accessories: __________________________________________________________________________________________ Measuring Equipment: _________________________________________________________________________________ Test Results Visual Inspection Pass Fail Measurements: ...
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