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SonoSite M-Turbo, SonoSite Edge II, SonoSite S Series, and Sonosite are trademarks and registered trademarks of FUJIFILM Sonosite, Inc. in various jurisdictions. FUJIFILM is a registered trademark of FUJIFILM Corporation. Value from Innovation is a trademark of FUJIFILM Holdings America Corporation.
1. Introduction About the user guide ............................1-1 Changes in this version ..........................1-2 Conventions ..............................1-2 Warranty statement ............................. 1-2 Technical support ..............................1-3 2. Getting Started About the TEExi transducer ..........................2-1 Intended uses ................................2-2 Contraindications ..............................2-2 Unpacking ..................................
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4. Transducer Care Before getting started ............................4-1 Process overview ............................4-2 Transducer components ........................... 4-2 Cleaning the transducer ............................. 4-3 Testing the transducer for electrical leakage ..................4-5 About leakage testing ..........................4-5 Disinfecting the transducer ..........................4-9 Dispose of the disinfectant according to the manufacturer’s guidelines......4-12 Identifying the transducer as clean and safe ..................4-12 Transporting the transducer ...........................4-12 Storing the transducer ............................4-14...
Introduction The TEExi transducer is a transesophageal echocardiographic transducer designed to operate with the FUJIFILM SonoSite M-Turbo, SonoSite S Series, or SonoSite Edge II ultrasound system. Transesophageal procedures carry a variety of inherent risks to the patient. The information and instructions in this user guide are intended to help you minimize those risks. In addition, the TEExi transducer is a highly complex and delicate precision instrument.
FUJIFILM SonoSite. The warranty does not cover damage caused by patient bite, misuse by the end user, disinfecting incorrectly or with chemicals not approved by FUJIFILM SonoSite, or circumstances beyond what is considered normal for the product’s intended application.
Technical support To order sheaths, bite guards, tip covers, and other supplies, see www.civco.com. For technical support, contact FUJIFILM SonoSite as follows. 877-657-8118 Phone (U.S. or Canada) 425-951-1330, or call your local representative Phone (outside U.S. or Canada) 425-951-6700 ffss-service@fujifilm.com Email www.sonosite.com...
Getting Started About the TEExi transducer FUJIFILM SonoSite does not recommend the use of WARNINGS high-frequency electromedical devices in proximity to its systems. FUJIFILM SonoSite equipment has not been validated for use with high-frequency electrosurgical devices or procedures. Use of high-frequency electrosurgical devices in proximity to its systems may lead to abnormal system behavior or shutdown of the system.
Inability to swallow or accommodate the transducer History of gastroesophageal diseases Unpacking Proper care and maintenance are essential. Follow the unpacking procedures. Contact FUJIFILM SonoSite or your local representative immediately to report any damage or discrepancies. WARNING To avoid injury to patient/operator, carefully inspect all equipment after receipt and prior to each use.
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2 Note any breakage or other apparent damage, retain the evidence, and notify the carrier or shipping agency. 3 Verify that the shipping case contains the components listed on the packing list: TEExi transducer TEExi Transducer User Guide TEE Transducer Care (contains cleaning and disinfection instructions) Puncture test tool Bite guards/blocks (3) Non-sterile tip covers (3)
2-11. Leakage test. See “Testing the transducer for electrical leakage” on page 4-5. Contact FUJIFILM SonoSite or your local representative immediately to report any damage or discrepancies. “Technical support” on page 1-3. WARNING To avoid injury to the patient, do not use the TEExi transducer if any irregularity, substandard function or unsafe condition is observed or suspected.
Transducer and system interface The TEExi transducer consists of an electronically steered phased array ultrasound transducer assembly mounted in a sealed tip at the end of a conventional endoscope. It connects to the ultrasound system with Figure 2-2). a cable and connector (see Figure 2-2 TEExi transducer: Flexible endoscopic shaft...
TEExi transducer controls Figure 2-3 The endoscope is designed for one-hand operation of the flexion and scan plane controls. shows the user holding the endoscope handle in the left hand. Thumb and first and second fingers operate the flexion and scan plane controls. Check the mechanical operation and physical integrity of the transducer after taking it out of the box and before each exam.
Tip flexion The TEExi transducer handle has two wheels for controlling the transducer tip flexion. The wheels control anterior/posterior and left/right tip flexion. Figure 2-4 shows the wheels in the neutral (unflexed) position. The lower wheel controls the anterior/posterior flexion of the tip. You can lock this control into position.
Anterior/posterior flexion control (lower wheel) Left/right flexion control (upper wheel) WARNING To avoid injury to the patient, if you observe a sharp “U-turn” of the transducer tip during the tip flexion inspection, do not use the transducer. To inspect tip flexion Inspect the tip flexion on the TEExi transducer after taking it out of the box and before each exam.
Tip control in locked position To inspect the tip flexion lock Inspect the tip flexion lock on the transducer after taking it out of the box and before each exam. 1 Confirm that the lock control is in the unlocked position. 2 Deflect the tip to the anterior direction.
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The scan plane rotation is driven by a motor in the transducer handle and is controlled by buttons on the handle (see Figure 2-7). Figure 2-7 Scan plane rotation controls Transducer tip Counterclockwise button (increases angle) Biplane button (rotates angle to orthogonal biplane) Clockwise button (decreases angle) A scan plane indicator on the system screen shows the orientation.
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The button closest to the transducer tip rotates the scan plane counterclockwise (scan plane angle increases). The button farthest from the transducer tip rotates the scan plane clockwise (scan plane angle decreases). Full rotation of the imaging plane can be rotated forward from the standard transverse 0° plane to 180° (mirror image of the standard transverse plane).
If you observe or suspect any irregularity, substandard functioning, or unsafe condition, do not use the TEExi transducer. Call FUJIFILM SonoSite or your local representative immediately. Perform the following before each exam: Visual tactile inspection.
Low-voltage electrical leakage test. See page 4-5. “Transducer Care” Clean and disinfect transducer. See on page 4-1. Contact FUJIFILM SonoSite or your local representative to report any damage or discrepancies. See “Technical support” on page 1-3. WARNINGS To avoid injury to the patient: FUJIFILM SonoSite recommends performing the above procedures prior to...
Use of a bite guard is mandatory for TEExi transducers. Each TEExi transducer from FUJIFILM SonoSite is delivered with three bite guards. For patients with dentures, you must still use a bite guard. Remove the dentures before placing the bite guard in the patient’s mouth.
During removal of the sheath, be careful not to use excessive force on the transducer tip; otherwise permanent damage to the TEExi transducer may occur. To provide suitable acoustic coupling within the sheath, FUJIFILM SonoSite recommends using a sterile gel. To install a transducer sheath Note FUJIFILM SonoSite recommends the use of market-cleared, transducer sheaths for intracavitary applications.
FUJIFILM SonoSite routinely tests cleaners and disinfectants for use with FUJIFILM SonoSite systems and transducers. Disinfectants and cleaning methods listed in this chapter are recommended by FUJIFILM SonoSite for efficacy and material compatibility with the products. Ensure that the disinfectant type, concentration, and contact time are appropriate for the equipment and application.
Process overview For manual cleaning, electrical leakage testing, and disinfecting the transducer, the following workflow is recommended. If using an automated disinfection process, follow manufacturer procedures. Table 4-1: Manual workflow Steps 1 Cleaning 2 Leakage testing 3 Disinfecting Transducer components Some components of the TEExi transducer have different cleaning requirements and restrictions than others.
Do not skip any steps or abbreviate the cleaning and disinfecting process in any way. Cleaners and disinfectants not listed on FUJIFILM SonoSite's website have not been evaluated for compatibility and may cause damage to the transducer. For approved chemicals, follow the manufacturer’s instructions for concentration, temperature, and duration.
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9 Dry the transducer with a clean, non-linting towel. Examine the transducer and cable for damage, such as cracks or splitting where fluid can enter. If damage is evident, discontinue use of the transducer, and contact FUJIFILM SonoSite or your local representative.
Testing the transducer for electrical leakage Caution If the watertight coating on the scan head or endoscopic shaft has been damaged or punctured, contact FUJIFILM SonoSite for instructions on cleaning and returning the transducer for repair. About leakage testing Electrical leakage caused by bite holes or other damages to the endoscope surface can be detected using a transducer leakage tester, such as the ULT-2000 series.
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To test the transducer for electrical leakage 1 Insert the transducer connector into the transducer adapter as shown in Figure 4-2. Figure 4-2 Insertion of the transducer connector 2 Insert the fork adapter securely under the flexion control wheels as shown in Figure 4-3.
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11 Rinse the transducer in a large volume of clean water (for example, eight liters) for at least three minutes. “Disinfecting the transducer” and visually inspect it for damage before proceeding to on page 4-8. If damage is evident, discontinue use of the transducer, and contact FUJIFILM SonoSite or your local representative. Transducer Care...
Do not steam, autoclave, or expose the transducer to Ethylene Oxide. Cleaners and disinfectants not listed on FUJIFILM SonoSite's website have not been evaluated for compatibility and may cause damage to the transducer. For a list of approved disinfectants, see www.sonosite.com/support/cleaners-disinfectants.
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2 At the disinfection station, prepare the disinfectant for use: a Check the expiration date on the bottle to ensure that the disinfectant has not expired. b Check that the disinfectant has the concentration recommended by the manufacturer (for example, use a chemical strip test).
4 Examine the transducer and cable for damage, such as cracks or splitting where fluid can enter. If damage is evident, discontinue use of the transducer, and contact FUJIFILM SonoSite or your local representative. 5 If not already in place, apply a clean tip cover over the transducer scan head. The tip cover encloses and protects the scan head from mechanical strain and impact during transportation and storage.
To identify the transducer as unsafe to use, you should include a sticker or certificate that travels with the transducer that includes the date of the test, the name or other identification of the tester, and the outcome of the test. Transporting the transducer When transporting the TEExi transducer, you must take precautions to protect the transducer from damage and avoid cross-contamination.
Whenever possible, avoid shipping a contaminated transducer. Before shipping, ensure the transducer has been cleaned, tested, and disinfected using the steps detailed in this chapter or according to special instructions received from FUJIFILM SonoSite. If you are returning the transducer to FUJIFILM SonoSite, document the disinfection on a “Declaration of Cleanliness,”...
The rack is sized and positioned to prevent the transducer from inadvertently falling. Make sure the connector is supported and secure. Disposing of the transducer WARNING Do not destroy the transducer by incinerating or burning it. Return the transducer to FUJIFILM SonoSite or your local representative for disposal. Transducer Care 4-13...
If any irregularity, substandard functioning, or unsafe condition is observed or suspected, do not use the TEExi transducer. Contact FUJIFILM SonoSite or your local representative immediately. WARNING The TEExi transducer has no protection in the event of a neutral electrode fault of a high frequency surgical device.
Avoid forceful intubation pressure which can cause lacerations or perforation of the gastrointestinal tract. Remove the transducer from the patient when using a defibrillator. FUJIFILM SonoSite recommends cleaning and disinfecting transducers after each use. See “Transducer Care” on page 4-1.
Cautions To avoid damaging the equipment, clean and disinfect the transducer using the recommended procedures only. To avoid damaging the transducer, the TEExi transducer shall be handled only by trained personnel. The TEExi transducer is a precision instrument and can be inadvertently damaged.
Reducing temperature The following are general guidelines for reducing temperature in 2D or Doppler imaging modes: Using 2D imaging (2D imaging typically results in the lowest transducer surface temperature.) In 2D imaging, selecting the Res or Gen optimization setting and increasing the image depth In PW Doppler imaging, decreasing the PRF and/or positioning the Doppler sample gate to a shallower depth In CW Doppler imaging, no imaging changes reduce the transducer surface temperature.
It is important that you establish and use a standardized procedure to ensure that the transducer is safe to use and functions properly prior to each use. If any irregularity, substandard functioning, or unsafe condition is observed or suspected, do not use the TEExi transducer. Call FUJIFILM SonoSite or your local representative.
Transducer temperature rise Table 5-4: Transducer surface temperature rise, internal use Test TEExi Still air Simulated use 4.7 (≤6°C) Output display Table 5-5: TI or MI ≥ 1.0 Transducer Index 2D/M Mode CPD/Color PW Doppler CW Doppler TEExi TIC, TIB, or TIS Safety...
Acoustic output Table 5-6: Transducer model: TEExi Operating mode: CW Doppler Index label Below Below surface surface surface surface surface Maximum index value Index component value at z (MPa) r,α P (mW) 34.4 (mW) 34.4 (cm) (cm) 1.10 (cm) (cm) pii,α...
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Table 5-7: Transducer model: TEExi Operating mode: PW Doppler Index label Below Below surface surface surface surface surface Maximum index value Index component value at z (MPa) r,α P (mW) 35.8 (mW) 35.8 (cm) (cm) 2.57 (cm) (cm) pii,α (MHz) 3.81 prr (Hz) srr (Hz)
Transducer Specifications TEExi/8-3 MHz transducer External Diameter: 10.5 mm Endoscopic shaft Length: 110 cm Clockwise rotation of the lower control wheel will flex the tip anterior. Counterclockwise rotation of the lower wheel will flex the tip posterior. Steering Clockwise rotation of the upper control wheel will flex the tip to orientation the right.
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Transducer tip Upper: 42.5° C temperature Lower: 17.5° C limits Transducer Center Frequency 5.0 MHz Maximum cable 7.2 ft/2.2 m (as measured between the strain reliefs) length All patient contact materials of the TEExi transducer/endoscope Biocompatibility system comply with ISO 10993-1. The transducer is latex free. Temperature: Environmental Shipping: -35°...
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