ohio care plus series 1000/2000 incubator...table of contents iv 600-0291-000 001 iv warnings before...

Ohio® Care Plus® Series 1000/2000IncubatorOperation and Maintenance Manual

Table of Contents

ii ii600-0291-000 001

User Responsibility

600-0291-000 001

0086

This Product will perform in conformity with the description thereof contained in this operating manual and accompanying labels and/or inserts, when assembled, operated, maintained and repaired in accordance with the instructions provided. This Product must be checked periodically. A defective Product should not be used. Parts that are broken, missing, plainly worn, distorted or contaminated should be replaced immediately. Should such repair or replacement become necessary, Ohmeda recommends that a telephone or written request for service advice be made to the nearest Ohmeda Regional Service Center. This Product or any of its parts should not be repaired other than in accordance with written instructions provided by Ohmeda and by Ohmeda trained personnel. The Product must not be altered without the prior written approval. The user of this Product shall have the sole responsibility for any malfunction which results from improper use, faulty maintenance, improper repair, damage, or alteration by anyone other than Ohmeda.

U.S. Federal and Canadian law restrict this device to sale by or on the order of a licensed medical practitioner.

Caution

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ii ii600-0291-000 001

Table of ContentsGeneral Precautions

Warnings .................................................................................................................................................................... iii

Cautions ..................................................................................................................................................................... iii

1/IntroductionIntroducing the Ohio Care Plus Incubator ................................................................................................. 1-1

2/Getting StartedMounting the Care Plus on the cabinet ..................................................................................................... 2-2

3/General InformationOperating modes ................................................................................................................................................ 3-1

The air control (manual) mode ........................................................................................................... 3-1The optional patient control mode ................................................................................................... 3-2

Controls and displays ......................................................................................................................................... 3-4

Alarms ...................................................................................................................................................................... 3-6

Cable connections and mechanical controls ..........................................................................................3-10

4/Preoperative Checkout ProcedureMechanical checks .............................................................................................................................................. 4-1

Accessory checks ................................................................................................................................................. 4-2

Controller checks ................................................................................................................................................. 4-3

Operational checks ............................................................................................................................................. 4-6

5/Using the IncubatorBasic operating procedure ............................................................................................................................... 5-2

Responding to alarms ........................................................................................................................................ 5-5Air circulation alarm ................................................................................................................................ 5-6Control temperature alarm .................................................................................................................. 5-6High air temperature alarm ................................................................................................................. 5-6Patient temperature alarm (Patient control models only) ........................................................ 5-7Probe failure alarm (Patient control models only) ....................................................................... 5-7Power failure alarm ................................................................................................................................. 5-8System failure alarm ............................................................................................................................... 5-8

Additional operating procedures .................................................................................................................. 5-8Accessing the patient ............................................................................................................................. 5-8Raising and lowering the hood ........................................................................................................5-10Trendelenburg and reverse Trendelenburg positioning-tilt handle models ...................5-11Administering oxygen ........................................................................................................................5-12Using the optional humidifier ...........................................................................................................5-14

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iii iii600-0291-000 001

6/Maintaining the IncubatorCleaning schedule .............................................................................................................................................. 6-1

Disassembling the incubator for a complete cleaning .......................................................................... 6-2

Cleaning and disinfecting individual components ................................................................................. 6-6Humidifier ................................................................................................................................................... 6-6Patient Probe ............................................................................................................................................. 6-7Controller assembly ................................................................................................................................ 6-8Porthole ....................................................................................................................................................... 6-9Compartment Temperature Probe .................................................................................................... 6-9Other Clear Plastic Parts ........................................................................................................................ 6-9Lower unit (mattress, mattress tray, base platform cover, etc.) ............................................... 6-9Oxygen inlet .............................................................................................................................................. 6-9Cabinet ........................................................................................................................................................ 6-9

7/Service ProceduresRepair Policy .......................................................................................................................................................... 7-1

Maintenance schedule ...................................................................................................................................... 7-1Operator maintenance .......................................................................................................................... 7-1Service maintenance .............................................................................................................................. 7-2

Troubleshooting incubator problems ......................................................................................................... 7-2

8/Illustrated PartsBase platform and cover assembly ............................................................................................................... 8-1

AppendixCare Plus specifications ......................................................................................................................................... 1

Electrical specifications ............................................................................................................................. 1Performance specifications ...................................................................................................................... 2Safety specifications ................................................................................................................................... 4Environmental specifications .................................................................................................................. 4Electromagnetic Compatibility (EMC) Specifications ..................................................................... 4Mechanical specifications ......................................................................................................................... 5

Additional Safety Information ............................................................................................................................ 6

Glossary ......................................................................................................................................................................7

Warranty

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iv iv600-0291-000 001

WarningsBefore using the Ohio Care Plus Incubator, read through this entire manual. As with all medical equipment, attempting to use this device without a thorough understanding of its operation may result in patient or user injury. This device should only be operated by personnel trained in its operation under the direction of qualified medical personnel familiar with the risks and benefits of this type of device. Additional precautions specific to certain procedures are found in the text of this manual.

Complete the “Pre-operative Checkout Procedures” section of this manual before putting the unit into operation. If the incubator fails any portion of the checkout procedure it must be removed from use and repaired.

Do not use the Care Plus in the presence of flammable anesthetics; an explosion hazard exists under these conditions.

Always disconnect the power before performing service or maintenance procedures detailed in this manual. Apply power only if you are specifically instructed to do so as part of the procedure.

Thoroughly air dry the incubator after cleaning it with flammable agents. Small amounts of flammable agents, such as ether, alcohol or similar cleaning solvents left in the incubator can cause a fire.

CautionsOnly competent individuals trained in the repair of this equipment should attempt to service it as detailed in the Service Manual (Stock Number 6600-0292-000).

Detailed information for more extensive repairs is included in the service manual solely for the convenience of users having proper knowledge, tools and test equipment, and for service representatives trained by Ohmeda.

This Product will perform in conformity with the description thereof contained in this operating manual and accompanying labels and/or inserts, when assembled, operated, maintained and repaired in accordance with the instructions provided. This Product must be checked periodically. A defective Product should not be used. Parts that are broken, missing, plainly worn, distorted or contaminated should be replaced immediately. Should such repair or replacement become necessary, Ohmeda recommends that a telephone or written request for service advice be made to the nearest Ohmeda Regional Service Center. This Product or any of its parts should not be repaired other than in accordance with written instructions provided by Ohmeda and by Ohmeda trained personnel. The Product must not be altered without the prior written approval. The user of this Product shall have the sole responsibility for any malfunction which results from improper use, faulty maintenance, improper repair, damage, or alteration by anyone other than Ohmeda..

General Precautions

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v v600-0291-000 001

Notes

1-1

1/Introduction

1-1600-0291-000 001

1/IntroductionIn this section

Introducing the Ohio® Care Plus® Incubator ............................................................................................. 1-1

How to use this manual .................................................................................................................................... 1-2

Introducing the Ohio Care Plus IncubatorThank you for selecting the Ohio Care Plus Incubator. The Care Plus adapts to your patient’s needs with: manual and optional patient operating modes; an optional passive humidifier; an oxygen inlet; removable inner wall; and zero or ten degree bed positions.

From its comprehensive series of alarms and quiet operation, to unique oval portholes for greater lateral access, the Care Plus offers both security and convenience. Its familiar styling integrates into the existing nursery environment.

Ohio® Care Plus® Incubator is a registered trademark of Ohmeda.

Figure 1-1 The Ohio Care Plus Incubator

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1/Introduction

1-2600-0291-000 001

Care Plus technology

The Care Plus combines microprocessor technology, a unique hood design with front to back air flow, and an optional humidifier to stabilize patient temperature:

• Themicroprocessorrespondsimmediatelytotemperaturechanges,minimizingthetemperature fluctuations of older, analog incubators.

• Heatedaircirculatedalongthehoodwall,orbetweentheoptionaldoublewalledhood, warms the surfaces surrounding the infant, reducing radiant heat loss.

• Limitingairmovementaroundtheinfantreducesconvectiveandevaporativeheatloss. Humidifying the air further reduces evaporative heat loss.

WARNING Before using the Ohio Care Plus Incubator, read through this entire manual. As with all medical equipment, attempting to use this device without a thorough understanding of its operation may result in patient or user injury.

What warnings and cautions mean

No matter what part of this manual you are using, you should always be familiar with the cautions and warnings that appear throughout this manual. Warningsalert you to conditions and actions that can cause injury. Cautions point out conditions or actions that may damage the incubator.

Please also take a moment to review the User Responsibility Statement on the inside of the front cover; it describes what is expected of you to maintain the Care Plus Incubator. Also read the Warranty on the back cover; it outlines Ohmeda’s responsibility in case of a functional defect.

Symbols used in this manual

An attention symbol in the left hand column alerts you to a warning or a caution in the text. The attention symbol looks like this:

Just as on the controller panel, we use arrow heads to represent the temperature switches:

M Increase the control temperature

? Decrease the control temperature

2-1

2/Getting Started

2-1600-0291-000 001

2/Getting Started

WARNINGS Safely mounting or dismounting the Care Plus Incubator requires two people. Remove the controller unit before mounting or dismounting the incubator.

Do not place the incubator in direct light. Exposing the infant or the incubator to direct radiation from the sun or incandescent lighting may cause the infant to overheat.

Items not covered in this chapter

If your system uses any accessories or external monitoring devices (phototherapy light, blender, etc.), follow the mounting instructions in the operation and maintenance manual for the device.

In this sectionMounting the Care Plus on the cabinet ..................................................................................................... 2-2

2-2

2/Getting Started

2-2600-0291-000 001

Mounting the Care Plus on the cabinet WARNING: Safely mounting or dismounting the Care Plus Incubator requires two people.

1. Install the four mounting knobs.

WARNING If mounting hardware is not securely fastened, the incubator could tip off the stand.

CAUTION When handling the controller, avoid bumping the fan or the heater. If these items are knocked out of alignment, the fan can grate against the heater or the base.

2. Install the controller. Lift the levers on the controller and slide it into the incubator as shown in Figure 2-2. Push the levers down to lock the controller in place.

3. Refer to section 4 in this manual to perform preoperative checkout procedures.

Figure 2-1 Mounting the Care Plus Incubator

Mounting Knob

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Controller

ControllerLever

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3/General Information

3-1600-0291-000 001

3/General InformationIn this section

Operating modes ................................................................................................................................................ 3-1The air control (manual) mode ........................................................................................................... 3-1The patient control (servo) mode ...................................................................................................... 3-2

Controls and displays ......................................................................................................................................... 3-4

Alarms ...................................................................................................................................................................... 3-6

Cable connections and mechanical controls ..........................................................................................3-10

Operating modesThe Care Plus has two operating modes: the air control (or manual) mode, which adjusts heater output to achieve a target air temperature; and the patient control (or servo) mode, which adjusts the incubator temperature to achieve a target infant skin temperature. In both modes, the target temperature appears in the Control Temperature display on the front of the controller and can be adjusted using the temperature switches (? and M).

To distinguish between control temperatures in the different modes, this manual uses the term “air control temperature” for the control temperature in the air control mode and the term “patient control temperature” for the control temperature in the patient control mode.

Note: This section briefly mentions displays, controls, and alarms that play a significant role in the air control and patient control modes. For further information, refer to the appropriate section “Controls and displays” or “Alarms.”

The air control (manual) mode

The air control mode compares the air temperature to the air control temperature to determine if the heater should be switched on or off. If the air temperature is too high, the heater switches off. If the air temperature is too low, the heater switches on.

Air control temperature

The air control mode lets you enter air control range temperatures from 20 to 37°C (68.0 to 98.6°F) using the temperature switches (? and M). Pressing the Override switch when the air control temperature is 37°C (98.6°F) lets you increase the air control temperature to 39.0°C (102.2°F).

Control temperature alarm

The control temperature alarm triggers if the air temperature exceeds a normal range air control temperature by more than 1.5°C (2.7°F) or if the air temperature falls more than 3.0°C (5.4°F) below the air control temperature. For air control temperatures above 37°C, the control temperature alarm triggers if the air temperature exceeds the air control temperature by more than 1.0°C (1.8°F).

To avoid unnecessary alarms, the control temperature alarm does not trigger during the first 30 minutes after power is switched on and for 15 minutes after you change the air control temperature or enter the air control mode from the patient control mode. During this period, normal incubator alarm routines verify proper operation and switch off the heater if the air temperature exceeds certain default safety limits: 38°C (100.4°F) for control temperatures below 37°C (98.6°F) and 40°C (104.0°F) for control temperatures above 37°C.

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Patient probe (Care Plus 2000 only)

In the air control mode, the patient probe has no affect on incubator operation; connecting the probe simply displays the patient temperature for your information.

The patient control mode (Care Plus 2000 only)

In the patient control mode, the control temperature (patient control temperature) corresponds to the desired patient skin temperature. To reach an incubator temperature that will maintain the desired skin temperature the incubator control system loops through the program shown in Figure 3-1. This program compares the patient control temperature setting to the actual patient temperature and raises or lowers the incubator temperature depending on whether the infant is hot or cold. The incubator temperature that maintains the desired skin temperature is referred to as the DET (Desired Environmental Temperature). The maximum DET that the incubator will maintain is 39.0°C (102.2°F).

You can reduce the time required to reach the DET by preheating the incubator in the air control mode before entering the patient control mode. The closer the air temperature gets to the actual air temperature required to maintain the desired infant skin temperature, the sooner the incubator will stabilize the infant’s temperature in the patient control mode. When you switch to the patient control mode, the previous air control temperature becomes the initial DET. The incubator automatically adjusts the DET using the three stage patient control mode program, shown in Figure 3-1.

The first stage of the loop checks to make sure that the patient probe is reporting a reasonable patient temperature before making any adjustments. If the patient temperature is less than 30°C (86.0°F) or above 42°C (107.6°F), the incubator assumes that the patient probe has detached from the infant, the patient temperature alarm triggers, the heater shuts off, and the DET remains unchanged.

The second stage of the loop calculates the PTG (Patient Temperature Gradient), the difference between the actual patient temperature and the selected patient control temperature, to determine if the infant is hot or cold. If the infant is too cold (PTG < -0.5°C), the heater switches On. If the infant is too hot (PTG > 0.5°C), the heater shuts down. The patient temperature continues to be checked every three seconds.

The third stage calculates the change in the patient temperature over the previous ten minute period. If the infant temperature differs from the patient control temperature setting by 0.2°C or more, and this difference has not decreased by at least 0.2°C during the last ten minute period, the DET will be adjusted. To prevent large incubator temperature swings and to allow time for the patient to respond to changes in the incubator temperature, the magnitude of the change in the DET depends on the PTG.

Patient control temperature range

The patient control mode lets you enter air control temperatures from 35.0 to 37.0°C (95.0 to 98.6°F) using the temperature switches (? and M). An internal adjustment lets you increase the patient control temperature to 37.5°C (99.5°F).

Patient temperature alarm

Patient temperature alarm monitoring runs concurrently with the control loop. A patient temperature alarm triggers if the patient temperature differs from the patient control temperature by more than 1.0°C (1.8°F), or 0.5°C (0.9°F) with an internal adjustment. Additional alarm routines verify proper operation and switch off the heater if the air temperature exceeds 40.0°C (104.0°F).

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Start

Is the PT42°C?

Is the PTG

0.5°C?

Yes

Infant ishot

Supply no heat

Yes

Infant iscold

Yes

Assume probeis dislodged

1) Switch heater off2) Activate alarm3) Keep DET constant

Yes

Assume probeis dislodged

No

No

No

Have 10 minpassed?

No

Supplymaximum heat

No

Repeat first stage

No

Infant iscold

Yes

Infant ishot

Is thePTG³0°C?

Is the DPT£-0.2°C?

Is the DPT³0.2°C?

DET change= 0

Yes Yes

DETPTG Change-0.5°C 0.3°C-0.4°C 0.3°C-0.3°C 0.2°C-0.2°C 0.1°C-0.1°C 0.0°C-0.0°C 0.0°C

DEPTG Chang0.5°C -0.3°C0.4°C -0.3°C0.3°C -0.2°C0.2°C -0.1°C0.1°C -0.0°C0.0°C -0.0°C

No No

Calculate new DET

New DET = Old DET + Change

PT = Patient TemperaturePCT = Patient Control TemperatPTG = PT-PCTDPT = Current PT - PT 10 min. previous

Yes

Startthirdstage

Stage 1

Stage 2

Figure 3-1Patient control mode logic diagram

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Stage 3

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Controls and displays

Figure 3-2Controls and displays

Patient temperature

During normal operation, the patient temperature display shows the temperature sensed at the patient probe tip, in Celsius or Fahrenheit. The patient probe must be properly connected to the incubator and the infant for an accurate patient temperature measurement.

Temperatures between 22.0 and 42.0°C (71.6 and 107.6°F) are displayed to the nearest 0.1°C or °F. Temperatures above this range result in a HHHH temperature display. Temperatures below this range cause LLLL to be displayed.

Depressing the Enable switch for more than five seconds tests the temperature monitoring system. If the monitoring system is functioning correctly, 25.05°C ±0.2°C replaces the patient temperature during the test.

Air temperature

During normal operation, the air temperature display shows the internal incubator temperature.

Air temperatures between 5 and 50.0°C (41 and 122°F) are displayed to the nearest 0.1°C or °F.

Depressing the Enable switch for more than five seconds tests the temperature monitoring system. If the monitoring system is functioning correctly, 37.95°C ±0.2°C replaces the air temperature during the test.

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Care Plus® 1000

Care Plus® 2000

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3-5600-0291-000 001

Control temperature

During normal operation, the control temperature display shows the control temperature (air or patient) selected by the operator. When you first power up the unit or if you enter the patient control mode, the control temperature flashes and a prompt tone sounds until you enter a control temperature.

In the air control mode, the control temperature range is 20 to 39.0°C (68 to 102.2°F). Air control temperatures above 37.0°C (98.6°F) require the use of the Override switch.

In the patient control mode, the control temperature range is 35 to 37°C (95.0 to 98.6°F).

Note: Qualified service personnel can configure maximum patient temperature to 37.5°C.

During a system failure alarm, the appropriate error code appears in the control temperature display.

Depressing the Enable switch for more than five seconds replaces the control temperature with the percentage of the rated line voltage supplied by the power outlet.

Four LED displays illuminate to show the average heater power over the last minute as a percentage of the maximum output (100%, 75%, 50% and 25%). In the example, the average heater power is 75% of the maximum power.

The alarm silence switch has two functions. Pressing the switch silences all audible alarms except for the system failure and power failure alarms. The length of the alarm silence period depends on the alarm condition as detailed in the “Alarms” section. The alarm silence indicators (next to the switch) illuminates for the duration of the alarm silence period.

Depressing alarm silence switch for five seconds or longer illuminates all control panel LEDs and causes “188.88” to appear in the temperature displays. The alternating, two tone alarm also activates.

The °F/°C switch changes the temperature displays from degrees Celsius to degrees Fahrenheit and vice versa.

Pressing the Enable switch activates the temperature switches (? and M), the mode switches, and the Override switch for approximately 12 seconds. The enable indicator illuminates when these switches are active. If the indicator goes out, you must press the Enable switch again to reactivate these switches.

Pressing the Air Control switch selects the air control mode of operation and illuminates the Air Control indicator (next to Control Temperature display). To prevent accidental mode changes, you must press the Enable switch to activate the Air Control switch. The audible alarm sounds briefly when the mode of operation is changed.

Note: The incubator defaults to the air control mode when power is first applied.

100%75%50%25%

°F / °C

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The Override switch lets you select air control temperatures higher than 37.0°C (98.6°F). To raise the air control temperature above 37°C, increase the control temperature to 37°C, press the Enable switch, press the Override switch, and then increase the air control temperature. The maximum set temperature is 39°C. The override indicator remains illuminated to indicate that the air control temperature exceeds 37.0°C.

Pressing the Patient Control switch selects the Patient control mode of operation and illuminates the Patient Control indicator (next to Control Temperature display). To prevent accidental mode changes, you must press the Enable switch to activate the Patient Control switch. The audible alarm sounds briefly when the mode of operation is changed. The first time that you select the patient control mode, the control temperature display also flashes and an operator prompt tone sounds until you enter a control temperature.

These switches adjust the control temperature. To prevent accidental changes, you must press the Enable switch to activate these switches. These switches remain active as long as the enable indicator is illuminated, approximately 12 seconds after the last switch is pressed.

The power switch is located on the right side of the controller assembly, adjacent to the power cord socket. It switches the incubator power On and Off. Two circuit breakers, located within the controller, limit the maximum current drawn by the incubator. If the circuit breaker trips, remove the unit from use and contact qualified service personnel for repair.

AlarmsNote: All silenceable alarms are preceded by a 30 second operator prompt tone.

Seven LEDs on the left side of the control panel illuminate for various alarm conditions. Each visual indicator is accompanied by an audio signal.

Figure 3-3Alarm indicators

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>37°C

Patient Temp

Control Temp

High Air Temp

Air Circulation

Probe Failure

System Failure

Power Failure

Alarm

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What the audible tone tells you about the alarm

The audio tone varies with the alarm’s priority: power failure and system failure alarms cannot be silenced; an alternating two tone alarm indicates a critical alarm that triggers automatic heater shutdown; an intermittent single tone alarm is used for all other alarms.

Silencing an alarm

With the exception of the power and system failure alarms, all audio alarms can be silenced by pressing the Alarm Silence switch. At the end of the silence period, the audio alarm reactivates unless the alarm condition has been resolved. The alarm silence period ends prematurely if another alarm triggers. When two or more alarms trigger, their respective indicators illuminate, and the audio signal sounds for the highest priority alarm.

Patient temperature alarm (Care Plus 2000 only)

The patient temperature alarm is only active in the patient control mode of operation. The alarm activates when the difference between the patient temperature and the control temperature is greater than 1.0°C (1.8°F) and resets when the patient temperature returns to within 0.8°C (1.4°F) of the control temperature.

Patient probe readings above 42.0°C or below 30.0°C trigger an alternating two tone alarm and automatic heater shutdown.

Note: Service personnel can configure the alarm to trigger if the difference exceeds 0.5°C and to reset when the difference is less than 0.3°C.


The control temperature alarm is only active in the air control mode. The alarm triggers when the air temperature exceeds the control temperature by more than 1.5°C, (2.7°F) or falls more than 3.0°C (5.4°F) below the control temperature. This alarm is inactive for 30 minutes after the incubator is first switched on. It is also inactive for 15 minutes after either a mode or control temperature change.

High air temperature alarm

The high air temperature alarm warns of abnormally high incubator air temperatures and automatically switches Off the heater. This alarm is produced by a circuit that is independent of microprocessor temperature monitoring.

The high temperature alarm is not self resetting. After the alarm has been activated, it must be manually reset even if the alarm condition has been resolved.

The alarm activation temperature varies with the mode of operation:

Mode Control Temperature Alarm Limit

Patient Control All Settings 40.0°C (104.0°F)

Air Control 20.0 to 37.0°C 38.0°C (100.0°F) 37.0° to 39.0°C 40.0°C (104.0°F)

Air circulation alarm

The air circulation alarm triggers when air flow inside the unit ceases or is restricted. This could be caused by a blower motor failure, or a missing fan. When this alarm occurs, the heater is automatically shut down.

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Probe failure alarm

In either operational mode, a disconnected air temperature sensor triggers the probe failure alarm. In the patient control mode, the probe failure alarm can also be caused by an open or a short circuit in the patient probe.

When a probe failure alarm triggers, the heater automatically shuts down. The temperature displays indicate the cause of the alarm; if the air temperature sensor is disconnected, the air temperature display flashes 00.0; if the patient probe is disconnected or malfunctioning, the patient temperature display flashes HHHH or LLLL respectively.

System failure alarm

The system failure alarm automatically shuts off the heater and triggers an alternating two tone alarm if an electrical failure is detected. This alarm cannot be silenced. An error code may replace the control temperature to give specific information on the nature of the failure.

Power failure alarm

A battery operated power failure alarm activates when the external power source fails or is accidentally disconnected. The battery powers the nonsilenceable audible alarm and the microprocessor for up to 10 minutes during a power failure. If power is restored within 10 minutes, the previous mode of operation and control temperatures are recalled.

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Audio Alarm HeaterAlarm* Signal† Mode Possible Causes Silence Status

Probe Failure Alternating All Disconnected air 1 min. Off two tone temperature sensor

Alternating Pat. Patient probe disconnected, 1 min. Off two tone open or shorted (patient control mode)

Control Intermittent Air Air temperature is 1.5°C 15 min. @ Temperature single tone above or 3.0°C below control temperature

System Alternating All Electrical malfunction or Cannot Off Failure two tone excessive EMI^ in the silence hospital environment. Note the error code and switch the power off. Wait ten seconds and switch the unit back on. If the system failure reoccurs, remove the incubator from use.

Air Circulation Alternating All See the “Troubleshooting” 5 min. Off Failure two tone section in Chapter 7.

Patient Intermittent Pat. The difference between the 15 min. @ Temperature single tone patient temperature and the (Care Plus control temperature exceeds 2000 only) 1.0°C&

Intermittent Pat. The difference between the 5 min. @ single tone patient temperature and the control temperatures exceeds 2.0°C

Alternating Pat. Patient temperature is above 1 min. Off two tone 42.0°C or below 30.0°C

High Air Alternating All In the air control mode without 5 min. Off Temperature two tone override: the air temperature exceeds 38.0°C

In the patient control or the air control mode with override: the air temperature exceeds 40.0°C

Power Failure Intermittent All Power outage while the power Cannot Off single tone switch is on. silence

* If a nonsilenceable alarm is present with no alarm indicator illuminated and the heater is shut down, a microprocessor failure may have occurred.

^ Electro Magnetic Interference from other electrical equipment.

@ Heater output is dependent on the patient temperature and the control temperature setting, in the patient control mode and on the control temperature setting in the air control mode. Output will also vary with the ambient room temperature, patient condition, etc.

& Service personnel can adjust patient alarm to trigger if the difference exceeds 0.5°C.

† All silenceable alarms are preceded by a 30 second operator prompt tone.

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MAX 1000 mLMIN

Cable connections and mechanical controls

Air Temp. Sensor

Tilt Handle

Portholes

Front Door Latch

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Figure 3-4The front of the incubator

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Patient Probe Connector(Model 2000 only)

Tubing AccessCovers

Controller Latches

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Figure 3-5 The left side of the incubator

Iris Port Holes

Air Temperature Sensor Connector

Filter Mounting Knobs (Cord Wrap)

HumidifierFill Tray(optional)

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Power Switch Oxygen Inlet

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Figure 3-6The right side of the incubator

Oxygen Inlet

OhmedaColumbia MD 21046 1801Made in USAU.S. Pat. No. 4,936,824

m

Oxygen Inlet: Ensure the Controlleris sealed and latched prior toadministering oxygen.

W WARNINGS: Fire hazard. Keep matches, lighted cigarettesand all other sources of ignition out of the room in which theincubator is located. Textiles, oils, and other combustibles areeasily ignited and burn with great intensity in air enriched withoxygen.Possible explosion hazard. Do not use in the presence offlammable anesthetics.Oxygen concentrations higher than 40% can increase the riskof retrolental fibroplasia. It is possible that even concentrationsof 40% or less (formerly considered safe) could be dangerousfor some infants. Therefore, arterial blood gas measurementsare extremely important for regulation of the concentration ofinspired oxygen when in an oxygen enriched environment.

Power must be disconnected prior to removing bed platform.Air Heater may be hot.The front door inner wall must be in place while a patientoccupies the incubator.Use only Ohmeda skin temperature probe.The humidity reservoir, or humidity reservoir plugs, must befully inserted for correct incubator operation, even if thehumidifier feature is not used.Use only hospital grade grounded power receptacle.W CAUTION: U.S. Federal and Canadian law restrcts thisdevice to sale by or on the order of a licensed medicalpractitioner.

Replace filter every three (3)months.

?

?

Oxygen Concentration Chart

NOTE: Oxygen concentration levels in thischart are intended as a reference only.Actual concentrations should be checkedwith an oxygen analyzer.

Oxygen input 5L/min 10L/min 15L/min

Average oxygenconcentration range 25-45% 35-55% 45-75%

Hood Tilt Release

Power Input

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4/Preoperative Checkout Procedure

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4/Preoperative Checkout ProcedureWARNINGS Do not perform the preoperative checkout procedure while a patient occupies

the incubator.

Complete the “Preoperative Checkout Procedures” section of this manual before putting the unit into operation. If the incubator fails any portion of the checkout procedure it must be removed from use and repaired.

In this sectionMechanical checks .............................................................................................................................................. 4-1

Accessory checks ................................................................................................................................................. 4-2

Controller checks ................................................................................................................................................. 4-3

Operational checks ............................................................................................................................................. 4-6

Mechanical checks

WARNING Disconnect the power cord for the mechanical portion of the preoperative checkout procedure.

1. Disconnect the power cord for the Care Plus Incubator for the mechanical portion of the preoperative checkout procedure.

2. Examine the power cord for damage. Replace the power cord if damage is evident.

3. Examine the incubator for obvious signs of damage.

4. Lock the two front casters and check that the unit is held in place. Release the locks and verify the unit moves smoothly.

5. On the cabinet, open the cabinet front doors (if present) and verify that the four incubator mounting knobs that attach the Care Plus to the cabinet are secured tightly in place.

6. Rotate both front door latches toward the center of the incubator, verify the red stamp is visible on both latches, and lower the door. Make sure that the inner wall is securely fastened to the door.

WARNING The front door inner wall must be in place while a patient occupies the incubator.

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7. Make sure that the front door is securely fastened to the incubator.

8. Check that the mattress and the mattress tray are properly installed. Verify that you must lift the tray slightly to slide it out of the hood. This prevents the tray from sliding out accidentally. Slide the mattress tray back into the hood.

9. Check the portholes. Open the portholes by pressing on the latch. The cover should swing open. If arm cuffs are installed, the elastic cuff band should fit into the groove around the porthole without obstructing the cover. Close the porthole and verify that the mounting posts hold the porthole securely to the hood and that the latch holds the porthole closed.

10. If the optional inner wall is installed, check that it is securely attached to the outer wall. To attach the inner wall, insert the two outside inner wall fasteners in the key holes in the inner wall and slide them along the slots until the wall is in position. Lock the wall in place by snapping the two inside fasteners into the holes in the middle of the inner wall.

11. Check that the tubing access covers are also installed on either side of the hood.

12. Check the hood tilt latch. Open the front door. Rotate the hood back approximately 30 degrees, until it locks into position. Push against the hood and make sure that it is held in place. To close the hood, support the hood and release the hood latch by pushing back on the release tab. Gently lower the hood.

13. Close the front door and rotate the latches upward. Verify that the red stamp on the latch is masked by the opaque patch on the hood.

14. Check the operation of the tilt mechanism. Rotate the tilt handles down to raise the bed until it locks in position, then rotate the handles up to return the bed to its original position.

15. Check that the controller is latched in position. The controller latches should be all the way down, parallel with the sides of the controller.

16. Locate the humidifier fill tray (if present) on the underside of the base. Slide the fill tray out. Verify that the seals are in good condition and that there is no obvious damage to any of the humidifier components. Slide the humidifier back in and push until it locks in position. Push it back until you feel slight resistance, then push harder till it snaps into position. Otherwise, verify that the plugs are in place.

17. Unscrew the two filter mounting knobs on the rear of the incubator, lift off the vented filter cover panel and check the condition of the filter. If the filter is dirty, has been used with an infectious patient, or has been in use for three months, it must be replaced. When you replace the filter, mark the date on the label supplied with the replacement filter. Affix the label to the side of the incubator.

Accessory checks1. Check that all accessories are securely mounted.

2. Check the operation of any accessories with reference to the appropriate operation and maintenance manuals.

3. Set up any required suction or gas supply systems. Check them for leaks as outlined in the appropriate operation and maintenance manuals.

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Controller checksWARNING Do not use the Care Plus in the Presence of flammable anesthetics; an

explosion hazard exists under these conditions.

Patient Control Mode and Patient Probe (available on Care Plus 2000 only)

Note: The Enable switch must be pressed to activate the temperature adjustment, the Override or the control mode switches. These switches remain active as long as the enable indicator is illuminated (approximately 12 seconds after the last time one of these switches is pressed).

Note: If the patient probe reading is below 22.0°C (71.6°F), LLLL appears in place of the patient temperature.

Note: All silenceable alarms are preceded by a 30 second operator prompt tone.

1. Make sure the power cord is connected to the socket on the right side of the controller.

2. Plug the patient probe into the labeled connection on the left side of the controller.

3. Line up the air temperature sensor connectors. Plug the air temperature sensor into the labeled connection on the left side of the controller.

4. Route the patient probe cord through the tubing access cover and place the patient probe inside the incubator.

5. Plug the power cord into an appropriately rated power source (see rating plate for proper voltage, etc.).

6. Switch the power On and verify the following sequence:

a. An alternating two tone audible alarm sounds for approximately five seconds, all the indicators illuminate and “188.88” appears in the three temperature displays.

b. All indicators are extinguished except for the air control and the enable indicators. The temperature displays change to show from left to right:

Patient Air Control Temperature Temperature Temperature

XX.XX (software 60H (AC frequency; 39.0°C (maximum version, for ex:01.01) 50H for 50 Hz units) air control temperature)

c. An operator prompt tone sounds, and the control temperature display flashes “33.0°C”. The operator prompt tone will sound every two seconds until a control temperature is entered by pressing one of the temperature switches (? or M).

d. If the system failure alarm sounds, note the error code and switch off the unit. Wait ten seconds and switch the unit back on. If the system failure alarm recurs, remove the incubator from use. Then, call for service.

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7. Adjust the control temperature to silence the prompt tone.

8. Check display illumination and the audible alarm by depressing the Alarm Silence switch until all the indicator LEDs illuminate and “188.8” appears in the three temperature displays (approximately five seconds). An audible alarm will sound.

9. Check the Enable switch. Press the Enable switch. The enable indicator should illuminate and go out after approximately 12 seconds. Verify that pressing the temperature switches (? and M) has no effect when the enable indicator is extinguished.

10. Check the analog to digital calibration and the line voltage. Depress the Enable switch until the temperature displays show, from left to right (approximately five seconds):

Patient Air Control Temperature Temperature Temperature

25.05°C (±0.2°C) 37.95°C (±0.2°C) From 09.00 to 11.00 (low calibration point) (high calibration point) (Service use only)

Note: An audible alarm will sound to indicate that the actual temperatures are not displayed.

11. Check the patient probe. Warm the patient probe by placing it between your fingers. Verify that the displayed patient temperature increases. If you have an ASTM approved thermometer, accurate to ±0.1°C, place the thermometer and the patient probe in a glass of warm water. Stir the water and wait several minutes until the thermometer reading stabilizes. Verify that the patient temperature shown on the control panel is within 1°C of that shown on the thermometer. Replace the probe if the difference exceeds 1°C.

12. Check the normal range of air control temperatures. Press the Enable switch to activate the temperature switches (? and M). The enable indicator will illuminate. Press and hold the ? switch. Verify that the lowest control temperature attainable is 20.0°C. If the enable indicator has gone out, press the Enable switch again. Depress the M switch and verify that the air control temperature cannot be set above 37.0°C.

13. Check the extended range of air control temperatures. With the control temperature set to 37.0°C, sequentially press the Enable and Override switches. The enable indicator should illuminate and the override indicator should blink. Depress the M switch and verify that the maximum air control temperature is now 39.0°C. The override indicator will blink as long as the control temperature setting remains at, or above, 37.0°C.

14. Check the °F/°C switch. Adjust the control temperature to 36.0°C and press the °F/°C switch. Verify that the control temperature is now displayed as 96.8°F. Press the switch a second time to return to a Celsius display.

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15. Switch to the patient control mode of operation. Press the Enable and the Patient Control switches and verify the following sequence:

a. The enable and the patient control indicators illuminate.

b. The control temperature display flashes “36.5°C”and an operator prompt tone sounds every two seconds. Adjust the control temperature to silence the prompt tone. The enable indicator will be extinguished approximately 12 seconds after the last time one of the temperature switches (? and M) is pressed.

Note: A patient temperature alarm will be triggered if the patient probe temperature differs from the control temperature by more than 1.0°C. If the probe temperature is below 30.0°C or above 42.0°C the heater will not switch On.

16. Check the range of patient control temperatures. Press the Enable switch to activate the temperature switches (? and M). The enable indicator will illuminate. Press and hold the ? switch. Verify that the lowest control temperature attainable is 35.0°C. If the enable indicator has gone out, press the Enable switch again. Depress the M switch. Verify that the patient control temperature cannot be set above 37.0°C.

Note: The maximum patient control temperature can be raised to 37.5°C by internal adjustments specified in the service manual.

17. Check the patient temperature alarm. Press the Enable switch and adjust the patient control temperature until it exceeds the patient temperature by more than 1.0°C. An alarm should sound, the patient temperature should flash and the patient temperature alarm indicator should illuminate. Press the Enable switch and adjust the patient control temperature until it is within 0.8°C of the patient temperature. The alarm should cancel.

Note: Service personnel can configure the alarm to trigger if the difference exceeds 0.5°C and to reset when the difference is less than 0.3°C.

18. Check the probe failure alarm.

a. Unplug the patient probe from the controller. Verify that an alternating two tone alarm sounds, the probe failure LED illuminates, HHHH flashes in the patient temperature display and the heater power LEDs are extinguished. Plug the probe back in and verify that the alarm cancels.

b. Unplug the air temperature sensor from the controller by pushing in the back of connector while pulling back on the “T” handles. Verify that an alternating two tone alarm sounds, 00.0°C flashes in the air temperature display, the probe failure LED illuminates, and the heater power LEDs are extinguished. Align the connectors and plug the air temperature sensor back into the controller. Verify that the alarm cancels.

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19. Check the power failure alarm and the battery backed memory. Verify that you are still in the patient control mode. Adjust the patient control temperature to 36.0°C. Switch to the air control mode and adjust the control temperature to 35.0°C. Unplug the incubator. An intermittent, nonsilenceable alarm should sound and the power failure LED should illuminate. All other displays and indicators will be extinguished. Wait two minutes and plug the incubator back in. Verify that the alarm cancels and the unit returns to the air control mode of operation with a control temperature of 35.0°C. Switch to the patient control mode and verify a control temperature of 36.0°C.

Note: A fully charged battery should supply the power failure alarm for approximately 10 minutes. If the alarm is tested for the full 10 minutes the incubator must be run for at least two hours to recharge the battery before it is used with a patient. Total recharge time is 8 to 10 hours.

20. Check the Alarm Silence switch. Unplug the air temperature sensor and press the Alarm Silence switch. Verify that the alarm is silenced for one minute. Reconnect the air temperature sensor.

Note: The functionality of the remainder of the alarms is continually checked by the microprocessor software during normal operation. If a fault occurs in any of this circuitry, an indicator lights and a tone is sounded.

Computer independent circuitry continuously measures and compares the incubator temperature with a factory set level. Visual and audible alarms are activated and the heater is shut-off if the incubator temperature exceeds this pre-set level, independent of the software.

Additionally, a computer independent “watchdog” circuit will reset the computer, turn off the heater, and activate the alarms in the event of a microprocessor failure or software error.

Operational checks1. Make sure that the incubator is in the air control mode.

2. Verify that the front door, the portholes and the hood are closed.

3. Set the control temperature as close to the air temperature as possible. Allow the air temperature reading to stabilize. Verify that the air temperature remains within 0.5°C of the control temperature for five minutes after stabilization.

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5/Using the Incubator5/Using the IncubatorWARNINGS Complete the “Preoperative Checkout Procedure” section of this manual

before putting the unit into operation. If the incubator fails any portion of the checkout procedure it must be removed from use and repaired.

Do not leave the patient unattended when using the incubator. Check the patient’s temperature at least every half hour. For maximum patient monitoring over an extended period of time, select the patient control mode of operation.

Residual ether or similar gases exhaled by a post surgical patient may be decomposed by the heater to produce formaldehyde.

The optional patient probe is not isolated from earth ground. Any additional equipment used with the Care Plus must comply with UL 544, CSA 22.2, IEC 601, and VDE 750.

Do not use the Care Plus or the in the presence of flammable anesthetics; an explosion hazard exists under these conditions.

Using an incubator with a fan motor that has worn parts can produce unacceptable noise levels within the incubator.

Direct sunlight or other radiant heat sources can cause an increase in incubator temperature to dangerous levels.

CAUTIONS Proper temperature control depends on continuous, unobstructed air circulation. Do not cover air circulation openings around the bed as obstruction will result in loss of air circulation, loss of heat, and carbon dioxide buildup.

Do not mount or rest a radiant warmer or incandescent light on or over the incubator hood; ineffective heating and damage to the hood may result. If using incandescent phototherapy lamps, check manufacturer’s recommended minimum distance to hood.

Note: Because the mattress tray is radiopaque, x-ray plates must be placed directly under the infant.

In this sectionBasic operating procedure ............................................................................................................................... 5-2

Responding to alarms ........................................................................................................................................ 5-5Air circulation alarm ................................................................................................................................ 5-6Control temperature alarm .................................................................................................................. 5-6High air temperature alarm ................................................................................................................. 5-6Patient temperature alarm ................................................................................................................... 5-7Probe failure alarm .................................................................................................................................. 5-7Power failure alarm ................................................................................................................................. 5-8System failure alarm ............................................................................................................................... 5-8

Additional operating procedures .................................................................................................................. 5-8Accessing the patient ............................................................................................................................. 5-8Raising and lowering the hood ........................................................................................................5-10Trendelenburg and reverse Trendelenburg positioning .........................................................5-11Administering oxygen ........................................................................................................................5-12Using the optional humidifier ...........................................................................................................5-14

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5/Using the IncubatorBasic operating procedure

This section tells you how to setup and use the incubator in the air and the patient control modes.

For more detailed information on humidifier setup, oxygen administration, opening and closing the door, or Trendelenburg or reverse Trendelenburg positioning, refer to the section “Additional operating procedures” at the end of this chapter.

WARNINGS Always set the brakes before placing a patient in the incubator.

On units equipped with a humidifier the humidifier must be installed for proper incubator operation, even if you do not plan to use the humidifier.

1. Verify that the air temperature probe is connected to the controller and that the humidifier or the hole plugs are installed. Plug the incubator into a power outlet and set the caster brakes. If desired, fill the humidifier (if present), position the mattress tilt, and set up any additional equipment.

2. Use the temperature switches (? and M) to enter the control temperature. The normal range for air control temperatures is 20.0 to 37.0°C.

3. To select a control temperature above 37.0°C, adjust the control temperature to 37.0°C, make sure the enable indicator is still illuminated, and press the Override switch. If the enable indicator has gone out, the Enable switch has to be depressed before the Override switch will function.

4. Select either Celsius or Fahrenheit temperature readings with the °F/°C switch.

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5/Using the Incubator5. For optional patient control mode operation, connect the patient probe. For air

control mode operation, the patient probe is optional. Connect it only if you wish to display patient skin temperature.

a. If you plan to use the patient control mode, use steps 2 and 3, as appropriate, to preheat the incubator to the air temperature required to maintain the desired skin temperature.

b. Place the metal side of the skin temperature probe on the patient’s skin over the liver area of the infant’s abdomen. Attach reusable probes with a heat reflecting patch. Remove the paper protecting the hypoallergenic adhesive of the Heat Reflective Patch and secure the skin temperature probe to the patient’s skin with the adhesive side of the patch (Figure 5-1). Do not remove the heat reflecting foil.

c. If the patient is prone, place the skin temperature on the patient’s back, where it will not be against the mattress. If the probe is between the patient and the mattress, it will produce false readings.

WARNING Intimate contact between the skin temperature probe tip and the patient’s skin must be maintained to assure accurate skin temperature measurement. Under or over heating may result from poor contact between the skin temperature probe and the patient. Check this attachment regularly to assure the patient’s safety.

CAUTION Avoid placing excessive strain on the skin temperature probe lead. Always remove the probe from the patient by grasping and removing the heat reflective patch first, then remove the probe from the patient or the patch. Always remove the probe by grasping the plug at the panel. Do not pull on the probe lead.

d. Connect the skin temperature probe to the unit.

Note: The disposable probe comes with the heat reflecting pad attached.

Figure 5-1 Attaching the patient probe to the infant

Heat Reflecting Patch with Reflective Side Facing Up

White Paper Protector

Patient Probe (Place the metal side in contact with the infants skin)

CI.0

2.00

6

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5/Using the Incubatore. Route the wire through the left tubing access cover and plug the probe

connector into the side of the controller. Refer to Figure 5-2.

If the ambient temperature is less than 22.0°C (71.6°F), LLLL appears in place of the patient temperature until you attach the probe to the infant.

WARNINGS Use only the Reusable Ohmeda skin temperature probe (Stock No. 0208-0697-700) and Heat Reflective Patches (Stock No. 0203-1980-300, 50/pkg) or the disposable probe (Stock No. 6600-0208-700,10/pkg; Stock No. 6600-0196-700, 50/pkg) to monitor the patient’s skin temperature. Use of other manufacturer’s probes may affect the accuracy of equipment operation and the electrical safety of the patient.

In incubators equipped with radiant or phototherapy lamps, the skin temperature probe should be located on the patient’s skin in an area which is directly in the path of the radiant heat. It should not be attached to an area which is shielded from the radiant heat or between the patient and the mattress. Large temperature gradients and very long servo response times will result from improper probe placement.

Rectal temperatures must never be used to control a patient’s temperature.

Figure 5-2 Connecting the patient probe to the Care Plus 2000 incubator

Air Temperature Sensor

Patient Probe

Air Temperature Sen-sor Connector

Patient Probe Connector

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5/Using the Incubator6. If you plan to use the patient control mode, verify that the incubator has warmed

up to the Desired Environmental Temperature. Then press the Enable switch followed by the Patient Control switch:

a. The patient control and the enable indicators illuminate.

b. The control temperature display flashes “36.5°C” and an operator prompt tone sounds every two seconds. The alarm will continue to sound until you enter a control temperature. The heater will not operate unless a control temperature is entered.

Note: When patient control mode operation first begins, a patient temperature alarm may trigger. Silence the alarm and attend the patient. This alarm triggers normally if the patient probe temperature differs from the control temperature by more than 1.0°C. If the probe temperature is below 30.0°C or above 42.0°C, the heater will not switch On.

Responding to alarms

WARNINGS Excessive EMI levels in the hospital environment can trigger the system failure alarm. Note the error code and switch off the unit. Wait ten seconds and switch the unit back on. If the system failure alarm recurs, remove the incubator from use.

If an alarm is silenced, closely monitor the patient.

Note: Refer to the troubleshooting section in Chapter 7 for problems that do not involve an alarm indicator.

Many things can trigger alarms. For example: a patient’s condition may change; a patient probe may detach; or a change in the control temperature may increase the difference between the control temperature and the monitored temperature (air or patient) to an unacceptable level.

If an alarm triggers:

• Evaluatethepatient

Attend the infant.

• Identifythealarm

Check the indicators to identify the active alarm. When two or more alarms are active, their respective indicators illuminate. If an indicator illuminates, look the alarm up alphabetically in this section. If two or more alarms have been triggered, the audio signal sounds for the highest priority alarm.

• Silencingthealarm

If desired, silence the alarm. At the end of the silence period the audio alarm reactivates unless the alarm condition has been resolved. The length of the alarm silence period depends on the alarm. Power failure and system failure alarms cannot be silenced.

Another alarm prematurely ends the alarm silence period.

• 30secondoperatorPrompttone

All silenceable alarms are preceded by a 30 second operator prompt tone, in order to minimize disturbance to the infant.

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5/Using the IncubatorAir circulation alarm

Air is not circulating through the incubator. The most common cause is a missing fan or a fan that is not rotating.

If the alarm continues, stop using the incubator and call for service.


The air temperature is 1.5°C above or 3.0°C below the air control temperature (air control mode alarm).

The control temperature alarm is automatically silenced for 30 minutes after you switch on the unit and for 15 minutes after you change the control temperature or switch to the air control mode.

1. Evaluate the patient:

• Openingtheincubatordoorcausessomeheatloss.

• Iftheincubatorstartsoutcold,oryoumakealargechangeinthecontroltemperature, the incubator may take longer than the automatic alarm silence period to warm up.

2. If the alarm continues, stop using the incubator and call for service.

High air temperature alarm

The air temperature exceeds fixed limits:

Control High TemperatureMode Temperature Alarm Limit

Patient Control Entire Range 40.0°C (104.0°F)

Air Control 20.0 to 37.0°C 38.0°C (100.4°F) (68.0 to 98.6°F)

37.0 to 39.0°C 40.0°C (104.0°F) (98.6 to 102.2°F)


• Haveyouchangedtheaircontroltemperature?Intheaircontrolmode,decreasing the control temperature below 37.0°C decreases the alarm limit from 40°C to 38°C. Making this change while the incubator temperature exceeds 38°C triggers the alarm.

• Haveyouchangedoperatingmodes?Thesamethingcanhappenifyouswitchfrom the patient control mode (alarm limit 40°C) to the normal air control mode (alarm limit 38°C).

2. Press the alarm silence button and monitor the patient. This alarm does not self cancel if the temperature falls below the alarm limit. You must press alarm silence to reset it.

3. If the alarm recurs, stop using the incubator and call for service.

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5/Using the IncubatorPatient temperature alarm (Care Plus 2000 only)

The patient temperature differs from the patient control temperature by more than 1.0°C or the patient temperature is outside the 30.0 to 42.0°C range (patient control mode alarm).

Note: Service personnel can adjust this alarm to trigger at a temperature difference of 0.5°C


• Openingtheincubatordoorcausessomeheatloss.

• Controltemperaturechangescantemporarilyincreasethedifferencebetweenthe patient and the control temperatures.

2. Make sure that the patient probe is properly connected to the patient: the metal side of the probe must make good contact with the infant’s skin. With a reusable probe, you must also attach a separate reflecting patch. Make sure the metal side of the patch faces up.

3. If HHHH or LLLL appears in the patient temperature display while the patient probe is properly connected to the patient, replace the patient probe.


Probe failure alarm (Care Plus 2000 models only)

One of the temperature sensors is disconnected or contains an open or shorted circuit.

In the air control mode:

1. If 00.0 appears in the air temperature display, plug the air temperature sensor into the controller.


In the patient control mode:

1. If 00.0 appears in the air temperature display, plug the air temperature sensor into the controller.

2. Make sure that the patient probe is plugged into the controller.

3. If HHHH or LLLL appears in the patient temperature display and the patient probe is plugged into the controller, replace the patient probe.


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5/Using the IncubatorPower failure alarm

The incubator is switched on, but it is not getting any power.

1. Make sure that one end of the power cord is plugged into the controller and that the other end of the cord is plugged into a power outlet.

2. Plug another device into the outlet to verify that the power outlet has power.

3. Replace the power cord.


System failure alarm

Excessive EMI levels in the hospital environment can trigger the system failure alarm. Note the error code and switch off the unit. Wait ten seconds and switch the unit back on. If the system failure alarm recurs, remove the incubator from use. Then, call for service.

Additional operating proceduresThis section provides more information on opening the hood, using the humidifier, and administering oxygen.

Accessing the patient

Opening the front door:

Opening the front door gives you total access to the patient without affecting the air flow. To lower the door, rotate the door latches down (Figure 5-3).

WARNINGS Do not leave the infant unattended while the front door or the portholes are open.

When opening or closing the front door or the portholes, make sure that the infant, any clothing, the monitoring leads, etc., are completely within the confines of the bed.

Opening the porthole:

To open a porthole, press in on the latch until the porthole opens. To close a porthole, push the cover shut until the latch clicks into position.

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5/Using the Incubator

Figure 5-3 Opening the front door

Pulling out the mattress tray:

Pulling out the mattress tray facilitates procedures that require total access to the infant. This can only be done when both tilt mechanisms are at their lowestposition. Lower both tilt mechanisms, lift the tray slightly at the edge of the doorand gently pull the tray out (Figure 5-4).

WARNINGS While sliding the mattress tray out, make sure the square tabs on the back corners of the tray are engaged in the guide tracks at both ends of the platform cover.

When sliding out the mattress tray, carefully guide any tubes or monitoring leads through the tubing access covers. If there is insufficient slack or the tubing gets stuck, the attached devices could accidentally disconnect or the patient could be harmed.

CAUTION Do not operate the tilt mechanisms when the mattress tray is pulled out. The tilt mechanism may jam as a result.

Porthole Latch

Door Latch

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Figure 5-5Raising the hood

Front Door (Open Position)

Figure 5-4 Pulling out the mattress tray

Raising and lowering the hood

WARNING Do not raise the hood when a patient occupies the incubator. Raise the hood only for hood disassembly and cleaning.

The hood can be raised to facilitate cleaning. The hood tilt latch on the right rear corner of the incubator holds the hood open. To tilt the hood, push on the tab on the hood latch and rotate the hood back until it locks in position. See Figure 5-5. To return the hood to its normal position, support the hood and release the hood tilt latch by pushing back the release tab on the latch. Then slowly lower the hood.

Mattress Tray

CI.2

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CI.2

3.00

9

Hood Latch

Press Here

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5/Using the IncubatorTrendelenburg and reverse Trendelenburg positioning-tilt handle models

CAUTION Do not use the tilt handles to maneuver the incubator.

Tilt handles on the front of the unit, allow ten degree Trendelenburg (feet up) or reverse Trendelenburg (head up) positioning.

Tilting the mattress:

1. Grasp the tilt handle on the side of the mattress that you wish to raise (Figure 5-6).

2. Rotate the tilt handle down until it locks in position to raise the corresponding side of the mattress.

WARNING Verify that the mattress is locked in position before releasing the tilt handle.

Returning to the horizontal position:

To return the mattress to the horizontal position, rotate the handle up to lower the mattress.

Figure 5-6Tilting the mattress

Air Temp. Sensor

Tilt Handle

Portholes

Front Door Latch

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5/Using the IncubatorAdministering oxygen

WARNINGS Additional oxygen should only be administered under the direction of qualified medical personnel.

The use of head boxes, hoods and oxygen inlets can increase the noise level inside the incubator.

Remove all sources of ignition including smoking materials, and sources of electrical discharge from the area when oxygen is in use. In the presence of high oxygen concentrations, even relatively nonflammable items can ignite and burn rapidly. Do not place auxiliary equipment producing sparks inside the incubator. Even small quantities of highly flammable items (such as organic cleaning solvents) may explode.

Ensure the controller is seated and latched prior to administering oxygen.

You can increase the internal incubator oxygen concentration by connecting an oxygen source to the inlet on the right hand side of the incubator. Either pipeline or regulated cylinder supplies may be used.

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Figure 5-7 Connecting oxygen supplies

1. Connect the output of the oxygen flow meter to the inlet fitting on the right hand rear corner of the incubator (Figure 5-7).

WARNING Always use a back pressure compensated flow meter to deliver oxygen to the incubator. Other flow meters may not compensate for the back pressure created by the oxygen inlet and could deliver incorrect flow rates.

2. Set up an oxygen analyzer to monitor the hood oxygen concentration. Position the sampling tube or sensor near the center of the infant compartment. Route the tube or sensor cable out the hood through one of the tubing access covers.

WARNINGS Monitor the oxygen concentration at a position near the infant’s head. The concentration vs flow rate chart on the side of the incubator gives only approximate concentrations to aid in setting the initial flow rate. It must not be used in place of an oxygen analyzer.

Use an oxygen monitor whenever oxygen is being administered. Concentration of inspired oxygen does not predictably determine the partial pressure of oxygen in the blood; blood gas measurements are extremely important for the regulation of inspired oxygen concentrations when an oxygen enriched environment is necessary. Oxygen concentrations above 40% can increase the risk of retrolental fibroplasia (retinopathy of prematurity). Even concentrations of 40% or less oxygen (formerly considered safe) could be dangerous to some infants. (See current edition of “Standards and Recommendations on Hospital Care of Newborn Infants” prepared by the Committee on Fetuses and Newborns of the American Academy of Pediatrics.)

Oxygen Inlet

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5/Using the Incubator3. Switch On the incubator. Unless the incubator is operational, there will be no air

flow to ensure adequate mixing inside the hood.

4. Set up the initial flow rate using the oxygen concentration table next to the oxygen inlet. The chart will give you a general idea what flow rate will be required to maintain the desired concentration. The actual concentration will vary with the condition of the incubator air inlet filter, hood seals, door seals and the number of open portholes, as well as the infant’s condition.

5. Wait 30 minutes and then check the oxygen concentration inside the unit, without opening the hood. Adjust the flow rate if required. Allow 30 minutes between adjustments for the new concentration to stabilize.

Using the optional humidifier

WARNING The humidifier must be installed for proper incubator operation, even if you do not plan to use the humidifier.

The Care Plus offers three levels of humidification: none, low, and high. If you do not want humidification, do not put water in the humidifier.

Even at the high setting, the humidifier reservoir holds more than enough water to last for 24 hours.

1. Gently slide the humidifier out of the base. You will feel an initial resistance, but apply a steady pull to avoid spilling its contents (Figure 5-8).

2. Set the humidifier down on a level surface and add water to the fill level indicated on the label (1000 ml maximum).

Note: Do not fill the humidifier past the fill level. Filling past the fill level actually DECREASES humidification.

3. Slide the humidifier back into the base.

4. Adjust the slide on the side of the humidifier to set the humidification level:

•Forhighhumidificationmovetheslidecompletelyback.

•Forlowhumidificationmovetheslidecompletelyforward.

Drain the humidifier when the unit is not in use. Disinfect the humidifier weekly or after each patient. Refer to the section “Cleaning and disinfecting individual components” in chapter 6 for disinfection instructions.

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CI.2

3.01

0

Humidifier

Lid

Slide

Figure 5-8 Using the humidifier

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Notes

6-1

6/Maintaining the Incubator

6-1600-0291-000 001

6/Maintaining the IncubatorWARNINGS The heater is hot enough to cause skin burns. Unplug the incubator and

allow the heater to cool before disassembly or cleaning.

Always disconnect the power before performing service or maintenance procedures detailed in this manual. Apply power only if you are specifically instructed to do so as part of the procedure.

Thoroughly air dry the incubator after cleaning it with flammable agents. Small amounts of flammable agents, such as ether, alcohol or similar cleaning solvents left in the incubator can cause a fire.

Never oil or grease oxygen equipment unless a lubricant that is made and approved for this type of service is used. Oils and grease oxidize readily, and in the presence of oxygen, will burn violently.

In this sectionCleaning schedule .............................................................................................................................................. 6-1

Disassembling the incubator for a complete cleaning .......................................................................... 6-2

Cleaning and disinfecting individual components ................................................................................. 6-6Humidifier ................................................................................................................................................... 6-6Patient Probe (Reusable) ....................................................................................................................... 6-7Controller assembly ................................................................................................................................ 6-8Porthole ....................................................................................................................................................... 6-9Compartment Temperature Probe .................................................................................................... 6-9Other Clear Plastic Parts ........................................................................................................................ 6-9Lower unit (mattress, mattress tray, base platform cover, etc.) ............................................... 6-9Oxygen inlet .............................................................................................................................................. 6-9Cabinet ........................................................................................................................................................ 6-9

Cleaning scheduleThis schedule lists the minimum frequencies. Always follow hospital and local regulations for required frequencies.

Weekly or after each patient

Disinfect the humidifier if it was used.

Perform a complete cleaning and if necessary disinfect the entire incubator.

Check the air filter; replace the air filter after use with an infectious patient.

Check the front door and the porthole latches and hinges to make sure that they will not open accidently.

Quarterly

Replace the air filter.

When the incubator is not in use, use standard analytical methods to make sure that the infant compartment and any direct contact components, such as the humidifier and the oxygen inlet, meet hospital cleanliness standards.

6-2

6/Maintaining the Incubator

6-2600-0291-000 001

Disassembling the incubator for a complete cleaningIf the incubator has been exposed to body fluids, check your hospital’s infection control procedures. You may need to wear protective clothing and eye wear or use special sterilization agents and cleaning procedures.

WARNING Disconnect the power cord before disassembling or reassembling the lower unit.

CAUTIONS Electronic devices in the microprocessor controller are susceptible to damage from discharges of static electricity. These devices are adequately protected, but can be damaged if the unit is disassembled beyond that recommended for cleaning and maintenance.

Do not remove the air temperature sensor mounted to the rear hood wall; the air temperature sensor must remain in the correct position for proper incubator operation.

1. Turn the power switch Off and unplug the unit from the power outlet.

2. If the incubator was previously on, allow it to cool for at least 30 minutes.

3. Remove the filter by unscrewing the two filter mounting knobs on either side of the vented rear panel. Pull off the panel and remove the filter.

WARNING The air filter cannot be cleaned and must be replaced every three months, when visibly dirty or after use with an infectious patient. If the air filter is exposed to liquids or disinfectants, replace it with a new filter.

4. Unplug the power cord from the right side of the controller.

5. Unplug the air temperature sensor and the patient probe (if present) from the controller.

6. Pull up on both controller latches and slide the controller forward, out of the lower unit. Be careful not to bump the heater or the fan. They may grate against each other or the base platform if they are knocked out of alignment.

7. Open the incubator door and tilt the hood back to its locked position. Remove the inner wall by pressing up on the center of the wall until it flex

ohio care plus series 1000/2000 incubator...table of contents iv 600-0291-000 001 iv warnings before...

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