Citadel Plus Bariatric Care System Instructions For Use Rev E Sept 2019

Table of Contents General Warnings ...5 • Safety Information ...8 • Power Drive System Safety Information ...10 Introduction ...12 • Product Overview ...12 • Optional features ...13 Clinical Applications ...15 • Intended Use ...15 • Indications ...15 • Contraindications ...15 • General Product Information ...16 Installation ...17 • Weighing System Preparation...17 • Power Drive Shipping Pin Removal ...17 • Electricity Supply ...18 • Potential Equalization Terminal ...19 • Electrical Connections ...19 • Power Cord ...19 • Nurse Call and RS232 Connections ...19 • Auxiliary Power Outlet (Optional Feature)...20 • Skin IQ Family Power Cable ...20 • Skin IQ Installation...21 • Mattresses...21 Operating Instructions ...23 • Lifting Pole and Accessory Sockets ...23 • Drainage Bag Rails ...24 • Bed Length Adjustment ...24 • Bed Width Adjustment ...26 • Foot Pedal for Adjustment of Bed Height (Optional Feature) ...27 • Brakes and Steering...27 • Side Rails ...28 • Head and Foot Boards ...29 • Patient Restraints ...29 • Under Bed Light ...30 • Backup Battery ...31 • Recharging the Backup Battery ...32 • Over-Use Lockout ...32 • Attendant Control Panel (ACP), Nurse Control Panel and Patient Control Panel...33 • Patient Handset (Optional Feature) ...36 • Weigh Scale Panels (With and Without Unit Selection) ...37 • Weighing Accuracy ...38 • Weighing Initialization ...39 Citadel Plus Bariatric Care System

3

• Weighing ...39 • Weighing Units ...40 • Auto Compensation...40 • Weighing System Error Codes ...41 • Angle Indication...41 • VariZone Patient Movement / Exit Detection ...42 • VariZone Operation ...43 • Anti-Entrapment System ...44 • SafeSet™ (Optional Feature)...45 • RS232 Connection ...47 • Controls for television and lighting ...48 Power Drive ...49 • Preparation for Transport ...49 • Power Drive LEDs ...49 • Operating Power Drive ...50 Patient Placement ...52 • Power On ...52 • Preparation for Patient Placement ...52 • Completion of Patient Placement ...53 Nursing Care ...54 • CPR...54 • CPR Backrest Release ...55 • Patient Bathing ...55 • Patient Transfer from the Citadel Plus Bariatric Bed Frame System...56 • Patient Transport ...56 Care and Cleaning...57 • Deck Sections ...57 • Decontamination ...57 • General Recommendations ...59 • Cleaning the Citadel Plus Bariatric Bed Frame System While in Use ...59 Preventive Maintenance ...60 • Weighing System ...61 • Battery Test ...61 Troubleshooting ...62 • Error Codes ...63 • Fault Indications ...64 • Product Lifetime ...64 Accessories ...64 EMC Information...65 Warranty and Service ...68 6SHFL¿FDWLRQV ...69 Explanation of Symbols Used...71

4

Citadel Plus Bariatric Care System

GENERAL WARNINGS The following warnings should be considered prior to using this product:

Before using the bed, make sure that the Power in rating on the VSHFL¿FDWLRQODEHOLVFRPSDWLEOHZLWKWKHORFDOHOHFWULFLWVXSSO To make sure the patient can use the bed safely, their age and condition VKRXOGEHDVVHVVHGEDFOLQLFDOOTXDOL¿HGSHUVRQ7KHXVHRIKHDG down tilt (Trendelenburg) or foot down tilt (reverse Trendelenburg) may EHFRQWUDLQGLFDWHGIRUFHUWDLQPHGLFDOFRQGLWLRQV7KHWLOWIXQFWLRQVKRXOG RQOEHXVHGXQGHUWKHJXLGDQFHRIDFOLQLFDOOTXDOL¿HGSHUVRQDIWHU DVVHVVPHQWRIWKHSDWLHQW¶VFRQGLWLRQ All accessories added to the system reduce the safe working load of the IUDPHEWKHVDPHDPRXQW If the power cord or plug is damaged, the complete assembly must be UHSODFHGEDXWKRUL]HGVHUYLFHSHUVRQQHO'RQRWUHPRYHWKH¿WWHGSOXJ RUXVHDUHZLUHDEOHSOXJRUDGDSWHU 0DNHVXUHWKHSRZHUFRUGLVQRWVWUHWFKHGNLQNHGRUFUXVKHG 'RQRWDOORZWKHSRZHUFRUGWRWUDLORQWKHÀRRUZKHUHLWPDFDXVHD WULSKD]DUG Make sure the power cord does not become entangled with moving SDUWVRIWKHEHGRUWUDSSHGEHWZHHQWKHEHGIUDPHDQGKHDGERDUG Always adjust the bed frame and deck to the same length and make VXUHERWKDUHODWFKHGVHFXUHOLQSRVLWLRQ $OZDVXVHDPDWWUHVVRIWKHFRUUHFWVL]HDQGWSH,QFRPSDWLEOH PDWWUHVVHVFDQFUHDWHKD]DUGV Entrapment hazards may exist when using a very soft mattress, even if LWLVWKHFRUUHFWVL]H 7KHFOLQLFDOOTXDOL¿HGSHUVRQUHVSRQVLEOHVKRXOGFRQVLGHUWKHDJHVL]H DQGFRQGLWLRQRIWKHSDWLHQWEHIRUHDOORZLQJWKHXVHRIVLGHUDLOV Side rails are not intended to restrain patients who make a deliberate DWWHPSWWRH[LWWKHEHG To prevent possible entrapment, make sure the patient’s head and limbs DUHFOHDURIWKHVLGHUDLOVZKHQDGMXVWLQJWKHGHFN Make sure the locking mechanism is securely engaged when the side UDLOVDUHUDLVHG

Citadel Plus Bariatric Care System

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Prior to engaging any mattress turn feature, make sure that bed frame has side rails and that all side rails are fully engaged in their full upright DQGORFNHGSRVLWLRQ'RQRWDFWLYDWHWKHWXUQLQJIHDWXUHRQDQPDWWUHVV VVWHPZKHQSDWLHQWUHVWUDLQWVDUHLQXVH Patient restraints should be used in compliance with all applicable federal and state regulations and in accordance with the healthcare facility’s own SROLFLHVDQGSURFHGXUHV Patient restraints, even when correctly used, can result in entrapment or LQMXUSDUWLFXODUOLIWKHSDWLHQWLVGLVRULHQWDWHGRUUHVWOHVV7KHGHFLVLRQWR use patient restraints must be made by the clinician overseeing the care RIWKHLQGLYLGXDOSDWLHQWIROORZLQJDIXOOGRFXPHQWHGULVNDVVHVVPHQW 3DWLHQWUHVWUDLQWVDUHQRWLQWHQGHGDVVXEVWLWXWHVIRUJRRGQXUVLQJSUDFWLFH $UMRPDNHVQRUHFRPPHQGDWLRQVUHJDUGLQJWKHXVHRIVXFKUHVWUDLQWV To make sure the battery is kept fully charged and prevent damage to the battery, the bed should be connected to the electricity supply at all times GXULQJQRUPDOXVH 7KHEDWWHULVLQWHQGHGIRUHPHUJHQFVKRUWWHUPXVHRQO,WVOLIHZLOOEH UHGXFHGLILWLVXVHGWRSRZHUWKHEHGIRUORQJSHULRGV 2QOFRQQHFWGHYLFHVGHVLJQHGWREHXVHGZLWKWKHEHG Connecting devices not designed to be used with the bed may result in GDPDJHWRWKHHTXLSPHQWRUWRWKHEHG $WPLQLPXPKHLJKWFOHDUDQFHXQGHUQHDWKWKHVLGHUDLOVLVUHGXFHG.HHS your feet away from the areas below the side rails and take extra care ZKHQXVLQJSDWLHQWKRLVWVRUVLPLODUHTXLSPHQW The weighing system should only be used by staff trained in the correct XVHRIWKHZHLJKLQJIXQFWLRQ The weighing system should only be used in closely supervised HQYLURQPHQWVZKHUHIDFWRUVLQÀXHQFLQJSDWLHQWZHLJKW VXFKDVDGGLWLRQV to the bed) can be controlled as described in the following instructions for XVH 6FDOH5HDGLQJV6FDOHVSDWLHQWZHLJKWVDUHIRUUHIHUHQFHRQO6FDOH UHDGLQJVVKRXOGQRWEHUHOLHGXSRQIRUPHGLFDWLRQGRVDJH$OOHTXLSPHQW RQWKHZHLJKHGSRUWLRQRIWKHXQLWLVLQFOXGHGLQZHLJKWGLVSODHG The weighing system MUST be zeroed every time a new patient is to be SODFHGRQWKHEHG 7KHZHLJKLQJVVWHP0867EH]HURHGHYHUWLPHDPDWWUHVVLVFKDQJHG The weighing system cannot be zeroed if a mattress or accessories ZHLJKLQJPRUHWKDQNJ OE DUH¿WWHG7RPDNHVXUHWKHEHGFDQEH ]HURHGFRUUHFWORQOXVH$UMRDSSURYHGPDWWUHVVHV 6

Citadel Plus Bariatric Care System

'DWDUHWULHYHGIURPWKH56FRQQHFWLRQQRWLQWHQGHGWREHXVHG WRPDNHFOLQLFDOGHFLVLRQV$OOSDWLHQWGLDJQRVLVWUHDWPHQWDQGFDUH should be performed under the supervision of an appropriate healthcare SURIHVVLRQDO The manual CPR release should only be used in an emergency; repeated HYHUGDXVHFDQFDXVHSHUPDQHQWZHDU 'LVFRQQHFWWKHEHGIURPWKHPDLQVZDOORXWOHWEHIRUHVWDUWLQJDQFOHDQLQJ RUPDLQWHQDQFHDFWLYLW7KHEHGZLOOVWLOORSHUDWHRQEDWWHUSRZHULIWKH IXQFWLRQKDVQRWEHHQORFNHGRQWKH$WWHQGDQW&RQWURO3DQHO To prevent cross contamination or equipment damage, Arjo recommends that the Citadel Plus Bariatric Care System be cleaned during use and between patients according to the Care and CleaningVHFWLRQLQWKLV,)8 Local protocols and regulations / procedures for blood borne pathogens PDEHXVHGSURYLGHGWKHPDQXIDFWXUHU¶VLQVWUXFWLRQVDUHIROORZHG Always disconnect the Citadel Plus Bariatric Care System from mains wall RXWOHWEHIRUHFOHDQLQJ)DLOXUHGRVRFRXOGUHVXOWLQHTXLSPHQWGDPDJH DQGRUHOHFWULFVKRFN 'RQRWDOORZÀXLGVWRSHQHWUDWHWKH&LWDGHO3OXV%DULDWULF&DUH6VWHP FRQWUROSDQHOV If the bed is stored for a long time, it should be connected to the electricity VXSSOIRUKRXUVHYHUWKUHHPRQWKVWRUHFKDUJHWKHEDFNXSEDWWHU RWKHUZLVHLWPDEHFRPHXQVHUYLFHDEOH Multiple people may be required to manually transport the bed depending RQSDWLHQWZHLJKWDQGÀRRUFRQGLWLRQV $VVHPEORSHUDWLRQVH[WHQVLRQVUHDGMXVWPHQWVPRGL¿FDWLRQV WHFKQLFDOPDLQWHQDQFHRUUHSDLUVPXVWEHSHUIRUPHGETXDOL¿HG SHUVRQQHODXWKRUL]HGE$UMR&RQWDFW$UMRIRULQIRUPDWLRQUHJDUGLQJ PDLQWHQDQFHDQGUHSDLU The nurse call button on Citadel Plus has not been evaluated for the UHTXLUHPHQWVRI&ODXVH 1RUPDO2SHUDWLRQ RI8/7KHXVHULV responsible to determine the operability of the nurse call button with all VVWHPVWRZKLFKWKHPHGLFDOGHYLFHLVFRQQHFWHG If a serious incident occurs in relation to this medical device, affecting the user, or the patient then the user or patient should report the serious LQFLGHQWWRWKHPHGLFDOGHYLFHPDQXIDFWXUHURUWKHGLVWULEXWRU,QWKH European Union, the user should also report the serious incident to the &RPSHWHQW$XWKRULWLQWKHPHPEHUVWDWHZKHUHWKHDUHORFDWHG

Citadel Plus Bariatric Care System

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Safety Information General Protocols – Follow all applicable safety rules and institution protocols concerning patient and caregiver safety. Brakes – Set all caster brakes before transferring patient. Bed Height – To minimize risk of falls or injury, the bed should always be in the lowest practical position when the patient is unattended. Fluids±$YRLGVSLOOLQJÀXLGVRQXQLWFRQWUROV,IVSLOOVGRRFFXUXQSOXJXQLWFOHDQ ÀXLGIURPXQLWZHDULQJUXEEHUJORYHVWRDYRLGDQSRVVLELOLWRIVKRFN2QFHÀXLG is removed, check operation of components in area of spill. Fluids remaining on controls can cause corrosion, which may cause components to fail or to operate erratically, possibly producing hazards for patient and staff. Oxygen Use - Make sure that the unit is not contained in an oxygen enriched HQYLURQPHQW3RVVLEOH¿UHKD]DUGZKHQEHGLVXVHGZLWKR[JHQDGPLQLVWHULQJ equipment other than the nasal prongs, mask or half bed length tent type. Oxygen tent should not extend below mattress support level. Lock-Outs – Lock-outs for bed functions should be used at staff’s discretion to prevent unintentional operation of bed. Power Cord – Make sure power cord is kept free from all pinch points, moving parts and is not trapped under casters. Improper handling of power cord can FDXVHGDPDJHWRWKHFRUGZKLFKPDSURGXFHULVNRI¿UHRUHOHFWULFVKRFN3XOO the power cord out of the mains wall outlet to remove power from the unit. Avoid Fire Hazards±7RPLQLPL]HWKHULVNRI¿UHFRQQHFWWKHXQLW¶VSRZHUFRUG directly into a wall-mounted outlet. Do not use extension cords or multiple outlet strips. In the US, review and follow FDA’s Safety Tips for Preventing Hospital Bed Fires. Outside the US, consult the local Competent Authority or Government $JHQFIRU0HGLFDO'HYLFH6DIHWIRUVSHFL¿FORFDOJXLGDQFH Disposal – At the end of useful life, dispose of waste according to local requirements or contact the manufacturer for advice. There may be special requirements for disposal of batteries, leaded foam and / or angle sensors (if present in this product). Improper disposal of any component may result in regulatory non-compliance. Moving Parts - Keep all equipment, tubes and lines, loose clothing, hair and parts of the body away from moving parts and pinch points. Patient Entrance / Exit – Caregiver should always aid patient in exiting the bed. Make sure a capable patient knows how to get out of bed safely (and, if necessary, KRZWRUHOHDVHWKHVLGHUDLOV LQFDVHRI¿UHRURWKHUHPHUJHQF Side Rails / Patient Restraints - Whether and how to use side rails or restraints is a decision that should be based on each patient’s needs and should be made by the patient and the patient’s family, physician and caregivers, with facility protocols LQPLQG&DUHJLYHUVVKRXOGDVVHVVULVNVDQGEHQH¿WVRIVLGHUDLOUHVWUDLQWXVH (including entrapment and patient falls from bed) in conjunction with individual 8

Citadel Plus Bariatric Care System

patient needs, and should discuss use or non-use with patient and / or family. Consider not only the clinical and other needs of the patient but also the risks of fatal or serious injury from falling out of bed and from patient entrapment in or around the side rails, restraints or other accessories. In the US, for a description RIHQWUDSPHQWKD]DUGVYXOQHUDEOHSDWLHQWSUR¿OHDQGJXLGDQFHWRIXUWKHU reduce entrapment risks, refer to FDA’s Hospital Bed System Dimensional and Assessment Guidance To Reduce Entrapment. Outside the US, consult the local Competent Authority or Government Agency IRUVSHFL¿FORFDOJXLGDQFHRQ0HGLFDO'HYLFH6DIHW&RQVXOWDFDUHJLYHUDQG FDUHIXOOFRQVLGHUWKHXVHRIEROVWHUVSRVLWLRQLQJDLGVRUÀRRUSDGVHVSHFLDOO with confused, restless or agitated patients. It is recommended that side rails (if used) be locked in the full upright position when the patient is unattended. Make sure a capable patient knows how to get out of bed safely (and, if necessary, KRZWRUHOHDVHWKHVLGHUDLOV LQFDVHRI¿UHRURWKHUHPHUJHQF0RQLWRUSDWLHQWV frequently to guard against patient entrapment. :KHQVHOHFWLQJDVWDQGDUGPDWWUHVV DVGH¿QHGE,(& PDNH sure the distance between top of side rails (if used) and top of mattress (without compression) is at least 22 cm (8.66 in) to help prevent inadvertent bed exit or falls. Consider individual patient size, position (relative to the top of the side rail) and patient condition in assessing fall risk. Make sure the distance between top of side rails (if used) and WRSRIDVSHFLDOLWPDWWUHVV DVGH¿QHGE,(&  ZLWKRXWFRPSUHVVLRQ LVDSSUR[LPDWHOFP LQ RU greater. Consider individual patient size, position (relative to the top of the side rail) and patient condition in assessing fall risk. Skin Care – Monitor skin conditions regularly and consider adjunct or alternative therapies for high acuity patients. Give extra attention to skin over any raised side bolster and to any other possible pressure points and locations where moisture or incontinence may occur or collect. Early intervention may be essential to preventing skin breakdown. Maximum Recommended Patient Weight - Total patient weight capacity should not exceed 454 kg (1000 lb). The use of accessories on the bed may decrease the patient weight capacity of the bed. Contact Arjo Customer Service for questions concerning the use of accessories and see the Questions and Contact Information section of this guide for contact information. I.V. and Drainage Tubes – Prior to activating any positioning function assess the security of all invasive lines and tubes to accommodate the desired angle of articulation and minimize the risk of binding, disconnecting or dislodging. 7XEHVDQGOLQHVVKRXOGDOZDVKDYHVXI¿FLHQWVODFNIRUDUWLFXODWLRQDQGSDWLHQW movement. Turning - Prior to engaging any mattress turn feature, make sure that bed frame has side rails and that all side rails are fully engaged in their full upright and locked position. Do not activate the turning feature on any mattress system when patient restraints are in use. Citadel Plus Bariatric Care System

9

Scale Readings - Scales / patient weights are for reference only. Scale readings should not be relied upon for medication dosage. All equipment on the weighed portion of the unit is included in weight displayed. Patient Migration – Specialty surfaces have different shear and support characteristics than conventional surfaces and may increase the risk of patient movement, sinking and / or migration into hazardous positions of entrapment and / or inadvertent bed exit. Monitor patients frequently to guard against patient entrapment. Skeletal Traction or Unstable Fracture (if not contraindicated) – With skeletal traction, unstable pelvic fracture or any other unstable fracture (to the extent not contraindicated), maintain physician directed angle of articulation and guard DJDLQVWULVNVRISDWLHQWPLJUDWLRQRULQDGYHUWHQWGHÀDWLRQRIVXUIDFH Electromagnetic Interference – Although this equipment conforms with the intent of electromagnetic compatibility, all electrical equipment may produce interference. If interference is suspected, move equipment away from sensitive devices or contact the manufacturer. Shock Hazard – Electrical shock hazard; do not remove electrical compartment FRYHUV5HIHUWRTXDOL¿HGVHUYLFHSHUVRQQHO

Power Drive System Safety Information To minimize the risk of serious injury, carefully read and follow all Safety ,QIRUPDWLRQDQG2SHUDWLQJ,QVWUXFWLRQVEHIRUHRSHUDWLQJ3RZHU'ULYH 6VWHP$OVRPDNHVXUHDOOSKVLFLDQRUGHUVDQGIDFLOLWSURWRFROVDUH IROORZHG Steep Slopes - When operating on slopes, always use slow speed. Do not operate on slopes in excess of > 7°. Wet Surfaces - Do not operate power drive system on wet surfaces. Indoor Use Only - Do not operate power drive on outside walkways, outside ramps or parking lots. Unplug - Ensure power cord is unplugged from wall and properly stored before transport. Clear Area - Ensure area beneath power drive system is clear before engaging drive system. Clear Path - Ensure pathway is clear of cords, hoses and obstacles before driving bed forward or backwards. Avoid Trapping People - Ensure there is space to operate before forward or reverse movement. Take caution in crowded areas to prevent trapping a patient or caretaker between bed frame and wall, furniture, equipment or other objects. Crowded Areas - Operate with caution in crowded hallways, elevators and rooms. Navigate Slowly - Use slow speed when moving bed around corners and through elevators and rooms. 10

Citadel Plus Bariatric Care System

Limited Space Maneuvering - To maneuver the bed in small or tight areas, GLVHQJDJHWKHSRZHUGULYHIURPWKHÀRRUDQGPDQXDOOPRYHWKHEHGLQWKH desired direction. Automatic Brakes - When the Forward or Reverse switch is released, the power drive system will stop; brakes are automatically engaged to prevent continued movement.

Citadel Plus Bariatric Care System

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INTRODUCTION These instructions contain information for the installation, use and maintenance of the Arjo Citadel™ Plus Bariatric Care System. These beds have multiple functions to help provide optimal care and safety for both patient and care giver.

Product Overview A

B

C D E F

G H

X V

W I

U

J T

K S R

L Q

P O

N M

Figure 1: Product overview

A. B. C. D. E. F. G. H. I. J. K. L. M. N. O.



Foot Board Foot End Side Rail Thigh Section Seat Section Backrest Section Patient Controls Head End Side Rail Power Drive Controls (see page 48) Head Board Accessory Socket Anti-Entrapment Sensor Caster Lifting Pole Socket Side Rail Release Lever Weighing / Movement Detection System Controls

P. Q. R. S. T. U. V.

Power Drive Lift Pedal Power Drive Drainage Bag Rail Attendant Control Panel (ACP) Foot End Brake Pedal CPR Release Handle Width Extensions (total of eight see page 26) W. Care Giver Controls X. Roller Buffer Not shown in this view: Y. Leg Extension Latch (see page 25) Z. Blue Extension Locking Handle (see page 25) Citadel Plus Bariatric Care System

All Citadel Plus beds have the following standard features: • Folding split side rails with integrated bed controls • Electrical adjustment of bed height and leg section elevation • Electrically operated retracting backrest • Auto-Chair facility • Electrical adjustment of head down tilt (Trendelenburg) and foot down tilt (reverse Trendelenburg) • Electrical adjustment of calf section vascular position • Mattress support surface with removable panels • Adjustable length mattress support surface • Drainage bag rails • Under bed lights • 150 mm dual casters • Patient weighing and VariZone™ patient egress detection • Anti-Entrapment System • Width extension (adjustable width mattress support surface)

Optional features • One-way nurse call • Two-way nurse call • Environmental controls • RS232 connection allowing transfer of bed status data • DIN accessory rails • Foot pedal for adjustment of bed height • Patient handset • Power Drive • Hinged power drive handles 2SWLRQDOIHDWXUHVDUHVSHFL¿HGEWKHFXVWRPHUDWWKHWLPHRIRUGHULQJ7KHFKRVHQ options are indicated by the equipment model number.

Citadel Plus Bariatric Care System

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7KHPRGHOQXPEHUDQGVHULDOQXPEHUFDQEHIRXQGRQWKHVSHFL¿FDWLRQODEHOZKLFKLV located on the bed frame below the head board.

Before using the bed, make sure that the power-in rating on the VSHFL¿FDWLRQODEHOLVFRPSDWLEOHZLWKWKHORFDOHOHFWULFLWVXSSO

Citadel Bariatric Care System

ArjoHuntleigh AB Hans Michelsensgatan 10 211 20 Malmö, SWEDEN www.arjohuntleigh.com YYYY-MM-DD MADE IN POLAND

0086 IPX4

522 kg 1150 lb

DUTY 10% 2 min ON / 18 min OFF POWER in 115V~ 9.5 A MAX 60Hz

E348583

Citadel Bariatric Care System

)LJXUH6SHFL¿FDWLRQODEHO

14

Citadel Plus Bariatric Care System

CLINICAL APPLICATIONS Intended Use The Citadel Plus Bariatric Care System is intended for the acute and post-acute care environments. It is not intended for use in the home care environment. The bed is suitable for use in the following situations: • Intensive / critical care provided in a hospital where 24-hour medical supervision and constant monitoring is required, e.g. ITU, ICU and CCU. • Acute care provided in a hospital or other medical facility where medical supervision and monitoring is required, e.g. general medical and surgical wards. • Long term care in a medical area where medical supervision is required and monitoring is provided if necessary, e.g. nursing homes and geriatric facilities.

Indications The Citadel Plus Bariatric Care System is indicated for medical purposes to aid the patient and staff during the performance of routine care.

Contraindications The Citadel Plus Bariatric Care System is contraindicated for patients weighing in excess of 454 kg (1000 lb). The care giver should refer to and follow any contraindications in the product labeling for the pressure redistribution surface being used with the Citadel Plus Bariatric Care System. Width extensions retracted: The bed is not suitable for patients under 45 kg (100 lb) in weight. Width extensions expanded: The bed is not suitable for patients with a Body Mass Index (BMI) <30.

To make sure the patient can use the bed safely, their age and condition VKRXOGEHDVVHVVHGEDFOLQLFDOOTXDOL¿HGSHUVRQ The use of head down tilt (Trendelenburg) or foot down tilt (reverse 7UHQGHOHQEXUJ PDEHFRQWUDLQGLFDWHGIRUFHUWDLQPHGLFDOFRQGLWLRQV The tilt function should only be used under the guidance of a clinically TXDOL¿HGSHUVRQDIWHUDVVHVVPHQWRIWKHSDWLHQW¶VFRQGLWLRQ

Citadel Plus Bariatric Care System

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General Product Information Safe working load (SWL)... 522 kg (1150 lb) Maximum patient weight... 454 kg (1000 lb) The recommended patient height is between 146 cm (58 in) and 190 cm (75 in). At the discretion of the care giver, patients taller than 190 cm (75 in) may be accommodated by extending the bed - refer to bed length adjustment on page 24. Make sure that the patient’s height does not exceed the in-bed length. (828 kg /1825 lb) (306 kg /675 lb)

(522 kg /1150 lb) • 146 cm

BMI • 17

454 kg / 1000 lb

(522 kg / 1150 lb 832.780

Figure 3a: Recommended Patient Height and Weight. Option without Power Drive. (882 kg /1943 lb) (360 kg /793 lb)

(522 kg /1150 lb) • 146 cm

(522 kg / 1150 lb

BMI • 17

454 kg / 1000 lb

832.781

Figure 3b: Recommended Patient Height and Weight. Option with Power Drive.

All accessories added to the system reduce the safe working load of the IUDPHEWKHVDPHDPRXQW

16

Citadel Plus Bariatric Care System

INSTALLATION The following chapter describes how to install the bed.

Weighing System Preparation 3RVLWLRQWKHEHGRQDÀDWOHYHOVXUIDFHDQGDSSOWKHEUDNHV Remove the four transport locking bolts (1) and washers (2); there are two locking bolts at the head end of the bed and two at the foot end.

Max 522 kg (1150 lb)

.

CPR

2

2

1

1

Figure 4: Removing the transport bolts

Retain the bolts and washers in case the bed needs to be transported at a later date.

To prevent damage to the weighing mechanism, replace the transport ORFNLQJEROWVDQGZDVKHUVEHIRUHWUDQVSRUWLQJWKHEHG7KLVLVQRW QHFHVVDUZKHQPRYLQJWKHEHGVKRUWGLVWDQFHV When replacing the transport locking bolts care must be taken to avoid WUDSSLQJRUGDPDJLQJDQFDEOHV

Power Drive Shipping Pin Removal 'RQRWORZHUSRZHUGULYHZKHHOVZLWKRXWUHPRYLQJVKLSSLQJSLQ If transporting frame to a new facility, insert shipping pin to lock the SRZHUGULYHSHGDO Before attempting to lower power drive wheels, remove the shipping pin (1) and store (2). 2 1

Figure 5: Removing the shipping pin Citadel Plus Bariatric Care System

17

Electricity Supply %HIRUHWKH¿UVWXVHRULIWKHEHGKDVEHHQXQXVHGIRUPRUHWKDQWKUHHPRQWKV connect the bed to the electricity supply for at least 24 hours to allow the backup battery to recharge fully; failure to do this may reduce the life of the battery. After charging, check that the battery is fully serviceable by carrying out a battery test as shown on page 61. Connect the mains plug to a suitable outlet. Make sure the plug is easily accessible so it can be unplugged quickly in an emergency. When the bed is connected to the electricity supply, the Power On Indicator LED will light on the Attendant Control Panel (see page 33). 7KHIRRWERDUG  LV¿WWHGZLWKDSODVWLFKRRN   When not in use or before moving the bed, clip the hook onto the head board, coil up the cable and place it over the hook as shown. 2

3 1

Figure 6: Power supply cord and potential equalization terminal

To isolate the bed from the electricity supply, unplug the mains plug from the outlet.

If the power cord or plug is damaged, the complete assembly must be UHSODFHGEDXWKRUL]HGVHUYLFHSHUVRQQHO'RQRWUHPRYHWKH¿WWHG SOXJRUXVHDUHZLUHDEOHSOXJRUDGDSWHU 0DNHVXUHWKHSRZHUFRUGLVQRWVWUHWFKHGNLQNHGRUFUXVKHG 'RQRWDOORZWKHSRZHUFRUGWRWUDLORQWKHÀRRUZKHUHLWPDFDXVHD WULSKD]DUG Make sure the power cord does not become entangled with moving SDUWVRIWKHEHGRUWUDSSHGEHWZHHQWKHEHGIUDPHDQGKHDGERDUG Unplug the power cord from the electricity supply, and store it, before PRYLQJWKHEHG

18

Citadel Plus Bariatric Care System

Potential Equalization Terminal A potential equalization terminal (Figure 6, item 3) is located at the head end of the bed. When other electrical equipment is within reach of the patient or care giver, potential differences between the equipment can be minimized by connecting together their potential equalization terminals.

Electrical Connections The Citadel Plus Bariatric Care System contains the following electrical connections. )UDPH





• Power Cord • Nurse Call Connector • 56&RQQHFWRU LIVSHFL¿HG  • Auxiliary Power Outlet • Skin IQ™ Family Power Cable

Power Cord The power cord is located at the head end of the bed. Make sure power cord is kept free from all pinch points, moving parts and is not trapped under casters. Improper KDQGOLQJRISRZHUFRUGFDQFDXVHGDPDJHWRWKHFRUGZKLFKPDSURGXFHULVNRI¿UH or electric shock. Pull the power cord out of the mains wall outlet to remove power from the unit.

1XUVH&DOODQG56&RQQHFWLRQV 1. Connect one end of the nurse call cable to the 37-pin D-type outlet, located below the head end of the bed on the patient's right hand side. 2. Connect the other end of the nurse call cable to a compatible nurse call system. The type of connector will vary depending on the nurse call system. 3. Connect one end of an RS232 cable to the 9-pin D-type outlet, located below the head end of the bed on the patient's right hand side. 4. Connect the other end of the RS232 cable to a device capable of receiving data through an RS232 connection. &RQQHFWLRQWRWKHQXUVHFDOODQG56FRQQHFWRUPXVWEHPDGHZLWK WKHFRUUHFWFDEOHV8VHRIWKHZURQJFDEOHVPDFDXVHPDOIXQFWLRQRI WKHEHGRUGHYLFHVFRQQHFWHGWRWKHQXUVHFDOORU56FRQQHFWRUV

Citadel Plus Bariatric Care System

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Verify correct operation of the nurse call system before placing a SDWLHQWRQWKHEHG 'RQRWDOORZWKHQXUVHFDOORU56FDEOHVWRWUDLORQWKHÀRRUZKHUH WKHPDFDXVHDWULSKD]DUG8QSOXJERWKFDEOHVEHIRUHPRYLQJWKH EHG 'RQRWDOORZWKHFDEOHVWRWRXFKWKHEHGIUDPHDVWKLVPDDIIHFWWKH DFFXUDFRIWKHZHLJKLQJVVWHP 2QOFRQQHFWGHYLFHVGHVLJQHGWREHXVHGZLWKWKHEHG Connecting devices not designed to be used with the bed may result LQGDPDJHWRWKHHTXLSPHQWRUWRWKHEHG 2QOXVHFDEOHVZLWKDQLQOLQHEUHDNDZDFRQQHFWRU EHORZ )DLOXUH to do so could result in damage to the bed or to other hospital HTXLSPHQW

Breakaway connection Connect to bed

Connect to Nurse call system

Figure 7: Example of an in-line breakaway connector

Auxiliary Power Outlet (Optional Feature) Auxiliary power outlet is provided as a convenience for powering devices intended to be placed at or near the foot end of the bed.

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This outlet does not remain powered when the bed is on battery EDFNXS



Citadel Plus Bariatric Care System

Skin IQ Family Power Cable Skin IQ Power Cable is provided for powering Skin IQ. This feature remains powered for four hours when the bed is on battery backup. A 12 VDC power cable is located at the foot end of the bed which provides a connection point for the Skin IQ of products.

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Skin IQ Installation 1. Stretch the Skin IQ coverlet over existing surface and use straps to secure to existing mattress. 2. When using the Skin IQ on the Citadel mattress, the mattress comes already equipped with straps located mid way under the mattress exclusively for attaching the tie-down straps from the Skin IQ coverlet. 3. Use the 12 VDC power cable, centered at the foot end of the bed to plug in the Skin IQ. Cable has a tag indicating it is for Skin IQ use.

Auxiliary power outlet located on the under side of foot board weldment

Skin IQ connection located behind foot board weldment

Figure 8: Auxiliary power outlet and Skin IQ Family power cable

Refer to Skin IQ Instructions for Use for detailed installation instructions.

Mattresses When choosing bed and mattress combinations, it is important to consider the use of side rails based on clinical assessment of each individual patient and in line with local policy. When assessing the suitability of a mattress for use with side rails, the following factors should be considered: • The bed is designed to provide an acceptable side rail height when used with a foam mattress between 15 cm (6 in) and 20.5 cm (8 in).

Citadel Plus Bariatric Care System