Huntleigh Autoexcel User Manual April 2001

CONTENTS Introduction... 1 About this Manual... 1 About Autoexcel... 2 Clinical Applications... 3 Indications... 3 Contra-indications... 3 Patient In Chair... 3 Product Description... 4 Overlay... 4 Pump... 5 Bed Bracket... 6 Tube-Set... 6 Installation... 7 Preparing the Pump and Overlay... 7 Inflating Autoexcel... 10 Testing the Power Fail Alarm... 10 Operation... 12 System Optimisation... 12 Silencing Audible Alarms... 12 CPR Control... 12 Controls, Indicators And Alarms... 13 Cleaning... 14 During Use... 14 Laundering... 14 Overlay Cover... 15 Overlay Base And Cells... 15 Pump... 16 Troubleshooting... 17 Fuse Replacement... 17 Warranty... 18 Routine Checks... 19 Overlay... 19 Pump... 19 Technical Description... 20

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Safety Before you connect the system pump to a mains socket, read carefully all the installation instructions in Section 4 – Installation. The system has been designed to comply with regulatory safety standards including: · BS5724, Part 1 · IEC601-1 · VDE 0750 : Teil 1 · UL544 For your own safety and the safety of the equipment always take the following precautions: · Keep the pump away from sources of liquids · Do not expose the system, especially the mattress, to naked flames, such as cigarettes etc. · Do not store the system in direct sunlight · Do not use hypercarbonate or phenolic based cleaning solutions · Keep sharp objects away from the mattress · Ensure that the system is clean and dry prior to storage · Store the pump and overlay in the protective bags supplied · Do not use the Autoexcel overlay on the bed base. It must always be used on top of an existing mattress. Failure to do so can put the patient at risk. · We recommend the use of cot sides on the bed while the system is in use and the patient is positioned on top. Local policies regarding the use of cot sides should be taken into account. · Keep these instructions handy for reference

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SAFETY WARNING The cover of this product is vapour permeable but not air permeable and may present a suffocation risk. It is the responsibility of the care giver to ensure that the user can use this product safely.

WARNINGS Electrical equipment may be hazardous if misused, the pump case back should only be removed by authorised technical personnel. Do not use the Autoexcel pump in the presence of flammable gases such as anaesthetic agents.

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1. Introduction About this Manual

This manual is your introduction to the Autoexcel® system, use it to initially set up the system and keep it handy as a reference for day-to-day routines and as a guide to maintenance. Section 2 –

Clinical Applications: gives examples

of the type of patients that could benefit from this system.

Section 3 –

Product Description: a technical

Section 4 –

Installation: explains how to set up and install the Autoexcel system.

Section 5 –

Operation: a reference guide for

Section 6 –

Cleaning: routine cleaning and

Section 7 –

Troubleshooting: routine maintenance

Section 8 –

Warranty and Service: details the

Section 9 –

description of the system.

day-to-day operation and contains important information on what to do in the event of a cardiac arrest. recommended laundering procedures. procedures and solutions for minor problems that may occur.

warranty and what to do if the equipment requires servicing or repair. Routine Checks: details periodic

inspections of the pump and overlay.

Section 10 – Technical Description: a list of technical data.

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About Autoexcel

The Autoexcel system is a micro-perforated air loss system comprising an overlay, top cover, tube set and pump. The system is used for the prevention and management of pressure sores. Transverse cells provide interface pressures below 20mmHg for over 50% of the cycle. A stable pillow section is created by three cells permanently inflated which prevent the patient’s head from rising and falling. Contoured cells provide additional support at the sides, thus containing the patient in a central position on the overlay. The Autoexcel system incorporates a unique Auto-Matt® sensor pad, which ensures that the patient is automatically supported at optimum pressures regardless of size, height, position or weight distribution. The overlay is designed for use with standard hospital beds as well as most domestic beds. Users are able to employ established practises for lifting, turning and moving patients. Beds can also be adjusted or gatched in the normal way without impairing the overlay’s pressure relieving performance. A water resistant, vapour permeable cover is supplied which enhances patient comfort by preventing heat build-up whilst protecting the overlay interior from contamination. It is simple to clean in situ but can be easily removed for laundering. In the event of cardiac arrest, the overlay can be quickly deflated in less than 10 seconds to allow cardiac resuscitation procedures to be performed. The pump provides a dynamic system of inflating the support surface beneath the patient, cycling every 10 minutes to produce periods of pressure relief for the whole body.

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2. Clinical Applications The Autoexcel system, with its ability to provide reduced interface pressures in dynamic operating mode, is used for those patients who are at high risk from developing, or who have pressure ulcers. A risk assessment tool combined with clinical judgement should be used when determining a patient’s level of risk of developing pressure ulcers. Patient risk assessment should be an ongoing process as changes in the patient’s condition may increase or decrease their risk level. Indications

The Autoexcel system is appropriate for patients assessed to be at high risk of developing pressure ulcers, or with existing pressure ulcers up to and including grade 3 (EPUAP, 1998)1. The Autoexcel system is designed to operate in dynamic mode only which continuously changes the tissue pressure points, providing a high degree of pressure relief. The Autoexcel system can be used for patients weighing between 45-203kg (100-450lbs).

Contra-indications

The Autoexcel system should not be used for patients with unstable spinal fractures. In the case of patients with other unstable fractures, where a moving surface could be harmful, advice should be obtained from the appropriate physician before using the Autoexcel system.

Patient In Chair

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If the patient will be sitting in a chair for any period of time, it is strongly recommended that a pressure reducing or relieving seat cushion is used.

The Autoexcel system is an aid to the prevention and management of pressure ulcers. If there is no improvement in the patient’s condition, specialist advice should be sought. The above are guidelines only and should not replace clinical judgement or experience.

1

European Pressure Ulcer Advisory Panel (1998). Pressure Ulcer Treatment Guidelines, British Journal of Nursing 7(5):888-9.

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3. Product Description Overlay

The Autoexcel overlay is comprised of a series of 18 individual cells, 15 of which inflate alternately. The best way of describing cell arrangement is that, if all cells were numbered 1 to 15, the odd number cells inflate simultaneously whilst the even number cells are deflated and then vice versa. Micro-perforations enable air to circulate beneath the patient enhancing comfort and preventing heat build-up. The three cells at the head end are permanently inflated, in order to give the patient a stable pillow section.

Cells

Air Feed Tube Connector/ CPR Control

Double Manifold

Auto-Matt

The sequence of dynamic pressure relief is : l l

l l

Phase 1 – odd numbered cells inflated for approximately 4 minutes. Phase 2 – total support period where all cells are inflated (cross-over) for approximately one minute. Phase 3 – even numbered cells inflated for approximately 4 minutes. Phase 4 – as phase 2 (one minute)

At the foot end of the overlay a 5 way connector serves to inflate and alternate the Autoexcel overlay, to control pressure and to deflate the overlay quickly in the event of cardiac arrest. To reinflate the Autoexcel overlay, securely lock the connector on the tubeset to the manifold. 4

Pump

À Á Â Ã

Power (and alarm reset) Switch

Tube Set Connector

ON WAIT ALARM MUTE

Power Cord

À Á

Power ON indicator Wait indicator

 Ã

Alarm indicator Mute button and indicator

The pump comprises a rugged moulded case with non slip feet on the base and rear and an integral carry handle. The unit has been designed to maintain sustained operation and to withstand prolonged use in the hospital and homecare environments. Weight has been minimised and is evenly distributed throughout the case with the centre of gravity beneath the carry handle. The On/Off switch is situated on the side panel; other controls and indicators (lights) are located on the front panel which is recessed to prevent accidental operation. The pump incorporates a sophisticated alarm system that differentiates between normal operation and genuine system faults. If an alarm situation is detected a flashing indicator will illuminate and an audible warning will sound.

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Bed Bracket

The pump can be fixed to the foot end of a hospital style bed by the separate bed bracket which has been designed for simplicity and ease of use. It features a simple self adjusting mechanism that clips onto most common bed frames (18-50mm wide) and a hook that fits into the pump handle. Once installed the pump is not likely to be accidentally dislodged from the end of the bed. The pump can also be stood on the floor, either vertically or horizontally.

Tube-Set

The tube-set incorporates a flexible, compact anti-kink tube that is resistant to crushing and the obstruction of air flow. Each end has a quick connect system for easily connecting and disconnecting the air connection at the pump and overlay.

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4. Installation These instructions cover initial set up and operation of the Autoexcel system. More detailed information regarding controls, alarms and indicators is in Section 5. Preparing the Pump and Overlay Fitting the Autoexcel Pump

1. Remove the pump from the carton together with the overlay and cover. You should have the following items: l l l

overlay with cover pump and bed bracket tube-set

2. The pump can be suspended from the bed foot rail by means of the hanging device or alternatively stood upright or on its back on any convenient horizontal surface.

Old

New

3. Check there are no protruding bed springs or similar sharp objects on the bed mattress surface.

Caution Do not use the overlay directly on the bed frame.

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4. Place the Autoexcel overlay on the bed mattress with the air feed tube connector socket located near the pump at the foot of the bed, ensuring that the Auto-Matt sensor pad is flat and smooth and that the CPR swing label is hanging freely.

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4 5. Ensure individual cells of the Autoexcel overlay are uppermost.

6. Secure the Autoexcel overlay by positioning the four straps under the corners of the bed mattress. Tuck the flaps under the bed mattress. 7. Place the protective cover sheet on the overlay and fix into position with the press studs provided.

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8. Connect air feed tube connector/CPR to air outlet on pump unit and inlet on the overlay, ensuring that the tubes are not twisted. Push the connector in until it clicks into position.

Correct Tube-set Connection

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Inflating Autoexcel

1. Insert the mains power plug into the power socket.

2. Switch the pump On/Off switch to ON: the ON light on the front panel should illuminate. 3. The pump will now run a self test for approximately 3 seconds when all lights will be illuminated. 4. If the pump detects low pressure it will enter an inflation sequence with the WAIT message illuminated. Once normal operating pressure has been reached, the

WAIT light will switch off. It may take up to 20 minutes to fully inflate the Autoexcel overlay.

Testing the Power Fail Alarm

The power fail alarm is powered by a rechargeable battery. The duration of the alarm will depend on the level of charge in the battery. In use, it may have become discharged or reached the end of its life. It is therefore recommended that the alarm be tested before use. 1. Connect the pump to the mains, switch on and allow to run for 10-15 seconds. 2. Remove the mains power at the wall socket without switching the pump off. 3. The alarm should operate within 10 seconds.

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Caution If the power fail alarm does not operate after this test, only use the pump under supervision to ensure that the power-on status is checked at regular intervals. 4. If the alarm does not operate, run the pump for 4 hours to recharge the battery. 5. Retest the alarm after at least 4 hours. Allow the alarm to operate for 2 minutes to ensure that it has been adequately recharged. 6. If the alarm does not operate for 2 minutes, call the service engineer. Continue to use the pump only under supervision to ensure that the power-on status is checked at regular intervals. All other alarms will continue to function as normal.

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When rolling up the overlay after a period of use, always roll from the foot end.

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5. Operation These instructions cover day-to-day operation of the system. Other operations, such as maintenance and repair, should only be carried out by suitably qualified personnel. System Optimisation

The Autoexcel system automatically compensates for patient weight distribution and position optimising the pressure relieving performance. To ensure that the pressure relieving properties are not impaired, the cover must not be pulled tight and any covering sheets are not fitted too tightly.

Silencing Audible Alarms

Audible alarms can be silenced using the MUTE pushbutton. To silence an alarm simply push the MUTE button once.

CPR Control

IMPORTANT In the event of cardiac arrest, disconnect the tubeset connector at the foot end of the overlay. A swing label indicates the position of the connector in the event of bed covers obscuring the tubeset location.

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The overlay will deflate sufficiently for CPR procedures to commence within 10 seconds of disconnection.

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Controls, Indicators And Alarms Controls On/Off Switch (And Alarm Reset)

Situated on the side panel of the pump, this switches the mains power on and off. It is combined with an internal battery circuit that will activate the alarm system if the power supply is interrupted prior to switching off. Examples are accidental mains lead removal or mains power failure.

O I ON

A green light on the front panel indicates that the power is ON.

MUTE

An audible alarm mute is provided to cancel audible warning sounds during an alarm condition. The yellow light is illuminated when the alarm has been silenced.

WAIT

If the pump detects low pressure in the overlay, the WAIT indicator is illuminated and the pump performs a start up procedure to inflate the overlay. Once correct operating pressures have been reached the WAIT indicator goes out.

ALARM

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The pump unit incorporates a sophisticated alarm detection system to differentiate between patient movement and genuine alarm conditions. Whenever an alarm occurs, the flashing red indicator is illuminated. Additionally, an audible warning will sound unless cancelled by the MUTE button as described earlier. Once an alarm has been initiated, it can only be cancelled by switching the pump unit off and then switching back on. For possible causes for the alarm, see the table in Section 7.

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6. Cleaning The following guidelines have been established in accordance with infection control procedures. Should you have any questions regarding cleaning or if you require further information please contact our Customer Services Department or your local Huntleigh Healthcare representative.

Caution Gloves and protective clothing should always be worn when carrying out cleaning procedures. During Use

The mattress, pump and tube set should be cleaned weekly using a damp soft cloth and mild detergent. The pump can then be wiped with a sodium hypochlorite or sodium chloroisocyanurate (NaDCC) solution to a dilution of 1000ppm. Hypercarbonate and phenolic based cleaning solutions should never be used. The mattress cover can be easily unzipped for complete removal, laundering or sterilisation. The mattress can be cleaned in the normal way using soap and water. Heavily soiled mattresses can be cleaned with a sodium hypochlorite or sodium chloroisocyanurate (NaDCC) solution to a dilution of 1000ppm before laundering. Never use Phenol based solutions as these will damage the surface coating. If there appears to be staining or body fluids on the mattress cells they can be treated using a sodium hypochlorite solution or sodium chloroisocyanurate (NaDCC) to a dilution of 1000ppm. The tube-set should be thoroughly cleaned with soap and water followed by sodium hypochlorite or sodium chloroisocyanurate (NaDCC) solution to a dilution of 1000ppm.

Laundering

The top cover should be laundered in accordance with washing of hospital soiled linen procedures. Temperatures must be maintained at 80° centigrade (176°F) for a minimum of 3 minutes through the disinfection stage followed by rinsing and extraction. 14

Overlay Cover

The cover can be washed and thermally disinfected in a washing machine. The recommended temperature is 80°C.

Laundry Washing Cycle Industrial

Domestic

Break wash Main wash Main wash 2 Extraction 3 Cold Rinses Extraction

Cold 10 minutes 65°C (149°F) 10 minutes 80°C (176°F) 3 minutes 2 minutes

Prewash Main Wash Extraction Cold Rinses Extraction

Cold 71°C (160°F) 10 minutes 2 minutes

5 minutes

5 minutes

TUMBLE DRYING OR TUNNEL DRYING IS NOT RECOMMENDED. Overlay Base And Cells

The base and cells can be wiped over with a solution of sodium hypochlorite 1000ppm or any other non-phenolic germicidal solution.

Disinfection

Temperatures must be maintained at 80°C (176°F) for a minimum of 3 minutes through the disinfection stage followed by rinsing and spinning.

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Pump

WARNING Switch off the electrical supply to the pump and disconnect the power cord from the mains supply before cleaning and inspection. Cleaning

The pump casing is manufactured from plastic and should be cleaned using a damp soft cloth dampened with a mild detergent. This can be followed by a sodium chloroisocyanurate (NaDCC) solution to a dilution of 1000ppm. Do not use abrasive compounds or pads.

General Care, Maintenance And Inspection

Check all electrical connections and power cord for signs of excessive wear. Test power fail alarm system before use. For procedure, see Installation section. In the event of the pump being subjected to abnormal treatment, e.g. immersed in water or dropped, the unit must be returned to an authorised service depot.

Maintenance

The equipment has been designed to be virtually maintenance-free between service periods. It is recommended that the pump is serviced annually by a Huntleigh Healthcare authorised service agent.

Servicing

Huntleigh Healthcare will make available on request service manuals, component parts lists, and other information necessary for Huntleigh Healthcare trained personnel to repair the system.

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