Echo Beds Owners Manual

Table of Contents I. Echo™Bed / Echo™Bed Dual Echo™Bed / Echo™Bed Dual Set-Up Safety Features Patient Positioning Sonographer Positioning Operation and Annual Maintenance 1. Hand wand 2. Drop section 3. Drop Section Exntension 4. Non-pinch flap 5. Caster use 6. Maintenance Operation - All Ways Echo Bed Cleaning Instructions Troubleshooting Guide Warranty

II. Parts Lists and Diagrams

I I I I I I I I I I I I I I I

- 1 - 3 - 4 - 7 - 9 - 10 - 12 - 16 - 17 - 18 - 20 - 23 - 26 - 28 - 30

II - 1

III. Accessories Collapsible Safety Rail Operation Paper Roll Holder Instalation Pediatric / Geriatric Adaptor Use

IV. Specification Sheets

III - 1 III - 2 III - 3

IV - 1

EBSPB0606

Echo™Bed / Echo Bed™Dual Set Up Introduction Your Echo™Bed /Echo™Bed Dual has been tested to insure perfect operation on day one. Please closely inspect your Echo™Bed/ Echo™Bed Dual when you receive it to insure no damage has occurred during shipment. Because the Echo™Bed / Echo™ Bed Dual is a complex piece of equipment you are offered the following precautions.

Echo™Bed Sonographer’s Entry Drop Section

Imaging Window Drop Section

Echo™Bed Dual

To Avoid Injury or Damage To reduce the risk of electrical shock, do not remove secured covers. Refer servicing to qualified personnel. Lock all casters before using equipment. Place hand wand on hook or holder when not in use. Keep cable clear of moving parts. Grounding reliability can only be achieved when the equipment is connected to an equivalent receptacle marked “hospital only” or “hospital grade”. Protect vinyl upholstery from sharp objects and abrasion to avoid damage. Refer to instructions located in this manual for vinyl cleaning recommendations. Do not use abrasives to clean painted surfaces. Risk class is 2G.--120 VAC, 50 to 60hz.

(continued)

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In This Section Your Echo™Bed /Echo™Bed Dual has been shipped to you in “plug and play” condition. In this section you will learn how to program the handwand and perform an initial test of your Echo™Bed /Echo™Bed Dual to insure that each function is in correct working order. After reviewing this manual you are ready to begin using your Echo™Bed / Echo™Bed Dual.

System Test Procedure The hand wand is a low voltage, DC operated device. The cable begins at the hand wand and plugs into the control box. Step 1

Action After removing padding and packaging materials, locate primary power supply cord and attach to suitable grounded 120 VAC outlet.

2

To test actuator functions, locate the hand control wand and depress each function button one at a time. (Depressing multiple buttons simultaneously may prevent motors from operating.)

BED UP



REVERSE TRENDELENBURG

BED DOWN TRENDELENBURG

FOWLER UP

FOWLER DOWN P 1

MEMORY POSITION 1 P 3

P 2

MEMORY POSITION 2

M

MEMORY POSITION 3

MEMORY SET BUTTON MEDICAL POSITIONING

Figure 1 I-2

(Refer to pages I-13 for memory programming instructions.)

System Test Procedure Step 3

Action If any function does not operate, perform the test procedures listed in the “Troubleshooting Guide” located in this manual.

Safety Features In This Section This section lists the safety features built into your Echo™Bed.

Safety Features

The Echo™Bed is equipped with multiple automated safety features to prevent danger or damage during use. The entire system is loop-grounded to UL-544 and C.S.A. Hospital Standards. The actuator assemblies are current overload protected. If overloaded, the actuators will stop and reset automatically. When equipped with a supine ergometer, electrical current is routed through a UL-544, C.S.A. approved multiple outlet power strip which utilizes a safety ground-fault circuit breaker. The sealed hand-held wand operates the actuators by directing small amounts of low voltage D.C. current to the control box. All of the actuator drives are equipped with internal limit switches which automatically prevent over-extension. The Echo™Bed is equipped with Single pedal braking and steering casters which can be engaged with the stainless steel lever located at the center of the base frame. When equipped with Trendelenburg, a level indicator is located on the sides of the bed surface to allow quick repositioning to level after Trendelenburg procedures.

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Patient Positioning Introduction Medical Positioning, Inc. is the only provider of the patented drop section which allows a sonographer to:
Place the patient in a full left lateral decubitus position
Improve image clarity
Reduce image acquisition time
Provide uninhibited access to to the apical window
Expand intercostal spaces (with SafeTwedge™)
Reduce foreshortening of apical images The American Society of Echocardiography provides supporting commentary in the “Recommendations for Quantitation of Two Dimensional Echocardiograms” on the value of the drop section as well as the optimum patient position for performing an echocardiogram. It is recommended that for obtaining optimum apical views, the patients be positioned in steep lateral recumbency for examination. Once this position has been achieved, it should be maintained with a wedge or pillow...(When) the patient is in a steep left lateral position, it is frequently difficult to transect the true apex unless there is a mattress with a scoop or excavation at the point where the apex impulse is generally located...Lack of specialized examining tables makes quantitative measurements more difficult in the critical care setting where modifying the bed is not practical. 1

With your imaging surface from Medical Positioning, Inc., you are well-equipped to start improving the quality of your images.

In This Section You will learn how to correctly position patients on your imaging surface to optimize the results of your echo studies. Before you begin,be sure the casters are in the locked position-refer to “Caster Use” section for detailed instructions.

Patient Positioning Procedure Step 1

Action Place a SafeTwedge™flush with the head end of the bed (where the drop section is located). The SafeTwedge™should be evenly centered between the sides of the bed.

2

With the drop section closed, ask the patient to lie on their back on the imaging surface. (continued)

1

Nelson B. Schiller, MD, et al..”Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiograms,” Journal of the American Society of Echocardiography, 1989, Vol. 2, pp. 358-367.

I-4

Patient Positioning Procedure (cont.) Step 3

Action Explain to the patient that you will be opening the drop section. While the patient will not feel anything, do not surprise the patient by opening the drop section without warning.

4

Adjust the patient so that he or she is in the middle of the bed (side to side) and so that the patient’s armpit or axilla is aligned with the top edge of the drop section. (See Figure 2)

Figure 2

If there is any question about proper positioning, roll the patient up onto their left side, open the Imaging Window Drop Section either remotely or manually (for instructions on how to operate the drop section, refer to pages II-14 to II-17) and locate the patient’s imaging windows. Make any adjustments required to patient position. If you are beginning a procedure such as a treadmill exercise echo where the patient will be off and then back on the bed, you should alert the patient to his / her current position and explain to the patient he / she must assume the same position post exercise. Some sonographers use tape on the bed to mark the hip location and tell the patient to return to that marked position following exercise. This technique can be useful, but BE CAREFUL, image windows frequently shift with exercise. (continued)

I-5

Patient Positioning Procedure (cont.) Step 5

Action When imaging (both resting and stress) it is helpful to ask the patient to place their left hand behind their head. This keeps their arm clear of the imaging window. When using this product with small children, senior citizens or well-endowed women, a Pediatric / Geriatric Adapter (available from Medical Positioning, Inc.) may be helpful.

6

Parasternal views can be obtained with the drop section either open or closed. When obtaining apical images, always open the drop section. At the completion of the study, but before the patient gets up to leave the exam surface, be sure to securely close the drop section.

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Sonographer Positioning Introduction The Echo™Bed Dual is designed to both improve images and maximize sonographer ergonomics. The two drop sections built into the bed are identified as the Imaging Window Drop Section and the Sonographer’s Entry Drop Section. The Sonographer's Entry Drop Section on the right of the patient provides a place for the right sided sonographer to sit, close to the patient while maintaining an upright position during imaging. Once you have properly positioned the patient on his or her left side over the Imaging Window Drop Section (see Patient Positioning for instructions) you are ready to place yourself in the proper position, open the Imaging Window Drop Section and begin imaging the patient.

In This Section You will learn how to correctly position yourself on your Echo™Bed Dual in order to insure maximum comfort and continued upright posture while you are imaging your patients.

Sonographer Positioning Procedure Before you begin this procedure, please familiarize yourself with the “Patient Positioning Procedure” and the “Operation Section”. In preparation for an echocardiography study, and before you work with any patient, lower the Sonographer’s Entry Drop Section and seat yourself on the table, facing the head of the bed and perpendicular to where the patient will be located. Place your ultrasound unit in close proximity to where you are seated to minimize the reach from the table to the ultrasound unit. For maximum comfort, it is important that you be able to maintain an upright position while you are operating both the controls on your ultrasound unit and the transducer. With your equipment in the proper place, you are ready to begin working with a patient.

(continued)

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Sonographer Positioning Procedure (cont.) Step 1

Action Prior to beginning an echo procedure, familiarize the patient with the Echo™Bed Dual. Explain to him/her that you will be opening the drop sections, that their opening will be slightly noisy, but the patient will be both comfortable and secure throughout the procedure.

2

Insure the patient is in the correct left lateral decubitus position. Tell the patient that you will be opening the Sonographer’s Entry Drop Section. While the patient will not feel anything, do not surprise the patient by opening the drop section without warning. Open the Sonographer’s Entry Drop Section and enter the cut-out area of the table. Seat yourself on the table, facing the head of the bed and perpendicular to the patient.

3

Tell the patient that you will be opening the Imaging Window Drop Section. Again, the patient will not feel anything, however, do not surprise the patient by opening the drop section without warning. Lower the Imaging Window Drop Section by activating the remote release as described in the “Remote Drop Section Operation” on page III-18.

4

You are now ready to begin imaging the patient.

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Operation Introduction The Echo™Bed / Echo™Bed Dual is shipped assembled and ready for use. Each function has been pre-tested to insure perfect working order on day one. Your control wand and Echo™Bed may not be equipped with all of the described functions. A “Troubleshooting Guide” is included to instruct you in the event of a malfunction. The Echo™Bed is designed for the sonographer that sits on the left side of the patient. This model is equipped with a single drop section, the Imaging Window Drop Section. The Echo™Bed Dual is designed for the sonographer that sits on the right side of the patient and reaches over the patient to scan. The Echo™Bed Dual is equipped with two drop sections: 1) An Imaging Window Drop Section and 2) the Sonographer’s Entry Drop Section. The Sonographer's Entry Drop Section on the right of the patient provides a place for the sonographer to sit, facing the head of the bed and perpendicular to the patient.

Remote Release for Imaging Window Drop Section

In This Section

This position, close to the patient, provides several advantages for the right sided sonographer. First, the sonographer’s drop section allows increased control of patient location and greater access to the intercostal imaging areas. In addition, it allows the sonographer to maintain a more upright position and should reduce stress to the shoulder, back and wrist of the sonographer. You will be provided with a basic understanding of the operation of the Echo™Bed. You will be instructed on the proper use of the Echo™Bed; including --using the hand wand --operating the drop section & remote drop section -- sonographers drop section extension --care of the non-pinch flap --caster use --annual maintenance I-9

Hand Wand Procedure - Memory Positioning Instructions Your handwand will contain appropriate functions for the bed shipped.

BED UP

1

Initialize all of the actuators by running each actuator (one at a time) to it’s fully retracted position. This would be; lower the height actuator all the way down, position the lateral tilt actuator to level and place the bed in reverse Trendelenburg position (the Trendelenburg actuator is fully retracted in this position).

2

Using the buttons on the hand wand, utilizing as many of the actuator motors as necessary but running only one actuator at a time, place the bed in the desired position for the first memory selection. When you are satisfied with the position attained, press and hold-down the [P 1] and [M] buttons at the same time. An audible tone will be produced by the actuator control box when the memory position is stored.



BED DOWN

REVERSE TRENDELENBURG

TRENDELENBURG

LATERAL TILT UP

LATERAL TILT DOWN P1

P2

MEMORY POSITION 2

MEMORY POSITION 1 P3

M

MEMORY SET BUTTON

MEMORY POSITION 3 MEDICAL POSITIONING

(Handwand will contain positions according to the functions of the bed received.)

Figure 3 I - 10

Hand Wand Procedure - Memory Positioning Instructions (cont.) Step

Action

3

Repeat step 2 for memory positions 2 and 3, using the [P 2] button for memory position 2 and the [P 3] button for memory position 3.

Step 4

Action To change any of the stored memory positions, repeat steps 1 and 2 for the position you wish to 3. change. It is not necessary to reprogram all of the positions in order to change only one or two of them.

The hand wand attaches to the bed in one of the two (2) following ways: Beds without safety rails - The hand wand has a Velcro strip on the back and the bed has Velcro on the side. (See Figure 4)

Back View of Hand Wand Velcro

Figure 4 Beds with safety rails - The hand wand has a hook installed on the back which is designed to hang on the safety rail. (See Figure 5)

Hand Wand Hook (hook over safety rail)

Side View of Hand Wand

Figure 5

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Drop Section (Imaging Window Only) The drop section is designed to be opened or closed easily with one hand. Do not place other hand within the drop section area during operation. Step 1

Action To open the drop section, locate the metal handle mounted on the bottom of the drop section at the front edge. (See Figure 6)

Move Release Lever Figure 6

2

Pulling the handle outward, from under the drop section, will release the latch mechanism and allow the drop section to swing open. Do not abruptly yank or jerk on handle, it is designed to work with a smooth, steady pull.

3

To close the drop section, grasp the pull tab (fabric loop) located on the front edge of the drop section and lift the drop section smoothly until it is securely in the full, upright and locked position. (See Figure 7)

Figure 7

4

It is not necessary to "slam" the drop section closed. Slamming the drop section closed will startle the patient and may result in damage to the mechanism. After closing, always lift up on the drop section to assure that is totally locked before patient entry or exit.

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Dual Drop Sections The Imaging Window Drop Section and the Sonographer’s Dual Entry Drop Section are designed to be opened or closed easily with one hand. The Imaging Window Drop Section may also be opened remotely by using the remote release handle conveniently located adjacent to the Sonographer’s Dual Entry Drop Section. The Sonographer’s Dual Entry Drop Section also functions as a back support for the patient. Follow Steps 1 and 2 for manual operation of either drop section, proceed to Step 3 for remote operation of the Imaging Window Drop Section and proceed to the “Dual Drop Section Patient Support” section for instructions on positioning the Drop Section in upright positions. Do not place hands within the drop section area during operation. Step 1

Action To open the drop section, locate the handle mounted on the bottom of the drop section at the front edge. (See Figure 8)

Move Release Lever Figure 8

2

Pulling the handle outward, from under the drop section, will release the latch mechanism and allow the drop section to swing open. Do not abruptly yank or jerk on handle, it is designed to work with a smooth, steady pull.

To close either drop section, proceed to Step 4.

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Remote Drop Section Operation Begin here for instructions on how to operate the remote release for the Imaging Window Drop Section. Step Action 3 To use the remote release, position the patient in left lateral decubitus position, pull out on the lever handle far enough to allow the Imaging Window Drop Section to open. You can accomplish this step while seated. (See Figure 9)

Figure 9

4

To close either of the drop sections, grasp the pull-tab (fabric loop), located on the front of the each Drop Section and lift the Drop Section smoothly until it is securely in the full, upright and locked position. (See Figure 10)

Figure 10

5

It is not necessary to “slam” the drop section closed. Slamming the Imaging Drop Section closed will startle the patient and may result in damage to the mechanism. Slamming the Sonographers Drop Section will cause it to over travel the latches. After closing the Imaging Drop Section, always lift up to assure that it is totally locked before patient or personal entry or exit.

6

The drop section latches are adjustable. In order for the Imaging Window Drop Section and the Sonographer’s Entry Dual Drop Section to continue to operate correctly, you must inspect annually. I - 14

Dual Drop Section Patient Support The Sonographer’s Dual Entry Drop Section may be lowered (as previously described), enabling correct posture for the right handed Sonographer or raised to provide support and proper positioning for the patient. When raised the Drop Section may be locked into one of two different positions. To raise and return to level, please perform the following: Step 1

Action Lift the Drop Section until it engages in the first locked position. If a steeper angle is desired, momentarily pull out on the Drop Section mechanism release handle at the front edge of the drop section (the same handle you use to lower the drop section) and pull the Drop Section until it engages the second locked position.

2

To lower the Drop Section back to level, pull out on the Drop Section mechanism release handle at the front edge of the drop section (the same handle) and let the Drop Section down until it engages the mechanism receivers.

I - 15

Sonographers Drop Section Extension The Sonographer Drop Section Extension is designed to increase the usable sitting area and comfort for the sonographer. This addition improves posture and body position for the right handed scanning sonographer. The extension is removable and mounts into a support bracket (The extension is shipped with the dual drop section bed but packaged separately)

UPHOLSTERY PAD

PILOT TUBE USE POSITION SUPPORT BRACKET

TRANSPORT POSITION

Figure 11

The Sonographer Extension Support Bracket is mounted to the side of the bed a few inches away from the Sonographers Drop Section. It has been placed in the Shipping/Storage position. Step 1 2

Action Rotate the Support Bracket to the Use Position (Straight out of the bed side) (See Figure 11) Insert the Pilot Tube into the Support Tube as shown.

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Non-Pinch Closure The Non-Pinch Closure Flaps, located at the back edge of both the Imaging Window Drop Section, and the Sonographer’s Entry Drop Section prevent the patient from being pinched when either drop section is closed after imaging. Examine the Non-Pinch Closure Flap with the drop section open and closed. The flap attaches to the bed surface with hook and loop tape that has been permanently attached to the surface. The drop section should not be operated without the non-pinch closure flap in place. The flap is attached to the bed with Velcro tape and can easily be adjusted whenever necessary. (See Figure 12) Flap

Figure 12

Occasionally the flap may become bent or creased. When that occurs, remove the flap from the bed surface by separating the Velcro tapes. Next, return the flap back to original shape by bending it farther in the opposite direction of the bend or crease and allowing it to spring back to flat. Should the flap require replacement, you may order one through Medical Positioning, Inc. at 1-800-593-ECHO (3246).

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Caster Use Procedure (for beds with individual locking casters) The casters installed on your Echo™Bed are total locking casters. When in the locked position, the caster is prevented from both rolling and swiveling. Before beginning any procedure involving a patient, insure the casters are in the locked position. Step 1

Action To lock the caster, step down on the outermost edge of the black locking tab located at the top of the caster wheel. (See Figure 13)

To lock

Figure 13

2

To unlock the caster step down on the top, innermost edge of the locking tab or lift up on the outermost edge of the tab.(See Figure 14)

To release

Figure 14

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