nimbus_4_and_nimbus_professional_instructions_for_u.pdf
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NIMBUS® 4 AND
NIMBUS® PROFESSIONAL
Instructions For Use
Product Photo
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Contents
General Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
About this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
About Nimbus 4 and Nimbus Professional . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus 4 Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus Professional Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mattress CPR and Transport Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
1
1
2
2
3
3
Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Care of the patient when sitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4
4
4
4
Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Preparing the System for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Installing the Nimbus 4 or Nimbus Professional Mattress . . . . . . . . . . . . . . . . . . . . .
Installing the Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Testing the Power Fail Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Tubeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disconnecting the Tubeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5
5
6
7
8
8
8
Controls, Alarms and Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Pump Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Pump Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Installing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Comfort Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mattress Vent Valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guidelines for Selecting Vent Valves to Open . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Transport Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deflating the Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CPR Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
12
12
12
12
13
13
14
14
15
Nimbus Professional Mattress: Patient Positioning Guide . . . . . . . . . . . . . . . . . .
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supine Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prone Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
16
17
18
Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
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Routine Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus 4 and Nimbus Professional Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nimbus 4 and Nimbus Professional Mattresses . . . . . . . . . . . . . . . . . . . . . . . . . . .
Serial Number Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
21
21
21
21
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Technical Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mattress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cover Options and Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cover Specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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23
23
24
24
25
26
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GENERAL SAFETY
Before you connect the system pump to a mains socket, read carefully all the installation
instructions contained within this manual.
The system has been designed to comply with regulatory safety standards including:
• EN60601-1:1990/A13:1996 and IEC 60601-1:1988/A2:1995
• UL60601-1, UL2601-1 and CAN/CSA C22.2 No. 601.1-M90
Safety Warnings
• It is the responsibility of the care giver to ensure that the user can use this product
safely.
• Whilst the patient is unattended, safety sides should be used based on clinical
assessment and in line with local policy.
• Alignment of the bed frame, safety sides and the mattress should leave no gap
wide enough to entrap a patient's head or body, or to allow egress to occur in a
hazardous manner where entanglement with the mains power cable and tubeset or
air hoses may result. Care should be exercised to prevent occurrence of gaps by
compression or movement of the mattress. Death or serious injury may occur.
• Make sure that the mains power cable and tubeset or air hoses are positioned to
avoid causing a trip or other hazard, and are clear of moving bed mechanisms or
other possible entrapment areas. Where cable management flaps are provided
along the sides of the mattress, these should be used to cover the mains power
cable.
• Electrical equipment may be hazardous if misused. There are no user-serviceable
parts inside the pump. The pump's case must only be removed by authorised
technical personnel. No modification of this equipment is allowed.
• The mains power socket/plug must be accessible at all times. To disconnect the
pump completely from the electricity supply, remove the plug from the mains
power socket.
• The CPR control and/or the CPR indicator tag must be visible and accessible at all
times.
• Disconnect the pump from the mains power socket before cleaning and inspecting.
• Keep the pump away from sources of liquids and do not immerse in water.
• Do not use the pump in the presence of uncontained flammable liquids or gasses.
• The cover of this product is vapour permeable but not air permeable and may
present a suffocation risk.
• Only the pump and mattress combination as indicated by ArjoHuntleigh should be
used. The correct function of the product cannot be guaranteed if incorrect pump
and mattress combinations are used.
• To avoid the risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.
• Due to the inherently lower flame retardancy of the high performance eVENT®1
fabric, it is NOT suitable for use in the homecare environment.
Precautions
For your own safety and the safety of the equipment, always take the following
precautions:
1. eVENT® is a registered trademark of BHA Technologies Inc.
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• Placing extra layers between the patient and the mattress potentially reduces the benefits
provided by the mattress and should be avoided or kept to a minimum. As part of sensible
pressure area care, it is advisable to avoid wearing clothing which may cause areas of
localised high pressure due to creases, seams, etc. Placing objects in pockets should be
avoided for the same reason.
• Do not expose the system, especially the mattress, to naked flames, such as cigarettes,
etc.
• In the event of a fire, a leak in the seat or mattress could propagate the fire.
• Do not store the system in direct sunlight.
• Do not use phenol-based solutions to clean the system.
• Make sure the system is clean and dry prior to use or storage.
• Never use sharp objects or electrically heated under blankets on or under the system.
• Store the pump and mattress in the protective bags supplied.
Electromagnetic Compatibility (EMC)
This product complies with the requirements of applicable EMC Standards. Medical electrical
equipment needs special precautions regarding EMC and needs to be installed in accordance
with the following instructions:
• The use of accessories not specified by the manufacturer may result in increased
emissions by, or decreased immunity of, the equipment, affecting its performance.
• Portable and mobile radio frequency (RF) communications equipment (e.g. mobile/cell
phones) can affect medical electrical equipment.
• If this equipment needs to be used adjacent to other electrical equipment, normal
operation must be checked before use.
• For detailed EMC information contact ArjoHuntleigh service personnel.
Environmental Protection
Incorrect disposal of this equipment and its component parts, particularly batteries or other
electrical components, may produce substances that are hazardous to the environment. To
minimise these hazards, contact ArjoHuntleigh for information on correct disposal.
Service Information
ArjoHuntleigh recommend that this system should be serviced every 12 calendar months or,
where applicable, when the service indicator is illuminated.
Design Policy and Copyright
® and ™ are trademarks belonging to the ArjoHuntleigh group of companies. As our policy is
one of continuous improvement, we reserve the right to modify designs without prior notice.
© ArjoHuntleigh 2009.
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1. Introduction
About this Manual
About Nimbus 4 and
Nimbus Professional
This manual is your introduction to the Nimbus® 4 and
Nimbus Professional systems. Use it to initially set up the
system, and keep it as a reference for day-to-day routines and
as a guide to maintenance.
Nimbus 4 and Nimbus Professional are highly effective
Dynamic Flotation Systems providing active therapy for the
prevention, treatment and management of pressure ulcers.
The systems comprise a pump and mattress replacement
which can be used on standard hospital and normal domestic
beds. Beds with divided sections for independent elevation
of a patient's head and/or knees can be adjusted with these
mattresses in position.
Both systems use the same Nimbus pump, which has two
operating modes:
• Dynamic mode that cycles the support surface beneath
the patient every 10 minutes providing periods of
pressure relief for the whole body.
• Static mode where the support surface remains constant
(all cells equally inflated).
The Nimbus Professional mattress combines all the
qualities of the Nimbus range of mattresses with the added
benefit of optional head cell deflate; this will assist the
clinician with a range of nursing procedures including prone
nursing, intubation, neck cannulation and hygiene, while the
body of the mattress continues to provide optimal alternating
pressure redistribution.
Both mattresses have been designed with specialised Vent
Valves, so that some of the cells (including the three head
cells on the Nimbus Professional mattress) can be
selectively deflated to assist with pressure area care and
patient management.
The mattresses incorporate an advanced AutoMatt® sensor
pad which ensures the patient is automatically supported at
optimum pressures regardless of size, height, position or
weight distribution. Both mattresses incorporate the five
Heelguard® cells at the foot end of the mattress which
ensure that the patient’s heels are provided with the
maximum pressure relief.
If cardiac arrest occurs, the mattresses can be rapidly
deflated using the CPR (Cardio-Pulmonary Resuscitation)
Control to allow cardiac resuscitation procedures to be
performed.
Caution
Federal law restricts this device to sale by or on the order of a physician.
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Nimbus Pump
Mains Power Switch
Carry Handle
Alarm Indicators
Comfort Control
Mains Power Cable
Tubeset
Connector
Front Panel
Static Control
Mute Control
Nimbus 4 Mattress
5 Heelguard Cells
8 Torso Cells
4 Thigh Cells
CPR/Transport
Control
3 Head Section Cells
(Constant Pressure)
FOOT END
HEAD END
5 Vent Valves
Carry Handle
Drag Handle
Detachable Cover
Securing Strap
Cable Management Flap
2
CLOSED
OPEN
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Nimbus Professional Mattress
Shoulder Support (4th) Cell
(Alternating, No Vent Valve)
3 Head Section Cells
(Alternating Pressure)
5 Heelguard Cells
3 Thigh Cells
CPR/Transport
Control
8 Torso
Cells
FOOT END
HEAD END
19 Vent Valves
Carry Handle
Drag Handle
Detachable Cover
Securing Strap
Cable Management Flap
CLOSED
OPEN
Mattress CPR and Transport Controls
CPR Control
Transport Control
FAST DEFLATE
CP
NORMAL
NORMAL
TRANSPORT
TRANSPORT
R
1
2
3
Tubeset
Connector
Pump Tubeset
This is common to both Nimbus 4 and Nimbus Professional mattresses, and
is at the foot end of the mattress on the opposite side to the Vent Valves.
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2. Clinical Applications
Indications
The Nimbus 4 and Nimbus Professional systems
are indicated for the prevention and management of all
categories1 of pressure ulcer when combined with an
individualised monitoring, repositioning and wound care
programme.
The Nimbus 4 and Nimbus Professional mattress is
designed for patients weighing up to 250 kg (550 lb).
Contraindications
Cautions
Do not use Nimbus 4 and Nimbus Professional
systems for patients with unstable spinal fractures.
If patients have other unstable fractures, or conditions
which may be complicated by a soft or moving surface,
advice should be sought from an appropriate clinician
before use.
While the Nimbus 4 and Nimbus Professional
systems have been designed to manage patients up to the
weight limits indicated above, those approaching this
upper limit are likely to have additional care and mobility
needs and may be better suited to a specialist bariatric
system.
Active therapy (alternating) cushions may be unsuitable
for patients with poor sitting posture or pelvic deformity;
advice from a seating specialist should be sought.
Care of the patient
when sitting
Seated patients are at increased risk of pressure ulcers
particularly if they are immobile or have wounds over the
seating area. For optimal outcome, provide a pressure
redistributing seat cushion in a chair which promotes a
good sitting posture and has a level base seat to support the
cushion, in addition to an individualised repositioning
programme.
The above are guidelines only and should not replace clinical judgement.
The Nimbus 4 and Nimbus Professional systems represent one aspect of
a pressure ulcer management strategy; if existing wounds do not improve or the
patients condition changes the overall therapy regimen should be reviewed by
the prescribing clinician.
Mattress and cushion combinations may have different upper weight limits.
Cushions should be used in combination with pressure-redistributing
mattresses to provide 24-hour therapy.
1. NPUAP/EPUAP International Pressure Ulcer Guideline, 2009.
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3. Installation
The Nimbus 4 and Nimbus Professional systems are very simple to install using
the following guidelines.
Refer to Section 4, Page 9 “Controls, Alarms and Indicators” for a
comprehensive description of the controls and indicators on the pump.
Preparing the
System for Use
1. Remove the system from the packaging. You
should have the following items:
• Nimbus pump, with integral mains power cable
and bed bracket.
• Nimbus 4 mattress replacement or
Nimbus Professional mattress replacement.
• Tubeset.
Installing the Nimbus 4 or Nimbus Professional Mattress
1. Remove the conventional mattress from the bed
frame and check that there are no protruding bed
springs or sharp objects on the bed frame surface.
Heavily ridged bed baseboards may require special
considerations for correct system operation consult your ArjoHuntleigh representative.
2. Unroll the mattress onto the bed base and make
sure that the CPR is at the foot end, and the CPR
label is hanging freely.
3. Attach the mattress to the bed frame using the new
fastener straps, as shown. These 8 fastener straps
can be moved to any of the 10 anchor points on the
base of the mattress, to allow for attaching the
mattress to different types of bed frame.
If the bed has divided sections for independent
elevation of a patient's head and/or knees, attach the
mattress to the movable parts of the bed frame only.
4. To make sure that the pressure relieving properties
are not impaired, the mattress cover must not be
pulled tight and covering sheets should fit loosely.
5. Make sure that ALL the Vent Valves are closed:
Closed
5
Open
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6. Make sure the CPR control is closed and locked in
position and the Transport control is set to
NORMAL.
FAST DEFLATE
CP
NORMAL
NORMAL
R
1
TRANSPORT
TRANSPORT
2
3
CPR Control
Installing the Pump
Transport Control
1. If the pump is to be hung from the end of the bed,
make sure that the bed bracket is securely attached
to the pump, and then attach the pump and bed
bracket to the bed frame.
2. Alternatively the pump can be placed underneath
the bed, either upright or lying on its back.
Cable Management
3. Insert the connector on the end of the mains power
cable into a suitable mains power outlet.
The mains power cable should be put through one of the
cable management flaps which are on each side of the
mattress base cover, as follows:
1. Locate one of the cable management flaps.
2. If necessary, open the press studs along the flap.
3. Run the mains power cable along the side of the
mattress securing the flap round the cable using the
press studs.
Press Stud
Cable
Management
Flap
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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.
The battery may have become discharged or reached the
end of its life.
It is therefore recommended that the alarm is tested
when the pump is installed, as follows:
Refer to Section 4, Page 9 “Controls, Alarms and
Indicators” for a comprehensive description of the
controls and indicators on the pump.
1. Connect the pump to the mains power supply,
switch on the pump and allow it to run for 10-15
seconds.
2. Remove the mains power at the wall socket
without switching the pump off.
3. The power fail alarm should operate within 10
seconds, as follows:
• The red Alarm triangle will flash.
• The Power indicator will flash.
• An audible warning will sound.
4. The alarm will continue until the mains power is
resumed or the pump is switched off using the
Power switch on the pump control panel.
5. If the alarm does not operate, run the pump for
approximately four hours to recharge the battery.
6. Retest the alarm after the battery has been
recharged. Allow the alarm to operate for
approximately two minutes to ensure that it has
been adequately recharged.
7. If the alarm does not operate for two minutes, call
the service engineer.
If the Power Fail Alarm does not operate after this
test and a service engineer has been called, the
pump can continue to be used with regular checks of
the Power-On status. All other alarms will continue
to function as normal.
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Connecting the
Tubeset
To connect the tubeset to the mattress and pump:
1. Locate the bottom of the tubeset connector onto the
bottom of the pump/mattress connector.
2. Pull the top of the tubeset connector up and over the
top of the pump/mattress connector, until the
tubeset connector “clicks” into position.
3. Make sure both connections are secure.
2
1
Disconnecting the
Tubeset
To disconnect the tubeset from the mattress and pump:
1. Move the tubeset connector down by pulling the
tubeset extrusion downwards, and then pull the
bottom of the tubeset connector away from the
bottom of the pump/mattress connector.
2. Lift the top of the tubeset connector off the top of
the pump/mattress connector.
2
1
System Operation
The system is now ready for use. Refer to
Section 4, Page 9 “Controls, Alarms and Indicators”
and Section 5, Page 12 “Operation” for day-to-day
operating instructions.
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4. Controls, Alarms and Indicators
Power Switch
& Reset Alarm
Mute Control
& Indicator
Alarm
Indicator
High Pressure
Indicator
Low Pressure
Indicator
Service
Indicator
Comfort
Control
Wait
Indicator
On/Reset Alarm
Indicator
Static Control
& Indicator
Pump Controls
Power Switch (and
Reset Alarm)
Power Fail
Indicator
Pump Fault
Indicator
The pump front panel has the following controls:
Switches the mains power to the pump on and off.
The green indicator is illuminated when the mains
power is connected and the pump switched on.
The switch is also used to reset the pump after an alarm
condition has been detected.
Static Mode
Alarm Mute
Comfort Control
Selects the operating mode, either Static or Dynamic.
Static mode is confirmed when the yellow indicator on
the button is illuminated.
When Dynamic mode (default) is selected the yellow
indicator will be extinguished.
An Alarm Mute button is provided to cancel warning
sounds during an alarm condition.
The Nimbus 4 and Nimbus Professional systems
automatically compensate for patient weight
distribution and position, to optimise the pressure
relieving performance. However, the mattress cell
pressure can be manually adjusted for patient comfort
using the rotary Comfort Control.
Turn the Comfort Control clockwise for a firmer
setting and counterclockwise for a softer setting.
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Page 16
Pump Indicators
On / Reset Alarm
Static Mode
Alarm Mute
The pump front panel has the following indicators:
The green On / Reset Alarm indicator below the Power
switch is illuminated when the mains power is
connected and the pump switched on.
The indicator on the Static button is illuminated when
Static mode has been selected for operation.
The indicator on the Mute button is illuminated when an
audible alarm has been silenced.
Wait
High Pressure
Low Pressure
The indicator will NOT be illuminated when a
Power Fail alarm is muted.
The Wait indicator is illuminated when the mattress is
being inflated.
The indicator will remain illuminated until the mattress
has been fully inflated. This may take up to 15 minutes.
The High Pressure indicator is illuminated whenever
the pump detects high pressure within the mattress.
If this condition occurs, the air supply from the pump is
switched off until normal pressure is detected. After 2
seconds of normal pressure being detected the indicator
is switched off and the air supply restarted.
The Low Pressure indicator is illuminated whenever
the pump detects low pressure within the mattress.
This may indicate that there is insufficient pressure to
support a patient or that the Transport control is turned
to the Transport position whilst the pump is on and
connected to the mattress.
Alarm
The Low Pressure indicator will be switched off once
normal pressure is reached.
The pump unit incorporates a sophisticated alarm
detection system that differentiates between patient
movement and genuine alarm conditions.
Whenever an alarm condition is detected the red Alarm
triangle starts flashing together with an indicator of the
cause of the alarm. Additionally, an audible warning
will sound, which can be cancelled by pressing the
Alarm Mute button (Refer to “Alarm Mute” on page 9).
The triangular Alarm symbol is displayed with one or
more of the following indicators:
• Low Pressure (refer to “Low Pressure” on page 10).
• High Pressure (refer to “High Pressure” on
page 10).
• Pump Fault (refer to “Pump Fault” on page 11).
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• Power (refer to “Power Fail” on page 11).
For all alarm conditions except Power Fail, once
the alarm condition has been detected and
displayed, it can only be cancelled by switching the
pump unit off and then back on.
Pump Fault
Power Fail
Refer to Section 9, Page 22 “Troubleshooting” for
possible causes of the above alarm conditions.
The Pump Fault indicator is illuminated when an
internal pump malfunction is detected.
The fault can only be rectified by carrying out a service
on the pump.
The Power indicator will flash when a mains power
failure has been detected.
The alarm will continue until the mains power is
resumed or the pump is switched off using the Power
switch on the pump control panel.
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. The battery may have
become discharged or reached the end of its life; it is
therefore recommended that the alarm is tested before
the pump is used (refer to “Testing the Power Fail
Alarm” on page 7).
Service Indicator
If the Power Fail Alarm does not operate after this
test and a service engineer has been called, the
pump can continue to be used with regular checks of
the Power-On status. All other alarms will continue
to function as normal.
The Service Indicator symbol will be illuminated after
a set number of running hours to indicate that the pump
is ready for a service. This service period is set to 12
months run time.
The pump will continue to operate normally even
when the Service Indicator symbol is illuminated.
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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.
Refer to Section 4, Page 9 “Controls, Alarms and Indicators” for a
comprehensive description of the controls and indicators on the pump.
Installing the System
Before using the Nimbus 4 or Nimbus Professional
system make sure that it has been installed correctly in
accordance with Section 3, Page 5 “Installation”.
• The CPR unit on the mattress is closed and locked in
position.
• The Transport control on the mattress is set to
Normal.
• ALL Vent Valves on the mattress are closed.
Inflating the Mattress
1. Connect the pump to the mains power supply and
switch on the pump.
2. The pump will now run a self test for
approximately 3 seconds when all the indicators on
the front panel will be illuminated.
3. Once normal operating pressure has been reached
both the Low Pressure and Wait lights will
extinguish.
Comfort Control
Operating Modes
It may take up to 15 minutes to inflate the mattress.
Adjust the Comfort Control to the patient’s
requirements.
The system has two operating modes:
• Dynamic mode provides the optimum pressure
relieving performance and should be used in most
cases. In Dynamic mode the support surface beneath
the patient is cycled every 10 minutes.
• Static mode provides a stable, non-moving support
surface (all cells are equally inflated).
• The pump defaults to the Dynamic operating mode
when switched on.
Select the required operating mode.
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Mattress Vent Valves
On the Nimbus 4 and Nimbus Professional
mattresses, the Vent Valves along the side of the
mattress offer further operating modes to assist with
pressure area care and patient management:
1. Nimbus 4 mattress has only 5 Vent Valves in the
Heelguard section at the foot end of the mattress.
2. Nimbus Professional mattress:
• The 3 Head Section cells have Vent Valves.
• The 8 Torso cells, 3 Thigh cells and 5 Heelguard
cells have Vent Valves.
• The single Shoulder Support (4th) cell has no
Vent Valve and cannot be deflated.
3. During system operation, open individual Vent
Valves on the Torso, Thigh and/or Heelguard cells
to deflate the cell and assist with pressure area care
and patient management, including everyday
interventions such as CXR imaging.
Nimbus Professional Mattress - Vent Valves
Head
End
Foot
End
Head
Cells
Torso
Cells
Thigh
Cells
Heelguard
Cells
Shoulder Support Cell
Guidelines for Selecting Vent Valves to Open
The following guidelines should be adhered to when
selecting Vent Valves to open on the Nimbus 4 and
Nimbus Professional mattresses:
1. For permanent off-loading/pressure relief:
• Select no more than one cell directly under the
area you want to relieve (head, torso, calf or heel
section).
• Open the Vent Valve to deflate the cell.
This single cell can be left permanently deflated.
2. For temporary nursing procedures:
• Select one or more adjacent cells.
• Open the Vent Valve(s) to deflate the cell(s).
• Once the nursing/clinical procedure is complete
re-inflate the cell(s) by closing the Vent Valve(s).
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Deflating more than one adjacent cell may affect the
support of the patient during the normal alternating
cycle, so should only be used for temporary
procedures.
3. For complex patient needs, you can off-load more
than one area on the patient for longer periods, but
with the following restrictions:
Transport Control
• Deflate only one cell in the torso section.
• Deflate only one cell in the calf/heel section.
• Deflate only one cell in the Head Section when
the patient is in the supine position, or all three
cells in the Head Section when the patient is in
the Prone position.
Do not deflate any more cells in each area or it may
affect the support of the patient during the normal
alternating cycle.
This sets the mattress into Transport mode where the
mattress is sealed and the support surface is equally
pressurised; the pump and/or tubeset can then be
removed. In this mode the mattress will support the
patient for up to 12 hours.
To set Transport mode:
1. Turn the Transport control knob clockwise to
Transport.
2. Turn the pump off and disconnect the tubeset.
If the Transport control is set to Transport with the
tubeset connected and the pump switched on, the
pump will indicate a Low Pressure fault alarm.
To resume normal operation:
1. Re-connect the pump and tubeset to the mattress.
2. Turn the Transport control knob counterclockwise
to Normal.
Deflating the
Mattress
To deflate and store the mattress, do the following:
1. Switch off the pump, and disconnect the pump from
the mains power supply.
2. Remove the tubeset from the pump and mattress.
3. Activate the CPR control.
4. Make sure the Transport control is set to Normal.
5. Roll up the mattress, starting at the foot end.
Make sure the mattress is dry before rolling it up.
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CPR Control
IMPORTANT
IN THE EVENT OF CARDIAC ARREST.
To Activate the CPR
In the event of a patient suffering cardiac arrest and CPR
needing to be administered:
1. Lift the red CPR handle at the foot end of the
mattress.
FAST DEFLATE
CP
NORMAL
R
1
TRANSPORT
2
3
2. Turn the handle counterclockwise.
FAST DEFLATE
CP
NORMAL
R
1
TRANSPORT
2
3
3. Pull the handle away from panel.
FAST DEFLATE
R
CP
NORMAL
1
TRANSPORT
2
3
To Reset the CPR
4. The grey triangular seal will rotate and the air will
rapidly exhaust from the mattress.
1. Turn the grey triangular seal clockwise and push
onto the connectors.
2. Turn the red handle clockwise.
3. Fold the handle flat to lock in position.
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6. Nimbus Professional Mattress: Patient Positioning Guide
The Nimbus Professional mattress allows the patient to be placed in either the
Supine or Prone positions.
WARNING
A full patient assessment, as to the suitability for Prone Nursing, is
essential before commencing the procedure.
Safety sides should be used where appropriate (Refer to “General
Safety” on page iii).
It is important that the patient’s head, neck and shoulders are in the
correct anatomical position.
When using the Head Section deflate, care must be taken to
support the head and neck, and any lines or tubes which are at risk
of displacement, and to avoid running lines underneath the head
where unrelieved pressure may cause blockage or tissue injury.
Care should be taken at all times to check that all tubes/lines are
positioned correctly.
In the Prone position, regular checks should be made to make sure
the patient is free from a build up of pressure on the anatomically
sensitive areas such as:
• Head and facial areas including eyes
• Top of the shoulders
• Sternum
• Breasts and genitals
• Knees and toes
General
In both the Supine and Prone positions, patients should be positioned on the mattress
so that the shoulders are in line with the Shoulder Support (4th) cell.
It is important for the optimal use of the system that patients are positioned
correctly on the mattress.
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Supine Position
Prone Position
Shoulder Support Cell (4)
(Alternating)
Head Section Cells
(1 - 3) Alternating
Shoulder Support Cell (4)
(Alternating)
Head Section Cells
(1 - 3) Fully Deflated
Supine Position
Make sure the Vent Valves on the three Head Section cells are closed so that the cells
are fully inflated to support the head.
In Dynamic mode, all 20 mattress cells, including the Head Section cells, alternate
on a 10-minute cycle. This affords protection to all vulnerable areas including the
occiput (back of the head).
Rarely, some patients prefer not to have gentle cell alternation beneath the
head; this can be resolved by placing a thin pillow underneath the head.
Head Section Deflate: Supine Position
• When the patient is in the supine position, the Head Section cells can be deflated
to enable:
• Neck extension (e.g. for emergency procedures or cannulation).
• Access to the head (e.g. hygiene or wound care).
• The action should be supervised by a competent clinician.
• Always support the neck before and during Vent Valve operation.
• Open the Vent Valves on the three Head Section cells so that up to three of the
cells are fully deflated.
• Never leave the patient unattended.
• If the head cells are to remain deflated ensure adequate support of the head and
shoulders and provide other methods of routine pressure redistribution.
The Shoulder Support (4th) cell will continue to alternate.
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Prone Position
• Prone nursing is usually prescribed as an emergency therapy for patients in acute
respiratory distress or to manage extensive wounds on the dorsum, such as
pressure ulcers or burns.
• The decision to adopt the prone position must be authorised by the clinician
responsible for the patient’s care.
Turning a patient into a prone position carries a moving and handling risk to
both the patient and the clinical staff: conduct a full assessment, comply with
local protocols and use positioning aids and side rails where necessary.
The anaesthetist or most senior member of the team should be positioned at the
head end of the bed and will co-ordinate the turning procedure. This person
will also be responsible for the safety of the patient’s head, neck and ventilation
tubing. The other members of the team will help safeguard all lines and assist
with the turning procedure as directed.
Before commencing the turn, it is recommended that all non-essential lines and
monitoring equipment are disconnected.
1. Press the Static button to put the pump into Static mode, so that the mattress
cells remain constant with all cells equally inflated.
The mattress must be stable and not alternating while the patient is turned, so
that the patient is correctly positioned on the mattress.
2. Position the patient so that the shoulders are in line with the Shoulder Support
(4th) cell.
3. Open the Vent Valves on the three Head Section cells so that they are deflated.
4. Turn the patient into the prone position whilst supporting the head.
5. Adjust the head position using pillows, foam or gel pads so that a comfortable
posture is achieved without hyperextension.
6. Make sure that any lines/tubes are not placed underneath the head, check that
the ears are free from pressure and bony prominences are well padded.
7. Check that the shoulders are still in line with the Shoulder Support (4th) cell.
The Shoulder Support (4th) cell has no Vent Valve and continues to alternate
to provide both support to the patient’s shoulders and pressure redistribution
over the vulnerable shoulder area.
8. Press the Static button to put the pump back into Alternating mode.
Wait for at least one full cycle (10 minutes) before making a final adjustment
of any supporting pillows or pads.
9. Determine an individualised repositioning schedule based upon the patient's
condition.
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7. Decontamination
The following processes are recommended, but should be adapted to comply with
the local or national guidelines (Decontamination of Medical Devices) which may
apply within the Healthcare Facility or the country of use. If you are uncertain, you
should seek advice from your local Infection Control Specialist.
The Nimbus 4 and Nimbus Professional system should be routinely decontaminated
between patients and at regular intervals while in use; as is good practice for all
reusable medical devices.
WARNING
Remove the electrical supply to the pump by disconnecting the
mains power cord from the mains power supply before cleaning.
Protective clothing should always be worn when carrying out
decontamination procedures.
Caution
Do not use Phenol-based solutions or abrasive compounds or pads
during the decontamination process as these will damage the
surface coating. Do not boil or autoclave the cover.
Avoid immersing electrical parts in water during the cleaning
process. Do not spray cleaning solutions directly onto the pump.
To clean
Clean all exposed surfaces and remove any organic
debris by wiping with a cloth moistened with a simple
(neutral) detergent and water. Dry thoroughly.
Chemical Disinfection
To protect the integrity of the cover we recommend a
chlorine-releasing agent, such as sodium hypochlorite,
at a strength of 1,000ppm available chlorine (this may
vary from 250ppm to 10,000ppm depending on local
policy and contamination status).
Wipe all cleaned surfaces with the solution, rinse and
dry thoroughly.
Alcohol based disinfectants (maximum strength 70%)
may be used as an alternative.
Ensure the product is dry before storage.
If an alternative disinfectant is selected from the wide
variety available we recommend that suitability for use
is confirmed with the chemical supplier prior to use.
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DO NOT WRING/MANGLE, AUTOCLAVE OR USE
PHENOLIC BASED SOLUTIONS.
Thermal Disinfection
For information for the mattress top cover, including
laundering guidelines, refer to “Cover Options and
Features” on page 26.
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