Huntleigh Autoexcel User Manual April 2001

Page 3

CONTENTS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

About this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

About Autoexcel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Clinical Applications .

Indications. . . . .

Contra-indications .

Patient In Chair . .

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3

3

3

3

Product Description .

Overlay . . . . .

Pump . . . . . .

Bed Bracket . . .

Tube-Set . . . .

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4

4

5

6

6

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Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Preparing the Pump and Overlay . . . . . . . . . . . . . . . . . . . . . . . . 7

Inflating Autoexcel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Testing the Power Fail Alarm . . . . . . . . . . . . . . . . . . . . . . . . . 10

Operation . . . . . . . . . . . . . . .

System Optimisation . . . . . . .

Silencing Audible Alarms . . . .

CPR Control . . . . . . . . . . .

Controls, Indicators And Alarms .

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12

12

12

12

13

Cleaning . . . . . . . . . .

During Use . . . . . . .

Laundering . . . . . . .

Overlay Cover . . . . .

Overlay Base And Cells

Pump. . . . . . . . . .

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14

14

14

15

15

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Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Fuse Replacement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Routine Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Overlay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Pump. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Technical Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

(i)

Page 4

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

(ii)

Page 5

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.

(iii)

Page 6

(iv)

Page 7

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.

1

Page 8

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.

2

Page 9

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

+

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.

3

Page 10

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

Page 11

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

Â

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.

5

Page 12

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.

6

Page 13

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.

7

Page 14

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.

6

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.

8

Page 15

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

9

Page 16

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.

10

Page 17

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.

+

When rolling up the overlay after a period of use,

always roll from the foot end.

11

Page 18

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.

+

The overlay will deflate sufficiently for CPR procedures to

commence within 10 seconds of disconnection.

12

Page 19

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

+

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.

13

Page 20

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

Page 21

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.

15

Page 22

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.

16

Page 23

7. Troubleshooting

The following table provides a trouble shooting guide for the Autoexcel system

in the event of malfunction.

Possible

Problem

Indicator

WAIT

Possible Cause

Remedy

The pump is inflating

the overlay.

This indicator will go

out when operating

pressure is reached.

The tube-set is not

connected

properly.

Check connections and

resecure.

There is a leak in the

system.

Call service engineer.

There is a block in the

pneumatic circuit.

Check in bottom layer

of overlay that

Auto-Matt is flat and

not kinked.

CONTINUOUS

ALARM

LOW

PRESSURE

FLASHING

HIGH

PRESSURE

Tube set blocked.

POWER FAIL

No mains power

Check for kinked tube.

Check plug and socket.

Check for power cut.

PUMP FAULT

ALARM

Dynamic valve fault.

Call service engineer.

Control board fault.

Call service engineer.

CONTINUOUS

Fuse Replacement

If the system fails to operate when plugged in and

switched on, the fuses situated above the mains inlet

socket on the pump should be checked. To do this,

disconnect the pump from the main power supply and

remove fuse holder cap using a suitable screwdriver.

Important

To protect against fire hazard, replace blown fuse with identical

type and rating - 500mA quick blow. If the fuse blows again

contact a service engineer or suitably qualified personnel.

17

Page 24

8. Warranty

Huntleigh Healthcare’s standard terms and conditions apply to all sales. A copy

is available on request. These contain full details of warranty terms and do not

limit the statutory rights of the consumer.

For service, maintenance and any questions regarding this, or any other

Huntleigh Healthcare product, please contact:

Huntleigh Healthcare

310 – 312 Dallow Road

Luton Beds LU1 1TD UK

Tel: 01582 413104

Fax: 01582 459100

or your local distributor.

18

Page 25

9. Routine Checks

Overlay

1.

Remove top cover and inspect for signs of wear or any tears.

2.

Check all cover fasteners are secure.

3.

Check integrity of all connectors including cell to manifold and sensor

pad to inlet plate.

4.

Ensure all cell fasteners are snapped to the base sheet and are not loose

or faulty.

Pump

1.

Check the outer casing of the pump unit for damage.

2.

Examine the mains supply lead of the pump unit for signs of wear/

damage.

3.

Test power fail alarm system before use. For procedure, see

Installation section.

19

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10. Technical Description

Pump

Supply Voltage:

Supply Frequency:

Electrical rating:

Fuse rating:

Size:

Weight:

Case material:

Air inlet filter:

Operating cycle:

Electrical Safety Standards

AU.1000

AU.1000/J/50

240 Vac

100 Vac

50Hz

50Hz

15VA

F500mA

Length 336mm (13.2")

Height 210mm (8.3")

Depth

100mm (4")

3.5kg (7.7lb)

ABS/polycarbonate alloy

Service replaceable

10 mins.

AU.1000/J/60

100Vac

60Hz

IEC601-1

BS5724, Part 1

VDE 0750 : Teil 1

UL544

Degree of protection

against electric shock:

Degree of protection

of ingress of liquids:

Mode of operation:

Symbols

Class I, type BF

Ordinary (not protected)

Continuous

alternating current

O (Off) power disconnection from the mains

supply.

I (On) power connection to the mains

supply.

Type BF

Tube Set

Length:

Material

Tube:

Connectors:

1 metre (39.4")

5-way moulded PVC

Moulded nylon

20