Babycare TENS Ltd

Elle TENS Plus Instructions for Use Jan 2014

Instructions for Use

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Instructions for use

The Elle TENS+™is a 3-in-1 state-of-the art, efficient method of drug-free pain relief. This powerful digital TENS unit is smooth, sophisticated and simple to use. It has been cleverly crafted by Babycare TENS specifically for home use for mums-to-be, for the management of pain for labour and beyond. The Elle TENS+ contains a powerful TENS unit to combat labour pain with a built in contraction timer, a TENS unit for general pain relief and a Pelvic Floor Stimulator (PFS) for treating post-natal incontinence. The instructions in this manual are designed to cover most operational issues. If you have any questions concerning setting up, using or maintaining this device which are not covered by these instructions or any other concerns please do not hesitate to contact Babycare TENS at [email protected]. TENS is recognised as a safe and highly effective method of pain relief and is regularly recommended by medical professionals. TENS is drug-free, with no known side effects. It can also be used in conjunction with any additional medication if required.

Explanation of symbols on unit Equipment providing a particular degree of protection against electric shock particularly regarding allowable leakage currents having an F type (floating) applied part. Warning Please read these instructions before use.

Denotes a product which must be disposed of safely.

What is TENS? Section TENS (Transcutaneous Electrical Nerve Stimulation) works by passing mild electrical impulses through the skin, via electrode pads, into the nerve fibres which lie below.

Using your Elle TENS+ in BIRTH mode:

Section

Using your Elle TENS+ in PAIN mode:

See page 4

The TENS impulses help your body produce its own pain killing chemicals, such as endorphins. The level of pain relief obtained varies from person to person.

What can the Elle TENS+ be used for?

See page 16

1. The Elle TENS+ provides pain relief during labour. However some people may find that other analgesics are also needed during the later stages of labour. 2. The Elle TENS+ can be used for many chronic and acute pain conditions such as back pain, shoulder pain, arthritis, sciatica, sports injuries, migraine, period pain and post-operative pain. 3. The Elle TENS+ can also be used for treating incontinence. (NOT to be used during the 12 weeks following childbirth).

Section

Using your Elle TENS+ in PELVIC mode: See page 24

Section

For more information Please also refer to your ‘Women’s guide to drug free pain relief’.

BIRTH mode Waiting for that big day to finally arrive is exciting, but it is perfectly natural to feel a little apprehensive. You will be thinking about how to make giving birth as easy as possible - preparation is essential. Babycare TENS has become the most popular choice for mums-to-be as it is specifically designed to combat pain during childbirth. This is a safe, effective drug-free method of pain relief, which still allows you to use other analgesics, such as pethidine or gas-and-air if you wish.

Contents for BIRTH mode

Controls on your Elle TENS+ Display symbols and their meanings Setting up your Elle TENS+ for birth Suggested electrode placement diagram Entering BIRTH mode Adjusting intensity for pain relief during labour Burst (use between contractions) Boost (use during contractions) Using the contraction timer Recalling your contraction history The Mode Button The Opti-Max Key Questions, answers and troubleshooting

5 6 7 9 10 10 11 11 12 12 13 14 15

Controls on your Elle TENS+ in BIRTH mode

Leadwire Jack Plug Sockets

im Boost/T

The Elle TENS+ is very simple to use. However, it is essential to read these instructions to obtain the most out of the unit. Please ensure that all of the contraindications and precautions have been read thoroughly. See pages 34 and 35. Opti-Max Key Adjusts depth of the pulses: Refer to p14 for more details. Channel 1 Intensity Adjustment Keys

Mode Button Selects modes. Space to attach neck cord

Boost/Timer Button Used for an extra surge of power during contractions and also activates Contraction Timer.

ELLETENS+

BIRTH PAIN PELV

On/Off Button

+ Opti Max

CH1

CH2

Mode CH1

Channel 2 Intensity Adjustment Keys

CH2

N.B. Automatic Power Off When the intensity levels are zero, and the Elle TENS+ has not been in use for 5 minutes, it will shut off automatically.

Display symbols and their meanings in BIRTH mode Mode 1 and 2 There are two mode ranges available each with a Burst and Boost function (see page 13).

/Timer Boost

BURST This function is used at the onset of labour and in between contractions. There are two Burst modes available indicated by a 1 or 2. You can switch between them by pressing the Mode Button (see page 11). BOOST The Boost Button at the top right of the unit activates the BOOST mode. This function is used during contractions. There are two Boost modes available indicated by a 1 or 2. You can switch between them by pressing the Mode Button. Between Contraction Timer Starts by pressing the Boost Button, this automatically measures the time interval between your contractions.

ELLETENS+

BIRTH PAIN PELV

Opti Max

CH1

CH2

Mode

Low Battery Indicator This sign will start flashing if the batteries run low. If this is the case, change both batteries. Please refer to page 7 for instructions. Power Bar This shows the output from 0 to 15 for both channel 1 and 2. Each segment represents approximately 7% of the total output. Contraction Timer Starts by pressing the Boost Button, this automatically records the duration of your contractions. Opti-Max Indicates the Opti-Max output. Refer to p14 for more details. Pad contact warning (safety cut-out) This symbol will appear if any of your pads are not attached securely to the skin.

Setting up your Elle TENS+ for BIRTH Press

AA R6 1.5v AA R6 1.5v

AA R6 1.5v

b) Release the battery compartment cover and insert 2 x AA batteries ensuring the positive (+) and negative (-) terminals are correctly positioned as marked in the battery compartment. Replace the cover.

Rotate

a) Press and rotate the belt clip at the back of the Elle TENS+ in either direction to reveal the battery compartment.

AA R6 1.5v

• 1 x Elle TENS+ Unit • 1 x Pack of 4 Self Adhesive Electrodes (40mm x 100mm) • 2 x Leadwires and 1 Spare • 2 x AA Batteries and 2 Spare • 1 x Carrying Pouch • 1 x Easy-Release Neck Cord • 1 x Instruction Manual • 1 x Quick Start Guide • 1 x Women’s Guide* • 1 x Electrode Placement Chart* • 1 x Lubricant Gel Sachet 1 x vaginal probe (NOT to be used until at least 12 weeks after childbirth. See contraindications and precautions on pages 34 and 35. For use only in the PELVIC mode see p24).

The Assembly Stage

Check the following contents:

Cover

Release

*(only if you have purchased this unit)

Setting up your Elle TENS+ for BIRTH

c) Take two of the pink leadwires and insert each of the black jack plugs into the sockets at the top of the Elle TENS+ unit. Jack Plug

Jack Plug

d) Now insert the pins (at the other end of the leadwires) into the sockets attached to the sticky electrodes. Do not remove the electrodes from the backing at this stage.

If you wish, attach the easy-release neck cord which enables you to hang the Elle TENS+ from your neck.

AA R6 1

AA R6 1.5v

N.B. Each leadwire has a red and black pin. It makes no difference which electrode they are attached to.

Pins

Sockets Sticky Electrodes

Suggested electrode placement diagram

The sticky electrode pads need to be placed in the correct position for maximum pain relief. It is preferable to obtain assistance from either your birthing partner or medical adviser when positioning the pads. Please read the following instructions carefully: 1. Clean the skin thoroughly and allow skin to dry before applying the pads. CH1

CH1

2. Carefully peel the pads from the plastic backing using your forefinger and thumb. Do not pull on the lead wires. Retain plastic backing and pouch for storage after use. 3. Position the top two pads (connected to the left socket CH1) approximately 4cm either side of the spine and 4-5cm above the imaginary navel line as seen in the diagram.

Bra line

Naval line

CH2

CH2 Panty line

4. Position the bottom two pads (connected to the right socket CH2) approximately 4cm either side of the spine and 4-5cm below the imaginary navel line as seen in the diagram.

Reference: Cluett E. (1994) SRN RM ADM PGCEA. Analgesia in Labour: A review of the TENS method. Professional Care of Mother and Child. Mar;4 (2): 50-2.

Using the Elle TENS+ in BIRTH mode Press

Display

Entering BIRTH mode a). You are now ready to use your Elle TENS+. Ensure that the Boost Button located at the top right of the unit is not pressed in. Switch the unit ON by pressing the On/Off Button. You will see ‘BIRTH’ flashing in the top left corner of the display. Mode

Opti Max

b). Press Mode to confirm ‘BIRTH’ mode, otherwise your Elle TENS+ will automatically enter the BIRTH mode after a few seconds. c). If the unit does not already display ‘BIRTH’ (i.e. PAIN or PELVIC is flashing), use the Opti-Max Key to cycle through the modes, until ‘BIRTH’ is flashing. N.B. Your Elle TENS+ always starts up in the mode used previously. To select another mode you must first turn off the unit and follow the instructions as above.

CH1

Adjusting intensity for pain relief during labour Begin by pressing the CH1+ key. Each time this key is pressed, ‘half-moons’ will appear on the screen increasing in number and size as the intensity is

BIRTH

Using the Elle TENS+ in BIRTH mode

Display increased. You will begin to feel a pulsating sensation. The unit is in BURST mode. Press CH1- should you wish to reduce the intensity.

CH2

Repeat the previous step with the CH2+ and CH2- keys. You will now feel a sensation in both sets of pads.

Burst 1 (use between contractions*) This is the first mode that you will use. It feels like a pulsing, tingling sensation i.e. the pulses are off and on periodically. This mode will help to promote those all-important natural pain-killing chemicals known as ‘endorphins’ and ‘encephalins’.

imer Boost/T

Boost 1 (use during contractions*) When experiencing a contraction, simply press the Boost Button once and release. This is the big button located at the top right of the unit. Your Elle TENS+ will then switch automatically into the BOOST mode for that extra surge of power required to combat pain during contractions. This will feel like a continuous sensation. You do not need to hold the button in. *See page 13 for additional BURST and BOOST information.

Using the Elle TENS+ in BIRTH mode

Display imer Boost/T

Once the contraction has passed, release the Boost Button by lightly pressing it. The Elle TENS+ will return to the original BURST 1 mode. Continue this cycle during the early stages of labour.

Using the contraction timer The first time you press the Boost Button, the Elle TENS+ will automatically trigger the Contraction Timer (CT). This can be seen in the bottom right of the display. This measures the duration of your contractions in seconds. Once the contraction has passed and the Boost Button is released, the unit will trigger the Between Contraction Timer (BCT) which measures the time between contractions. Press CH1

CH2

Opti Max

Recalling your contraction history To recall a list of your last 5 ‘Contraction Times’ (CT) and ‘Between Contraction Times’ (BCT) press the CH1- and CH2- buttons simultaneously. The last recorded set of BCT and CT times are shown as -1. Use the Opti-Max - Key to go back to previous sets (eg, -2, -3, -4, -5) or forward again by pressing the OptiMax + Key. Recalling the contraction history will not interrupt the functionality of the unit. N.B. To avoid losing contraction history, do NOT switch unit off.

Using the Elle TENS+ in BIRTH mode

Display CH1

CH2

To return back to the original BIRTH mode screen, press the CH1- and CH2buttons together again.

The Mode Button There are two mode ranges available on the Elle TENS+, each with a Burst and Boost function. Mode 1 (BURST 1 and BOOST 1), which has been described above, is primarily used for the earlier stages of labour. Mode 2 (BURST 2 and BOOST 2) usually used when your labour advances and your contractions become more frequent. Press Mode

Press the Mode Button to switch between mode ranges. You will see from the User Display, that the number in the centre of the display will change from 1 to 2 and vice-versa. N.B. Both modes are interchangeable and can be used according to your preference, not necessarily for the stage of labour you are in.

Using the Elle TENS+ in BIRTH mode

Display

The Opti-Max Key This provides extra versatility to your Elle TENS+. Increasing or decreasing the Opti-Max Key will allow you to either heighten or lessen the level of pulse power transmitted to the electrode pads. Press

Opti Max

Pressing the Opti-Max Key either + or - will increase or decrease Opti-Max sensation. This is extremely useful for the final stages of labour when you need an extra surge of power. There are 5 Opti-Max levels in the BIRTH mode: 50, 100, 150, 200 and 250애s (microseconds). The unit will always start up at OptiMax 150애s, which is exactly half way between the highest and lowest setting. N.B. 1. The Opti-Max Key can be used according to your preference and not necessarily for the stage of labour you are in. 2. When operating the Opti-Max Key the CT information will temporarily be replaced but will return automatically.

When you have finished

Press the On/Off Button to turn the unit off before removing the wires. Remove the jack plugs from sockets holding the plugs between the forefinger and thumb. Remove electrodes returning them to the plastic backing and pouch as supplied.

Useful Tips Continue stimulation for as long as necessary, unless you experience discomfort. If you stimulate for a number of hours ensure the pads do not become dry. If this occurs, switch off the unit, disconnect the electrodes, and apply a small drop of water to them.

Questions, answers and troubleshooting

Q When shall I start using my Elle TENS+? A Use as early as you can after the onset of labour to allow time for your body’s pain-killing chemicals to rise.

Q What conditions can TENS be used to treat? A

Q Can I try the Elle TENS+ before going into labour? A Yes, using one leadwire, place 2 pads on your forearm to feel the different pulse sensations following the instructions on page 9. Q Can I combine the Elle TENS+ with other medication? A Yes, you can still use analgesics such as gas and air (entinox) or pethidine. Q Can the Elle TENS+ be used in hospital? A Yes. However, a midwife may ask you to switch it off temporarily. Q Can I use the Elle TENS+ if I am considering a water birth? A Yes, but not in the water itself.

If you are unsure about using TENS please consult your medical adviser or contact Babycare TENS at [email protected].

Troubleshooting Questions Q Why does the pulse sensation not appear to be as strong after you have used the Elle TENS+ for a while? A

Yes, TENS is used widely for pain relief and is recommended by medical professionals.

Q Can I use it with other medications? A

Yes. TENS is drug-free so you can use it with any other medication including paracetamol.

Increase the intensity, you may have become acclimatised to a lower setting.

Q Why does the pulse sensation feel strong but ineffective? A

Q Is TENS safe? A

TENS can be used to treat numerous pain conditions such as back pain, neck pain, period pain and arthritic pain etc.

You may need to reposition the electrode pads (don’t forget to switch the Elle TENS+ off before doing so).

Q What should I do if I can not feel any or little sensation even on a high intensity setting? A

Check that the leadwires are properly connected and the pads are fixed to the skin. Also check batteries.

Section

Pad Placement For help with placement of pads please refer to diagrams found in your ‘Electrode Placement Chart’.

PAIN mode

TENS (Transcutaneous Electrical Nerve Stimulation) works by passing mild electrical impulses through the skin, into the nerve fibres which lie below, via electrode pads. TENS impulses help your body produce its own pain-killing chemicals, such as‘endorphins’. TENS can be used for many chronic and acute pain conditions such as back pain, shoulder pain, arthritis, sciatica, sports injuries, migraine, period pain and postoperative pain.

Contents for PAIN mode

Controls on your Elle TENS+ in PAIN mode Display symbols and their meanings About the modes Entering PAIN mode Adjusting intensity for pain relief Mode selection Opti-Max (pulse width) adjustment Using the timer When you have finished Questions, answers and troubleshooting

17 18 19 20 20 21 22 22 23 24

Controls on your Elle TENS+ in PAIN mode

Leadwire Jack Plug Sockets

im Boost/T

The Elle TENS+ is very simple to use. However, it is advisable to read these instructions to obtain the most out of the unit. Please ensure that all of the contraindications and precautions have been read thoroughly. See pages 34 and 35. Opti-Max Key Adjusts depth of the pulses Refer to p22 for more details. Channel 1 Intensity Adjustment Keys Mode Button Selects one of four different modes: Refer to p19 for more details. Space to attach neck cord

Timer Button

ELLETENS+

BIRTH PAIN PELV

On/Off Button

+ Opti Max

CH1

CH2

Mode CH1

Channel 2 Intensity Adjustment Keys

CH2

N.B. Automatic Power Off When the intensity levels are zero, and the Elle TENS+ has not been in use for 5 minutes, it will shut off automatically.

Display symbols and their meanings in PAIN mode Timer Shows your selected length of treatment.

/Timer Boost

Mode Indicator indicates mode currently in use. For more information on the modes available see opposite page. Pad contact warning (safety cut-out) This symbol will appear if any of your pads are not attached securely to the skin.

ELLETENS+

BIRTH PAIN PELV

Opti Max

CH1

CH2

Mode

Setting up your Elle TENS+ in PAIN mode First set up unit as described on page 7. Please contact Body Clock Health Care should you require a new set of electrode pads for using your Elle TENS+ in the PAIN mode. www.bodyclock.co.uk Tel +44 (0)20 8532 9595.

About the modes The Elle TENS+ has 4 TENS modes. Each has been designed to provide a different sensation. You can use any of the TENS modes to treat your pain. CONSTANT Pulses are continuous and feel like a tingly sensation. This mode is generally used for acute pain conditions. BURST Pulses are off and on in a regular cycle and will feel like a heartbeat sensation. This mode is generally used for chronic pain conditions. MASSAGE The pulses decrease and then increase in regular cycles creating a massaging sensation. MIXED (Dense Disperse or Han Stimulation*) 3 seconds of Constant and 3 seconds of Burst as described above. * Professor Han suggests that switching between lowand high-frequency stimulation for three seconds each i.e. 2/100 stimulation produces a simultaneous activation of the of the enkephalin and dynorphin systems which creates a more potent analgesic effect to combat pain. Published in the January issue of 2003 of ‘Trends in Neuroscience’ (26:17-22).

Using the Elle TENS+ in PAIN mode

Display

Press

Entering PAIN mode a). Switch the unit ON by pressing the On/Off Button. Note that your Elle TENS+ will always start up in perviously used mode. You need to select ‘PAIN’.

Opti Max

Mode

b). If the unit does not already display ‘PAIN’ press the Opti-Max Key to cycle through the 3 available modes, (BIRTH, PAIN, PELVIC) until ‘PAIN’ flashes at the top of the display as shown in the diagram. c). Press the Mode Button to confirm ‘PAIN’ mode, otherwise your Elle TENS+ will automatically enter PAIN mode after a few seconds. To select another mode you must first turn off the unit and follow instructions as in a) above.

Adjusting intensity for pain relief

CH1

Begin by pressing the CH1+ key. Each time this key is pressed, ‘half-moons’ will appear on the screen increasing in number and size as the intensity is increased. You will begin to feel a tingling sensation. Press CH1- should you wish to reduce the intensity.

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