Malem Enuresis Alarms Instruction Booklet Sept 2009

Contents

Instructions for MO3, MO4, MO5 & MO6 ...2-4

Important/Hints ...5

Batteries ...6

Choice Selection ...7

Sensors ...7 Fault Finding ...7

Guarantee ...8

Repairs and Reconditioning ...8

Cleaning ...8 Electrical Safety and Disposal...8

Bed-Mat Enuresis Alarm - MO3, MO4, MO5 & MO6 ...9-11 Model MO3 - Enuresis Alarm ...12

Model MO4 - Ultimate 1 Enuresis Alarm ...13

Model MO4S - Ultimate 1S Enuresis Alarm ...14

Model MO5 - Ultimate 1 + Record Enuresis Alarm ...15

Model MO6V - Vibrating Unit for Bedside Alarm ...16

Model MO6 - Ultimate Bedside Alarm ...17-18

Model MO8 - Sit Up Sensor ...19 Model PC9 - Queenʼs Square Bladder Stimulator...20

MM101109

Malem Enuresis Alarms

Instructions for the MO3, MO4, MO5 & MO6 alarms. For Bed-Mat alarms see PAGES 9-11 1. 2.

3. 4. 5.

Insert sensor plug into alarm socket making sure the Easy-Clip© Sensor lever is lifted up (see diagram). Do not unplug unless for cleaning or replacement. (Remove battery isolation tag if present)

Carefully attach the alarm to pyjama jacket or night dress close to the shoulder and thread cord inside top as shown. For small children, loop and tie cord to shorten length. Attach to material before wearing garment if preferable. Optional shoulder clips are available for clinics on request if you do not wish to use the safety pin. (These clips are universal to all the body alarms, see diagram on page 12). Clip to clothing near shoulder. (Do not use safety pin if faulty)

For Vibrating alarms, attach on the inside of close fitting top or T-shirt close to the collar bone.

For VCA (Light Emitting), attach in a position on clientʼs or childʼs clothing where it can readily be seen by carer or nursing staff. Alternatively, attach alarm to the end of the bed where it can be seen by nursing staff and secure sensor/mat under bed sheet.

For Easy-Clip© Sensor: Lift sensor clip lever, attach to the outside of close fitting underwear, at the location most likely to get wet first, by inserting material inside sensor jaws at the front and closing lever. (Dispose of insulating tag if present)

Lowering the lever without any dry material in the jaws will trigger the alarm and prevent the alarm from resetting. Lift the lever and press the reset button. IMPORTANT: DO NOT PLACE Lock the Easy-Clip ANY MATERIAL UNDER THE onto the material by SECURING LEVER. pressing down the lever.

Place underwear material into mouth (jaws) at the front of the Easy-Clip .

2

IMPORTANT: Regularly CLEAN Easy-Clip Sensor in soapy water, rinse and shake dry.

6.

7.

For Standard Sensor: Cut off one end of the absorbent pad and insert the sensor in between the layers. Anchor with the crocodile clip to prevent sensor from being pulled out. Uncover the backing strip and stick the pad inside a pair of close fitting pants, insuring the sensor is located where it will come in contact with the flow of urine.

PLEASE NOTE THAT SENSOR & CLIP ARE GOLD PLATED.

Boys who prefer not to use pads can sandwich the sensor between TWO PAIRS of cotton briefs (not boxer shorts) or place within fold of Y-Front, and anchor by locating the crocodile clip on the outside below the waistband of the pants. Adhesive tape may also be used to fasten the sensor plate correctly in the area of urine flow. The sensor plate and crocodile clip must not be in direct contact with the skin. Avoid nylon/polyester underwear.

For Bed-Mat Sensor: See instruction on page 9.

Outer Pants

Inner Pant

Please make sure the sensor plate and the crocodile clip are attached between the two pairs of pants and do not come in contact with the skin. 3

8.

Upon waking up to the alarm, try to stop any more urine from being released from the bladder. Remove the Standard sensor and wipe dry with a cloth. Remove the Easy-Clip sensor and keep the lever open. Do NOT unplug the cable from the body of the alarm. Stop the sound or vibration by pressing the small reset button, use the lavatory to completely empty the bladder, replace the sensor into a fresh pad or clip to a dry pair of pants as before. Always test alarm by wetting sensor or closing the Easy-Clip lever before use. Parental help in waking up children when the alarm sounds is reassuring and helpful especially during the first few nights.

Vibrating ʻPCTʼ- Personal Continence Trainer a. The vibration signals the start of urination - retrain the bladder by tensioning the pelvic floor muscles. With practice, it is possible to stop urination until the toilet is reached. b. Note down the times of urination as they occur. Gradually, over a period of time, a pattern will be apparent and the bladder can be emptied before wetting.

Light Emitting ʻVCAʼ - Visual Continence Alarm a. Can be used to give visual indication of urination so that the client is changed to prevent prolonged exposure of skin to urine with associated risk and complications. b. Can be used to develop a toileting regime by tabulating the clientʼs urination times. A pattern can be established and the need for a bedpan or use of toilet anticipated. This can result in a significant reduction in management cost as well as an improvement in clientʼs moral.

MO4 & MO4S Ultimate 1 Alarm The choice of Sound/s Only, Sound/s and Vibration or Vibration Only is selectable by sliding the lever inside the battery compartment to setting 1, 2, or 3 accordingly. See diagram on page 13 and 14.

MO5 Ultimate 1 + Record Alarm For choice selection of sound, vibration or recording see diagram on page 15. 4

Important G

G G

G

Rapid wakening on hearing or feeling the alarm is vital for success. Most children, including non-bedwetters, tend to sleep soundly and heavily at home. Better results are obtained if Parents/Guardians help to wake the child up on hearing the alarm. The child must wake up sufficently to be able to recall the event in the morning. Use the progress chart. Great encouragement is derived by seeing steady improvement. Always praise the user for a dry night; never scold or chastise for a wet night. Encouragement is the key to success. You can not help a child who does not want to help him or her self. Try and find out why they do not want to be helped, it could be some other problem. To avoid relapse use the alarm for a minimum of two weeks after dryness has been achieved. At the same time, increase fluid intake before sleep to achieve over learning and avoid possibility of relapsing at a later stage. Avoid fizzy drinks, tea, coffee & milk.

Hints G

G G G

G G

The Reset Button will stop the alarm from sounding only if the Standard Sensor plate is dry or the Easy-Clip© lever is LIFTED OPEN and REMOVED from the underwear. Do not unplug the sensor from the Alarm. There is no on/off switch that could allow the alarm to be switched off and ignored. Current drain on the batteries is minute except when the alarm is sounding. The sensor is positively locked to the alarm to prevent accidental disconnection. However, the sensor can be unlocked and detached for cleaning or replacement. Do not unplug the sensor from the alarm during normal use. It is intentional that one of the sounds of the Eight Tone Alarm (8T) does not stop immediately upon pressing the reset button. REGULARLY CLEAN the Easy-Clip© sensor in soapy water, rinse and shake dry to prevent “fluff” and urine accumulation inside the jaws. 5

Batteries (remove isolating tag if present) Batteries are provided free of charge by ourselves during manufacture and units are tested prior to packaging. Batteries are safely secured within the alarm. They should not be accessed by children. Batteries should be replaced only by adults. For model MO3 button size Alkaline batteries AG13 or equivalent. L1154, SP675H, V357, LR44, H1154, MR44, RW52, PX675, 675RP, HG13, SR44 or SG13. See diagram on page 12. PLEASE DO NOT USE ZINC AIR BATTERIES (also known as hearing aid batteries) AS THEY CONTINUOUSLY DISCHARGE REGARDLESS OF BUZZING AND ARE UNABLE TO SUSTAIN POWER TO THE ALARM. (They have a sticker when new and tiny holes on the +ve side). Do not allow ribbon to slip between batteries.

For Ultimate 1 Alarm, Model M04 & MO4S, use 2 x AAA Alkaline batteries (see diagram on page 13 & 14). For Ultimate 1 + Record Alarm, Model M05, use 3 x AAA Alkaline batteries (see diagram on page 15). For Model M06, use 4 x AA Alkaline batteries. To change the batteries, remove the battery cover. Take special care to observe correct polarity when replacing all the batteries (see diagram on page 17). Make sure batteries are not loose within the compartment. Do NOT mix old and new batteries.

Batteries do tend to deteriorate during use and storage and it is advisable to test the unit before use; this can be simply done by moistening the finger and touching the sensor or closing the EasyClip© lever. The alarm should always sound, vibrate or light up. If the unit does not respond, replace the batteries. In use, the batteries should not be expected to last more than 1-2 months, so it is advisable to test the unit regularly. Maximum continuous operating time is about 60 minutes per set of button batteries and up to 10 hours for the AAA Alkaline batteries. Important - please remove batteries and clean sensor if the alarm is not going to be used for some time. 6

Choice Selection

To change setting combination for MO4 & MO5 remove battery cover and slide lever inside battery compartment (see diagram on page 13 and 15). Position 1 = Sound/s Only. Position 2 = Sound/s + Vibration. Position 3 = Vibration Only. For MO4S see page 14.

To select message or sound for MO5 & MO6 (see diagram on pages 15, 17 & 18). To record a new message make sure the selection switch is in message position, then press record button and speak into the speaker at the front of the alarm for MO5. Maximum recording time is 10 seconds. Recording a message from Mum or telephone tones is very effective.

Sensors

Sensors are an important component and must always be clean and dry. The crocodile clip is gold plated and should be used to anchor the sensor in the correct position. Wash clean with soapy water and rinse. Remove any material from jaws of Easy-Clip© sensor. Dry before use.

Sensor Wire

The wire that connects the sensor to the alarm unit is a vitally important link. The wire is sufficiently flexible to be comfortable in use but sufficiently robust to ensure long life. It will not however tolerate abuse, being bitten or chewed. Do not use the wire to pull the sensor out of the pad or underwear - always undo the clip. Do not clip the crocodile clip to the sensor wire. Do not unplug the sensor from the body worn alarms.

Fault Finding a)

b)

c)

Unit fails to sound:- replace batteries, ensure correct polarity. Always use “fresh batteries”. Do not use Zinc/Air batteries (the ones with the small holes in the positive side and sticker when new). Make sure ejector ribbon has not slipped between batteries. Make sure battery contacts are clean and free from deposits. Make sure batteries are not loose and are making good contact. Unit will not turn off:- sensor plate is wet (Dry sensor). Sensor is faulty or has a damaged wire replace sensor. Easy-Clip© sensor lever is closed or material is wet, lift lever, remove material & press the reset button. Easy-Clip© is dirty and requires cleaning see page 2. Batteries are nearly exhausted please replace batteries. Alarm is or has been flooded. Intermittent buzzing:- faulty sensor. Loose or flat batteries in the battery compartment. Damaged wire. 7

Guarantee

Under normal usage the Malem Alarm Unit is guaranteed for a period of three months from purchase. This excludes batteries, sensors, Bet-Mat, flooding, misuse or accidental damage. If the alarm should malfunction during this period please contact us before sending. Please remove the batteries and decontaminate the unit/sensor before returning. (see below). Do not return flooded or contaminated alarms.

Repairs and Reconditioning

If your alarm requires repair, we will exchange it for a new one (repairs are not undertaken for hygiene reasons). Please contact us by telephone, e-mail or in writing, for the cost of this service. Please decontaminate the unit before return.

Cleaning

Alarm Unit: Wipe clean alarm and safety pin using mild detergent or skin disinfectant. Use a damp cloth and dry thoroughly. NEVER IMMERSE IN WATER. Standard sensor: Rinse with detergent and dry thoroughly. Easy-Clip sensor: Lift lever and regularly clean in soapy water, rinse and shake dry. If the alarm is to be reused by another client/patient/child then use a new sensor or Bed-Mat. The National Guidelines states one child, one sensor. To replace the sensor, unlock the sensor by lifting the small tag and gently pulling the plug out of the alarm.

Electrical Safety

Designed to meet all Department of Health and British Standard BS5724 Part 1, RE1004/03 and IEC performance, construction and safety requirements. Maximum current across the sensor is less than 10µA. BSI certificate No.: 115627. BSI EMC test certificate No.: EZ000505. Electrical Safety Symbol Type BF. Marked.

Disposal

At the end of the alarm working life, please dispose of the product at a special local Authority Differentiated Wast Collection Centre. The manufacturer reserves the right to change specification without prior notice. ©2009 Malem Medical.

8

Malem Bed-Mat Enuresis Alarm

Instructions for MO3, MO4, MO5 and MO6 G G G

G G

G G

G G G G G

Under no circumstances should any of the alarms be attached to the usersʼ clothing when using a Bed-Mat.

Place a clean and dry Bed-Mat correct side up over the mattress in the area which is normally wetted and gently tie down.

Cover the Bed-Mat with a Clean Dry Cotton sheet and/or Bath Towel and make the bed up as usual. Avoid nylon/polyester sheets as they can cause ʻfalseʼ alarms due to increased perspiration. Adjust cover thickness over the mat to suit.

Do not place plastic sheets directly under the Bed-Mat as condensation will cause the alarm to trigger. (See diagram page 10) Attach the Bed-Mat wire to the chosen Malem Alarm and place the alarm beside the bed apart from the Vibrating alarm which can be placed under the pillow. Please tuck in the Bed-Mat wire so that it is not in the way for getting in and out of bed. Upon waking to the alarm, try to stop any more urine from being released and use the lavatory to completely empty the bladder.

The alarm sound can be stopped ONLY when the Bed-Mat wire is unlocked from the alarm and the reset button is pressed.

The Bed-Mat must be wiped clean with detergent and dried then replaced in a freshly made bed, as before, for reuse. Adjust the loudness of the sound with the volume control. (MO6 only)

To test the alarm, place a damp cloth across the foil tracks on the Bed-Mat. Bed-Mat sensitivity can be reduced by sliding switch on side of MO6 Alarm. (See diagram on page 17) 9

Under NO circumstances should any of the alarms be attached to the usersʼ clothing when using a Bed-Mat. If using a plastic protective mattress sheet place adhesive tape over the Bed-Mat lower contacts.

Bath Towel Sheet

Bet-Mat

Holes for tying Bet-Mat to the mattres.

Use a BATH TOWEL to cover the Bed-Mat and cotton sheet. Adjust towel thickness to suit.

Mattress

Pillow

Bedside alarm or other small Malem Alarm.

Place cotton sheet over Tuck wire from Bed-Mat to Tie Bed-Mat Bed-Mat. around mattress. alarm away neatly to prevent tripping or entanglement. 10

Bedside table

Important G

G

G G

Rapid wakening on hearing the alarm is vital for success but parents believe that bed-wetting children are very heavy sleepers so better results are obtained if parents help to wake the child when the alarm sounds especially during the first few nights. To avoid relapse use the alarm for at least 2 weeks after dryness has been achieved. At the same time, increase fluid intake before sleep to achieve over learning and avoid possibility of relapsing at a later stage. Avoid fizzy drinks, tea, coffee and milk. Use the progress chart. Great encouragement is derived by seeing steady improvement. Always praise the user for a dry night; never scold or chastise for a wet night. Encouragement is the key to success.

Hints G G

G

G G G G

The reset button will stop the alarm from sounding only if the Bed-Mat is dry or disconnected. The Bed-Mat positively locks to the alarm to prevent accidental disconnection. However, it must be unlocked before attempting to reset the alarm. Please use a thicker cotton sheet or place a bath towel above the Bed-Mat if sweating is triggering the alarm prematurely. Avoid plastic and man-made fibres as they may cause static discharge and false alarm. Reduce alarm sensitivity. (See diagram) Treat the Bed-Mat with care. Avoid folding it or jumping over it. Please replace the Bed-Mat with a new one if it has deteriorated and use a new one with each child. (National Guidelines) Please note that sleeping directly on an uncovered Bed-Mat or touching it by hand may trigger the alarm. Do not place plastic sheets directly under the Bed-Mat as condensation may trigger the alarm. 11

Loop the cord from the clip around the holder. Then push the holder from the left into the alarm until secure.

Malem Enuresis Alarm MODEL MO3

With optional clip for clinic use

If you DO NOT wish to use the safety pin please ask for the Malem Shoulder Clip Carefully attach to garment near shoulder

Safety pin white cover slide sideways to lock or unlock

lock unlock

Twist slotted screwdriver to slide battery cover.

To remove or replace the safety pin. Turn the pin ninety degrees from the alarm & slide the holder to the left until it is clear of the alarm.

Make sure battery ejection ribbon does NOT slide between batteries

Reset button Sensor locking socket

Please observe correct polarity when replacing batteries

Batteries are AG13 or equivalent. L1154, SP675H, V357, LR44, H1154, MR44, RW52, PX675, 675RP, HG13, SR44 or SG13. Use Alkaline batteries ONLY No Zinc/Air please 12

Malem Ultimate 1 Enuresis Alarm MODEL MO4 Carefully attach to garment near shoulder

lock

OPEN 1 2 3

Reset button

Sensor locking socket

unlock

Safety pin slide sideways to lock or unlock Twist slotted screwdriver to slide battery cover

Use 2 x AAA Alkaline batteries Please observe correct polarity when replacing batteries

Combination Selection Switch Slide to:

1 For Sound/s only 2 For Sound/s and vibration 3 For Vibration only

Use Alkaline batteries ONLY 13

Malem Ultimate 1S Enuresis Alarm MODEL MO4S

Slide to: 1 = Single Sound* 8 = 8 Sounds**

*See sound selection switch for choice. **Sound selection switch must be on in position 1.

Sound 8

1

Carefully attach to garment near shoulder

lock

Reset button

unlock

Sensor locking

Slide to: socket S For Sound/s only V&S For Sound/s and vibration V For Vibration only

For 8 sound choice

Only switch position 1 must be on (rest in off position)

Single sound selection switch use a very small screwdriver or paper clip to activate switch (be careful)

Use Alkaline batteries ONLY 14

Twist slotted screwdriver to slide battery cover

Use 2 x AAA Alkaline batteries Please observe correct polarity when replacing batteries

On Off

Combination Selection Switch

2xAAA

V

V&S

Vibration/Sound

S

8 7 6 5 4 3 2 1

ALKALINE

On Off

OPEN

Safety pin slide sideways to lock or unlock

Sound Selection Switch

Selection Switch

8 7 6 5 4 3 2 1

Malem Ultimate 1 + Record Enuresis Alarm MODEL MO5 The microphone is behind the speaker grid on the front under ʻMalemʼ

Carefully attach to garment near shoulder

1 2 3

OPEN

1 2

Reset button

Combination Selection Switch

lock

Slide to: 1 For Sound/s only 2 For Sound/s and vibration 3 For Vibration only

Sensor locking socket

Press to record sound. Maximum 10 seconds recording time.

Use Alkaline batteries ONLY 15

unlock

Safety pin slide sideways to lock or unlock

Remove battery isolator if present

Twist slotted screwdriver to slide battery cover Use 3 x AAA Alkaline batteries

Please observe correct polarity when replacing batteries

Combination Selection Switch

Slide to: 1 For Message 2 For Sound/s and vibration This switch must be in position 1 to be able to record a new message

Vibrating Unit for Malem Ultimate Bed-side Alarm

MODEL MO6V

lock

unlock Safety pin slide sideways to lock or unlock

OPEN

OPEN

Remove battery isolator if present

Slide battery cover Use 2 x AA Alkaline batteries

OPEN

Please observe correct polarity when replacing batteries

To stop vibration; disconnect Bed-Mat wire from Ultimate Bed-side Alarm then press the reset button on the MO6

Locking socket for connecting wire to the MO6 external vibrating socket

Use Alkaline batteries ONLY 16

Malem Ultimate Bed-side Alarm MODEL MO6

Bed-Mat wire locking socket

LED

Reset button

External Vibration Extension Socket

+

External Sound Extension Socket Mains Adaptor Socket 6vDC

Speaker On Off

1 2

1 2

Normal

Low

Sensitivity switch

OPEN

-

1 2 3

Slide battery cover

OPEN

Volume control

Slide control cover off

Combination Selection Switch

Use 4 x AA Alkaline batteries

Please observe correct polarity when replacing batteries

Microphone

Use Alkaline batteries ONLY 17

Slide to: 1 = LED + Sound 2 = LED only 3 = No LED or Sound

1 2

*

Single sound selection switch On Off Select only one

*

Combination Selection Switch

Single sound selection switch must be on sound 1 (Top switch) for 8 sounds selection to be active

On

Single sound 1 2 3 4 5 6 7 8

Off

1 2

1 = Message 2 = Sounds

Slide to: 1 = 8 Sounds* 2 = Single Sound

1 2

Test Button

1 2 3

This LED is on when recording a new message as long as the record button is pressed

Combination Selection Switch

Slide to: 1 = LED + Sound 2 = LED only 3 = No LED or Sound

Press to record (Max 10 secs recording time). To record a message the message/sound Combination Selection Switch must be in position 1 (message)

18

1 2

Vertical

Ala rm

Malem Sit Up Sensor MODEL MO8

Push arm and pull to release from socket

Activation Angle

rm Ala No

Horizontal

MO8

SIT UP SENSOR

The Alarm will activate if the users movement make the sensor stand upright.

For best results: 1. Attach alarm inside a Pyjama Top pocket or 2. Attach on the inside of a TʼShirt Collar or 3. Clip alarm to an elasticated bandage around the thigh.

2xAAA

ALKALINE

OPEN

To Stop Alarm: 1. Place Sit Up Sensor in horizontal position and press the reset button on the side. 2. Remove Sit Up Sensor from alarm and press the Reset button.

MO8

SIT UP SENSOR

Push Sensor up into locking socket to secure

Sit Up Sensor can be used with all Malem Alarms 19