ACCESSORIESCARDIOLOGY2 0 1 3 / 2 0 1 4Fi ghti ng Di sease wi th El ectroni cswww.nihonkohden.net 2 Dear Customer,Formorethan60yearsNIHONKOHDENhasbeenoneofJapansleadingplayersinmedicaltechnologydevelopmentand manufacturing and has subsidiaries and representative ofces in Europe, the US, as well as in the Middle and Far East.Fighting Disease with Electronics our corporate philosophy reects the high standards we have set ourselves in combating disease by developing medical systems, contributing to higher quality of life for patients.Ourlargeproductrangeofaccessoriesandconsumablesisknownforitsoutstandingquality,easeofuseandreliability.Please note, that only the use of original NIHON KOHDEN approved accessories and consumables guarantee optimal examination results and make an important contribution towards ensuring that your device will continue to function impeccably and reliably even in years to come, while preserving the devices features and functional capabilities.Asyourpartnerincardiology,NIHONKOHDENprovidesonlytestedandapprovedproductsolutionsfromstandardvital signsparametersuchasECG,SpO2,NIBPorTemperaturetospecicparameterslikeCapnographyorIBPMeasurement.Our commitment to ensure continually highest quality allows you the best care of your patients and enhances your ECG, AED/TRN and Debrillator performances.NIHONKOHDENinvitesyoutodiscoverthequalityandfeaturesofourcompleteaccessoriesandconsumablesportfoliointhis catalogue. Call today for more information or order directly!Best regards,NIHON KOHDEN EUROPE GmbHKristin BaarProduct Manager Accessories & ConsumablesIntroduction Introductionwww.nihonkohden.net 3 Accessories & Consumables CardiologyContent User Guide6Product Innovation & Smart CableTMTechnology7Highest Safety and Quality Standards 8Quick Guide Electrocardiographs, Debrillators, AED/TRN 91 ECG Measurement10Typical Arrhythmia Waveforms111.1 ECG Cables121.1.11.1.21.1.31.1.4ECG 10-Lead CableECG 12/15-Lead CableECG Veterinary 5-Lead CableAdditional Cable Accessories131415151.2 ECG Electrodes 161.2.11.2.21.2.31.2.41.2.51.2.6Clip Electrodes Chest & Plate ElectrodesTab ElectrodesECG Electrodes for AdultsECG Electrodes for Children, Infants & NeonatesECG Electrode Adapter1718192021211.4 ECG Batteries221.5 ECG Paper241.6 Additional ECG Accessories 272 Accessories for Debrillators 302.1 Debrillator Batteries & Battery Charger 312.2 Debrillator Paper 332.3 Debrillator Bags 35www.nihonkohden.net 4 2.4 Disposable Debrillator Pads 372.4.12.4.2Disposable Pads with NIHON KOHDEN ConnectorDisposable Pads with R2 Connector38392.5 Paddle Electrodes 402.5.12.5.22.5.3Internal Paddle Electrode with Discharge Button for Series TEC-8300Internal Paddle Electrode with Discharge Button for TEC-5500/7700Neonate Paddle Adapter for TEC-5500/77004142422.6 ECG Measurement 43Typical Arrhythmia Waveforms 442.6.1 ECG Cables 452.6.1.1 ECG Cables for TEC-8300 462.6.1.1.12.6.1.1.2ECG 3/6-Lead CablesECG 10-Lead Cables47482.6.1.2 ECG Cables for TEC-5500 & TEC-7700 492.6.1.2.12.6.1.2.22.6.1.2.3ECG 3-Lead CablesECG 5-Lead CablesFurther Debrillator Connection Cables5051522.7 ECG Electrodes for Debrillators 532.7.12.7.2ECG Electrodes for AdultsECG Electrodes for Children, Infants & Neonates54552.8 SpO2 Measurement 562.8.1 SpO2 Cables 572.8.2 SpO2 Probes 592.8.2.12.8.2.22.8.2.2.12.8.2.2.22.8.2.2.32.8.2.2.4Reusable SpO2 ProbesDisposable SpO2 ProbesDisposable SpO2 Probes 24 pcs/box - cable length: 0.8 mDisposable SpO2 Probes 24 pcs/box - cable length: 1.6 mDisposable SpO2 Probes 5 pcs/box - cable length: 0.8 mDisposable SpO2 Probes 5 pcs/box - cable length: 1.6 m616363646466Contentwww.nihonkohden.net 5 2.9 ETCO2 Measurement (Capnography) 68ETCO2Selection Guide 69ETCO2 Measurement Overview 702.9.1 ETCO2 Mainstream 712.9.1.12.9.1.22.9.1.3Intubated Expired ETCO2Intubated Expired and Inspired ETCO2 - Opening a New Era in CapnographyIntubated and Non-Intubated Expired ETCO2 CapOne - Opening a New Era in Capnography7273742.10 Temperature Measurement 762.10.12.10.2Standard Temperature MeasurementMeasurement of 2 Additional Temperatures77772.11 NIBP Measurement (Non-invasive Blood Pressure) 782.11.12.11.22.11.32.11.3.12.11.3.2NIBP Air HosesReusable NIBP Cufs - NEW YAWARA CUFF 2Disposable NIBP CufsDisposable NIBP Cufs for Infants & ChildrenDisposable NIBP Cufs for Adults79808282832.12 IBP Measurement (Invasive Blood Pressure) 842.12.12.12.2IBP Transducer Cable with Direct ConnectionIBP Transducer Cable with Adapter Cable K95285862.13 Portable CPR 882.14 Additional Debrillator Accessories 903 Accessories for AED & Training Unit 923.13.2Accessories for AED UnitsAccessories forAED Training Unit TRN-2100K9696Accessory Order Form 97Index as per Supply Code 98Index as per Model Code 100Contentwww.nihonkohden.net 6 Care of Environment NIHONKOHDENismakingeverypossibleeforttoensurethattheactionsofthecompanyanditsemployeescontributeto preserving the environment. In order to conserve paper resources, we decided a more environment friendly approach which allows us to update the cataloguemore frequently in the future. Therefore the new accessories and consumables catalogue was designed for view on your computer. It allows you to zoom pictures in order to see more details of the product. If you need indeed certain chapters in print version, you can easily select and print them.Find the right accessories in the catalogue You do not know exactly which article you need for your examination?Following this user guide you will nd the content of this cataloguewhich is organized into parameter categories. In a particular categoryyouwillseealistofaccessoriesandconsumableswithcorrespondingsupplycodes,modelcodes,descriptionsand pictures.Ifyouarenotsureifoneofthelistedproductswillttoyourrequirements,pleasecontactusoroneofourregional representatives.You already know the article that you need for your examination? In the index of the catalogue , from page 98 to page 99, the articles are listed alphabetically as per supply code; page 100,the products are listed alphabetically as per model code. They will help you to nd directly the according product page.IfyouareusingthePDFversion,simplyusethesearchfunctionofthisbyenteringthedescription,supplyormodelcode. Or just click on the related chapter on the left side of the document.Order informationToorderNIHONKOHDENaccessoriesandconsumablesortogetmoreinformation,pleaserefertotheindicatedregional NIHON KOHDEN representatives below. Foryourconvenience,wehaveaprintableorderformattheendofthiscataloguesothatyoucanfaxinyourorderdirectlyor mail/e-mailittous.Pleasemakesuretolloutallrequestedinformationaswellastherequiredsupplycodeandaccording quantity.Pleasecheckthegeneraltermsandconditionsincludingdeliverytime,paymentandgeneralwarrantywithyour responsible regional NIHON KOHDEN representatives:User GuideFor Germany, Austria, Switzerland and BeneluxNIHON KOHDEN EUROPE GmbH, VertriebDeutschland Albert-Einstein-Ring 9, 14532 Kleinmachnow, DeutschlandFax: +49 (0) 33203/573-19, E-Mail: bestellung@nke.de For Spain and Portugal NIHON KOHDEN IBERICA S.L. C/Ulises, 75A, 28043 Madrid, SpainFax: +3491 300 46 76, E-Mail: info@nkib.esFor United KingdomNIHON KOHDEN UNITED KINGDOM Ltd. Tolworth Tower 19th Floor, Ewell Road, Surbiton, Surrey KT6 7EL, United KingdomFax: +44 (0) 20 83 90 46 75, E-Mail: mail@nihonkohden.co.uk For France NIHON KOHDEN FRANCE SARL 8, rue Franois Delage, 94230 Cachan, FranceFax: +33 (0) 1 49 08 93 32, E-Mail: info@nkfrance.frFor Italy NIHON KOHDEN ITALIA S.r.l. ViaFratelli Bronzetti,28, 24124 Bergamo, ItalyFax:+39 (0) 35-232546, E-Mail: info@nkitaly.com For all other European Countries, Russia, Turkey and Israel NIHON KOHDEN EUROPE GmbHRaifeisenstrae 10, 61191 Rosbach v. d. H., GermanyFax:+49 (0) 6003/827-599, E-Mail: info@nke.deUser Guidewww.nihonkohden.net 7Product Innovation & Smart Cable TechnologyWith NIHON KOHDEN Smart Cable Technology, you will get complete mo-dular exibility at a signicantly reduced cost and without all of the incon-venienceassociatedwithtraditionalmodularsystems.SmartCableTM technologyminiaturizescircuitsfoundintraditionalmodulesandem-beds that circuitry into the cable. When you plug a Smart CableTM into aMULTIconnector,itautomaticallydetectsthetypeofparameterand starts measuring.Smart Connector Technology is available for the following parameters:NIHON KOHDEN - Smart Cable Technology A Cost-Efective Solution to Modular MonitoringSynthesized 18-lead ECG - Identify Invisible Ischemia -A New Technology for More Informative ECG Exam What is Synthesized ECG ?Synthesized 18-lead ECG uses the 12-lead ECG waveforms to mathematically derive the waveforms of the right chest leads (V3R, V4R, V5R) and back leads (V7, V8, V9). The measurement procedure is the same as the standard 12-lead ECG but more information can be obtained. 18-lead synthesized ECG is expected to be useful in detecting right side and posterior infarction.The most common ECG exam is the standard 12-lead ECG. It is simple to measure, has low burden on the body, and observing the heart from these 12 directions provides a lot of information which has a wide range of clinical applications.However,someareas,especiallypathologicalchangeintherightventricleandtheposteriorwallcannotbeobservedfromthe 12-leadECG.Inordertoactuallymeasuretherightchest(V3R, V4R, V5R)andback(V7, V8, V9)areas,itisnecessarytousediferentelec-trodepositionsthanthestandard12-leadECG.Inparticular, electrodesmustalsobeattachedtothepatientsbacksothat normalsuctioncupelectrodescannotbeused.Also,thepati-ent must be turned over in some cases and in an emergency it is often difcult to use back electrodes. This complicates the exam pro-cedure. Synthesized 18-lead ECG uses the 12-lead ECG waveforms to mathematically derive the waveforms of the right chest leads (V3R, V4R, V5R) and back leads (V7, V8, V9).Standard 12-lead ECG Synthesized 18-lead ECGSynthesized right side leads (V3R-V5R) andsynthesized back leads (V7-V9) are addedV1 V2 V3V4V5V6syn-V5Rsyn-V7syn-V4Rsyn-V3RV1 V2 V3V4V5V6syn-V8syn-V9Version 08/2013; Subject to change without noticeParameter Series TEC-8300 BSM-1700 PVM-2700 BSM-3000 BSM-6000 BSM-9100 BSM-2300initial SW initial SW SW-V.03-30 SWV.04-12 SWV.04-12 SW-V.13-05 SWV.04-31Flo Trac(APCO) BISx Bispectral Index with YJ-671Pwith YJ-671Pwith YJ-230PBISx remarks via JA-69xP (DAU)via AUX port onlyDual SpO (Second SpO2) via JA-69xP (DAU) IBP (Invasive Blood Pressure)onlyPVM-2703CO (Cardiac Output) EtCO (Capnography) with PVM-2703TEMP (Temperature) RESP (Respiration) FiO (Fraction of inspired oxygen) =Available = N/A Debrillator Patient MonitorsCurrent Products Older Productswww.nihonkohden.net 8 Highest Safety and Quality Standards Comprehensive quality assurance systems ensure that each of the more than 4,000 NIHON KOHDEN staf members makeshis/hercontributiontowardsdevelopment,manufacture,marketingandcustomerservicessuchthat maximum product quality is guaranteed.NIHON KOHDEN is certied according to ISO 9001, ISO 13485 and ISO 14001.NIHONKOHDENdesignsandmanufacturesmedicalequipmentinconformitywiththestandardsofIEC60601-1 (Medical Electrical Equipment: General Requirements for Safety).NIHON KOHDEN products have earned a reputation for quality and long life. One reason is that all export products and major components are manufactured in our own ISO 9001 and IEC 13485 certied factories.In1984,NIHONKOHDENimplementedacomprehensivecompanywidequalitysystem,IQCIntegratedQuality Control. Under this system, quality begins at the earliest stage of every products life. Our IQC applies to the entire manufacturingprocess,fromtheplanningstagethroughproductdevelopment,design,partsprocurement, production, inspection, storage, sales, distribution and after-sales support. IQC also involves nearly every employee.Our rigid test procedures are structured to exceed the provisions of the GMP, Good Manufacturing Practice, codes enforced by the US Food and Drug Administration. NIHON KOHDEN also has 130 in-house quality control inspection staf to ensure that standards are implemented and maintained in every department of the company.IQC extends beyond production and into sales and support at each subsidiary. This staf is responsible for ongoing contact with customers to determine their needs and making sure that these changing requirements are reected innewproducts.Serviceengineersareresponsibleforcommunicatinganyproblemthatmayariseintheuseof NIHON KOHDEN products, and assuring the customers of NIHON KOHDENs commitment to their satisfaction.In 1995, NIHON KOHDEN received ISO 9001 certication, the international standard for quality systems. In addition, NIHON KOHDENs four manufacturing facilities in Japan are the rst factories in the medical equipment industry to be certied by the CSA, Canadian Standards Association, under their category certication system. Most products sent to North America carry the CSA label.Quality improvement is and always has been an ongoing process for NIHON KOHDEN. Convince yourself of our expertise and the high quality of our products and services! Order directly!Highest Safety and Quality Standardswww.nihonkohden.net 9 Quick Guide NIHON KOHDENECG-2350ECG-2550ECG-1500/1550 ECG-1150 ECG-1250ECG-1350 ECG-1950 ECG-9620ECG-9320 ECG-9130/9132ECG-9110 ECG-9020/9022ECG-9010 ECG-8830 ECG-8820/8823 ECG-8420/8450ECG-8350/8370ECG-8330/8340ECG-8240/8270ECG-8110ECG-6851ELECTROCARDIOGRAPHSTEC-8321/8322/8332/ TEC-5521/5531TEC-7721/7731 TEC-7621/7631 TEC-7511/7521/7531 TEC-7100/7200/7300 8342/8352 TEC-6100 TEC-2202/2203DEFIBRILLATORS Quick GuideElectrocardiographs, Debrillators, AED/TRNAED/TRNAED-2100AED-2150/2151/2152 TRN-2100 TRN-2150050010001500200025003000Without ec1 With ec1Number of false alarmsNIHONKOHDENsec1arrhythmiaanalysisprovidessuperioreliminationoffalse alarms. ec1 has been evaluated with worlds standard arrhythmia databases as well as NIHON KOHDENs ECG database, with a result of 80%reduction of false alarms.Highly accurate ec1 arrhythmia analysisECG MeasurementTachyV. RhythmVPC RunVTExt. TachyVFwww.nihonkohden.net 11 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Cardiology Typical Arrhythmia WaveformsLead C1C2C3C4C5C6Typical Arrhythmia WaveformsHeart AnatomyNihon Kohden products which detect arrhythmiaElectrocardiographs / Dellibrators / Bedside MonitorsDiagnostic ECG ElectrodePlacement Cardiac Conduction SytemR and L electrodes should be placed just below the right and left clavicle.N and F electrodes should be placed on the lower edge of the rib cage, or at the level of the umbilicus at the mid-clavicular line.Electrode PlacementFourth intercostal space at the right border of the sternumFourth intercostal space at the right border of the sternumMidway between locations C2 and C4At the mid-clavicular line in the fth intercostal spaceAt the anterior axillary line on the same horizontal level as C4At the mid-axillary line on the same horizontal level as C4 and C5 1.Inferior vena cava2.Superior vena cava3. Right atrium4. Tricuspid valve5. Right ventricle6. Pulmonary valve7. Pulmonary artery8. Pulmonary vein9. Left atrium10.Mitral valve11. Left ventricle12. Aortic valve13. Coronary artery 14. Aorta15. Brachiocephalic artery16. Left common carotid artery17. Left subclavian artery18. Descending aortaSA nodeThe sinoatrial (SA) node generates a wave of electrical excitation.The excitation travels through the internodal pathways to the atria and the atrial muscles contract. This is recorded as the P-wave.The excitation travels to theatrioventricular (AV) node.The excitation then travels through the bundle of His and down through the right and left bundle branches.The excitation terminates at the Purkinje bers in the ventricles and the ventricular muscles contract. This is the depolarization and is recorded as the QRS complex.The ventricular muscles relax. This is the repolarization and is recorded as the T- wave.123456789101112131415 16 1718778C1 C2C3FC4C5C6NR L1223455123456AV nodeRightbundlebranchPurkinjebersPurkinjebersHis bundleVentriclesLeftbundlebranchAtriaPremature Ventricular Contractions (PVC) Premature contractions Bizarre and wide QRS complexes Full compensatory pause Frequent PVCs are serious Fast pulse rate greater than 100 bpm 3 or more irregular beats Needs emergency treatment and countershock May progress to Ventricular Tachycardia (VT)Multi- focal PVC Ventricular Fibrillation (VF) Multi form PVCs Bizarre and wide QRS complexes No discernable P-waves, R-waves, P-R rythm or QRS complexes Needs emergency treatment and countershock12Short run PVCSecond-degree atrioventricular (AV) block, Mobitz type II Sudden absence of QRS complexes (P-waves observed) May progress to cardiac arrest Possibillity of Adams-Stokes syndrome Occasionally needs pacing P P P Consecutive PVCs May progress to ventricular tachycardiaPremature Supraventricular Contractions(Premature Atrial Contractions (PAC)) Atrial Fibrillation (AF) Narrow QRS (excluding aberrant ventriular conduction) Ectopic focus higher than His-bundle Non-compensatory pause Slight ripples on the baseline Irregular R-R intervals Inverted QRS complexes Non-compensatory pauseP P123.456--------------------------------------------------------------------------------------------------------------------R-on-T PVC Third-degree (complete) atrioventricular (AV) block Independent development of P-waves and QRS complexes Possibility of bradycardia Possibility of Adams-Stokes syndrome Needs pacing PVC on summit of T-wave Bizarre and wide QRS complexesP P P P P P P P P P PPQ STRECG Cableswww.nihonkohden.net 13 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Electrocardiographs > ECG CablesECG 10-Lead CableSupply CodeK081ModelBJ-902DDescription10-Lead ECG Patient Cable, 4 mm banana plug (IEC), limb 3.4 m/chest 2.9 mFor current products: ECG-1150/1250/1350/2350Packing unit: 1 pcs K082 BJ-903D 10-Lead ECG Patient Cable, snap (IEC), limb 3.4 m/chest 2.9 mFor current products: ECG-1150/1250/1350/2350Packing unit: 1 pcs K079 BJ-901D 10-Lead ECGPatient Cable, 3 mm banana plug (IEC), limb 1.2 m/chest 0.7 mFor current products: ECG-1150/1250/1350/2350Packing unit: 1 pcs K093C BR-912D 10-Lead ECG Patient Cable, 4 mm banana plug (IEC), for input-box JC-901D, for resting ECG, limb 1.2 m/chest 0.7 mFor current products: ECG-1550Packing unit: 1 pcs K093D BR-913D 10-Lead ECG Patient Cable, clip (IEC), for input-box JC-901D, for resting ECG, limb 1.2 m/chest 0.7 mFor current products: ECG-1550Packing unit: 1 pcs K093F BR-913E 10-Lead ECG Patient Cable, clip (IEC), for input-box JC-901D, for stress test, limb/chest 0.6 mFor current products: ECG-1550Packing unit: 1 pcs K096A 490933 Connection Cable for Patient Input-Box JC-901D, cable length: 2.0 mFor current products: ECG-1550Packing unit: 1 pcs K096B 669269 Connection Cable for Patient Input-Box JC-901D, cable length: 5.0 mFor current products: ECG-1550Packing unit: 1 pcs www.nihonkohden.net 14 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Electrocardiographs > ECG CablesECG 12/15-Lead CableSupply CodeK093LModelBR-921DDescription15-Lead ECG Patient Cable, 3 mm banana plug (IEC), for input-box JC-901D, for stress test, limb/chest 1.2 mFor current products: ECG-1550Packing unit: 1 pcs KB010 BR-202D 12-Lead Set (Electrode Leads: R,L,F,N,C1,C2,C3,C4,C5,C6), 4 mm banana plugFor current products: ECG-2550Packing unit: 1 pcs KB012 BR-202D XYZ-Lead Set, 4 mm banana plugFor current products: ECG-2550Packing unit: 1 pcs K118 Slide Clipper for ChestFor current products: ECG-2550Packing unit: 1 pcs K119 Slide Clipper for LimbFor current products: ECG-2550Packing unit: 1 pcs Supply Code Model Chest Lead Label Color Cable Length Cable Color For current productsPacking unitKB01A BR-202D C1 redKB02A BR-202D C2 yellowKB03A BR-202D C3 greenKB04A BR-202D C4 brownKB05A BR-202D C5 blackKB06A BR-202D C6 violetKB07A BR-202D CX1KB08A BR-202D CX2KB09A BR-202D CX3KB10Cred KB11CyellowKB12Dgreen1.4 mKB13B

1.0 mKB13D 1.4 mKB14ByellowKB15BredKB16BblueKB17BorangeKB18BbrownKB19Cwhite 1.2 mwhitewhiteECG-25500.7 mgrey1.2 m1.0 m white1 pcs blackwww.nihonkohden.net 15 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Electrocardiographs > ECG CablesECG Veterinary 5-Lead CableSupply Code K098Model BJ-904DDescription 5-Lead Veterinary ECG Connection Cable, 3 mm banana plug (IEC) For current products: ECG-1950Packing unit: 1 pcs Additional Cable AccessoriesSupply Code K097ModelBM-901DDescription Adapter for ECG Vacuum Equipment with 15 PIN Sub-D Connector to input-box JC-901DFor current products: ECG-1500/1550Packing unit: 1 pcs It is important to prepare the skin before attaching the electrodes bycleaningitandremovingchesthair.Afterthispleaseattach theleadwiretotheelectrodesbeforeplacingthemontheskin. Thisavoidspaintothepatient.Securetheleadwiretotheskin (stressloop)preventingmovingoftheleadwireandtherefore noise on the ECG signal.Standard Electrodes PlacementsECG ElectrodesThree electrodesTen electrodeswww.nihonkohden.net 17 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!FactsTheNIHONKOHDENFastclipECGElectrodesallowaexibleapplicationforroutineworkandemergencyoneverypaediatricandadult patient thanks to a simple adjustability of the clip pressure (clip size).A more comfortable handling is guaranteed due to diferent con-nectors for any existing adapter type, a big contact area for reliable ECG measurements and easier cleaning after the measurement because of less asperity of the clip. In addition to this IEC colored label sets are delivered with NIHON KOHDEN Fastclip ECG Electrodes. By following the next steps, optimized derivations can be realized with NIHON KOHDEN Fastclip ECG Electrodes:1.) Clean the according skin areas with alcohol in order to remove traces of dirt and oil on the skin.2.) Apply a thin layer of CardioCream F010 on the cleaned skin areas and on the electrode part.3.) Clip the electrode on the wrist or ankle. Adjust the electrode positon by sliding the electrode part accordingto the thickness of the limb.Supply Code H068ADescription Fastclip ECG Electrode, 3 mm, child/adult, blue, adjustable sizeFor current products: all ECG/EEGPacking unit: 4 pcs H068B Fastclip ECG Electrode, 4 mm, child/adult, blue, adjustable sizeFor current products: all ECG/EEGPacking unit: 4 pcs H072 Veterinary Clip Electrode, 3 mm, cable length: 0.3 m, for K098For current products: ECG-1950/9022Packing unit: 5 pcs Any of tip, clip and snap type connector is available. Less asperity easy cleaning.Three types of connectors available Easy cleaningOpens more widly*, and roundform brings easy to grip. (*compared to the previous model)Easy to handleContact pressure and position of elec-trodes section can be adjusted accor-ding to patients conditions.AdjustabilityTip Snap ClipPrevious model New modelRaised dots Trench shapestrongmiddleweakspringwidenarrowElectrocardiographs > ECG ElectrodesClip Electrodeswww.nihonkohden.net 18 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Chest & Plate ElectrodesSupply Code H041AModel 6144-000427Description Chest Suction Electrode, 3 mm, adult, size: 20 mm dia, grey rubber ballPacking unit: 3 pcs H043A 6144-011852 Chest Suction Electrode, 4 mm, adult, size: 20 mm dia, grey rubber ballPacking unit: 3 pcs H044A NC-124D Chest Suction Electrode Tako, 4 mm, child, size: 14 mm dia, pink octopus rubber ballPacking unit: 3 pcs H044B NC-124D Chest Suction Electrode Kuma, 4 mm, child, size: 14 mm dia, blue bear rubber ball Packing unit: 3 pcs H049 Grey Rubber Ball Set for Adult Suction Electrode H043APacking unit: 3 pcs H052A Pink Octopus Rubber Ball Set for Children Suction Electrode H044APacking unit: 3 pcs H052B Blue Bear Rubber Ball Set for Children Suction Electrode H044BPacking unit: 3 pcs Electrocardiographs > ECG Electrodeswww.nihonkohden.net 19 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Supply Code NKD-Z715Description Plate Electrode, adult, size: 30 mm dia, suitable limb electrode straps, for NKD-Z722 Packing unit: 1 pcs NKD-Z722 Rubber Strap, chest, size: 135 cm x 7 cm, black, 5 rows of holes, for plate electrode NKD-Z715Packing unit: 1 pcs NKD-Z723 Attachment Button for Rubber Strap NKD-Z722Packing unit: 1 pcs Tab ElectrodesSupply Code NKD-ECG/TAB1Description ECG Tab Electrode Normal, Ag/AgCl, child/adult, radiolucent (X-ray, MRI), size: 26 x 34 mm, bio-solid gel, backing material: graphite, for resting ECGPacking unit: 500 pcs NKD-ECG/TAB2 ECG Tab Electrode Small, Ag/AgCl, child, radiolucent (X-ray, MRI), size: 13 x 34 mm, bio-solid gel, backing material: graphite, for resting ECGPacking unit: 500 pcs NKD-H/ADAPTER2 ECG Tab Electrode Clamps for NKD-ECG/TAB1 & NKD-ECG/TAB2, 4 mm banana plugPacking unit: 10 pcs Electrocardiographs > ECG Electrodeswww.nihonkohden.net 20 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!ECG Electrodes for AdultsNIHON KOHDEN VITRODE Disposable ECG ElectrodesThe result of over 30 years experience in disposable electrode manufacturing. The ECG electrodes are the most important portions of the ECG/arrhythmia monitoring system. It is through these electrodes that the electrical signals are conducted from the patient and into the monitoring system. If the electrodes are left in place for an extended period of time (over 48 hours), or they are reused once they are removed, they do not adhere to the patients skin and they cause noisy ECG signals because of the poor conduction. In addition, the patients movement causes the electrodes to lose conducting capabilities intermittently, and this leads to a wandering ECG waveform and muscle artifact. The standard monitoring practice is to change these electrodes at least every 48 hours. Please contact us for individual offer based on your annual volume! Use the possibility of call orders! Supply Code G203ModelL-150Description ECG Electrode Vitrode L, Ag/AgCl, adult, size: 35 mm dia, foam tape, solid gel, general usePacking unit: 5 x 30 pcs G204 C-150 ECG Electrode Vitrode C, Ag/AgCl, adult, size: 47 mm dia, breathable cottony softcloth with an elastic quality for tension, solid gelPacking unit: 5 x 30 pcs G207 L-150X ECG Electrode Vitrode L, Ag/AgCl, adult, size: 35 mm dia, radiolucent (X-ray), foam tape, solid gelPacking unit: 5 x 30 pcs G210D F-150M ECG Electrode Vitrode F, Ag/AgCl, adult, size M: 25 x 45 mm, cotton tape especially for sensitive skin, adhesive gelPacking unit: 3 x 50 pcs G236 M-150 ECG Electrode Vitrode M, Ag/AgCl, child/adult, size: 40 mm dia, foam tape, highbrid gel, for stress testPacking unit: 5 x 30 pcs G250 J-150 ECG Electrode Vitrode J, Ag/AgCl, adult, size: 40 mm dia, foam tape, solid gel, excellent adhesion even on sweaty skinPacking unit: 5 x 30 pcs Electrocardiographs > ECG Electrodeswww.nihonkohden.net 21 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!ECG Electrodes for Children, Infants & NeonatesSupply Code G210CModelF-150SDescription ECG Electrode Vitrode F, Ag/AgCl, neonate/child, size S: 18 x 36 mm, cotton tape especially for sensitive skin, adhesive gelPacking unit: 3 x 50 pcs ECG Electrode AdapterSupply Code N-00Description Snap Adapter for Disposable ECG Electrodes, 4 mm dia plug to clip connectorPacking unit: 5 pcs N-08 Clip Adapter for Disposable ECG Electrodes, 4 mm dia plug to snap connectorPacking unit: 10 pcs Electrocardiographs > ECG Electrodes ECG Batterieswww.nihonkohden.net 23 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!ECG BatteriesSupply Code X065Model NKB-301VDescription Battery Pack, 12V, 2800 mAh, nickel-metal hydride (NiMH), rechargeableFor current products: ECG-1350/2350/TEC-5500/7700Packing unit: 1 pcsX071 SB-901D Battery Pack, 12V, 1950 mAh, nickel-metal hydride (NiMH), rechargeableFor current products:ECG-1150/1250/1950Packing unit: 1 pcsX073 SB-150D Battery Pack, 12V, 3600 mAh, nickel-metal hydride (NiMH), rechargeableFor current products: ECG-1500/1550Packing unit: 1 pcsX078 SB-201D Battery Pack, 14.4V, 3400 mAh, nickel-metal hydride (NiMH), rechargeableFor current products:ECG-2550Packing unit: 1 pcsX040 LCS-2012NK Battery Pack, 12V, 2000 mAh, lead-acid, rechargeableFor old products: ECG-6000/OEC-8110Packing unit: 1 pcsX041A LCT-1912ANK Battery Pack, 12V, 1900 mAh, lead-acid, rechargeableFor old products:ECG-9022/9132Packing unit: 1 pcsX041B LC-S2912NK Battery Pack, 12V, 2900 mAh, lead-acid, rechargeableFor old products:ECG-9320/TEC-7500Packing unit: 1 pcsElectrocardiographs > ECG Batteries ECG Paperwww.nihonkohden.net 25 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!ECG PaperSupply Code A052Model FQW210-10-295Description Thermal Paper, Z-fold, 210 mm x 100 m (page 295 mm), 339 pages, with queue mark/perforationFor old products: ECG-9320Packing unit: 10 pcs A053 FQW210-30-295 Thermal Paper, Z-fold, 210 mm x 300 m (page 295 mm), 1017 pages, without grid, with queue mark/perforationFor current products: ECG-2550/1550 |For old products: ECG-9320Packing unit: 1 pcs A128 RQS50-3 Thermal Paper, roll, 50 mm x 30 m, orange gridFor current products: TEC-8300For old products: ECG-6651/TEC-7100/7200/7300Packing unit: 10 pcs A129 RQS63-3 Thermal Paper, roll, 63 mm x 30 m, with grid, without queue mark/perforationFor old products: ECG-1150Packing unit: 10 pcs NKD-210-10/295 Thermal Paper, Z-fold, 210 mm x 100 m (page 295 mm), 339 pages, without grid, with queue mark/perforation, equivalent to A052 & NKD-210-10AFor old products: ECG-9320/old MEBPacking unit: 10 pcs NKD-210-5-295 Thermal Paper, Z-fold, 210 mm x 50 m (page 295 mm), 169 pages, without grid, equivalent to A053For current products: ECG-2550/1550 |For old products: ECG-9320Packing unit: 10 pcs NKD-A054 Thermal Paper, Z-fold, 210 mm x 30 m (page 140 mm), 214 pages, without grid, with queue mark/perforationFor current products: ECG-1350/2350 |For old products: ECG-9132Packing unit: 10 pcs NKD-A730 Thermal Paper, Z-fold, 110 mm x 20 m (page 140 mm), 143 pages, without grid, with queue mark/perforationFor current products: ECG-1250/1950 |For old products: ECG-9022Packing unit: 10 pcs Electrocardiographs > ECG Paperwww.nihonkohden.net 26 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Supply Code NKD-63Description Thermal Paper, Z-fold, 63 mm x 30 m (page 75 mm), 400 pages, with grid, without queue mark/perforationFor old products: ECG-9620Packing unit: 10 pcs NKD-A129 Thermal Paper, roll, 63 mm x 30 m, with grid, without queue mark/perforation, equivalent to A129For current products: ECG-1150 |For old products: ECG-9620Packing unit: 10 pcs NKD-145-2,5 Thermal Paper, Z-fold, 145 mm x 25 m (page 100 mm), 85 pages, orange grid, equivalent to A036BFor old products: ECG-8400Packing unit: 10 pcs NKD-145-6A300 Thermal Paper, roll, 145 mm x 60 m (page 300 mm), 200 pages, orange grid, equivalent to A132 but without queue mark/perforationFor old products: ECG-8821Packing unit: 10 pcs NKD-A134A Thermal Paper, roll, 210 mm x 30 m, without grid/queue mark/perforationFor old products: ECG-9110/9130/9132Packing unit: 10 pcs Electrocardiographs > ECG Paper Additional ECG Accessorieswww.nihonkohden.net 28 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Additional ECG AccessoriesSupply Code F010Model Z-101BCDescription CardioCream ECG Electrode Paste, 100 g tubePacking unit: 2 pcs NKD-G711 Electrode Spray Gyrolux, skin preparation for use of suction vacuum pumps, 250 ml bottlePacking unit: 1 pcs NKD-SD1GB Memory SD Card 1 GBPacking unit: 1 pcs Y011 404617 Thermal Head Cleaner PenFor current products: all ECG/TEC/old MEB/EEG/allBSM/PVM/OPV/WEPPacking unit: 1 pcs NKD-BAG Carrying Bag for ECG & AccessoriesFor current products: ECG-1150/1250/1350/1950/2350Packing unit: 1 pcs NKD-L936 Power Cable, Schuko plug, cable length: 2.0 mPacking unit: 1 pcs NKD-POWERLINE Multiple Power Socket (4 slots), medical certicationPacking unit: 1 pcs Electrocardiographs > Additional ECG Accessorieswww.nihonkohden.net 29 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Supply Code K117ADescription Connection Cable for Input Box, cable length: 2.0 mFor current products: ECG-2550Packing unit: 1 pcs K117B Connection Cable for Input Box, cable length: 5.0 mFor current products: ECG-2550Packing unit: 1 pcs K117C Connection Cable for Input Box, cable length: 10.0 mFor current products: ECG-2550Packing unit: 1 pcs Electrocardiographs > Additional ECG Accessories Accessories for DebrillatorsDebrillator Batteries & Battery Chargerwww.nihonkohden.net 32 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Debrillator Batteries & Battery ChargerDebrillator Batteries & Battery ChargerSupply CodeX065ModelNKB-301VDescriptionBattery Pack, 12V, 2800 mAh, nickel-metal hydride (NiMH), rechargeableFor current products: TEC-5500/7700/ECG-1350 Packing unit: 1 pcs X077 SB-831V Battery Pack, 14.4V, 6300 mAh, lithium-ion battery, rechargeableFor current products: TEC-8300Packing unit: 1 pcsX041 LCT-1912NK-1 Battery Pack, 12V, 1900 mAh, lead-acid, rechargeableFor old products: TEC-7100/7200Packing unit: 1 pcsX041B LC-S2912NK Battery Pack, 12V, 2900 mAh, lead-acid, rechargeableFor old products: ECG-9320/TEC-7500Packing unit: 1 pcsX060A NKB-102V Battery Pack, 12V, 1700 mAh, nickel-cadmium (NiCd), rechargeableFor old products: TEC-8200Packing unit: 1 pcsSB-801V External Dual Battery Charger, for 2x battery X077For current products: TEC-8300Packing unit: 1 pcs SC-831V AC/DC Module for Series TEC-8300KFor current products: TEC-8300Packing unit: 1 pcs SB-551V External Dual Battery Charger, for 2x battery X065For current products: TEC-5500/7700Packing unit: 1 pcs Debrillator Paperwww.nihonkohden.net 34 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Debrillator PaperDebrillator PaperSupply CodeA128ModelRQS50-3DescriptionThermal Paper, roll, 50 mm x 30 m, orange gridFor current products: TEC-8300 |For old products: ECG-6651/TEC-7100/7200/7300Packing unit: 10 pcsA222 FQS50-3-100 Thermal Paper, Z-fold, 50 mm x 30 m (page 100 mm), 300 pages, orange gridFor current products: TEC-7700Packing unit: 10 pcsA226 FQS50-2-100 Thermal Paper, Z-fold, 50 mm x 20 m (page 100 mm), 200 pages, orange gridFor current products: TEC-5500/BSM-2300/3000Packing unit: 10 pcsA238 PS50-2 Thermal Paper, roll, 50 mm x 20 m, orange grid, without queue mark/perforationFor old products: TEC-6600Packing unit: 10 pcsNKD-A226 Thermal Paper, Z-fold, 50 mm x 20 m (page 100 mm), 200 pages, orange gridFor current products: TEC-5500Packing unit: 10 pcs Debrillator Bagswww.nihonkohden.net 36 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Debrillator BagsDebrillator BagsSupply CodeNKD-DEFIBAG83DescriptionSoftbag for Series TEC-8300K incl. Warning Sign Label Please indicate the specied abbreviation letter for the required language when ordering:English (K), German (G), French (F), Italian (R), Spanish (E), Turkish (TR) or Russian (RU)! For current products: TEC-8300Packing unit: 1 pcs NKD-STRAP83 Shoulder Strap for Series TEC-8300K SoftbagFor current products: TEC-8300Packing unit: 1 pcs NKD-DEFIBAG2 Carrying Bag 2 with 2 Additional Attached Accessory BagsFor current products: TEC-7700Packing unit: 1 pcs NKD-DEFIBAG3 Carrying Bag 3 with 1 Additional Attached Accessory BagFor current products: TEC-5500Packing unit: 1 pcs NKD-DEFIBAG6 Accessory BagFor current products: TEC-5500/7700Packing unit: 1 pcs Disposable Debrillator Padswww.nihonkohden.net 38 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Disposable Debrillator PadsDisposable Pads with NIHON KOHDEN ConnectorSupply CodeH312ModelP-513DescriptionDebrillation Pads with Outside Connector, infant (< 10 kg), for use with adapter cable JC-765V/K342B, weight: 80 g 10 g, size: 73 mm 8 mm x 110 mm 11 mm, conductive surface: 48.40 cm2 10%, cable length: 1.5 mFor current products: TEC-5500/7700/8300Packing unit: 1 pair H327 P-511 Debrillation Pads with Outside Connector, child/adult (> 10 kg), for use with adapter cable JC-765V/K342B, weight: 90 g 15 g, size: 108 mm 10 mm x 159 mm 10 mm, conductive surface: 99 cm2 10%, cable length: 1.5 mFor current products: TEC-5500/7700/8300Packing unit: 1 pair K342B JC-865V Adapter Cable for Disposable Debrillator Pads H312/H327/H324A, cable length: 3.5 mFor current products: TEC-8300Packing unit: 1 pcs JC-765V Adapter Cable for Disposable Pads H312/H327/H324A, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcs Y206A AX-250V AED Cable Testing Unit for NIHON KOHDEN-Pads with Adapter Cable JC-765V/K342BFor current products: TEC-5500/7700/8300Packing unit: 1 pcs www.nihonkohden.net 39 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Disposable Debrillator PadsDisposable Pads with R2 ConnectorSupply CodeNKD-H405Model DescriptionDebrillator Pads with Outside R2 Connector, adult, for use with adapter cable JC-755V/K342A, size: 159.93 cm, conductive surface: 114.75 cm, cable length: 1.28 mFor current products: TEC-5500/7700/8300Packing unit: 1 pair NKD-H406 Debrillator Pads with Outside R2 Connector, child, for use with adapter cable JC-755V/K342A, size: 78.13 cm, conductive surface: 53.80 cm, cable length: 1.28 mFor current products: TEC-5500/7700/8300Packing unit: 1 pair K342A JC-855V Adapter Cable for Disposable Debrillator Pads NKD-H405/NKD-H406 with R2 Connector, cable length: 3.5 mFor current products: TEC-8300Packing unit: 1 pcs JC-755V Adapter Cable for Disposable Debrillator Pads NKD-H405/NKD-H406 with R2 Connector, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcs Y206B AX-251V AED Cable Testing Unit for R2 Pads with Adapter Cable JC-755V/K342AFor current products: TEC-5500/7700/8300Packing unit: 1 pcs Paddle Electrodeswww.nihonkohden.net 41 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Paddle ElectrodesInternal Paddle Electrode with Discharge Button for Series TEC-8300Supply CodeND-893VDescriptionInternal Paddle Electrode with Discharge Button, including handle & electrode, size: 35 mm diaFor current products: TEC-8300Packing unit: 1 pair ND-894V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 45 mm diaFor current products: TEC-8300Packing unit: 1 pair ND-895V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 55 mm diaFor current products: TEC-8300Packing unit: 1 pair ND-896V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 65 mm diaFor current products: TEC-8300Packing unit: 1 pair ND-897V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 75 mm diaFor current products: TEC-8300Packing unit: 1 pair www.nihonkohden.net 42 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > Disposable Debrillator PadsInternal Paddle Electrode with Discharge Button for TEC-5500/7700Supply CodeND-593VDescriptionInternal Paddle Electrode with Discharge Button, including handle & electrode, size: 35 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairND-594V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 45 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairND-595V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 55 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairND-596V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 65 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairND-597V Internal Paddle Electrode with Discharge Button, including handle & electrode, size: 75 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairNeonate Paddle Adapter for TEC-5500/7700Supply CodeND-612VDescriptionPaddle Adapter, neonate, size: 44 mm diaFor current products: TEC-5500/7700Packing unit: 1 pairNIHONKOHDENsec1arrhythmiaanalysisprovidessuperioreliminationoffalse alarms. ec1 has been evaluated with worlds standard arrhythmia databases as well as NIHON KOHDENs ECG database, with a result of 80%reduction of false alarms.Some functions are limited on series TEC-8300K. Contact your NIHON KOHDEN repre-sentative for details.Highly accurate ec1 arrhythmia analysis ECG Measurement050010001500200025003000Without ec1 With ec1Number of false alarmsTachyV. RhythmVPC RunVTExt. TachyVFwww.nihonkohden.net 44 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Lead C1C2C3C4C5C6Typical Arrhythmia WaveformsHeart AnatomyNihon Kohden products which detect arrhythmiaElectrocardiographs / Dellibrators / Bedside MonitorsDiagnostic ECG ElectrodePlacement Cardiac Conduction SytemR and L electrodes should be placed just below the right and left clavicle.N and F electrodes should be placed on the lower edge of the rib cage, or at the level of the umbilicus at the mid-clavicular line.Electrode PlacementFourth intercostal space at the right border of the sternumFourth intercostal space at the right border of the sternumMidway between locations C2 and C4At the mid-clavicular line in the fth intercostal spaceAt the anterior axillary line on the same horizontal level as C4At the mid-axillary line on the same horizontal level as C4 and C5 1.Inferior vena cava2.Superior vena cava3. Right atrium4. Tricuspid valve5. Right ventricle6. Pulmonary valve7. Pulmonary artery8. Pulmonary vein9. Left atrium10.Mitral valve11. Left ventricle12. Aortic valve13. Coronary artery 14. Aorta15. Brachiocephalic artery16. Left common carotid artery17. Left subclavian artery18. Descending aortaSA nodeThe sinoatrial (SA) node generates a wave of electrical excitation.The excitation travels through the internodal pathways to the atria and the atrial muscles contract. This is recorded as the P-wave.The excitation travels to theatrioventricular (AV) node.The excitation then travels through the bundle of His and down through the right and left bundle branches.The excitation terminates at the Purkinje bers in the ventricles and the ventricular muscles contract. This is the depolarization and is recorded as the QRS complex.The ventricular muscles relax. This is the repolarization and is recorded as the T- wave.123456789101112131415 16 1718778C1 C2C3FC4C5C6NR L1223455123456AV nodeRightbundlebranchPurkinjebersPurkinjebersHis bundleVentriclesLeftbundlebranchAtriaPremature Ventricular Contractions (PVC) Premature contractions Bizarre and wide QRS complexes Full compensatory pause Frequent PVCs are serious Fast pulse rate greater than 100 bpm 3 or more irregular beats Needs emergency treatment and countershock May progress to Ventricular Tachycardia (VT)Multi- focal PVC Ventricular Fibrillation (VF) Multi form PVCs Bizarre and wide QRS complexes No discernable P-waves, R-waves, P-R rythm or QRS complexes Needs emergency treatment and countershock12Short run PVCSecond-degree atrioventricular (AV) block, Mobitz type II Sudden absence of QRS complexes (P-waves observed) May progress to cardiac arrest Possibillity of Adams-Stokes syndrome Occasionally needs pacing P P P Consecutive PVCs May progress to ventricular tachycardiaPremature Supraventricular Contractions(Premature Atrial Contractions (PAC)) Atrial Fibrillation (AF) Narrow QRS (excluding aberrant ventriular conduction) Ectopic focus higher than His-bundle Non-compensatory pause Slight ripples on the baseline Irregular R-R intervals Inverted QRS complexes Non-compensatory pauseP P123.456--------------------------------------------------------------------------------------------------------------------R-on-T PVC Third-degree (complete) atrioventricular (AV) block Independent development of P-waves and QRS complexes Possibility of bradycardia Possibility of Adams-Stokes syndrome Needs pacing PVC on summit of T-wave Bizarre and wide QRS complexesP P P P P P P P P P PPQ STRCardiology Typical Arrhythmia Waveforms ECG Cables ECG Cables for TEC-8300www.nihonkohden.net 47 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementECG 3/6-Lead CablesV4 V4V56-lead ECG measurementPowerful ECG measurement96 % of an ischaemia change can be detected by 6 electrodes (II, V4, V5)ST Change Detection Report Only with I lead symbol 33% Only with V5 lead symbol 75% II + V5 lead symbol 80% II + V5 + V4 lead symbol 96%More accurate ischaemia detectionSupply Code6124-039432Model DescriptionConnection Cable Cover for DIN Type Electrodes for K922For current products: TEC-8300/all BSM/PVM; ZS-910/920/930/940/530PG;ZM-920/930/940PGPacking unit: 1 pcsK120 NA-0003 Electrode Lead Tube for K911/K910AFor current products: TEC-8300/5500/7700/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 5 pcsK910A BR-913P 3-Lead ECG Electrode Cable, clip, cable length: 0.8 m TEC-55/7700: for connection to debrillators L153 is required BSM/PVM/TEC-8300: for connection to monitors K922 is requiredFor current products: TEC-8300/5500/7700/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsK911 BR-903P 3-Lead ECG Electrode Cable, snap, cable length: 0.8 mTEC-55/7700: for connection to debrillators L153 is requiredBSM/PVM/TEC-8300: for connection to monitors K922 is requiredFor current products: TEC-8300/5500/7700/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsK913A BR-906V 6-Lead ECG Electrode Cable, clip, cable length: 0.6 mFor current products: TEC-8300/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsK912 BR-906P 6-Lead ECG Electrode Cable, clip, cable length: 0.8m requires K922For current products: TEC-8300/all BSM/PVM; ZM-920/930/940PGPacking unit: 1 pcswww.nihonkohden.net 48 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementSupply CodeK915ModelBR-916PDescription6-Lead ECG Electrode Cable, snap, cable length: 0.8m,requires K922For current products: all BSM/PVM/TEC-8300; ZM-920/930/940PGPacking unit: 1 pcsK922 JC-906P 3/6-Lead ECG Connection Cable for K910A/K911/K912/K915 to patient monitors/debrillator, cable length: 3.0 mFor current products: TEC-8300/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsECG 10-Lead CablesSupply CodeK901ModelBJ-900PDescription 10-Lead ECG Patient Cable (12 channel ECG), clip, cable length: 3.8 m, incl. patient electrode lead & connection cableFor current products: BSM-1700/3000/5100/6000/9100/TEC-8300Packing unit: 1 pcsK354 BJ-831V 10-Lead ECG Patient Cable (12 channel ECG), clip, cable length: 2.5 mFor current products: TEC-8300Packing unit: 1 pcs ECG Cables for TEC-5500 & TEC-7700www.nihonkohden.net 50 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementECG 3-Lead CablesSupply CodeK120ModelNA-0003DescriptionElectrode Lead Tube, for K911/K910AFor current products: TEC-5500/7700/8300/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 5 pcsK910A BR-913P 3-Lead ECG Electrode Cable, clip, cable length: 0.8 mTEC-5500/7700: for connection to debrillators L153 is requiredBSM/PVM/TEC-8300: for connection to monitors K922 is requiredFor current products: TEC-5500/7700/8300/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsK911 BR-903P 3-Lead ECG Electrode Cable, snap, cable length: 0.8 mTEC-5500/7700: for connection to debrillators L153 is requiredBSM/PVM/TEC-8300: for connection to monitors K922 is requiredFor current products: TEC-5500/7700/8300/all BSM/PVM; ZS-910/920/930/940/530PG; ZM-920/930/940PGPacking unit: 1 pcsK225 BR-018P 3-Lead ECG Connection Cable (IEC), clip, cable length: 0.8 m, for use with L152For current products: TEC-5500/7700Packing unit: 1 pcsK226 BR-019P 3-Lead ECG Connection Cable (IEC), snap, cable length: 0.8 m, for use with L152For current products: TEC-5500/7700Packing unit: 1 pcsK336 JC-005P Connection Cable (IEC), cable length: 3.0 m, for ECG Electrode LeadK225/K226/K227/K228For current products: TEC-5500/7700Packing unit: 1 pcsK352A BC-763VA 3-Lead ECG Connection Cable (AHA), snap, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcsK353A BC-763V 3-Lead ECG Connection Cable (IEC), snap, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcswww.nihonkohden.net 51 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementECG 5-Lead CablesSupply CodeK227ModelBR-020PDescription5-Lead ECG Connection Cable (IEC), clip, cable length: 0.8 m, for use with L152For current products: TEC-5500/7700Packing unit: 1 pcsK228 BR-021P 5-Lead ECG Connection Cable (IEC), snap, cable length: 0.8 m, for use with L152For current products: TEC-5500/7700Packing unit: 1 pcsK336 JC-005P Connection Cable (IEC), cable length: 3.0 m, for ECG Electrode LeadK225/K226/K227/K228For old products: TEC-8250/8251Packing unit: 1 pcsK352B BC-765VA 5-Lead ECG Connection Cable (AHA), clip, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcsK353B BC-765V 5-Lead ECG Connection Cable (IEC), clip, cable length: 3.5 mFor current products: TEC-5500/7700Packing unit: 1 pcs www.nihonkohden.net 52 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementFurther Debrillator Connection CablesSupply CodeK232ModelBR-002PDescription3-Lead ECG Connection Cable (IEC), clip, cable length: 0.8 mFor old products: TEC-7000Packing unit: 1 pcsK350A BC-753V 3-Lead ECG Connection Cable (IEC), clip, cable length: 3.5 mFor old products: TEC-7500Packing unit: 1 pcsK234 BR-004P 5-Lead ECG Connection Cable (IEC), clip, cable length: 0.8 mFor old products: TEC-7000Packing unit: 1 pcsK332 JC-002P Connection Cable (IEC) for ECG Electrode Lead K234, cable length: 3.0mFor old products: TEC-7000Packing unit: 1 pcsK351A BC-755V 5-Lead ECG Connection Cable (IEC), clip, cable length: 3.5 mFor old products: TEC-7500Packing unit: 1 pcsL151 JC-761V External ECG Input Cable, connection to patient monitors, cable length: 2.9 mFor current products: TEC-5500/7700Packing unit: 1 pcsL152 JC-762V External Debrillator Connection Cable, cable length: 3.0 m, for ECG Electrode Lead K225/K226/K227/K228For current products: TEC-5500/7700Packing unit: 1 pcsL153 JC-763V External Debrillator Connection Cable, cable length: 3.0 m, for ECG Electrode Lead K910A/K911For current products: TEC-5500/7700Packing unit: 1 pcs NIHON KOHDEN Vitrode Disposable ECG ElectrodesThe result of over 30 years experience in disposable electrode manufacturing. The ECG electrodes are the most important portions of the ECG/arrhythmia monitoring system. It is through these electrodes that the electrical signals are conducted from the patient and into the monitoring system. If the electrodes are left in place for an exten-ded period of time (over 48 hours), or they are reused once they are removed, they do not adhere to the patients skin and they cause noisy ECG signals because of the poor conduction. In addition, the patients movement causes the electrodes to lose conducting capabilities intermittently, and this leads to a wandering ECG waveform and muscle artifact. The standard monitoring practice is to change these electrodes at least every 48 hours. Please contact us for individual ofer based on your annual volume! Use the possibility of call orders! ECG Electrodes for DebrillatorsStandard Electrodes PlacementsIt is important to prepare the skin before attaching theelectrodesbycleaningitandremovingchest hair.Afterthispleaseattachtheleadwiretothe electrodesbeforeplacingthemontheskin.This avoids pain to the patient. Secure the lead wire to theskin(stressloop)preventingmovingofthe lead wire and therefore noise on the ECG signal.Three electrodesTen electrodes Six electrodeswww.nihonkohden.net 54 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!ECG Electrodes for AdultsSupply CodeG203ModelL-150DescriptionECG Electrode Vitrode L, Ag/AgCl, adult, size: 35 mm dia, foam tape, solid gel, general usePacking unit: 5 x 30 pcs G204 C-150 ECG Electrode Vitrode C, Ag/AgCl, adult, size: 47 mm dia, breathable cottony soft-cloth with an elastic quality for tension, solid gelPacking unit: 5 x 30 pcs G207 L-150X ECG Electrode Vitrode L, Ag/AgCl, adult, size: 35 mm dia, radiolucent (X-ray), foam tape, solid gelPacking unit: 5 x 30 pcs G210D F-150M ECG Electrode Vitrode F, Ag/AgCl, adult, size M: 25 x 45 mm, cotton tape especially for sensitive skin, adhesive gelPacking unit: 3 x 50 pcs G250 J-150 ECG Electrode Vitrode J, Ag/AgCl, adult, size: 40 mm dia, foam tape, solid gel, excellent adhesion even on sweaty skinPacking unit: 5 x 30 pcs G272A V-09OM3 ECG Electrode Vitrode V, Ag/AgCl, child/adult, size: 25 x 45 mm, cable length: 1.0 m, radiolucent (X-ray), hydrogel, foam & cotton tape, 3 pre-wired electrodes with 1.5 mm touch proof connectorPacking unit: 30 x 3 pcs G272B V-040M4 ECG Electrode Vitrode V, Ag/AgCl, child/adult, size: 25 x 45 mm, cable length: 1.0 m, radiolucent (X-ray), hydrogel, foam & cotton tape, 4 pre-wired electrodes with 1.5 mm touch proof connector for limb leadsPacking unit: 10 x 4 pcs Debrillators > ECG Measurementwww.nihonkohden.net 55 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > ECG MeasurementSupply CodeG272CModelV-06OM6DescriptionECG Electrode Vitrode V, Ag/AgCl, child/adult, size: 25 x 45 mm, cable length: 1.0 m, radiolucent (X-ray), hydrogel, foam & cotton tape, 6 pre-wired electrodes with 1.5 mm touch proof connector for chest leadsPacking unit: 10 x 6 pcs G278A V-09IO3 ECG Electrode Vitrode V, Ag/AgCl, child/adult, size: 25 x 45 mm, cable length: 1.5 m, radiolucent (X-ray), foam tape, 3 pre-wired electrodes with 1.5 mm touch proof connectorPacking unit: 30 x 3 pcs ECG Electrodes for Children, Infants & NeonatesSupply CodeG210CModelF-150SDescriptionECG Electrode Vitrode F, Ag/AgCl, neonate/child, size S: 18 x 36 mm, cotton tape especially for sensitive skin, adhesive gelPacking unit: 3 x 50 pcs G271A V-120S3 ECG Electrode Vitrode V, Ag/AgCl, neonate/infant, without motif print, size: 20 mm dia, cable length: 0.6 m, radiolucent (X-ray), foam & cotton tape, 3 pre-wired electrodes with 1.5 mm touch proof connectorPacking unit: 40 x 3 pcs A Pulse Oximeter is a non-invasive device used to percutaneously measure oxygen saturation in the blood by use of a clip-on nger probe. Pulse oximeter works with the integration of a probeplacedontopatientsngertiportoe,obtainssignalsfromtheprobeandthemain device calculates oxygen saturation in the body.OxygensaturationmeasuredbyaPulseOximeterisSpO2.Pstandsforpulse,andthe measurement principle is based on beat-by-beat changes in blood volume. In general, arteri-al oxygen saturation measured by spectroscopic analysis is called SaO2, and oxygen satura-tion measured by pulse oximeter is called SpO2.The method for determination of arterial oxygen saturation, based on the photoelectric ple-thysmography, was conceptualised and implemented in 1972 by the Japanese bio-engineer Takuo Aoyagi (NIHON KOHDEN Corporation). This idea came about while using an ear den-sitometerforrecordingdilutioncurvesfordyes(pigments). Therstcommercialoximeter OLV-5100 was presented by NIHON KOHDEN back in 1975.Dr.Aoyagisinnovativetechnology,pulseoximetry,hasrapidlyspreadworldwideandbecomeessentialincriticalcare.In 2002,Dr.AoyagiwasawardedtheMedalofHonorinJapan,inrecognitionofhisgreatcontributiontoclinicalmedicine. The NIHON KOHDEN SpO Sensors of the BluPRO Series are at the cutting edge of this progressive technology. SpO Measurement SpO2 Cableswww.nihonkohden.net 58 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > SpO2 MeasurementSpO2 CablesSupply CodeK931ModelJL-900PDescriptionSpO2 Connection Cable, cable length: 2.5 m, rectangular connectorFor current products: TEC-8300/all BSM/PVM/PSG-1100Packing unit: 1 pcs Y095A JL-550T2 SpO2 Connection Cable, cable length: 2.5 m, round connectorFor current products: TEC-5500/7700/JE-912A/921A/921AGPacking unit: 1 pcs NoteSpO2 measurement starts when the SpO2 connection cable and SpO2 probe are connected to the device, and the SpO2 probe is attached to the patient.When not measuring SpO2, disconnect the SpO2 connection cable from the device. Otherwise, noise from the probe sensor may interfere and incorrect data is displayed on the screen.BluPRO SpO Probes A Unique Sensing TechnologyReliability and high quality of our probes provide a continuous accurate and safe monitoring with highest patient comfort. The comfortable, sure tting and lightweight characteristic reduces the efect of hand movement for highly reliable SpO measurement.Thisensurespatientsafety,reducesthecostsofcareandincreasesthereforeclinicalefciencyandcost efectiveness. NIHON KOHDEN BluPRO SpO Probes are comfortable, durable, accurate and needs-oriented.Note that accurate and safe measurement is assured only when you use probes, connection cords and parts manu-facturedbyNIHONKOHDEN.SomeprobesinthemarketmayadvertiseascompatiblewithNIHONKOHDEN probes.Westronglyrecommendyoutoavoidtheseprobesasacorrectmeasurementcannotbeguaranteedon NIHON KOHDEN devices. NIHON KOHDEN is not responsible for problems caused by using other manufacturers probes.Please contact us for an individual ofer based on your annual volume! Use the possibility of call orders! SpO Probeswww.nihonkohden.net 60 Debrillators > SpO MeasurementSpO Probes Low birth weightNeonate Infant Child Adult2 kg 3 kg 1000 g 30 kg 10 kg 20kg 40 kg 50 kgDisposableReusableP204F (TL-272T3)P203C (TL-273T)P203D (TL-274T)P204C (TL-273T)P204D (TL-274T)P228A (TL-051S)P229A (TL-061S)P225F (TL-201T)P204G (TL-273T3)P204H (TL-274T3)P228B (TL-052S)P229B (TL-062S)P225H (TL-201T1)P225G (TL-220T)P203G (TL-273T3)P203H (TL-274T3)P204B (TL-272T)P203E (TL-271T3)P203A (TL-271T)P204E (TL-271T3)P203F (TL-272T3)P204A (TL-271T)P203B (TL-272T)Supply Code (Model)Cable length (m)Packing unit 1.60.80.80.80.80.80.81.61.61.61.61.60.61.61.61.60.81.60.81.61.60.80.8 24555245245245P310C (TL-630T3) 1.6P311C (TL-631T3) 1.61www.nihonkohden.net 61 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Debrillators > SpO2 MeasurementReusable SpO2 ProbesFactsNIHON KOHDEN reusable SpO2 nger-clips probes have parallel mounted upper and lower sensor shells, thus, providing an exact alignment of the op-tical sensor components and markedly enhanced comfort during long-term attachment. In addition, exible lateral aps shield the measuring signals from the external light, thus resulting to minimize the interference by additional articial light sources! Bright LEDs provide more accurate measure-ment even for thicker ngers or dark skin tones. The nger-clip reusable probe is the most popular type of SpO2 probes. Instead of the typical hinge near the nger tip, P225F/P225H have a unique sure tting and comfortable mechanism using two sliding pieces for the front and back of the nger with two rubber aps along both sides of the nger. When you press the button, the two halves of the probe slide directly open, parallel to each other. No additional xation tape is needed. For a stable and comfortable measurement P225F/P225H, always keep the light emitters and detector aligned. NIHON KOHDEN provides unique reusable SpO2 probes.Supply CodeP225FModelTL-201TDescriptionSpO2 BluPRO Finger-Clip Probe, child/adult (> 20 kg) finger, cable length: 1.6 m, reusableFor current products:all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 1 pcs P225H TL-201T1 SpO2 BluPRO Finger-Clip Probe, child/adult (> 20 kg) finger, cable length: 0.6 m, reusableFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 1 pcs FactsThe multi-site probe P225G can be used for neonatal feet as well as adult ngers as its curved contact surface is designed to t on diferent attachment sites. The light emitter and detector are separate which allows especially an accurate alignment of the LED on the infant/neonatal instep. A unique sliding adjuster gives the best t on the attachment site secured by taping. Supply CodeP225GModelTL-220TDescription SpO2 BluPRO Multi-Site Probe, neonate (< 3 kg) instep,child/adult ( > 3 kg) nger/toe, cable length: 1.6 m, reusableFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPacking unit: 1 pcs Reusable, but always clean NIHON KOHDEN washable probes.The reusable probesof the BluPRO series are durable and washable, so you can clean them under running water or even immerse them in a soapy alkaline or disinfectant solution (glutaraldehyde solution 2.0 % or hydrochloric alkyl diaminoethylene glycine 0.5 %)! P225F / P225H P225GDurable, washable, demand-oriented!P310C / P311Cwww.nihonkohden.net 62 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Facts Our special designed nger-tip probes, P310C and P311C, t immediately on the nger and are perfect for long-term measurement. A less covered nger area and cushioned materials lead to decrease pressure to the attachment site. The 3D molding attachment ensures a comfortable t. In combination with the soft and lightweight design the patient stress or discomfort is reduced and the probes can be remained up to 8 hours to one attachment site. A stable measurement is assured by gentle xation tapes P263 or P267 that avoid the falling of of the probes and reduce artifact from cable movement.Reusablebutwiththecomfortofadisposableprobe,P310CandP311Carealsoapplicableforsleepstudies,forpatientsthatareoftenbendingtheir ngers or obese patients.Supply CodeP310CModelTL-630T3Description SpO2 BluPRO Finger-Tip Probe L, child/adult (> 50 kg) nger, cable length: 1.6 m, long-term use, reusableFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 1 pcs P311C TL-631T3 SpO2 BluPRO Finger-Tip Probe M, child/adult (> 20 kg) nger, cable length: 1.6 m, long-term use, reusableFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 1 pcs P263 Disposable Probe Cable Fixing Tape for P310C/P311C, size: 15 x 130 mmFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 3 x 30 pcsP267 YS-093P2 Disposable Probe Fastener Tape for P310C/P311C,size: 15 x 140 mmFor currentproducts: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 30 pcs Debrillators > SpO2 Measurementwww.nihonkohden.net 63 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Disposable SpO2 ProbesNIHON KOHDEN disposable probes, from neonate to adult sizes, place special emphasis on the exact positioning of the LEDs and detector. For this reason the two optical components are designed separately and can thus be brought into precise alignment witheachotherbytheuser.Allprobeshavebreathablematerialandcanberemainedupto8hoursononeattachmentsite. Paediatric probes have a cute cartoon character printed on the tape to reassure children. Self-adhesive, soft and thin tape provides a secure t. The special design allows an easy application to the attachment site. To get the most comfortable t, please bend the probe before attaching, do not strongly pull the attachment tape when attaching and do not push the tip of the nger with the attachment tape. Disposable SpO2 Probes 24 pcs/box cable length: 0.8 m Supply CodeP203AModelTL-271TDescription SpO2 BluPRO Probe, adult (> 30 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203B TL-272T SpO2 BluPRO Probe, child (10 50 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203C TL-273T SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 40 kg) nger/toe, cable length: 0.8 m, disposableFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203D TL-274T SpO2 BluPRO Probe, infant (3 20 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs Debrillators > SpO2 Measurementwww.nihonkohden.net 64 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Disposable SpO2 Probes 24 pcs/box cable length: 1.6 mSupply CodeP203EModelTL-271T3Description SpO2 BluPRO Probe, adult (> 30 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203F TL-272T3 SpO2 BluPRO Probe, child ( 10 50 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203G TL-273T3 SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 40 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs P203H TL-274T3 SpO2 BluPRO Probe, infant (3 20 kg) nger/toe, cable length: 1.6 mFor current products:all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 24 pcs Disposable SpO2 Probes 5 pcs/box cable length: 0.8 m Supply CodeP204AModelTL-271TDescription SpO2 BluPRO Probe, adult (> 30 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P204B TL-272T SpO2 BluPRO Probe, child (10 50 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs Debrillators > SpO2 Measurementwww.nihonkohden.net 65 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Supply CodeP204CModelTL-273TDescription SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 40 kg) nger/toe, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P204D TL-274T SpO2 BluPRO Probe, infant ( 3 20 kg) nger/toe, cable length: 0.8 m For current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs FactsAbsolutely cost-efective, the series P228 and P229 are intended for long-term measurement on a single patient. The probes do not need to be replaced with a new one before 96 hours by changing the attachment site every 8 hours. So your running costs can be reduced!The light emitter and detector are covered by sponge and the entire attachment site has a at surface. This reduces the risk of skin burn and irritation. Since the probe itself is not self-adhesive, you can easily remove and attach the probe to change the attached nger. For xation, wrap the probe around the nger with attachment tape P259.Supply CodeP228AModelTL-051SDescription SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 50 kg) nger, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcsP229A TL-061S SpO2 BluPRO Probe, infant/child (3 15 kg) toe, child (15 50 kg) nger, cable length: 0.8 mFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P259 COTTONY Tape for xing disposable SpO2 ProbesFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPackingunit: 20 pcs Debrillators > SpO2 Measurementwww.nihonkohden.net 66 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Disposable SpO2 Probes 5 pcs/box cable length: 1.6 m Supply CodeP204EModelTL-271T3DescriptionSpO2 BluPRO Probe, adult (> 30 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P204F TL-272T3 SpO2 BluPRO Probe, child (10 50 kg) nger/toe,cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P204G TL-273T3 SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 40 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P204H TL-274T3 SpO2 BluPRO Probe, infant (3 20 kg) nger/toe, cable length: 1.6 mFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs Debrillators > SpO2 Measurementwww.nihonkohden.net 67 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!FactsAbsolutely cost-efective, the series P228 and P229 are intended for long-termmeasurement on a single patient. The probes do not need to be replaced with a new one before 96 hours by changing the attachment site every 8 hours. So your running costs can be reduced! The light emitter and detector are covered by sponge and the entire attachment site has a at surface. This reduces the risk of skin burn and irritation. Since the probe itself is not self-adhesive, you can easily remove and attach the probe to change the attached nger. For xation, wrap the probe around the nger with attachment tape P259.Supply CodeP228BModelTL-052SDescription SpO2 BluPRO Probe, neonate (< 3 kg) instep, adult (> 50 kg) nger, cable length: 1.6 m, disposableFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P229B TL-062S SpO2 BluPRO Probe, infant/child (3 15 kg) toe, child (15 50 kg) nger, cable length: 1.6 m, disposableFor current products: all BSM/PVM/TEC/EEG; ZS-930/530/940PG; ZM-930/940PGPacking unit: 5 pcs P259 COTTONY Tape for xing disposable SpO2 Probes, disposableFor current products: all BSM/PVM/TEC/EEG/PSG-1100; ZS-930/530/940PG; ZM-930/940PGPacking unit: 20 pcs Handling of the probe afects measurement accuracy and patient safetyFortheproperplacementoftheprobeonthenger,itisadvisablethatthelightemitteranddetectorareplacedjustoppositetoeach other. When using a nger clip probe, it is necessary to ensure that the probe covers the nger properly, otherwise some portion of the light never passes through the body tissues and may reach the light-receiving part directly, leading to incorrect measurement results.The more distant the light emitter and detector gets, the weaker the transmitted light intensity becomes. Additionally, a thinner body part tends to have small amount of blood, which makes it difcult to extract the arterial blood signal component. The most suitable thickness of the probe site is about 10 mm. Too loose probes may interfere with alignment of LEDs and detector, come of easily by body movement, cause larger motion artifacts or be efected by venous pulse.Too tight probes may cause venous pulsation, cause skin injuries such as burn and necrosis or unstable measurement because of a lower pulsatile signal.Debrillators > SpO2 MeasurementReasons to measure ETCO(the level of carbon dioxide in the air exhaled from the body normal value is about 38 mm Hg): Capnography helps to detect life-threatening problems in: Airway Breathing Circulation and MetabolismCapnography is a fast and reliable help to determinate respiratory difculties, wrong connections of airway adapters, leaks in the ventilator circuit due to its placement in the respiratory circuit. An early detection by capnography might help to avoid inadequate oxygen supply of the body. ETCO2 Measurement (Capnography)www.nihonkohden.net 69 Debrillators > ETCO2 MeasurementETCO2 Measurement (Capnography)The necessity of monitoring ETCO2 is recognized by various health care associations guidelines:Canadian Anesthesia Society (CAS)Guidelines for Sedation January, 2012 Anesthesia Patient Safety Foundation (APSF)Monitoring with Use of Post-op Opioids August, 2011 American Society for Anesthesiologists (ASA)Standards for Basic Anesthetic Monitoring July, 2011 Association of Anaesthetists of Great Britain & Ireland (AAGBI) The use of capnography outside the operating theatre May, 2011 American Association of Respiratory Care (AARC) CPG for Capnography/CapnometryDuringMechanical Ventilation April, 2011 British Royal Collegeof AnesthetistsAirwayRecommendation (NAP4) March, 2011 European Resuscitation Council (ERC)Guidelines for Resuscitation November, 2010 American Heart Association (AHA)Resuscitation Guideline November, 2010 Suck inSampling tubeSidestream MethodIn a sidestream system, a gas sample is removed from the patients airway anddelivered to a distant sensor.Measurement values delayed.Not possible with NIHON KOHDEN debrillators.CapnometerCO2 SensorCO2 SensorMainstream MethodIn a mainstream system, the sensor is located directly in the patients breathing circuit.Real time measurement values.CapnometerIs CO2 the only gas to measure?Is the patient a neonate?Is the patient intubated?Mainstream measurementYesYesYesYesNoNoMulti-gas measurementPlease use NIHON KOHDENpatient monitors!CO2 sensor kit P907 (TG-920P) & P908 (TG-921T3)Both intubated & non-intubatedEmergencyIs a humidier or nebulizer used?CO2 sensor kit P909 (TG-970P)R805 (YG-211T) Airway adapter adult (> 7 kg)CO2 sensor kit P909 (TG-970P)R805 (YG-211T) Airway adapter adult (> 7 kg)CO2 sensor kit P903 (TG-900P)R801 (YG-101T) Airway adapter adult, (> 10 kg)With nebulizerNoIntubatedR804 (YG-111T) Airway adapter (> 7 kg)Non-intubatedNoV921 (YG-120T) Nasal adapter (> 10 kg) V922 (YG-121T) Nasal/Oral adapter (>10 kg) V923 (YG-122T) Nasal/Oral adapter with O supply tube adapter (> 10 kg)NKD-02-Cap Oxygen cannulaNo measurement possibleNoStart ETCO2 Selection GuideNormal capnograph and ETCO2 waveformETCO2 shows clinical and technical problems ETCO2 Measurement OverviewThe best way to observe the patients respitatory conditionNormal range: steep rising and at expiratory phase Hyperventilation HypoventilationmmHgPaCO2 levelETCO24535Hypoventilation Increasing CO Malignant high fever Pain of light anesthesiaNormal rangeHyperventilationDecreasing COPulmonary embolismDeep anesthesiaTrend Downward UpwardDisconnection in breathing circuitAsphyxiaVentilator stopHyperventilationDecreasing COPulmonary embolism Temperature decreasePartial obstruction ofbreathing circuitSudden disappearance of CO2 waveformHypoventilationTemperature increaseMalignant high fever40404040Breathing circuit abnormality Respiratory abnormalitySudden decrease of CO2Gentle expiratory phase Breathing circuit abnormality Obstructive defect, bronchial spasm ETCO2=PaCO240 40Sudden decrease of CO2 toward zero Gentle expiratory phase Ventilation disconnection Rebreathing40 40Zero CO2 or very low CO2Cumulative irregular respiratory waveform Esophageal intubation Spontaneous breathing40 40CO2monitorBloodcirculationBreathingAirwayMetabolismPulmonary circulationGas exchangeConnector VentilatorRespiratory CircuitFresh gas CO2 absorberConditions reected by ETCO25 phases of the capnographBeginning ofexhalationStart exhalationof CO2in alveoliof the lungPlateau of CO2 in alveoli of the lungInhalation phaseEnd of exhalationETCO2 and PaCO2 show ventilation and pulmonary blood ow condition46 mmHg 46 mmHg40 mmHg ( PaCO2)40 mmHg ( ETCO2)40 40 40 46 404043 mmHg ( PaCO2)20 mmHg ( ETCO2)40 mmHg ( PaCO2)Normal ventilation Abnormal ventilation and normal pulmonary blood owNormal ventilation and abnormal pulmonary bloodow46 mmHg 46 mmHg 46 mmHg 46 mmHg40 mmHg ( ETCO2)Early detection of trouble in breathing or ventilation equipmentInadequateventilation Kink DisconnectionApnea ObstructionEsophageal intubationLeakMalfunctionIndequategas owCO2 Measurement is useful in many hospital sitesER ORICU With ventilator or nebulizerSedation Neonate PSG Both intubated and non-intubated cap-ONE CO2 SensorNihon Kohden Unique Sensing Technology4040 040 ETCO2 MainstreamApplicationFieldsofAirwayAdaptersfor Intubated Patients ApplicationFieldsofNasalAdaptersfor Non-Intubated PatientsEmergency / Pre-hospital Care Detection of endotracheal tube displacement Control of CPR ecacy ROSC detection (Return of Spontaneous Circulation) Oxygenation management Airway circuit management Keeping ICP appropriate by checking ETCO2 level (i.e. patients with craniocerebral injury CCI) Detection of respiratory distress (occlusion, connection leak, accidental extubation, ventilator trouble etc.) Detection of poor pulmonary perfusion Apnea monitor Detection of eectiveness of treatmentTransport / Pre-hospital Care Detection of changes in respiratory status (over- or underventilation of trauma / shockvictims; COPD patients) Detection of respiratory depression of sedated patients or anaesthesia withoutintubation Spot-checking of ETCO2 level & respirationrate of critically ill non-intubated patients Detection of eectiveness of treatmentwww.nihonkohden.net 72 Disposable accessories are intended for single use only, on one patient, during a single examination! Do not re-use disposable accessories! Reusable accessories are intended for repeated patient use on diferent patients during diferent examinations. Please make sureto clean reusable accessories after each patient or between diferent applications to prevent or reduce the risk of cross infections!Intubated Expired ETCO2Supply CodeP906ModelTG-901T3DescriptionCO2 Sensor Kit for Intubated Patients, semi-quantitative measurement, incl. CO2 sensor and CO2 adapter, expiratory CO2, cable length: 3.0 m For Airway Adapters: R801For current products: TEC-5500/7700Packing unit: 1 pcs P903 TG-900P CO2 Sensor Kit for Intubated Patients, semi-quantitative measurement, incl. P922A/K981, expiratory CO2, cable length: 3.0 m For Airway Adapters: R801For current pr