Enraf-Nonius s Endopress 442 Touch User manual

Brand: Enraf-Nonius

Model: s Endopress 442 Touch

Type: User manual

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FT05MI06 – User Manual – Rev02 - ENG

ENDOPRESS 442

It is important to read the following instructions carefully before using this device

properly and safely. The manufacturer cannot be held responsible for the results of using

this device for any purposes other than described in these operating instructions.

If the use of this device may have caused or contributed to an undesirable event such as

death or serious injury to the user, the manufacturer AND the competent authority of the

Member State MUST be notified immediately!

FT05MI06 - User Manual - Rev02 – ENG

2023-03-02

0476

Instructions for use

EN109-1442761-40

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Table of contents

1 Introduction ...................................................................................................................................................... 3

2 Description-symbols used and device markings ................................................................................ 7

3 Device components ....................................................................................................................................... 9

4 Package contents ......................................................................................................................................... 10

5 Installation ...................................................................................................................................................... 11

6 Intended use and intended user ............................................................................................................ 12

7 Indications ...................................................................................................................................................... 12

8 Contra-indications ....................................................................................................................................... 12

9 Precautionary instructions ........................................................................................................................ 13

10 Operation ........................................................................................................................................................ 15

11 Application information ............................................................................................................................ 23

12 Maintenance and troubleshooting ........................................................................................................ 23

13 Specifications ................................................................................................................................................. 25

14 Contact ............................................................................................................................................................. 27

15 Product liability ............................................................................................................................................. 27

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1 Introduction

Foreword

We are pleased that you have purchased a ENDOPRESS 442.

This ENDOPRESS 442 is specially designed for the demands of the physical and manual therapist.

During development and production of this ENDOPRESS 442 a great deal of care was put into the

reliability, safety, ease of use and durability.

The result is a device with extraordinary versatility based on simplicity of operation.

The ENDOPRESS 442 is equipped with a touch screen.

The user-friendly interface includes set protocols, parameters that can be set manually and favorites can

be created and stored for future use.

Device Description

The Endopress 442 is a unit for compression therapy. The Endopress 442 system works with pneumatic

leg and arm garments for a non-invasion treatment of lymph edema, insufficiencies of the veins. The

segments of the garments fill up with air whereby the compression rises in the arm or leg to the adjusted

pressure. The garments are composed of several independent sectors, in fact, a different pressure value

can be set in each sector. The maximum pressure that can be set is 150 mm Hg.

The device needs to be connected to the power supply to function and is equipped with a clear touch

screen display that allows you to navigate the software.

Frequently Used Functions

Frequently used functions are:

 Connection of the kit-points in the appropriate connector;

 Switch on / off the device;

 Change and setting of reference parameters;

 Loading a preset protocol or a favorite protocol;

 Start of therapy;

 Creation and saving of protocols;

 Stop therapy using the stop or pause key;

 Switching off the DM through the ON-OFF switch;

 Cleaning and repositioning of the kit points after each single treatment.

Principle of Operation

The Lymphatic System

A basic function of the lymphatic system is to supervise the maintenance of correct water tissue balance:

this action is conducted on the lymph in order to purify it from the substances “collected” by it on the

outside, and then send it back into circulation ready to perform its functions.

This action tends to develop in places where excessive “liquid stagnation” in tissues is signalled for

various reasons.

The lymphatic system is structurally similar to the more well-known venous system. It actually follows it

branching out into peripheral channels and collection “centers” distributed at various levels.

The surface lymph vessels differ from the deeper ones in the lower limbs.

The surface vessels run along the surface and give origin to a rich lymphatic network distributed on the

plantar and dorsal surfaces of the feet. The deeper vessels accompany the deep blood vessels and

collect the lymph that comes from the muscles and the bones of the lower limbs.

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The surface lymph vessels converge in the inguinal lymph nodes that are at the surface in the fold of

the groin area.

Points of highest concentration of lymph nodes

(Elbows, knees and along the collar are slightly less).

The arrows show the direction of lymph flow.

The deep lymphatics meet the anterior tibial lymph nodes along their path, situated in the higher,

anterior part of the leg, and the lymph nodes of the popliteal cavity (4-5 in number), situated on

the posterior face of the knee. They then reach the deep inguinal lymph nodes that are located

deep in the inguinal area.

In addition to the superficial lymph vessels of the lower limb, the surface inguinal lymph nodes (18-

20 in number) collect the lymphatics of the buttocks, perineum, the anus, the external genital

organs, and lower part of the abdomen. In addition to the deep popliteal lymphatic vessels, the

deep inguinal lymph nodes (2-3 in number) mostly collect what comes from the surface inguinal

lymph nodes.

The largest of these lymph nodes is called the Cloquet lymph node and is located higher up and

deeper down than the others, extruding therefore into the abdominal cavity. Main Groups of lymph

nodes of the lower limbs

Main groups of lymph nodes of the lower limbs

These lymph node centers of the lower limbs are very important in the functioning of the whole

system, as they act as collection tanks, and also purify the lymph coming from the lower limbs. The

lymph stays in these centers as long as necessary to be filtered, i.e. purified, and is then poured

back into the renal system with increase of diuresis. This increase of the diuresis is often

encountered after therapy with pressure systems (massage pressure therapy) and confirms

activation of the lymphatic system mechanisms in the lower limb tissues.

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General Concepts of lymphatic circulation Casley-Smith Pump

Lymphatic circulation is not just a system that intervenes in cases of “over fullness” but also permits

the rapid absorption of proteins and colloids.

Thanks to the lymphatic system, large or insoluble plasmatic protein molecules that cannot

normally be reabsorbed by the venous system are reintroduced into the blood circulation.

The molecules pass the capillary membrane in a manner that is inversely proportional to their

weight: the amount of albumin is higher in lymph, which has a lower molecular weight than

globulin. Of course variations of the capillary permeability caused by increase in intercapillary

hydrostatic pressure or toxic-anoxic factors for example, mean that there is an increase in that

transfer, in a modification of the lymph flow or its composition.

For further clarification, we provide Rossing’s findings on the matter:

1. the intravascular masses of albumin and immunoglobulin depend on the amount of

synthesis and the amount of fractionated catabolism;

2. The ratios of intravascular masses to the total masses depend on the amount of

transcapillary escape and on the amount of extravascular return;

3. the amount of transcapillary escapes are inversely related to the molecular weights of the

proteins; the amount of transcapillary escape increases with the filtration pressure in the

vessels, i.e. with the loss at micro vessel level, as seen in diabetes mellitus;

4. the amount of extravascular return reflects the lymphatic protein transport and is inverse

to the extravascular transit time. It is of the same magnitude for albumin, lg.G, and perhaps

a bit less for lg.M;

5. the extravascular transit time includes a wide series of transit times: short (liver, kidneys,

lungs), long (skin, muscles, with maximum deposit of extravascular proteins);

6. in most cases of hypoproteinemia, the amount of intravascular/extravascular plasmatic

protein distribution changes in favor of the intravascular space;

7. the extravascular pathological build-up of plasmatic protein occurs in a few diseases, and

when the transcapillary escape increases without a corresponding increase in the amount

of lymphatic return. This can be seen in cirrhosis with ascites, in untreated myxedema and

in some types of cancer, particularly those with hepatopathy and ascites. If anything, the

extravascular build-up of plasmatic protein will occur in the tumoral and post-operative

tissue in the wounds.

The main function of the lymphatic system is therefore to allow its penetration by the previously

mentioned molecules, prevent escape, and encourage progression.

By way of the capillary filtration, protein molecules and water are plentiful in blood circulation, thus

causing a build-up of liquids osmotically linked to the protein in the interstitial tissue.

The liquid leads to an imbibition of the tissue, stretching the endothelial cells of the initial lymphatics

and further opening the lymphatic interendothelial junctions.

Other movements intervene in keeping the junctions “open”:

 muscular movement;

 rhythmic contractions of the arterial vessels

 the negative intrathoracic pressure;

 the cells and any other elementary corpuscles that are pushed through the open junctions in

the initial lymphatics. During their transit, these corpuscles act like dilators, keeping the passage

free through the junction of the initial capillary lumen. In the most active areas of the body, the

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products of cellular metabolism increase blood flow and the capillary permeability, so liquid

contained in the interstitial tissue increases further, and its pressure keeps the input routes

accessible to the lymphatic capillaries.

An increase in local tissue pressure follows this initial stage, caused by muscular contraction that

compresses the initial lymphatics, and therefore pushing the lymph to close the intercellular junctions.

In this phase, a certain quantity of water spreads out from the lymphatics and the lymph itself becomes

more concentrated than the interstitial liquid.

The higher compression releases the system from fibrils attached to the lymphatic endothelium. The

lymphatics that have been compressed like this will obviously be smaller with lower diameters, being

adhesive endothelial cells and therefore overlapping with the junctions hermetically closed.

At this point, the third phase begins: a further compression on the initial lymphatics pushes the lymph

through the first valve, the sudden lowering of pressure means that the lymphatics expand again, and

the intercellular junctions open up again.

This mechanism is called the “CASLEY-SMITH lymphatic pushing pump”. Intercellular lymphatic

junctions have been defined as “aspiration valves” while the first lymphatic valve is known as the “escape

valve”.

The initial lymphatics comprise several aspirations and pushing pumps whose function is not strictly

mechanical but can be adapted to different needs.

Importance of pressure between Lymphatic and Interstitial space

Mc Master measured the pressure values both of lymphatic capillaries, and of the interstitial space,

finding:

 Lymphatic capillary pressure = 0.7 +/- 0.3 cm. H2O.

 Interstitial space pressure = 1.9 +/- 0.5 cm. H2O.

This pressure difference explains the direction of liquid flow and of the protein molecules of the blood

capillaries to the interstitial tissue, and of the interstitial tissue to the lymphatic capillaries.

The difference found (0.3 +/- 0.5 cm. H2O), clearly shows how much pressure variation is needed to start

up the lymph. In pathological conditions, if there is an increase in interstitial pressure, the difference will

be higher. This explains the increase in production of lymph in the presence of edema. The variation in

absorption potential also holds importance at the frontier-zone between the basic substance and the

lymphatic capillary.

The propulsion of lymph is therefore mainly due to the gradient generated between a zone of higher

pressure and a zone of lower pressure. For the entire lymphatic cycle, many other mechanisms

contribute to the progression of lymph, that carry greater or lesser importance (as previously

mentioned). Among these are the structures of the lymphatic vessel walls and the unidirectional valves

which are also antigravitational mechanisms (with the lymph nodes).

The speed of progression of the lymph varies widely according to the various zones, the functional

situation, and according to whether there are any obstacles to normal flow.

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Device Design

Particular attention has been paid to the design, easy operation, function and safety of the equipment

and the result is this modern, compact unit, which offers an extremely logical operative sequence

supported by a clearly legible display. A wide range of therapeutic applications guaranteed patient and

therapist safety make, the Endopress 442 of the highest quality

The power entry module can be found under the device the unit and consists of a three-pole socket

for the cord set. The on/off switch is in at the bottom of the side panel next to an extractible fuse box

with two fuses (see Technical specifications).

In order to switch on the device, insert correctly the three-pole plug of the cord set into the power entry

module and use the main switch.

Safety Features

The ENDOPRESS 442 unit has a simple and intuitive software design.

All working parameters are handled and controlled in real time by a sophisticated microprocessor

electronic circuit which clearly displays its functions accompanied by acoustic signaling. The beginning

and the end of the therapy are signaled by a start/end sound of the treatment.

For hygienic reasons, the treatment must not be performed using the sleeves in direct contact with the

patient's skin. For this it is necessary to perform the treatment by interposing clothes (shirt or leggings)

between the patient's limbs and the sleeves.

The device is in wheeled configuration and for safety reasons the wheels are equipped with brakes.

Once the device has been positioned, all four wheels must be locked.

Essential Performance

No essential performances are foreseen for the ENDOPRESS 442 device.

2 Description-symbols used and device markings

Symbol used Description

Follow the instructions in the Instructions for Use.

It is important that you read, understand and observe the precautionary and

operating instructions

Label indicating devices sensitive to electrostatic charges, placed near the

connector for serial connection.

No pushing label applied behind the trolley at the top center

Label indicating no access and placed near the rear wheels of the device.

Identification labels for point kits (bracelets and leggings) and for their case,

is applied as a flag on the end of the tube

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Type BF applied part complying with the specified requirements to provide a

higher degree of protection against electric shock than that provided by

type B applied parts.

Input features

Network power supply

Absorbed power

Network emission frequency

Temperature Range.

Indicates acceptable temperature range

Humidity Limits.

Indicates acceptable relative humidity

Atmospheric Pressure.

Indicates the range of atmospheric pressure to which the medical device can

be safely exposed.

Waste electrical items that can be recycled.

Indicates the electrical and electronic components of the device can be

recycled and has to be disposed separately.

Manufacturer name, address and date of manufacture.

Model of device Endopress 442

Commercial code EME / ENRAF

Serial Number

Indicates the serial number so that a specific medical device can be

identified.

Fuse

Ratings are described in chapter “Specifications”

0476

CE Mark along with number indicates conformity with European Council of

directive concerning Medical Devices and this device is under the direct

supervision of the Notified Body.

Output features

Pressure leaving the device

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3 Device components

Part Description Function

1 Wheels with

brakes

Lower and raise the lever to lock and unlock the wheels.

Once the device is positioned, lock all four wheels to prevent

unintentional movement

2 Foot Do not put the device in a place where someone could trip over the

foot.

3 Connector for

power cord

Plug the power cord into the appropriate connector and then plug it into

the socket.

4 On/Off Switch

and

fuse box

0 device turned off, 1 device turned on

Two spare fuses are contained in the fuse box. For their replacement

refer to the paragraph 12 Maintenance and troubleshooting - Fuse

replacement procedure.

5 Column /

6 Sleeve

connector

Multiple output pneumatic connector for connecting the sleeves.

7 Push Handle The correct transport position of the machine requires that the device is

moved only by pushing with both hands and gripping the handle.

8 Touch Screen User interface that allows the operator tocheck the device and change

the parameters of the treatment protocols.

9 USB

Connection

Binding of a USB stick. It is used for software updates.

Do not connect powered USB devices externally or other computer

equipment because this could negatively affect patient safety.

The power supply current of this connection is limited to 100 mA. Do

not connect USB mass storage devices as hard drives powered by USB,

because this could result in data loss. They are allowed USB sticks only

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Part Description Function

Connection [6] is intended for the connection of type BF applied parts comply with the leakage

current requirements of IEC 60601-1.

4 Package contents

Below mentioned Standard accessories will be contained in the main device packaging.

Standard accessories

1x MAC9160 / 1442921 ENDOPRESS 442 230 Vac or 1x MAC9161 / 1442922 ENDOPRESS 442 115 Vac

1x Power Cord

2x Spare fuses

1x User Manual

Optional accessories

ACC9270 / 1442802 Lower limbs sleeves 9 chambers

ACC9280 / 1442804 Single upper limb sleeve 7 chambers

ACC9281 / 1442803 Upper limbs sleeves 5 chambers

ACC9290 / 1442808 Pouch for storing accessories

The ACCESSORIES that can be replaced by the RESPONSIBLE ORGANIZATION and that can influence

the conformity of the EM EQUIPMENT:

 Pneumatic cable for linking the KIT POINT. The cable length must be less than 3m.

Do not use accessories other than the original ones supplied: these could damage the machine

and void the warranty claim. Should problems or installation problems arise, contact the Enraf-

Nonius BV technical assistance service.

Use of accessories other than those specified or supplied by Enraf-Nonius BV could result in

increased electromagnetic emissions or decreased electromagnetic immunity level of the device,

resulting in improper operation.

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5 Installation

Unpacking the device

The device weighs approximately 22 kg without the sleeves. The weight of the three sleeves is 9Kg.

It must be unpacked by at least 2 persons.

Inspection

Immediately upon unpacking the device, perform the following steps:

 Verify the delivery documents to make sure that the delivery is complete.

 Verify that the packaging contains all the items listed in the standard accessories list (Refer chapter-

Package Contents in this Instructions for Use).

 Check the external components and accessories for possible damage due to transport.

In case of damage from transport is noticed, contact your local distributor.

DO NOT USE the device!

The use of any other cable other than the one supplied is strictly FORBIDDEN as it affects the

safety of the patient and the correct functioning of the device

Connection to mains supply

Plug in the device to a wall socket using the mains cable.

To disconnect the device:

 Switch off the device using on/off button [4].

 Unplug the device from the wall socket.

Use of any other cable other than the supplied cable is strictly PROHIBITED as it

affects patient safety and the proper function of the device.

Make certain that the device is electrically grounded by connecting only to a grounded

electrical service receptacle conforming to the applicable national and local electrical codes.

Do not put the device in a place where someone could trip over the cable power supply or

where it may run the risk of being pulled out of the socket current during treatment.

Do not try to use the device if it is not properly grounded. Make sure that the device is

electrically grounded by connecting it only to a socket grounded electrical current conforming

to national and local electrical standards applicable to medical environments.

Transport condition

The push handle is designed to push the device.

Be careful not to tip the device over when pulling it.

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6 Intended use and intended user

The ENDOPRESS 442 may only be used to support patients during physical and manual therapy.

The use of ENDOPRESS 442 is strictly limited to operators, such as physiatrists, physiotherapists and

pain therapists, who, by virtue of their professional education, would offer a guarantee of an appropriate

use and the complete safety of the patient.

In fact, the operator must be appropriately qualified and he carefully studied the contents of the user

manual in order to use the device; or, it must operate under the supervision of a health professional

adequately qualified to use the machine, able to understand the benefits and the limits of therapy and

to work in conditions of safety for the person undergoing treatment.

The machine may be used in hospital and clinic premises, as long as it operated by qualified personnel

and in compliance to what stated in this user manual.

The ENDOPRESS 442 device has been produced in accordance with directive MED 93/42/CEE on

medical devices.

7 Indications

The ENDOPRESS 442 can be used for the below mentioned symptoms or medical conditions:

 Circulatory insufficiency;

 Lymphatic stasis;

 Lipodistrophy;

 Lymphedema;

 Cutaneous fibrosis;

 Hard edema;

 Surgery follow-up;

 Hypotonia*

*treatment not covered by medical CE.

8 Contra-indications

The ENDOPRESS 442 MUST NOT be used during or for:

 Heartfailure;

 Severeperipheralarterialinsufficiency;

 Plexopathyandneuropathy;

 Unresolvedinfectiousphenomena;

 Skinlesions:erysipelas,mycosis,pyoderma;

 Lymphangitis;

 Acutedeepveinthrombosis;

 Acuteinflammationoftheveins(thrombo‐phlebitis);

 Pulmonaryedema;

 Malignanttumors;

 Arterialsystemdisorders;

Side-effects

No Side effects are reported due to the normal use of ENDOPRESS 442.

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9 Precautionary instructions

This device should be used only under the continued supervision of a physician or licensed

practitioner.

This device should be kept out of the reach of children.

The patient and the device must be in sight of the therapist at all times.

Should the use of this device lead to an undesirable event such as death or serious injury to the

user, the manufacturer and the competent authority of the Member State MUST be informed

without delay!

In case of damage from transport is noticed, contact your local distributor.

DO NOT USE the device!

Use of any other cable other than the supplied cable is strictly PROHIBITED as it

affects patient safety and the proper function of the device.

Use of accessories and cables other than those specified or provided by the manufacturer of this

equipment could result in increased electromagnetic emissions or decreased electromagnetic

immunity level of this equipment and result in improper operation.

Keep yourself informed of the contra-indications.

Do not use this device in so called “Wet Rooms” (hydrotherapy rooms).

Do not use the device after extreme temperature fluctuations.

Should any liquid or foreign object fall into the cabinet, turn off the power, unplug the device

and have it checked by your nearest authorized service dealer before any further operation.

Good air circulation is essential to prevent internal heat build-up. Do not install the device in a

location near the heat sources such as radiators or air ducts and prevent exposure to direct

sunlight.

The device should be installed in such a way, that its warmth can be passed on to the

surroundings. Do not cover the ventilation openings.

Care must be taken when operating this equipment around other equipment. Potential

electromagnetic or other interference could occur to this or to the other equipment. Try to

minimize this interference by not using other equipment in conjunction with it.

Strictly follow the WARNINGS mentioned in the chapter “EMC Details”.

It is recommended to perform periodic maintenance every two years, in order to check:

 the intensity of any leakage currents;

 the continuity and thus the integrity, of the ground conductor;

 the correctness of the value of insulation resistance;

in order to ensure the electrical safety of the device, ensure that it is operating in a safe

guaranteed. For this kind of interventions you should contact a qualified service technician or

alternatively Enraf-Nonius or one of its authorized service centers.

Please ensure that you are well informed of the local rules and regulations regarding to the

removal of equipment and accessories.

This equipment is not suitable for use in the presence of flammable anesthetics mixture with

air, oxygen, or nitrous oxide.

Do not expose the device to direct sunlight, heat radiated from a heat radiator, excessive

amounts of dust, moisture, vibrations and mechanical shocks.

Before administering any treatment to a patient, you should become acquainted with the

operating procedures for each mode of treatment available, as well as the indications,

contraindications, warnings and precautions. Consult other resources for additional information

regarding the application of shortwave therapy.

Before performing any user maintenance, switch off the device and disconnect the plug from

the mains supply.

Do not use cleaning agents that contain strong alkalis, lye, acid, detergents with fluoride or

detergents with ammonia.

Use no liquid detergents, these can damage the device.

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In the case of ingress of liquids, unplug the device from the mains supply and have it checked

by an authorized person (see the paragraph on technical maintenance).

For safety purposes the cord set is provided with an earthed plug.

Make sure that power supply socket has been earthed.

The equipment must only be connected to the mains which are in conformity with EEC

standard directives. To avoid the risk of electric shock, in fact, this appliance must always be

connected to power supply networks with protective earth.

When using an extension lead, make sure that this has been earthed

Failure to comply with the above instructions may lead to dangerous electrical discharge

causing hazard to persons and the machine function.

Remember to perform the pressure therapy treatment avoiding direct contact between the

patient's skin and the sleeves. It is advisable to deliver the treatment by always placing clothes

between the patient's lower and upper limbs and the sleeves.

Do NOT OPEN the unity, as HIGH VOLTAGE ELECTRICITY is present and may prove VERY

DANGEROUS.

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10 Operation

Operation keys

Symbols used in the display panel:

Home - return to the Home screen

Back - return to the previous screen/option

Next - allows you to select the next option

Accept - Accept the selected option

Play - Start / Continue treatment

Pause - Treatment break

Stop - stops the treatment

Delete favorite

Store - Store therapy settings in a favorite.

Sounds on - indicates that sounds are enabled.

Sounds off - indicates that sounds are disabled.

Set up

Do not use the device after extreme temperature fluctuations!

Switch on

Turn on the unit using button [4].

The unit starts by running the self test.

At the end of the self-test, a beep sounds and the unit enters the main menu and is ready for use.

Once the device is turned on, before starting treatment, make sure that the kit points are worn

properly and that the Velcro is closed properly around the patient's limb.

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Home menu

From the Home menu, user can start a

treatment by selecting

1) A preset clinical protocol, or by

2) Retrieving a previously stored favorite

3) Setting a protocol manually.

User can also set the desired system settings

from home menu.

Mode of operation

All the control functions and the machine itself are handled and coordinated by a microprocessor: apart

from making available pre-memorized programs for application the microprocessor ensures that the

machine can be personalized and operate in a highly safe and efficient manner. Interfacing allows for

the operator to dialogue with the apparatus by means of large, clear graphic backlit liquid crystal display

screen (LCD): all the information for operation required by the operator, work status during operation

and any eventual errors are visualized. The following paragraphs illustrate the procedures to be carried

out and the technical specifications of the Endopress 442. They also deal with the different options

available from the selection of pre-programmed protocols for use in specific treatments as well as how

to determine the correct working parameters for “personalized” application.

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Parameters of the device

The displayed and modifiable parameters are

the same for Manual Operation, Favorites and

Clinical Protocols and they are: TREATMENT

TIME (min), PAUSE (sec), PRESSURE (mmHg), KIT

POINT and PRESSURE IN EACH SEGMENT (%).

Use the to start the therapy.

The parameters can also be changed after

starting the treatment.

When all parameters have been set, the newly

created combination can be saved as favorites:

a store button is available on the navigation bar

before starting the treatment.

To store the settings:

 tap the Store button in the navigation

bar;

 Enter the name of your favorite using

the keyboard;

 Tap to store your favorite under

the name you just entered.

The treatment is saved in the Favorites section.

TREATMENT TIME:

The treatment time can be changed:

 using the up and down arrows.

 selecting a preset duration.

The button confirms the set value

while the button returns to the

previous screen.

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PAUSE:

The pause time can be changed:

 using the up and down arrows.

 selecting a preset duration.

The button confirms the set value

while the button returns to the

previous screen.

PRESSURE:

The pressure can be changed:

 using the up and down arrows.

 selecting a preset pressure.

The button confirms the set value

while the button returns to the

previous screen.

SLEEVE:

In this section it is possible to select the sleeves

you intend to use for the execution of the

treatment. The possible sleeves are:

 Single arm sleeve (7 segment): delivery

of a treatment to a single upper limb;

 Double arm sleeves (5 segment):

delivery of a treatment to both upper

limbs;

 Lower limbs sleeves (9 sectors):

provision of treatment to both upper

limbs;

The button confirms the set value

while the button returns to the

previous screen.

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PRESSURE IN EACH SEGMENT:

In all the sleeves, for each segment it is possible

to set a specific pressure value. Select, in the

lower part of the display, the bar with the

percentages and a screen will appear where it is

possible:

 Select the reference sector using the

back and forward arrows;

 Modify the percentage value associated

with the selected sector using the + or -

keys;

The button confirms the set value

while the button returns to the

previous screen.

Pressure therapy must be carried out by applying the correct pressure fields and not interfering

with the physiology of arterial, venous or lymphatic circulation (which is why the arms and legs

are constructed in a herringbone structure with partially overlapping sectors). The maximum

level of pressure applied to the patient is also a very important parameter. In certain cases, this

value must be kept very low (for example if the pressure therapy is used for physiological

massage on patients for whom other types of active or passive movement is impractical). The

value can be higher in other applications such as anti-cellulite applications.

The Endopress 442 can supply a maximum pressure of 150 mmHg per segment. Treatments are

normally carried out between pressures of 40 and 80 mmHg. Higher pressures can only be used

in special cases under strict medical supervision.

The operator should limit the pressure applied in order to avoid opposing arterial flow.



Page 20 of 30 FT05MI06 – User Manual – Rev02 - ENG

Clinical protocols

When selecting Clinical Protocols, a list

of protocols will be displayed.

 Touch the treatment name to

select it.

 Press  icon to scroll up and

scroll down the page.

After reading the information on the

treatment, select to select the

displayed treatment.

A screen will appear in which it is

possible to view the reference

parameters set and modify them as

described in Manual operation.

The following table shows the preset treatments present in the ENDOPRESS 442 device. These

treatments cannot be deleted or overwritten by the user.

Basic

programs

Active sectors Suggested

sessions

(N°)

step 1 step 2 step 3 step 4 step 5 step 6 step 7 step 8 step 9

1 5 6 7 8 9 1 2 3 4 *

2 1 1.2 2.3 3.4 4.5 5.6 6.7 7.8 8.9 *

3 6 7 8 4 4.5 6 7 8 9 *

4 1 1.2 1,2,3

1,2,3

4.5

1,2,3

4,5,6

1,2,3

4,5,6

1,2,3

4,5,6

7,8

1,2,3

4,5,6

7,8,9

5 1 2 3 4 5 6 7 8 9 *

6 7 7.8 1 1.2 2.3 3.4 4.5 5.6 *

7 1 1 4 4 6 6 7 *

8 5 6 7 1 2 3 4 *

9 1 1.2 2.3 3.4 4.5 5.6 6.7 *

10 6 7 3 4 4.5 6 7 *

11 1 1.2 1,2,3

1,2,3

4.5

1,2,3

4,5,6

1,2,3

4,5,6

12 1 2 3 4 5 6 7 *

13 7 1 1.2 2.3 3.4 4.5 6 *

14 1 1 4 4 6 6 7 *

15 5 1 2 3 4 *

16 1 1.2 2.3 3.4 4.5 *

17 5 2 3 4 4.5 *

18 1 1.2 1,2,3

1,2,3

4.5 *

19 1 2 3 4 5 *

20 1 1.2 2.3 3.4 4.5 *

21 1 1 4 4 5 *

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Enraf-Nonius s Endopress 442 Touch User manual

Enraf-Nonius s Endopress 442 Touch User manual

Enraf-Nonius s Endopress 442 Touch User manual

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