Enraf-Nonius Endomed 182 USA User manual

Brand: Enraf-Nonius

Model: Endomed 182 USA

Type: User manual

Endomed 182

Operating Instructions

Enraf-Nonius B.V.

P.O. Box 12080

3004 GB Rotterdam

The Netherlands

Tel: +31 (0)10 – 20 30 600

Fax: +31 (0)10 – 20 30 699

info@enraf-nonius.nl

www.enraf-nonius.com

Part number: 1416.753-41

2nd edition, August 2005

Endomed 182

Operating Instructions

Content

1 Product Description .................................................................................................................... 5

1.1 Therapy possibilities............................................................................................................ 5

2 Foreword ...................................................................................................................................... 5

2.1 Product liability .................................................................................................................... 5

2.2 Limitations of liability ........................................................................................................... 5

3 Precautionary instructions......................................................................................................... 6

4 Installation.................................................................................................................................... 6

5 Package Contents ....................................................................................................................... 7

5.1 Standard Accessories ......................................................................................................... 7

5.2 Optional Accessories .......................................................................................................... 7

6 Indications/Contraindications Adverse Effects for Electrical Stimulation............................ 7

6.1 Interferential, Premodulated and (Burst) TENS .................................................................. 7

6.1.1 Indications.............................................................................................................................7

6.1.2 Contraindications ..................................................................................................................7

6.1.3 Warnings...............................................................................................................................7

6.1.4 Precautions ...........................................................................................................................8

6.1.5 Adverse Effects.....................................................................................................................8

7 User Maintenance........................................................................................................................ 8

8 Technical Maintenance ............................................................................................................... 8

9 Unit Orientation ........................................................................................................................... 9

10 Interferential and Isoplanar Vector.......................................................................................... 10

10.1 Waveform description .................................................................................................... 10

10.2 Operation Step-by-Step ................................................................................................. 11

11 Pre-modulated ........................................................................................................................... 12

11.1 Waveform description .................................................................................................... 12

11.2 Operation Step-by-Step ................................................................................................. 12

12 TENS ........................................................................................................................................... 13

12.1 Waveform description .................................................................................................... 13

12.2 Operation Step-by-Step ................................................................................................. 14

13 Burst TENS................................................................................................................................. 15

13.1 Waveform description .................................................................................................... 15

13.2 Operation Step-by-Step ................................................................................................. 15

14 Protocols .................................................................................................................................... 16

14.1 Protocol selection........................................................................................................... 16

14.2 Programming ................................................................................................................. 16

14.3 Return to default manufacturer settings ........................................................................ 17

14.4 Protocol parameter settings........................................................................................... 17

15 Stimulator Output Parameters ................................................................................................. 18

16 Illustrations ................................................................................................................................ 18

16.1 Interferential current waveform...................................................................................... 18

16.2 Premodulated and Isoplanar Vector waveform ............................................................. 18

16.3 TENS waveform............................................................................................................. 19

16.4 Burst TENS waveform ................................................................................................... 19

16.5 Modulation program 1-1................................................................................................. 19

16.6 Modulation program 6-6................................................................................................. 19

16.7 Modulation program 1-30............................................................................................... 20

17 Technical Specifications .......................................................................................................... 20

18 Pictures ...................................................................................................................................... 21

1 Product Description

The Endomed 182 offers a new dimension in electrotherapy treatments. It offers three Pain Management

waveforms that are available on two channels. There are 30 factory programmed protocols available, that

can be changed by the user.

The Endomed 182 is a prescription device that should only be used under the supervision or by the order

of a physician or other licensed healthcare provider.

1.1 Therapy possibilities

The Endomed 182 offers the following therapy possibilities:

• Electrotherapy with Interferential current.

• Electrotherapy with Isoplanar vector current.

• Electrotherapy with Pre-modulated current.

• Electrotherapy with asymmetric biphasic pulsed current (TENS).

• Electrotherapy with asymmetric biphasic pulsed current (TENS) in burst mode.

The therapies are available on two channels, that operate synchronously. The current amplitude can be

set individually on each channel. Parameter settings apply to both channels together.

2 Foreword

This manual has been written for the owners and operators of the Endomed 182. It contains general

instructions on operation, precautionary practices, maintenance and parts information. In order to

maximize use, efficiency and the life of your unit, please read this manual thoroughly and become familiar

with the controls as well as the accessories before operating the unit.

Specifications put forth in this manual were in effect at the time of publication. However, owing to Enraf-

Nonius BV policy of continual 'improvement, changes to these specifications may be made at any time

without obligation on the part of Enraf-Nonius BV.

2.1 Product liability

A law on Product Liability has become effective in many countries. This Product Liability law implies,

amongst other things, that once a period of 10 years has elapsed after a product has been brought into

circulation, the manufacturer can no longer be held responsible for possible shortcomings of the product.

2.2 Limitations of liability

To the maximum extent permitted by applicable law, in no event will Enraf-Nonius or its suppliers or

resellers be liable for any indirect, special, incidental or consequential damages arising from the use of or

inability to use the product, including, without limitation, damages for loss of goodwill, work and

productivity, computer failure or malfunction, or any and all other commercial damages or losses, even if

advised of the possibility thereof, and regardless of the legal or equitable theory (contract, tort or

otherwise) upon which the claim is based. In any case, Enraf-Nonius’ entire liability under any provision of

this agreement shall not exceed in the aggregate the sum of the fees paid for this product and fees for

support of the product received by Enraf-Nonius under a separate support agreement (if any), with the

exception of death or personal injury caused by the negligence of Enraf-Nonius to the extent applicable

law prohibits the limitation of damages in such cases.

Enraf-Nonius can not be held liable for any consequence resulting from incorrect information provided by

its personnel, or errors incorporated in this manual and / or other accompanying documentation (including

commercial documentation)

The opposing party (product’s user or its representative) shall disclaim Enraf-Nonius from all claims

arising from third parties, whatever nature or whatever relationship to the opposing party.

3 Precautionary instructions

1. CAUTION: Read, understand and practice the precautionary and operating instructions. Know

the limitations and hazards associated with using any electrical stimulation device. Observe the

precautionary and operational decals placed on the unit.

2. CAUTION: Do not operate the Endomed 182 when connected to any unit other than Enraf-

Nonius BV devices. Do not operate the unit in an environment of short-wave diathermy use.

3. WARNING: Federal law restricts this device to sale by, or on the order of, a physician or licensed

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

licensed practitioner.

4. CAUTION: DO NOT use sharp objects such as a pencil point or ballpoint pen to operate the

buttons on the control panel as damage may result.

5. WARNING: Equipment not suitable for use in the presence of flammable anesthetics mixture with

air, oxygen, or nitrous oxide. The warning symbol for this hazard is prominently displayed on the

cabinet.

6. WARNING: This device should be kept out of the reach of children.

7. WARNING: 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.

8. CAUTION: This unit should be operated, transported and stored in temperatures between 50 °F

and 104 °F (10 °C and 40 °C), with Relative Humidity ranging from 10%-90%.

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

electrotherapy.

4 Installation

Initial Set-up Instructions

• Remove the Endomed 182 unit and any additional items ordered from the carton and inspect for

damage that may have occurred during shipment.

• Check that the voltage rating on the serial decal located on the mains adapter ENB-1530 (100 V

– 240 V) corresponds with the available mains supply.

• Connect the mains adapter ENB-1530 to connector [14].

• Connect the mains adapter to a wall socket. The flashing dot in the upper display [3]. indicates

that the unit is connected to the mains supply and stand-by.

CAUTION

• DO NOT attempt to use Direct Current (DC).

• DO NOT place unit in a location where the power cord could be tripped over or pulled out during

treatment.

• DO NOT connect the Endomed 182 to another type of adapter than type ENB-1530 as this

adapter is part of the supply circuit on which the device’s safety depends.

Mains supply connections must comply with the national requirements regarding medical rooms.

The Endomed 182 is double insulated and does not require a grounded mains outlet for safe operation.

5 Package Contents

1416.921 Endomed 182

5.1 Standard Accessories

The following accessories are included with your Endomed 182:

3444.057 Self adhesive electrodes, size 50x50mm, 1 sheet of 4 pc

3444.058 Self adhesive electrodes, size 50x90mm, 1 sheet of 4 pc

1416.753 Operating manual Endomed 182

3444.101 Adapter cable, conform FDA CFR 898

3444.102 Electrode cable 2mm, 2 pc conform FDA CFR 898

3444.110 Mains adapter 15 Volt / 3,4 Ampere, ENB-1530

3444.111 Mains cable

5.2 Optional Accessories

3444.056 Self adhesive electrodes, size 32mm Ø, 1 pack = 10 sheets of 4 pc

3444.135 Self adhesive electrodes, size 50mm Ø, 1 pack = 10 sheets of 4 pc

3444.143 Self adhesive electrodes, size 70mm Ø, 1 pack = 10 sheets of 4 pc

3444.057 Self adhesive electrodes, size 50x50mm, 1 pack = 10 sheets of 4 pc

3444.058 Self adhesive electrodes, size 50x90mm, 1 pack = 10 sheets of 4 pc

3444.146 Self adhesive electrodes with double lead, size 50x100mm, 1 pack = 10 sheets of 2 pc

1497.801 Remote control 2 channels

1416.800 Holder for remote control 1497.801

6 Indications/Contraindications Adverse Effects for Electrical

Stimulation

6.1 Interferential, Premodulated and (Burst) TENS

6.1.1 Indications

• Symptomatic relief of chronic, intractable pain. Management of pain associated with post-

traumatic or postoperative conditions.

6.1.2 Contraindications

• This device should not be used for symptomatic pain relief unless etiology is established or

unless a pain syndrome has been diagnosed.

• This device should not be used on patients with demand type cardiac pacemakers.

• This device should not be used over cancerous lesions.

• Electrode placements must be avoided that apply current to the carotid sinus region (anterior

neck).

• Electrode placements must be avoided that apply current transcereberally (through the head).

• Electrode placements must be avoided that apply current transthoracically (the introduction of

electrical current into the heart may cause cardiac arrhythmias).

6.1.3 Warnings

• The long-term effects of chronic electrical stimulation are unknown.

• Safety has not been established for the use of therapeutic electrical stimulation during pregnancy.

• Adequate precautions should be taken when treating individuals with suspected or diagnosed

heart problems, or epilepsy.

• Benefits of Interferential stimulation have not been established for pain of central origin.

• This device is to be used as a symptomatic treatment for pain and has no curative value.

Patients should be cautioned and their activities regulated if pain is suppressed that would

otherwise serve as a protective mechanism.

• Electronic monitoring equipment (such as ECG monitors and ECG alarms) may not operate

properly when electrical stimulation is being utilized.

6.1.4 Precautions

• Isolated cases of skin rash may occur at the site of electrode placement following long-term

applications. The irritation may be reduced by use of an alternate conductive medium or an

alternative electrode placement.

• Effectiveness of this treatment is dependent upon patient selection.

6.1.5 Adverse Effects

• Skin irritation and burns beneath the electrodes have been reported with the use of therapeutic

electrical stimulation.

7 User Maintenance

To clean, turn unit off and unplug the power supply. Clean the unit with a damp cloth. Do not use

abrasive cleaners. A small amount of mild household detergent may be used, if desired.

Between patient uses, patient applied parts should be wiped clean with a clean damp cloth, then use

another clean cloth to clean with a hospital grade germicide. Follow germicide manufacturer directions.

Some highly concentrated germicide mixtures could damage the product if not diluted in accordance with

directions of the germicide manufacturer.

8 Technical Maintenance

No attempt should be made to disassemble the unit. Maintenance and all repairs should be carried out by

authorized personnel only. The manufacturer will not be held responsible for the results of maintenance

or repairs by unauthorized persons.

This unit operates with high voltages. Servicing of the Endomed 182 should be referred to qualified

service technicians or returned directly to the distributor. To assure continued compliance with FDA 21

C.F.R. 1050.10 standards, the Endomed 182 should be calibrated and safety tested at least once each

year. The producer recommends that all service work be performed by the distributor. However, a service

manual can be obtained by writing to the factory for those who are qualified to service the device and are

fully aware of their responsibilities.

9 Unit Orientation

See page 20.

[1] On / off button.

Use this button to switch the unit on and off.

[2] Current waveform display

This display shows the current selection using LED’s. To change the current waveform push button [16].

[3] Display for Beat frequency and Frequency Modulation

This display shows the Beat frequency or Frequency Modulation. The display mode can be changed with

button [4].

[4] Selection button Beat frequency or Frequency Modulation

With this button you can change the read-out mode of display [3] and the function of the adjustment

buttons [5] from Beat frequency to Frequency Modulation.

[5] Adjustment buttons for Beat frequency and Frequency Modulation

Use this [-] / [+] buttons to adjust the Beat frequency and Frequency Modulation.

[6] Display for timer and indicators for Modulation Program

The numerical display shows the treatment time and the LED’s indicate the selected Modulation

Program.

[7] Selection button for Modulation Program

Selection button for the Modulation Program. The Modulation Program selection is indicated with a LED

in display [6].

[8] Adjustment buttons for the treatment time

Use this [-] / [+] buttons to adjust the timer.

[9] Display for amplitude read-out in channel 1

Shows current amplitude in channel 1, channel selection and balance.

[10] Display for amplitude read-out in channel 2

Shows current amplitude in channel 2.

[11] Selection button channel 1 or 2

Use this button to select the channel in which the amplitude is adjusted with buttons [13].

[12] Connector for patient cable.

Connection for the patient cable for both channels.

CAUTION:

Connection of accessories other than the ones specified by the manufacturer can adversely affect the

safety of the patient and correct functioning of the equipment, and is therefore not permitted.

For combined applications only use Enraf-Nonius type BF equipment. The very low leakage current of

this type of equipment ensures absolutely safe therapy.

[13] Adjustment buttons for the Amplitude and factory programmed protocols

Use this [+]/[-] buttons to adjust the current amplitude or to select a factory programmed protocol.

[14] Supply Connector

Connector for the external mains adapter.

[15] Memory button

To activate the memory recall or store function. Read-out is on display [9] en [10]. This button gives you

access to the factory programmed protocols.

[16] Selection button Current Waveform

Use this button to select the current waveform. The waveform selection is displayed on display [2]

[17] Connection plug remote control

Connector for the optional remote control unit. The remote control unit provides two sets of up/down keys

with which the current amplitude can be set individually in each channel. Additionally a Stop key is

provided, with which a running therapy can be terminated.

10 Interferential and Isoplanar Vector

10.1 Waveform description

Interferential

With this therapy method four electrodes are used and two non modulated currents leave the equipment.

The frequency of one channel is fixed, while the other channel has a variable frequency, based on the

Beat frequency and Frequency Modulation settings. Interference occurs where the two currents intersect

within the tissue. The modulation depth depends on the direction of the currents, and can vary from 0 to

100 %. 100 % modulation depth only occurs at the diagonals (and hence at the intersection) of the two

currents. This is, of course, a theoretical situation, based on the assumption that the tissue is

homogeneous. In the real situation, the tissue is heterogeneous, so that the current balance between the

two channels has to be used to get the 100 % modulation depth (Fig. 1). The current balance can also be

used to compensate for differences in sensation occurring under the electrode pairs.

Fig. 1

In the interferential method, the modulation

depth is only 100 % at the diagonals.

Isoplanar vector method with dynamic vector technique

The dynamic vector technique is intended to increase the area where effective stimulation occurs.

Amplitude modulation occurs in the equipment and a special phase relation between the two channels

ensures a 100% modulation depth between the four electrodes in all positions.

The advantage of this method is a less critical positioning of the four electrodes so

that the affected tissue will be treated effectively. The sensation of the Isoplanar

vector mode is soft and equally divided over the whole treatment area ( modulation

depth is 100%)

Press button [16] to select the Interferential or the Isoplanar Vector waveform.

Beat Frequency defines the channel frequency difference in Interferential mode and the rate at which the

amplitude is modulated in the Isoplanar vector mode. To change the Beat frequency press button [4] to

select “Beat frequency” and use the + and – buttons [5] to change its value.

Frequency Modulation defines a variable frequency range that is summed to the Beat frequency. I.e,

when the Beat frequency is set to 80 Hz and the Frequency Modulation is set to 40 Hz, the final

frequency will vary from 80 – 120 Hz. To change the Frequency Modulation, press button [4] to select

Frequency Modulation and then use the + and – buttons [5] to change its frequency range.

Modulation Program defines the time and sequence in which the frequency will sweep through the

Frequency Modulation range. See for the available Modulation Programs fig 16.5 – 16.7. The Modulation

Program is selected with button [7].

Treatment Time is displayed under [6]. To change the time parameter, press the buttons [8].

Amplitude is displayed under [9], for channel 1 and [10] for channel 2. To change the amplitude press

button [11] to select “1+2” and use + and – buttons [13] to change its value. The amplitude in channel 1

and 2 will change simultaneously.

Balance increases the amplitude in one channel and reduces it with the same amount in the other

channel. To change the balance press button [11] to select “Balance” and use + and – buttons [13] to

change its value. The Balance control is not available in the Isoplanar Vector mode.

10.2 Operation Step-by-Step

Switch on

• Connect the standard mains adapter to connector [14].

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1].

During the start-up period a self-test is run.

• Connect the cable adapter to connector [12].

• Connect the electrode cables to the cable adapter.

• Fix the electrodes to the patient.

Therapy selection.

• Push button [16] to select 4P for Interferential current or 4P + W for Isoplanar Vector. The

selected waveform is indicated on display [2] with one or two large green LED’s.

Adjusting Beat frequency.

• Select the Beat frequency read-out with button [4]. LED  is turned on.

• Adjust the Beat frequency with buttons [5]. Its value appears on display [3].

Adjusting Frequency Modulation.

• Select Frequency Modulation read-out with button [4]. LED * is turned on.

• Adjust the Frequency Modulation range with buttons [5]. Its value appears on display [3].

Adjusting Modulation Program.

• Adjust the Modulation Program with button [7]. Three options are available: 1-1, 6-6, 1-30. The

selection is indicated with a LED.

Adjusting Treatment time.

• Adjust the treatment time with the buttons [8]. Read-out is on display [6].

Adjusting the Amplitude on channel 1 and 2.

• Push button [11] to select “amplitude”. LED’s 1 and 2 are turned on. Push buttons [13] to set the

amplitude in channel 1 and 2 simultaneously.

Adjusting the Balance between channel 1 and 2 (not available in Isoplanar Vector mode).

• Push button [11] to select “balance”. LED X is turned on. Push buttons [13] to change its

value. The effect on the amplitude is visible on display [10].

Stop the treatment.

• Set the Treatment timer to zero or select another current waveform.

11 Pre-modulated

11.1 Waveform description

With Pre-modulated current therapy the Beat frequency is not generated by interference in the tissue but

by amplitude modulation in the equipment. Its main advantage is that it can be applied with only two

electrodes. Pre-modulated current therapy provides a good alternative to Interferential treatment,

especially when treating areas of the body where four electrodes cannot be utilized.

Beat Frequency defines the rate with which the amplitude is modulated. To change the Beat frequency

press button [4] to select “Beat frequency” and use the + and – buttons [5] to change its value.

Frequency Modulation defines a variable frequency range that is summed to the Beat frequency. I.e,

when the Beat frequency is set to 80 Hz and the Frequency Modulation is set to 40 Hz, the final

frequency will vary from 80 – 120 Hz. To change the Frequency Modulation, press button [4] to select

Frequency Modulation and then use the + and – buttons [5] to change its frequency range.

Modulation Program defines the time and sequence in which the frequency will sweep through the

Frequency Modulation range. See for the available Modulation Programs fig 16.5 – 16.7. The Modulation

Program is selected with button [7].

Treatment Time is displayed under [6]. To change the time parameter, press the buttons [8].

Amplitude is displayed under [9], for channel 1 and [10] for channel 2. To change the amplitude press

button [11] to select channel 1 or 2 and use + and – buttons [13] to change its value.

11.2 Operation Step-by-Step

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

During the start-up period a self-test is run.

• Connect the cable adapter to connector [12].

• Connect the electrode cables to the cable adapter.

• Fix the electrodes to the patient.

Therapy selection.

• Push button [16] to select 2P for Pre-modulated. The selected waveform is indicated on display

[2] with a large green LED.

Adjusting Beat frequency.

• Select the Beat frequency read-out with button [4]. LED  is turned on.

• Adjust the Beat frequency with buttons [5]. Its value appears on display [3].

Adjusting Frequency Modulation.

• Select Frequency Modulation read-out with button [4]. LED * is turned on.

• Adjust the Frequency Modulation range with buttons [5]. Its value appears on display [3].

Adjusting Modulation Program.

• Adjust the Modulation Program with button [7]. Three options are available: 1-1, 6-6, 1-30. The

selection is indicated with a LED.

Adjusting Treatment time.

• Adjust the treatment time with the buttons [8]. Read-out is on display [6].

Adjusting the Amplitude on channel 1 and 2.

• Push button [11] to select channel 1 or 2 and push buttons [13] to set the amplitude in the

selected channel.

Stop the treatment.

• Set the Treatment timer to zero or select another current waveform.

12 TENS

12.1 Waveform description

TENS (Transcutaneous Electrical Nerve Stimulation) is the application of electrodes to the skin with the

aim of reducing pain by stimulating the thick afferent nerve fibers. In view of the fact that other current

types such as diadynamic currents, 2-5 current and interferential currents also stimulate the nerves via

the skin, the choice of the term TENS is somewhat unfortunate.

With TENS there generally is an alternating current, characterized by a variable phase duration and a

variable phase interval, which can be used to vary the frequency. The phase duration is generally very

short, varying from 10 to 250 µs.

Thus, the TENS current types make it possible to stimulate the nerve fibers selectively.

The best-known types of TENS application are Conventional TENS (high-frequency, low-intensity TENS)

with a frequency between 80 and 100 Hz, and low frequency, high-intensity TENS ('acupuncture-like

TENS') with a frequency of less than 10 Hz. More recently other frequencies and current types (Burst

TENS) have been used.

Asymmetrical biphasic TENS waveform

Phase Duration is the elapsed time from the beginning to the termination of the pulse phase. See fig

16.2 for details. In the Endomed 182 the phase duration is fixed at 150 µs.

Pulse Frequency defines the repetition rate of the pulses in Hz or pps (pulses per second). To change

the Pulse frequency press button [4] to select “Pulse frequency” and use the + and – buttons [5] to

change its value.

Frequency Modulation defines a variable frequency range that is summed to the Pulse frequency. I.e,

when the Pulse frequency is set to 80 Hz and the Frequency Modulation is set to 40 Hz, the final

frequency will vary from 80 – 120 Hz. To change the Frequency Modulation, press button [4] to select

Frequency Modulation and then use the + and – buttons [5] to change its frequency range.

Modulation Program defines the time and sequence in which the frequency will sweep through the

Frequency Modulation range. See for the available Modulation Programs fig 16.5 – 16.7. The Modulation

Program is selected with button [7].

Treatment Time is displayed under [6]. To change the time parameter, press the buttons [8].

Amplitude is displayed under [9], for channel 1 and [10] for channel 2. To change the amplitude press

button [11] to select channel 1 or 2 and use + and – buttons [13] to change its value.

12.2 Operation Step-by-Step

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

During the start-up period a self-test is run.

• Connect the cable adapter to connector [12].

• Connect the electrode cables to the cable adapter.

• Fix the electrodes to the patient.

Therapy selection.

• Push button [16] to select  for TENS. The selected waveform is indicated on display [2] with a

large green LED.

Adjusting Pulse frequency.

• Select the Pulse frequency read-out with button [4]. LED  is turned on.

• Adjust the Pulse frequency with buttons [5]. Its value appears on display [3].

Adjusting Frequency Modulation.

• Select Frequency Modulation read-out with button [4]. LED * is turned on.

• Adjust the Frequency Modulation range with buttons [5]. Its value appears on display [3].

Adjusting Modulation Program.

• Adjust the Modulation Program with button [7]. Three options are available: 1-1, 6-6, 1-30. The

selection is indicated with a LED.

Adjusting Treatment time.

• Adjust the treatment time with the buttons [8]. Read-out is on display [6].

Adjusting the Amplitude on channel 1 and 2.

• Push button [11] to select channel 1 or 2 and push buttons [13] to set the amplitude in the

selected channel.

Stop the treatment.

• Set the Treatment timer to zero or select another current waveform.

13 Burst TENS

13.1 Waveform description

Burst TENS consists of a train or 'burst' of pulses at a fixed burst rate of 2 Hz. Each burst lasts for 100 ms

and the number of pulses in the burst depends on the selected Pulse frequency. At a Pulse frequency of

100 Hz, 10 pulses are available in each burst.

Burst TENS waveform

Phase Duration is the elapsed time from the beginning to the termination of the pulse phase. See fig

16.2 for details. In the Endomed 182 the phase duration is fixed at 150 µs.

Pulse Frequency defines the repetition rate of the pulses in Hz or pps (pulses per second). To change

the Pulse frequency press button [4] to select “Pulse frequency” and use the + and – buttons [5] to

change its value.

Frequency Modulation defines a variable frequency range that is summed to the Pulse frequency. I.e,

when the Pulse frequency is set to 80 Hz and the Frequency Modulation is set to 40 Hz, the final

frequency will vary from 80 – 120 Hz. To change the Frequency Modulation, press button [4] to select

Frequency Modulation and then use the + and – buttons [5] to change its frequency range.

Modulation Program defines the time and sequence in which the frequency will sweep through the

Frequency Modulation range. See for the available Modulation Programs fig 16.5 – 16.7. The Modulation

Program is selected with button [7].

Burst Frequency defines the burst rate. In the Endomed 182 the burst rate is fixed at 2 Hz. Each Burst

lasts for 100 ms.

Treatment Time is displayed under [6]. To change the time parameter, press the buttons [8].

Amplitude is displayed under [9], for channel 1 and [10] for channel 2. To change the amplitude press

button [11] to select channel 1 or 2 and use + and – buttons [13] to change its value.

13.2 Operation Step-by-Step

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

During the start-up period a self-test is run.

• Connect the cable adapter to connector [12].

• Connect the electrode cables to the cable adapter.

• Fix the electrodes to the patient.

Therapy selection.

• Push button [16] to select +. for Burst TENS. The selected waveform is indicated on

display [2] with two large green LED’s.

Adjusting Pulse frequency.

• Select the Pulse frequency read-out with button [4]. LED  is turned on.

• Adjust the Pulse frequency with buttons [5]. Its value appears on display [3].

Adjusting Treatment time.

• Adjust the treatment time with the buttons [8]. Read-out is on display [6].

Adjusting the Amplitude on channel 1 and 2.

• Push button [11] to select channel 1 or 2 and push buttons [13] to set the amplitude in the

selected channel.

Stop the treatment.

• Set the Treatment timer to zero or select another current waveform.

14 Protocols

The Endomed 182 is supplied with 30 factory programmed protocols, that contain frequently used

treatment parameters on positions P1 – P30. These parameters are listed in section 14.4.

14.1 Protocol selection

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

During the start-up period a self-test is run.

• Connect the cable adapter to connector [12].

• Connect the electrode cables to the cable adapter.

• Fix the electrodes to the patient.

Program selection

• Push button [15]

• Select a program number (P 1 - P 30 ) with buttons [13]. Display [9+10] shows the program

number, the other displays show the parameters of the selected program.

Start the treatment

• Wait until the program number disappears from display [9+10].

• Start the program by adjusting the amplitude.

• The countdown starts.

Stop the treatment

• Adjust the timer to zero or select another current waveform

14.2 Programming

The parameters stored program number P0 – P30 can be changed at will. Program P0 holds the

parameters that will be set when the apparatus in is turned on. This position is ideal to store the most

frequently used parameters.

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

During the start-up period a self-test is run.

Program selection

• Push button [15]

• Select a program number (P0 - P 30 ) with buttons [13]. Display [9+10] shows the program

number, the other displays show the parameters of the selected program.

• Select a waveform and adjust its parameters

Storing

• Push program button [15] for a minimum of 3 seconds.

• The parameters will be stored under the previously selected program number. The store

operation will be confirmed with a double beep.

14.3 Return to default manufacturer settings

Switch on

• Connect the standard mains adapter to connector [14]

• Connect the mains adapter plug to the mains socket.

• Switch the unit on with the button [1]

Program selection

• Push button [15].

• Select any program number between (P0 - P 30) with buttons [13]. Display [9+10] shows the

program number.

• Push + and – buttons [13] together and release them after a double beep.

The manufacturer settings are restored.

14.4 Protocol parameter settings

Program

Number

Waveform Beat

Frequency

Modulation

Program

Treatment time

1 Premodulated 50 Hz 50 Hz 1-30 15 min

2 Premodulated 100Hz 50Hz 1-30 15 min

3 Premodulated 100 Hz 50 Hz 1-30 15 min

4 Premodulated 120 Hz 50 Hz 6-6 20 min

5 Premodulated 50 Hz 50 Hz 1-1 15 min

6 Premodulated 50 Hz 0 Hz - 30 min

7 Premodulated 100 Hz 50 Hz 1-1 15 min

8 Interferential 100 Hz 50 Hz 1-30 20 min

9 Premodulated 150 Hz 50 Hz 1-30 10 min

10 Interferential 80 Hz 50 Hz 1-30 20 min

11 Premodulated 100 Hz 75 Hz 1-30 15 min

12 Premodulated 130 Hz 0 Hz 1-30 10 min

13 Premodulated 150 Hz 100 Hz 6-6 15 min

14 Premodulated 150 Hz 100 Hz 6-6 10 min

15 Premodulated 10 Hz 40 Hz 1-1 10 min

16 Interferential 100 Hz 50 Hz 6-6 15 min

17 Premodulated 100 Hz 30 Hz 1-1 15 min

18 Interferential 80 Hz 40 Hz 6-6 15 min

19 Isoplanar 50 Hz 50 Hz 1-30 15 min

20 Asym. TENS 150 Hz 50 Hz 1-1 20 min

21 BURST TENS 100 Hz - - 15 min

22 Asym. TENS 180 Hz 50 Hz 1-1 20 min

23 Asym. TENS 150 Hz 50 Hz 1-30 20 min

24 BURST TENS 80 Hz - - 15 min

25 Asym. TENS 150 Hz 80 Hz 1-1 20 min

26 Asym. TENS 150 Hz 80 Hz 1-30 20 min

27 Asym. TENS 80 Hz 80 Hz 1-30 15 min

28 Asym. TENS 80 Hz 30 Hz 6-6 15 min

29 BURST TENS 80 Hz - - 15 min

30 Asym. TENS 80 Hz 80 Hz 1-30 15 min

15 Stimulator Output Parameters

Parameter Interferential Isoplanar vector Premodulated TENS

Asymmetrical

Burst TENS

Carrier frequency 4000 Hz 4000 Hz N/A N/A N/A

Beat frequency 5 – 200 Hz 5 – 200 Hz 5 – 200 Hz N/A N/A

Pulse frequency N/A N/A 1 – 200 Hz 20 – 200 Hz

Frequency

modulation.

0 – 180 Hz 0 – 180 Hz 0 – 180 Hz 0 – 180 Hz N/A

Modulation

program

1-1, 6-6, 1-30s 1-1, 6-6, 1-30s 1-1, 6-6, 1-30s 1-1, 6-6, 1-30s N/A

Phase duration N/A N/A N/A 150µs 150µs

Burst frequency N/A N/A N/A N/A 2 Hz

Amplitude 0 – 99 mA 0 – 99 mA 0 – 99 mA 0 – 99 mA 0 – 99 mA

Voltage (max) 150 Volt 150 Volt 150 Volt 150 Volt 150 Volt

Treatment time 0 – 60 min. 0 – 60 min. 0 – 60 min. 0 – 60 min. 0 – 60 min.

N/A = Not Applicable

All parameter settings apply to both channels simultaneously. There are no individual channel settings,

except for the current amplitude.

16 Illustrations

4kHz

100mA max.

16.1 Interferential current waveform

Beat frequency

100mA max.

16.2 Premodulated and Isoplanar Vector waveform

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Enraf-Nonius Endomed 182 USA User manual

Enraf-Nonius Endomed 182 USA User manual

Enraf-Nonius Endomed 182 USA User manual

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