Z-STIM IF250 * Interferential / Russian Stimulator

Transcription

1 Z-STIM IF250 * Interferential / Russian Stimulator User's Guide Amrex electrotherapy equipment a division of Amrex-Zetron, Inc. *Federal law (USA) restricts this device to sale by or on the order of a licensed practitioner licensed by the law of the state in which he practices to use or order the use of this device.

2 IF250 User's Guide Interferential/Russian Stimulator Revised February 2014 Copyright Amrex-Zetron, Inc All rights reserved. Printed in the United States of America The following are registered or trademarked by Amrex: Amrex Z-Stim Flextrode AMREX electrotherapy equipment a division of Amrex-Zetron, Inc Jackson Street Paramount, California (310) Toll Free Customer Service (800) Fax (310) amrex@amrex-zetron.com Web Site

3 Thank you... for selecting the Amrex Z-Stim IF250 Interferential/Russian Stimulator. We believe that you will find this instrument to be versatile, dependable and user friendly. The IF250 provides three widely used modalities: Quad-Polar True Interferential, Bi-Polar Interferential and Russian stimulation. Your IF250 has been manufactured by a group of dedicated, highly trained employees who exemplify the Amrex tradition, since 1935, of manufacturing therapeutic equipment of the highest quality while supporting you with prompt, courteous customer service. Upon receipt of your IF250, verify your accessories against the enclosed check list. Promptly return the postage paid Registration Card to Amrex. Save the original shipping carton and all packing materials. Please carefully review this User s Guide prior to operating the Amrex Z-Stim IF250 Interferential/Russian Stimulator. Should you have any questions regarding your new purchase, or need assistance, telephone Amrex Technical Services at (800) i

4 Limited Warranty Amrex-Zetron, Inc. (Manufacturer) warrants each instrument it manufactures to be free from defects in material and workmanship under normal use and service for a period of two (2) years from the date of purchase. This two year warranty extends only to the original purchaser and shall not apply to batteries, fuses, accessories or any instrument which has been subjected to misuse, neglect, accident or abnormal conditions of operation. The Manufacturer's obligation under this warranty is limited to repairing or replacing, at the Manufacturer's option, any instrument returned to the factory within two (2) years from the date of purchase. If the Manufacturer determines that the product fails to conform to this warranty due to misuse, alteration or abnormal condition of operation, including evidence that nonauthorized personnel have attempted to repair the device, the instrument will be repaired at customers expense. This warranty is exclusive and in lieu of all other warranties, expressed or implied, including but not limited to any other warranty of merchantability or fitness for any particular purpose. Manufacturer shall not be liable for any special, incidental or consequential damages, whether in contract, tort or otherwise. Service and Shipping Information Amrex Technical Services has a representative to assist you should your equipment require service or repair. It is necessary to obtain a Return Merchandise Authorization (RMA) number before returning equipment to the factory for warranty repair. Call our representative toll free (800) Damage, resulting from repairs made outside the factory, is not covered under the warranty. To maintain original design specifications, your Amrex IF250 must be calibrated and safety tested on an annual basis. Amrex strongly recommends that servicing be referred to the factory. Call toll free (800) Save the original shipping carton and all packing materials to safely return Amrex equipment to the factory for service; repair; annual calibration, electrical and mechanical safety check. All accessories, including the ac line cord, must be included with the returned instrument. The customer is responsible for all freight charges. The Manufacturer shall assume NO responsibility for damage in transit. ii

5 Contraindications Warnings Precautions THIS INSTRUMENT OPERATES ON 120 VOLTS AC 60 Hz. (unless otherwise indicated on the unit) AND MUST BE PROPERLY GROUNDED FOR SAFETY. The three wire power cord with "hospital grade" plug should be connected to a GROUNDED AC wall receptacle. It is the personal responsibility and obligation of the user to insure that this instrument is properly connected to the AC POWER source before use. Warning Risk of burns and fire. DO NOT use near conductive material such as metal bed parts or innerspring mattresses. Renew electrode cables upon evidence of deterioration. Use of controls, adjustment, or performance of procedures, other than those specified herein, may result in hazardous exposure to electrical energy. Important AMREX Intensity Reset Circuit: The Amrex IF250 incorporates a unique safety reset function as part of the Intensity controls. This is to prevent any sudden or inadvertent stimulation output to the patient in the event that: at power on, the Intensity controls are not set to the 0/Reset position enabling the audible "clicks" the treatment period has ended the Patient Treatment Stop Switch is activated the Reset Functions control is pressed the ac power is interrupted the Quad-Polar mode Channel 1 Intensity setting varies more than ± 20% from the Channel 2 Intensity setting for longer than 30 seconds When the Amrex IF250 safety reset functionis initiated, stimulator output will be discontinued immediately, the Reset Intensities indicator light will flash and an audible signal will be emitted from the generator. The Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", a treatment time selected, and the Start Timer control pressed before stimulator output can be activated. Note: The generator will default to factory settings unless the treatment period has ended without interruption or the Patient Treatment Stop Switch has been activated. Patient Treatment Stop Switch: When the Patient Treatment Stop Switch is activated, stimulator output will be discontinued immediately. The Reset Intensities indicator light will flash and an audible signal will be emitted from the generator. Stimulator output cannot be resumed until the Channel 1 Intensity and Channel 2 Intensity controls are returned to the 0/Reset position enabling the audible "clicks", a treatment time selected and the Start Timer control pressed. NOW the stimulator output can be activated. Note: All generator settings are maintained except the treatment time which reverts to the factory default setting of fifteen minutes. iii

6 Electrical Muscle Stimulation Contraindications Contraindicated for patients with cardiac demand pacemakers Should not be used on cancer patients Electrical Muscle Stimulation Warnings Long term effects of chronic electrical stimulation are unknown Safety has not been established for the use of electrical muscle stimulation during pregnancy Adequate precautions should be taken in the case of persons with suspected heart problems Adequate precautions should be taken in the case of persons with suspected or diagnosed epilepsy Do not stimulate over the carotid sinus nerves, especially in patients with a known sensitivity to the carotid sinus reflex Severe spasm of the laryngeal and pharyngeal muscles may occur when the electrodes are positioned over the neck or mouth. The contractions may be strong enough to close the airway or cause difficulty in breathing Electrical muscle stimulators should not be applied transcerebrally Electrical muscle stimulators should not be used over swollen, infected or inflamed areas or skin eruptions Caution should be used in the transthoracic application of electrical muscle stimulators in that the introduction of electrical current into the heart may cause arrhythmias Electrical muscle stimulators should be kept out of the reach of children Electrical Muscle Stimulation Precautions Precautions should be observed: When there is a tendency to hemorrhage following acute trauma or fracture Following recent surgical procedures when muscle contraction may disrupt the healing process Over the menstruating uterus Where sensory nerve damage is present by a loss of normal skin sensation Some patients may experience skin irritation or hypersensitivity due to the electrical stimulation or the conductive medium. The irritation can usually be reduced by use of an alternate conductive medium or alternate electrode placement. Skin irritation and burns beneath the electrodes have been reported with the use of electrical muscle stimulators. iv

7 Table of Contents Part 1 Overview... 1 Part 2 Power/Timer Section... 5 Part 3 Quad-Polar Interferential Modality... 9 Part 4 Bi-Polar Interferential Modality Part 5 Russian (2500 Hz) Modality Part 6 IF250 General Operation and Application Procedures General Operation of Quad-Polar Interferential Modality Interferential Burns Application of Electrical Muscle Stimulation Quad-Polar General Operation of Bi-Polar Interferential Modality Application of Electrical Muscle Stimulation Bi-Polar General Operation of Russian (2500 Hz) Modality Application of Electrical Muscle Stimulation Russian Adverse Effects - Shortwave Diathermy Interference Electrical Muscle Stimulation Indications Electrical Muscle Stimulation Contraindications Electrical Muscle Stimulation Warnings Electrical Muscle Stimulation Precautions Appendix A Specifications Appendix B References v

8 vi

9 Overview Part 1 AMREX The layout of the IF250 panel consists of controls, indicator lights, digital displays and output jacks. IF250 User's Guide 1

10 Part 1 In the illustration below, dashed lines surround each of the IF250's sections. A brief description of each section follows the illustration. Parts 2 through 5 of this manual contain detailed descriptions. 2 IF250 User's Guide

11 Power / Timer Section Overview Use Power / Timer Section to activate the main ac power, select the treatment modality, set the treatment duration and activate the timer. When the treatment is complete the generator will emit an audible signal and the Reset Intensities indicator light will flash. Quad-Polar Interferential Modality Section Select the beat frequency, set the intensities and monitor the output of the Standard or Dynamic Quad-Polar Interferential mode with the controls and digital displays. Bi-Polar Interferential Modality Section Select the amplitude modulation frequency, set the intensity and monitor the output of the Bi-Polar Interferential mode (single or dual channel) with the controls and digital displays. Russian (2500 Hz) Modality Section Set the intensity and monitor the output of the Continuous, Exercise or Rehab Russian (2500 Hz) mode (single or dual channel) with the controls and digital displays. IF250 User's Guide 3

12 Part 1 4 IF250 User's Guide

13 Power / Timer Section Part 2 AMREX In the illustration below, dashed lines surround the IF250's Power / Timer section. IF250 User's Guide 5

14 Part 2 The Power / Timer section of the IF250 panel is depicted below. Items referenced with circled numbers (1 9) are explained on the following page. 6 IF250 User's Guide

15 Power/Timer Section 1. QUAD-POLAR INTERFERENTIAL MODALITY INDICATOR LIGHT 2. MODE CONTROL: Selects the Quad-Polar, Bi-Polar or Russian modality. The selected modality indicator light will illuminate. The Russian modality indicator light will flash. Note: The Mode control is inoperable after the Start Timer control is pressed. 3. BI-POLAR INTERFERENTIAL MODALITY INDICATOR LIGHT 4. RUSSIAN (2500 Hz) MODALITY INDICATOR LIGHT 5. START TIMER CONTROL: Activates treatment timer when pressed. A flashing decimal point on the Power / Timer display indicates timer countdown. Note: After the Start Timer control is pressed, the Mode control is inoperable. 6. POWER / TIMER DISPLAY: Digital display of treatment duration. Ranges from 1 to 99 minutes. A flashing decimal point indicates timer countdown in 1 minute increments. 7. TIME CONTROL (INCREASE - upward arrow): Ranges from 1 minute to 99 minutes as indicated on the Power / Timer display. The default setting is 15 minutes. To adjust the treatment duration in one minute increments, press and release. For rapid adjustment, press and hold until the desired treatment duration setting is reached. The treatment duration setting may be increased during the treatment period. 8. TIME CONTROL (DECREASE - downward arrow): Ranges from 99 minutes to 1 minute as indicated on the Power / Timer display. The default setting is 15 minutes. To adjust the treatment duration in one minute increments, press and release. For rapid adjustment, press and hold until the desired treatment duration setting is reached. The treatment duration setting may be reduced during the treatment period. 9. POWER CONTROL: Controls the main ac power. When the power is turned on, the generator will self-test. All indicators will illuminate, an audible signal will be emitted and the generator will default to factory settings. If the intensity controls are not set to the 0/Reset position, the generator will emit a series of audible signals and the Reset Intensities indicator light will flash. The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The generator will default to factory settings. IF250 User's Guide 7

16 Part 2 8 IF250 User's Guide

17 Part 3 AMREX Quad-Polar Interferential Modality In the illustration below, dashed lines surround the IF250's Quad-Polar Interferential section. IF250 User's Guide 9

18 Part 3 The Quad-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (10 14) are explained on the following page. 10 IF250 User's Guide

19 Quad-Polar Interferential Modality 10. CONSTANT MODE AND SWEEP MODE INDICATOR LIGHTS 11. CONSTANT / SWEEP FREQUENCY MODE CONTROL: Selects a Constant or Sweep mode. The Constant mode provides is a preset beat frequency and the Sweep mode provides a preset beat frequency range. The indicator light for the selected mode will illuminate. The Constant or Sweep mode can be changed during the treatment period except when the Dynamic mode is activated. Note: Before changing the Constant or Sweep mode during the treatment period, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 12. CONSTANT / SWEEP FREQUENCY INDICATOR LIGHT ARRAY: Indicates the selected Constant mode beat frequency or the Sweep mode beat frequency range. 13. FREQUENCY CONTROL: Selects a Constant beat frequency or a Sweep beat frequency range. The indicator light for the selected beat frequency will illuminate. The Channel 2 Output frequency is 4000 Hz less the selected Constant mode beat frequency or Sweep mode beat frequency range. The Channel 1 Output frequency is 4000 Hz. Constant Mode Selects a preset beat frequency of : 1, 10, 30, 80, 130 or 150 Hz Sweep Mode Selects a preset beat frequency range of: ( Hz) Pain, (1-10 Hz) Edema, (1-150 Hz) Rehab, Hz, Hz, or Hz The Constant mode beat frequency selection or the Sweep mode beat frequency range selection can be changed during the treatment period except when the Dynamic mode is activated. Note: Before changing the Constant mode beat frequency or the Sweep mode beat frequency range during the treatment period, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 14. FREQUENCY DISPLAY: Digital display of the selected Constant mode beat frequency or Sweep mode beat frequency range. The digital display ranges from a minimum of 1 Hertz to a maximum of 150 Hertz. During the Sweep mode, the beat frequency is displayed as it alternates between the minimum to maximum value of the selected beat frequency range. IF250 User's Guide 11

20 Part 3 The Quad-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (15 18) are explained on the following page. 12 IF250 User's Guide

21 Quad-Polar Interferential Modality 15. CHANNEL 1 INTENSITY CONTROL : Regulates Channel 1 Intensity from Min to Max. The Channel 1 Intensity display will indicate the intensity in milliamps. The Channel 1 Intensity setting must not vary more than ±20% of the Channel 2 Intensity setting. If the intensity settings vary more than 20%, the intensity display for the channel with the greater intensity setting will flash for thirty seconds before: the intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays the treatment duration reduces to 00 as indicated on the Power / Timer display the Reset Intensities indicator light flashes and the generator emits a sequence of audible signals Note: When the treatment period has ended without interruption, the generator will revert to the above three conditions. The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. 16. CHANNEL 1 INTENSITY DISPLAY: Digital display of Channel 1 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. 17. CHANNEL 2 INTENSITY CONTROL: Regulates Channel 2 Intensity from Min to Max. The Channel 2 Intensity display will indicate the intensity in milliamps. The Channel 2 Intensity setting must not vary more than ±20% of the Channel 1 Intensity setting. If the intensity settings vary more than 20%, the intensity display for the channel with the greater intensity setting will flash for thirty seconds before: the intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays the treatment duration reduces to 00 as indicated on the Power / Timer display the Reset Intensities indicator light flashes and the generator emits a sequence of audible signals Note: When the treatment period has ended without interruption, the generator will revert to the above three conditions. The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. 18. CHANNEL 2 INTENSITY DISPLAY: Digital display of Channel 2 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. IF250 User's Guide 13

22 Part 3 The Quad-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (19 22) are explained on the following page. 14 IF250 User's Guide

23 Quad-Polar Interferential Modality 19. TREATMENT STOP JACK: Connection for the Patient Treatment Stop Switch. Note: When the Patient Treatment Stop Switch is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00, the Reset Intensities indicator light will flash and a sequence of audible signals will be emitted from the generator. Stimulator output cannot be resumed until: the Channel 1 Intensity and Channel 2 Intensity controls are returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The treatment time will default to the factory setting a treatment time is selected the Start Timer control is pressed NOW the stimulator output can be activated. 20. CHANNEL 1 OUTPUT JACKS: The Channel 1 Output jacks are black. 21. RESET INTENSITIES INDICATOR LIGHT: The Reset Intensities indicator light will flash and an audible signal will be emitted from the generator in the event that: at power on, the intensity controls are not set to the 0/Reset position enabling the audible "clicks" the treatment period has ended the Patient Treatment Stop Switch is activated the Reset Functions control is pressed the ac power is interrupted the Quad-Polar mode Channel 1 Intensity varies more than ± 20% from the Channel 2 Intensity for longer than 30 seconds To turn off the Reset Intensities indicator light and the audible signal, the Channel 1 Intensity control and Channel 2 Intensity control must be returned to the 0/ Reset position enabling the audible "clicks". Before stimulator output can be activated, set a treatment time and press the Start Timer control. Note: The generator will default to factory settings unless the treatment period has ended without interruption, the Patient Treatment Stop Switch is activated, or the Channel 1 Intensity varies more than ± 20% from the Channel 2 Intensity for longer than 30 seconds. 22. CHANNEL 2 OUTPUT JACKS : The Channel 2 Output jacks are white. IF250 User's Guide 15

24 Part 3 The Quad-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (23 25) are explained on the following page. 16 IF250 User's Guide

25 Quad-Polar Interferential Modality 23. DYNAMIC MODE INDICATOR LIGHT: The Dynamic mode indicator light will illuminate indicating that the Dynamic cycle has been activated. 24. DYNAMIC CONTROL: (QUAD-POLAR MODALITY ONLY) When Dynamic control is pressed, the Dynamic mode indicator light will illuminate indicating that the Dynamic cycle has been activated. The Channel 1 Intensity will decrease 50% and return to the original intensity setting. Then the Channel 2 Intensity will decrease 50% and return to the original intensity setting. This alternating cycle repeats every 8 seconds. Note: The Dynamic control can only be activated after Quad-Polar treatment has begun, unless one of the intensity displays is flashing. The settings for Channel 1 Intensity and Channel 2 Intensity may be independently reduced during treatment. If the Channel 1 Intensity and/or Channel 2 Intensity is increased above the original setting(s), the intensity display(s) will indicate the increased setting(s) by flashing. The intensity display(s) will continue to flash until the intensity is reduced to the original setting(s). The Dynamic control may be deactivated and reactivated during treatment unless one or both of the intensity displays are flashing. 25. RESET FUNCTIONS CONTROL: When the Reset Functions control is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00 Milliamps The Power / Timer display reduces to 00 Time in Minutes The Reset Intensities indicator light flashes and the generator emits a sequence of audible signals The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The generator will default to factory settings. IF250 User's Guide 17

26 Part 3 18 IF250 User's Guide

27 Part 4 AMREX Bi-Polar Interferential Modality In the illustration below, dashed lines surround the IF250's Bi-Polar Interferential section. IF250 User's Guide 19

28 Part 4 The Bi-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (10 14) are explained on the following page. 20 IF250 User's Guide

29 Bi-Polar Interferential Modality 10. CONSTANT MODE AND SWEEP MODE INDICATOR LIGHTS 11. CONSTANT / SWEEP FREQUENCY MODE CONTROL: Selects a Constant or Sweep mode. The Constant mode provides a preset amplitude modulation frequency and the Sweep mode provides a preset amplitude modulation frequency range. The indicator light for the selected mode will illuminate. The Constant or Sweep mode can be changed during the treatment period. Note: Before changing the Constant or Sweep mode during the treatment period, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 12. CONSTANT / SWEEP FREQUENCY INDICATOR LIGHT ARRAY: Indicates the selected Constant mode amplitude modulation frequency or the Sweep mode amplitude modulation frequency range for Channel 1 Output and Channel 2 Output. 13. FREQUENCY CONTROL: Selects a Constant amplitude modulation frequency or a Sweep amplitude modulation frequency range. The indicator light for the selected amplitude modulation frequency will illuminate. The Channel 1 Output and Channel 2 Output frequency is 4000 Hz amplitude modulated by the selected Constant mode frequency or Sweep mode frequency range. Constant Mode Selects a preset amplitude modulation frequency of: 1, 10, 30, 80, 130 or 150 Hz Sweep Mode Selects a preset amplitude modulation frequency range of: ( Hz) Pain, (1-10 Hz) Edema, (1-150 Hz) Rehab, Hz, Hz, or Hz The Constant mode amplitude modulation frequency selection or the Sweep mode amplitude modulation frequency range selection can be changed during the treatment period. Note: Before changing the Constant mode amplitude modulation frequency or the Sweep amplitude modulation frequency range during the treatment period, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 14. FREQUENCY DISPLAY: Digital display of the selected Constant mode beat frequency or Sweep mode beat frequency range. The digital display ranges from a minimum of 1 Hertz to a maximum of 150 Hertz. During the Sweep mode, the beat frequency is displayed as it alternates between the minimum to maximum value of the selected beat frequency range. IF250 User's Guide 21

30 Part 4 The Bi-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (15 18) are explained on the following page. 22 IF250 User's Guide

31 Bi-Polar Interferential Modality 15. CHANNEL 1 INTENSITY CONTROL : Regulates Channel 1 Intensity from Min to Max. The Channel 1 Intensity display will indicate the output intensity in milliamps. When the treatment period has ended without interruption: the output intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays the treatment duration reduces to 00 as indicated on the Power / Timer display the Reset Intensities indicator light flashes and the generator emits a sequence of audible signals The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. 16. CHANNEL 1 INTENSITY DISPLAY: Digital display of Channel 1 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. 17. CHANNEL 2 INTENSITY CONTROL : Regulates Channel 2 Intensity from Min to Max. The Channel 2 Intensity display will indicate the output intensity in milliamps. When the treatment period has ended without interruption: the output intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays the treatment duration reduces to 00 as indicated on the Power / Timer display the Reset Intensities indicator light flashes and the generator emits a sequence of audible signals The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. 18. CHANNEL 2 INTENSITY DISPLAY: Digital display of Channel 2 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. IF250 User's Guide 23

32 Part 4 The Bi-Polar Interferential section of the IF250 panel is depicted below. Items referenced with circled numbers (19 22) are explained on the following page. 24 IF250 User's Guide

33 Bi-Polar Interferential Modality 19. TREATMENT STOP JACK: Connection for the Patient Treatment Stop Switch. Note: When the Patient Treatment Stop Switch is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00, the Reset Intensities indicator light will flash and a sequence of audible signals will be emitted from the generator. Stimulator output cannot be resumed until: the Channel 1 Intensity and Channel 2 Intensity controls are returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The treatment time will default to the factory setting a treatment time is selected the Start Timer control is pressed NOW the stimulator output can be activated. 20. CHANNEL 1 OUTPUT JACKS: The Channel 1 Output jacks are black. 21. RESET INTENSITIES INDICATOR LIGHT: The Reset Intensities indicator light will flash and an audible signal will be emitted from the generator in the event that: at power on, the intensity controls are not set to the 0/Reset position enabling the audible "clicks" the treatment period has ended the Patient Treatment Stop Switch is activated the Reset Functions control is pressed the ac power is interrupted To turn off the Reset Intensities indicator light and the audible signal, the Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position enabling the audible "clicks". Before stimulator output can be activated, set a treatment time and press the Start Timer control. Note: The generator will default to factory settings unless the treatment period has ended without interruption or the Patient Treatment Stop Switch is activated. 22. CHANNEL 2 OUTPUT JACKS : The Channel 2 Output jacks are white. IF250 User's Guide 25

34 Part 4 The Bi-Polar Interferential section of the IF250 panel is depicted below. Item referenced with circled number (23) is explained on the following page. 26 IF250 User's Guide

35 Bi-Polar Interferential Modality 23. RESET FUNCTIONS CONTROL: When the Reset Functions control is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00 Milliamps The Power / Timer display reduces to 00 Time in Minutes The Reset Intensities indicator light flashes and the generator emits a sequence of audible signals The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The generator will default to factory settings. IF250 User's Guide 27

36 Part 4 28 IF250 User's Guide

37 Part 5 AMREX Russian (2500 Hz) Modality In the illustration below, dashed lines surround the IF250's Russian (2500 Hz) section. IF250 User's Guide 29

38 Part 5 The Russian (2500 Hz) section of the IF250 panel is depicted below. Items referenced with circled numbers (10-15) are explained on the following page. 30 IF250 User's Guide

39 Russian (2500 Hz) Modality 10. REHAB MODE INDICATOR LIGHT 11. EXERCISE MODE INDICATOR LIGHT 12. EXERCISE REHAB CONTROL: Selects the Exercise mode (10 seconds on, 10 seconds off) or Rehab mode (10 seconds on, 50 seconds off). Before selecting the Exercise or Rehab mode: the Start Timer control must be activated the Channel 1 Intensity control and/or the Channel 2 Intensity control must be set at the desired treatment level(s) the Russian (2500 Hz) modality indicator light must be flashing The indicator light for the selected Exercise or Rehab treatment mode flashes simultaneously with the Russian (2500 Hz) modality indicator light for 10 seconds to allow for initiation of the selected treatment mode. 13. START CYCLE CONTROL: Initiates the selected Exercise mode or Rehab mode. The selected mode indicator light will cease to flash and remain illuminated. To return to the continuous output Russian (2500 Hz) modality, press the Start Cycle control during treatment in the Exercise or Rehab mode. Note: Intensity can be increased during treatment in the continuous Russian (2500 Hz) output mode ONLY. If an attempt is made to increase the Channel 1 Intensity and/or Channel 2 Intensity during treatment in the Exercise or Rehab mode, the Channel 1 Intensity and/or Channel 2 Intensity display(s) will indicate the increased setting(s) by flashing until the intensity(s) is reduced to the level originally selected. 14. FREQUENCY DISPLAY: Digital display of the preset amplitude modulation. The frequency setting for Russian Stimulator Channel 1 Output and Channel 2 Output is 2500 Hz amplitude modulated at 50 Hz. 15. RESET FUNCTIONS CONTROL: When the Reset Functions control is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00 Milliamps The Power / Timer display reduces to 00 Time in Minutes The Reset Intensities indicator light flashes and the generator emits a sequence of audible signals The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The generator will default to factory settings. IF250 User's Guide 31

40 Part 5 The Russian (2500 Hz) section of the IF250 panel is depicted below. Items referenced with circled numbers (16 20) are explained on the following page. 32 IF250 User's Guide

41 Russian (2500 Hz) Modality 16. TREATMENT STOP JACK: Connection for the Patient Treatment Stop Switch. Note: When the Patient Treatment Stop Switch is activated, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00, the Reset Intensities indicator light will flash and a sequence of audible signals will be emitted from the generator. Stimulator output cannot be resumed until: the Channel 1 Intensity and Channel 2 Intensity controls are returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The treatment time will default to the factory setting a treatment time is selected the Start Timer control is pressed NOW the stimulator output can be activated. Note: When the Patient Treatment Stop switch is activated, the treatment time will default to the factory setting and the generator will default to continuous Russian (2500 Hz) modality. 17. CHANNEL 1 INTENSITY CONTROL : Regulates Channel 1 Intensity from Min to Max. Intensity is indicated in Milliamps on the Channel 1 Intensity display. Note: Intensity can be increased during treatment in the continuous output mode ONLY. If an attempt is made to increase the output intensity during treatment in the Exercise or Rehab mode, the Channel 1 Intensity display will flash until the intensity is reduced to the level originally selected. 18. CHANNEL 1 INTENSITY DISPLAY : Digital display of Channel 1 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. 19. CHANNEL 2 INTENSITY CONTROL : Regulates Channel 2 Intensity from Min to Max. Intensity is indicated in Milliamps on the Channel 2 Intensity display. Note: Intensity can be increased during treatment in the continuous output mode ONLY. If an attempt is made to increase the output intensity during treatment in the Exercise or Rehab mode, the Channel 2 Intensity display will flash until the intensity is reduced to the level originally selected. 20. CHANNEL 2 INTENSITY DISPLAY : Digital display of Channel 2 Intensity. Ranges from 0 to 99 milliamperes in one milliampere increments. IF250 User's Guide 33

42 Part 5 The Russian (2500 Hz) section of the IF250 panel is depicted below. Items referenced with circled numbers (21-23) are explained on the following page. 34 IF250 User's Guide

43 Russian (2500 Hz) Modality 21. CHANNEL 1 OUTPUT JACKS : The Channel 1 Output jacks are black. 22. RESET INTENSITIES INDICATOR LIGHT: The Reset Intensities indicator light will flash and a sequence of audible signals will be emitted from the generator in the event that: at power on, the intensity controls are not set to the 0/Reset position enabling the audible "clicks" the treatment period has ended the Patient Treatment Stop Switch is activated the Reset Functions control is pressed the ac power is interrupted To turn off the Reset Intensities indicator light and the sequence of audible signals, the Channel 1 Intensity control and Channel 2 Intensity control must be returned to the 0/Reset position enabling the audible "clicks". Before stimulator output can be activated, set a treatment time and press the Start Timer control. Note: The generator will default to factory settings unless the treatment period has ended without interruption, or the Patient Treatment Stop Switch is activated. 23. CHANNEL 2 OUTPUT JACKS: The Channel 2 Output jacks are white. IF250 User's Guide 35

44 Part 5 36 IF250 User's Guide

45 IF250 General Operation and Application Procedures Part 6 AMREX General Operation of Quad-Polar Interferential Modality 1. Connect the IF250's ac power cord to the IF250's ac receptacle and plug the "Hospital Grade" connector to a properly grounded 120Vac, 60Hz receptacle. 2. Connect the Patient Treatment Stop Switch to the Treatment Stop Jack. 3. Reduce the Channel 1 Intensity control and the Channel 2 Intensity control to the 0/Reset position enabling the audible "clicks". 4. Depress the Power control. The generator will self-test. All indicators will illuminate. An audible signal will be emitted and the generator will default to factory settings of: Quad-Polar Interferential modality Power/Timer display 15 minutes Frequency display 080 Hz Preset Sweep frequency range for Pain ( Hz) Channel 1 Intensity and Channel 2 Intensity displays 00 Milliamps Note: If the Intensity controls are not in the 0/Reset position, the generator will emit a sequence of audible signals and the Reset Intensities indicator light will flash. Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", to return to factory default settings. 5. Verify that the Quad-Polar Interferential modality indicator light is illuminated. If not, press the Mode control to select the Quad-Polar Interferential modality. IF250 User's Guide 37

46 Part 6 6. Press the Constant Sweep control to select Constant mode or Sweep mode. The Constant or Sweep mode indicator light will illuminate. Note: The Constant Sweep control selection can be changed anytime during treatment, except when the Dynamic cycle is activated. However, to avoid possible patient discomfort, before changing the Constant Sweep control selection, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 7. Press the Frequency control to select the desired Constant beat frequency or Sweep beat frequency range. The selected beat frequency indicator light will illuminate and the Frequency display will indicate the selection. Note: The Constant beat frequency or the Sweep beat frequency range can be changed anytime during treatment. However, to avoid possible patient discomfort, before changing the Constant beat frequency or Sweep beat frequency range, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks". 8. Verify that the Channel 1 Intensity and Channel 2 Intensity controls are set at the 0/Reset position. 9. Prepare the four pad electrodes and apply them to the patient. The pad electrodes may be held in place by means of retention straps or weight bags. Hand the Patient Treatment Stop Switch to the patient and explain its function. Note: When the Patient Treatment Stop Switch button is pressed, stimulator output will be discontinued immediately. The Channel 1 Intensity and Channel 2 Intensity displays reduce to 00, the Reset Intensities indicator light will flash and a sequence of audible signals will be emitted from the generator. Stimulator output cannot be resumed until: the Channel 1 Intensity and Channel 2 Intensity controls are returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the sequence of audible signals. The treatment time will default to the factory setting. a treatment time is selected the Start Timer control is pressed NOW the stimulator output can be activated. Note: Quad-Polar Interferential treatment requires the use of 4 electrodes. 10. Set the treatment duration using the Time controls. To adjust in one minute increments, press and release. For rapid adjustment, press and hold until the desired treatment duration setting is reached. The treatment duration will be indicated on the Power / Timer display. Treatment duration may be reduced or increased during the treatment period. 38 IF250 User's Guide

47 IF250 General Operation and Application Procedures 11. Press the Start Timer control to activate the treatment timer. A flashing decimal point on the Power / Timer display indicates timer countdown in 1 minute increments. 12. Slowly increase the Channel 1 Intensity control to the desired output level. The Channel 1 Intensity display will indicate the output intensity selected. Slowly increase the Channel 2 Intensity control to the desired output level. The Channel 2 Intensity display will indicate the output intensity selected. The Channel 2 Intensity setting must not vary more than ± 20% from the Channel 1 Intensity setting. If the intensity setting varies more than ±20%, the intensity display for the channel with the greater output setting will flash for thirty seconds before: the intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays the treatment time reduces to 00 as indicated on the Power / Timer display the Reset Intensities indicator light flashes and the generator emits an audible signal The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. Note: Quad-Polar Interferential treatment requires the use of 4 electrodes. 13. DYNAMIC CONTROL OPTION: Press the Dynamic control to select Dynamic mode. The Dynamic mode indicator light will illuminate indicating that the Dynamic cycle has been activated. Channel 1 Intensity will decrease 50% and return to the original intensity setting. Channel 2 Intensity will decrease 50% and return to the original intensity setting. This alternating cycle repeats every 8 seconds. Note: The Dynamic control must be activated after Quad-Polar treatment has begun. The Channel 1 Intensity and Channel 2 Intensity settings may be independently reduced during treatment. If the Channel 1 Intensity and/or Channel 2 Intensity is increased above the original setting(s), the intensity display(s) indicating the increased intensity setting(s) will flash. The intensity display(s) will continue to flash until the output intensity is reduced to the original setting(s). The Dynamic control may be deactivated and reactivated during treatment unless one or both of the intensity displays are flashing. IF250 User's Guide 39

48 Part When treatment is completed, stimulator output will be discontinued immediately. The intensities reduce to 00 as indicated on the Channel 1 Intensity and Channel 2 Intensity displays The treatment duration reduces to 00 as indicated on the Power / Timer display The Reset Intensities indicator light flashes and the generator emits an audible signal The Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", which will turn off the Reset Intensities indicator light and the audible signal. The treatment time will default to the factory setting. Interferential Burns With the use of interferential current, there has been a growing awareness of so called interferential burns. Interferential current is symmetrically biphasic; it does not produce a chemical build up in tissue. Therefore, the so called interferential burns cannot be of a chemical nature; they cannot be an acid or alkaline burn. Also, interferential current, under normal circumstances, is of insufficient intensity to produce significant amounts of heat in tissue. Therefore, the so called interferential burns are not likely to be a thermal burn. It seems most likely that interferential burns are, in fact, an adverse skin reaction produced by too high a current density in the pad area. Old, worn, cracked or dried out pads will cause the interferential current to concentrate in small areas rather than be evenly distributed throughout the entire pad surface area. Deteriorated pads have the effect of increasing the current density since the current is being delivered through a smaller area. It is the personal responsibility and obligation of the user to verify that patient cords and electrode pads show no evidence of deterioration prior to patient application. When such evidence exists, replace the cords or electrodes. Some patients have sensitive skin and may react to any type of electrical stimulation. Electrotherapy causes increased blood flow, especially underneath the pads. In some patients, this may cause an accumulation of fluids just under the skin which may result in a rash, burn or blister. When this type of reaction does occur, ice massage to the area may be helpful and can be performed two or three times a day. If the area has broken down into a blister, then ice massage may be given to the surrounding tissue. If necessary, a clean dry dressing may be applied. Medical advice should be sought if the problem does not resolve quickly. It should also be kept in mind that creams, liniments or other preparations on the patients skin may cause an unusual reaction. 40 IF250 User's Guide

49 IF250 General Operation and Application Procedures Application of Electrical Muscle Stimulation Quad-Polar Quad-Polar Interferential electrical muscle stimulation is usually applied through carbon type pad electrodes with sponge covers, or sponge type pad electrodes. The Flextrode System has been designed for the application of electrical stimulation with the use of carbon type electrodes. The Flextrode pad electrode must be used with the Flextrode sponge cover. The sponge cover provides increased conductance to the patient. To obtain maximum conductivity, it is important to properly prepare the Flextrode pad electrode and sponge cover before application of electrical muscle stimulation. The Flextrode pad electrode and sponge cover must be completely and thoroughly moistened by immersion in water. Apply a generous amount of Flextrode Conductive Spray to the moistened sponge cover. If the Flextrode Conductive Spray is not desired, apply a generous amount of Amrex Conductance and Coupling Gel to the thoroughly moistened Flextrode sponge cover. A generous amount of Flextrode Conductive Spray or Amrex Conductance and Coupling Gel is required to insure good conductivity. Thoroughly clean pads and sponge covers with warm water after each treatment. Important It is the personal responsibility and obligation of the user to verify that patient cords and electrode pads show no evidence of deterioration prior to patient application. When such evidence exists, replace the cords or electrodes. Never sharply bend or twist the cords. Loose connections or broken cords can cause poor conductance and possible discomfort to the patient. Should the patient complain of low stimulation output, no output or sudden irregular increases in output, immediately discontinue treatment. Check for the following: secure cord connections; proper electrode contact with the patient; electrode wear or lack of cleanliness. Replace patient cords and/or pad electrodes that show any evidence of deterioration. IF250 User's Guide 41

50 Part 6 General Operation of Bi-Polar Interferential Modality 1. Connect the IF250's ac power cord to the IF250's ac receptacle and plug the "Hospital Grade" connector to a properly grounded 120Vac, 60Hz receptacle. 2. Connect the Patient Treatment Stop Switch to the Treatment Stop Jack. 3. Reduce the Channel 1 Intensity control and the Channel 2 Intensity control to the 0/Reset position enabling the audible "clicks". 4. Depress the Power control. The generator will self-test. All indicators will illuminate. An audible signal will be emitted and the generator will default to factory settings of: Quad-Polar Interferential modality Power/Timer display 15 minutes Frequency display 080 Hz Preset Sweep frequency range for Pain ( Hz) Channel 1 Intensity and Channel 2 Intensity displays 00 Milliamps Note: If the Intensity controls are not at the 0/Reset position, the generator will emit a sequence of audible signals and the Reset Intensities indicator light will flash. Channel 1 Intensity and Channel 2 Intensity controls must be returned to the 0/Reset position, enabling the audible "clicks", to return to factory default settings. 5. Press the Mode control to select the Bi-Polar Interferential modality. The Bi- Polar Interferential modality indicator light will illuminate. 6. Press the Constant Sweep control to select Constant mode or Sweep mode. The Constant or Sweep mode indicator light will illuminate. Note: The Constant Sweep control selection can be changed anytime during treatment. However, to avoid possible patient discomfort, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks", before changing the Constant Sweep control selection. 7. Press the Frequency control to select the desired Constant beat frequency or Sweep beat frequency range. The selected beat frequency indicator light will illuminate and the Frequency display will indicate the selection. Note: The Constant beat frequency or the Sweep beat frequency range can be changed anytime during treatment. However, to avoid possible patient discomfort, reduce the Channel 1 Intensity and Channel 2 Intensity controls to the 0/Reset position, enabling the audible "clicks", before changing the Constant beat frequency or Sweep beat frequency range. 42 IF250 User's Guide