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How to Use Your Nox A1™ Online Recordings Noxturnal Version 5.1

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How to Use Your Nox A1™ Online Recordings Noxturnal Version 5.1 How to use your Nox A1™ online recordings Noxturnal version 5.1 ResMed.com/NoxA1 Contents Nox A1 system …………………………………………………………………………………………………………………………………… page 3 Patient hook-up …………………………………………………………………………………………………………………………………… page 7 Make a new recording Start a recording …………………………………………………………………………………………………………………………………… page 21 Check signals with a PC (option 1) ……………………………………………………………………………………………………………… page 24 Check signals with a tablet (option 2) …………………………………………………………………………………………………………… page 27 End the recording ………………………………………………………………………………………………………………………………… page 36 Clean devices and accessories…………………………………………………………………………………………………………………… page 37 Score a recording Open an existing recording ……………………………………………………………………………………………………………………… page 40 Analyse data ……………………………………………………………………………………………………………………………………… page 41 Generate a report ………………………………………………………………………………………………………………………………… page 51 Troubleshooting …………………………………………………………………………………………………………………………………… page 53 Consumables and accessories …………………………………………………………………………………………………………………… page 58 2 Nox A1 system Accessories Devices Consumables USB cable Abdomen cable Nasal cannula with filter x2 Nox A1 Recorder EKG and PLM cables EEG head cable Disposable RIP belts (Sizes: XSx1, Sx1, Mx1, Lx1, XLx1) EEG 5 lead gold Noxturnal software CD Nonin 3150 oximeter Battery 1.5V AA x2 electrode cable x2 and SpO2 sensor size M Battery 1.5V AAA x4 3 Nox A1 system 5 6 5 14 15 14 8 7 11 1 9 13 10 12 4 2 3 NUMBER FUNCTION 1 Display 9 Unipolar input - EEG channels 2 Push button - Turn on the device 10 Reference ground input 3 Push button - Forward 11 Bipolar inputs - EKG and PLM inputs 4 Push button - Backward 12 Battery lid - Covers the battery and the USB connector 5 Clip strap loops 13 Battery lid pin - Keeps battery compartment closed 6 Microphone and light sensor - Records respiratory 14 Metal snaps - Connect to thorax RIP belt sounds and light 15 Metal snaps - Connect to abdomen cable 7 Device status indicator light 8 Pressure lock - Connects to external nasal cannula/ mask pressure tube 4 Nox A1 system • Options available The Nox A1 device can be used with the following external devices. Device Function Part number Static IP camera with infrared light 7074224 Records video and transfers it directly to Noxturnal software via ethernet. ResMed TxLink Enables remote control of ResMed therapy devices. It also transfers data from the therapy device to Noxturnal via ethernet. 25101 6 signals available among: Flow, I:E, Leak, Minute Ventilation, Pressure, Resp Rate, Tidal Volume, Ti, Target Ventilation. SenTec™ capnograph Measures and records capnography data. Capnography data can be transfered directly to 7072194 Noxturnal software via ethernet. Signals available: TcCO2, Pulse, SpO2, Pulsation Index. Contact your ResMed representative for more details. 5 Nox A1 system • Online study Clean Insert Patient Check Start a View online devices and batteries hook-up signals recording signals accessories 6 Patient hook-up 7 Patient hook-up • Insert batteries Insert a new lithium battery or a fully recharged NiMh battery into the Nox A1 device. For the Nox A1: 1 AA battery For the Nonin 3150 oximeter: 2 AAA batteries • Lithium batteries are recommended. They provide up to 15h • Alkaline batteries last for up to 24h. It is recommended of recording. Replace them after each recording. that they are replaced every 2 recordings. • If using NiMh batteries, 2700mAh Powerex or 2500mAh • Rechargeable batteries should be recharged completely Panasonic Eneloop Pro batteries are the recommended option. before every recording. They provide 8 to 10 hours of recording. Alkaline batteries are not compatible with the Nox A1 device. 8 Patient hook-up • Attach the device and the belts 2 1 3 1 - Clip the abdomen cable to the back 2 - Wrap the RIP belt around the patient’s of the device and snap the clips thorax and snap it at the back of the onto the patient’s pyjamas. device. 3 - Repeat this for the abdomen belt and snap it to the cable. 9 Patient hook-up • Place the EKG cable Equipment needed: EKG snap-on lead wire - Orange (PN 7072172) 2 disposable adhesive electrodes (PN 7075209) Electrode site: Scrub the patient’s skin with NuPrep before placing the adhesive electrodes. Under the right clavicle. On the 7th left rib. Connection to the Nox A1: The EKG cable must be plugged into the bipolar EKG channel. 10 Patient hook-up • Place the PLM cables Equipment needed: PLM snap-on lead wire PLM snap-on lead wire 4 disposable adhesive electrodes Grey (PN 7073438) Black (PN 7073439) (PN 631526) Electrode site: Scrub the patient’s skin with NuPrep before placing the adhesive electrodes. Electrodes must be placed on the tibialis anterior muscle. If needed, secure the electrodes with tape and/or a Surgilast net. Connection to the Nox A1: Connect the black cable (left leg) to the LM1 bipolar input and the grey cable (right leg) to the LM2 bipolar input. 11 Patient hook-up • Place the chin EMG electrodes Equipment needed: 3 disposable adhesive electrodes (PN 7073775) Electrode site: Scrub the patient’s skin with NuPrep before placing the adhesive electrodes. F - On the midline and 1 cm above the inferior border of the mandible. 1 - 2 cm below the inferior border of the mandible and 2 cm right of the midline. 2 - 2 cm below the inferior border of the mandible and 2 cm left of the midline. Connection to the Nox A1: Connect corresponding electrodes to the inputs F, 1 and 2. 12 Patient hook-up • Place the EEG head cable Before attaching the electrodes, it is important to properly position the ground reference of the EEG head cable. 1 - Choose a snap-on electrode and place 3 - Connect the 2 EEG lead cables as the EEG head cable as shown below: shown below: 2 - Scrub the patient’s forehead with 4 - Pre-position the cups on the head. NuPrep and attach the electrode to the forehead by gently pressing on the white ring of the electrode. 13 Patient hook-up • Place the electrodes (10/20 system) E1 and E2 are respectively 1 cm below the left eye and 1 cm above the right eye. O1 and O2 are 3 cm below the occipital protuberance and 3 cm from the midline. C3 and C4 are on the pre-auricular points axis and 7 cm from the midline. M1 and M2 are respectively on the left and the right mastoids behind the ear. F3 and F4 are 1 cm before the hair line and 4 cm from the midline. 14 Patient hook-up • Attach the EEG electrodes Equipment needed: NuPrep abrasive gel 1 - Scrub the different electrode sites with NuPrep and a cotton bud. (PN 7073511) Remove excess gel with gauze. Ten20 conductive paste 2 - Fill the cups with Ten20 conductive paste and place them (PN 7073512) on the correct spots. EC2 electrode cream 3 - Place a small amount of EC2 cream on a piece of gauze. (PN 7073513) Place the gauze over the cup and onto the patient’s scalp so the cup stays in place. Cotton bud and gauze 15 Patient hook-up • Attach the nasal cannula Gently position the nasal Pull the cannula tubing over Slide the bolo up under the cannula in the nostrils with the ears. chin so it is snug but not too the prongs facing inwards. tight. You can put a little piece of tape on the cannula on either cheek to hold it securely in place. • Connect the nasal cannula with the filter to the pressure input of the Nox A1. 16 Patient hook-up • Attach the oximeter 1 3 2 1 - Place the oximeter on the patient’s left wrist if they 3 - Wrap tape around the finger to secure are right-handed or on their right wrist if they are the sensor cable. left-handed. 2 - Then place the probe on the index finger. The fingertip should reach the end of the probe but should not go past it. Push the grey activation button if the device doesn’t start automatically. 17 Patient hook-up • Therapy device option: pressure tubing installation Make sure you use an appropriate recording type. Equipment needed: - Pressure tubing (PN 7072092) - Nasal cannula filter (PN 7072097) - Mask adapter (PN 26915) Connect the pressure tubing to the mask and the Nox A1: 1 - Insert a filter into the pressure input of the Nox A1, where you would usually insert the nasal cannula. 2 - Screw the male luer-lock connector of the pressure tubing into the filter. 3 - Connect the female luer-lock connector of the tubing to the pressure port of the mask adapter. Set-up picture: 1 2 3 18 Patient hook-up • Therapy device option: installation of the Nox C1 differential pressure sensor Make sure you use an appropriate recording type. Equipment needed: - Flow sensor (PN 7073740) - 2 mask tubing 180 cm (PN 7072092) - 2 Nox filters (PN 7072097) Install the differential pressure sensor: 1 - Insert two Nox filters into the PRES + and - sockets of the Nox C1. 2 - Plug the flow sensor into the filters using the two mask tubings. 3 - Place the flow sensor between the patient tubing and the mask or the therapy device, depending on the situation. Set-up picture: 19 Make a new recording 20 Start a recording • Open the software Click on the Noxturnal icon on your computer desktop. Go to the Recording tab and click on Configure Recording. 21 Start a recording • Step 1: Recording type Select the correct recording type. Click on Next to enter patient information. 22 Start a recording • Step 2: Patient information Complete patient information (at a minimum, patient’s first and last names or patient ID). The Tags field can be used to link keywords to the patient so s/he can easily be found later in the recordings library. • Option 1: If you’re using PC software, click on Start Recording then go to page 24 of this guide for information on checking patient hook-up and signals. • Option 2: If you’re using a tablet, click on Standby Mode then go to page 27 of this guide for information on checking patient hook-up and signals.
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