Edan Cadence
Edan Cadence
Edan Cadence
CADENCE II
Fetal Monitor
Copyright
© Copyright EDAN INSTRUMENTS, INC. 2008-2009. All rights reserved.
Statement
This manual will help you understand the operation and maintenance of the product better. It
is reminded that the product shall be used strictly complying with this manual. User’s
operation failing to comply with this manual may result in malfunction or accident for which
Edan Instruments, Inc. (hereinafter called EDAN) can not be held liable.
EDAN owns the copyrights of this manual. Without prior written consent of EDAN, any
materials contained in this manual shall not be photocopied, reproduced or translated into
other languages.
Materials protected by the copyright law, including but not limited to confidential information
such as technical information and patent information are contained in this manual, the user
shall not disclose such information to any irrelevant third party.
The user shall understand that nothing in this manual grants him, expressly or implicitly, any
right or license to use any of the intellectual properties of EDAN.
EDAN holds the rights to modify, update, and ultimately explain this manual.
WARNING
A WARNING label advises against certain actions or situations that could result in personal
injury or death.
CAUTION
A CAUTION label advises against actions or situations that could damage equipment,
produce inaccurate data, or invalidate a procedure.
I
NOTE: A NOTE provides useful information regarding a function or a procedure.
Revision History
II
Table of Contents
Chapter 1 Safety Guidance...................................................................................................... 1
1.1 Intended Use.................................................................................................................. 1
1.2 Instruction for Safe Operation....................................................................................... 1
1.3 Ultrasound Safety Guide ............................................................................................... 2
1.4 Safety Precautions ......................................................................................................... 2
1.5 Definitions and Symbols ............................................................................................... 5
Chapter 2 Installation Guidance............................................................................................. 8
2.1 Opening the Package and Checking.............................................................................. 8
2.2 Installing Battery ........................................................................................................... 8
2.3 Connecting the Power Cable ......................................................................................... 9
2.4 Feeding Paper................................................................................................................ 9
Chapter 3 Introduction .......................................................................................................... 11
3.1 Functions ..................................................................................................................... 11
3.2 Monitor........................................................................................................................ 12
3.2.1 Display .............................................................................................................. 12
3.2.2 Key Functions and Operations .......................................................................... 15
3.2.3 Indicators........................................................................................................... 16
3.2.4 Sockets on the Right Side of the Monitor ......................................................... 17
3.2.5 Base Panel ......................................................................................................... 17
3.3 Transducers and Cables............................................................................................... 17
3.3.1 Transducers ....................................................................................................... 18
3.3.2 Remote Event Marker ....................................................................................... 18
3.3.3 Fetal Spiral Electrode ........................................................................................ 19
3.4 Ordering Information .................................................................................................. 19
Chapter 4 Alarm..................................................................................................................... 21
4.1 Alarms Classification .................................................................................................. 21
4.2 Audible Alarm............................................................................................................. 21
4.3 Visual Alarm ............................................................................................................... 21
4.4 Treatment Measures .................................................................................................... 22
4.5 Testing Alarms ............................................................................................................ 22
4.6 Alarm Messages .......................................................................................................... 22
4.7 Alarm Defaults ............................................................................................................ 24
Chapter 5 Printing.................................................................................................................. 25
5.1 Function Description ................................................................................................... 25
5.2 Printing Configuration................................................................................................. 26
5.2.1 Switching Auto-Print On and Off ..................................................................... 26
5.2.2 Choosing the Paper Speed................................................................................. 26
5.2.3 Choosing the Time Length................................................................................ 26
5.2.4 Switching Print Test On and Off....................................................................... 26
5.3 Examples of Printing Pattern....................................................................................... 27
Chapter 6 Pre-Monitoring Preparation ............................................................................... 29
6.1 Confirming Fetal Life.................................................................................................. 29
6.2 Switching On the Monitor........................................................................................... 29
6.3 Setting Date and Time................................................................................................. 30
6.4 Connecting Transducers.............................................................................................. 30
6.5 Adjusting the Volume ................................................................................................. 31
III
Chapter 7 Monitoring ............................................................................................................ 32
7.1 Confirming Fetal Life.................................................................................................. 32
7.2 Monitoring FHR with Ultrasound ............................................................................... 32
7.2.1 Parts Required ................................................................................................... 32
7.2.2 Operation Procedure.......................................................................................... 32
7.2.3 Switching the FHR Alarm On or Off ................................................................ 34
7.2.4 Changing the FHR Alarm Limits ...................................................................... 34
7.2.5 Changing the FHR Alarm Keep Time............................................................... 34
7.2.6 Switching the Probe Detecting Alarm On or Off.............................................. 35
7.2.7 Switching the FHR Signal Quality Alarm On or Off........................................ 35
7.3 Monitoring FHR with DECG (optional) ..................................................................... 35
7.3.1 Contraindications .............................................................................................. 35
7.3.2 Parts Required ................................................................................................... 36
7.3.3 Preparing the Patient's Skin Prior to Placing Electrodes................................... 36
7.3.4 Directions for Use of Fetal Spiral Electrode ..................................................... 36
7.3.5 DECG Monitoring Procedure............................................................................ 37
7.3.6 Detaching the Fetal Spiral Electrode................................................................. 37
7.3.7 Switching DECG Arrhythmia Logic On or Off ................................................ 37
7.3.8 Changing DECG Volume.................................................................................. 38
7.4 Dual Heart Rate Monitoring........................................................................................ 38
7.4.1 Monitoring Twins Externally ............................................................................ 38
7.4.2 Monitoring Internally (Optional) ...................................................................... 38
7.4.3 Signals Overlap Verification (SOV) ................................................................. 39
7.4.4 Changing FHR2/DECG Offset.......................................................................... 39
7.5 Monitoring Uterine Activity (UA) Externally ............................................................ 40
7.5.1 Parts Required ................................................................................................... 40
7.5.2 Operation Procedure.......................................................................................... 40
7.5.3 Changing the UA Baseline................................................................................ 40
7.5.4 Switching the UA Probe Detecting Alarm On or Off ....................................... 41
7.6 Monitoring Uterine Activity Internally (optional) ...................................................... 41
7.6.1 Parts Required ................................................................................................... 41
7.6.2 Directions for Use of IUPC............................................................................... 41
7.6.3 Operation Procedure.......................................................................................... 43
7.6.4 Checking Intrauterine Pressure Cable Function................................................ 44
7.7 Fetal Movement Monitoring ....................................................................................... 44
7.7.1 Choosing the FM Source................................................................................... 44
7.7.2 Auto Fetal Movement Monitoring (AFM) ........................................................ 44
7.7.3 Enabling/Disabling AFM Trend........................................................................ 45
7.7.4 Changing AFM Threshold ................................................................................ 45
7.7.5 Changing AFM Gain......................................................................................... 45
7.7.6 Manual Fetal Movement Monitoring (MFM) ................................................... 45
7.7.7 Clearing FM Count............................................................................................ 46
7.8 Login ........................................................................................................................... 46
7.8.1Inputting Patient’s Bed ID.................................................................................. 46
7.8.2 Inputting Patient’s Information ......................................................................... 46
7.8.3 Enabling / Disabling Manual Login .................................................................. 47
7.9 Start Monitoring .......................................................................................................... 47
7.10 Screen Display........................................................................................................... 47
7.10.1 Fetal Monitoring Trends.................................................................................. 48
7.10.2 Trends Playback .............................................................................................. 48
7.10.3 Trends Loading ............................................................................................... 49
IV
7.10.4 Fetal Monitoring Values.................................................................................. 50
7.11 Completing Monitoring............................................................................................. 50
7.12 Switching Off the Monitor ........................................................................................ 50
Chapter 8 Maintenance, Care and Cleaning ....................................................................... 51
8.1 Preventive Maintenance .............................................................................................. 51
8.1.1 Maintaining Inspection...................................................................................... 51
8.1.2 Maintenance of the Monitor.............................................................................. 51
8.1.3 Maintenance of the Transducers ....................................................................... 52
8.1.4 Storage of Recorder Papers ............................................................................... 52
8.1.5 Cleaning of the Recorder................................................................................... 52
8.2 Cleaning ...................................................................................................................... 53
8.2.1 Cleaning of the Monitor .................................................................................... 53
8.2.2 Cleaning of the Accessories .............................................................................. 53
8.3 Disinfecting ................................................................................................................. 54
8.4 Sterilizing .................................................................................................................... 55
Chapter 9 Warranty and After-Sales Service ...................................................................... 56
9.1 Warranty...................................................................................................................... 56
9.2 After-Sales Service...................................................................................................... 56
Appendix 1 Product Specifications ....................................................................................... 57
A1.1 Environmental Specifications................................................................................... 57
A1.2 Physical Specifications............................................................................................. 57
A1.3 Performance Specifications...................................................................................... 58
A1.4 Recorder Specifications............................................................................................ 60
A1.5 Lithium-ion Battery Specifications .......................................................................... 60
A1.6 Low Output Summary Table.................................................................................... 61
Appendix 2 Signal Input/Output Connector ....................................................................... 62
Appendix 3 Troubleshooting ................................................................................................. 63
A3.1 No Display................................................................................................................ 63
A3.2 Noise......................................................................................................................... 63
A3.3 Recorder Error.......................................................................................................... 63
A3.4 Ultrasound Monitoring of FHR................................................................................ 64
A3.5 DECG Monitoring of FHR....................................................................................... 64
A3.6 Monitoring Contractions (External) ......................................................................... 65
A3.7 Monitoring Contractions (Internal) .......................................................................... 65
A3.8 Blown Fuses ............................................................................................................. 65
Appendix 4 EMC Information – Guidance and Manufacture’s Declaration ................ 67
A4.1 Electromagnetic Emissions – for all EQUIPMENT and SYSTEMS....................... 67
A4.2 Electromagnetic Immunity – for all EQUIPMENT and SYSTEMS .................... 68
A4.3 Electromagnetic Immunity – for EQUIPMENT and SYSTEM that are not
LIFE-SUPPORTING ........................................................................................................ 69
A4.4 Recommended Separation Distance......................................................................... 71
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
IUP
This symbol indicates that this is an IEC/EN 60601-1 Type BF applied part.
DECG
This symbol indicates that this is an IEC/EN 60601-1 Type CF applied part.
WARNING :
For using safety:
A CADENCE II is provided for the use of qualified physicians or personnel
professionally trained. They should be familiar with the contents of this user manual
before operation.
A Only qualified service engineers can install this equipment. Only service engineers
authorized by EDAN can open the case.
A This device is not intended for home use.
A EXPLOSION HAZARD - Do not use the monitor in the presence of flammable
anesthetics or other materials.
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CAUTION :
A Federal (U.S.) law restricts this device to sale by or on the order of a physician.
A The device is designed for continuous operation and is “ordinary” (i.e. not drip or
splash-proof). Keep it far from corrosive medicine, dust area, high-temperature and
humid environment.
A Do not operate the unit if it is damp or wet because of condensation or spills. Avoid
using the equipment immediately after moving it from a cold environment to a warm,
humid location.
A Sterility can not be guaranteed if the package of the fetal spiral electrode is broken
or opened.
A Do not sterilize the monitor or any accessory.
A Electromagnetic Interference - Ensure that the environment in which the fetal
monitor is installed is not subject to any source of strong electromagnetic
interference, such as radio transmitters, mobile telephones, etc.
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CADENCE II Fetal Monitor User Manual
A While the battery is charged, used or stored, keep it away from objects or materials
with static electric charges.
A Do not short-circuit the battery socket or the battery plug.
A If the battery connector becomes dirty, wipe it with a dry cloth.
A The recommended charge temperature range is from 0 ºC (32 ºF) to 40 ºC (104 ºF).
Do not exceed these ranges.
A Batteries have life cycles. If the time that the monitor uses the battery becomes
much shorter than usual, the battery life is at an end. Replace the battery with a
new one the same as the one provided or recommended by EDAN.
A When not using battery for an extended period, or any peculiar smell, distortion or
discoloration is detected, remove it from the monitor and dispose of it properly.
A The device and accessories are to be disposed of according to local regulations
after their useful lives. Alternatively, they can be returned to the dealer or the
manufacturer for recycling or proper disposal. Batteries are hazardous waste. Do
NOT dispose them together with house-hold garbage. At the end of their life hand
the batteries over to the applicable collection points for the recycling of waste
batteries. For more detailed information about recycling of this product or battery,
please contact your local Civic Office, or the shop where you purchased the
product.
Socket for TOCO transducer ( Type B applied part) or IUP cable (Type BF
applied part)
Power Socket
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CADENCE II Fetal Monitor User Manual
Fuse Socket
RJ45 Interface
The symbol indicates that the device complies with the European Council
Directive 93/42/EEC concerning medical devices.
The symbol indicates that the device should be sent to the special agencies
according to local regulations for separate collection after its useful life.
The symbol indicates that the device should be sent to the special agencies
according to local regulations for separate collection after its useful life and that
this unit was put on the market after 13 August 2005.
Part Number
Serial Number
Date Of Manufacture
Manufacturer
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CADENCE II Fetal Monitor User Manual
Recycle
Rx only (U.S.) Federal (U.S.) Law restricts this device to sale by or on the order of a physician
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CADENCE II Fetal Monitor User Manual
WARNING :
Switch off the monitor and unplug it before installing or removing the battery.
(1) Battery Installation
A Carefully place the monitor upside down on a flat surface covered with cloth or other types
of protecting pad.
A Remove the screw of the battery compartment.
A Remove the battery compartment cover.
A Take the battery out from package. Place the battery into the compartment with the wired
direction on the outside.
A Insert the cable connector into the socket.
A Close the battery compartment cover and fix it with the screw.
NOTES:
1) When a battery is configured, after the device is transported or stored, the battery
must be charged. Connecting the monitor to AC power supply will charge the battery
no matter if the monitor is powered on.
2) If a rechargeable battery is configured, charge it fully each time after use to ensure
the electric power is enough.
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CADENCE II Fetal Monitor User Manual
WARNING :
If the protective grounding (protective earth) system is doubtful, the monitor must be
powered only by the inner power.
1) Press the position simultaneously on both sides of the recorder cover to open the paper
compartment.
2) Take out the Z-fold thermosensitive paper from the wrapper. Place the pack in the
compartment with the pane facing down and the green safety area on the left.
3) Feed the recorder paper into the paper advance slot (Figure 2-1). The paper will come out
from the notch automatically. Adjust the paper length by rotating the gear on the left of the
handle if required.
4) If the paper is slantwise, pull the handle up and rotate the gear to force the paper out. Push the
handle down and then feed paper again.
5) After closing the cover, make sure that the paper can come out from the paper notch.
NOTES:
1) When feeding paper, the black handle must be down. If a paper jam happens, pull up
the handle first, and then push the gear to force the paper out.
2) Feed the paper gently and avoid touching the print head.
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CADENCE II Fetal Monitor User Manual
3) Make sure the paper coming out from the notch aligns with the notch edges.
Otherwise, the trend printed on the recorder paper will be inaccurate or paper jam
may happen.
4) Only use EDAN approved paper to avoid poor printing quality, deflection and paper
jam.
5) The printing function cannot be executed when ultrasound transducer or DECG
cable connector falls off.
NOTE:
Be careful when feeding paper. Avoid damaging the thermosensitive print head. Unless
feeding paper or shooting troubles, do not leave the recorder compartment open.
Removing Paper Jam
When the recorder does not function or sound properly, open the paper compartment to check for
a paper jam. Remove the paper jam in this way:
A Cut the recorder paper from the paper notch edge.
A Open the paper compartment, and then rotate the gear of the recorder.
A Remove the rest of the paper.
A Feed the paper again.
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CADENCE II Fetal Monitor User Manual
Chapter 3 Introduction
3.1 Functions
The CADENCE II Fetal Monitor can provide different configurations according to different user
requirements: FHR1 (Fetal Heart Rate 1), FHR2 (Fetal Heart Rate 2), TOCO, AFM (automatic
fetal movement monitoring), MFM (manual fetal movement monitoring), FS (fetal stimulator,
optional), DECG (direct fetal ECG, optional) and IUP (Intra-uterine Pressure, optional).
A 5.7” LCD display is applied by the monitor to display the FHR1, FHR2/DECG (dual
configuration) and TOCO/IUP trend and numerics. Also a built-in thermal recorder is used to
print the trends and other information. A rechargeable lithium-ion battery is provided for your
option.
A DB9 interface is built in the monitor. With it, the monitor can be connected to a computer or
the MFM-CNS central monitoring system via 485 network. Optionally, you can order a built-in
wireless network module to connect the monitor via wireless network. The data collected and
stored by CADENCE II can be analyzed by the Insight software running on PC or MFM-CNS
(Refer to MFM-CNS Central Monitoring System User Manual and the relevant information of
wireless network module).
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CADENCE II Fetal Monitor User Manual
3.2 Monitor
NOTE: The pictures and interfaces in this manual are for reference only.
Alarm Indicator
Charging Indicator
Keys
Recorder
TOCO Transducer
3.2.1 Display
The display of the monitor is used to show the information of the monitor, menus, and collected
fetal parameters and trends etc.
To fit different mounting situations, the display can be tilted to one of the four preset positions.
To tilt the display, you need to lift the display forward to the desired angle.
To fold the display, you need to push the display backward to the desired angle.
Fold the display completely flat when the monitor is mounted on wall.
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CADENCE II Fetal Monitor User Manual
The screen display includes three frames: (1) information frame, (2) trend/menu frame, (3)
parameter frame (see Figure 3-3).
Information frame
Figure 3-3 Display screen
(1) Information Frame
The information frame is located at the bottom of the screen, which indicates current status of the
monitor.
a) : AC power supplied;
: no AC power supplied.
b) : The battery is loaded, and the white pane indicates the charge of the battery;
means no battery is loaded.
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
CADENCE II Fetal Monitor is a user-friendly device with operation conducted by a few keys on
the monitor. Their functions are as follows:
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CADENCE II Fetal Monitor User Manual
During playback this key is invalid. An abnormal audio will be heard when you press it.
Function:
1) If US1 socket and US2 socket are separately connected with an ultrasound transducer during
monitoring, press this key, the fetal heart sound will toggle between US1 and US2. The default
fetal heart sound comes from US1.
2) In the setup menus, when the cursor is located at the required item, press this key to confirm
selection.
3.2.3 Indicators
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CADENCE II Fetal Monitor User Manual
Hanging Hole
Label
Battery
Compartment
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CADENCE II Fetal Monitor User Manual
3.3.1 Transducers
1 Serial number label of the US transducer, pink. U:xxxxx is the serial number.
2 Specification label of the US transducer, pink.
3 Transducer cable
4 Belt buckle
5 Serial number label of the TOCO transducer, blue. T:xxxxx is the serial number.
6 Specification label of the TOCO transducer, blue.
CAUTION :
The waterproof parts of the US/TOCO transducer are restricted to the main body and the
cable. Do not immerse the plug into any liquid in the process of monitoring or cleaning.
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CADENCE II Fetal Monitor User Manual
Accessories supplied or approved by EDAN can be used with the monitor. See the following
table for details. The accessories employed by EDAN, such as the rechargeable battery (model
No.: HYLB) manufactured by HENGYU are products having passed the authentication of CE,
and they have the characteristics specified by their manufacturers.
Belt MS2-02264
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
Chapter 4 Alarm
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
The fetal monitoring board can not Restart the monitor and try again,
FM Board fault communicate with the system contact EDAN if the connection
successfully. still fails.
The DECG board can not Restart the monitor and try again,
DECG Board fault communicate with the system contact EDAN if the connection
successfully. still fails.
US2 probe off Ultrasound transducer 2 is not well Check the connection of the
connected. transducer.
DECG probe off The DECG lead is not well Check the connection of the
connected to the monitor. DECG cable.
IUP probe off The IUP connecting cable is not well Check the connection of the IUP
connected to the monitor. connecting cable.
DECG lead off The spiral electrode is not well Check the connection of the spiral
connected. electrode.
Low battery energy The battery power is too low to Connect the monitor to AC power
support further work of the monitor. supply.
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CADENCE II Fetal Monitor User Manual
FHR1/FHR2/DECG Upper Limit 150 bpm ~ 210 bpm, in increments of 5. 160 bpm
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CADENCE II Fetal Monitor User Manual
Chapter 5 Printing
5.1 Function Description
The built-in thermal recorder applied in CADENCE II prints continuous FHR1/ FHR2 (DECG)
/TOCO /AFM trends synchronously along with some other symbols:
- A list of date, time, TOCO type, print speed, BedID and FHR2/DECG offset (at the beginning of
the printing).
- The current time (every 10 minutes afterward).
- Trends marks (FHR1, TOCO ext/TOCO int, AFM) (every 8 minutes afterward).
- Symbol marks (Start, Alarm, FM, event, zeroing) (whenever it happens).
The monitor supports some other functions listed below:
A Auto Start Printing: If this function is enabled, the recorder starts printing automatically
when a new monitoring starts (the AUTO key is pressed). Otherwise you have to press the
PRINT key to start printing.
A Fixed Length Printing: The recorder prints trends of a fixed time length each time. A music
sound will be heard at the end of the printing. This length is adjustable. Refer to 5.2.3
Choosing the Printing Time Length.
A Data Caching: When the paper drawer runs out of paper, the recorder stops printing. The
data from this moment on (at most 15 minutes) will be temporarily saved in the internal
memory. When new paper is loaded, the recorder resumes printing automatically.
NOTE:
If both the US transducer and the DECG cable are unplugged, or if the monitor is
switched off, the data in the internal memory will be lost.
A FHR2 Offset: You can set the offset of the FHR2 trend to separate the two FH trends on the
screen and the recorder paper. Refer to 7.4.4 Changing FHR2/DECG Offset.
A Print Test: The recorder prints a trend for self-testing when the monitor is switched on.
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
CAUTION :
1) If there is any difference between the display and the printout, take the printout as
criterion.
2) If the data is doubtful, clinicians should use other methods to verify the results or
make diagnoses based on the real condition.
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CADENCE II Fetal Monitor User Manual
Besides the trends, some other symbols appear among the trends on the recorder paper:
This symbol indicates that the monitor is zeroed by pressing the AUTO
ZERO key.
TOCO ext/
The TOCO trend from external / internal monitoring.
TOCO int
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CADENCE II Fetal Monitor User Manual
If they do not comply with the lines, reload paper or ask the service engineer to check the paper
settings of the monitor.
CAUTION : Make sure the paper is correctly loaded before starting printing.
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CADENCE II Fetal Monitor User Manual
NOTE:
The date and time remain in the monitor for at least two months after it switches off. You
do not have to set date and time before monitoring each time.
When disconnecting a transducer, hold the afterbody of the transducer outshell (the shaded part
shown in figure 6-2) with fingers and push it in slightly, and then pull it out. Refer to figure 6-2.
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CADENCE II Fetal Monitor User Manual
NOTE:
When the monitor does not execute the function of a key, it gives a “Do” sound.
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CADENCE II Fetal Monitor User Manual
Chapter 7 Monitoring
WARNING :
1) The monitor is not intended for use in intensive care units (ICU), operating rooms or
for home use.
2) The monitor is not protected against defibrillation. Do not apply it during
electro-surgery or MRI; otherwise it might result in harming the patient or the
operator.
3) Always check if the alarm settings are appropriate for your patient before starting
monitoring.
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CADENCE II Fetal Monitor User Manual
2) Acquiring FH Signal
Search for the location of the fetal heart using a stethoscope or a fetoscope.
Apply a certain amount of acoustic gel on the transducer and move it slowly around the fetus
site until a clear characteristic hoof-beat sound of the fetal heart is heard. Refer to figure 7-1
for the transducer position.
Measure TOCO
Measure FHR
Figure 7-1 Ultrasound transducer & TOCO transducer positioning (single fetus)
CAUTION :
Do not mistake the higher maternal heart rate for fetal heart rate.
NOTES:
1) The best quality records will only be obtained if the transducer is placed in the
optimum position.
2) Positions with strong placental sounds or umbilical blood flow sound should be
avoided.
3) If the fetus is in the cephalic position and the mother is supine, the clearest heart
sound will normally be found on the midline below the umbilicus. During examining,
the pregnant woman’s prolonged lying in the supine position should be avoided
owing to the possibility of supine hypotension. Sitting up or lateral positions are
preferable and may be more comfortable.
4) It is impossible to examine FHR unless an audible fetal heart signal is present. The
fetal pulse can be distinguished from the maternal pulse by feeling the mother’s
pulse during the examination.
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CADENCE II Fetal Monitor User Manual
WARNING :
Do not switch off the FHR alarm for the condition where the patient’s safety may be
endangered.
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CADENCE II Fetal Monitor User Manual
7.3.1 Contraindications
The fetal spiral electrode can be used when amniotic membranes are adequately ruptured and
sufficient cervical dilatation is ensured. The fetal electrode tip is designed to penetrate the
epidermis of the fetus; therefore, trauma, hemorrhage and/or infection can occur. The electrode
should be used with strict adherence to aseptic technique.
The fetal spiral electrode should not be applied to the fetal face, fontanels or genitalia.
Do not apply the fetal spiral electrode when placenta previa is present; when the mother has
visible genital herpes lesions or reports symptoms of prodromal lesions; when the mother is HIV
sero-positive; when mother is a confirmed carrier of hemophilia and the fetus is affected or of
unknown status; or when it is not possible to identify fetal presenting part where application is
being considered. This method is not recommended when fetus is extremely premature, or in the
presence of a maternal infection such as Hepatitis B, Group B hemolytic strep, syphilis or
gonorrhea, unless a clear benefit to the fetus or mother can be established.
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CADENCE II Fetal Monitor User Manual
1) Remove the fetal spiral electrode from package, leaving the electrode wires locked in the
handle notch.
2) Gently bend the guide tube to the desired angle.
3) With the patient in the dorsal lithotomy position, perform a vaginal examination and clearly
identify the fetal presenting part.
4) Holding the drive handle, ensure the spiral electrode is retracted approximately one inch (2.5
cm) from the distal end of the guide tube.
5) Place the guide tube firmly against the identified presenting part.
6) Maintain pressure against the fetal presenting part with guide and drive tubes. Turn the drive
tube by rotating the drive handle clockwise until gentle resistance is encountered. Resistance
to further rotation and recoil of the drive handle indicates attachment. This will usually occur
after one complete rotation.
7) Release the electrode wires from the handle notch and straighten them. Slide the drive and
guide tubes off the electrode wires.
8) Insert the safety cap into DECG cable.
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CADENCE II Fetal Monitor User Manual
WARNING :
Do not plug the fetal spiral electrode wire into the power socket.
CAUTION :
Do not mistake the higher maternal heart rate for DECG.
NOTES:
1) If there is any doubt as to the presence of a fetal heart signal with ECG, check with
the US transducer on the patient’s abdomen or with a separate diagnostic
instrument. The presence of an audible Doppler heart sound at a rate distinct from
that of the maternal pulse is unequivocal evidence of the fetal life.
2) After the electrode is well attached, allow a few minutes for the electrode and fetal
tissue to become stabilized. It is essential that the ECG signal electrode is in good
contact with the fetal presenting part.
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CADENCE II Fetal Monitor User Manual
recorded.
When the DECG arrhythmia logic is disabled, the monitor records all the fetal heart beats.
If you have doubts about arrhythmia of the fetus, disable the DECG arrhythmia logic.
To switch DECG arrhythmia logic on or off,
1 Press the SETUP key five times to open the Interpartum Configuration menu.
2 Press the CHANNEL key when the cursor stays at DECGAntiArt.
3 Press the UP key or DOWN key to toggle between On (default) and Off.
4 Press the CHANNEL key to confirm selection.
5 Press the AUTO key to exit.
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CADENCE II Fetal Monitor User Manual
NOTE:
If the DECG sound is not switched off, the fetal heart sound of the twins will be heard
simultaneously.
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Preparation
1) Gather supplies: ACCU-TRACE IUPC, reusable cable, and amnioinfusion supplies if
needed.
2) Open the sterile ACCU-TRACE IUPC package.
Insertion
NOTE: This product is designed for use with the introducer.
3) Using aseptic technique, remove the catheter from the package.
4) Perform vaginal exam to ensure ruptured membranes and adequate dilation.
5) Advance the catheter tip to the cervical os along the examination hand, using the hand as a
guide. Do not advance the introducer through the cervix.
6) Continue to gently advance the catheter tip through the cervical os and feed the catheter into
the intra-amniotic cavity until the 45cm mark is at the introitus. If the 45cm mark is not
clearly visible, stop advancing when the symbol on the catheter meets the introducer.
NOTE: For easier insertion, do not twist the catheter in the introducer.
7) The IUPC may spontaneously fill with amniotic fluid. This can be seen in the clear lumen of
the catheter. The filter cap will prevent the amniotic fluid from leaking.
8) Slide the introducer out of the vagina along the catheter. When the introducer is completely
out of the vagina, slide thumb between catheter and introducer tab, which will begin to
separate the introducer from the catheter. (See figure 7-3)
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CADENCE II Fetal Monitor User Manual
WARNING :
1) Before insertion, placental position should be confirmed, amniotic membranes
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CADENCE II Fetal Monitor User Manual
CAUTION :
1) Since procedures vary according to hospital needs/ preferences, it is the
responsibility of the hospital staff to determine exact policies and procedures for
both monitoring and amnioinfusion. The safe and effective use of the IUPC depends
on the skill of the clinician who applies / uses it.
2) Read Directions For Use of Disposable IUPC prior to insertion. The Product has
been sterilized by gamma radiation and is sterilized and non-pyrogenic unless
package is broken or open. Do not re-sterilize it.
NOTE:
Refer to the instruction on the package for more information about using the IUPC.
1) Insert IUPC using the procedure described in section 7.6.2 Directions for Use of IUPC.
2) Connect the IUPC to the IUP cable. (See figure 7-7)
3) Connect the IUP cable to the connecting cable. (They might have already been well
connected in the package.)
4) Plug the connecting cable to the TOCO/IUP socket of the monitor.
5) Momentarily pressing the re-zero button on the IUP cable. The green light on the cable will
flash for five seconds. During this time, zero the monitor by pressing the AUTO ZERO key.
Make sure the display value and trend are both “0”.
6) Ask the mother to cough. A spike on the trend in response to the cough indicates proper
positioning and function of the IUPC.
7) Wash timely during monitoring. A spike on the tracing will respond to the washing.
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CADENCE II Fetal Monitor User Manual
NOTE:
If the light is flashing, verify that the cable check plug is inserted completely into the
cable.
WARNING :
The cable test function is not meant to check the accuracy of the system, only to confirm
cable function.
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CADENCE II Fetal Monitor User Manual
fetal arms or legs); lower frequency is because of the lower velocity of the fetal movements
compared with those of the fetal heart.
Only FHR1 channel can perform AFM. But be aware that when monitoring twins, the movements
detected by FHR1 may also be caused by the second fetus’s movement.
The movement of the fetus will be detected and displayed in the form of a trend on the screen and
the recorder paper.
You can choose whether to display the AFM trend and change the AFM threshold & AFM gain.
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CADENCE II Fetal Monitor User Manual
1) Insert the remote event marker connector into the MARK socket on the monitor.
2) Let the patient hold the marker in hand; ask her to press the top key of it when a fetal
movement is felt. Continuous movements in 5 seconds are considered to be one
movement and only press the key once.
7.8 Login
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CADENCE II Fetal Monitor User Manual
5 Press the UP key or DOWN key to move the cursor to GesWeek, press the CHANNEL
key. Input the patient’s name in the same way. Press the CHANNEL to confirm selection.
6 Press the UP key or DOWN key to move the cursor to GesDay, press the CHANNEL key.
Input the patient’s name in the same way. Press the CHANNEL to confirm selection.
7 Press the AUTO key to exit.
1 Press the SETUP key six times to open the Auto Monitor menu.
2 Press the UP key or DOWN key to move the cursor to Login; press the CHANNEL key.
3 Press the UP key or DOWN key to toggle between ON and OFF (default).
4 Press the CHANNEL key to confirm selection.
5 Press the AUTO key to exit.
The monitoring starts immediately after exiting from the menu.
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CADENCE II Fetal Monitor User Manual
Alarm message
FHR1 Trend
FHR2/DECG Trend
AFM Trend
TOCO/IUP Trend
During monitoring or playback, the trend frame displays four trends at most (refer to Figure 7-10):
FHR1 trend, FHR2/DECG trend, AFM trend and TOCO/IUP trend.
FHR1, FHR2/DECG trend
FHR1 trend is the broad one.
The y-axis of the trend indicates the values of FHR, whose range is 30 ~ 240bpm (American
standard) or 50 ~ 210bmp (International standard).
AFM trend
The y-axis indicates the scope of fetal movement.
NOTE:
The AFM trend is only for reference, please take the MFM marks as criterion.
TOCO/IUP trend
The y-axis indicates the value of TOCO/IUP, whose range is 0% ~ 100%.
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CADENCE II Fetal Monitor User Manual
Press the UP key to play the trends forward. The symbol turns into >. Keep pressing it to
accelerate until it reaches the maximum speed; the symbol turns into >>>>>. Press the DOWN
key to decelerate.
During playback, the current patient monitoring does not stop. The fetal heart sound and FHR
values are all real-time information of the patient.
During playback pause, press the FREEZE key to return to real-time monitoring.
CAUTION :
Playback must pause before printing starts. Printing in the process of playback might
result in failure information on the paper.
NOTE:
The process of playback does not bear the limit of returning to the upper directory
interface if no operation is performed within 30 seconds.
Review them in the same way as playback. The information of the patient will be updated
synchronously.
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: FH refreshing rate
169: FHR1 value.
CAUTION :
Do not press the POWER switch continuously. Allow at least 10 seconds between
switching the monitor on and off.
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WARNING :
Failure on the part of the responsible individual hospital or institution employing the use
of this equipment to implement a satisfactory maintenance schedule may cause undue
equipment failure and possible health hazards.
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CADENCE II Fetal Monitor User Manual
The gathering of dew on the display may occur with abrupt temperature or humidity changes. A
table environment is recommended.
Scratching and damaging the display should be avoided.
Avoid high voltage and static charge.
CAUTION :
Only use the recorder paper provided by EDAN, or it may damage the recorder. This
kind of damage is not covered by warranty.
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CADENCE II Fetal Monitor User Manual
8.2 Cleaning
In order to avoid infection, clean and disinfect the monitor and accessories after each use.
WARNING :
Unplug the monitor from the AC power source and detach all accessories before
cleaning.
Clean the monitor enclosure with a soft cloth and diluent non-caustic detergents, such as soft soap
water, Tensides, Ethylate and Acetaldehyde.
Clean the screen with a dry soft cloth.
CAUTION :
1) Although the monitor is chemically resistant to most common hospital cleaners and
non-caustic detergents, other cleaners are not recommended and may stain the
monitor.
2) Many cleansers must be diluted before use. Follow the manufacturer’s directions
carefully to avoid damaging the monitor.
3) Don’t use strong or chemical solvents, such as acetone, acidic or alkali solutions.
4) Never use an abrasive such as steel wool or metal polish.
5) Do not allow any liquid to enter the product, and do not immerse any part of the
monitor into any liquid.
6) Avoid pouring liquids on the monitor while cleaning.
7) Do not remain any cleaning solution on the surface of the monitor.
NOTES:
1) The monitor surface can be cleaned with hospital-grade ethanol and dried in air or
with crisp and clean cloth.
2) EDAN has no responsibility for the effectiveness of controlling infectious disease
using these chemical agents. Please contact infectious disease experts in your
hospital for details.
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CADENCE II Fetal Monitor User Manual
To clean the US transducer, TOCO transducer, IUP cables, and DECG lead, follow these steps:
1) Wipe them with a soft cloth dampened in cleaning solution;
2) Clean them with a soft cloth dampened in water;
3) Air-dry them or wipe off the remaining moisture with a soft dry cloth.
The recommended cleansers for accessories are listed below:
Accessory Cleansers
Ultrasound Transducer BURATON LIQUID
TOCO Transducer MIKROZID
ETHANOL 70%
SPORACIDIN
CIDEX
DECG Leads, IUP cable, IUP
Mild alcohol-free soap water
connecting cable
CAUTION :
1) Be sure the temperature of cleaning solutions does not exceed 45 ºC (113 ºF).
2) Do not immerse them in any liquid.
3) Only clean the outer surface of the connectors, make sure no liquid goes into the
connector.
4) After cleaning, no remaining cleanser is allowed on the surface.
Wash soiled belts with soap and water. The water temperature must not exceed 60 ºC (140 ºF).
8.3 Disinfecting
Clean the equipment before disinfecting.
The table below lists the allowed disinfectant bases:
Type Base
Instrument Disinfectant Glutaraldehyde up to 3.6%
Surface Disinfectant Ethanol
1- and 2- Propanol
CAUTION :
1) Do not use any disinfectant containing additional active ingredients other than those
listed.
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CADENCE II Fetal Monitor User Manual
2) Follow the manufacturer’s instruction to dilute the solution, or adopt the lowest
possible density.
3) Do not immerse any part of the monitor or any accessory into liquid.
4) After disinfection, no remaining disinfectant is allowed on the surface.
5) Check if the monitor and accessories are in good condition. If any aging or damage
is detected, replace the damage part(s) or contact EDAN for service before reusing
them.
NOTE:
EDAN has no responsibility for the effectiveness of controlling infectious disease using
these chemical agents. Please contact infectious disease experts in your hospital for
details.
8.4 Sterilizing
Do not sterilize the monitor or the accessories, unless this is necessary according to your hospital
regulation.
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CADENCE II Fetal Monitor User Manual
9.1 Warranty
EDAN’s obligation under this warranty is limited to repairing, at EDAN’s option, any part which
upon EDAN's examination proves defective. If the product doesn’t function as warranted during
the warranty period, we will repair or replace it without charge.
Software or Firmware
EDAN software and firmware products which are designated by EDAN for use with a hardware
product, when properly installed on that hardware product, are warranted not to fail to execute
their programming instructions due to defects in materials and workmanship. If EDAN receives
notice of such defects during the warranty period that begins on the date of shipment, EDAN
shall repair or replace software media or firmware which does not execute their programming
instructions due to such defects. But EDAN doesn’t warrant that operating of the hardware,
software, or firmware shall be uninterrupted or free from error.
NOTE: The charges of freight and others are excluded under warranty.
This unit has no parts can be repaired by users themselves. All the service should be performed
by authorized and qualified personnel.
Limit of Warranty
The warranty is void in the case of
♦ Assembly, extensions, readjustments of any parts;
♦ Modification and repair by unauthorized persons;
♦ Subsequent damage caused by improper use or maintenance;
♦ Replacement or remove of Serial number label and manufacturer label;
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CADENCE II Fetal Monitor User Manual
Monitor
Size mm (depth x width x 330mm x 270mm x 100mm
Dimensions and Weight height) :
Degree of Protection against Harmful Ordinary equipment (sealed equipment without liquid
Ingress of Water proof)
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CADENCE II Fetal Monitor User Manual
p- <1 MPa
Iob <10 mW/cm2
Ispta <100 mW/cm2
FHR Measurement Range: 50 bpm ~ 240 bpm
Resolution: 1 bpm
Accuracy: ±2 bpm
Dielectric Strength: > 4000Vrms
Resolution: 1%
Resolution: 1%
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CADENCE II Fetal Monitor User Manual
Record Message: Date, time, TOCO type, paper speed, FHR type, bed No., etc.
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CADENCE II Fetal Monitor User Manual
Ispta.3 Ipa.3@MImax
Transducer Model TI Type TI Value MI
(mW/cm2) (W/cm2)
TIS 0.055
PW 1.0 MHz 2.77 0.029 0.01
TIB 0.629
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CADENCE II Fetal Monitor User Manual
Appendix 3 Troubleshooting
A3.1 No Display
A3.2 Noise
Symptom Possible Cause Solution
The FHR volume is set to be
Adjust the volume down
too high.
Noise
Interfered by handset or Keep the handset or other
other interfering source interfering source far away
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CADENCE II Fetal Monitor User Manual
WARNING :
Switch off the monitor and unplug it before changing the fuse.
Replace the fuse when it is blown.
The two fuses of CADENCE II monitor are located on the right panel, their specifications are:
Size: Ф5mm*20mm; Model: T1.6AL 250V.
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CADENCE II Fetal Monitor User Manual
To replace a fuse:
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CADENCE II Fetal Monitor User Manual
The CADENCE II Fetal Monitor is intended for use in the electromagnetic environment specified
below. The customer of the user of the CADENCE II Fetal Monitor should assure that it is used in
such and environment.
RF emission
Class A
CISPR 11 The CADENCE II Fetal Monitor is suitable for
Harmonic emissions use in all establishments, other than domestic
Class A
IEC 61000-3-2 and those directly connected to the public
low-voltage power supply network that supplies
Voltage fluctuations/
flicker emissions Complies buildings used for domestic purposes.
IEC 61000-3-3
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CADENCE II Fetal Monitor User Manual
Electrical fast ± 2 kV for power ± 2 kV for power Mains power quality should be
transient/burst supply lines supply lines that of a typical commercial or
IEC 61000-4-4 hospital environment.
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CADENCE II Fetal Monitor User Manual
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CADENCE II Fetal Monitor User Manual
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reflection from structures, objects and people.
a) Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast
cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to
fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field
strength in the location in which the CADENCE II Fetal Monitor is used exceeds the applicable RF
compliance level above, the CADENCE II Fetal Monitor should be observed to verify normal
operation. If abnormal performance is observed, additional measures may be necessary, such as
reorienting or relocating the CADENCE II Fetal Monitor.
b) Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
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CADENCE II Fetal Monitor User Manual
The CADENCE II Fetal Monitor is intended for use in an electromagnetic environment in which
radiated RF disturbances are controlled. The customer or the user of the CADENCE II Fetal Monitor
can help prevent electromagnetic interference by maintaining a minimum distance between portable
and mobile RF communications equipment (transmitters) and the CADENCE II Fetal Monitor as
recommended below, according to the maximum output power of the communications equipment.
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be estimated using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to
the transmitter manufacturer.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
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EDAN INSTRUMENTS, INC.
3/F-B, Nanshan Medical Equipments Park, Nanhai Rd 1019#, Shekou,
Nanshan Shenzhen, 518067 P.R. CHINA
TEL: +86-755-26882220 FAX: +86-755-26882223
EC REPRESENTATIVE
Shanghai International Holding Corp. GmbH (Europe)
Eiffestrasse 80, D-20537 Hamburg Germany
TEL: +49-40-2513175 FAX: +49-40-255726
E-mail: [email protected]