Axiom iconos r200 руководство

AXIOM Iconos R200 with fixed table height

Operator Manual

AXIOM Iconos R200 with fixed table height

Operator Manual

Rückenschild für Ordner A4 (50 mm Rückenbreite); Zuschneiden auf 205 mm x 50 mm

AXIOM Iconos R200 with fixed table height

Operator Manual

AXIOM Iconos R200 with fixed table height

Operator Manual

Rückenschild für Ordner A4 (30 mm Rückenbreite); Zuschneiden auf 205 mm x 23 mm

AXD3-340.620.13.01.02 AXD3-340.620.13.01.02 AXD3-340.620.13.01.02 AXD3-340.620.13.01.02

System Overview

Table of Contents

System Overview

System Description

Application

The ICONOS R200 is an X-ray system for universal use and is suitable both as intensively used universal workstation and as a highly loaded special workstation.

You can perform examinations with the following techniques:

Fluoroscopy through image intensifier and television system

Cassette exposures with spotfilm device (optional)

–Spotfilms

–Bucky exposures

–Tomography (optional)

Digital radiography DR

–Spotfilms

–Tomography (optional)

–Periscanning

–Peristepping (optional)

–DR scanning (optional)

–Digital subtraction angiography (optional)

Tabletop cassette exposures

Bed-side exposures

Exposures onto the wall stand (optional)

Product description

ICONOS R200 universal X-ray diagnostic unit with swivelling overtable X-ray tube assembly, oblique projection and tomography in all table positions and gently starting and braking system movements.

Two-stage setting of the source-image distance.

Table tilt + 90° to — 17° with soft start and braking.

Motor-driven longitudinally and transversely moving tabletop.

Fully automatic spotfilm device with extensive subdivision program and 33 cm or 40 cm image intensifier or I.I. image receptor with 40 cm image intensifier, each with a large axial travel range.

Fluoroscopy and imaging system with ergonomic remote control.

Integrated system movement control on the spotfilm device.

System Overview

System Description

System configuration

The label with MODEL NO.: 59 02 767 bears the CE 0123 marking for the entire

ICONOS R200 system and is attached to the back of the table frame.

Standard version

ICONOS R200 system

Cassette spotfilm device with image intensifier with SIRECON 33 cm or 40 cm image intensifier or I.I. image receptor with SIRECON 40 cm image intensifier

VIDEOMED DH TV system (with DSA) or DHC (without DSA)

OPTITOP X-ray tube assembly

POLYDOROS SX X-ray generator

Primary collimator

Monitor trolley or ceiling suspension system

44 cm or 54 cm monitor(s)

FLUOROSPOT Compact with DICOM Send and Storage Commitment

Footswitch for fluoroscopy and radiography

Options

DICOM functions:

–Get Worklist and MPPS

–Query/Retrieve

–Print

Reference image monitor(s)

VERTIX PRO/TOP Bucky wall unit

2nd X-ray tube assembly on the 3D-TOP ceiling-mounted support

PACS/SIENET connection

High-pressure contrast medium injector

Measuring device for area dose product

Mobile tableside console

System Overview

System Description

System overview

(1)

(3)

AXIOM

(2)

(4)

(9)

(8)

(5)

(6)

(7)

(1)ICONOS R200 examination unit

(2)Generator ON/OFF console

(3)Monitor trolley (optional)

(4)System remote control console

(5)FLUOROSPOT Compact keyboard

(6)Foot switch for fluoroscopy and radiography

(7)Desk (optional) for operating consoles

(8)Tableside control console with foot switch for fluoroscopy and radiography (optional)

(9)Bucky wall unit (optional)

System Overview

System Description

Unit overview

(9)

(8)

(10)

(7)

(6)

(11)

AXIOM

(12)

(5)

(13)

(4)

(14)

(3)

(15)

(2)

(1)Image intensifier TV system with safety shut-off device

(2)Handgrip (at the front), adjustable

(3)Cassette spotfilm device or I.I. receptor unit with tableside control panel and removable scattered radiation grid

(4)Grip protection strip (head end), detachable

(5)Handgrip strip (located on back), adjustable, secure in all patient positions

(6)Compression device (optional)

for inserting a compression cone, continuously adjustable compression force

(7)Collimator with automatic format collimation and numerical format indication, with integrated motor-driven additional Cu filters, motor-driven adjustable semi-transparent filters (optional)

(8)X-ray tube assembly

air-cooled, partly enclosed, can be swivelled

(9)Handle for swivelling the tube assembly

(10)Tube assembly stand on the longitudinal carriage

coupled with the spotfilm device by centering rod, axially swivelling, telescopic (SID 115cm and 150cm)

(11)Longitudinal carriage with attached tube assembly stand

motorized longitudinal travel, precisely controllable speed

System Overview

System Description

(12)Tomographic height display (option) with laser line light localizer

(13)Tabletop with flat accessory rails motor-driven longitudinal and transverse travel

(14)Footboard

adjustable for use as seat,

with attachment points for foot restraints,

can be changed over from foot end to head end.

(15)Table frame

motor-driven adjustable in height, can be tilted + 90°/-17°

(16)Unit base with tilting drive on installation plate

System Overview

System Description

System Overview

Protective Measures

Emergency Procedures

Warning

Due to the complexity of the system, the loss of X-ray imaging or other system functions during an examination or procedure can not be completely excluded.

Risk of failure during interventions

Consider therefore the need to establish emergency procedures in such cases.

Cleaning and disinfection

Caution

Use of harsh cleaning agents, liquids or sprays.

Risk of electrical hazard or damage to the system

Use only substances for cleaning and disinfection, which are recommended.

Do not let cleaning liquids seep into the openings of the system (e.g. air openings, gaps between covers).

Observe the following cleaning and disinfection instructions.

System Overview

Protective Measures

Radiation protection zones

Position and size of the main operating area

Horizontal patient table:

x

107

200

90

60

60

Main operating area

Dimensions in cm

System Overview

Protective Measures

Vertical patient table:

x

200 140

x

107

40

60

60

Main operating area

Dimensions in cm

System Overview

Protective Measures

Mechanical safety

Danger zones with unit in horizontal position

The places marked in the illustrations show possible danger zones at which the patient or operator can be injured.

System Overview

Protective Measures

Danger zones with unit in vertical position1

The places marked in the illustration indicate possible danger points where the patient or operating personnel can be injured.

x

Danger zone

If the patient is located in the danger zone, it must always be ensured that the operating personnel are in the room and within reach of an emergency stop. If the operating personnel leaves the room and/or moves out of reach of an emergency stop, then the patient has to be moved out of the danger zone.

Warning signs

Special danger zones are marked on the unit with a warning sign.

This warning sign is a reference to a possible risk of injury by crushing for the patient and/or examiner.

This warning sign shows the position of the patient table in cardiopulmonary reanimation (CPR) with pressure compression up to 500N (50kg).

1 Between -90° and +90°, depending on the system version

System Overview

Protective Measures

Grip locations

Warning

When handling the system correctly as well as when positioning the patient, operators and patients should use only the grip locations

provided for this purpose.

The following grip locations are provided:

1 handgrip (front)

Grip protection strip (head end)

Handgrip strip (back)

Ensure that the handgrip strip, the grip protection strip and the handgrip are always attached.

If these grip locations cannot be used:

Pay special attention to the stated possibilities of crushing between moving parts and their guide openings.

Ensure during the examination that the patient under no circumstances holds on to the edges of the patient table.

Not intended as gripping point:

The handle for turning the tube assembly must not be used as grip location or hold for the patient.

Danger zones

The dotted areas mark the danger zone, where no objects must be located during tilting.

Danger zone

Movement range of the positioning table

Prior to activating any movements of the unit, especially tilting of the unit, make sure that there are no objects such as stairs, steps, stands, waste containers, instrument tables, beds, gurneys, monitor support systems, operating consoles or the like in its movement range.

System Overview

Protective Measures

These objects are not detected by the collision monitoring of the unit. Avoiding collisions of the unit with these objects is subject to the operator’s duty to take care.

If a collision of the unit with a rigid obstacle (e.g. step) has occurred,

press one of the red emergency stop buttons,

rescue the patient,

Warning

Under no circumstances must the unit be tilted down further or tilted up, since externally invisible, but safety-relevant damage to the tilting drive may occur. Severe consequential damage including personal damage cannot be excluded in this case.

immediately notify the SIEMENS Uptime Service.

Avoid standing or sitting immediately adjacent to the system and especially do not sit next to the system with your legs or knees under the cross-beam at the head or foot end of the table.

Take care that during system movements no one is in the area between the unit base and table.

Take care that with the footboard attached there is a risk of collision with the extended cone (optional) when the tabletop and / or the longitudinal carriage are moving.

Do not grasp in the loading shaft of the spotfilm device because of the risk of crushing.

Patient positioning

All safety-related equipment must be installed and operable. In particular the handgrip strips (head end and lateral), handgrip, footboard, foot restraints, compression belt and shoulder supports.

The patient’s hands, arms, legs, head and hair must not extend unsecured beyond the edge of the tabletop.

Observe the patient while moving the tabletop and in system movements and take care that any catheter is correctly located.

In examinations with the table tilted up vertically, the footboard serves as an adjustable step or seat.

–Ensure that the footboard is locked together with the tabletop on both sides.

–Check the firm location of the footboard.

System Overview

Protective Measures

Patient positioning with unit in vertical position

During examinations with the unit in the upright position there is a risk of crush injuries to the patient if the X-ray system (stand with tube unit/receptor unit with image intensifier) is moved in the longitudinal direction.

Position the X-ray system approximately in the acquisition position.

Move the patient into the acquisition position.

Set the X-ray system to object height. Always watch the patient when initiating this movement.

Remote compression (optional)

The motor-driven compression device requires special care on the part of the examiner for the applied compression forces, especially in the case of frail (e.g. infants), sick and elderly patients.

Observe especially that both an increased risk of crushing for the patient with consequential injury and considerable mechanical shearing forces with risk of damage can occur between the compression cone and attached accessories, e.g. shoulder supports, lateral support (optional) or motor-driven infant cradle holder (optional) by collision during the motor-driven tabletop movement.

When moving the compression carriage into the lowest position, the carriage may collide with the patient’s hand on the grip protection strip.

– Use extreme caution when actuating the cone movement.

Safety devices

(1)

(1)Switch rail between tabletop and stand

(2)Switch rails in each case at the end of the travel of the spotfilm unit

(3)Safety switching sensors on the image intensifier TV device (2 sensors))

System Overview

Protective Measures

On activation of one of the safety devices (shutdown devices) all system movements stop and are blocked.

This means that one cannot move out from the blockage oneself.

If it is not possible to remove the obstruction causing the problem, call in the Siemens Uptime Services.

Movements are possible again only after one of the safety devices has be deactivated.

Possible collisions of the system with a ceiling-mounted support1

System movements are possible only if the ceiling-mounted support is in its park position or if the bypass switch is activated if necessary.

Prior to actuating system movements with the bypass switch activated, verify that no collision can take place with the ceiling-mounted support, the X-ray tube assembly or the collimator. (No collision monitoring.)

Warning

If system movements are possible even though the ceiling-mounted support is not in the park position and the bypass switch is not activated,

immediately press the emergency shutdown button and notify the SIEMENS Uptime Service.

Measures for avoiding equipment damage

Before activating system movements, especially tilting the table, make sure that the movement range is free of obstructions.

Move especially monitor support systems, operating consoles, gurneys, beds and instrument tables out from the tilting range of the table and remove chairs, steps, stands, waste containers and similar objects from the movement area. (No collision monitoring.)

Do not place any objects or consumable material on the cover of the table support, on the spotfilm device and on the longitudinal guides of the stand carriage.

–Considerable forces which can damage these objects in the area of movement of the systems arise during movements of the spotfilm device or of the tabletop.

Do not place any loose objects anywhere on the table.

–These objects could fall down when the table is tilted, causing injury or damage.

1 optional

System Overview

Protective Measures

Do not stand at any place on the spotfilm device or on the covers of the table support outside the marked areas provided for this.

–The covers can be deformed.

Components located underneath them are damaged and thus lead to operating disturbances.

Place no objects on the operating areas of the control consoles and the tableside control.

Caution

Unintentional activation of control elements for movements

Collision with patient, operator or equipment

Do not load the remote console with any objects, accessories, folders or documents.

To avoid unintentional activation of control elements for movements concerning bed exposure, please adhere to the following workflow:

Select aquisition mode Bed exposure at the generator control console.

Tilt the system and move it to the correct SID.

Rotate the tube assembly accordingly.

Position the patient.

Control patient and system.

Don’t let patient stay in system area during absence of operator.

In vertical table positions do not use the stand column, the tube assembly support arm, the tube assembly cover or the primary collimator as seat or support.

–This unallowed loading can lead to material breakage and damage to bearings.

Never put contrast medium cups or open containers with liquid or pasty contents on the unit, on the remote console or on the control cabinets.

–Contrast medium can spill, leak or overflow into system parts and lead to operational disturbances of the unit or to misinterpretation of exposures.

When storing contrast medium in the cup holder on the compression carriage, use only cups with a maximum volume of 0.25 liter made of unbreakable materials, i.e. under no circumstances glass or porcelain.

–Remove contrast medium traces immediately!

Measures for avoiding unwanted radiation

Before starting system movements make sure that the foot switch for fluoroscopy and radiography (optional) in the examination room is not in the travel range of the image intensifier light distribution system.

System Overview

Protective Measures

Safety-relevant parts subject to wear

This system contains no safety-relevant parts subject to wear.

Maintenance intervals

Maintenance must be performed annually in order to ensure the safety and functioning ability of the system.

If you have not concluded a maintenance contract, please notify the Siemens Uptime Service on time.

CAREWATCH

Display data

At the start of fluoroscopy/acquisition the following system parameters are displayed in the lower right area of the live monitor:

1st line

– Display of the prefilter in fluoroscopy

2nd line

– Display of the prefilter in radiography With the area dose product meter (optional)1

3rd line

– Area dose product in cGycm²

4th line

During fluoroscopy

– Display of the patient entrance dose2 in mGy/min

In the radiation pauses

–the percentage of the patient entrance dose reached related to a configurable limit1 of 0.5 to 5 Gy or

–the accumulated patient entrance dose in mGy is displayed.

The measuring device must be calibrated at regular intervals. This is done within the scope of a maintenance contract. If no maintenance contract have been concluded, the measuring device can be calibrated by the Siemens Uptime Service of the manufacturer.

1can be configured by the SIEMENS Uptime Service

2standardized to 30 cm above the tabletop

System Overview

Protective Measures

Resetting the area dose product

Once the examination is finished,

actuate the reset button at the integrated generator control console

–The displays for the area dose product and the patient entrance dose are reset to zero.

Refer to the Operator Manual of Fluorospot Compact.

System Overview

Protective Measures

System Overview

Operating and Display Elements

System remote control console1

STOP

1,15

Displays general

«Radiation ON» indicator

– Symbol lights up orange

“Generator is busy” indicator

– Symbol lights up orange

Indicators in the display2

Oblique projection angle

Table tilt angle

1User interface is identical for the optional mobile tableside control console

2depending on the operating mode

System Overview

Operating and Display Elements

System settings

Compression device (optional)

–decompress

–compress

without function

Joystick for table tilt down/tilt up

Oblique projection (cranio-caudal/caudo-cranial)

System Overview

Operating and Display Elements

Oblique projection +/- 0º (orthogonal projection)

Joystick for

–X-ray system longitudinal movement

–Tabletop transverse movement

Coordinate switch for moving tabletop longitudinally/transversely

Fulcrum height for oblique projection (= isocenter)

Tomographic height setting above tabletop (optional)

Move cassette into unloading position

–only with cassette spotfilm device

Source-image distance with cassette spotfilm device (115 cm, 150 cm)

Source-I.I. distance with I.I. image receptor unit (115 cm, 150 cm)

Automatic stop for tilt (0°) on/off

Move to automatic position of all system movements for patient transfer

Start position for various system settings in the operating modes

–Tomography (optional)

–Periscanning

–Scanning technique (optional)

–Peristepping (optional)

Image intensifier formats

Image intensifier full format

Image intensifier zoom formats (zoom stages 1, 2, 3)

System Overview

Operating and Display Elements

Automatic fluoroscopy control

Automatic fluoroscopy program 1

1

Automatic fluoroscopy program 2

2

Automatic fluoroscopy program 3

3

Automatic fluoroscopy stop

R

Additional filter

Select additional Cu filter (0.1 mm, 0.2 mm, 0.3 mm)

Collimator settings

Coordinate switch for adjusting the primary collimator by motor drive (open/ close)

– Rectangular collimation

– Iris (octagonal) collimation in fluoroscopy and DR

Select rectangular or iris (octagonal) primary collimator for manual collimation

Switch light localizer of the primary collimator on/off

Display of graphics for CAREPROFILE (option)

System Overview

Operating and Display Elements

Semitransparent filters1

Semitransparent wedge filter

Semitransparent double wedge filter

Move semitransparent wedge filter and double wedge filter out from the beam path

– LED lights up: no filter in the beam path

Coordinate switch for right wedge filter (patient-related, a.p. projection) and double wedge filter

– Move in/out

– Turn to the right/left

Coordinate switch for left wedge filter (patient-related, a.p. projection) and double wedge filter

– Move in/out

– Turn to the right/left

Radiation release

Exposure release button with preand main contact

Stop button

STOP Red emergency stop button

General operating elements

Room light on/off (on-site installation required)

1 only in operation with «DSA filter diaphragm” option

System Overview

Operating and Display Elements

Preselection functions

Automatic format collimation for cassette exposures (only with cassette spotfilm device)

–Height and width: both LEDs light up

–Height: left LED lights up

–Width: right LED lights up

–Without automatic format collimation: no LED lights up

Object setting

– Oriented to the monitor: left LED lights up

– Oriented to the table: right LED lights up

Switching over single image / series for digital radiography with seriolography

– LED lights up: series

System Overview

Operating and Display Elements

Selection of tomographic program for DR or cassette1 (optional)

Exposure technique with/without scattered radiation grid

– LED lights up: grid in the beam path

Segmentation program1

Full format

Format segmented 2 on 1

Format segmented 3 on 1

Format segmented 4 on 1

1 only with cassette spotfilm device

System Overview

Operating and Display Elements

Generator on/off console

(1)System OFF button

(2)System ON button

(3)Radiation indicator

(4)Radiation release in Vertix (bucky wall stand) and Iconos Bed (free exposure) mode

All other generator control functions are integrated in the FLUOROSPOT Compact imaging system.

For more information refer to the FLUOROSPOT Compact Operator Manual.

System Overview

Operating and Display Elements

Foot switch for fluoroscopy and radiography in the control room1

(1)Switch for radiography in Iconos DFR and Iconos Cassette mode (without precontact)

(2)Switch for fluoroscopy only with cassette spotfilm device

Tableside control panel

System Overview

Operating and Display Elements

System Overview

Operating and Display Elements

Image intensifier formats

Image intensifier full format

Image intensifier zoom formats (zoom stages 1, 2, 3)

Collimator settings

Coordinate switch for open/close

– Rectangular primary collimator

– Iris primary collimator

Switch light localizer of the primary collimator on/off

LCD Monitor

Operating elements The buttons for adjusting the LCD monitor are located in the housing.

The necessary settings are made at start-up. No operation is required during operation.

Power on/off The unit has a power switch on the bottom which you must operate only if the LCD monitor is not switched through a system.

System Overview

Operating and Display Elements

Operating indicator The unit has a green LED operating indicator on the right side above the adjusting elements.

If no input signal is present, the ’No Signal’ message appears.

Primary collimator

Control elements and displays at the front

(1)Accessory rails

(2)Button for full-field light localizer and laser light localizer, switches off automatically after 10 — 90 s (configurable)

(3)Manual setting of width and height of the radiation field

–Turning to the right opens the collimator

–Turning to the left closes the collimator

(4)Motorized prefilter selection button

(5)Display field

(6)Selection of the collimated radiation field of the last exposure

(7)Stop lever for +/-45° rotation of the collimator about the vertical axis1, stop position 0°

1 configurable by SIEMENS Uptime Service

System Overview

Operating and Display Elements

(8)Buttons for entering the SID for free setting

(9)Tape measure for SID setting (cm and inch)

(10)Slide for covering the laser line light localizer

(11)Integrated measuring chamber for dose area product (optional)

(12)Manual prefilter levers at the left side (not shown )

Display field

(1)Selected = tube assembly selected

(2)Operating mode:

ACSS/PBL = with automatic format collimation, Manual = without automatic format collimation

(3)Ready = system ready for exposure

(4)Display of the selected prefilter in mmCu if prefilter is selected using a button or via remote control.

–Nothing is displayed in this field if the collimator is equipped with a manual filter unit.

(5)Format display (height x width in cm or inches)1

(6)Display of SID (in cm or inches)1

(7)Display: Collimator centered on image receptor2

(8)Display: Collimator rotated2

1can be configured in cm or inch by Siemens Uptime Service

2Display function not available with all systems

System Overview

Operating and Display Elements

Control elements at the underside

(1)Button for full-field light localizer and laser line light localizer, switches off automatically after 10 — 90 s (configurable)

(2)Laser line light localizer with slider to cover the outlet opening

(3)Crosshairs in the light localizer window

(4)Locking spring for accessories

Laser line light The laser line light localizer projects the axis mark for longitudinal centering, localizer (2) which is aligned with the centering mark on the receptor.

If necessary, the laser radiation exit of the laser line light localizer can be closed with the slider (2a).

System Overview

Operating and Display Elements

Caution

Beam of laser light localizer strikes patient’s or user’s eye

Risk of visual disturbance

Eye injury

Do not look into laser beam.

Take care that neither you nor any other person look directly into the light beam.

Close the laser radiation exit of the Laser light localizer with the sliding cover to protect the eyes of the patient or any other person.

Caution

Long operating time of light localizer lamp

Overheating of housing and danger of burns

Take care when touching the collimator housing

To switch the laser line light localizer on, press the button at the front of the

collimator.

To switch the laser line light localizer off, press the button again.

–The laser line light localizer can also be switched off automatically by an internal time switch.

The full field light localizer for projecting the crosshairs is switched on with the button at the front of the collimator.

To switch it off press the button again.

–The full field light localizer can also be switched off automatically by an internal time switch.

The laser line light localizer and the full field light localizer cannot be switched independently of one another.

Locking spring The locking spring is located on the left guide rail at the underside of the collimator.

The locking spring locks the compensating filters, templates etc. inserted in the accessory rails of the collimator, thus securing them against falling out.

To remove the accessories, press the locking spring to the left until the compensating filter, template etc. can be removed from the collimator.

System Overview

Operating and Display Elements

Prefilter selection

Caution

Malfunctioning of prefilter

Incorrect radiation dose

Take care of correct filter setting on manual prefilter

Motorized prefilter selection1

To select a prefilter press the prefilter selection button.

–The Cu prefilter changes to the next value each time the button is pressed

–Possible settings are:

0.0mm Cu (no) prefilter

0.1mm Cu prefilter

0.2mm Cu prefilter

0.3mm Cu prefilter

–The currently selected prefilter is shown in the display.

Manual prefilter selection2

(1)

Manual prefilter selection is performed using two levers (1) on the left side of the multileaf collimator.

Four combinations of lever positions are possible:

0.0 mm Cu (no) prefilter: Set both levers to the left

0.1 mm Cu prefilter: Set the upper lever to the right and the lower lever

to the left

0.2 mm Cu prefilter: Set the upper lever to the left and the lower lever to the right

0.3 mm Cu prefilter: Set both levers to the right

1Not with variant PBL II

2Only with variant PBL II

System Overview

Operating and Display Elements

Changing the bulb of the laser light localizer

As soon as the lamp brightness decreases, this symbol is shown in the collimator display. It recommends to change the bulb.

Although you can continue working with less brightness, we recommend to change the bulb as soon as possible.

To change the bulb proceed as follows:

Switch the system off at the generator ON/OFF console.

If necessary, turn the collimator to get better access.

Refer to the description in the according system Operator Manual.

Lamp cover at the backside of the collimator

Loosen the 3 screws on the lamp cover using a conventional slotted screwdriver.

Remove the lamp cover.

Heat shield

System Overview

Operating and Display Elements

Heat shield might be very hot! Please let it cool down before removing it.

Loosen (single turn) the two heat shield screws (1) on the lamp.

Remove the heat shield (2).

Remove the defective bulb (2).

Do not touch the bulb with your bare fingers — it can be very hot!

Insert the new bulb using a cloth and make sure both contacts (3) are touching the frame stop position.

Do not touch the bulb with your bare fingers!

Insert the heat shield to the stop position and tighten the screws (1).

Attach the lamp cover.

Caution

Lamp breaks

Patient and/or user injured by glass splinters

Use only OEM Siemens spare parts