The following conventions are used in this manual:

• All feedback and questions on the product design, function, and usefulness of this manual are valued by the company.
• Please send an email to: VPSTechSupport@teleflex.com

• Only Teleflex trained, and authorized service providers may service the Arrow® VPS Rhythm® DLX Device.
• Contact your local Customer Service, Sales Representative, or Distributor for service options in your area.

• For other technical questions not included in this manual, please contact Teleflex VPS Technical Support at VPSTechSupport@teleflex.com.

• On the right you can see the complete setup of the Arrow® VPS Rhythm® DLX Device.

• The "Intravascular ECG" display window will be black with a white waveform, in the lower section of the display.

• Snapshots can be taken either during external or Intravascular ECG mode.
  The Remote Control or the Touchscreen can be used to select the "Snapshot" icon (1).
• Once the image is taken it will be displayed for a few seconds in the middle of the screen before moving to the right side where the most recent two snapshots are shown (2), and any tracing using the T-Piece (3).

• The "Finish" icon on the far right will be used in the following cases. Otherwise, the "Finish" icon should not be selected.
  • The case is complete after all necessary snapshots have been taken and the PICC is placed properly.
  • The procedure was unsuccessful and a chest X-ray is needed.

• This side facing up.
• The Teleflex logo should be visible below the patient's chin.
• The notch of T-Piece should be placed at the patient's sternal notch.

• The 2 ports on the rear of the unit are USB 3.0 but will work with 2.0 rated flash drives.
• Common formats of FAT32 and NTFS are compatible.
• We recommend using quality name brand flashdrives of 4GB or larger.
• Secure USB Flash Drives can be used if unlocked prior to use.

• The various accessories can be connected or disconnected at any point without harming the system:
  1. Remote Control
  2. T-Piece
  3. Ultrasound Probe
• This can be done while the system is running.

• Prior to each use, the system components should be inspected for damage, and any damaged components replaced.
• It is recommended that the CMOS battery should be checked annually. This can be done by reviewing the voltage reading found in the "Settings" screen.
• The system does a check of the voltage on the CMOS battery during startup.
• It is recommended that when the voltage shown drops to 2.3 V that the battery be replaced to prevent any possible loss of date/time information.

• DLX-200-BAT

• DLX-200-RC

• DLX-200-ECGPC

• RHY-100-ECGA-1 - Red, White, Black (AHA)
• RHY-100-ECGB-1 - Red, Yellow, Green (IEC)

• DLX-200-PWR
  (AC power cord sold separately)

Refer to https://www.iec.ch/world-plugs for descriptions of the plug pin configuration and the countries they are used in:

• DLX-200-PWRC-B
• DLX-200-PWRC-EF
• DLX-200-PWRC-G
• DLX-200-PWRC-I
• DLX-200-PWRC-L
• DLX-200-PWRC-N

• DLX-200-USC

• DLX-200-ISO
  (For use with Dymo 4XL printer)

• RHY-100-ECGJ
  Arrow® VPS Rhythm® ECG Accessory Pack with Arrow® Johans™ Adapter, contains Clip Cable
  
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• RHY-177-TTSAP
  Contains TipTracker™ Stylet
  
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• Teleflex offers the Dymo LabelWriter 4XL printer that can be connected to the Arrow® VPS Rhythm® DLX Device via a USB cable.
• This Arrow® VPS Rhythm® DLX Device Printer allows the clinician to print JPG files from the Arrow® VPS Rhythm® DLX Device onto a label, which can then be placed, or scanned, into the patient record.
• Please see the printer "Instructions for Use" for full operational details or visit www.dymo.com for local language information.

• The Arrow® VPS Rhythm® DLX Device can be mounted to the RHY-100-CARTA, using the additional arm and holder accessory kits that includes all the required hardware such as VESA adapter plate and screws.
• DLX-200-ARM contains the metal arm, VESA plate, and screws.
• DLX-200-TGR contains the T-Piece holder and gel/remote holders as shown in the picture on the right.

• Prior to using a printer, it must be set up while the Biomed is logged in, and USB ports must be enabled.
  For more details, see section Activating USB Ports.
• For complete instructions on printer setup please refer to the Operator's Manual (DLX-200-OPM-XX).

• The Biomed will also choose which color of ECG leads are used in their facility, which will be reflected in the graphics displayed.

• The USB ports are inactive by default and require a Biomed login to activate.
  • This is for cybersecurity integrity.
  • USB ports should only be activated when required and deactivated at all other times.
• USB Port activation is required for:
• Printing using the Dymo 4XL printer
• Downloading Log Files to a USB flash drive
• Updating Software
• Exporting All Data

• During setup a Clinician PIN code needs to be set by the clinicians. This PIN code is intended to protect access to patient data stored in the monitor.
• The Clinician PIN code is required to access the Manage Cases function which allows printing and viewing of stored cases.

• The Service password unlocks the various "System Configuration" settings, and the "System Maintenance" functions.
• If the Service password is forgotten, the following process will need to be followed to reset the password.

• Ability to adjust the Brightness, Logout timer, and Screen Saver delay.
• Ability to change Clinician PIN or Language of the display.
• Ability to access the Training video to view an example of the expected ECG p-wave behavior.

• This panel offers information about
• System hardware
• Software versions
• Memory (RAM)
• MAC address (defaults to blank as Ethernet is disabled)

• This panel shows results of the self tests performed during startup.

This panel shows the current Battery Status and whether it is detecting AC power.

• Level, % - How charged the battery is.
  • The battery will take approximately 8h to fully charge with the unit powered off and 12h with the unit powered on.
  • The battery can power the device for at least 2h, longer if not using Ultrasound.
• Power, W - The consumption or output
  • On battery power the value should be -18W to -35W.
    
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  • Plugged in the value should be 7-14W.
    
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  • Values outside these ranges indicate a battery that should be replaced.
• Efficiency, % - How efficient the battery is charging

  NOTE

  If the Efficiency drops below 75% and the unit is primarily used for extended periods of time on battery, it is recommended to consider replacing the battery (DLX-200-BAT).

• This panel indicates whether the signal is detected coming from each of the ECG leads.

• This panel can be used to test the buttons on the remote control without being in a case.

• This panel indicates if the S tylet is detected as being connected to the Remote Control stereo plug.

• This panel shows the current test status for the T-Piece.
• It can be used to test the coils on the T-Piece without being in a case.
  • If the T-Piece test is run, the results will display.
  • If the T-Piece test has not been run, the panel will show "UT" (UnTested).

• This panel shows the Firmware versions, temperature status and power output of the Single Board Computer.

• This panel shows the version and connection status as well as the serial number of the Ultrasound Probe.

• Service login is required to gain access to "System Configuration" and "System Maintenance" features.
• For more details, see section Service Login Setup.

The "System Configuration" menu offers the following options:

• System Date / Time
  Allows the date and time to be set appropriate to your location.
• Screen Calibration
  Allows the color calibration of the screen. No password required, just click enter to proceed and follow the instructions on the screen.
• Printer Settings / Install Bluetooth Print Driver
  Allows you to set up a printer to use with the system. See the Operators Manual for detailed steps on setting up the Dymo 4XL USB printer or the Brother MW-260Mfi Bluetooth printers which have been tested with the DLX.
• Settings for Printer media size
  Use Letter/A4 for the Brother printer and Label/A6 for the Dymo printer.
• Lead type
  AHA (Red/Black/White) or IEC (Red/Yellow/Green).
• Enable USB port checkbox
  Must be checked to enable the USB ports.
  For more details, see section Activating USB Ports.

  NOTE

  • When the Ultrasound Probe is in use, the USB ports are temporarily disabled.
  • Once the Ultrasound screen is exited, the USB ports will become active again if they are set to be enabled.

The "System Maintenance" menu offers the following options:

• Reset Clinician Pin
  If the clinician PIN is forgotten, it can be reset.
  For more details, see section Clinician PIN Reset.
• Repair Application
  If the software is not working as intended, this will allow Windows to reinstall the application software. All cases and logs remain, only the application is reinstalled.
• Log File Manager
  This allows viewing and exporting off the log files, which may be requested to investigate errors or other issues.
  For more details, see section Downloading Log Files.
• Update History
  Shows the log of any software updates that have been applied to the system since manufacture.
• Export All Data
  Allows for export of database to USB flash drive. This may be requested by Teleflex Service for troubleshooting purposes.

• During troubleshooting with Teleflex Technical Support, they may request that the log files collected at the time of an event be sent to them for analysis and investigation.
• Follow these steps to download the files to a flash drive so they can be emailed to VPSTechSupport@teleflex.com.

• Remove the Battery and press the charge button to view LED charge meter.
• Verify that the Battery shows at least 1 bar on the LED charge meter.

• Verify the switch next to the Battery is in the forward position (toward the front of the monitor) to ensure the Battery can charge.

• Connect Power Supply to Monitor and plug into AC outlet.
• Verify green LED is illuminated on rear of Monitor.

• Remove and reinsert Battery.

• If the condition persists, remove the unit from use and request service from your local Teleflex Authorized Service Center.

• Check green LED on Power Supply is illuminated when Power Supply is plugged into the AC outlet.
• If not, replace Power Supply (DLX-200-PWR) or Power Cord (RHY-100-PWRC (B / G / I / L / N / EF)).

• Remove and reinsert Battery.

• If Battery will still not charge, remove unit from use and request service from your local Teleflex Authorized Service Center.

• If the condition persists, remove the unit from use and request service from your local Teleflex Authorized Service Center.

• Remove and reinsert Battery.

• Unplug the unit and remove the battery.
• Inside the battery compartment you will see a small opening with a button.
• Using a small tool, reach in and press and hold the button for about 5 seconds to reset the CMOS battery.
• Insert the battery and reboot the unit. It will run for 10 seconds with a blank screen and power down. The second reboot should be normal.
• If necessary, reset the date and time. For more details, see section System Configuration: Date / Time.

• If the condition persists, remove the unit from use and request service from your local Teleflex Authorized Service Center.

• Remove the unit from use and request service from your local Teleflex Authorized Service Center.

• Check ECG Snap Lead connections to patient cable or T-Piece.
• If any lead is damaged, replace (RHY-100-ECGA-1 or RHY-100-ECGB-1).

• Check that External ECG is detected (verify symbol at right displays on Monitor).

• You should hear or feel a click when it connects.
• If not, replace the ECG Patient Cable (DLX-200-ECGPC) or T-Piece (DLX-200-TP).

• Replace ECG Patient Cable (DLX-200 ECGPC) or T-Piece (DLX-200-TP).

• Check ECG Snap Lead connections to ECG Patient Cable or T-Piece.
• If any lead is damaged, replace (RHY-100-ECGA-1 or RHY-100-ECGB-1).

• You should hear or feel a click when it connects.
• If not, replace the ECG Patient Cable (DLX-200-ECGPC) or T-Piece (DLX-200-TP).

• Check horizontal and vertical scaling setting.
• Set both horizontal and vertical scaling options to "Auto".

• Power OFF unit and then power back ON.

• Remove unit from use and request service from your local Teleflex Authorized Service Center.

• Check that the plastic sleeve was pierced when connecting to Remote Control Stereo connector.

• Check connection of Remote Control to Monitor.

• Remove unit from use and request service from your local Teleflex Authorized Service Center.

• Replace Patient Cable (DLX-200 ECGPC) or T-Piece (DLX-200-TP).

• Verify the flash drive is working by plugging it into a familiar device such as a computer and viewing the drive.

• If files are still unable to export, remove unit from use and request service from your local Teleflex Authorized Service Center.

• If exported files are still corrupted, remove unit from use and request service from your local Teleflex Authorized Service Center.

• Replace Remote Control (DLX-200-RC).

• If Printer still will not power ON, replace Printer RHY-100-PRN (ANZ / EMEA / LATAM / NA / UKHK)
  (Dymo LabelWriter 4XL Printer).

• Verify connections between the opto-isolator and the rear of the Monitor and the printer and the opto-isolator.

• Verify Printer icon is active, not greyed out.

• Verify the Printer has proper labels loaded.
• For more details, see section Printer Information.

• Check bottom of "Settings" screen to verify Label/A6 is highlighted.
• This can be enabled by the Biomed using the Service Login established during Monitor installation.

• Replace Printer RHY-100-PRN (ANZ / EMEA / LATAM / NA / UKHK)
  (Dymo LabelWriter 4XL Printer).

• Replace Printer RHY-100-PRN (ANZ / EMEA / LATAM / NA / UKHK)
  (Dymo LabelWriter 4XL Printer).

• Replace Printer RHY-100-PRN (ANZ / EMEA / LATAM / NA / UKHK)
  (Dymo LabelWriter 4XL Printer).

• If jam persists, replace Printer RHY-100-PRN (ANZ / EMEA / LATAM / NA / UKHK)
  (Dymo LabelWriter 4XL Printer).

• Verify T-Piece is connected to grey port in rear of Monitor.
• If T-Piece connection is not secure, disconnect and reconnect.

• Replace T- Piece (DLX-200-TP).

• Check ECG Snap Lead connections to patient cable or T-Piece.
• If any lead is damaged, replace (RHY-100-ECGA-1 or RHY-100-ECGB-1).

• Check that External ECG is detected (verify symbol at right displays on Monitor).

• You should hear or feel a click when it connects.
• If not, replace the ECG Patient Cable (DLX-200-ECGPC) or T-Piece (DLX-200-TP).

• Replace ECG Patient Cable (DLX-200 ECGPC) or T-Piece (DLX-200-TP).

• Replace Stylet (RHY-177-TTSAP).
  
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• Replace Remote Control (RHY-100-RC).
  
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• Make sure the cable is fully inserted into the probe.
• Note the orientation.

• Verify no pins are broken or bent.

• Remove probe from use and request service from your local Teleflex Authorized Service Center.

• Make sure the cable is fully inserted into the probe.
• Note the orientation.

• Verify no pins are broken or bent.

• Inspect the housing for cracks.

• Remove probe from use and request service from your local Teleflex Authorized Service Center.

• Arrow® VPS Rhythm® DLX Device Monitor Bundle and additional accessories (Monitor, Power Supply, AC Power Cord, Snap Leads, ECG Patient Cable, Remote Control).
• ECG Simulator capable of outputting a 60 bpm, 1 mV signal, with a V1 terminal to clip to.
• ECG Clip Cable - part of RHY-100-ECGJ (ECG-only Accessory Pack)
• TipTracker™ Stylet - part of RHY-177-TTSAP (TipTracker™ Stylet Accessory Pack), only needed if a T-Piece is being tested.
• USB mouse

• Connect the system as shown.

• Connect the ECG leads to the corresponding terminals on the ECG Simulator.
• The ECG Clip Cable is plugged into the Stereo Plug of the Remote Control.
• Clip the other end to the V1 terminal on the ECG simulator.
• Set simulator to: 60 bpm, 1 mV Amplitude

• Connect the system as shown.

• The Hipot test is performed during manufacturing to ensure the insulation within the power supply is functioning as intended.
• It is not required to repeat this test after servicing.

• Teleflex recommends following standard local testing procedures appropriate for local regulatory requirements to measure the leakage current of the Arrow® VPS Rhythm® DLX Device as a whole system including the VPS Rhythm® DLX Device Monitor, Power Supply, and Remote Control.
• If there is no standard local Current Leakage testing protocol, the following information can be used as a guideline for testing using local test equipment.