Philips M5066A manual

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Table of contents for the manual

  • Page 1

    HeartStart Defibrillator OWNER’S MANUAL Guid e to Set U p, O peration , Mai ntenan ce, an d Acce ssories M5066 A Editi on 7[...]

  • Page 2

    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

  • Page 3

    Phil ip s Me dic al Sy ste ms Th e Hear tSta r t Defibr ill ator M 5066A Pads Car tridge Han dle . Pul l the handl e to tur n on the Hea rtStart a nd r e mo v e the car trid ge’ s hard cover . Ready Light. Th is g r ee n li gh t tells you the readin ess of the Hea rtStart. Blin ki ng: st and by mo de (rea dy for use) Solid: in use Off: needs att [...]

  • Page 4

    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

  • Page 5

    Phil ips Medi cal Syste ms Hear tStar t Def ibr illator M5066A QUICK REFERENC E[...]

  • Page 6

    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

  • Page 7

    Phil ips Medi cal Syste ms Hear tStar t M5066A Automated Exter nal Def ibr illator Ed ition 7 IMPOR T A NT NO T E: It is impo rta nt to un derst and that su r vival r ates for sudde n cardiac arrest are directly rela ted to how s oon v ictim s receive treatm ent. For eve r y minu te o f delay , the c han ce o f sur vi val decl ines by 7% to 1 0%. D[...]

  • Page 8

    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

  • Page 9

    Phil ips Medi cal Syste ms HEARTSTA RT M5066A About this e ditio n The informa tion in this g uide applies to the mod el M5066A He artStart Defib ri llator . Its techn ical cont ents apply to all m odels in the He artSt ar t HS1 family of de fibrilla tors, inc ludi ng th e HeartS tart, th e HeartSta rt OnS ite, and the Hea rtStart Fir st A id De fi[...]

  • Page 10

    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

  • Page 11

    Phil ips M edica l Syst ems i CONTENT S 1 Introduction to the H eartStart Desc riptio n ...... ..... ..... ...... ..... ...... ........ ..... ...... ..... ...... ..... ...... ..... ...... ........ ..... ...... ... 1-1 Sud den Cardiac Arres t ..... ..... ...... ..... ..... ...... ........ ..... ...... ..... ...... ..... ...... ........ ..... . 1-1 I[...]

  • Page 12

    Ph ilip s M edica l Sy ste ms ii HEARTSTA RT M5066A APPEND ICES A Accessori es for the HeartStart B Gloss ary of term s C Gl ossa ry of sy mbol s/cont rols D Warni ngs a nd preca utions E T echn ica l info rm ation F Configuration G Testing and troubleshooting H Additional technica l i nformatio n required for European conformity[...]

  • Page 13

    Phil ips Medi cal Syste ms 1-1 1 1 Int rodu cti on to th e He ar tS tar t Descri ption The Hear tStart Defibril lator M5066A is pa rt of the Philips Hear tStar t HS1 fa mily of defibri llators. Sm all, light we ight, and batter y p ow ered, it is designe d for sim ple and r e liabl e oper atio n. Sudde n Cardia c Arrest The Hear tS tar t is used t [...]

  • Page 14

    1-2 Phil ips Medi cal Syste ms HEARTSTART M5066A T ra ining a nd pra ctice The HeartS tart is one part of a w ell- desi gned eme rge ncy r espon se pla n. An y emerg ency re spons e plan sh ould be und er the ov ersi ght of a ph ysicia n and sho uld incl ude tra inin g in car dio pulmo nary resus citat ion (CPR ). Philip s r ecommend s that y ou tr[...]

  • Page 15

    Phil ips Medi cal Syste ms 2-1 2 2 S ett ing up the He ar tStar t Package content s Che ck the cont ent s of the HeartSta rt Def ibri llator M5066A bo x to be su r e it contai ns: • 1 Hear tS tar t D efibrill at or • 1 batt ery M5070A • 1 Adul t SMAR T Pads Cartri dge M50 71A, conta ining one s et of a dhesive d efibrilla tion pads • 1 Ow n[...]

  • Page 16

    2-2 Phil ips Medi cal Syste ms HEARTSTART M5066A 3. In sert the cartri dge in to th e ca rtrid ge wel l on th e f r ont of the de fib ri lla tor . It shoul d click into place when p roperly sea ted. The green PULL h andle should be al l the wa y do wn. NO TE: T o pre v ent the pad s’ adhe siv e g el fr om drying out, do no t op en the ha r d co v[...]

  • Page 17

    2-3 Phil ips Medi cal Syste ms 2 6. Pla ce t he defib rillator in t he carr y ca se, pressing it firmly into p lace . Inse rt the Quic k Reference G uide, * f ace up , in the clea r pla stic wi ndow on th e i nsid e of the c ase. If you pur c h ased a spar e SMAR T Pads Cartridge or an Infant /Chi ld Pads Cart ridge , pla ce it in the storag e area[...]

  • Page 18

    2-4 Phil ips Medi cal Syste ms HEARTSTART M5066A Recommended a ccessories It is al wa ys a goo d ide a to have a spare batt er y and a spare p ads set . Ot her th ings that ar e us eful to k eep wi th th e HeartSta rt incl u de: • sci ssors — for c utting t he victim’ s c lothes if ne eded • dis posa ble gloves — to protec t the u ser •[...]

  • Page 19

    Phil ips Medi cal Syste ms 3-1 3 3 Using t he Hear tS tar t IM POR T ANT NO TE: Be sure to read the R emi nd ers se cti on a t th e en d o f this cha pter as we ll as t he wa rni ngs a nd pr ecautio ns in Appe ndix D . Ov erview If you t hink s omeone is in S C A, act quick ly and c almly . If s omeon e el se is availa ble , ask hi m or her to ca l[...]

  • Page 20

    3-2 Phil ips Medi cal Syste ms HEARTSTART M5066A STEP 1 : PULL the green handle T urn on th e Hear tS tar t by pu lli ng th e SMA R T Pad s Car t ridg e’ s green hand le . * Rem ov e the hard cover from the p ads ca rtrid ge and s et i t aside . Rem ain c alm and follow the He ar tStar t’ s inst ruction s. The Hear t Star t sta rts by di rectin[...]

  • Page 21

    3-3 Phil ips Medi cal Syste ms 3 STEP 2 : PLA CE the pads Pul l t he t ab at t he to p of t he pa ds cartri dge to peel of f the fi lm s eal. I nsid e ar e tw o adhe siv e pa ds on a plast ic li ner . Remov e the pad s fr om the cart ridg e. P eel on e pad o ff th e li ner . Pla ce the pad on the pati ent ’ s bar e sk in, exactly as shown in the [...]

  • Page 22

    3-4 Phil ips Medi cal Syste ms HEARTSTART M5066A STEP 3 : PR ESS the Shock button As soon as t he H ear tSt art det ects tha t the pa ds are a ttach ed t o th e pa tien t, it beg ins ana lyzin g the pa tien t’ s he ar t rhythm. I t te lls you that no one sh ould be touc hing the pat ient , a nd t he Cautio n l igh t be gins f lash ing a s a r emi[...]

  • Page 23

    3-5 Phil ips Medi cal Syste ms 3 T reat ing infants and childr en W A RNING: Most card iac arrests in child ren ar e not ca used by hear t proble ms. When r espond ing to cardia c arrest in an infa nt or child : • Provide in fant/child CPR while a bystan der c alls EMS and brings the Hea rtS tar t. • If no bystande r is available , provide 1 -2[...]

  • Page 24

    3-6 Phil ips Medi cal Syste ms HEARTSTART M5066A If the patient is under 55 pounds or 8 ye ar s ol d, but yo u do NO T have an Infant/Child P ads Cartr idge: • DO NO T DEL A Y TREA TM ENT . • Remo v e all clot hing fr om the tors o , to bare both the ches t and the bac k. • Appl y the H eartStart usi ng the adu lt pad s cartrid ge, but pla ce[...]

  • Page 25

    3-7 Phil ips Medi cal Syste ms 3 Reminders • R emov e any medi cin e patch es and r esi dual ad hesi ve fr om the pat ient ’ s chest bef or e a ppl ying the pa ds. • Do no t allo w th e p ads to co nta ct o the r ele ct r ode s or meta l part s th at ar e in con tact w ith the p atien t. • A void placin g the pads directly over an implan te[...]

  • Page 26

    Phil ips Medi cal Syste ms HEARTSTART M5066A Notes[...]

  • Page 27

    Phil ips Medi cal Syste ms 4-1 4 4 After using the Hear t Star t After e ach use 1. Chec k th e o utsi de o f the Hear t Star t for sign s of d ama ge, dir t, or conta mination . If y ou see sign s of damage , cont act Philips for tec hnical suppo rt . If th e de fibrilla tor is d irty or co ntam inated , clean it ac cording t o the gui delin es in[...]

  • Page 28

    4-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Follow your lo cal protocol w ith regard to prompt data trans fer for medi cal review af ter using th e He artStart. * Details ab out da ta trans fer and timi ng are provided in Event Revi ew do cumen tat ion. The i nf ormati on autom ati cal ly st or ed b y th e HeartSta rt includes a sum mar y of l[...]

  • Page 29

    Phil ips Medi cal Syste ms 5-1 5 5 Maintaining the Hear t Star t Routine M aintenance The Hear tSta rt is ver y si mple to ma intain . The defibri llator p erforms a self- test ever y day . In a ddition , a bat ter y i nser ti on se lf- test i s ru n wh enever a ba tter y is install ed in the device . The defib rillator’ s ex tensive autom atic s[...]

  • Page 30

    5-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Cleaning the H ear tStar t The outsi de o f the Hea rt Star t an d its carr y ca se c an be clea ned w ith a soft clot h damp ened in so ap y water , chl orine bleac h (2 table spoons per qua r t or liter of water ), or amm onia- base d clean ers . Rem inder s: • Do not u se isopr opyl (rubbing) al[...]

  • Page 31

    Phil ips Medi cal Syste ms A-1 A A Acce sso r ies fo r the He ar t Sta r t Access ori es * for th e H eart Star t Defib rillato r a vailab le separa tely from y our Philips representative o r on- line at www .medical.p hilips .com/hea rt start includ e: • Batte ry (spar e recomme nded ) [REF: M5070A] •P a d s • Ad ul t S MAR T Pads Cart ri dg[...]

  • Page 32

    A-2 Phil ips Medi cal Syste ms HEARTSTART M5066A • T raining • Adult T raining Pa ds Cartridg e [REF : M5073A] • Adult T raining Re plac ement P ads [REF : M5093A] • Adult P ads Pla cemen t Guide [REF: M5090A] • Inf ant/Ch ild T ra ining Pa ds Cartridg e [REF : M5074A] • Inf ant/C hild T ra ini ng Replac ement P ads [R EF: M509 4A] • [...]

  • Page 33

    Phil ips Medi cal Syste ms B-1 B BG l o s s a r y o f t e r m s The terms lis ted in this Glossar y are defin ed in the context of the Philips Hea rtS tart De fibrilla tor and its use . AED Au tomated e xternal defibril lator (a s emi-au tomatic defibrillat or). AE D mode T he stan da rd tr e atment mod e fo r the He artSt art Def ibr illa tor . It[...]

  • Page 34

    B-2 Phil ips Medi cal Syste ms HEARTSTART M5066A fibrilla tion A dist urbance of the norma l hea rt rh ythm t hat result s in chaotic , dis organ ized activ ity tha t cann ot effecti vely pump bloo d. V entric ular fib rillation (fibrill ation in the l ow er c hamber s of the hea rt) is as sociat ed wi th sud den c ar diac ar r es t. HeartSta rt Ev[...]

  • Page 35

    B-3 Phil ips Medi cal Syste ms B On/Of f but to n sto ps the ba tt ery in sertion se lf -te st th at automa ti cal ly run s when a batte ry is ins ert ed. pads Se e “SM AR T p ads. ” pa tient care pa use A d efine d pau se to all ow pa tient a sse ssme nt, tre atmen t, a nd/or CPR . See “NSA pause” and “pr otocol pause. ” per iodic se l[...]

  • Page 36

    B-4 Phil ips Medi cal Syste ms HEARTSTART M5066A cartr idge. The pad s ar e ap pli ed t o the p ati ent’ s bar e ski n and us ed t o de te ct the patie nt’ s hear t rhythm a nd to transfer the defib rillation shock . Only H ear tStar t SMA R T Pads can be used with the Hea rtS tar t Defib rillat or . standb y mode The o peratin g mo de of the H[...]

  • Page 37

    Phil ips Medi cal Syste ms C-1 C C Gl ossar y of symbols/controls sym bol descri ption Pads cartrid ge ha ndl e. Gre en. Pulling t he ha ndle turns on the de fibrilla tor and open s pads car tridge for u se. Refer to operating ins tructio ns. On/Of f butt on. Gr een. Pr essing the On/ Off butto n when the de fibrilla tor is in standby m ode tu rns [...]

  • Page 38

    C-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Cer tified by the Canad ian Standards A ssociation. Reference o rd er num ber . Expirat ion date . Lith iu m ma nganes e dio xi de b att ery . One batt ery in package. Do n ot c rus h the ba ttery . Do not expose th e bat tery to high hea t or open flames . Do no t incine rate th e batt er y . Do no [...]

  • Page 39

    C-3 Phil ips Medi cal Syste ms C This sid e up . T r ansportati on r equir ements ( ref er to asso ciated thermometer symbol). Storage requirements (refer to asso ciated therm ometer symbol). Envir onmen tal (temperature and r elative humidity) requirements. Thes e pad s a r e disp osab le a nd ar e for s ingl e pat ient u se only . Car tridge cont[...]

  • Page 40

    C-4 Phil ips Medi cal Syste ms HEARTSTART M5066A Serial number . Lot numb er . Fe de ral la w (U SA) r estr ic ts thi s de vi ce to s ale by or on the or d er of a ph ysic ian. Dispose o f in accordance with your coun try's r equirements. Pri nte d on re cy cl ed pa p er . sym bol descri ption[...]

  • Page 41

    Phil ips Medi cal Syste ms D-1 D D W ar nings and precautions It is impor t ant to underst and how to use you r Hea rtS tar t D efibrill ator sa fely . Pleas e r e ad thes e warning s and pr ecaution s c ar efu lly . A wa rning de scr ibes so met hing that c ould caus e seri ous pe rson al inj ury or death. A pr ecaut i on d escribe s some thi ng t[...]

  • Page 42

    D-2 Phil ips Medi cal Syste ms HEARTSTART M5066A pad s Do not allo w the pad s to cont act ot her elect r ode s or met al parts tha t ar e in con tact w ith the p atien t. Precautions de vic e handli ng The He artStart was desi gned to be stur dy and r eli able for man y diff er ent u se condi tio ns. How ev er , handling the Heart Start too r ou g[...]

  • Page 43

    Phil ips Medi cal Syste ms E-1 E E T ec hni cal infor m at ion HeartSt art Defibril lat or spec ific atio ns The s pecific ations provided in the following ta bles a re nomin al va lues. Addit ional in form at ion c an b e foun d in the T echni cal Refe rence Manual for He artSta rt Auto mated Exter nal De fibrillato rs, lo cated online at ww w .me[...]

  • Page 44

    E-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Co ntrols and ind icato rs seali ng Drip pr oof per EN 60529 clas s IPx1. Solid Obj ects per EN 60529 clas s IP2x. ESD/EMI (rad iated an d imm unity ) See El ectr omagneti c Conf ormi ty ta bles . cate gor y spec ifications cate go ry spe cification s controls Green SMAR T Pa ds cartri dge handle Gre[...]

  • Page 45

    E-3 Phil ips Medi cal Syste ms E De fibr illa ti on Wa ve form cate gor y spec ifications wa vef orm parameters Biphas ic truncated ex ponential. W a v eform parameters a r e automati call y ad justed as a fu nction of patient defibr illation impe dance . In t he d iagram a t left, D is t he durati o n of ph ase 1 and E i s t he durati on of pha se[...]

  • Page 46

    E-4 Phil ips Medi cal Syste ms HEARTSTART M5066A ene rgy * (pe diatric d oses in dicated ar e based on C DC gro wt h charts for t he 50th per centile we ight s for bo ys.) Using HeartStart Adult SMAR T Pads: 150 J nomi nal ( ± 15% ) into a 50 ohm lo ad. Usin g Hea rt Start Infant /Child SMAR T Pa ds: 50 J nom inal ( ± 15%) int o a 50 o hm load. S[...]

  • Page 47

    E-5 Phil ips Medi cal Syste ms E ECG analysis system cat eg o ry sp ecific ations func tion Eval uates impe danc e of adhe siv e pads for pr oper co ntact with th e pati ent’ s skin, and ev aluat es the ECG r h ythm and sign al q uali ty t o det ermine if a shock is appr opriate. sh ockable rhythms V entr icular fibril lation (VF) a nd some ventr[...]

  • Page 48

    E-6 Phil ips Medi cal Syste ms HEARTSTART M5066A ECG analysis performance rhythm class ECG tes t samp le a siz e meets AHA r ecommend ations b f or adult defibr illation obser ved 90% one-sided performance lower c onfidence limit shoc kab le rh ythm — ventricular fibri llation 300 sen sitiv ity >90 % (meets AAMI DF80 re quir e ment) (87%) shoc[...]

  • Page 49

    E-7 Phil ips Medi cal Syste ms E Acc ess ori es sp ecif icat ion s Batt e ry M5070A Hea rtSt ar t Adul t SMAR T Pads M 5071A and Infant /Chil d SMAR T Pads M5072A catego r y specifica tions batt er y type 9 VDC , 4.2 A h, lithium man gane se dioxide. Dispo sable , long-life pr imar y cell. ca paci ty When new , a minim um of 200 shoc ks or 4 h ours[...]

  • Page 50

    E-8 Phil ips Medi cal Syste ms HEARTSTART M5066A Envir onmen tal c onsidera tions By co mplying w ith you r natio nal regu lations regarding di spos al of e lectric , ele ctr o nic, and ba ttery waste, yo u can mak e a positi v e cont ri butio n to our shar e d envi r onm ent. Suc h w aste can int r odu ce harm ful e le ment s i nto t he environ me[...]

  • Page 51

    Phil ips Medi cal Syste ms F-1 F FC o n f i g u r a t i o n Ov erview The Ph ilips H ear tStar t D efibri llator co mes wit h a f actor y default config uration desi gne d to meet t he ne eds of mo st u sers. Thi s c on figur ati on c an onl y be chan ged by an aut hori zed per son using HeartSt art Configu re PD A soft war e or Ev ent Re vie w s o[...]

  • Page 52

    F-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Patient treatment pr otocol opti ons para meter se tt in gs default default de script ion “call E MS” voice re mi nde r ti mi ng • At po w er o n ( when the us er tu rns on the Hear tS tar t) • At po w er on and at the sta rt of th e f irst pati e nt car e pa use • A t the star t of the fir[...]

  • Page 53

    F-3 Phil ips Medi cal Syste ms F pr ot ocol pause timer (minut es) 0.5, 1. 0, 1.5, 2.0, 2 .5, 3.0 2.0 A 2-m inut e pr oto col pa us e fo r CP R auto matic ally start s after voice ins truction is given when a shock ser ies is com plet ed. A fter the prot ocol pause, the def ibr illat or r et urns to rh ythm a nalysis. If th e use r presses th e i-b[...]

  • Page 54

    F-4 Phil ips Medi cal Syste ms HEARTSTART M5066A NSA pause timer (minut es) 0.5, 1. 0, 1.5, 2.0, 2 .5, 3.0 2.0 A 2-min ute NSA paus e for CPR auto matic ally start s after voice ins truction is gi v en when no shock is advised (NSA). * If th e use r presses th e i-b utton for opti onal CPR coach ing, the Hea rtStart pro vi des coac hing for 5 cy cl[...]

  • Page 55

    F-5 Phil ips Medi cal Syste ms F CPR Coac hing adu lt ventila tion instru ction Y es, No Y es Opt ional CPR Coaching incl udes r escu e br ea ths at th e rate de term ined by the CPR Coaching compression :v entilation ratio f or adults when an adul t pa ds cartridg e is ins talled. NO TE: i f t his p ar a met er is c onf igur ed to NO, CPR Coachi n[...]

  • Page 56

    Phil ips Medi cal Syste ms HEARTSTART M5066A Notes[...]

  • Page 57

    Phil ips Medi cal Syste ms G-1 G G T esting and troubl eshooting Te s t i n g As long as a b atter y i s i nstalled, the Hear tS tar t Def ibrill ator a utoma tically t ests itsel f ev ery day and aler ts you if it finds a problem . The self-te st include s pads readiness test ing. In additio n, it ru ns a pa ds self -test e ach t ime a pads c ar t[...]

  • Page 58

    G-2 Phil ips Medi cal Syste ms HEARTSTART M5066A no s par e battery is a v ailab le, r e mov e the in sta lled ba ttery fo r fiv e second s, then reinser t it a nd run a batter y in ser tion self- test. If th e prob lem co ntinue s, do no t us e the Hea rt Star t. A tten d to the p ati ent, pro vidin g CPR if neede d, un til Emerg ency Me dical S e[...]

  • Page 59

    G-3 Phil ips Medi cal Syste ms G ... to sto p al l moti on • The pati en t is be ing mo v ed or jost led. • The en vir onment is dry and mov e me nt ar ound the patie nt is causi ng stat ic elect ricity to inte rfe r e with ECG anal ysis. • Radio or elec tr ical so ur ce s are interferin g with ECG an alysis. • Sto p CP R; do no t to uch th[...]

  • Page 60

    G-4 Phil ips Medi cal Syste ms HEARTSTART M5066A T roublesho otin g while th e Hear tS tart is no t in use (g r een R eady li gh t is not on) beha vior possib le cau se re co mmende d actio n chirp s or i-but ton f la shes • The bat tery pow e r is lo w or the SMA R T Pads cart ri dg e nee d s to be re pla ce d. • The defibri lla tor ma y ha ve[...]

  • Page 61

    Phil ips Medi cal Syste ms H-1 H H Additional technical inf or mation required f or European conformity Electromagne tic con formity Guidanc e and man uf actur e r’ s dec larati on: Th e HeartSt art is in tend ed f or u se i n the elect romagn etic environm ent spe cifi ed in th e tab les b elow . Th e c ustom er or u ser of the Hear tSta rt shou[...]

  • Page 62

    H-2 Phil ips Medi cal Syste ms HEARTSTART M5066A Elec tr omagnetic immunity imm unit y test IEC 60 601 tes t le vel comp liance level elec troma gnet ic envi r onme nt - guidanc e elect rosta tic di scha rge (ESD) IEC 61000-4 -2 ± 6 kV contac t ± 8 kV air ± 6 kV c ont act ± 8 kV ai r Ther e ar e no specia l r equi r ement s with r e spec t to e[...]

  • Page 63

    H-3 Phil ips Medi cal Syste ms H Reco mm end ed s epa ra tion dis ta nces be tw e en po rtabl e and mob il e RF co mm uni ca tio ns eq ui pme n t an d th e Hea rtSt art The He artSt art is inte nded for use i n an elec tr omagneti c en vi r onme nt in which ra diat ed R F di stur ba nces ar e co ntr ol led . T he cus tomer or the u ser of the Heart[...]

  • Page 64

    H-4 Phil ips Medi cal Syste ms HEARTSTART M5066A Impor tant warnings and reminders • Do not allo w the pad s to cont act ot her el ect r ode s or met al parts tha t ar e in con tact w ith the p atien t. • Be fore deliv erin g a shock, it is impor tant to d isconnec t the patie nt from oth er medic al elect ric al equ ipm ent, such as blood -fl [...]

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    Phil ips Medi cal Syste ms Intent iona lly blan k.[...]

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    Inte ntio nall y blank . Phil ips Medi cal Syste ms[...]

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    Phil ips Medi cal Syste ms Intent iona lly blan k.[...]

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    Phil ips Medi cal Syste ms Inte ntio nall y blank .[...]

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    Phil ips Medi cal Syste ms Intent iona lly blan k.[...]

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    PO WER T O SA VE A LIFE Phili ps Medical Systems is par t of Ro ya l Philips Electr onics Philips Me dical Sys tem s Uni t ed S t ates Philips Medical System s 2301 Fifth Av enue , Suite 200 Seattle, W A, USA 98121 (800) 263-3342 Cana da Philips Medical System s 281 Hillmount Road Markham, Onta rio L6C 2S3 (800) 291-6743 Europe, M iddle Ea st, a nd[...]