Codman HAKIM Manual Del Usuario página 15

5. Push the transmitter unit's START button. Instruction 3 on the control
panel illuminates. During programming, the pressure selector buttons
light sequentially until the selected pressure setting is attained.
6. When programming is completed (approximately five seconds),
Instruction 4 on the panel illuminates momentarily and a
buzzer sounds.
Postimplantation Programming Procedure
1.
Insert the pronged plug from the transmitter unit into the receptacle
at the back of the programming unit.
2. Plug the power cord from the programming unit into an appropriate
power source.
3.
Prior to programming, it is advisable to take an x-ray of the patient's
head to verify the valve's pressure setting and position.
Note: The instructions contained in steps 4 through 11 are for the
CODMAN HAKIM Programmers ONLY. When using another Integra
programmer, please refer to the instructions for use packaged with
your programmer.
4.
Press the programming unit's power button ON. The ON button
and Instruction 1 on the panel illuminate. Press the desired pressure
selection button; Instruction 2 on the programmer panel and the
center hole of the transmitter unit will illuminate.
5. Note: It is not necessary to shave the scalp for this procedure.
Palpate the scalp to locate the implanted valve, specifically, the inlet
valve, located distal of the reservoir. A fluoroscopic screen may assist
in this process. Place the tip of the left forefinger precisely over the
inlet valve, keeping the index finger parallel to the valve system and
pointing in the direction of flow (Figure 7).
6.
Place the transmitter unit's four prongs around the inlet valve so that
the prongs are sitting on the scalp. The arrows on the transmitter unit
should be parallel to the forefinger and pointing in the direction of
flow (Figure 8).
7. Center the transmitter unit so that the illuminated opening is directly
above the nail of the index finger (Figure 9).
8.
Remove finger from the valve and push the transmitter unit's START
button (Figure 10). Instruction 3 on the control panel illuminates,
indicating that the valve is programming.
CAUTION: Do not move the transmitter unit during programming.
9.
During programming, the pressure selector buttons light sequentially
until the selected pressure setting is attained.
10. When programming is completed (approximately five seconds),
Instruction 4 on the panel illuminates momentarily and
a buzzer sounds.
11. Verify the valve pressure setting with an x-ray.
X-Raying the Valve
Note: The instructions contained in X-Raying the Valve are for the
CODMAN HAKIM Programmers ONLY. When using another Integra
programmer, please refer to the instructions for use packaged with
your programmer.
It is advisable to x-ray the complete system immediately after implantation
to have a permanent record of component placement and to verify valve
pressure. It is also advisable to x-ray the valve whenever valve pressure
is reprogrammed.
Use an x-ray with intensifying TV screen, or an x-ray plate to confirm proper
valve pressure. When documenting the valve pressure with x-rays, take care
when positioning so that:
• the nonimplanted side of the head rests on the plate (the implanted side
is uppermost from the plate), and,
• the inlet valve is parallel to the x-ray plate.
Viewing the x-ray, the white marker on the valve indicates the right-hand
side of the valve. The pressure indicator on the white ring indicates the
chosen pressure setting (Figure 11).
There is a direct correlation between the position of the programming unit
control panel pressure selector buttons and the position of the pressure
indicator on the valve as seen when x-rayed. Note that when the valve is
programmed to 70, 120, or 170, the pressure indicator aligns with the "X"
in the center of the valve (Figure 12).
Programming Procedure in Case of an Inverted Valve
Note: The instructions contained in Programming Procedure in Case of
an Inverted Valve are for the CODMAN HAKIM Programmers ONLY. When
using another Integra programmer, please refer to the instructions for use
packaged with your programmer.
An inverted valve can be diagnosed on x-ray; the white marker will appear on
the left side of the valve, instead of the right side. Programming the inverted
valve requires a "double programming" to obtain the desired pressure setting.
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