PORTABLE ELECTRONIC LIQUID OXYGEN SYSTEM OPERATOR S MANUAL

PORTABLE ELECTRONIC LIQUID OXYGEN SYSTEM OPERATOR S MANUAL

TABLE OF CONTENTS TABLE OF CONTENTS... 2 SPECIAL NOTES.... 3 IMPORTANT SAFEGUARDS... 4 PHYSICIAN NOTES... 5 SPECIFICATIONS... 6 PACKAGING / HANDLING... 7 INTRODUCTION... 8 FEATURES... 9 Components - Definition of Terms... 9 Flow Rate Selector... 9 Fill Coupler... 9 Vent-to-Fill Lever... 9 Vent Tube... 9 Oxygen Outlet Fitting... 9 Carrying Handle... 10 Continuous Flow Selector... 10 Batteries... 10 Contents Indicator... 10 Contents Indicator Strap... 10 Indicators... 10 Low Battery... 10 Pulse Mode... 11 FILLING INSTRUCTIONS... 11 CONTENTS INDICATOR OPERATION... 14 POSITION OF ESCORT DURING USE... 15 Acceptable Positions... 16 Unacceptable Positions... 16 BREATHING FROM THE ESCORT... 17 TRAVELING WITH LIQUID OXYGEN... 18 MAINTENANCE OF THE ESCORT... 18 Care of the Escort... 18 Cleaning of the Escort... 19 USE TIMES... 19 TROUBLE SHOOTING... 20 ACCESSORIES... 25 WARRANTY... 26 2

SPECIAL NOTES WARNING/CAUTION notices as used in the manual apply to hazards or unsafe practices that could result in personal injury or property damage. NOTICE The information contained in this document is subjected to change without notice. WARNING DO NOT install, maintain or operate the Escort without reading, understanding, and following proper instructions; otherwise - injury or damage may result. Federal law restricts this device for sale by, or on the order of, a licensed physician. Administration of liquid oxygen may be hazardous or contraindicated. Use only by or under the supervision of a licensed practitioner who is experienced in the use and administration of liquid oxygen and is familiar with the indications, effects, dosages, methods and frequency and duration of administration, and the hazards, contraindications, and side effects and the precautions to be taken. If at any time the patient or attendant concludes he/she is receiving an insufficient amount of oxygen, the supplier and/or physician should be contacted immediately. No adjustments should be made to the flow rate unless prescribed by a physician. This system delivers only medical grade (U.S.P) oxygen. Oxygen supplied by the system is supplemental and is not considered life-supporting. DO NOT store the Portable ESCORT coupled together with a Base Unit. Separate these units when they are not in use. Make sure the equipment is always in the ZERO (OFF) position when not in use. Avoid creation of any spark near medical oxygen equipment. This includes sparks from static electricity created by any type of friction. All electrical equipment near oxygen equipment must be properly grounded. If you suspect that equipment has been damaged, contact your Service Representative immediately. Your Service Representative must handle all maintenance. Keep all equipment out of reach of children. SAVE THESE INSTRUCTIONS 3

IMPORTANT SAFEGUARDS WARNING RISK OF FIRE: Oxygen does not burn. However, it will accelerate burning of flammable materials. TO PREVENT FIRE: DO NOT SMOKE when operating this equipment. A NO SMOKING sign should be prominently displayed. Keep the equipment at least 5-feet away from any electrical appliances such as radios. TV s, air conditioners, fans, electric razors, etc. Keep the equipment away from open flames or heating sources such as furnaces or stoves. Keep flammable materials away from the equipment such as oils, grease and aerosol sprays. These can ignite and burn quickly in the presence of concentrated oxygen. TO PREVENT HIGH CONCENTRATIONS OF OXYGEN: Keep the equipment in a well ventilated area at all times. Turn OFF the flow rate selector when the equipment is not in use. Keep the Reservoir upright at all times. If the Reservoir is turned over, gaseous oxygen will escape. Should this happen, ventilate the area. If a liquid spill should occur for any reason, open doors and windows to ventilate the area. Keep the Escort in one of the following positions at all times: upright, flat on its back, or any position in between. DO NOT wear the Escort under any clothing. The Escort must be worn on the outside of any clothing and must be visible at all times. RISK OF FROSTBITE: Liquid oxygen is extremely cold (-297 F [-183 C]). Contact with liquid oxygen can cause frostbite. DO NOT touch frosted fittings or piping. If there is any exposure to liquid oxygen, contact a physician IMMEDIATELY. OTHER PRECAUTIONS: Never attempt to lubricate the oxygen equipment. Never tamper with the equipment. Doing so could create a hazardous condition and possibly cause the equipment to malfunction. If you have any questions, call your liquid oxygen system Dealer or Service Representative. 4

PHYSICIAN NOTES 1. Do not use the Escort with patients who breathe less than 6 breaths per minute (BPM) or more than 40 BPM. 2. Do not use the Escort with patients who consistently fall to trigger the equipment (i.e., mouth breathers with closed, soft pallets). 3. Verify that the patient is getting adequate PaO 2 or SaO 2 levels in the pulse delivery mode. 4. Use only the standard nasal cannula with pulse delivery, do not use a pediatric (low-flow) nasal cannula or mask with pulse delivery. 5. A mask or any nasal cannula may be used in the continuous flow delivery mode. 6. Do not use the Escort with other equipment (i.e., humidifier, nebulizer, etc.) when in the pulse delivery mode. 5

SPECIFICATIONS Characteristic 20 PSIG Operating Pressure System 50 PSIG Operating Pressure System Delivery Mode Pulse or Continuous Pulse or Continuous Capacity: (Liquid Liter).38.38 Equivalent Oxygen Gas (Liters NTP) 315 301 *Selectable Flow Rates (LPM) 0.25, 0.50, 0.75, 1.00, 1.50, 2.00, 2.50, 3.00, 4.00, 5.00, 6.00 0.25, 0.50, 0.75, 1.00, 1.50, 2.00, 2.50, 3.00, 4.00, 5.00, 6.00 **Average Fill Time, Warm (Seconds) 40 40 **Average Fill Time, Cold (Seconds) 30 30 Dimensions Height (in/cm) Width (in/cm) Depth (in/cm) 10.8 (27.4) 5.8 (14.7) 4.2 (10.7) 10.8 (27.4) 5.8 (14.7) 4.2 (10.7) Weight Empty (lbs/kg) Full (lbs/kg) 3.14 (1.42) 4.06 (1.84) 3.14 (1.42) 4.02 (1.82) Flow Duration Pulse Mode @ 2 LPM Setting (Hours) 16 BPM 20 BPM 9.84 7.87 9.41 7.53 * Flow rates are LPM at NTP ** Average fill times are at a fill pressure of 30 to 35 psig for 20 psig systems and 55 to 60 psig for 50 psig systems. Performance varies with environmental and filling conditions. 6

PACKAGING / HANDLING PACKAGING Operator s Manual Escort Unit in Plastic Bag AA Alkaline Batteries Carton Liner Outer Carton HANDLING UNPACKING 1. Check for any obvious damage to the carton its contents. (If damage is evident, notify your local Essex Industries dealer.) 2. Remove all packaging from the carton. 3. Carefully remove all components from the carton. NOTE: Unless the Escort is going to be used immediately, retain the box and packaging material for use in storing the Escort until usage is required. INSPECTION 1. Examine the exterior of the Escort for nicks, dents, scratches or other damage. STORAGE 1. Store the repackaged Escort in a dry area. 2. DO NOT place other objects on top of the repackaged equipment. 7

INTRODUCTION The Escort is a compact, lightweight, portable, liquid oxygen system intended to provide a portable supply of oxygen to a user at a flow rate prescribed by a physician. It is designed to be filled from a liquid oxygen reservoir. The Escort provides a supply of oxygen to increase the mobility of the end user. The amount of oxygen remaining in the Escort is displayed by the Contents Indicator. Essex Industries has incorporated pulse technology into the Escort to dramatically extend the use time for increased mobility, improved comfort, and increased efficiency. The Escort is simple to use but is quite different from previous oxygen delivery systems. The pulse concept is based on the fact that the normal breathing pattern is inhalation for 1/3 of the time and exhalation for about 2/3 of the time. As a result, pulsing extends the use time of an oxygen system by an average of 3 fold. The pulse system senses the start of inhalation and instantly releases a short, pulsed dose at the very beginning of the breathing cycle. Since practically all of the pulsed oxygen finds its way into the lungs, less oxygen is required to accomplish the same effect as a traditional, continuous flow, oxygen system. This means that a pulse oxygen system will last approximately three times longer than a continuous flow oxygen system yet provides the same therapeutic benefit. Because the oxygen is released only during inhalation, the constant flow of oxygen into the nostrils is eliminated. Many users find that pulse flow systems are more comfortable than continuous flow systems. The short pulse of oxygen delivered during inhalation is almost unnoticeable and the humidity in the room air maintains a more normal level of moisture in the nasal cavity. This greatly reduces the discomfort of dehydration associated with a continuous flow oxygen system. The Escort portable has visible indicators to signal that the system is operating properly. Continuous flow from the Escort is possible and is delivered by the operation of a switch. The pulse system is powered by two AA alkaline batteries. Supplemental oxygen is a medication that has been prescribed by your physician. Like any medication, oxygen should be taken as directed by your physician. The dosage has been prescribed by your physician based on medical tests and evaluation. Never change the dosage without your physician s direction. If your physician changes the prescribed dosage or oxygen usage, notify your oxygen provider of the change to ensure that your delivery schedule is modified if necessary. 8

FEATURES WARNING DO NOT wear the Escort under any clothing. The Escort MUST be worn on the outside of any clothing and be visible at all times. Familiarize yourself with the unit before attempting use. If there are any questions call your Service Representative or Dealer. FIGURE 2 ESCORT PRODUCT FEATURES COMPONENTS DEFINITION OF TERMS Flow Rate Selector: Marked in liter per minute increments. It will activate and set the flow of oxygen to the user when the unit is in the pulse operating mode. Fill Coupler: Connects the Portable unit to the Base Unit for filling the Portable. Vent-to-Fill Lever: Opens the Vent-to-Fill Valve on the Portable. To be opened when filling the Portable unit. It allows vaporized liquid to be vented from the unit and thus maximizes filing capacity. See Filling the Portable in this manual. This valve is opened during the FILLING PROCESS ONLY. Leaving the valve open while the Portable is in use or during non-usage time will allow moisture to contaminate the system. Vent Tube: When the Vent-to-Fill Lever is opened, this tube allows the vaporized liquid to be routed from the Portable through the Base Unit Portable Vent located on the Base Unit Shroud. Oxygen Outlet Fitting: The Delivery point of oxygen from the Portable. The fitting is barbed to securely hold the crush-proof tubing for safe oxygen delivery to the user. 9

Carrying Handle: Used to carry the portable. Continuous Flow Selector: Sets the oxygen delivery mode of the system to the continuous flow or pulse mode. In the continuous flow mode the system supplies a continuous flow of 2 liters per minute. To change to the continuous flow mode, move the Flow Rate Selector to the zero (OFF) position and the Continuous Flow Selector to the CONTINUOUS (outward) position. Batteries: Powers the pulsing device and the Low Battery and Pulse Mode Indicator light emitting diodes (LED s). Contents Indicator: Displays the quantity of liquid oxygen in the unit. Contents Indicator Strap: Lift by this strap to display the quantity of liquid oxygen in the unit. Low Battery INDICATORS The low battery indicator is a red LED that illuminates when the batteries have lost their useful life. When the low battery indicator illuminates, replace the two AA alkaline batteries. If replacement batteries are not available, change the unit to the continuous oxygen flow mode by moving the Flow Rate Selector to the zero (OFF) position and the Continuous Flow Selector to the CONTINUOUS (outward) position. WARNING In the continuous flow mode the Escort will be delivering oxygen continuously rather than on demand so the oxygen supply will be consumed more rapidly. Make plans to obtain a source of oxygen within the time constraint of the remaining supply so that you do not run out of oxygen. NOTE: The continuous flow mode is NOT powered by the battery and can be used whether the low battery indicator is on or not. Pulse Mode The green pulse mode LED will illuminate with each inspiratory effort signaling that the pulse system is being triggered. NOTE: The pulse mode indicator will illuminate if an inspiratory effort is detected regardless of the liquid oxygen contents of the Escort. 10

FILLING INSTRUCTIONS WARNING Do not leave the Escort unattended during the filling operation. Stay with the unit until the fill is completed so that immediate action can be taken if a problem should occur. The Escort is filled from the Base Unit as follows: NOTE: The fill connectors must be clean and dry in order to avoid malfunctions due to freezing. Contamination may cause the couplings to seize and cause difficulty in separating the Escort from the Base Unit. 1. Check the Oxygen Contents Gage on the Base Unit to be sure that the Base Unit has an ample supply of liquid oxygen for the filling purposes. The Base Unit Oxygen Contents Gage should NOT indicate that the Base Unit needs to be filled soon. 2. Confirm that the Flow Rate Selector is in the zero (OFF) position. 3. Confirm that the Continuous Flow Selector is in the PULSE position. 4. Check the fill couplers on the bottom of the Escort and top of the Base Unit for the presence of moisture. If moisture exists, wipe the coupler with a clean, dry, lint-free cloth. 5. For Escorts with an operating pressure of 20 psig: a. Hold the Escort in the upright position with both hands. Align the fill couplers and lower the Escort such that the Base Unit coupler enters the Escort coupler. b. Engage the couplers and push down gently on the Escort. WARNING Only slight effort is required. DO NOT force. The fill couplers may be damaged if too much force is applied. c. The Escort and the Base Unit are now fully coupled. NOTE: During the fill process one hand should maintain a gentle downward pressure on the top of the Escort. 11

6. For Escorts with an operating pressure of 50 psig: a. Hold the Escort in the upright position with both hands. Align the fill couplers so that the Escort coupler enters the Base Unit coupler and the pin on the Escort coupler is in alignment with the slot in the Base Unit coupler. b. Push down and turn the Escort clockwise to lock it in place. WARNING Only slight effort is required. DO NOT force. The fill couplers may be damaged if too much force is applied. c. The Escort and Base Unit are now fully coupled. 7. Begin filling the Escort by opening the Vent-to-Fill Valve by pulling down on the Vent-to-Fill Lever. NOTE: You should hear a hissing sound. NOTE: Approximately every 30 seconds rapidly lift and lower the Vent-to-Fill Lever OFF and ON a couple times. This helps prevent ice from forming in the Valve. NOTE: The fill process will typically take between 30 and 40 seconds. (Fill times will vary with environmental and filling conditions and the difference in temperature between a warm and cold unit. 8. You can tell that the portable is full when: a. The hissing sound changes in tone. b. Liquid oxygen starts to vent through the vent tube on the bottom of the Escort. 9. Close the Vent-to-Fill Valve. 10. After completing Step 9, wait 15 seconds then disengage the Escort from the Base Unit by: a. (for Escorts with an operating pressure of 20 psig) holding the Escort with one hand and depressing the Release Button on the Base Unit. Always hold the Escort with at least one hand when attempting to disengage it. b. (for Escorts with an operating pressure of 50 psig) holding the Escort with both hands and turning the Escort counterclockwise. This will disengage the fill couplers. 12

NOTE: If the units will not disengage easily, they may have become frozen. DO NOT USE FORCE. Simply allow a few minutes for the frozen fill couplers to warm, then disengage the Escort when the ice has melted. NOTE: Should liquid oxygen leakage occur when the Escort is disengaged, reengage the Escort several times. This will dislodge any ice or other obstruction. WARNING Should leakage be extreme to the point of a continuous stream of liquid oxygen, re-engage the Escort ventilate the area and leave. CALL YOUR OXYGEN SUPPLIER IMMIEDIATELY. Contact with liquid will cause frostbite. Oxygen does not burn. However, it will accelerate the burning of flammable materials. 13

CONTENTS INDICATOR OPERATION Check the liquid content of the Escort by lifting the Escort by the Contents Indicator Strap as shown in Figure 3 and read the green flag in the Contents Indicator Window which indicates the amount of oxygen available for use. Always ensure that there is an adequate supply of oxygen available to last the amount of time away from the Base Unit. Contents Indicator Strap Contents Indicator Window Almost Empty Half Full Full FIGURE 3 CONTENTS INDICATOR 14

POSITION OF ESCORT DURING USE WARNING Always keep the Escort in one of the following positions: upright, flat on its back, or any position in between, as shown below. The Escort was designed to operate in the variety of positions shown above for the convenience of the user. The Escort must always be kept in one of the positions shown or oxygen may escape from the unit. This will shorten the time you can be away from your oxygen supply source. The Escort was designed to work when sitting upright, when laying flat on its back, or any position in between. The Escort cannot be placed on its front, on its edge, or with the handle lower than the bottom on the unit. Figure 4 shows how the Escort must be positioned. Figure 5 shows unacceptable positions. CAUTION If the Escort is placed in an unacceptable position for more than five minutes, check the Contents Indicator to determine how much oxygen is remaining in the unit. Set the Escort in an acceptable position for at least 15 minutes before attempting to fill the unit. Placing the Escort in an unacceptable position may cause loss of oxygen. 15

FIGURE 4 ACCEPTABLE POSITIONS Escort laying flat on its back Escort laying in an inclined position on its back Escort in the upright position. FIGURE 5 UNACCEPTABLE POSITIONS Escort laying on its front Face or edge. Escort laying on its back with the handle lower than the bottom of the unit. Escort laying on its front with the handle lower than the bottom of the unit. 16

BREATHING FROM THE ESCORT 1. Check the Oxygen Contents Indicator and verify there is an adequate oxygen supply. 2. Confirm that the Continuous Flow Selector is in the PULSE position. 3. Connect the Single Lumen Cannula to the Oxygen Outlet Fitting. NOTE: Use only a Standard Single Lumen Nasal Cannula with the Electronic Escort. A mask should not be used with the Escort as it may not fit the face well enough to allow the system to sense inhalation efforts. Also, the therapeutic effect of the oxygen pulse will not be realized as the dose of the oxygen will be diluted in the mask prior to inhalation. NOTE: A pediatric, or low-flow, cannula cannot be used in the pulse delivery mode. The reduced diameter of the cannula causes too much back pressure and will affect the oxygen volume delivered. NOTE: When using the Escort in the continuous flow oxygen delivery mode, any nasal cannula or mask may be used. NOTE: The total oxygen tubing length must not exceed 35 feet in the pulse delivery mode. While the unit will operate, the therapeutic effect of the pulse will not be realized. 4. Turn the Flow Rate Selector to the setting corresponding to the dosage prescribed by your physician. WARNING The Flow Rate Selector MUST be set to the setting prescribed by your physician and the detent must be felt to receive the prescribed flowrate of oxygen. If this does not occur, CALL YOUR OXYGEN SUPPLIER IMMEDIATELY. NOTE: Do not adjust the cannula to the nose and face prior to turning the Continuous Flow Selector to the pulse position. Failure to follow this procedure will improperly set the sensitivity of the pulse device and cause the unit to trigger incorrectly. 5. Adjust the cannula so that it is positioned comfortably on the nose and face. 6. Breathe normally. The green pulse indicator should blink at the beginning of each inhalation indicating that the unit is triggering in response to your breathing pattern. NOTE: In the pulse mode, oxygen is delivered in a very short puff ; oxygen is not delivered during the entire inhalation cycle. The length of time that the pulse 17

delivers oxygen will not vary from breath to breath. The time is set in correlation with the patient s prescription setting as indicated on the Flow Rate Selector. NOTE: The pulse device is designed to prevent the deliver of pulses more than every 1.0 second. If the breath rate is fast (greater than 60 breaths per minute) this feature prevents delivery of too much oxygen. With breath rates greater than 60 breaths per minute, oxygen will not be dosed on every breath. 7. The Oxygen Contents Indicator will show how much liquid oxygen is remaining. It should be checked periodically to ensure that the supply is adequate. TRAVELING WITH LIQUID OXYGEN The Escort can be used anywhere a portable oxygen source is designed to be used. A Base Unit will be required to refill the Escort. Plan any trip carefully to arrange for oxygen refill at points along the way and at the final destination. Your oxygen provider and/or a helpful travel agent can be of assistance in making travel arrangements. Most bus and train lines allow the use of personal oxygen systems but they require advance notification. Oxygen patients are allowed on commercial aircraft, however, FAA requirements call for the use of airline oxygen equipment while in flight. Each airline determines its own fee schedule for this service and notification requirements vary. Be prepared to arrange for oxygen at the departure and arrival airports as well as at any stopover points. With careful advanced planning and cooperation between patient, physician and oxygen provider, there is no reason that the pleasure of travel cannot be enjoyed by oxygen patients. CARE OF THE ESCORT MAINTENANCE The Excort is designed for durability, but it must be protected from abuse. It should be kept clean and free from moisture, dust, and protected from extreme temperatures. Keep the unit in a clean, dry, well-ventilated place away from excessive heat, children, and untrained personnel. 18

CLEANING THE ESCORT CAUTION Never apply waxes, polishes, alcohol, solvents, or other similar products on any surface of the Escort as these compounds may be/are flammable. 1. Remove dirt and dust from the Escort with a mild, household cleaner and a nonabrasive cloth or sponge. 2. Dry the Escort with a dry, lint-free cloth. USE TIMES Use times stated in the tables below are approximate. Variables such as level of filling, idle time since filling, and breathing rate will affect duration of use. As you develop your own use times you will be able to predict the duration of your oxygen supply with reasonable accuracy. Approximate Use Time Hours Flow Rate Liters/min. 20 psi System 50 psi System 20 cpm 16 cpm 20 cpm 16 cpm 0 NA NA NA NA.25 *15.84 *15.84 *15.84 *15.84.5 *15.84 *15.84 *15.84 *15.84.75 *15.84 *15.84 *15.84 *15.84 1 15.73 *15.84 15.05 *15.84 1.5 10.48 13.10 10.03 12.54 2 7.87 9.84 7.53 9.41 2.5 6.29 7.86 6.02 7.53 3 5.25 6.56 5.02 6.28 4 3.94 4.93 3.77 4.71 5 3.15 3.94 3.01 3.76 6 2.62 3.28 2.51 3.14 *Use times at low flow rates are exceeded by NER. 19

TROUBLE SHOOTING Problem Possible Cause Solutions Portable will not fill. Base Unit Empty Portable Vent-to-Fill Valve not open. Call your Dealer or Service Representative immediately. Open Vent-to-Fill Lever. Base Unit/Portable freeze together during fill. Overfilling of Portable Defective Body Seal in Base Unit Filling-Coupler. Moisture or foreign matter on Filling-Couplers (Base Unit/Portable). Cold: 25 to 35 seconds fill time. Warm: 35 to 45 seconds fill time. Call your Dealer or Service Representative immediately. Close Vent-to-Fill Lever and wait for Couplers to thaw (15-20 minutes). To prevent freezing, check Filling Couplers before each fill and clean if necessary. One or both of the Filling Couplers on Base Unit and/or Portable freeze open following a fill. Moisture or foreign matter on Fill Couplers prior to fill. Re-engage the Portable unit several times. This will dislodge any ice or other obstruction. The Relief Valve (not accessible) vents excessively (continuous hissing sound) Relief Valve did not seat properly after filling procedures. Re-engage the Portable. Leave Vent-to-Fill Valve closed. This will open the Relief Valve and allow flow to clear seat. If condition persists, call your Dealer or Service Representative immediately. 20

TROUBLE SHOOTING (cont.) Problem Possible Cause Solutions No Flow Unit Empty. No pressure. Flow Rate Selector in Zero (OFF) position. Problem internally. Refill. Allow unit to stabilize. If leaks are present, call Dealer immediately. Turn to prescribed flow rate. Call Dealer or Service Representative immediately. Portable did not fill properly. The Vent-to-Fill Lever/Valve was not closed early enough near the termination of the fill process. The Vent-to-Fill valve is improperly seated. Reconnect the Portable unit to the Base Unit with the Portable Vent-to-Fill Lever/Valve closed until the Relief Valve on the Portable vents (hissing sound) for approximately five (5) seconds. Jostle the Vent-to-Fill Lever back and forth rapidly to seat the Valve. Oxygen Contents Gauge: Erroneous gauge reading. Gauge malfunction. Call your Dealer or Service Representative immediately. Use times are different from those stated in the literature. If use times vary significantly from printed guidelines, there may be a system leak. Contact your oxygen provider. 21

TROUBLE SHOOTING (cont.) Problem Possible Cause Solutions Oxygen is not being delivered even though the Pulse indicator is flashing every time I breathe. Oxygen supply is empty. Check Contents Indicator; Refill the portable if necessary. Will not pulse. Cannula is not adjusted properly. Batteries are dead. Triggering sensitivity is temporarily interrupted due to pinched cannula, tubing, or continuous flow use. Flow Rate Selector turned to D. Unit not fully pressurized. Sensitivity adjustment required. Check all Cannula connections to make sure they are tight and adjust the cannula to fit comfortably in your nose. Change the Batteries. Pulse will adjust automatically within 1-2 minutes or the sensitivity can be manually reset: A) Turn the Flow Rate Selector to 0. B) Remove the Cannula from your nose and face. C) Turn Continuous Flow Selector to Continuous then back to Pulse delivery mode. D) Return Flow Rate Selector to prescribed flow setting. E) Put the Cannula back on and adjust to fit comfortably in your nose. Turn the Flow Rate Selector to the prescribed flow setting. Leave portable coupled to the reservoir at least 1-2 minutes after the Vent-to- Fill Valve is closed prior to disengaging the portable Contact your oxygen provider. 22

TROUBLE SHOOTING (cont.) Problem Possible Cause Solutions Pulses on exhalation. Triggering sensitivity is temporarily interrupted due to pinched Cannula, tubing, continuous flow use, etc. Sensitivity adjustment required. Pulse will adjust automatically within 1-2 minutes or the sensitivity can be manually reset: A) Turn the Flow Rate Selector to 0. B) Remove the Cannula from your nose and face. C) Turn Continuous Flow Selector to Continuous then back to Pulse delivery mode. D) Return Flow Rate Selector to prescribed flow setting. E) Put the Cannula back on and adjust to fit comfortably in your nose. Contact your oxygen provider. PulseDose triggers whenever the cannula moves the slightest bit. Triggering sensitivity is temporarily interrupted due to pinched cannula, tubing, continuous flow use, etc. Sensitivity adjustment required. Pulse will adjust automatically within 1-2 minutes or the sensitivity can be manually reset: A) Turn the Flow Rate Selector to 0. B) Remove the Cannula from your nose and face. C) Turn Continuous Flow Selector to Continuous then back to Pulse delivery mode. D) Return Flow Rate Selector to prescribed flow setting. E) Put the Cannula back on and adjust to fit comfortably in your nose. Contact your oxygen provider. 23

TROUBLE SHOOTING (cont.) Problem Possible Cause Solutions Pulse works fine for a couple of minutes, then sensitivity seems to drift and may stop working altogether. Using pediatric, or low-flow, Cannula or a Cannula that restricts continuous flow capacity of 10 lpm. Replace with standard nasal Cannula. 24

ACCESSORIES BELT PACK The Belt Pack provides a convenient means of carrying the Escort Portable. Escort Belt Pack 25

LIMITED WARRANTY This warranty is extended only to the original purchaser/user of our products. This warranty gives you specific legal rights and you may also have other legal rights which vary from state to state. Essex Industries warrants its product to be free from defects in materials and workmanship for a period of one (1) year (excluding relief valves and batteries); and three (3) years for the portable vacuum, from the date of purchase. If within such warranty period any such product shall be proven to be defective, such product shall be repaired or replaced, at Essex Industries option. This warranty does not include any labor or shipping charges incurred in replacement, part installation, or repair of any such product. Essex Industries sole obligation and your exclusive remedy under this warranty shall be limited to such repair and/or replacement. For warranty service, please contact the dealer from whom you purchased your Essex Industries product. In the event you do not receive satisfactory warranty service, please write directly to Essex Industries at the address on the back cover. Provide the dealer s name, address, and the date of purchase. Indicate the nature of the defect and, if the product is serialized, indicate the serial number. Do no return products to our factory without our prior consent. LIMITATIONS AND EXCLUSIONS: THE FOREGOING WARRANTY SHALL NOT APPLY TO: SERIAL NUMBERED PRODUCTS IF THE SERIAL NUMBER HAS BEEN REMOVED OR DEFACED; PRODUCTS SUBJECTED TO NEGLIGENCE, ACCIDENT, IMPROPER OPERATION, MAINTENANCE OR STORAGE; PRODUCTS MODIFIED WITHOUT ESSEX INDUSTRIES EXPRESS WRITTEN CONSENT INCLUDING, BUT NOT LIMITED TO, MODIFICATION THROUGH THE USE OF UNAUTHORIZED PARTS OR ATTACHMENTS; PRODUCTS DAMAGED BY REASON OF REPAIRS MADE TO ANY COMPONENT WITHOUT THE SPECIFIC CONSENT OF ESSEX INDUSTRIES; OR TO A PRODUCT DAMAGED BY CIRCUMSTANCES BEYOND ESSEX INDUSTRIES CONTROL; AND SUCH EVALUATION WILL BE SOLELY DETERMINED BY ESSEX INDUSTRIES. THE WARRANTY SHALL NOT APPLY TO PROBLEMS ARISING FROM NORMAL WEAR OR FAILURE TO ADHERE TO THE INSTRUCTIONS. THE FOREGOING WARRANTY IS EXCLUSIVE AND IN LIEU OF ALL OTHER EXPRESS WARRANTIES. IMPLIED WARRANTIES IF ANY, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PUSPOSE, SHALL NOT EXTEND BEYOND THE DURATION OF THE EXPRESSED WARRANTY PROVIDED HEREIN AND THE REMEDY FOR VIOLATIONS OF ANY IMPLIED WARRANTY SHALL BE LIMITED TO REPAIR OR REPLACEMENT OF THE DEFECTIVE PRODUCT PURSUANT TO THE TERMS CONTAINED HEREIN. ESSEX INDUSTRIES SHALL NOT BE LIABLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES WHATSOEVER. This warranty shall be extended to comply with state/provincial laws and requirements. 26

ESSEX INDUSTRIES Manufacturing Facility 4150 Carr Lane Court St. Louis, MO 63119-2128 314.659.4399 314.645.0499 fax For more information on any of our products or services, please visit our website at essexindustries.com or contact us by email, info@essexind.com.

Essex Industries 4150 Carr Lane Court St. Louis, MO 63119-2128 Customer Service / Technical Service 877.877.3774 or 888.443.7210 Document No. ZZ-3427-AA Rev. 4