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Zero the FiberOptix™ sensor before insertion

Procedure AC3O · fos-zero

Overview

Zeroing the FiberOptix™ sensor (FOS), the fiber-optic arterial pressure (AP) sensor in the tip of an Arrow® intra-aortic balloon (IAB), so its pressure numbers are accurate. The AC3 Optimus™ does this automatically through the Getting Started Checklist once the calibration (CAL) key and the sensor slider are connected, and the clinician confirms it by tones and on-screen checks. It can only be done before the IAB goes into the patient.

When to perform

Every time a FiberOptix™ IAB is prepared for insertion on an AC3 Optimus™, before the balloon leaves the tray.

Equipment

  • FiberOptix™ IAB in its tray, prepared per the IAB Instructions for Use
  • the CAL key supplied with that IAB (not needed for an RFID-tagged IAB with a Yellow slider)

Steps

  1. Prepare the IAB per its Instructions for Use and leave it in the tray during zeroing.1

    Auto-zero runs only while no AP pressure is detected and the pump is not assisting, so the sensor must still be outside the patient and at rest.

  2. Hand the FOS slider off to the clinician at the IABP.1

    The slider connects at the console while the sterile operator keeps the balloon in the tray.

  3. Connect the CAL key into the CAL key slot on the front panel. Skip this if the IAB has an RFID tag (Yellow slider), whose data is read automatically on connection.2

    The sensor cannot be zeroed or read correctly without its calibration data; if both a CAL key and an RFID tag are present the pump uses the RFID.

  4. Connect the FOS slider (Blue or Yellow) into the FOS connector on the upper right of the front panel with the Arrow® logo facing LEFT, pushing gently until it clicks, and listen for the two-beep tone.3

    The slider fits one way and a recessed or forced connector gives no FOS signal; the two beeps confirm the optical connection is made.

  5. Confirm that FOS connected and CAL key Read both show a green check in the Getting Started Checklist.1

    The checklist confirms both prerequisite connections before the pump will attempt the zero.

  6. Wait for AutoZero: FOS zero in Progress shows a green check while the pump zeros the sensor, which takes about 5 to 15 seconds.4

    Auto-zero starts only after the two connections are made, no AP waveform is present and the pump is not assisting.

  7. Confirm the zero is complete and the four-beep tone is heard.2

    The four beeps are the pump's signal that the sensor now reads zero and the IAB may be inserted.

  8. Verify the date and time of the zero are correct, the Zero icon no longer has the red line through it, and the AP value in the hemodynamics area reads 0 mmHg.5

    A Zero icon with a red line means the current source is NOT zeroed, and a non-zero reading means the offset was not applied.

  9. If the sensor did not zero automatically, zero it manually: press the Zero icon key (it may show a red slash), select the FIBER OPTIC source in the AP menu if it is not already selected, press ZERO, then verify the four-beep tone, the 0 mmHg reading and the updated date and time.5

    A manual zero recovers from an interrupted auto-zero as long as the sensor is still outside the patient.

  10. Insert the IAB.4

    Once an AP waveform from the FOS is detected, zeroing can no longer be performed, so insertion must follow the completed zero.

Cautions

  • Zero the FiberOptix™ sensor PRIOR to IAB insertion; the sensor cannot be zeroed after IAB insertion, and failure to properly zero may affect AP accuracy.4
  • Do not re-zero the FiberOptix™ sensor during use; this may affect the accuracy of the AP FiberOptix™ values.4
  • Use only the CAL key or RFID tag supplied with the IAB; otherwise AP values may be inaccurate or absent.4
  • Leave the CAL key connected at all times. Removing and reinserting the same key keeps the calibration and zero values; inserting another key loses all previous CAL and zero values.6
  • The FOS sensor cannot be zeroed if the CAL key is not connected or the RFID is not read (AP FOS CAL KEY MISSING OR CORRUPT).7
  • Do not use excessive force with the slider; if there is resistance, pull back, straighten and retry.6
  • A non-zeroed FiberOptix™ signal is adequate for WAVE™ timing but should not be used for hemodynamic assessment; if the zero was missed, FOS MAP CAL is the only correction available.8
  • If a balloon reaches the patient un-zeroed, the pump can still start (Start Pump depends only on helium, trigger and IAB connection) and timing works; correct the pressure numbers with FOS MAP CAL.9,10

Related knowledge

References

  1. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 48.
  2. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 104.
  3. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 105.
  4. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 46.
  5. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 47.
  6. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 17.
  7. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 202.
  8. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 118.
  9. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 100.
  10. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. p 120.
  11. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. pp 14-17.
  12. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. pp 46-48.
  13. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. pp 100-105.
  14. Arrow International Inc. AC3™ Series IABP System Service Manual. Part No. IAM-9011, Rev 00. Reading, PA: Arrow International Inc (Teleflex); 2015. pp 118-120.