English( Original )TM-2657P

Automatic Blood Pressure Monitor
Instruction Manual

1WMPD4002893E

2304

© 2019 A&D Company, Limited. All rights reserved.
No part of this publication may be reproduced, transmitted, transcribed or translated
into any language in any form by any means without the express written consent of
A&D Company, Limited.
The contents of this manual and the specifications of the instruments covered by thismanual are subject to change without notice.
Windows is a registered trademark of the Microsoft Corporation.
The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth
SIG, Inc. and any use of such marks by A&D is under license.
QR code is a registered trademark of DENSO WAVE Incorporated.
Other trademarks and trade names are those of their respective owners.

WARNING DEFINITIONS
To prevent accidents due to inappropriate handling, this product and its manual containthe following warning signs and marks. The meaning of these warning signs and marks
are as follows.

Warning Definitions
DANGERWARNINGCAUTION

An imminently hazardous situation which, if not avoided, will result indeath or serious injury.
A potentially hazardous situation which, if not avoided, could result indeath or serious injury.
A potentially hazardous situation which, if not avoided, may result inminor or moderate injury. It may also be used to alert against unsafe
practice.

Symbol Examples
indicates “Caution.”
The symbol
The nature of the caution required is described inside or near the symbol, using
text or a picture.
The example on the left indicates caution against electrical shock.
indicates “Do not.”The symbol
The prohibited action is described inside or near the symbol, using text or a
picture.
The example on the left indicates “Do not disassemble.”
The symbol z indicates mandatory action.
The mandatory action is described inside or near the symbol, using text or a
picture.
The example on the left indicates general mandatory action.

Other
Note

Provides information useful for the user to operate the device.

Precautions for each operation are described in the instruction manual. Read the
instruction manual before using the device.

iPRECAUTIONS FOR USE
In order to use the TM-2657P Automatic Blood Pressure Monitor safely and correctly,
carefully read the following precautions before using the monitor. The following content
summarizes general matters regarding the safety of patients and operators, in addition tosafe handling of the monitor.

1. When installing and storing the monitor.
WARNING
Keep the monitor away from areas where flammable anesthetics or flammablegases are present, high-pressure oxygen chambers, and oxygen tents. Using
the monitor in these areas may cause an explosion.

CAUTION
Consider the following when using and storing the monitor. If the monitor isstored in an environment beyond the specified temperature or humidity, it may
not perform to its capabilities.
Avoid locations where the monitor may be splashed by water.
Avoid locations with high temperature, high humidity, direct sunlight, dust,
salt and sulfur in the air.
Avoid locations where the monitor may be tilted, vibrated, or impacted(including during transportation).
Avoid locations where chemicals are stored or gas occurs.
Installation site: A location with a temperature between +10 °C and +40 °C
and a humidity between 15% RH and 85 % RH (no condensation).
Storage site: A location with a temperature between -20 °C and +60 °C anda humidity between 10 % RH and 95 % RH.
A location with an electrical outlet that can supply sufficient power(frequency, voltage, current) for the monitor.
Avoid locations where removal and insertion of AC power cable isprohibited.
The surface temperature of the cuff may become 46 °C when used in a
40 °C environment.

Note
Please be aware that the rubber feet may discolor the top of the stand.

2. Before using the monitor.
WARNING
Make sure that the electrical outlet is properly grounded and supplies the
specified voltage and frequency (100-240V~ 50-60 Hz, more than 85VA).
Connect the monitor to a grounded, 3-prong outlet.
If a grounded, hospital-grade, 3-prong outlet is not available, connect the
ground wire to an outlet with a contact terminal and ground it. Using themonitor with an incorrect outlet may cause an electrical shock.
ii

CAUTION
Use the monitor safely and correctly.
Connect all cables correctly and securely.
Do not place objects on the monitor or power cable.
Using other devices in conjunction with this monitor may cause incorrect
diagnosis or safety problems. When used, check for safety.
Always use accessories and consumables approved by A&D.
Carefully read the instruction manuals provided with optional items.
The precautions for these items are not listed in this manual.
For safe and correct use of this monitor, always perform a pre-inspection (aninspection before use).
If the monitor is covered with condensation, allow it to dry before switching
the power on.
If the monitor has not been used for an extended period, check that themonitor operates normally and safely before using it.
The pressure of the cuff may cause a patient’s arm to become numb.

3. When using the monitor.
WARNING
Do not use a mobile phone near the monitor. It may cause a malfunction.
Do not use the monitor in a moving vehicle as this may result in inaccurate
measurements.
Do not use the device where flammable gases, such as anesthetic gases,
are present. It may cause an explosion.

CAUTION
Always check the condition of the monitor, its parts and the patient for safety.
If a problem is found with the monitor, its parts or the patient, stop using themonitor, check the status of the patient and take appropriate actions.
Frequent measurements can cause injury to the patient by interfering withblood flow.
Check the condition of the patient on a regular basis if measurements are
performed frequently for a long time. There is a risk of causing damage byinterfering with blood flow.
To ensure accurate measuring, we recommend measuring blood pressure
after being in a relaxed state for at least five minutes.

iii

4. After using the monitor.
CAUTION
Do not forcibly pull out the cables. Hold the connector with your hand when
disconnecting the cables.
Use the specified procedure to return switches to their state before usage,then switch the power off.
Clean the accessories and arrange them before storage.
Keep the monitor clean and in proper operating condition so that it can beused without problem for the next operation.

5. If you suspect there is a problem with the monitor, perform thefollowing actions.
WARNING
Ensure the safety of the patient.
Stop the operation of the monitor, switch the power off, and then disconnect
the power cable from the outlet.
If the air in the cuff is not released by pressing the START/STOP switch,press the FAST STOP switch.
Label the monitor with a sign that says "Out of order" or "Do not use" andthen contact A&D immediately.

6. When performing a maintenance inspection.
WARNINGFor your safety, before performing a maintenance inspection, switch thepower off and disconnect the power cable from the outlet.
Always perform a pre-inspection and maintenance inspection to ensure safe
and correct operation. The organization that installs the monitor (hospital,
clinic) is responsible for use, maintenance, and management of medical
electrical devices. Neglecting pre-inspection and maintenance inspection
can result in accidents.
Never disassemble or modify the monitor (medical electrical device).

CAUTION
When maintaining the monitor, use a dry, soft cloth. Do not use rags soakedin volatile liquids such as thinner and benzene.

iv

7. Be aware that strong electromagnetic waves can cause malfunctions.
CAUTION
This monitor complies with EMD-standard IEC60601-1-2:2014. However, toprevent electromagnetic interference with other devices, do not use mobile
phones close to within 30 cm of near the monitor.
If this monitor is located near strong electromagnetic waves, noise may
enter in waveforms and malfunctions may occur. If unexpected malfunctions
occur during use of this monitor, inspect the electromagnetic environment
and take appropriate actions.
The following are examples of general causes and countermeasures.
Use of mobile phones
Radio waves may cause unexpected malfunctions.
Instruct visitors to rooms or buildings with medical electrical devices not
to use mobile phones or small wireless devices.
High frequency noise is being introduced from other devices via theelectrical outlet.
Check for the source of noise, and then perform countermeasures, suchas using a noise cancellation device on this line.
If the noise source is a device that can be stopped, stop using it.
Use another electrical outlet.
Effects from static electricity are suspected (discharges from devices or thesurrounding area)
Before using the monitor, ensure that the operator and patient havedischarged static electricity.
Humidify the room.
If lightning is occurring nearby, the monitor may receive excessive voltage.
In such cases, power the monitor using the following method.
Use an uninterruptible power supply.

8. Environmental considerations
CAUTION
Before disposing of this monitor, remove the lithium battery from the monitor.

v

PRECUATIONS FOR SAFE MEASUREMENT
The following lists precautions related to measurement. Always consult with a doctor forevaluation of the results and treatment. Self-diagnosis and self-treatment from results
can be dangerous.

WARNING
Do not measure on an arm receiving an intravenous drip or bloodtransfusion. This may cause an accident.
Do not perform measurement if the arm has external injuries. Not only will
the wound worsen, there is a risk of spreading disease.
If the arm cuff cover is soiled with blood, dispose of the cover. There is a riskof spreading disease.
Items that may be contaminated must be disposed of as medical waste.

CAUTION
Measurement cannot be performed in the following cases.
The patient who has thin or thick arms.
Measurement is intended for arms with circumferences of 18 to 35 cm.
The arm of the patient is wet.
Wet arms may cause accidents or electrical shock.

Note
Blood pressure measurement may cause subcutaneous bleeding. Thissubcutaneous bleeding is temporary and disappears with time.
If thick clothing is worn, correct measurement is not possible. Measure when thepatient is wearing a sleeveless or thin shirt.
If the patient rolls up their sleeve and this pinches their arm, correct measurement is
not possible.
Measurement is not possible with patients with peripheral hypoperfusion, very low
blood pressure, or low body temperature (since blood flow to the measurement
location is low).
Measurement is not possible for the patient who frequent arrhythmia recurrences.
Measurement locations are restricted to the right and left upper arms. Other
locations cannot be measured.
Insert the arm into the arm insertion section up to the top of the shoulder.
Adjust the height of the cuff so that is the same height of heart using chair. If heightof cuff and patient' heart are different, correct measurement is not possible.
If the patient does not feel well, stop measurement immediately and take appropriate
actions.
Hold the option air cushion chair firmly when you sit on it.
Measurement cannot be performed with the following patients.
Patients who have just exercised
Blood pressure after exercise is higher than ordinary blood pressure.
Measure after the patient has rested for several minutes and has taken deep
breaths.
Patients with shaking arms
If the patient’s body moves, correct measurement is not possible. Wait until thevishaking stops, and then perform measurement. (This includes shaking from thecold or muscle movements after moving heavy objects.)
Consult the doctor for any of the following situations.
The application of the cuff on any limb with intravascular access or therapy, or anarteriovenous (A-V) shunt.
Simultaneous use with other medical monitoring equipment on the same limb.
The blood circulation of the patient needs to be checked.

vii

UNPACKINGCAUTION
This monitor is a precision device and must be handled carefully. If it
receives a strong impact, it may be damaged.

NoteThis monitor has been shipped in specially designed packaging to prevent damage
during shipping. Check the monitor for damage when unpacking it.
Before using the monitor, ensure that everything is included and then check the main unit
and each standard accessory for damage.
For optional items, see "13. ACCESSORIES AND OPTIONS LIST".
Main unit .................................................. 1
Standard accessories
Power cable ....................................... 1
Arm cuff cover ................................... 1 (One already installed on the main unit)
Instruction panel ................................ 1
Printer paper ...................................... 1
Instruction manual (this manual) ....... 1

viii

TABLE OF CONTENTS
1.

INTRODUCTION.................................................................................................... 3

2.

FEATURES ............................................................................................................ 33.

abbreviations and symbols ..................................................................................... 4

4.
4.1.
4.2.
4.3.
4.4.
4.5.

Specifications ......................................................................................................... 6
Model configuration............................................................................................ 6
Performance specifications ................................................................................ 6
External dimensions........................................................................................... 7
Operation principles ........................................................................................... 8Standards .......................................................................................................... 8

5.

Part names ............................................................................................................. 9

6.
6.1.
6.2.
6.3.
6.4.
6.5.

Before use ............................................................................................................ 13
Monitor installation ........................................................................................... 13
Power connection ............................................................................................ 13
Security slot ..................................................................................................... 13
Attaching the instruction panel ......................................................................... 14
Pre-inspection .................................................................................................. 15

7.

Blood pressure measurement .............................................................................. 16

8.

Setting the clock ................................................................................................... 17

9.
9.1.
9.2.

Printer .................................................................................................................. 18
Installing the printer paper ............................................................................... 18
Selecting the print format ................................................................................. 20

10.
Changing functions .............................................................................................. 22
10.1.
Procedure to Change Function Settings ........................................................ 22
10.2.
Display time ..................................................................................................... 25
10.3.
Applied pressure .............................................................................................. 25
10.4.
IHB ................................................................................................................... 25
10.5.
Print quality ...................................................................................................... 26
10.6.
ID and name printing........................................................................................ 26
10.7.
Mean arterial pressure (MAP) printing ............................................................. 27
10.8.
Measurement value printing ............................................................................. 28
10.9.
Graph printing .................................................................................................. 29
10.10. Bitmap printing ................................................................................................. 29
10.11. Beep sound ...................................................................................................... 30
10.12. External input/output protocol .......................................................................... 30
10.13. Transmission speed (Mini-DIN) ........................................................................ 32
10.14. Transmission speed (D-Sub) ........................................................................... 32
10.15. Stop bit (Mini-DIN) ........................................................................................... 32
10.16. Stop bit (D-Sub) ............................................................................................... 321

10.17.
10.18.
10.19.
10.20.
10.21.
10.22.

Blood pressure result output ............................................................................ 33
Date format ...................................................................................................... 33
Time format ...................................................................................................... 33
ICT printing ...................................................................................................... 34
Bluetooth® connection timing .......................................................................... 35
Bluetooth® Airplane mode ............................................................................... 35

11.
Transmission specifications ................................................................................. 36
11.1.
External input/output unit ................................................................................. 36
12.
Maintenance......................................................................................................... 47
12.1.
Inspection and safety management ................................................................. 47
12.2.
Cleaning ........................................................................................................... 48
12.3.
Periodic inspection ........................................................................................... 51
12.4.
Replacing the arm cuff cover ........................................................................... 52
12.5.
Checking the number of measurements .......................................................... 53
12.6.
Disposing of the component parts.................................................................... 55
12.7.
Before requesting service ................................................................................ 55
12.8.
Error codes ...................................................................................................... 57
13.

Accessories and options list ................................................................................. 60

14.

about blood pressure ........................................................................................... 60

15.
Sending bitmap patterns ...................................................................................... 61
15.1.
Size of original bitmap patterns ........................................................................ 61
15.2.
Sending bitmaps .............................................................................................. 62
Appendix: EMD information .............................................................................................. 63

2

1. INTRODUCTION
This device conforms to the European Directive 93/42/EEC for Medical Products. Thisis evidenced by the CE mark of conformity accompanied by the reference number of adesignated authority.
This device is a blood pressure monitor that measures systolic and diastolic bloodpressure and pulse rate for diagnosis and checkup. The intended users are generaladults, or 13 and older, with common knowledge about blood pressure measurement,
who can perform a measurement on either their right or left arm.
This device is designed to be used at outpatient clinics of general hospitals. It can also
be used at health facilities, fitness gyms and other public facilities for blood pressure
management of the visitors.
Notes
Do not attempt to evaluate the blood pressure measurement results. Always consult
with a doctor for evaluation of the results and treatment, especially when the results
are greatly different from your ordinary values. Self-diagnosis and self-treatment fromsuch results can be dangerous.
Do not attempt to use this device on newborns or infants. Using this device on smallchildren could cause injury to them. This device is designed for measuring adults.
Facilities with the device installed should employ at least one person who has goodknowledge of blood pressure measurement and can give advice to users about how topose for measurement or general information about blood pressure. The person
should also have basic knowledge about maintenance of the monitor and know
procedures to request training for maintenance if necessary.

2. FEATURES
Measurement can be performed using either the right or left arm.
The arm cuff is inflated around the arm by pressing the START/STOP button anddeflation speed is automatically controlled. No special adjustment is required. All you
have to do is insert your arm into the arm insertion section to the shoulder and press
the START/STOP button. The rest of the procedure is done automatically for a quick
and easy measurement of blood pressure.
The printer is equipped with a cutter to automatically cut the printed paper.

Options
An optional external input/output unit can be connected to a computer for data
management or automation as necessary.

33. ABBREVIATIONS AND SYMBOLS
Abbreviation/
SymbolMeaning
Alternating current

mmHg
/min.
--SYS
MAP
DIA
PUL

Exx

Blood pressure unit
Heartbeats per minuteDisplayed when measurement is not possible
Systolic blood pressure(Used for table printing)
Mean arterial blood pressure (Used for printing, depending on settings)
Diastolic blood pressure(Used for table printing)Pulse(used for table printing)Irregular Heartbeat symbol(IHB)
Power off

(disconnected from the power source)

Power on(connected to the power source)

Serial number
Error code display (xx=00 to 99)
Displays extent of electric shock protection: B-type applied part
Follow Instructions for use
Date of manufacture
RS-232C serial interface
EC directive medical device label
WEEE label
EU authorized representative
Manufacturer
Displays the measurement status. "MEASUREMENT IN PROGRESS".
Displays the measurement status. "TAKE MEASUREMENT AGAIN""FAST STOP" for rebooting the device.
Caution: "Please do not pull printer paper during printing."
Caution: "The printer paper is automatically cut.""POWER" switch.
Used to change functions.
Used to change function setting.
Used to display the number of measurements to date.
Describes how to change printer paper.
To indicate generally elevated, potentially hazardous, levels of
non-ionizing radiation, or to indicate equipment or systems e.g. in the
medical electrical area that include RF transmitters or that intentionally
apply RF electromagnetic energy for diagnosis or treatment.
4

What is IHB (Irregular Heartbeat)?
IHB appears when an irregular heartbeat is detected. The mark is printed when a veryslight vibration like shivering or shaking is detected.
When the monitor detects an irregular rhythm during the measurements, the I.H.B.
indicator will appear on the display with the measurement values.

Note
We recommend contacting your physician if you see this () I.H.B. symbol frequently.

When is the IHB mark printed?
The IHB mark is printed in the measurement data in the following two cases.
‫ ە‬When a beat varies during measurement.
‫ ە‬When the arm or monitor is moved during measurement.

5

4. SPECIFICATIONS
4.1. Model configuration
Model
Included functions
Printer
Measurement status LED
Time,Date format

TM-2657P-EX

TM-2657P-EG: Bult-in

24hour,DD/month/YYYY

12hour,month/DD/YYYY

4.2. Performance specifications
GeneralAC Power supply
Power consumption
Safety standard
MDD Classification
EMD compliance
Type of protection
Type of protection againstelectrical shock

100 V-240 V㹼50 Hz-60 Hz
50-80 VA
IEC60601-1:2012
Class IIa (continuous operation mode)
Complies with EMD standard IEC60601-1-2:2014.
NIBP: type B
Applied part
Class I

Blood pressure measurement
Measurement method
Pressure display range
Pressure display accuracy
NIBP Measurement range
NIBP Clinical test
Pulse rate accuracy
Cuff
Applicable arm circumference
Inflation
Deflation
Rapid deflation

Oscillometric measurement0-299 mmHg
Pressure: ±3 mmHg
SYS
40-270 mmHg
DIA
20-200 mmHg
Pulse rate 30-240 bpm
EN1060-4 :2004±5%
Winding mechanism operated by geared motor
18-35 cm
Automatic inflation by air pump
Automatic deflation by mechanical exhaust
Automatic rapid deflation by solenoid valve

Environment specifications
Operating environment
Storage environment
Atmospheric pressure range

Temperature: 10-40 °C
Humidity: 15-85% RH (no condensation)
Temperature: -20 to 60 °C
Humidity: 10-95% RH (no condensation)
70-106 kPa (both for operation and storage)

6

Physical specifications
External dimensions
Weight241 (W) x 324 (H) x 390 (D) mm
Approx. 5.5 kg

Functional specifications
Display method
Printer
Usable life

3-digit display LED & LED lamp
Thermal printing, paper width: 58 mm
5 years from installation
According to A&D data (tested for use under recommended
environment, including maintenance inspection. Results
may be different under other conditions.)

Transmission specifications
Standard

USB 2.0 (Option)

4.3. External dimensions

Unit:mm7

Bluetooth® Low Energy (Option)

4.4. Operation principles
The cuff pressure is raised to approximately 30 mmHg higher than the anticipated systolicpressure and then gradually depressurized. Pulsations occur in the cuff pressure thatmatches the heart rate. These pulsations have an undulating pattern. They start small andthen gradually increase with depressurization. After the maximum amplitude (MAP) isreached, they decrease. An oscillometric blood pressure monitor analyzes the amplitude
waveform data of these pulsations to determine the systolic and diastolic blood pressures.

4.5. Standards
The TM-2657P Automatic Blood Pressure Monitor complies with the following standards:
IEC 60601-1:2012 (Medical electrical equipment – Part 1: General requirements for safety
and essential performance);
IEC 60601-1-2:2014 (Medical electrical equipment – Part 1-2: General requirements
for basic safety and essential performance - Collateral Standard: Electromagnetic
disturbances - Requirements and tests);
EN ISO81060-1:2012(Non-invasive sphygmomanometers - Part 1: Requirements andtest methods for non-automated measurement type)EN 1060-3: 1997 + A2: 2009 (Non-invasive sphygmomanometers - Part 3:
Supplementary requirements for electro-mechanical blood pressure measuringsystems);
EN 1060-4: 2004 (Non-invasive sphygmomanometers - Part 4: Test procedures todetermine the overall system accuracy of automated non-invasive
sphygmomanometers)
IEC 80601-2-30: 2018 (Medical electrical equipment –Part 2-30: Particularrequirements for the basic safety and essential performance of automatednon-invasive sphygmomanometers).
The TM-2657P is not made with natural rubber latex.

8

5. PART NAMES
Front

5
6
7
8
9
10

1
2
3

11

4

12
13

No.
1
2
3
4
5
6
7

Name
Open printercover button
Printer paper
opening
Printer cover
Power cable
Systolic bloodpressure display
Diastolic bloodpressure display
Pulse display

8 Clock display
9

Measurement
status LED

10

START/STOP
button11 Arm cuff cover
12 Cuff section
FAST STOP
13
buttonDescription
Opens the printer cover.
Opening for printer paper to eject.
Holds down the printer paper.
AC power cable.
Displays the systolic blood pressure measurement value.
When a measurement error occurs, the error code is displayed.
Displays the diastolic blood pressure measurement value.
Displays the pressure during measurement.
Displays the pulse measurement value.
Displays the current time.
(24hour :TM-2657P-EX, 12hour :TM-2657P-EG)
Displays the measurement status.
"MEASUREMENT IN PROGRESS""TAKE MEASUREMENT AGAIN"
If this button is pressed in the standby mode, blood pressure
measurement is started.
If this button is pressed during blood pressure measurement,
blood pressure measurement is stopped.
Inner cover of the cuff.
Holds the arm cuff cover.
If this button is pressed, the power is switched off andmeasurement is stopped.

9

Rear

No.
Name
1 SELECT button2‫ ڸ‬button

3

COUNT button

4
5
6
7
8

Bitmap SD socket cover
Arm cuff cover
Cuff section
ArmrestExternal input/output unit

9

POWER switch

Cover for pressure
inspection area
11 AC INPUT connector

10

12 Security slot

Description
Used to change functions.
If pressed when the number of measurements to date isdisplayed, the number of measurements is printed.
Used to change functions.
Displays the number of measurements to date. (See"12.5. Checking the number of measurements")
Use for only maintenance.
Inner cover of the cuff.
Holds the arm cuff cover.
Location to rest the arm during measurement.
The optional external input/output unit.
Switches the power on and off.
Once the power is switched on, the monitor will be in thestandby mode.
Used to check pressure accuracy.
Location to insert the power cable.
Can be used with a security cable to secure the monitor
to a desk or pole. (For theft prevention)

10External input/output unit (option)

TM-2657-01 External input/output unit RS 2ch㸦option㸧

No.
Name
1 Mini-DIN 8 pin female  RS-232C
2 D-Sub 9 pin male 
RS-232C



TM-2657-02 External input/output unit USB 2ch㸦option㸧

No.
Name
1 USB Type-B female
2 USB Type-A femaleDescription

Description
USB 2.0Full-speed
USB 2.0Full-speed

TM-2657-03 External input/output unit RS 1ch㸦option㸧

No.
Name
1 D-Sub 9 pin male

Description
RS-232C

11



TM-2657-04 External input/output unit RS+Bluetooth® Low Energy

No.
Name
®
- Bluetooth low energy
1 D-Sub 9pin Male

Description®

Bluetooth Ver. 4.2
RS-232C

TM-2657-05 External input/output unit RS+Bluetooth®㸦option㸧

No.
Name
㸫 Bluetooth®
1 D-Sub 9 pin male

Description
Bluetooth® Ver.2.1 class1 SPP HDP correspondence
RS-232CNote
For details on EXTERNAL INPUT/OUTPUT UNIT (TM-2657-01, TM-2657-02,
TM-2657-03, TM-2657-04, TM-2657-05), contact your local A&D dealer.

12

6. BEFORE USE
See the precautions at the beginning of this manual and install the monitor in an
appropriate location using a safe and correct method.

6.1. Monitor installation
Attaching the armrest
Place the monitor on a stand so thatmeasurement can be performed in an
TM-2657 Cuff
appropriate posture. The patient's heart and thecuff should be at the same height and thepatient should be relaxed.
Stand
To prevent theft, we recommend using a chain
to connect the security slot and stand. (See "6.3.
Security slot")

6.2. Power connection
WARNINGŶ

To avoid the risk of electric shock, the monitor must only be connected to a
supply mains with protective earth.

Use the 3-pole power cable provided
with the monitor to connect between the
AC INPUT connector and an electricaloutlet.
3-pole power

6.3. Security slot
The monitor can be secured to a table or pole by passing a security cable through thehole of the protruding tab on the monitor to secure it.

13

6.4. Attaching the instruction panel
See the illustration below to attach the instruction panel to the rear side of the monitor.

CAUTIONŶ

Make sure to attach the instruction panel to the main unit before use.
The instruction panel contains precautions that the patient must observe to
use the monitor safely and correctly.

14

6.5. Pre-inspection
WARNINGŶ

6.5.1.

Perform the pre-inspection every day to ensure safe and correct usage.

Introduction

Before using the monitor for the first time each day, perform the following
pre-inspection.

6.5.2.

Before switching the power on

Is there any external deformation or damage to the monitor?
Is the monitor wet?
Is the monitor in a stable location free of tilting, vibrations and impacts?

Blood pressure measurement section
Is there damage or abnormalities around the arm insertion section (cuff area)?
Is the arm cuff cover attached?
Is the arm cuff cover overstretched?

Connection cable
Are the optional cables inserted firmly into the connectors of the monitor?

Power cable
Make sure that the electrical outlet is properly grounded and supplies the specified
voltage and frequency (100 V-240 V~ 50 Hz-60 Hz).

6.5.3.

After switching the power on

Is there any smoke or strange smell?
Can you hear any strange noises?

Checking the timeIs the time set correctly?
If the time is incorrect when recording data, the data will be incorrect.

Checking the display
After switching the power on, all LEDs switch on forseveral seconds and then blood pressure
measurement is possible. At this time, the diastolicblood pressure display displays "0".
15

DIA mmHg

7. BLOOD PRESSURE MEASUREMENTWARNINGŶŶ

To stop blood pressure measurement halfway through, press the START/STOP
button. The cuff rapidly deflates and returns to its original state.
If measurement cannot be stopped by pressing the START/STOP button, press
the FAST STOP button (on the front of the monitor).

1. Insert bare arm or arm with a thin
shirt into the arm insertion section
up to the top of the shou+lder. (Ifthick clothing is worn, themeasurement results will beincorrect. Remove thick clothing
before measurement.)

Top of shoulder
Opening for arm

SYS mmHg

SYS mmHg

2. Press the START/STOP button tostart blood pressure measurement.
3. The cuff automatically inflates.
Keep the arm still in the cuff during the measurement.
4. After inflation, deflation starts automatically. As the pressure
decreases, measurement is performed. The patient must
relax and remain still. (See "10.3. Applied pressure")

SYS mmHg

DIA mmHg

PUL /min.

5. After about one minute of measurement, the cuff
automatically deflates to its original state.
6. The measurement results are displayed.
7. The measurement results are printed on the printer paper. Remove the arm from thecuff. (See "10.5. Print quality")
Note
When performing continuous measurements, wait 2 to 3 minutes between
measurements for the patient to relax.
Blood pressure measurement results are affected by the posture and physical conditionof the patient.
If the patient moves or talks during measurement, correct measurement is not possible.
To obtain accurate measurement results, ensure the patient sits with good posture andhis/her back straight, and with his/her feet flat on the floor without crossing legs. Ensure
the patient is relaxed and remains still.
Adjust the height of the chair such that the cuff is at the same height as the heart. If thecuff is not at the same height as the heart, correct measurement is not possible.
16

8.

SETTING THE CLOCK

To set the date and time, use clock setting mode. Clock setting mode has the following
display.
Year
Month
Day

Hour

㻿㼅㻿

㼙㼙㻴㼓

Selected item
flashes㻰㻵㻭㼙㼙㻴㼓㻼㼁㻸 㻛㼙㼕㼚㻚

MinuteHour

Setting the date and time:
Use the following buttons.
SELECT button: 1. While the monitor is in standby mode, hold the SELECT button for 1
second to enter clock setting mode. The year value will start flashing.
2. Press the SELECT button to select the date or time value to be set.
Each time the SELECT button is pressed, the flashing value changes
from year, month, day, hour, minute, and then back to year. The
selected item flashes and can be changed.
‫ ڸ‬button:
Change the selected (flashing) values.
START/STOP button: Once the desired date and time is selected, press the START/STOP
button to save the changes and return to standby mode.
COUNT button:
If the COUNT button is pressed while configuring settings, changes
are not saved and the monitor returns to standby mode.

Example: Setting the clock to 4:37 PM, April 20, 2015
1.
2.
3.
4.
5.
6.
7.

Hold the SELECT button for 1 second. The systolic display section starts flashing.
Press the ‫ ڸ‬button to display. (2015)
Press the SELECT button. The diastolic display section starts flashing.
Press the ‫ ڸ‬button to display . (April)
Press the SELECT button. The pulse display section starts flashing.
Press the ‫ ڸ‬button to display. (20th)Press the SELECT button to select the hour on the clock display. The hour setting
starts flashing.
8. Press the ‫ ڸ‬button to display . (4 PM)
9. Press the SELECT button to select the minute on the clock display. The minute setting
starts flashing.
10. Press the ‫ ڸ‬button to display. (37 minutes)
11. Press the START/STOP button to return to standby mode.

Notes
If no operation is performed for about 10 seconds, the specified settings are set.
After
is displayed for 2 seconds, the monitor returns to the standby mode.
Dates up to December 31, 2050 are supported.

17

9. PRINTER
9.1. Installing the printer paper
CAUTIONŶ

Do not pull the printer paper during printing.
It may damage the printer head.

1. Press the Open printer cover button to open the printer cover.

Open printer cover button
Printer cover

2. Install the printer paper in the way shown in the illustration below.

Printer paper

3. With the end of the paper at the top and protruding out, secure the printer paper byclosing the printer cover until you hear a click. If the cover is not completely closed, apaper jam may occur.

Printer cover18

If the high-speed printing mode is used, approximately 700 prints are possible from one
printer paper roll. With 3-line printing mode, 600 prints are possible. When the end of theprinter paper roll becomes pink, replace the paper.
Use thermal paper only.
If the following error codes are displayed in the systolic display section, a printer error has
occurred.
Perform the required countermeasure.
Error code

Error/countermeasure
No printer paper. Install a new printer paper roll.
The printer cover is open. Firmly close the printer cover.
A printer cutter error. Open the printer cover, check the printer paper, andthen close the printer cover.

When no printer error is displayed and the monitor is in standby mode, holding down the ‫ڸ‬button for 2 seconds will cut the paper.
Note
If the direction of the printer paper is incorrect, printing is not performed.
Use genuine A&D printer paper. If genuine A&D paper is not used, the print may be
too light or paper jams may occur.
On the last 60 cm of printer paper, there are pink end marks (pink lines on both sides).
If these end marks appear, replace the printer paper.
Thermal printer paper is used. Note that discoloration or fading may occur.
Items that will be discolored:
Felt-tip pens and adhesive agents including starch and organic solvents.
Items that can cause fading:Highlight pens, tape, transparent storage cases, desk pads, sunlight andultraviolet.
Because of the abovementioned causes, make a copy of measurement results whensaving them.

199.2. Selecting the print format
By configuring settings in "10. CHANGING FUNCTIONS", users can format the informationon the printout. The printing area is divided into 4 sections: print header, measurement
value, graph and bitmap. Each section has printing items available for selection.
For details, see "10. CHANGING FUNCTIONS".
1. Print header
The values in the parentheses are the possible settings for each item.
a: ID and name printing (F08: oFF/1/2/3)
b: IHB (F05: on/off)Can be selected byc: Title (fixed)changing functions
d: Measurement start date format (F26)F08
e: Measurement start time format (F27)
1. Print header
F05
f : Height and weight values printing (F16)
F26
F27
F16
2. Measurement value printing (F11)
2. Measurement
F11
The following modes are available for selection.
value printing
F09
High-speed printing (1)Normal 3-line printing (2)Big font printing (3)F12
3. Graph printing
Table printing (4)For each mode, mean arterial pressure (MAP)
printing can be set to on or off. (F09)
3. Graph printing (F12)The following items are available for selection.
Graph printing (off)
Pulse fluctuation graph printing (1)4. Bitmap printing (F15)
The following items are available for selection.
Bitmap printing (off)Standard pattern printing (1)User pattern printing (2)4. Bitmap printing

F15

5. ICT printing

F29

5. ICT printing㸦F29㸧
The following items are available for selection.
ICT printing (off)Bar code printing .................................................................................... (1)QR code printing, including ID................................................................ (2)Bar code printing (CODE39, with check digit (modulus43) ) .................. (3)QR code printing V2, including ID .......................................................... (4)20Printing example 1: Initial settings
F05: IHB [on] (IHB detected)
F26: Date format [1] (EU format)
F27: Time format [24] (24 hour)
F11: Measurement value printing [2] (Normal 3-line printing)Printing example 2:
F08: ID printing [3]F05: IHB [on] (No IHB detected)
F26: Date format [1] (EU format)
F27: Time format [24] (24 hour)
F11: Measurement value printing [1] (High-speed printing)
F09: MAP printing [on]Printing example 3:
F05: IHB [on] (No IHB detected)
F26: Date format [2] (US format)
F27: Time format [12] (12 hour)
F11: Measurement value printing [1] (High-speed printing)
F09: MAP printing [off]21

10. CHANGING FUNCTIONS
The multi-functional monitor can be configured for various applications by changing
function settings. To change function settings, use the buttons located on the rear
panel of the monitor while the monitor is in standby mode.

10.1. Procedure to Change Function Settings
1. In power off mode, hold boWKWKHŸDQGSELECT buttons
down and switch the power on.
F01 is displayed in the systolic display section and themonitor enters the function changing mode.
2. Each time the SELECT button is pressed, the setting itemchanges to F02, F03...
3. Each item FDQEHFKDQJHGXVLQJWKHŸEXWWRQ
4. After completing the settings, switch the power off and then on again.
Setting
items

Details
Not used

Default

Diastolicdisplay section̿

Display time

, ,,Applied pressure,,

Not used
IHB
Not used

Applied pressure setting (mmHg)

̿
IHB-mark printing on/off,̿Printing off
Light printing (high speed)Standard printing
Dark high-quality printing (low speed)
ID : No
Name : No
ID : No
Name : Yes
ID : Yes
Name : No
ID : Yes
Name : Yes

ID and nameprinting

Mean arterial blood pressure (MAP)
printing on/off,̿High-speed printing
Normal 3-line printing
Big font printing
Table printing
Graph printing off
Pulse fluctuation graph printing

Measurement
value printing
Graph printing
Not used, Measurement result display time(seconds),

Print quality/
light or dark

Mean arterialpressure (MAP)
printing
Not used

Function̿
22

Setting
items

Details
Not used

Default

Diastolicdisplay section

̿Bitmap printing off
Standard pattern printing
User pattern printing
Height and weight values printing OFF
Printer mode printing
Integrated mode printing

Bitmap printing
Height and weightvalues printing
Not used
Beep soundNot used

Function̿
Beep sound on/off,̿
No connection
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: Blood pressure result
input/output (STD/RI/RB/BP/RA)
Mini-DIN: A&D weight scale
D-Sub:Blood pressure result
input/output (STD/RI/RB/BP/RA)
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: ID reader
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: Ux compatibility
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: RVX compatibility
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: A&D weight scale
Mini-DIN: Blood pressure result
input/output (STD/RI/RB/BP/RA)
D-Sub: RVY compatibility
1200 bps
2400 bps
4800 bps
9600 bps
1200 bps
2400 bps
4800 bps
9600 bps
Stop bit: 1
Stop bit: 2
Stop bit: 1
Stop bit: 2External
input/output
protocolTransmission
speed (Mini-DIN)

Transmission
speed (D-Sub)
Stop bit(Mini-DIN)
Stop bit (D-Sub)
23

Setting
items

Details

Default

Diastolicdisplay section

RB (no ID, immediately after
measurement) + STD
RI (with ID, immediately after
measurement)+ STD
BP (with ID, immediately after
measurement)only
STD (command response) only
RA (with ID, immediately after
measurement)
DD month., YYYY
month. DD, YYYY
24 hour
12 hour (AM/PM)

Blood pressure
result output

Date formatTimeformat
Not used

Function̿
ICT printing OFF
Bar code printing (CODE39)
QR code printing, including ID
Bar code printing (CODE39 , withcheck digit (modulus43) )QR code printing V2, including ID
Connection at the end of measurement
Connection at the start ofmeasurement
Airplane mode OFF
Airplane mode ON

ICT printingBluetooth®
connection timing
Airplane mode

F16 setting is valid only if F20 setting is 2 or 6.
Initial values are determined depending on each destination.
F35 setting is valid only when TM2657-04 is installed.
To reset all settings to factory default settings, hold the START/STOP button for 5
seconds when any of the "FXX" numbers are displayed.

24

10.2.

Display time

The display time for measurement results can be set using the function F02.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Display time setting
No display of results (All values are displayed as "---")
5 seconds
10 seconds
20 seconds
Remains displayed

Default

10.3. Applied pressure
The applied pressure can be set using the function F03.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section. (If automatic applied pressure (Aut) is set, pulsation is observed whilepressure is applied and the applied pressure value is automatically determined.)
DIA LED

Applied pressure setting
Automatic applied pressure
160 mmHg
180 mmHg
200 mmHg

Default

10.4. IHBThe IHB setting can be set using the function F05.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LEDIHB setting
IHB off
IHB onWhen IHB is on:
Printing example
When IHB is detected

When IHB is not detected

For details on IHB, see "3. ABBREVIATIONS AND SYMBOLS".

25

Default

10.5. Print quality
The print quality can be set using the function F07.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Print quality setting

Default

Printing off
Light printing (high speed)Standard printing
Dark high-quality printing (low speed)

10.6. ID and name printing
ID printing can be set using the function F08.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDppears in the diastolic display
section.
㸦Only TM-2657VP, TM-2657P㸧
DIA LEDID : No
ID : No
ID : Yes
ID : Yes

ID printing setting/ Name : No
/ Name : Yes/ Name : No
/ Name : Yes

When ID and name printing is on:
Printing example

DefaultID

Name
To input an ID, set the function F20 to 3, and connect an ID reader.
The ID data is maintained until the blood pressure is measured correctly and is cleared
immediately after the result is displayed or printed.

26

10.7. Mean arterial pressure (MAP) printing
Mean arterial pressure (MAP) printing can be set using the function F09.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Mean arterial pressure printing
Mean arterial pressure (MAP) printing off
Mean arterial pressure (MAP) printing on

When mean arterial pressure (MAP) printing is on:
Printing example
High speed printing

Mean arterial pressure (MAP)

Normal printing
Mean arterial pressure (MAP)

Big font printing

Mean arterial pressure (MAP)

27

Default

10.8. Measurement value printing
Measurement value printing can be set using the function F11.
Use the ŸEXWWRQWRFKDQJHWKHVHWWLQJ7Kis setting appears in the diastolic display
section.
DIA LED

Measurement value printing mode
High-speed printing
Normal 3-line printing
Big font printing
Table printing

Default

When Mean arterial pressure (MAP) printing is off:
Printing example
High-speed printing
Big font printing

Normal 3-line printing

Table printing

When IHB (F05) is on and IHB is detected

Note
In the table printing mode, paper is not cut automatically. To cut paper, hold the ‫ ڸ‬button
for 2 seconds while the monitor is in the standby mode.

28

10.9. Graph printing
The graph printing settings can be set using the function F12.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKH diastolic display
section.
DIA LED

Graph printing

Default

Graph printing off
Pulse fluctuation graph printing
Printing example: Pulse fluctuation graph printing㻜

10.10.

㼙㼙㻴㼓㻟㻜㻜

Bitmap printing

Bitmap printing can be set using the function F15.
UVHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Bitmap printing
Bitmap printing off
Standard pattern printing
User pattern printing

Default

For details about bitmap registration, see "15. SENDING BITMAP PATTERNS".
For details on user pattern printing, see "15. SENDING BITMAP PATTERNS".
Bitmaps up to 384 x 640 pixels can be printed.
Printing example: Standard pattern printingStandard bitmap

29

10.11.

Beep soundThe key operation sound when a measurement starts/ends can be set to ON/OFF
using the function F18.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\VHFWLRQDIA LED

BuzzerDefault

Beep sound off
Beep sound on

10.12.

External input/output protocol

The protocol settings for connections can be set using the function F20.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQthe diastolic display
section.
External input/output unit 㸺TM-2657-01㸼
DIA LED

External input/output unit (option) protocol

Default

No connection
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:
Mini-DIN:
D-Sub:

Blood pressure result input/output (STD/RI/RB/BP/RA)
Blood pressure result output (STD/RI/RB/BP/RA)
A&D height and weight scale
Blood pressure result input/output (STD/RI/RB/BP/RA)
Blood pressure result input/output (STD/RI/RB/BP/RA)
ID readerBlood pressure result input/output (STD/RI/RB/BP/RA)
Ux compatibility
Blood pressure result input/output (STD/RI/RB/BP/RA)
RVX compatibility
Blood pressure result input/output (STD/RI/RB/BP/RA)
A&D weight scale
Blood pressure result input/output (STD/RI/RB/BP/RA)
RVY compatibility

External input/output unit 㸺TM-2657-02㸼
DIA LED,,, ,External input/output unit (option) protocol
No connection, USB:
Blood pressure result input/output (STD/RI/RB/BP/RA)USB:
ID ReaderUSB:
Blood pressure result input/output (STD/RI/RB/BP/RA)USB:
ID Reader

30

Default

External input/output unit 㸺TM-2657-03㸼
DIA LED

External input/output unit (option) protocol
No connection
D-Sub:
Blood pressure result input/output (STD/RI/RB/BP/RA)
D-Sub:
Blood pressure result input/output (STD/RI/RB/BP/RA)
ID reader
D-Sub:
D-Sub:
Ux compatibility
D-Sub:
RVX compatibility
D-Sub:
A&D height and weight scale
D-Sub:
RVY compatibility

Default

External input/output unit 㸺TM-2657-04㸼
DIA LED

External input/output unit (option) protocol
No connection
Bluetooth® Low Energy: Blood pressure result input/output (RX)D-Sub:
Blood pressure result input/output (STD/RI/RB/BP/RA)
®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:
Blood pressure result input/output (STD/RI/RB/BP/RA)
®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:ID reader®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:
Ux compatibility
®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:
RVX compatibility
®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:
A&D height and weight scale®
Bluetooth Low Energy: Blood pressure result input/output (RX)D-Sub:
RVY compatibility

Default

External input/output unit 㸺TM-2657-05㸼
DIA LED

External input/output unit (option) protocol
No connection
Blood pressure result input/output (STD/RI/RB/BP/RA)
D-Sub:
D-Sub:
Blood pressure result input/output (STD/RI/RB/BP/RA)
D-Sub:ID reader
D-Sub:
Ux compatibility
RVX compatibility
D-Sub:
D-Sub:
A&D height and weight scale
D-Sub:
RVY compatibility

Default

For details on communication commands (STD/RI/RB/BP/RA), contact your local A&D
dealer.
For details on connecting ID readers, weight scales, or computers, contact your local
A&D dealer.
31

10.13.

Transmission speed (Mini-DIN)

The Mini-DIN
transmission speed can be set using the function F21.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQthe diastolic display
section.
DIA LED

Transmission speed (Mini-DIN)

Default

1200 bps
2400 bps
4800 bps
9600 bps

10.14.

Transmission speed (D-Sub)

The D-Subtransmission speed can be set using the function F22.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQthe diastolic display
section.
DIA LED

Transmission speed (D-Sub)

Default

1200 bps
2400 bps
4800 bps
9600 bps

10.15.

Stop bit (Mini-DIN)

The stop bit (Mini-DIN) can be set using the function F23.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Stop bit (Mini-DIN)

Default

Stop bit 1
Stop bit 2

10.16.

Stop bit (D-Sub)

The stop bit (D-Sub) can be set using the function F24.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Stop bit (D-Sub)
Stop bit 1
Stop bit 2

32

Default

10.17.

Blood pressure result output

The blood pressure result output can be set using the function F25.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Blood pressure result output
RB (no ID, immediately after measurement) + STD
RI (with ID, immediately after measurement) + STD
BP (with ID, immediately after measurement) only
STD (command response) only
RA (with ID, immediately after measurement)

Default

For details on transmission printing, contact the local A&D dealer.

10.18.

Date format

The printing date format can be set using the function F26.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LED

Date format

Default

DD month., YYYY
month DD, YYYY
The default setting depends on the destination.

10.19.

Time format

The time format can be set using the function F27.
8VHWKHŸEXWWRQWRFKDQJHWKHVHWWLQJ7KLVVHWWLQJDSSHDUVLQWKHGLDVWROLFGLVSOD\section.
DIA LEDTime format
24 hour
12 hour (AM/PM)

The default setting depends on the destination.

33

Default

10.20.

ICT printing

The ICT printing can be set using the function F298VHWKHŸEXWWRQWRFKDQJHWKH
setting. This setting appears in the diastolic display section.
DIA LED

ICT printing

Default

ICT printingOFF
Bar code printing(CODE39)
QR code printing, including ID
Bar code printing(CODE39 , with check digit (modulus43) )QR code printingV2, including ID
The following information is included in code printing.
ŶBar code printing(CODE39)

㸸 Systolic blood pressure value,
Mean blood pressure value,
Diastolic blood pressure value,
Pulse rateŶ

QR code printing
including ID

㸸 YYYY/MM/DD/HH/MM, ID (16 digits),
Systolic blood pressure value,
Mean blood pressure value,
Diastolic blood pressure value,
Pulse rateŶBar code printing
㸸 Systolic blood pressure value,(CODE39 , with check digit (modulus43) ) Diastolic blood pressure value,
Pulse rateŶ

QR code printing V2
including ID

㸸 YYYY/MM/DD/HH/MM, ID (16digits),
Systolic blood pressure value,
Mean blood pressure value,
Diastolic blood pressure value,
Pulse rate,
Height value,
Weight value

Printing example)
Bar code printing (CODE39)

Printing example)
QR code printing, including ID

34

Printing example)
Bar code printing(CODE39 , with check digit (modulus43) )Printing example)
QR code printing V2, including ID

For details on ICT printing, contact your local A&D dealer.
QR code is a registered trademark of DENSO WAVE Incorporated.

10.21.

Bluetooth® connection timing

The Bluetooth® connection timing can be set using the function F318VHWKHŸEXWWRQ
to change the setting. This setting appears in the diastolic display section.
DIA LED

ICT printing
Connect at the end of measurement
Connect at the start of measurement

Default

㸺Connect at the end of measurement㸼Connect with the host device after each measurement and start Bluetooth®
transmission.
㸺Connect at the start of measurement㸼Connect with the host device at the start of each measurement and start Bluetooth®
transmission.

10.22.

Bluetooth® Airplane mode

The time format can be set using the function F35.
Use the ‫ ڸ‬button to change the setting. This setting appears in the diastolic display
section.
DIA LED

Airplane mode
Airplane mode OFF
Airplane mode ON

35

Default

11. TRANSMISSION SPECIFICATIONS
The monitor can connect to the optional external input/output unit. Various settings for eachchannel are available from functions F20 to F25.

CAUTIONŶŶ

The personal computer and medical equipment connected to the device must
be located out of reach of the patient.
The personal computer or ID reader used must conform to EN60601-1.

11.1. External input/output unit
unit
TM-2657-01
TM-2657-02
TM-2657-03
TM-2657-04
TM-2657-05

function
Mini-DIN 8pin female, D-Sub 9pin male
USB Type-A ,USB Type-B
D-Sub 9pin male
Bluetooth® Low Energy, D-Sub 9pin male
Bluetooth®, D-Sub 9pin maleNote
For details on EXTERNAL INPUT/OUTPUT UNIT (TM-2657-01, TM-2657-02,
TM-2657-03, TM-2657-04, TM-2657-05), contact your local A&D dealer.

36

11.1.1. Mini-DIN 8 pin female(External input/output unit : only TM-2657-01㸧
㸧Transmission specifications
Main standard
Transmission format
Signal speed
Transmission format
Data bit length
ParityStop bit
Code

Complies with EIA RS-232C
Stop-start system (Full duplex)
1200, 2400, 4800 and 9600 bps (can be changed using F21)
Can be changed using F20
8 bits, 7 bits
None
1 bit, 2 bits (can be changed using F23)
ASCII

Pin assignment
Pin No.

Signal name

Description

1

TXD

Transmit data

2

RXD

Receive data

3

RTS

Request to send4㸫

No connection

5

CTS

Clear to send

6

GND

Signal ground7㸫

No connection8

㸫

No connection

Do not connect to Pins No. 4, 7, or 8. They are used for the blood pressure monitor.

Cable specifications for computer connection
TM-2657P
Mini-DIN 8 pin female
Content
Pin No.
TXD
1
RXD
2
RTS
3
ʊ
4
CTS
5
GND
6
ʊ
7
ʊ
8

Personal computer
D-Sub 9 pin maleContent
Pin No.
̿
1
RXD
2
TXD
3
DTR
4
GND
5
DSR
6
RTS
7
CTS
8
̿
9
37

11.1.2. D-Sub 9-pin male
(External input/output unit : except TM-2657-02)
Transmission specifications
Output standards
Transmission format
Signal speed
Transmission format
Data bit length
ParityStop bit
Code

Complies with EIA RS-232C
Stop-start system (Full duplex)
1200, 2400, 4800 and 9600 bps (can be changed using F22)
Can be changed using F20
8 bitsNone
1 bit, 2 bits (can be changed using F24)
ASCII

Pin assignment
Pin No.
1
2
3
4
5
6
7
8
9

Signal name
㸫
RXD
TXD
DTR
GND
DSR
RTS
CTS
㸫

Description
㸫Receive data
Transmit data
Data terminal ready
Signal ground
Data set ready
Request to send
Clear to send㸫The protocol depends on the equipment connected.

Cable connection between the device and a personal computer
TM-2657P
D-Sub 9 pin male

Personal computer or ID Reader
D-Sub 9 pin male38

11.1.3. USB Type-B (External input/output unit : only TM-2657-02)
Transmission specifications
Output standards
Signal speed
Transmission format
DriverComplies with USB 2.0 Full-speed
Full-speed (12Mbps)
Can be changed using F20
FTDICommunication partner
Personal computer

Pin assignment

11.1.4. USB Type-A (External input/output unit : only TM-2657-02)
Transmission specifications
Output standards
Signal speed

Complies with USB 2.0 Full-speed
Full-speed (12Mbps)

Communication partner
ID reader(Complies with HID)

Pin assignment

11.1.5. Bluetooth®
(External input/output unit : TM-2657-04 & TM-2657-05)
In order to use the Bluetooth® transmission function of the TM-2657 series safely andcorrectly, carefully read the following precautions before using the monitor. The
following content summarizes general matters regarding the safety of patients andoperators, in addition to the safe handling of the monitor.

Before using the monitor
WARNINGŶŶŶ

Do not use in places where wireless communication is prohibited, such as on
airplanes or in hospitals. This monitor may have an adverse effect onelectronic devices or medical electrical equipment.
If implantable heart pacemaker or implantable cardioverter defibrillator areused, please contact about the influence of radio waves individually to
medical electrical equipment manufacture.
For such as warning and caution about the handling of sphygmomanometer
body, please follow the description of the instruction manual of
sphygmomanometer.
39

CAUTION
ŶŶThis monitor has built-in wireless equipment with construction design
certification as wireless equipment of a low electric power data
communicating system based on regulations of the Radio Act. Therefore,
when the wireless function of this equipment is used, wireless station
permission is not necessary.
Disassembly or modification of this monitor may be punished by a law
because this monitor has construction design certification.

During use of the wireless equipment
CAUTIONŶŶŶ

We cannot accept any responsibility for any losses incurred such as
operating malfunctions or loss of data that may occur through the use of thismonitor.
This monitor is not guaranteed to connect with all Bluetooth® compatible
devices.
In the event of radio wave interference from the monitor to the other wirelessstation, change the location of use or stop using immediately.

For good wireless communication
WARNINGŶ

Do not use in the vicinity of cell phones. This could cause malfunction.

Note
Ensure wireless device is within view of the monitor. Wireless range is affected bybuilding structure and obstructions. Specifically, reinforced concrete can cause wirelessinterference.
When communicating using this equipment close to a wireless communication device
that is communicating using radio wave of near 2.4GHz, there are cases when theprocessing speed decreases at the both side. Do not use this equipment at a location
where a magnetic field, static electricity or wave interference around the microwave
ovens appears. (Doing so may prevent the devices from communicating properly.)
If the monitor cannot normally transmit data near a radio or broadcast station, pleasechange the location.

40

11.1.6. Bluetooth® (External input/output unit : TM-2657-05)
1) Transmission specifications
Main standard
Bluetooth® Ver.2.1 class1
Supported profiles
HDP
Communication distance Maximum of 100m (depends on usage)
Frequency band
2,402 - 2480 MHz
Modulation
GFSK/QPSK
Maximum RF output power < 20 dBm
Continua certified devices
Applications and devices that are compatible with SSP and
A&D specifications.
However, each device needs an application to receive data.
For connection methods, refer to the manual for each
Devices that can be
device.
connected
Bluetooth® devices described theBluetooth® logo mark.
Continua certified devices describedwith the Continua logo mark.
 This monitor may be changed for improvement without any prior notice.

2) Pairing
A Bluetooth® device needs to be paired with a different specific device in order tocommunicate with that device. When this monitor is paired with a receiver device,measurement data is transmitted automatically to the receiver device each time ameasurement is made.
Follow the steps below to pair the monitor with a Bluetooth® compatible receiverdevice. Also refer to pairing in the manual of the receiver device. Please use a pairing
wizard if it provided.
(1) Follow the instructions in the manual of the receiver device to switch it to the state thata pairing is possible. When pairing this monitor, place it as close as possible to thereceiver device to be paired with.
(2) Hold down the SELECT button and turn on the power.
Press the START/STOP button after "do" is displayed in the systolic display sectionand "PAr" is displayed in diastolic display section.
The monitor will be searchable from the receiver device for about one minute afterpressing the START/STOP button.
(3) Follow the manual of the pairing receiver device, the monitor performs a search, select,
and pair. If a PIN code is requested by the receiver device, enter "123456".
(4) "End" is displayed in the pulse rate display section when the pairing is oversuccessfully on the receiver device side, and the pairing is finished.
(5) If the pairing is failed, "Err" is displayed in the pulse rate display section.
Turn off the monitor and back on again, and then retry from the step (1).
41

Note
Other than the operation of the above (2), the monitor will be searchable from thereceiver device for about one minute after turning on the power. In this operation,"End/Err" are not displayed in the pulse rate display section when the pairing is over.
㸦 When reset with the FAST STOP button, searching is impossible.㸧
Be sure to turn off the power of Bluetooth® devices other than the monitor when
pairing. Multiple devices cannot be paired at the same time.

3) Measurement data transmission
Transmission after pairing is performed automatically by the following procedure.
Enable wireless communication on the receiving device.
(1) Press the START/STOP button to start blood pressure measurement.
(2) After measurement, the measurement data is transmitted automatically to the receiverdevice.
Note
When the function setting F20 of the Automatic Blood Pressure Monitor on which themonitor is installed is OFF, data transmission and reception are not performed. Ensure
F20 is not set to OFF.
If the receiver device cannot receive measurement data, try pairing again.
The communication distance between this monitor and the receiver device isdependent on the Bluetooth® output class of the receiver device.
When the receiver device is a Class 1 Bluetooth® device: Less than 100 m
When the receiver device is a Class 2 Bluetooth® device: Less than 10 m
This distance depends on the conditions in the surrounding environment. Please checkthat the distance is acceptable for transmitting measurement data.
In cases when the receiver device cannot receive measurement data, themeasurement data is temporarily stored in the monitor memory along with themeasurement time. A total of 200 sets of measurement data can be automaticallystored. When the amount of data exceeds 200 sets, the oldest data is deleted and the
new data is stored.
The data stored in the memory is transmitted the next time a connection is
successfully made to the receiver device, and when the reception is confirmed, it isremoved automatically. The amount of data that can be stored temporarily may varywith the receiver device.

424) Bluetooth® utility mode
Configure Bluetooth® settings for this monitor in Bluetooth® utility mode.
To change function settings, use the buttons located on the rear panel of the monitor
while the monitor is in standby mode.
(1) Hold down the SELECT buttons and turn on the
power.
"do" is displayed in the systolic display section and"PAr" is displayed in the diastolic display section,
when the Bluetooth® utility mode has started.
(2) Each time the SELECT button is pressed, the settingchanges to "un" / "PAr" ĺ"cLr" / "dAt" ĺ"do" / "PAr" ĺ«(3) Each item can be performed using the START/STOP button.

Pairing
See "11.2.3 2) Pairing" described above.

Unpairing
Devices can be unpaired.
Enter the Bluetooth® utility mode. Press the START/STOP button with "un" in thesystolic display section and "PAr" in the diastolic display section.
When "End" is displayed in the pulse rate display section, cancellation of the pairing iscompleted, but when "Err" is displayed in it, retry from the step (1).

Data clear
Erase data temporarily stored in the Automatic Blood Pressure Monitor.
Enter the Bluetooth® utility mode. Press the START/STOP button with "cLr" in thesystolic display section and "dAt" in the diastolic display section.
When "End" is displayed in the pulse rate display section, cancellation of the dataclear is completed, but when "Err" is displayed in it, retry from the step (1).
NoteThis function is valid only with the TM-2657-05.

5) TimeThis monitor has a built-in clock. The measurement data includes the date and timethat a measurement was taken.
The time is designed to be synced with the time of a receiver device side. Refer to thespecifications of the receiver device side.
Note
The clock in the monitor can be automatically set by the receiver device side function.
After the pairing, the time of the monitor is automatically set to the time of the receiverdevice 2 minutes after power on if there are no operations, or at the start of firstmeasurement.
When the setting function F20 is off, the above clock synchronization is not performed.
436) Contents of transmission
Transmission data
Systolic blood pressure, diastolic blood pressure, pulse rate, measurement time, ID
For more information, please contact the A&D ME Device Customer Response Center.

11.1.7. Bluetooth® Low Energy(External input/output unit : TM-2657-04)
1) Transmission specifications
Main standard
Bluetooth® Ver.2.4
Supported profiles
BLP (Blood Pressure Profile)Frequency band
2.4 GHz (2400 - 2483.5 MHz)
Modulation
GFSK
Maximum RF output power < 20 dBm
Applications and devices that are compatible with
Bluetooth®.
However, each device needs an application to receive data.
Devices that can be
For connection methods, refer to the manual for eachconnected
device.
Bluetooth® devices described theBluetooth® logo mark.
Communication data
SYS, DIA, MAP, PUL, Measurement time, ID

2) Bluetooth® Low Energy utility mode
Configure Bluetooth® settings for TM-2657-04 in Bluetooth® Low Energy utility mode.
To change function settings, use the buttons located on the rear panel of the monitor
while the monitor is in standby mode.
(1) Hold down the SELECT button and turn on the power.
(2) "INT" is displayed in the systolic display section and"___" is displayed in the diastolic display section,
when the initialize has started.
"E98" is displayed in the systolic display section and" -4" is displayed in the diastolic display section,
when the initialize has failed. Turn off the monitor andback on again, and then retry from the step (1).
(3) "do" is displayed in the systolic display section and "PAr" is displayed in the diastolic
display section, when the Bluetooth® Low Energy utility mode has started.
(4) Each item can be performed using the START/STOP button.

443) Pairing
A Bluetooth® device needs to be paired with a different specific device in order tocommunicate with that device. When this monitor is paired with a receiver device,measurement data is transmitted automatically to the receiver device each time ameasurement is made. Follow the steps below to pair the monitor with a Bluetooth®
compatible receiver device. Also refer to pairing in the manual of the receiver device.
Please use a pairing wizard if it provided.
(1) Follow the instructions in the manual of the receiver device to switch it to the state thata pairing is possible. When pairing this monitor, place it as close as possible to thereceiver device to be paired with.
(2) Hold down the SELECT button and turn on the power.
Press the START/STOP button after "do" is displayed in the systolic display sectionand "PAr" is displayed in diastolic display section.
The monitor will be searchable from the receiver device for about one minute afterpressing the START/STOP button.
(3) Follow the manual of the pairing receiver device, the monitor performs a search, select,
and pair.
(4) "End" is displayed in the pulse rate display section when the pairing is oversuccessfully on the receiver device side, and the pairing is finished.
(5) If the pairing is failed, "Err" is displayed in the pulse rate display section.
Turn off the monitor and back on again, and then retry from the step (1).
NoteThis function is valid only with the TM2657-04.
When the setting item F35 in the function settings is set to 2 (Airplane mode ON),
pairing cannot achieve. Set to 1 (Airplane mode OFF) for a pairing.

4) Measurement data transmission
Transmission after pairing is performed automatically by the following procedure.
Enable wireless communication on the receiving device.
(1) Press the START/STOP button to start blood pressure measurement.
(2) After measurement, the measurement data is transmitted automatically to the receiverdevice.
Note
When the function setting F20 of the Automatic Blood Pressure Monitor on which themonitor is installed is OFF, data transmission and reception are not performed. Ensure
F20 is not set to OFF.
If the receiver device cannot receive measurement data, try pairing again.
The measurement data will be erased when the monitor is turned off.
The communication distance between this monitor and the receiver device is dependent
on the Bluetooth® output class of the receiver device.
The communication distance when there are no obstacles is about 10 m.
This distance depends on the conditions in the surrounding environment. Please checkthat the distance is acceptable for transmitting measurement data.
454) Time
This monitor has a built-in clock. The measurement data includes the date and time thata measurement was taken.
The clock in the monitor can be set by sending a command from the receiver device.

46

12. MAINTENANCE
12.1. Inspection and safety management
Do not open the device. It uses delicate electronic components and an intricate air unitthat could be damaged. Do not change the adjustment volume setting of the power
supply. The device may not turn on if the settings are changed. If you cannot fix the
problem using the troubleshooting instructions, request service from your local dealer orfrom the A&D service group. The A&D service group will provide technical information,
spare parts and units to authorized dealers. Technical inspection procedures whichshould be done at least every two years, can be performed either by the manufacturer
or by an authorized repair service in accordance with the regulations governing
manufacturing of medical products.

Checking pressure accuracy

WARNINGŶWhen using a rubber pump, do not apply a pressure of 280 mmHg or higher
to the monitor or inspection equipment (UM-102, accurate mercury
sphygmomanometer or aneroid gauge).
Ŷ Perform the inspection only as described below or the setting values andfunction settings may be changed.
Ŷ After inspection, check that the air connector plug is inserted into the bloodpressure monitor. If the air connector plug is not inserted, pressure cannot beapplied and measurement is not possible. When inserting the plug, push in
until you hear a click.
Objective:
Compare the pressure values of the inspection equipment and theblood pressure monitor to check for errors in the monitor.
Inspection equipment: Inspection equipment (UM-102, Accurate mercury
sphygmomanometer or aneroid gauge)
Connection:

Connect the inspection equipment to the blood pressure monitor
as shown below. Remove the armrest of the blood pressure
monitor and then remove the cover of pressure inspection area.
Remove the air connector plug from the air socket of the bloodpressure monitor. Connect the coupling connector to theconnection hose, and connect it to the air socket.

Inspection equipment

Rubber pump

COUNT button

Connection hoseCA
Air connector
Cap

B




500 cc air tank

Coupling connector
47

Cover for pressure
inspection area

1. Hold the COUNT button on the rear of the blood pressure monitor, and turn the
POWER switch on.
2. "" appears in the clock display section.

3. With "" displayed, press the START/STOP button.
Pressure inspection mode starts and the current pressure is displayed.
4. Using the rubber pump, apply the pressures listed below. Compare and check thepressures of the blood pressure monitor and the inspection equipment.
No
Pressure setting
1 0 mmHg
2 50 mmHg
3 200 mmHg

Instrumental error A-B (standard)
0 mmHgWithin ±6 mmHg

A: Pressure displayed by the inspection equipment
B: Diastolic and systolic pressures displayed by the monitor
5. Confirm that the values are within standards. To exit the pressure inspection mode andreturn to the standby mode, switch the power off and switch the power on again.
Note
Use the coupling connector for exclusive use with the TM-2657P.

12.2. Cleaning
CAUTIONŶŶŶŶŶ

Before cleaning, switch the power off and disconnect the power cable fromthe electrical outlet.
When cleaning the monitor, never splash it with or soak it in water.
The blood pressure monitor is not waterproof device. Do not splash water on
it and avoid exposure to moisture.
When disinfecting the monitor, never use an autoclave or gas sterilization(EOG, formaldehyde gas, high concentration of ozone).
Never clean the monitor with solvents such as thinner or benzene.
Clean the monitor about once a month in the following manner based onpolicies and procedures determined by the hospital.

When the main body or the arm cuff cover is dirty, wipe them fully by using gauze or
cloth dampened with warm water and a neutral detergent avoiding excess water.
To prevent a risk due to infection, disinfect the main body and the arm cuff cover
regularly. When disinfecting them, wipe them gently by using the gauze or dampened
cloth with local antiseptic solution then wipe the moisture off the surface by using a dry
soft cloth.
The antiseptic solution should be used as a water solution by following a rule for notes
for its product at the dilution ratio. The following shows the example in which can beused as antiseptic solution.
48

Example of useable antiseptic solution (Ingredient name)Component Name
Benzalkonium chloride
Isopropanol
Ethanol

Product Name
Benzalkonium chloride 10% solution
70% in 1-propanol
Ethanol for disinfection 76.9 to 81.4 vol%Check that the arm cuff cover is not damaged. If it is damaged, replace it.
For the replacement procedure, see "12.4. Replacing the arm cuff cover".
Note
UThe arm cuff cover and cables are consumables.
If there are frequent measurement errors or measurement is not possible, these items
must be replaced.
Before ordering replacements, see "13. ACCESSORIES AND OPTIONS LIST".

Printer head
If the printer head has paper debris, or other foreign matter has collected, printing will
not be performed correctly. To prevent this, follow the procedure below to clean theprinter head.

CAUTIONŶŶ

Before cleaning, switch the power off and wait until the printer head hascooled completely. The printer head gets very hot and may cause burns.
Some printer parts have sharp edges. Take great care when handling them toavoid injury.

1. Switch the power off.
2. Press the Open printer cover button to open the printer cover.

Open printer cover button
Printer cover

3. Using a soft cotton swab or cotton cloth moistened with alcohol (ethyl or isopropyl),clean the heating element very gently.

49

Printerhead

Heating
element

Cottonswab

4. Clean the printer paper compartment to remove dust, paper debris and other foreign
matter. Debris in the paper output path may lower the printing quality.
5. Wait for the cleaned parts to completely dry and install the printer paper.

Printer paper

6. With the end of the paper at the top and protruding out, secure the printer paper byclosing the printer cover until you hear a click. If the cover is not completely closed, apaper jam may occur.

Printer cover

Note
When cleaning the printer head, be careful of static electricity. Static electricity candamage the printer head.
Do not use abrasive substances, such as sandpaper, to clean the printer head. They
will damage the heating element.
Make sure that the printer head is completely dry before installing the printer paperand switching the power on.
50

12.3. Periodic inspection
To ensure correct use of the monitor, perform a periodic inspection.
The main items of the periodic inspection are as follows.

Before switching the power on
Item

Description
Check for deformations and damage from drops.
Check parts for dirt, rust, scratches.
Exterior
Check panels for dirt, scratches, damage.
Check for moisture.
Operation parts
Check switches and buttons for damage, looseness.
Display
Check display for dirt, scratches.
Measurement parts Check the cuff and arm cuff cover for damage.
Check that the arm cuff cover is installed.
Arm cuff cover
Please use the arm cuff cover to prevent any foreign matter fromentering into this device.
PrinterCheck that the printer paper is the specified type
Check that the power cable is inserted correctly into the connector.
Check the power cable for damage
Power parts(exposed core wires, disconnection).
Check that the electrical outlet is properly grounded and supplies the
specified voltage and frequency (100-240 V~ 50-60 Hz).

After switching the power on
Item
Exterior

Details
Check for smoke or unusual smells.
Check for unusual noise.
Press the START/STOP button and check for errors.

Operation parts

Display

Printer

Backup function

Press the FAST STOP button during inflation to check thatpressurization stops.
Check the blood pressure, pulse and clock display sections formissing numbers or characters.
Check that no error codes are displayed.
Check that measurement values are near normal values.
Check that the paper availability and run out are detected.
Check that the printer paper is fed correctly.
Check that test printing has no missing items.
Check that the paper is cut after printing.
Check that the date and time are correct.
Check that the contents of set values are saved.

51

12.4. Replacing the arm cuff cover
1. Use a flathead screwdriver to loosen the screw.
2. Slide the front frame down, and then pull forward.

3. Loosen the screws (armrest securing
screws) on the rear side and remove
the screws.

4.

Lift the armrest and pull back.

5. Slide the rear frame down, then pull out.

6. Pull the arm cuff cover out from thevinyl ring groove to remove.

7. Insert the new arm cuff cover andpush the vinyl ring into the groove (onthe inner side of the frame) to attach.

52

8. Fit the new arm cuff cover over the front vinylring groove.

9. Reversing the steps used to remove, reattach therear and front frames, return the armrest to its
original position, then replace the armrest
securing screws (2) and front frame screw (1).
Note
The arm cuff cover is consumable. New covers must be purchased separately.
(arm cuff cover㸸AX-134005759-S)

CAUTIONŶ

Using a correct arm cuff cover and exchanging it are important for safety andmeasurement accuracy at this device.

12.5. Checking the number of measurements
The monitor can count the number of times blood pressure measurement has been
performed. This function is designed to check usage frequency and provide areference for scheduled cleaning. The count value is stored even after the power isswitched off.

53

12.5.1. Displaying the number of measurements
To display the number of measurements:
Hold the COUNT button for 1 second while the monitor isin the standby mode. The number of measurements is
displayed for about 60 seconds in the systolic and diastolic
display sections.
In the example display below, the number ofmeasurements is 2,382. (The maximum count is 999,999.)
SYS mmHg

DIA mmHg

PUL /min.

To reset the number of measurements:+ROGWKHŸEXWWRQIRUVHFRQGVWRGLVSOD\
the reset confirmation display.
Press the START/STOP button to reset thecount.

12.5.2.

SYS mmHg

SYS mmHg

DIA mmHg

DIA mmHg

PUL /min.

PUL /min.

Printing the count graph

To print the count graph:
Press the COUNT button. While the number of measurements
is displayed, press the START/STOP button to print the countgraph.
Total Count:
Number of measurements since shipping
Trip Count:
Number of measurements since the lastreset (See "12.5.1. Displaying the number ofmeasurements")
Weekly Count: A distribution of the number ofmeasurements in the last week.
Monthly Count: A distribution of the number ofmeasurements in the last month.
Note
If the function F07 is set to off, the count graph is not printed. (See "10.5. Print
quality")
After the count graph is printed, the number of measurements remains displayed forabout 60 seconds.
If "Low Battery" is printed in the lower left of the print out after the count graph isprinted out, please contact your local A&D dealer.
5412.6. Disposing of the component parts
Dispose of or recycle the monitor in an environmentally friendly manner according tolocal regulations.

Arm cuff coverAs there is a danger of infection, dispose of the arm cuff cover as medical waste.

Internal backup battery
The monitor is equipped with a lithium battery to back up settings and other data.
Before disposing of the main unit, remove the lithium battery and dispose of it
according to local regulations.
Product name

Model name

Package㸫Inside main unit㸫

Printer unit㸫External input/output unit
(Option)㸫Structure nameBox
Packing material
Bag
Case
Internal parts
ChassisBattery on PCB
CaseInternal parts
ChassisCase
Internal parts

Material
Cardboard
Cardboard
Vinyl
ABS/ABS plastic
General parts
Steel
Lithium battery
ABS/ABS plastic
General parts
Steel
ABS/ABS plastic
General parts

12.7. Before requesting service
Before requesting service, please review the following checklist and the error code listin the next section.
Problem
Nothing isdisplayed when
the power isswitched on.
E00 is displayed.
There is nopressure.

Check

Countermeasure

Is the power cableconnected correctly?

Connect the power cable correctly.

Wait until the air is released completely
Is there air remaining in thefrom the cuff, and then switch the power on
cuff?
again.
Is the arm cuff cover pulled See "12.4. Replacing the arm cuff cover" to
too far over the frames?
reattach the arm cuff cover correctly.
55

Problem

Check
Is the patient’s posturecorrect?

Countermeasure
Ensure that the arm and heart are at thesame height and that the patient is relaxed.
Ensure that the patient does not move theirarm.
If clothing is too thick, measurement is notpossible. Remove the clothing from thearm.
Measurement may not be possible withpatients with arrhythmia or a weak pulse.

Measurement is Is the patient relaxed?
not possible.
(An error code is̿̿̿̿̿̿̿̿̿
displayed.)̿̿̿̿̿̿̿̿̿

See "9.1. Installing the printer paper" to
The printer paper is notis displayed) install a new roll of printer paper.
installed. (The printer cover is open.
(
is displayed)
No printing

See "9.1. Installing the printer paper" toclose the printer cover.
See "9.1. Installing the printer paper" toA printer cutter error. (istemporarily open the printer cover and thendisplayed)close it again.
Is the printer paper causing See "9.1. Installing the printer paper",a jam?
readjust the paper.

The printing
Is the printing method
See Sections "10.4. IHB" to "10.10. Bitmap
content was notselection appropriate?
printing" to select the printing method.
as expected.
Check the clock setting.
Refer to "8.SETTING THE CLOCK"Is the Low Battery printed
on the lower left of the print The lithium battery for back up settings andDate and/or time out after the count graph is other data is dead. Contact your local A&D
printed as shown indealer.
are off.
12.5.2?
Check the clock setting on See the specifications of the receiver
the Bluetooth® receiver.
device.

CAUTIONŶ

Do not touch the interior of the monitor.

56

12.8. Error codes
When an error occurs, one of the following error codes is displayed in the systolic
display section.

Printer error codes
Error code

Error/countermeasure
No printer paper. Install a new roll of printer paper.
The printer cover is open. Firmly close the printer cover.
A printer cutter error. Open the printer cover, check the printer paper, and thenclose the printer cover.

Error code details
Error code
Details
Check items
Error related to blood pressure measurement
Check if there is air remaining in the cuff.
When the power is switched
Restart and then try blood pressureon, the pressure detection ismeasurement again. If the problem continues,
unstable.
stop using the monitor immediately.
An electrical error is
Restart and then try blood pressure
detected in the bloodmeasurement again. If the problem continues,
pressure measurement
stop using the monitor immediately.
section.
A condition that may affect the safety of thepatient was detected during measurement.
External vibrations may have been applied to the
The safety monitor of the
air system of the cuff or inside the monitor or an
blood pressure
obstruction may have been mistakenly detected.
measurement section
Check the patient condition and measurement
detected an error.
environment and try blood pressure
measurement again. If the problem continues,
stop using the monitor immediately.
Pressure is not applied at
There may be an air leak in the air system inside,
the start of thethe monitor. If the problem continues, stop using
measurement.
the monitor immediately.
Pressure cannot be applied There may be a leak in the air system inside thewithin a certain period ofmonitor or the cuff was applied loosely. If thetime.
problem continues, stop using the monitor.
There may be a bend or blockage in the air
Inflation speed is too fast.
system inside the monitor. If the problem
continues, stop using the monitor.
Air is not being correctly exhausted. There may
The exhaust speed is too
be a bend or blockage in the air system insideslow.
the monitor. If the problem continues, stop using
the monitor.
57

Error code

Details

Check items
The patient may have moved or a strong
The exhaust speed is too
external pressure was applied during
fast.
measurement. If the problem continues, stopusing the monitor.
The cuff pressure during measurement
exceeded 300 mmHg.
Excess pressure was
The patient may have moved or a strong
detected.
external pressure was applied to the cuff.
Watch for errors and try measurement again.
For the safety of the patient, measurement was
The time limit for one
cancelled because the measurement timemeasurement was
exceeded 180 seconds.
exceeded.
Measurement may have been repeated. Check
the patient for body movement and arrhythmia.
Blood pressure measurement was not possible
because the pressure was insufficient. During
inflation, patient movement or an external
vibration introduced noise into the cuff pulse andthe set pressure was detected or the patient’s
blood pressure rose greatly during blood
The pressure is insufficient.
pressure measurement.
Confirm the following conditions:
The cuff is not loose; no thick clothing on thearm; the patient remains still; and no external
vibrations on the cuff. And try measurement
again.
The pulse signal received by the cuff is too low.
The circulation of the patient may be poor or the
Pulse cannot be detected.
patient is wearing thick clothing.
Check the condition of the patient.
Diastolic blood pressurecannot be determined.
Mean arterial blood pressurecannot be determined.
Check the patient for body movement andSystolic blood pressurearrhythmia.
cannot be determined.
Pulse cannot be determined.
The blood pressure value isinappropriate.
SYS measurement range : 40-270 mmHg
SYS value is ‘out of range’. Check the patient for body movement andarrhythmia.
DIA measurement range : 20-200 mmHg
DIA value is ‘out of range’.
Check the patient for body movement andarrhythmia.
58Error code

Details
PUL value is ‘out of range’.

Check items
PUL measurement range : 30-240 mmHg
Check the patient for body movement andarrhythmia.

Other errors
Restart the power.
Restart the power. If the problem continues, stop
A power voltage error wasusing the monitor immediately.
todetected inside the monitor.
The function settings have been initialized.
Restart the power.
Check the settings. Restart the power. If the
A setting error was detected
problem continues, stop using the monitor
inside the monitor.
immediately.
Restart the power.
The counting function has been initialized.
A setting error was detected Restart the power. If the problem continues, stop
inside the monitor.
using the unit for the time being.
Restart the power.
Restart the power. If the problem continues, stop
A setting error was detected,using the monitor immediately.
inside the monitor.
Restart the power.
A memory error was
detected inside the monitor.
Restart the power.
Restart the power. If the problem continues, stop
A USB error was detectedusing the monitor immediately.
inside the monitor.
Restart the power.
Bluetooth® Low Energy error
was detected inside themonitor.
There may be a malfunction.
A font error was detected.
There may be a malfunction. Restart the power. If the problem continues, stopusing the monitor immediately and request
A cuff error was detected.
There may be a malfunction. repairs.
A blood pressure module
error was detected.

Displaying the error status
Press the COUNT button. The count is displayed. Press the SELECT button within 60
seconds. The past error codes (systolic display section), error sub codes (diastolic display
section) and the number of occurrences (pulse display section) are displayed. Each time
the SELECT button is pressed, past error codes are displayed in numerical order.
After 60 seconds of no operation, the monitor returns to standby mode.

59

13. ACCESSORIES AND OPTIONS LIST
Product name and descriptions
Printer paper
5 rolls
Arm cuff cover
5 piecesPower cable
cord setType CPower cable
cord setType BF
Fuse rating: T3AH250V
Power cable
cord setType A
External input/output unit RS 2ch
External input/output unit USB 2ch
External input/output unit RS 1ch
External input/output unit RS+Bluetooth® Low Energy
External input/output unit RS+Bluetooth®

Catalog Number
AX-PP147-S
AX-134005759-S
AX-KO243
AX-KO242
AX-KO115-EX
TM-2657-01-EX
TM-2657-02-EX
TM-2657-03-EX
TM-2657-04-EX
TM-2657-05-EX

14. ABOUT BLOOD PRESSURE
Blood pressure variations
Blood pressure is highly sensitive andchanges subtly with each beat to matchthe condition of the heart. It may vary by
30 to 50 mmHg in response to various
conditions.
That’s why it’s important not to focus ona single measurement, but insteadmeasure every day at the same time tolearn your average blood pressure andblood pressure trends. This bloodpressure information will be importantwhen visiting a doctor. Consult with adoctor to determine the meaning of yourresults.

SystolicBP

Diastolic

Sleep

Time
BP for one day, measuring every 5 minutes

What types of high blood pressure are there?
There are 2 types of high blood pressure: essential hypertension and secondary
hypertension. Secondary hypertension is caused by disease that raises bloodpressure. When kidney inflammation or pregnancy toxicosis causes high bloodpressure, treat the problem and the blood pressure will fall naturally.
In the case of essential hypertension, the cause is not clear, but the blood pressure ishigh. The combination of long periods of stress, high salt intake, obesity and genetic
problems can cause essential high blood pressure. Of these causes, genetics play alarge factor. If both or one parent has high blood pressure, the occurrence rate of highblood pressure is 60% and 30%, respectively, indicating a genetic component.
6015. SENDING BITMAP PATTERNS
15.1. Size of original bitmap patterns
Width: 384 pixels (fixed) (Bitmap data other than 384 pixels in width cannot be sent.)
Length: maximum 640 pixels (Bitmap data of an optional length from 1 to 640 pixels
can be sent.)
The maximum size of original bitmap patterns is as shown below:(Windows monochrome bitmap)

㻣㻢㻚㻤㼙㼙㻔㻢㻠㻜㼐㼛㼠㻕㻠㻤䡉䡉䠄㻟㻤㻠㼐㼛㼠㻕

Create the bitmap data of the abovementioned size with a file name "Logo.bmp" and saveit in the root folder of the SD card.
Note
For operable SD card standard, the device operation is checked with SD and SDHC.
Some SD cards cannot be recognized with the device.
In that case, please use other SD card.
For a file system, the device operation is checked with FAT16 and FAT32.

61

15.2. Sending bitmaps
1. Switch off the power of the monitor.

Bitmap SD socket cover

2. With the COUNTŸand SELECT buttons pressed, switch
the power on. The monitor enters the bitmap transfer mode.

3. Insert the SD card containing the bitmap file (Logo.bmp) saved in "15.1. Size oforiginal bitmap patterns" into the SD socket. Press the START/STOP button to startdata transfer.

After transfer, restart the power, and then set the function F15 to 2. The bitmap is printed
with the blood pressure value after blood pressure measurement.

62

APPENDIX: EMD INFORMATION
Medical electrical equipment requires special precautions regarding EMD and must be
installed and put into service according to the EMD information provided below.
Portable and mobile RF communication equipment (e.g. cell phones) can affect medical
electrical equipment.
The use of accessories and cables other than those specified may result in increased
emissions or decreased immunity of the unit.

- EMISSION Limits Phenomenon
Conducted and radiated RF EMISSIONCISPR 11
Harmonic distortion
IEC 61000-3-2
Voltage fluctuations and flicker
IEC 61000-3-3ComplianceGroup 1ࠊClass B
Class A
Compliance- IMMUNITY TEST LEVELS㸸㸸Enclosure Port Phenomenon
Electrostatic discharge

IEC 61000-4-2

Radiated RF EM fields

IEC 61000-4-3

Proximity fields from RF wirelesscommunications equipment
IEC 61000-4-3
Rated power frequency magnetic fields
IEC 61000-4-8

IMMUNITY TEST LEVELS±8 kV contact±2 kV, ±4 kV, ±8 kV, ±15 kV air
10 V/m80 MHz - 2.7 GHz
80 % AM at 1 kHz
See table (Test specifications for
ENCLOSURE PORT IMMUNITY to RF
wireless communications equipment)
30 A/m50 Hz or 60 Hz- IMMUNITY TEST LEVELS㸸Input a.c. power Port Phenomenon
IMMUNITY TEST LEVELSElectrical fast transients / bursts±2 kV 100 kHz repetition frequency
IEC 61000-4-4
Surges, Line-to-line
IEC 61000-4-5 ±0.5 kV, ±1 kV
3V0.15 MHz - 80 MHz
Conducted disturbances induced by RF fields 6 V in ISM and amateur radio bands
IEC 61000-4-6
between 0.15 MHz and 80 MHz
80 % AM at 1 kHz0%
UT; 0.5 cycle
At 0°, 45°, 90°, 135°, 180°, 225°,
270°, and 315°
Voltage dips
IEC 61000-4-11
0%
UT; 1 cycle, And
70 % UT; 25/30 cycle, Single phase: at 0°
Voltage interruption
IEC 61000-4-11 0%
UT; 250/300 cycle
NOTE UT is the AC mains voltage prior to application of the test level.

63

- IMMUNITY TEST LEVELS㸸㸸Signal input/output Port Phenomenon

IMMUNITY TEST LEVELS±8 kV contact
Electrostatic discharge
IEC 61000-4-2±2 kV, ±4 kV, ±8 kV, ±15 kV air
Electrical fast transients / bursts±1 kV 100 kHz repetition frequency
IEC 61000-4-4
3V
0.15 MHz - 80 MHz
Conducted disturbances induced by RF fields 6 V in ISM and amateur radio bands
IEC 61000-4-6
between 0.15 MHz and 80 MHz
80 % AM at 1 kHz- Test specifications for ENCLOSURE PORT IMMUNITY to RF wirelesscommunications equipment Testfrequency
(MHz)

Band
(MHz)

Service385

380 - 390TETRA 400450

430 - 470

GMRS 460
FRS 460

710
745
780

704 - 787

LTE Band
13,17

810
870

800 - 960

930
1720
1845
1970

2450

5240
5500
5785

Modulation
Pulse modulation
18 Hz
FM±5 kHz deviation
1 kHz sine

1.8

0.3

27

2

0.3

28

Pulse modulation
217 Hz

0.2

0.3

9

GSM 800/900
TETRA 800 Pulse modulation
CDMA 850
18 Hz
LTE Band 5

2

0.3

28

2

0.3

28

2

0.3

28

0.2

0.3

9

GSM 1800
CDMA 1900
GSM 1900
Pulse modulation
1700 - 1990
DECT
217 HzLTE Band
1,3,4,25
UMTS
Bluetooth®
WLAN 802.11
Pulse modulationb/g/n
2400 - 2570
217 Hz
RFID 2450
LTE Band 75100 - 5800

Maximum
IMMUNITY
Distance
power
TEST LEVEL
(m)
(W)
(V/m)

WLAN 802.11 Pulse modulationa/n
217 Hz64

Back cover: A&D grobal

A&D Company, Limited
1-243 Asahi, Kitamoto-shi, Saitama-ken 364-8585 Japan
Telephone: [81] (48) 593-1111
Fax: [81] (48) 593-1119

Emergo Europe B.V.
Westervoortsedijk 60, 6827 AT Arnhem, The Netherlands

A&D INSTRUMENTS LIMITED
Unit 24/26 Blacklands Way, Abingdon Business Park, Abingdon, Oxon, OX14 1DY, UNITED KINGDOM
Telephone: [44] (1235) 550420
Fax: [44] (1235) 550485

A&D ENGINEERING, INC.
A&D Engineering, Inc., 4622 Runway Boulevard, Ann Arbor, MI 48108 USA
Telephone: 1-888-726-9966

A&D AUSTRALASIA PTY LTD
32 Dew Street, Thebarton, South Australia 5031, AUSTRALIA
Telephone: [61] (8) 8301-8100
Fax: [61] (8) 8352-7409

OOO A&D RUS

OOO "ɗɃ ɷɧɞ Ⱦɂ Ɋɍɋ"ɉɨɱɬɨɜɵɣɚɞɪɟɫɊɨɫɫɢɣɫɤɚɹɎɟɞɟɪɚɰɢɹɝɆɨɫɤɜɚɭɥȼɟɪɟɣɫɤɚɹɞɨɦ
ɘɪɢɞɢɱɟɫɤɢɣɚɞɪɟɫɊɨɫɫɢɣɫɤɚɹɎɟɞɟɪɚɰɢɹɝɆɨɫɤɜɚɭɥȾɨɪɨɠɧɚɹɞɤɨɪɩɤɨɦɧɛ
( 121357, Russian Federation, Moscow, Vereyskaya Street 17 )ɬɟɥ>@  -33-44
ɮɚɤɫ>@  -55-66⡧ᆿᗭᢶ⹊䍮᱉δр⎭εᴿ䲆‫ޢ‬ਮ

A&D Technology Trading(Shanghai) Co. Ltdѝഭ к⎧ᐲ⎖ьᯠ४ ⎖ьই䐟855ਧ ц⭼ᒯ൪ 32ᾬCDᓗ 䛞㕆200120(32CD, World Plaza, No.855 South Pudong Road, Pudong New Area, Shanghai, China 200120)⭥䈍: [86] (21) 3393-2340
Րⵏ: [86] (21) 3393-2347

A&D INSTRUMENTS INDIA PRIVATE LIMITED
509, Udyog Vihar, Phase- , Gurgaon - 122016, Haryana, India
Telephone: [91] (124) 4715555
Fax: [91] (124) 4715599

Auto Control Médical an A&D Company / une compagnie A&D
6695 Millcreek Drive, Unit 6 Mississauga, Ontario L5N 5R8 Canada
Telephone: 1-800-461-0991

A&D SCIENTECH TAIWAN LIMITED. A&D‫؀‬᨜։ֆ‫ڜۦ ׹‬൓ैٝ‫ૻڶ‬ֆ‫׹‬‫؀‬㻨‫ؑק؀‬խ‫إ‬೴ॹ୾ࣟሁ 5 ᇆ 4 ᑔ
( 4F No.5 Ching Tao East Road, Taipei Taiwan R.O.C. )Tel : [886] (02) 2322-4722
Fax : [886] (02) 2392-1794

A&D INSTRUMENTS (THAILAND) LIMITED эіѧќѤъ ѯѠ ѰѠьчҙ чѨ ѠѧьѝъіѬѯє Җьъҙ (ѳъѕѰјьчҙ) лѼѥдѤч
168/16 ўєѬъҕ Ѩѷ 1 шѼѥэјіѤкѝѧш ѠѼѥѯѓѠыѤрэѫіѨ лѤкўњѤчюъѫєыѥьѨ 12110 юіѣѯъћѳъѕ
( 168/16 Moo 1, Rangsit, Thanyaburi, Pathumthani 12110 Thailand )Tel : [66] 20038911

0123