Digital Blood Pressure Monitor
Model UA-654MR
Original
Instruction Manual

Symbols printed on the device case.
Symbols
SYS
DIA
PUL

1WMPD4004573A

1. Dear Customers
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Congratulations on purchasing a state-of-the-art A&D blood pressure
monitor. Designed for ease of use and accuracy, this device will
facilitate your daily blood pressure regimen.
We recommend that you read through this manual carefully before
using the device for the first time.

2020

2. Preliminary Remarks
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The device is designed for use on adults, not newborns or infants.
Environment for use. The device is for use to operate by yourself inthe home healthcare environment.
This device is designed to measure blood pressure and pulse rate ofpeople for diagnosis.

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3. Precautions
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Precision components are used in the construction of this device.
Extremes in temperature, humidity, direct sunlight, shock or dust
should be avoided.
Clean the device and cuff with a dry, soft cloth or a cloth dampened
with water and a neutral detergent. Never use alcohol, benzene,
thinner or other harsh chemicals to clean the device or cuff.
Avoid tightly folding the cuff or storing the hose tightly twisted for long
periods, as such treatment may shorten the life of the components.
The device and cuff are not water resistant. Prevent rain, sweat andwater from soiling the device and cuff.
Measurements may be distorted if the device is used close to
televisions, microwave ovens, cellular telephones, X-ray or otherdevices with strong electrical fields.
When reusing the device, confirm that the device is clean.
Used equipment, parts and batteries are not treated as ordinary household
waste, and must be disposed of according to the applicable local regulations.
When the AC adapter is used, make sure that the AC adapter can bereadily removed from the electrical outlet when necessary.
Do not modify the device. It may cause accidents or damage to the device.
To measure blood pressure, the arm must be squeezed by the cuff hardenough to temporarily stop blood flow through the artery. This may cause
pain, numbness or a temporary red mark to the arm. This condition willappear especially when measurement is repeated successively. Any
pain, numbness, or red marks will disappear with time.
Take care to avoid accidental strangulation of babies or infants with thehose and cable.
Do not twist the air hose during measurement. This may cause injury due
to continuous cuff pressure.
Measuring blood pressure too frequently may cause harm due toblood flow interference. Check that the operation of the device does
not result in prolonged impairment of blood circulation, when using
the device repeatedly.
If you have had a mastectomy, please consult a doctor before using
the device.
Do not let children use the device by themselves and do not use the device
in a place within the reach of infants. It may cause accidents or damage.
There are small parts that may cause a choking hazard if swallowedby mistake by infants.
Wireless communication devices, such as home networking devices,mobile phones, cordless phones and their base stations, walkietalkies can affect this blood pressure monitor. Therefore, a minimum
distance of 30 cm should be kept from such devices.
Unplug the AC adapter when not in use during the measurement.
Use of accessories not detailed in this manual may compromise safety.
Should the battery short-circuit, it may become hot and potentiallycause burns.
Allow the device to adapt to the surrounding environment before use(about one hour).
Clinical testing has not been conducted on newborn infants andpregnant woman. Do not use on newborn infants or pregnant woman.
Do not touch the batteries, the DC jack, and the patient at the sametime. That may result in electrical shock.
Do not inflate without wrapping the cuff around the upper arm.

Contraindications

The following are precautions for proper use of the device.
T Do not apply the cuff on an arm with another medical electricalequipment attached. The equipment may not function properly.
T People who have a severe circulatory deficit in the arm must consult adoctor before using the device, to avoid medical problems.
T Do not self-diagnose the measurement results and start treatment by yourself.
Always consult your doctor for evaluation of the results and treatment.
T Do not apply the cuff on an arm with an unhealed wound.
T Do not apply the cuff on an arm receiving an intravenous drip or bloodtransfusion. It may cause injury or accidents.
T Do not use the device where flammable gases such as anesthetic
gases are present. It may cause an explosion.
T Do not use the device in highly concentrated oxygen environments,
such as a high-pressure oxygen chamber or an oxygen tent. It may
cause a fire or explosion.

4. Parts Identification
Proper fit range
Index Artery position markAir Hose
Cuff Holder

6.1. Installing / Changing The Batteries

Air Socket
Air Connector Plug
Battery Compartment
Battery Cover

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Insert the batteries as shown in the battery compartment. If installed
incorrectly, the device will not work.
Whenblinks on the display and the device announces that thebattery needs to be replaced, replace all batteries with new ones. Do
not mix old and new batteries. It may shorten the battery life, or cause
the device to malfunction. Replace the batteries two seconds or more
after the device turns off.
does not appear when the batteries are drained.
The battery life varies with the ambient temperature and may be shorter at
low temperatures. Generally, four new R6P batteries will last approximately
for three months when used twice for measurement each day.
Use the specified batteries only. The batteries provided with the device
are for testing the device performance and may have a limited life.
Remove the batteries if the device is not to be used for a long time.
The batteries may leak and cause a malfunction.

6.2. Installing the Cuff Holder

This device comes equipped with a removable cuff
holder for your convenience.
When not in use, simply slip your cuff into the holder
for storage.
T To install the cuff holder :1. Align the cuff holder with the rear of the device.
2. Slide the cuff holder into the rear of the device until
it snaps securely into place.
T To remove the cuff holder :1. Push the tab on the cuff holder away from theblood pressure monitor.
2. Slide the cuff holder away from the blood pressure
monitor as shown to the right.

6.3. Connecting The Air Hose
Insert the air connector plug
into the air socket firmly.

6.4. Connecting The
AC Adapter

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Using the correct cuff size is important for an accurate reading. If the cuff is
not the proper size, the reading may yield an incorrect blood pressure value.
The arm size is printed on each cuff.
The index  and proper fit range, on the cuff, tell you if you are
applying the correct cuff. Refer to "6.6 Applying The Arm Cuff".
If the index  points outside of the range, contact your local dealer topurchase a replacement cuff.
The arm cuff is a consumable. If it becomes worn, purchase a new one.

Arm Size
Recommended Cuff Size
Catalog Number
31 cm to 45 cm
Large Adult cuff
CUF-D-LA-ISO
22 cm to 42 cm
Wide range cuff
CUF-I-ISO
23 cm to 37 cm
Semi Large cuff
CUF-D-MA-ISO
22 cm to 32 cm
Adult cuff
CUF-F-A-ISO
Arm size: The circumference at the biceps.
Note:
Model UA-654MR is not designed for using a small cuff.

Symbols printed on the cuff.
Symbols Function / Meaning
Artery Position Mark



Index

Catalog number------------------------------Proper fit range for the adult cuff.
------------------------------It‘s printed on the adult cuff.
Over range printed on the semi large Use the large adult cuff instead
adult cuff.
of the semi large adult cuff.
Proper fit range for the large adult------------------------------cuff. It‘s printed on the large adult cuff.
Under range printed on the semi large------------------------------adult cuff.
Under range printed on the large
Use the semi large adult cuff
adult cuff.
instead of the large adult cuff.

Pulse Rate
IHB/AFib symbol
Heart Mark
Battery Indicator

Device internal error

Lot number-------------------------------

Manufacture-------------------------------

Medical Device-------------------------------

Each segment of the bar indicator WHO Classification Indicator
corresponds to the WHO blood
Severe hypertension
pressure classification.
Moderate hypertension:T he indicator displays a segment,
Mild hypertension
based on the current data,
High normal
corresponding to the WHO
Normalclassification.
Optimal

14. Troubleshooting
Problem
Nothingappears on
the display,even when
the power isturned on.

Pressurizing

Measurement in progress
Systolic pressure

Note: If an appropriate pressure
is not obtained, the device starts
to inflate again automatically.
4. When the measurement iscomplete, the systolic anddiastolic pressure readings andpulse rate are displayed. The
cuff exhausts the remaining air
and deflates completely.
5. Press the START button
again to turn off the power.

Diastolic pressure
WHO classification
Pulse rate
Exhausts remaining air
automaticallyTurn off with the
START button

Note: Model UA-654MR is provided with an automatic power shut-off function.
Allow at least 3 minutes between measurements on the same person.

7.2. Measurement with the Desired Systolic Pressure

If re-inflation occurs repeatedly,
use the following methods.
At heart level
If your systolic pressure is
expected to exceed 230 mmHg,
Press
the
START button
use this procedure.
1. Place the cuff on the arm atheart level (preferably theleft arm).
2. Press the START button.
3. During the zero blinks, press
Press and hold theand hold the START button
START button
until a number about 30 to
40 mmHg higher than your
Inflation in progress
expected systolic pressure
appears.
Release the START
button to stop inflation
4. When the desired number isreached, release the STARTThe desired pressure
button to start measurement.
Then continue to measure
your blood pressure as
Refer to the section
described on the section"7.1 Normal Measurement""7.1 Normal Measurement".

7.3. Notes for Accurate Measurement

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Sit comfortably on a chair. Rest your arm on the table. Do not crossyour legs. Keep your feet on the floor and straighten your back.
Sit down in a comfortable position. Place your arm on a table withyour palm facing upward and the cuff at the same level as your heart.
Place the center of the cuff at the same level as your heart.
Relax for about five to ten minutes before measurement. If you are
excited or depressed by emotional stress, the measurement willreflect this stress as a higher (or lower) than normal blood pressure
reading and the pulse reading will usually be faster than normal.
Remain still and keep quiet during measurement.
Do not measure immediately after physical exercise or a bath. Restfor twenty or thirty minutes before taking the measurement.
An individual‘s blood pressure varies constantly, depending on what
you are doing and what you have eaten. What you drink can have avery strong and rapid effect on your blood pressure.
This device bases its measurements on the heartbeat. If you have a very
weak or irregular heartbeat, the device may have difficulty determining
your blood pressure.
Should the device detect a condition that is abnormal, it will stop themeasurement and display an error symbol. Refer to the section"5. Symbols" for the description of the symbols.
This device is intended for use by adults. Consult with your physician before
using this device on a child. A child should not use this device unattended.
Try to measure your blood pressure at the same time every day.
The automatic blood pressure monitor‘s performance may be affectedby excessive temperature or humidity, or altitude.

8. Recalling the Memory Data
The device automatically stores up to sixty blood pressure and pulse
measurements in memory. Data stored in memory are assigned adata number in the order of the newest to the oldest. The oldest data
displays as "". The M symbol in the upper left corner of the display
indicates that you are viewing previous data stored in memory.

8.1. Recalling Data

1. When nothing isdisplayed, press andhold the START button
to recall the stored data.
2. Release the button
when displaying the
average data.
3. The data number
and stored data areautomatically displayedin order from the lastmeasurement.
4. The display will turn off
automatically after alldata is displayed.
Note: If you press the
START button while
recalling data, thedevice turns off.

8.2. Clearing Data

Press and hold the
START button

No data

Release the button
M markAverage Data
Data number

Stored Data

Release thebutton6.6. Applying The Arm Cuff

When the monitor detects an irregular rhythm during the measurements, theI.H.B./AFib indicator will appear on the display with the measurement values.
Note: W e recommend contacting your physician if you see thissymbol frequently.

Cuff

" to
Select "clear data.

5 seconds

The M mark blinks.
Data is cleared.
Turns off automatically

10. What is AFib
The heart contracts due to electrical signals occurring in heart and sends
blood through the body. Atrial fibrillation (AFib) occurs when the electricalsignal in the atrium becomes confused and leads to disturbances in thepulse interval. AFib can cause blood to stagnate in the heart, which caneasily create clots of blood, a cause of stroke and heart attack.

11. Pressure Bar Indicator
The indicator monitors the progress of pressure during measurement.

1 to 2 cm

Pressurizing

Releasing air

Artery position markRemove the batteries andpress the START button,
and then install thebatteries again. If the error
still appears, contact the
dealer.

Secure the fabric fastener firmly.
Air hoseIndex  and Proper fit range

15. MaintenanceDo not open the device. It uses delicate electrical components and an
intricate air unit that could be damaged. If you cannot fix the problem
using the troubleshooting instructions, contact the authorized dealer
in your area or our customer service department. The A&D customer
service will provide technical information, spare parts and units toauthorized dealers.
The device was designed and manufactured for a long service life.
However it is generally recommended to have the device inspected
every 2 years, to ensure proper functioning and accuracy. Pleasecontact the authorized dealer in your area or A&D for maintenance.

16. Technical DataType
Measurement method
Measurement range

UA-645MR
Oscillometric measurement
Pressure:
0 - 299 mmHg
Systolic pressure: 60 - 279 mmHg
Diastolic pressure: 40 - 200 mmHg
Pulse:
40 - 180 beats / minute
Measurement
Pressure:±3 mmHg
accuracy
Pulse:±5 %Rating
DC 6V 3W
Power supply
4 x 1.5V batteries (R6P, LR6 or AA) or
AC adapter (TB-233C INPUT: AC 100 – 240V
50 / 60 Hz 0.15A)) (Not included)
Number of measurements
Approx. 700 times LR6 (alkaline batteries)
Approx. 200 times R6P (manganese batteries)
With pressure value 180 mmHg, room
temperature 23 °C.
Classification
Internally powered ME equipment(Suppliedby batteries) / Class II (Supplied by adapter)
Continuous operation mode
Clinical test
According to ISO81060-2: 2013
In the clinical validation study, K5 was used on
85 subjects for determination of diastolic bloodpressure.
EMD
IEC 60601-1-2: 2014
MemoryLast 60 measurements
Operating conditions+10 to +40 °C / 15 to 85 %RH / 800 to 1060 hPa
Transport / Storage conditions -20 to +60 °C / 10 to 95 %RH / 700 to 1060 hPa
Dimensions
Approx. 106 [W] x 67 [H] x 143 [D] mm excluding
the cuff holder
WeightApprox. 240 g, excluding the batteries and cuff
holderIngress protection
Device:IP20
Type BF
Applied part
Cuff
Useful life
Device:5 years (when used six times a day)Cuff:
2 years (when used six times a day)AC adapter:5 years (when used six times a day)Accessory AC adapter
The adapter is to connect the device to a power source at home.
Please contact your local A&D dealer for purchasing. The AC adapter
is required to be inspected or replaced periodically.
TB-233C P lease contact your local A&D dealer for purchasing.
The AC adapter is required to be inspected or replaced
periodically.
Symbols that are printed on the AC adapter.

Accessories sold separately

9. What is the I.H.B./AFib

1. Wrap the cuff around the upper arm, about 1 to 2 cm above theinside of the elbow, as shown.
Place the cuff directly against the skin, as clothing may cause a faintpulse and result in a measurement error.
2. Constriction of the upper arm, caused by rolling up a shirtsleeve,
may prevent accurate readings.
3. Confirm that the index  points within the proper fit range.
Note: During measurement, it is normal for the cuff to feel very tight. (Do not
be alarmed).
Do not roll up shirtsleeve tightly

Note: If the actions described above do not solve the problem, contact
the dealer. Do not attempt to open or repair this product, as any
attempt to do so will make your warranty invalid.

Press and hold the
START button

Semi large cuff

Wide range cuff

Recommended Action
Replace all batteries with newones.
Reinstall the batteries withBattery terminals
negative and positive terminals
are not in the correct
matching those indicated on theposition.
battery compartment.
Battery voltage is
too low.
blinks.
The cuff does If the batteries are
Replace all batteries with new
not inflate.
drained completely, ones.
the mark does notappear.
The cuff is not
Apply the cuff correctly.
applied properly.
You moved yourMake sure you remain still andarm or body during
quiet during measurement.
The device
measurement.
does notSit comfortably and still. Placemeasure.
Readings are The cuff position is your arm on a table with yourpalm facing upward and the cuff
notcorrect.
too high or too
at the same level as your heart.
low.
If you have a very weak or
irregular heartbeat, the device-------------------------may have difficulty in determining
your blood pressure.
At a clinic or doctor‘s office,an apprehension may cause
The value isan elevated reading. Homedifferent from thatmeasurement reduces the effects
measured at a clinicof outside influences on bloodor doctor’s office.
Otherpressure readings, supplements
the doctor‘s readings.
Remove the batteries. Place themback properly and take another-------------------------measurement.

Turns off automatically

Adult cuff

Proper fit range
Large adult cuff

Possible Reason
Batteries are
drained.

Symbols

1. When turning off thedevice, press and holdthe START button until" is displayed.
the "" to clear
2. Select "data.
3. Data is cleared when
the M mark blinks.
4. The device turns off
automatically.

Pressure Bar Indicator and
WHO Classification Indicator

PUL DISPLAY ERROR
The pulse is not detected correctly.

Note: If you wish to stop inflation
at any time, press the START
button again.
3. When inflation is complete,deflation starts automatically(heart mark) blinks,
and theindicating that the measurement
is in progress. Once the pulse
is detected, the mark blinks witheach pulse beat.

13. WHO Classification Indicator

To next data

Recommended Action
Set the  mark on theartery of the upper arm orin line with the ring finger
on the inside of the arm.
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Blood pressure is the force exerted by blood against the walls of
the arteries. Systolic pressure occurs when the heart contracts.
Diastolic pressure occurs when the heart expands. Blood pressure ismeasured in millimeters of mercury (mmHg).

1. Place the cuff on the arm at
At heart level
heart level (preferably theleft arm). Sit quietly during
Press the START button
measurement.
2. Press the START button.
All of the display segments
All of the display segments are
displayed. Zero is displayed
blinking briefly. Then thedisplay changes, as indicatedin the figure at the right, as the
Zero display
measurement begins. The cuff
starts to inflate. It is normal forthe cuff to feel very tight. A
pressure bar indicator isdisplayed, as in the figure at
Starts inflation
the right, during inflation.

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Air Connector
Connector Plug
Plug
Air
Air Socket
SocketAir

6.5. Selecting The Correct Cuff

Diastolic Pressure

FULL BATTERY
The battery power indicator------------------------------during measurement.
Replace all batteries withLOW BATTERY
The battery power is low when new ones when the markblinks.
it blinks.
Take another measurement.
Unstable blood pressure due toRemain still during
movement during measurement.
measurement.
The systolic and diastolic values arewithin 10 mmHg of each other.
The pressure value did notincrease during the inflation.
Apply the cuff correctly, andtake another measurement.
The cuff is not applied correctly.

Air Hose
Hose
Air

12. About Blood Pressure
What is Blood Pressure?

7.1. Normal Measurement

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Insert the AC adapter plug into
AC adapter
adapter PlugPlug
AC
the DC jack. Then, insert the
DC JackJack
AC adapter into an electricalDC
outlet. The AC adapter,the model TB‑233C is soldseparately.
When disconnecting the AC
adapter from the electricaloutlet, grasp and pull the AC adapter body out of the outlet.
When disconnecting the AC adapter plug from the blood pressure
monitor, grasp and pull the AC adapter plug out of the monitor.

Systolic Pressure

Symbols Function / Meaning
Recommended Action
Appears while measurement is
Measurement is in progress.
in progress. It blinks when the
Remain as still as possible.
pulse is detected.
Appears when an irregularheartbeat is detected. It may light------------------------------when a very slight vibration likeshivering or shaking is detected.
Previous measurements stored------------------------------in memory.

Step 1
Step 4

CAUTION

MEMORY

5. Symbols
Symbols that appear on the display

Step 3

1. Remove the battery cover.
2. Remove the used batteries
from the battery compartment
in case of changing them.
3. Insert new batteries into
the battery compartment
as shown, taking care that
Step 2the polarities (+) and (-) arecorrect.
4. Replace the battery cover.
Use only R6P, LR6 or AA batteries.

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START Button

Display

6. Using the Monitor

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AC adapter Plug
Display
Arm Cuff

Keep dryT

DC jack

7. Measurements

Function / MeaningStandby and Turn the device on.
Systolic blood pressure in mmHg
Diastolic blood pressure in mmHg
Pulse per minuteBattery installation guide
Direct current
Type BF: Device, cuff and tubing are designed toprovide special protection against electrical shocks.
Manufacturer
Date of manufacture
Used equipment, parts and batteries are not treated asordinary household waste, and must be disposed ofaccording to the applicable local regulations.
Serial number
Refer to instruction manual/booklet
Polarity of DC jackInternational protection symbol

Measurement in progress
Inflation complete
Inflation in progress

Function / Meaning
For indoor use only
Class II device
Thermal fuse
Fuse
EC directive device label
EAC certification device label
Polarity of AC adapter plug

Cuff Catalog Number
Cuff Size
Arm Size
CUF-D-LA-ISO
Large Adult cuff
31 cm to 45 cm
CUF-I-ISO
Wide range cuff
22 cm to 42 cm
CUF-D-MA-ISO
Semi Large cuff
23 cm to 37 cm
CUF-F-A-ISO
Adult cuff
22 cm to 32 cm
Arm size: The circumference at the biceps.
AC Adapter

Catalog Number
Plug (Outlet type)TB-233C
Type C
Note: Specifications are subject to change without prior notice.
IP classification is the degrees of protection provided byenclosures in accordance with IEC 60529. This device is protectedagainst solid foreign objects of 12 mm diameter and greater suchas a finger. This device is not protected against water.