Evaluation: ArjoHuntleigh Flowtron ACS900 Intermittent Pneumatic Compression System for DVT Prevention

• The pump inflates the air bladders within the attached garment(s).
• On the ACS900, the pump also monitors the pressure in the garment and adjusts the delivered pressure to maintain the garment-specific target. It can also vent excess pressure internally to alleviate overpressure.
• The pump itself is configured with LEDs next to the screen and on the underside of the pump. These are green during normal use but change to orange in the event of an alarm to help visually alert users.
• There are also four physical buttons on the pump's face.
  • The power button is used to turn the pump on/off or put it in standby.
  • The left-hand button below the display is used to adjust the alarm volume.
  • The center button below the display is used to start/pause an inflation cycle.
    • A new cycle will not start without the user pressing start.
    • If a user turns on the pump and fails to hit start, the pump will beep to alert the user that another action must be taken before therapy can begin.
    • If the pump is turned off in the middle of a cycle and then turned back on, pumping will automatically restart when the pump is turned back on. Users do not need to press start in this situation.
  • The right-hand button below the display is used to reset the patient hours, as described below under "Flowtron ACS900 Pump Display."
• The pump is equipped with a battery that allows the system to be used during patient transport.
• Pump dimensions are 230 × 228 × 190 mm (9.1 × 9.0 × 7.5 in). The specified weight is 4.1 kg (9.0 lb).

• The pump display shows a number of icons: the attached garments, their inflation cycles, the play/pause indicator, alarms, patient hours, and the system charge.
• Display aspects:
  • Garment icons—There are two leg icons on the screen at all times when the system is powered on. When a garment is connected, the corresponding leg icon will change to one of three garment icons based on the garment attached. During the inflation/deflation cycle, this icon will be shaded in black if the garment is currently being inflated.
  • Inflation cycles—Above the garment icons is an indication of the current inflation pressure in mm Hg. When a garment is inflated, this number will increase to the measured delivered pressure so users can see if the garment is reaching its target pressure.
  • Play/pause indicator—Above the middle button under the display there is an icon on the display that switches from a "play" symbol to a "pause" symbol depending on whether the pump is in operation. It will display the pause symbol when the pump is running so users will know that pressing the middle button will pause the pump's operation at that point.
  • Alarms—Alarms will appear on the display in different areas depending on the issue. Garment-specific alarm icons will appear next to the affected garment for troubleshooting assistance.
  • Patient hours—In the bottom right corner of the display, there is an indicator for the number of hours a patient has been receiving treatment. This counts the time that the pump is operational on a particular patient. It must be reset to accurately portray hours for a new patient.
  • System charge—A battery bar is shown at the top right of the display with four divisions. Next to it, one of two icons will be present—either a plug or a plug crossed out depending on whether the system is currently operating on battery power or line power.

Garments

• Garments for DVT prevention wrap around a part of the patient's anatomy and inflate/deflate in cycles to promote blood flow. The ACS900 garments are all intended for single use.
• The ACS900 is available with garments that cover three different application sites—the feet, the calf, and full leg (referred to as Calf & Thigh by ArjoHuntleigh). The calf and full-leg-style garments, referred to collectively as leg garments hereafter, are available in two inflation styles—DVT and Tri Pulse/TRP, which ArjoHuntleigh calls "uniform" and "sequential," respectively. There are also sterile options available for some of the garments. These codes are denoted with an S.
  • Based on ECRI Institute's classification scheme, ArjoHuntleigh's DVT-style garments would be categorized as uniform, nonsequential garments (that is, the pressure is the same across the whole garment, and all the bladders inflate at the same time) and the Tri Pulse style would be gradient, sequential garments (that is, bladders inflate in sequence beginning with the most distal and ending with the most proximal, and the highest pressure is found at the distal end of the garment and the lowest pressure at the proximal end).
  • For descriptions of the various inflation styles used by IPC devices, see our Evaluation Backgroundon this technology.
• The table below lists the garments available with the ACS900 system.

Garments Available with the Flowtron ACS900 System​ ​ ​ ​ Code Application Site Compression Type (ECRI Institute Classification) Size Target Pressures (Factory Default) DVT10 Calf Uniform, Nonsequential Up to 43 cm (17 in) 40 ±5 mm Hg DVT10S Calf Uniform, Nonsequential Up to 43 cm (17 in) 40 ±5 mm Hg L501-M Calf Uniform, Nonsequential Up to 43 cm (17 in) 40 ±5 mm Hg DVT20 Calf Uniform, Nonsequential Up to 58 cm (23 in) 40 ±5 mm Hg DVT60L Calf Uniform, Nonsequential Up to 81 cm (32 in) 40 ±5 mm Hg TRP10 Calf Gradient, Sequential Up to 43 cm (17 in) 45 ±5 mm Hg TRP20 Calf Gradient, Sequential Up to 58 cm (23 in) 45 ±5 mm Hg TRP60L Calf Gradient, Sequential Up to 81 cm (32 in) 45 ±5 mm Hg DVT30S Calf & Thigh Uniform, Nonsequential Up to 71 cm (28 in) 40 ±5 mm Hg DVT30 Calf & Thigh Uniform, Nonsequential Up to 71 cm (28 in) 40 ±5 mm Hg L503-M Calf & Thigh Uniform, Nonsequential Up to 71 cm (28 in) 40 ±5 mm Hg DVT40 Calf & Thigh Uniform, Nonsequential Up to 89 cm (35 in) 40 ±5 mm Hg TRP30 Calf & Thigh Gradient, Sequential Up to 71 cm (28 in) 45 ±5 mm Hg TRP40 Calf & Thigh Gradient, Sequential Up to 89 cm (35 in) 45 ±5 mm Hg FG100 Foot Foot Up to U.S. men's size 7.5/U.S. women's size 9.5 130 ±10 mm Hg FG100S Foot Foot Up to U.S. men's size 7.5/U.S. women's size 9.5 130 ±10 mm Hg FG200 Foot Foot Above U.S. men's size 7.5/U.S. women's size 9.5 130 ±10 mm Hg FG200S Foot Foot Above U.S. men's...