The below diagram illustrates the different parts of a stethoscope.
Headset: The headset is the metal part of the stethoscope onto which the tubing is fitted. The headset is made up of the two eartubes, tension springs and the eartips.
Chest Piece: The chest piece is the part of the stethoscope that is placed on the location where the user wants to hear sound. Most cardiology stethoscopes contain a tunable diaphragm on each side of the chest piece. The large side can be used for adult patients, while the small side especially useful for pediatric or thin patients, around bandages and for carotid assessment.
Eartip: The eartips of a stethoscope fit into your ears. A good stethoscope will have eartips that offer comfort, seal and durability.
Eartube: The eartube is the part to which the eartips are attached.
Tunable Diaphragm: A traditional stethoscope consists of a bell and diaphraghm. The bell is used for light skin contact to hear low frequency sounds and the diaphragm is used with firm skin contact to hear high frequency sounds.
Stem: The stemp connects the stethoscope tubing to the chestpiece.
Tubing: All stethoscopes sold on hmint.com do not contain latex. 3M Littmann stethoscope.

A tunable diaphragm offers convenience and versatility. A tunable diaphragm on a two-sided stethoscope offers one the choice of using it as a traditional stethoscope, or using only the diaphragm side for both low and high frequency sounds.

Optimizing the Acoustical Performance
Proper Headset Alignment: Littmann stethoscopes have headsets which have been designed to be worn at an anatomically correct angle, oriented toward the user's ear canals. Before placing the eartips in your ears, hold the stethoscope headset in front of you so that the eartubes point away from you. When the eartips are in your ears, the eartips should be pointed forward. Not everyone's ear canals are the same. If after inserting the eartips in proper manner, the fit does not seem comfortable, and acoustic performance does not improve, grasp each of the eartubes, adjusting the headset for a custom fit. Improperly wearing the stethoscope headset can result in poor acoustical seal, and in some cases, complete sound blockage.
Proper Fit of Eartips: It is important that the proper sized eartips be used to achieve optimal acoustical performance. This is especially true when using the soft-sealing eartips. If the soft-sealing eartip is too large for the user, the compression of that eartip while in the ear, could result in poor acoustical performance. This could also be true if the eartip is too small. Finding the individual's correct ear size results in the best acoustical performance.
Check for Obstructions: If the stethoscope is commonly carried in a pocket, or hasn't routinely been cleaned, it is possible that lint or dirt could be obstructing the sound pathway. Routine care and maintenance can prevent this from happening.
Check the Seal: Stethoscopes rely on an airtight seal in order to transmit body sounds from the patient to the user's ear. Loose parts in the chestpiece, loose tubing, or cracked tubing can prevent an airtight seal.
Index the Bell: When using a double-sided stethoscope, the user needs to open, or index the bell or diaphragm by rotating the chestpiece. If the diaphragm is open, the bell will be closed, preventing sound from coming in through the bell, and vice versa.

We recommend you apply the cuff using the following directions. First, make sure you have removed any tight-fitting clothing from your left arm. Put your left arm through the cuff loop. The bottom of the cuff should be about one-half inch above your elbow. Turn your arm so your palm is facing up. Adjust the cuff around your arm so that the tubing runs down the center of your arm. Secure the cuff so it stays in place. 

D- Ring Duff: You should be able to fit one finger between the cuff and your arm. This space is imperative for an accurate reading because Omron's digital blood pressure monitors use the oscillometric method of blood pressure measurement that detects your blood's movement through your brachial artery and converts the movements into a digital reading.

Comfit Cuff: The cuff should be wrapped tightly around the arm. If the cuff slips or easily turns, the cuff should be tightened.

If the cuff is wrapped too loose or too tight, you may get an inaccurate reading or error message.

For information on software for Omron please visit the Omron Healthcare Software Support center at www.software.omronhealthcare.com
For information on software for Littmann please visit the Littmann Healthcare Software Support center at www. Littmann.com

When using your unit at home your readings may be lower due to a more relaxed environment. If you want to compare the readings from the measurements taken with your home unit to the readings taken with the device used by your healthcare provider please follow this direction; use the Omron blood pressure monitor to take the first measurement followed by the unit used in the healthcare provider's office. It is necessary to use the digital unit first because of the different methods used in the devices. The Omron Home Blood Pressure Monitor measures the vibration or movement of blood through your arteries and converts the movement to a digital reading (Oscillometric Method). A doctor listens for sound using a stethoscope and gauge (Ascultation). The artery is constricted during the measurement. Constricting the artery and not allowing the artery to return to its condition prior to the measurement may cause incorrect measurement values when using the digital device.

It is very important to use the appropriate size cuff for your arm to get accurate measurement results when using your blood pressure monitor. In order to determine the appropriate cuff size, you need to measure the circumference of your arm. You should periodically measure your arm size. This is especially needed if you have a borderline arm size measurement, or may have gained or lost weight.

• Measure the circumference of your arm. Make sure the arm cuff you are using with your monitor is the correct size for you. When the incorrect cuff is used you may get an inaccurate reading at the first measurement you take or after a short period of use because the cuff bladder will be damaged.
• To determine your arm size, use a cloth tape measure and place the tape measure midway between your elbow and your shoulder around the circumference of your upper arm. Wrap the tape measure evenly around your arm. Do not pull the tape tight. Note the precise measurement in inches.
• Cuff Sizes:
  D-Ring Cuff Sizing
  Small Adult Cuff - fits arm sizes 7.0 to 9.0 inches.
  Standard Adult Cuff - fits arm sizes 9.1 to 13.0 inches.
  Large Adult Cuff - fit arm sizes 13.1 to 17.0 inches
  
  Comfit Cuff Sizing
  The Comfit cuff will fit arms 9.0 to 17.0 inches.

When the cuff is assembled correctly, the hook material will be on the outside of the cuff loop and the metal D-ring will not touch your skin. If the cuff is not assembled, pass the end of the cuff furthest from the tubing through the metal D-ring to form a loop. The smooth cloth should be on the inside of the cuff loop.
1. Remove tight-fitting clothing from your upper arm.
2. Sit in a chair with your feet flat on the floor. Rest your left arm on a table so that the cuff is at the same level as your heart. Turn the palm of your hand upward. 
3. Put your left arm through the cuff loop. The bottom of the cuff should be approximately 1/2 inch above the elbow. The cuff tab should lie over the brachial artery on the inside of the arm. The cuff tube should run down the center of the arm even with the middle finger.
4. Secure the cuff around your arm using the cloth closure. Pull the cuff so that the top and bottom edges are tightened evenly around your arm. 
5. Make sure the cuff is wrapped firmly in place. You should be able to fit your index finger between the cuff and your arm easily.
6. Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart.
7. Be sure there are no kinks in the air tubing. 

There are several reasons why you may have inconsistent readings. Many factors exist that can cause a variation in blood pressure measurement values, for example, recent activities or even the time of day can alter the reading. 

Additionally, the user's technique is very important for reliable measurement results. Listed below are some of the common reasons you may get an inconsistent or inaccurate reading: 

Cuff Size
Measure the circumference of your arm. Make sure the arm cuff you are using with your monitor is the correct size for you. When the incorrect cuff is used you may get an inaccurate reading at the first measurement you take or after a short period of use because the cuff bladder will be damaged. To determine your arm size, use a cloth tape measure and place midway between your elbow and your shoulder around the circumference of your upper arm. Wrap the tape measure evenly around your arm. Do not pull the tape tight. 

Cuff Application
Make sure you are wrapping the cuff around your arm in the correct position. After wrapping the cuff around your arm check the location of the brachial artery marker. The air tube should run down the center of your arm. The cuff should not be wrapped too tight or too loose. 

Before Taking a Measurement
Avoid eating, drinking alcohol, smoking, exercising, and bathing for 30 minutes and rest for 15 before starting the measurement. Avoid taking a measurement during stressful times. Take the measurement in a quiet place.

Body Position
Sit in a chair with your feet flat on the floor. Rest your arm on a table with your palm facing upward. The cuff should be level with your heart. Do not talk or move during the measurement. 

Refer to the Instruction Manual provided with the unit for the complete operating instructions.

In a the most basic sense, blood pressure is a way of measuring how much force is being exerted on the walls of your blood vessels (artery) as blood flows through them. Systolic is the pressure exerted as your heart contracts or beats. This is measured as your heart sends a surge of blood through the vessels. A reading of less than120 mm Hg is considered normal. Diastolic is the pressure exerted when your heart relaxes in between heartbeats in the arteries. A reading of less than 80 mm Hg is considered normal.

According to American Heart Association, blood presure should normally be less than 120/80 mm Hg for an adult. Blood pressure that stays between 120-139/80-89 is considered prehypertension and above this level (140/90 mm Hg or higher) is considered high (hypertension).

*Your doctor should evaluate unusually low readings. 

Many healthcare providers strongly recommend home blood pressure monitoring. Home blood pressure monitoring is one of the best methods of trending a person's blood pressure in their own environment. In some people blood pressure rises above its usual level when it is measured in a doctor's office or clinical setting. This condition is called white coat hypertension. It is estimated one out of every five people have this condition. When this condition is suspected, the doctor may suggest blood pressure be monitored away from the office. Home Blood Pressure monitoring provides valuable information to the doctor.

Blood pressure measurement values vary from the left arm to the right arm. The average is generally within 10mmHg (millimeters of Mercury) for most individuals. The user should consult a doctor before using the right arm to take a measurement. The doctor can assist the user in determining their measurement values for the right arm. 
The cuff is designed mainly for use on the left arm. All validation testing is done on the left arm for the general population. 

Digital monitors measure blood pressure oscillometrically rather than by auscultation. In auscultation, stethoscopes are used to take blood pressure blood pressure by listening for the Korotkoff sounds which correspond to systolic and diastolic pressures. Oscillometric technology measures the vibration of blood traveling through the arteries and converts the movement into digital readings. 

Omron digital blood pressure monitors use the oscillometric method of blood pressure measurement. An oscillometric monitor does not need a stethoscope so the monitor is simple to use. 

All HMINT blood pressure monitors are clinically proven accurate. Pressure: +/- 3 mmHg or 2% of reading, Pulse: +/- 5% of reading. This meets or exceeds the AAMI (Assoc. for the Advancement of Medical Instrumentation) standards.

The process for deleting the stored data is unique to your model. Please check your instruction manual.

1. Remove tight-fitting clothing from your upper arm.
2. Sit in a chair with your feet flat on the floor and place your arm on a table so that the cuff will be at the same level as your heart. 
3. Hold the cloth closure on the cuff with your other hand.
4. Turn the palm of your hand upward. Apply the cuff on your upper arm.
5. Align the marker on the cuff over the brachial artery on the inside of the arm. 
6. The cuff tube should run down the center of the arm even with the middle finger.
7. The bottom of the cuff should be approximately ½ - 1 inch above the elbow.
8. Secure the cuff around your arm using the cloth closure.
9. Make sure the cuff is wrapped firmly in place.
10. Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart. 

For most models, the warranty coverage for the arm or wrist cuff is one year. Cuffs will need to be periodically replaced throughout the life of the monitor. When purchasing a replacement cuff for a arm unit please be certain to measure the circumference of your arm to purchase the correct cuff size.

Consumers should contact their individual insurance company to determine whether the purchase of a blood pressure monitor is covered by their insurance company.

The process for changing the mode of readings is unique to your model. Please check your instruction manual.

Walk 10 steps with your normal stride. Measure the distance from START to END in inches. Calculate your stride length by dividing the total distance that you measured by 10 then divide that number by 12. Stride length= Total distance in inches ÷ 10 (# of strides) ÷ 12 (inches per foot)

For example: 
Total distance (10 strides) = 320" 
Stride length Formula = 320" ÷ 10 ÷ 12" = 2' 8".

If you would like to manually calculate your lean body mass you can do so by subtracting your body fat in pounds from your total body weight. You can determine the amount of body fat in pounds by multiplying your weight by the body fat percentage. For example, a 200lb person with 20% body fat would have 40 lbs of fat (200 X .20). His lean body mass would then be 200-40= 160lbs.

The process for changing the mode of readings is unique to your model. Please check your instruction manual.

Yes, these batteries will occasionally need to be replaced throughout the life of the product. Both the watch and the transmitter belt require Lithium CR2032, 3V batteries. The batteries can be changed with the use of a small Phillips Head screwdriver. Batteries should be inserted with the "+" side facing up. To guarantee the water resistance take the monitor to a local jewelry store for battery replacement. Improper replacement will void the warranty.

For information on software please visit the Omron Healthcare Software Support center at www.software.omronhealthcare.com
For information on software for Littmann please visit the Littmann Healthcare Software Support center at www. Littmann.com

Fat Loss MONITOR with Scale estimates the body fat percentage by using the Bioelectrical Impedance (BI) Method. Muscles, blood vessels and bones are body tissues having a high water content that conducts electricity easily. Body fat is tissue that has little electrical conductivity. The Fat Loss MONITOR with Scale sends an extremely weak electrical current of 50 kHz and less and 500 µA through your body to determine the amount of fat tissue. This weak electrical current is not felt while operating the Fat Loss MONITOR with Scale.

We recommend you take the measurement in the morning before you exercise, eat, drink or take a shower. This will give you opportunity to develop a trend and a good comparison by day.

For hygienic purposes, we recommend applying a new probe cover after each use. Probe covers are intended to protect the thermometer from contamination. If the probe and sensor tip needs to be cleaned, clean with an alcohol swab or cotton swab moistened with 70% isopropyl alcohol. Probe covers are sold separately.

The process for changing the mode of readings is unique to your model. Please check your instruction manual.

Normal body temperature is specific to an individual. It is recommended that several readings are taken while healthy to establish an individual's normal baseline temperature. The following ranges are generally considered normal temperature ranges. For specific questions regarding your individual health, please contact your healthcare provider.

• Axillary (armpit): 94.5 - 99.1F
• Oral (mouth):
• Babies (0-2)-- 97.5-100.4F,
• Children (Ages 3 to 10)-- 97.0-100.4F,
• Young People and Adults (Ages 11 to 65)-- 96.6-99.7F,
• Elderly People (Over the age of 65) -- 96.4-99.5F.
• Rectal (Rectum) to age 5: 97.9 - 100.4F,
• Ear: 96.4 - 100.4.

Mesh caps are maintenance items and do not carry any warranty. Properly maintaining your mesh caps will prolong the life of your mesh cap.

1. After each inhalation treatment, remove the Mesh Cap from the Medication Bottle and discard remaining medication.
   
2. Pour a small amount of distilled water into the Medication Bottle and replace the Mesh Cap.
   
3. Turn on the unit to nebulize the water for 1-2 minutes to remove residual medication in mesh holes.
   
4. Turn off unit and remove the Medication Bottle from the Main Unit.
   
5. Remove the Mesh Cap from the Medication Bottle and discard remaining water from the Medication Bottle.
   
6. Rinse the Medication Bottle, Mesh Cap and other attached parts in distilled water. Do not wash the Medication Bottle or Mesh Cap under strong running tap water.
   
7. Wipe off excess water with a clean dry cloth and allow the parts to dry thoroughly in a clean environment. Do not use any type of cloth or tissue to wipe the Mesh Cap, the fibers may clog the holes of the Mesh Cap.
   
8. Reassemble the device and store it in the Storage Case or in a clean environment.

Consumers should contact their individual insurance company to determine whether the purchase of a nebulizer system or peak flow meter is covered by their insurance.
Your Insurance company may ask for the CPT code:
Nebulizer System:
General aerosol treatment non-pressurized - CPT 94640
First treatment: CPT 94664
Second treatment: CPT 94665

Attach the appropriate size mouthpiece on the input side of the Peak Flow Meter. Slide the indicator to the bottom (zero) side of the scale. Take a deep breath, put your mouth tightly over the mouthpiece and blow out hard and fast as possible, a short sharp blast. You do not have to expel all of the air in your lungs. The final position of the indicator is your PEFR (peak expiratory flow rate).

The following are current HCPC codes for Nebulizers:

E0570 - Standard Nebulizer with Compressor
Model Numbers: NE-C16, NE-C18, NE-C21V, NE-C25, NE-C28, NE-C30

E0571 - Battery Powered Aerosol Nebulizer
Model Numbers: NE-C21with Battery Pack

E0574 - Ultrasonic/electronic aerosol generator with small volume nebulizer 
Model Numbers: NE-U22V

A7005 - Non-Disposable (Reusable) Nebulizer Administration Set
Part Number: 9914, 9978-1 

A7003 - Disposable Nebulizer Kit