TRANSMITTER ZM-920PA/930PA If you have any comments or suggestions on this manual, please contact us at: www.nihonkohden.
Contents GENERAL HANDLING PRECAUTIONS ......................................... i WARRANTY POLICY .................................................................... iii EMC RELATED CAUTION ............................................................. v Conventions Used in this Manual and Instrument ....................... vii Warnings, Cautions and Notes ............................................... vii Explanations of the Symbols in this Manual and Instrument viii Introduction ........................
Check Items After Turning On the Power ............................... 17 Check Items After the Power Off ............................................ 18 ECG Monitoring ................................................................................ 19 ECG Measurement Procedure ................................................... 20 Selecting Electrode Lead and Disposable Electrode ................ 21 Option ....................................................................................
Changing the Transmitter Channel .................................................. 47 Lifetime and Disposal ....................................................................... 48 Disposing of Used Batteries ....................................................... 48 Replacement ......................................................................... 48 Disposal ................................................................................ 48 Disposing of Electrodes and SpO2 Probes ...................
GENERAL HANDLING PRECAUTIONS This device is intended for use only by qualified medical personnel. Use only Nihon Kohden approved products with this device. Use of non-approved products or in a non-approved manner may affect the performance specifications of the device. This includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode leads, input boxes and AC power. Please read these precautions thoroughly before attempting to operate the instrument. 1.
(5) All circuitry used for direct patient connection must be doubly checked. (6) Check that battery level is acceptable and battery condition is good when using battery-operated models. 4. During Operation (1) Both the instrument and the patient must receive continual, careful attention. (2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety. (3) Avoid direct contact between the instrument housing and the patient. 5.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or location of electrodes and/or transducers to avoid possible burn to the patient. 10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.
fire, lightning, vandalism, water or other casualty, improper installation or application, or on which the original identification marks have been removed. In the USA and Canada other warranty policies may apply. CAUTION United States law restricts this device to sale by or on the order of a physician. Equipment Authorization Requirement Operation of this equipment requires the prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service.
EMC RELATED CAUTION This equipment and/or system complies with the International Standard IEC60601-1-2 for electromagnetic compatibility for medical electrical equipment and/or system. However, an electromagnetic environment that exceeds the limits or levels stipulated in the IEC60601-1-2, can cause harmful interference to the equipment and/or system or cause the equipment and/or system to fail to perform its intended function or degrade its intended performance.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden representative for additional suggestions.
Conventions Used in this Manual and Instrument Warnings, Cautions and Notes Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information. WARNING A warning alerts the user to the possible injury or death associated with the use or misuse of the instrument.
Explanations of the Symbols in this Manual and Instrument The following symbols found in this manual/instrument bear the respective descriptions as given.
Introduction The ZM-920PA/930PA transmitter transmits ECG and other data from a patient to a Nihon Kohden monitor for continuous monitoring. Available parameters and functions vary between the models. Read the operator’s manual for the monitor before operation. Model Parameters ZM-920PA • ECG • Impedance respiration ZM-930PA • ECG • Impedance respiration • SpO2 Functions The following information is indicated by LED.
• The channel administrator must replace the channel number label on the transmitter with the new one after changing the channel. CAUTION • Do not use the same channel for different patients. If the same channel is used for two patients, the two patients’ data will be lost due to mutual modulation interference, or another patient’s data may appear on the receiving monitor screen. • Do not use transmitters of adjacent channels in a hospital.
Panel Description Top Panel For attaching a strap ZM-930PA only SpO2 socket Connects to the SpO2 probe. Refer to the warnings below Refer to the symbol page Refer to the symbol page Refer to the warnings below ECG/RESP socket Connects to the electrode lead for measuring ECG and/or respiration by the impedance method. WARNING • Before defibrillation, check that the electrode leads and SpO2 probe attached to the patient are properly connected to the transmitter.
Front Panel ZM-920PA Power switch Turns transmitter power on or off. Replace batteries LED Lights when the batteries need replacement. RA LA LL Va Vb Check electrodes LED Lights when the electrode is detached from the patient. USAch 9002 608.025 MHz CALL key When this key is pressed, a "peep" sounds at the transmitter, and "CALL" message appears at the monitor. Depending on the settings on the monitor, an ECG waveform is recorded when this key is pressed. Channel lable Refer to the warning below.
ZM-930PA For the descriptions except for the LCD, refer to the “ZM-920PA” section on the previous page. RA LA LL Va Vb USAch 9002 608.025 MHz LCD Battery replacement mark: Appears when the batteries are weak. Immediately replace the batteries when this appears. %SpO2: Displayed when the power is turned on. This indication is not displayed when SpO2 display is turned off. Pulse level bar graph: Displays pulse level in 7 steps. SpO2 data: Displays SpO2 data.
Important Safety Information General WARNING • Never use the transmitter in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. • Never use the transmitter in a hyperbaric oxygen chamber. Failure to follow this warning may cause explosion or fire. • Never take this transmitter into an MRI test room. • When performing MRI test, remove all electrodes from the patient which are connected to this instrument.
• Close the battery case cover during operation. If the transmitter is used with the battery case cover open, anyone who touches the opened battery case may receive an electrical shock when defibrillation is performed. Touching the opened battery case may cause electrostatic discharge and intermittently interfere with the waveform or data. CAUTION • Only use Nihon Kohden specified electrodes, electrode leads and SpO2 probes. Otherwise, the maximum performance from the instrument cannot be guaranteed.
Battery WARNING • Keep the battery pack away from fire. It may explode. • Do not damage, disassemble, drop or give impact to the battery. If the battery is damaged and substance inside the battery contacts the skin or clothes, wash immediately and thoroughly with water. • Never short-circuit the + and – terminals on the battery. It may cause overheating and fire. • Take care that the patient does not swallow batteries. CAUTION • Battery replacement must be performed by the operator.
• The channel administrator must replace the channel number label on the transmitter with the new one after changing the channel. For Patients Using Implantable Pacemaker WARNING Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac Monitoring and Diagnostic Equipment. The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker, may be affected by the transmitter which is connected to the same patient.
ECG Monitoring CAUTION • Only use Nihon Kohden specified electrodes and electrode leads. When other type of electrodes or electrode leads are used, the “CHECK ELECTRODE” message may be displayed and monitoring may stop. • When the “ELECTRODE OFF” or “CHECK ELECTRODE” message is displayed on the receiving monitor, ECG is not monitored properly and the ECG alarm does not function. Check the electrode and electrode leads, and if necessary, replace with new ones.
• A patient with peripheral circulation insufficiency • Neonate or low birth weight infant with delicate skin • When not monitoring SpO2, disconnect the SpO2 cable from the transmitter. Otherwise, noise from the probe sensor may interfere and incorrect data is displayed on the screen. • When using the TL-201T finger probe, do not fasten the probe and cable to the finger by wrapping with tape. This may cause burn, congestion or pressure necrosis from poor blood circulation.
• Do not use a probe that is deteriorated by aging. Accurate measurement cannot be performed. • Do not use damaged or disassembled probe. It causes incorrect measurement and may injure the patient. • If the skin gets irritated or redness appears on the skin from the probe, change the attachment site or stop using the probe. Take extreme care for the patients with delicate skin. • Do not pull or bend the probe cable, and do not put caster feet on the probe cable.
• Do not use a dirty sponge attachment tape. The measurement value may be incorrect. • When removing the probe from the attachment tape, do not pull the sensor cable because this can damage the cable. • Use the sponge attachment tape S and L only with the specified products. • Refer to the probe instruction manual for details. • When any of the following occurs, the probe may be broken. Replace it with a new one and check the probe. • The transmitter generates “pip” sound every 0.25 seconds.
Preparation Installing (Replacing) Batteries Use two AA(R6) type alkaline dry cell batteries, manganese dry cell batteries, NiCd rechargeable batteries or NiMH batteries. With new alkaline batteries, the transmitter can continuously measure ECG, respiration and SpO2 for approximately 3 days or ECG and respiration for approximately 4 days. Operation time depends on the thickness of SpO2 probe attachment site.
NOTE + and − Insert the batteries with the correct polarity (+ −). Procedure 1. Open the battery case cover. 2. Insert two dry cell batteries (LR6) into the battery case observing the correct polarity. 3. Close the cover and press it gently until it clicks. 1 3 2 WARNING and CAUTION for Battery Handling WARNING • Keep the battery pack away from fire. It may explode. • Do not damage, disassemble, drop or give impact to the battery.
NOTE • When using rechargeable NiCd batteries or NiMH batteries, shallow charging/discharging shortens battery capacity. For details, refer to the battery operator’s manual. • Remove the batteries from the transmitter before disposing of the transmitter. Situations Requiring Battery Replacement Replace the batteries when any of the following occurs. • The “ ” LED lights (ZM-920PA) or the “ ” mark is displayed on the LCD (ZM-930PA) on the transmitter.
Turning On/Off the Transmitter Check Items Before Turning On the Power To use the instrument in a safe and optimum condition, before turning on the transmitter power switch, check the following. Appearance • There is no damage or dirt on the outside of the transmitter. (Power switch, LED, LCD, CALL key, junction, battery case cover, battery case, etc.) • The transmitter is completely dry. • The electrode lead is not broken. • There is no damage or dirt on the SpO2 probe or on the disposable electrodes.
• • • • • All LEDs light and values are displayed on the LCD for about one second. The transmitter does not generate a continuous “pip” sound. The transmitter does not liberate excessive heat. The “ ” LED does not light or the “ ” mark is not displayed on the LCD. The transmitter does not interfere with the operation of medical instruments used near it. Basic Operation • The “signal loss” message is not displayed on the monitor when the transmitter is inside the receiving range of the monitor.
ECG Monitoring When 6 leads are used on this transmitter, up to 8 lead (I, II, III, aVR, aVL, aVF, Va and Vb) of ECG waveforms can be displayed on the receiving monitor. The heart rate is also measured. When 3 leads are used, one channel ECG waveform of lead II can be displayed on the receiving monitor. Refer to the operator’s manual of the monitor for details.
WARNING When the transmitter is used with an electrosurgical unit (ESU), firmly attach the entire area of the ESU return plate. Otherwise, the current from the ESU flows into the electrodes of the transmitter, causing electrical burn where the electrodes are attached. For details, refer to the ESU manual NOTE • This transmitter is not protected against noise generated from an electrosurgery unit.
Selecting Electrode Lead and Disposable Electrode CAUTION Only Use Nihon Kohden specified electrodes and electrode leads. When other type of electrodes or electrode leads are used, the CHECK ELECTRODE message may be displayed and monitoring may stop.
Connecting the Electrode Lead to the Transmitter Connect the electrode lead to the ECG/RESP socket on the transmitter. CAUTION • Do not shake or swing the transmitter holding the leads or cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. • Hold the connector of the electrode lead when connecting/ disconnecting the electrode lead. If you disconnect the electrode lead by pulling the lead, it damages the electrode lead.
Six Electrodes Electrode Position The 6-electrode method with lead II and lead V5 is effective for monitoring myocardial ischemia. You can improve monitoring accuracy considerably by adding lead V4 to this combination. Va and Vb can be at any position of the standard 12 leads V1 to V6, but V4 and V5 are most appropriate for myocardial ischemic monitoring.
Lead Position Standard limb leads Lead I RA Lead II LA Lead III RA LL N (RL) Monopolar limb leads aVR lead N (RL) aVL lead aVF lead RA LA RA LA N (RL) LA LL LL LL N (RL) LA LL LL N (RL) RA RA LA N (RL) Monopolar chest leads V1 to V6 leads to RA LA LL N (RL) When Using 4 to 6 DIN Type Leads to Monitor 6 Lead ECG When the BR-906PA/916PA electrode ON leads are not used, the transmitter is fixed to 3 lead ECG monitoring.
Three Electrodes By using the optional BR-913PA/903PA electrode lead, 3 lead ECG monitoring is available. Electrode Position • Lead MII, which is similar to standard lead II, used when ECG measurement has priority Electrode Position Symbol Lead Color Left infraclavicular fossa LA (N) Black Right infraclavicular fossa White RA (−) Below lowest rib on the LL (+) Red left anterior axillary line • Lead MI, which is similar to standard lead I Change LL and LA of the lead MII.
Connecting the Electrode Lead and Disposable Electrodes Preparing the Patient Skin Shave off excessive body hair. To reduce skin impedance, clean the electrode site with cream or with a cotton pad moistened with the electrode site with cream or with a cotton pad moistened with alcohol. Thoroughly dry the skin with a clean cotton pad. NOTE • For a patient with frequent body movement, rub the sites with Skinpure skin preparation gel. However, do not use Skinpure skin preparation gel for sensitive skin.
2. Carefully remove the backing paper from the electrode. Avoid touching the adhesive surface. 3. Place the electrode on the previously cleaned skin. Pay attention to the electrode lead color and symbol. 4. Fasten the electrode lead wire with surgical tape with an extra length of wire between the tape and the electrode. This lessens the movement of electrode leads by body movement and helps stable monitoring.
Respiration Monitoring Respiration is monitored by measuring changes in impedance between the RA and LL ECG electrodes. This transmitter sends the changes in impedance to the monitor as a respiration waveform. The monitor displays the respiration waveform and calculates respiration rate. Refer to the operator’s manual of the monitor for details.
Respiration Measurement Procedure 1. Select the electrode lead and disposable electrodes. 2. Connect the electrode lead to the ECG/RESP socket. 3. Connect disposable electrodes to the electrode lead and attach electrodes to the patient. After steps 1 to 3 are finished, respiration monitoring automatically starts. Electrode Position for Respiration Monitoring Place the RA and LL electrodes so that the lungs are between the electrodes.
Position 2 In this position, the waveform amplitude is usually large and the ECG lead is similar to Lead MII. This position can be generally recommended. RA LL Right infraclavicular fossa Fifth intercostal space on the left midaxillary line, V6 Position 3 In this position, the respiration waveform is optimum, but the ECG lead is unusual.
SpO2 Monitoring The SpO2 monitoring is only available on the ZM-930PA transmitter. This transmitter sends SpO2 and pulse waveform to the monitor and displays SpO2 data and pulse level bar graph on the LCD. Refer to the operator’s manual of the monitor for details. WARNING • SpO2 measurement may be incorrect in the following cases. • When the patient’s carboxyhemoglobin or methemoglobin increases abnormally. • When dye is injected in the blood. • When using an electrosurgical unit. • During CPR.
CAUTION • Turn off the power of mobile phones, small wireless devices and other devices which produce strong electromagnetic interference around a patient (except for devices allowed by the hospital administrator). Radio waves from devices such as mobile phones or small wireless devices may be mistaken as respiration or pulse waves and the displayed data may be incorrect. • Normal external light does not affect monitoring but strong light such as a surgical light or sunlight may affect monitoring.
Measurement Procedure 1. Select the SpO2 probe. 2. Connect the SpO2 probe to the SpO2 socket. 3. Attach the SpO2 probe to the patient. After steps 1 to 3 are finished, SpO2 monitoring automatically starts. Selecting SpO2 Probe Select an appropriate probe for the patient. CAUTION • Only use Nihon Kohden specified electrodes, electrode lead, SpO2 probe. Otherwise, the maximum performance from the instrument cannot be guaranteed. • Do not use damaged or disassembled probe.
Reusable Probes Model Finger Probe TL-201T Subject (Weight) Attachment Site Adults, children Finger (Weight more than 20 kg) Multi-site probe TL-220T Adult or Infant Finger or toe 3 kg or more Attachment tape Neonate Instep and sole 3 kg or less 34 Operator's Manual ZM-920PA/930PA
Disposable Probes CAUTION The disposable probe is not sterilized. Use the disposable probe only for a single patient. Never reuse the disposable probe for another patient because it causes cross infection.
Model TL-051S/052S Subject (Weight) Attachment Site Adults Finger (Weight more than 50 kg) Neonates Cable length TL-051S: 80 cm TL-052S: 160 cm TL-061S/062S Instep and sole (Weight less than 3 kg) Adults, children Finger (Weight from 15 to 50 kg) Children, infants Cable length TL-061S: 80 cm TL-062S: 160 cm 36 Toe (Weight from 3 to 15 kg) Operator's Manual ZM-920PA/930PA
Model TL-271T/271T3 Cable length TL-271T: 0.8 m TL-271T3: 1.6 m TL-272T/272T3 Cable length TL-272T: 0.8 m TL-272T3: 1.6 m TL-273T/273T3 Subject (Weight) Adult 30 kg or more Child 10 to 50 kg Neonate 3 kg or less Attachment Site Finger or toe Instep Adult 40 kg or more Cable length TL-273T: 0.8 m TL-273T3: 1.6 m TL-274T/274T3 Infant 3 to 20 kg Finger or toe Cable length TL-274T: 0.8 m TL-274T3: 1.
Connecting SpO2 Probe to the Transmitter Connect the probe to the SpO2 socket on the transmitter. CAUTION • Do not shake or swing the transmitter while holding the cables connected to the transmitter. The transmitter may come off and injure someone or damage surrounding instruments. • Hold the connector when connecting/disconnecting the probe. If you disconnect the SpO2 probe pulling the cable, it damages the cable.
• Check the circulation condition by observing the skin color of the measuring site and pulse waveform. Change the measuring site every 8 hours for disposable probes and every 4 hours for reusable probes. The skin temperature may increase at the attached site by 2 or 3°C (4 or 5°F) and cause a burn or pressure necrosis. When using the probe on the following patients, take extreme care and change the measurement site more frequently according to symptoms and degree.
sensor cable because this can damage the cable. • Do not immerse the disposable probe in detergents or water. If the probe adhesive surface gets wet, adhesiveness becomes weak and the probe cannot be attached to the skin. • Before using the TL-260T multi-site Y probe, be sure to attach the probe to the sponge attachment tape S or L. Do not use the probe without the sponge attachment tape attached.
Turning SpO2 Data and Pulse Level Bar Graph Display On/Off You can turn off the display of SpO2 data and pulse level bar graph on the LCD. SpO2 display off Press the CALL key for more than 3 seconds within 10 seconds after turning transmitter power on (after a “peep” sound). CALL key RA LA LL Va Vb “%SpO2” is not displayed. When SpO2 monitoring starts, SpO2 data and pulse level bar graph are not displayed on the LCD. USAch 9002 608.
Insufficient Light Alarm When sufficient light cannot be obtained from the photo emitter of the probe, the transmitter generates the following sound and indication. (4) (1) “peep” sound (every 1 second) (2) (2) pulse level bar graph is maximum (all bars are lit.) (3) SpO2 data is displayed as “ ” (4) %SpO2 is blinking. (3) In this case, change the attachment site to the appropriate site. Refer to the operator’s manual of the SpO2 probe.
Alarm List (5) %SpO2 indication (1) Displayed as LED on ZM-920PA (4) pulse level bar graph (2) Sound Single “peep” sound for 4 s --- (1) Continuous “peep” sound All lights are off --- Intermittent “pip” sound every 0.5 s Display --- (2) RA LA LL Va Vb (3) SpO2 data Cause Countermeasure The CALL key is pressed. The sound lasts while the key is pressed. The battery voltage decreases and battery charge is almost zero. Battery is completely discharged.
Sound Intermittent “peep” sound every 1 s Display (3) (4) all lit (5) blinking Cause Cannot receive sufficient light from the probe photo emitter. Intermittent “pip” sound every 0.25 s --- (3) 85%, blinking Broken probe (3) blinking Patient body movement Probe is not attached securely. 44 Countermeasure Attach probe to a site with 6 to 14 mm thickness where sufficient light can be received. Replace the probe with a new one.
Troubleshooting If the problem still remains after checking the following, contact your Nihon Kohden distributor. Problem The power cannot be turned on. Nothing is displayed on the LCD after turning the power on. (ZM-930PA only) Nothing is displayed on the monitor after turning the transmitter power on. Signal receiving condition is poor. Cause Batteries are not installed correctly. The battery polarity is wrong. Batteries are completely discharged. SpO2 display is turned off.
Problem 3 electrode leads are properly attached to the patient but LEDs light. Heart rate of the patient who is using an electric blanket cannot be monitored on the receiving monitor. ECG baseline is thick. (Hum is overlapping) Respiration waveform measurement is unstable. SpO2 data is unstable and not reliable. Cause The transmitter is fixed to 6 lead monitoring. Countermeasure Turn off and on the transmitter power. Pacing pulse detection is set to ON on the monitor.
Changing the Transmitter Channel The transmitter channel can be changed by the QI-901PK Channel Writer. To change the channel number, refer to the channel writer manual. WARNING The following actions must be taken to properly receive the transmitter signal of the correct patient on the receiving instrument. Otherwise, there may be signal loss or signals may mix causing a serious accident, such as monitoring a different patient.
Lifetime and Disposal Disposing of Used Batteries Replacement When the “ ” LED is lit or the “ ” is displayed on the LCD during operation, the batteries are running out. Replace the batteries with new ones. When using rechargeable batteries, recharge them. Disposal Before disposing of the batteries, check with your local solid waste officials for details in your area for proper disposal. It may be illegal to dispose of these batteries in the municipal waste stream.
Cleaning, Disinfection and Sterilization Transmitter and Electrode Lead WARNING If detergents or dirty liquid spills into the transmitter, clean it and dry it completely before use. If the wet transmitter is used, the patient or anyone in contact with the transmitter may receive an electric shock. CAUTION • Before cleaning or disinfecting the transmitter, remove the batteries from the transmitter. • The transmitter cannot be sterilized.
Disinfectant Glutaraldehyde solution Alkyldiaminoethylglycine hydrochloride Benzalkonium chloride Benzethonium chloride solution Chlorohexidine gluconate solution Concentration (%) 2.0 0.5 0.2 0.2 0.5 SpO2 Probe Refer to the probe manual.
Replacing the Battery Case Cover When the battery case cover is damaged, replace it with a new one. Battery case cover, code no. 6113-046365C. Other than the battery case cover, there are no serviceable parts for the transmitter. Repair Parts Availability Policy Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to maintain the performance of the instrument) for a period of 6 years after NKC announces discontinuation of the instrument.
Specifications ECG measurement Channels: Input range: DC offset: Input impedance: Pacing pulse detection: Respiration measurement Measuring method: Impedance range: SpO2 measurement Measuring range: Measuring accuracy When the measuring accuracy of the SpO2 probe is not considered: 4 ±5 mV or more ±500 mV or more 5 MΩ or more (5 Hz) ANSI/AAMI EC13 Based upon Pacemaker pulse rejection Capability Impedance method 0 to 2 kΩ 0 to 100%, in 1% steps ±1 digit (80% ≤ SpO2 ≤ 100%) ±2 digit (50% ≤ SpO2 ≤ 80%) Le
Antenna: Transmission channel: Transmission frequency range: Channel spacing: Modulation scheme: Occupied bandwidth: Effective radiated power: Safety standards Safety standard: According to the type of protection against electrical shock: ECG electrode lead indicated on the transmitter 608.0250 to 613.9750 MHz 50 kHz or 37.5 kHz (12.5 kHz when interleaved) FSK (Frequency Shift Keying) <20 kHz 1.0 mW (conducted) CSA C22.2 No.
Water resistance Water does not get inside the transmitter except for the battery case when immersed in water up to 30 cm deep for 3 minutes.
Standard Accessories Name Strap Operator's Manual ZM-920PA/930PA Q’ty 1 Supply code Y233 55
Options CAUTION Use only Nihon Kohden electrodes, electrode leads and SpO2 probes to assure maximum performance from your instrument.
SpO2 Name Finger probe (reusable) Multi-site probe (reusable) SpO2 probe (for adult, disposable) SpO2 probe (for child, disposable) SpO2 probe (for neonate, disposable) Multi-site Y probe (for low birth weight infant/child/ neonate, disposable) SpO2 probe (for adult, disposable) SpO2 probe (for child, disposable) SpO2 probe (for neonate/adult, disposable) SpO2 probe (for child/infant, disposable) SpO2 probe (for adult/neonate, disposable) SpO2 probe (for child/infant, disposable) COTTONY tape Foam tape for
