NC-stat DPNCheck Device Reference Guide
Contents
1. Retest 1 Confirm that the patient is relaxing leg muscles 2 Reposition patient if necessary 3 Retest Data quality issue e Biosensor backing not removed 1 Remove biosensor backing and retest Patient ankle cold e Temperature detector field of view obstructed e Patient s ankle temperature lt 28 C 1 Ensure that tester s hand does not obstruct temperature detector 2 Warm patient s lower leg by e putting a sock on and elevating the leg lf unsuccessful o instruct the patient to put on their shoes and socks then walk around for 1 2 minutes if able OR o wrap the patient s lower leg and ankle with a blanket or heating pad OR o briskly rub the patient s lower ankle Note Although it is not an ideal approach this technique can be used if the tester is in a hurry 3 Retest e Device Use e Testing Protocol e est Results e Troubleshooting Low battery e Battery is low 1 Replace battery 1 Contact Customer Service 1 Contact Customer Service Device hardware issue e Device hardware issue Excessive biosensor e Excessive biosensor reuse reuse detected detected Device is disabled e Excessive repeat testing Always remember to perform the test away from electrical equipment that may cause interference If you continue to experience issues please call Customer Service at 888 786 7287 NEUROMetrix 62 Fourth Avenue Waltham MA 02451 888 786 7287 www neurometrix com NEUR2. results appear on the display Results will display for 10 seconds and then the device will power off This mode can only be accessed when the device is powered off
3. OMetrix 2012 NeuroMetrix Inc All Rights Reserved PN2203591 Rev C Device Use Step 1 Lay the patient on an exam table and prepare the testing area with a Preparation Pad Step 2 Power on the device The display will show and the light will turn amber or red when the battery needs to be replaced Step 3 Fully insert the biosensor into the port The light will turn green once the biosensor has been properly inserted Align to foam The display will show 1 to set the leg to be tested Tip Both the outer ankle bone lateral malleolus and Achilles tendon should be easily accessible as shown at left Please reference the User Manual for alternative patient positions Tip Align the biosensor with the foam on all sides REMOVE BACKING label side faces up The test area should be vigorously scrubbed with the Preparation Pad provided Ankle Stimulation Sensory Recording Site Step 8 Align the device on the lower calf by pushing down firmly on the foam The device should point towards the back side of the knee with the inner edge of the biosensor placed next to the midline Achilles tendon Ensure that the device is aligned to but does not cross over the midline as shown by the dashed line in the image above Tip The probes should be placed behind but not over the outer ankle bone Testing Protocol 1 Testing a single leg is usually clinically sufficient e Whenever possi
4. Troubleshooting Data quality issue e Adequate signal could not be recorded e Insufficient gel on probes e Poor contact of probes with skin e Inadequate skin preparation in probe contact area e Probe movement during test Stimulation issue e Gel smeared between the probes Biosensor e Biosensor disconnected during disconnected test during test Data quality issue e Biosensor backing not removed e Incomplete biosensor contact e Skin in biosensor contact area inadequately prepared Data quality issue e Signal contamination due to patient movement or excessive muscle contraction 1 Ensure that the limb setting on the device is correct 2 If incorrect re select the limb on the device by pressing the button down for 1 2 seconds until correct limb is selected left r right 3 Retest 1 Confirm placement and retest 1 Re do skin preparation and device placement e Clean probes and re apply gel e Vigorously scrub the ankle area e Reposition the device on the patient with firm pressure to both probes and on biosensor 2 Retest with constant force to limit device movement during test 1 Re insert biosensor with tail traces facing outward e Entire biosensor tail must be inserted 2 If problem persists replace biosensor 1 Remove biosensor backing and retest e Check for good contact on both sides of the foam 2 lf problem persists re prepare skin and replace with new biosensor 3
5. ble the same leg should be tested first in all patients 2 The test will provide a nerve conduction result the first time in most patients 3 If the first test does not provide a result or to confirm the result the test should be repeated e Pressing the test button again is usually all that is required see Troubleshooting Tip In certain circumstances it may be beneficial to confirm the results Examples include Confirm CV if amplitude is lt 4 uV Confirm undetectable response Confirm result inconsistent with clinical findings f the leg setting on the device was incorrect then the test should be repeated 4 If the repeat test does not provide a result or for further confirmation of the results the opposite leg should be tested e The same biosensor may be used on both legs This protocol is intended only as a guide It is the responsibility of the provider to determine the clinical necessity of nerve conduction testing Step 6 Remove the backing from the biosensor Step 4 Set the leg to be tested The device display screen will blink with the leg selected left r right To switch the leg hold the button down for 1 2 seconds and the selection will change to the opposite leg Step 5 Apply a small amount of conductive gel to each probe The head of the probe should be covered with gel Tip Remove excess gel that may lead to gel smearing between the two probes Tip Whenever possible
6. test the me leg in all ients TTE a Step 7 Locate the patient s outer ankle bone to align the long probe just behind it Tip The anode short probe A and cathode long probe C should be aligned to the outer ankle bone B The cathode should be adjacent to the middle central prominence of the ankle bone The nerve is stimulated only under the cathode Step 9 Press the button to start the test The light will blink with each stimulation Limb selected will be displayed Tip Check for good contact on both sides of the foam Tip During test maintain a Firm pressure on probes b Firm pressure on biosensor c Steady positioning Step 10 Maintain constant force throughout the test The test time may vary per patient but normally lasts for 10 15 seconds The results will display once completed Test Results DIGI f Wal SEG Result Actions Conduction Velocity meters second Record and interpret result Amplitude microvolts Record and interpret result Undetectable Response no Record and interpret result Conduction Velocity displayed Note displayed code and refer to Troubleshooting on back Test Unsuccessful Note If the device displays an Amplitude gt O but does not display a CV the CV could not be reported on this individual Record Amplitude and interpret result To recall test results after the device powers down press and hold the button for 3 seconds and you will see the
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