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CP200 User Manual

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1. llle ee 34 Transferring a Configuration to Another Electrocardiograph 35 Configuring the Electrocardiograph for Wireless Communication 36 This chapter documents the system settings which affect both ECG and spirometry functions For information on the following related tasks see the procedures identified here e Reviewing ECG settings See Reviewing the ECG Settings on page 37 e Reviewing spirometry settings Spirometry manual e Printing all settings See Reviewing the Device Information on page 31 28 Chapter 3 Reviewing the System Settings Welch Allyn CP 200 Electrocardiograph System Settings Menu Tree System Settings Device Device Device _ Connectivity Configuration Info Administration Settings I Set Date Time L About See Managing Data Connectivity Mode Language Print Settings Security on page 75 Network Settings Date Format Manage Settings Wireless Settings Time Format Enable Options Auto Send ECG Weight Unit Upgrade Software Auto Send Spirometry Height Unit L Service Info Auto Save ECG Power Save View Available Networks Practice ID Test Connectivity Settings Device ID Audio Beeper Flow Unit Pressure Unit Temperature Increase Display Contrast r Decrease Display Contrast
2. will be blank because this information varies over time For ECG tests go to Step 4 on page 58 For spirometry tests see the spirometry manual Directions for Use Chapter 5 Performing ECG Tests 67 To Choose a Patient from the Scheduled Patients List 1 From the Enter New Patient screen Figure 37 on page 57 press Schedule If prompted to log in enter your user ID and password The electrocardiograph searches its own scheduled patients list If there is no scheduled patients list then it searches for orders in a connected EMR system if any via a Welch Allyn HL7 interface If one or more scheduled patients match your entry their names appear Figure 45 Scheduled Patient List Screen for Recalling Data 9 17AM Oct 16 08 Scheduled Patient List Patient ID Patient Name Today s scheduled patients New Patient Search Select Highlight the desired name Press Select The next screen in your procedure appears Most of the patient s data is automatically filled in Some data fields medications blood pressure comments history height weight will be blank because this information varies over time For ECG tests go to Step 4 on page 58 For spirometry tests see the spirometry manual Note The other two softkeys exit this search e New Patient returns to the Enter New Patient screen See Figure 37 on page 57 e Search brings up the Search for Patient screen Go to To S
3. Replace the electrode Verify that the electrode area has been properly prepared shaved cleaned with alcohol or acetone allowed to dry Verify that electrodes have been properly stored and handled Wandering baseline an upward and e Electrodes that are dirty corroded e Clean skin with alcohol or acetone downward fluctuation of the waveforms loose or positioned on a bony area e Reposition or replace electrodes e Insufficient or dried electrode gel e Help patient relax e Oily skin or body lotions e f wandering baseline persists turn the baseline e Rising and falling of chest during rapid ilter on See Baseline Filter on page 68 or apprehensive breathing Muscle tremor interference random e Patient is uncomfortable tense e Help patient get comfortable e Check all electrode contacts irregular voltage superimposed on the waveforms May resemble or coincide with AC interference bebe d ll nervous e Patient is cold and shivering e Exam bed is too narrow or short to comfortably support arms and legs e Armor leg electrode straps are too tight f interference persists turn the muscle tremor ilter on See Muscle Filter on page 68 f interference still persists the problem is probably electrical in nature See the following suggestions for reducing AC interference Directions for Use Table 2 Lead Quality Problems Continued Chapter 8 Troubleshooting 91 Conditio
4. 35 Configuring the Electrocardiograph for Wireless Communication 36 4 Reviewing the ECG SettingsS 0 00 cee eee 37 ECG Settings Men Trees guerre LIA SII Gene be had PEEL 38 AboutAuto ECG Reports 2 24 ens i b eS emen EIER eee ed pane 39 iv Contents Welch Allyn CP 200 Electrocardiograph Reviewing the Format Settings for Auto Reports 0 41 Reviewing the Interpretation and Copy Settings for Auto Reports 43 Reviewing the Patient Data Fields Available for Auto Reports 44 Reviewing the Auto Report Settings llis 46 Reviewing the Rhythm Report Settings lessen 47 Reviewing the Miscellaneous ECG Settings lllo 48 Turning the Augmented Pediatric Lead Set On and Off 0 49 5 Performing ECG Tests ut Re RR a atu ee e e afecte 51 Connecting the Leads to the Patient llle 52 RecordingiamAuto ECG sod ie rp ebd hee CT uie eau 56 Recording a Normal Auto ECG sabar ee 57 R ecordinga Stat Auto ECG foes ek EIL ae E rede de 62 Recording a Rhythim EC sy aces e tux E eee eae Se twa SE 63 Recalling Saved Patient Data 0 ee 64 Adjusting the ECG Waveforms 2 20 0 eee 68 6 Performing Administrative Tasks 0000 eee ee eeee 69 Managing Saved Tests In the Test Directory 0 0000s 70 Managing the Scheduled Patients List 0000 00 00 c cece eee 7A Managing Data Security edes penbI eh V RB
5. OK Accepts data that you have entered or chooses a highlighted item See Moving Through the Menus on page 12 i Directions for Use About the Main Menu The main menu appears when you press the Menu key If you are in spirometry mode when you press this key the Spirometry Settings menu appears Figure 9 Main Menu 9 17AM Oct 16 08 Main Menu 1 Test Directory 2 Scheduled Patients 3 ECG Settings 4 Spirometry Settings 5 System Settings 6 Edit Medication List 7 Edit History List 0 Exit Vi4le gt Chapter 1 Introduction 11 Submenu Purpose Procedure Test Directory Scheduled Patients ECG Settings Spirometry Settings System Settings Edit Medication List Edit History List Edit confirm print or send saved tests View the scheduled patients list add patients to the list or delete patients from the list Review or change ECG settings Auto Report format Rhythm Report format and so on Review or change spirometry settings display settings print settings and so on Review or change system settings device configuration device info user setup and so on Edit the list of medication choices available to choose during patient data entry See Managing Saved Tests In the Test Directory on page 70 See Managing the Scheduled Patients List on page 74 See Reviewing the ECG Settings on page 37 See spirometry manual See Reviewing th
6. and battery The date of purchase is 1 the date specified in our records if you purchased the Product directly from us 2 the date specified in the warranty registration card that we ask you to send to us or 3 if you don t return the warranty registration card 30 days after the date on which the Product was sold to the dealer from whom you bought the Product as documented in our records This warranty does not cover damage caused by 1 handling during shipping 2 use or maintenance contrary to labeled instructions 3 alteration or repair by anyone not authorized by Welch Allyn and 4 accidents If a Product or accessory covered by this warranty is determined to be defective because of defective materials components or workmanship and the warranty claim is made within the warranty period described above Welch Allyn will at its discretion repair or replace the defective Product or accessory free of charge If your Product requires repairs covered by this warranty upon your request Welch Allyn will loan to you at no cost a substitute Product for use until your repaired Product is returned You must obtain a return authorization from Welch Allyn to return your Product before you send it to Welch Allyn s designated service center for repair Contact Welch Allyn Technical Support For phone numbers see page ii THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES EXPRESS OR IMPLIED INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIE
7. 685 4560 www welchallyn com Advancing Frontline Care Reorder Number multi language CD 401151 Mat Number manual only 708793 Ver F
8. Check the AC power source e Check the AC fuses See Replacing the AC Fuses on page 86 Won t turn on when unplugged from AC power e Battery disconnected or incorrectly connected e Battery low not charging depleted or bad e Blown battery fuse e Check battery connections See Replacing the Battery on page 83 e Recharge the battery See Recharging a Fully Discharged Battery on page 82 e Replace battery See Replacing the Battery on page 83 e Replace battery fuse See Replacing the Battery DC Fuse on page 85 Shuts down during printing Battery low or bad e Recharge the battery See Recharging a Fully Discharged Battery on page 82 e Replace battery See Replacing the Battery on page 83 Prints fewer than 10 reports on a full battery charge Degraded battery Replace battery See Replacing the Battery on page 83 Unresponsive for an extended time System frozen Press the reset button by inserting a small object such as a paper clip into the hole Reset button The screen is too dark or too light The contrast is to high or too low Press Ctrl R The contrast resets to its default value 92 Chapter 8 Troubleshooting Table 4 System Messages alphabetical order Welch Allyn CP 200 Electrocardiograph System Message Problems Actions A test is being printed that has not been saved and will be lost Continue
9. Contact Information Printer Select CAPS Lock Applicable for spirometry only Directions for Use Chapter 3 Reviewing the System Settings 29 Reviewing the Device Configuration Settings 1 Press the Menu key 2 Choose System Settings gt Device Configuration The following screen appears Figure 19 Device Configuration Screen Ml 9 17AM Oct 16 08 Device Configuration 1 Set Date Time 2 Language 3 Date Format 4 Time Format 5 Weight Unit 6 Height Unit 7 Power Save 8 Practice ID 9 Device ID A Audio Beeper vi l i 3 Change any desired settings Setting Description Set Date Time Current date and time Language List of languages available Changes take effect when the next screen appears Date Format MM DD YY month day year DD MM YY day month year Time Format 24 hour or AM PM Weight Unit Kilograms kg or pounds Ib Height Unit Centimeters cm inches in or feet and inches ft in Power Save On or off When on the electrocardiograph turns itself off after several idle minutes Practice ID Name of the practice clinic or hospital This ID prints on all ECG reports When this field is filled in for multiple electrocardiographs a connected EMR system can direct work orders appropriately via a Welch Allyn HL7 interface Device ID Electrocardiograph identification Enter up to 20 characters This ID prints on all ECG reports When this field is filled in for
10. ECGs Report print formats Auto ECGs Rhythm ECGs Average cycles ECG storage Frequency range Digital sampling rate Pacemaker detection Power requirement Fuses AC DC battery fuse Lead configurations Computer controlled dot array 8 dots mm Inkjet or laser printer that supports PCL printer control language 10 25 50 mm s 5 10 20 mm mV AUTO 5 10 20 mm mV 3x4 3x44 1R 3x4 3R 6x2 12x1 6x2 50 mm s 6x2 Ext 2x6 1R 6x2 1R 3 6 or 12 leads at a time 3x4 50 mm s 3R 6x2 50 mm s 6R Up to 50 ECGs 0 3 to 150 Hz gt 1 000 samples second channel ANSI AAMI EC11 Universal AC power supply 100 240 V 50 60 Hz 2 2 A maximum Time delay type 2 amp 250 V rating Littlefuse 0215002 or equivalent Fast acting type 10 amp 32 V rating Bussman ATC 10 or equivalent Standard Cabrera 96 Appendix A Specifications Welch Allyn CP 200 Electrocardiograph Item Continued Specification Continued Rechargeable battery Filters Safety EMC and regulatory compliance Standard connectivity Connectivity with electronic medical records Electrodes Cables and wires Environmental operating conditions Temperature Relative humidity Altitude Environmental storage conditions Temperature Relative humidity Altitude Protection against electric shock Protection against ingress of water per IEC 60529 Mode of operation Lead acid gel 6 volt 5 AH Prints up to 100 c
11. Mid axillary line on same horizontal level as V4 and V5 purple purple G LA L Just above left wrist on inside of arm black yellow H LL F Just above left ankle red green l RL N Just above right ankle green black J RA R Just above right wrist on inside of arm white red 54 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Figure 33 Electrode Placement Locations Augmented Pediatric To use the augmented pediatric lead set you must enable it in the settings See Turning the Augmented Pediatric Lead Set On and Off on page 49 F G Electrodes AHA IEC Locations A V1 C1 Fourth intercostal space at right sternal border red red B V2 C2 Fourth intercostal space at left sternal border yellow yellow C V4 C4 Fifth intercostal space at left of midclavicular line blue brown D V7 C7 Posterior axillary line at the same horizontal level as V4 orange black E V6 C6 Mid axillary line on same horizontal level as V4 purple purple F LA L Just above left wrist on inside of arm black yellow G LL F Just above left ankle red green H RL N Just above right ankle green black l RA R Just above right wrist on inside of arm white red J V3R C3R Mirror position to standard V3 placement with respect to the mid green green sternal line Directions for Use 4 5 Chapter 5 Performing ECG Tests 55 If the electrocardiograph s display is blank press 0 If prompted to select a lead s
12. OG Gd Rex w edo 3 Standard Features amp Benefits isses cese ec ke PEE eee ews 3 Optlansiceserzieec x en MER md unm E m EEEN EEA EENE EEEN 5 ACGBSSDEOS 21 woe ase id doi asl eed dn eec xe eta ew a bord ck ed Ca rx 6 Controls Indicators and Connectors 00000 cece eee 7 About the Main Menu airis si ss rack RE EYE ruodi tnae 11 Moving Through the Menus 00 cece ree 12 About the Patient Cable and Leads lle 13 SUmbeslg 2a sc guis ARR ogg dt Ingi a aed 8 6n RAE oce Dn Roc Rd eR Ole A eg datus 14 Using the Electrocardiograph Safely 000 c cece eee e eee eens 16 Getting Help oe eue us ae Ries esc SUR Sessa me Ros RGB SCIRE IRE Ro awa pe Ses Ru ae 19 2 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph About This Manual This manual is written for clinical professionals with a working knowledge of medical procedures and terminology as required for monitoring cardiac patients Before using the CP 200 electrocardiograph for clinical applications or before setting up configuring troubleshooting or servicing the electrocardiograph you must read and understand this manual and all other information accompanying the electrocardiograph and related options or accessories Product Overview The Welch Allyn CP 200 electrocardiograph can display print save and send ECGs electronically It features a full alphanumeric keyboard a color display to preview ECGs and edit settings storage f
13. PER ELE 75 Working With the User List and User Login iilii seis 76 Working With the Audit Trail le 78 7 Maintaining the Electrocardiograph 000005 79 Inspecting the Equipment iilsslsssslll les 80 Cleaning the Equipment liess 80 Testing the Equipment educ pr EPI i D e rd et eid 81 Recharging a Fully Discharged Battery 0 000 cece esee 82 Replacing the Battery 0 0 0 eee 83 Replacing the Battery DC Fuse 2 0 ene 85 Replacinigsthie AG Fuses s oed a ee aus ae an faves e d e hee e et 86 Storing the EGuipMent zc eere d ad Rd Aa en eet als 87 Disearding the Equipment i2 su less serui dirag Se bere 3 ed UY eae 87 8 Troubleshooting xoa Er I RE REEF toe AE A EE 89 Problem Solving Suggestions seri 22 fee eoque p EP ene ee eee 4 90 Limited Warranty iz cases hee A ELA RH oth Mle AP tidak bath i ay debes lad 93 SOM WIGS POMC YS atte ha enters te eR e REDDERE e DR UE ERR ect E De OE dete d 94 A Specifications cess quet rox Ipsos sue pU qo S E 95 B EMC Guidance and Manufacturer s Declarations 97 Glossary d acid iaca i xc fo dd a met ee atau a DA AH d dat ded dra ode 101 Introduction About This Manual 0 000 cece ee eee I rrr 2 Product Overviesv ilis use deen Sni oe Re ia ded Wade ao eo ac e wt wc a gel de 2 Intended Use 2 s seu ex xb a eigo od cR Ee eee eus x RC Rio 2 Indications Tor USE sos s el E haa eq pEUex ee ea CE
14. Welch Allyn The use of accessories other than those specified may result in degraded performance of this device Caution Portable and mobile RF communications equipment can affect the performance of the electrocardiograph Caution The electrocardiograph meets the Class A requirements of IEC 60601 1 2 2000 regarding incidental emission of radio frequency interference As such it is suitable for use in commercial grade electrical environments If the electrocardiograph is used in residential grade electrical environments and you experience incidental interference with other equipment that uses radio frequency signals to operate minimize the interference as described under EMC Guidance and Manufacturer s Declarations on page 97 Caution Other medical equipment including but not limited to defibrillators ultrasound machines pacemakers and other stimulators may be used simultaneously with the electrocardiograph However such devices may disturb the electrocardiograph signal Caution The power cord must be disconnected from AC power before cleaning maintaining or servicing Directions for Use Chapter 1 Introduction 19 Getting Help You can get help with the electrocardiograph in a variety of ways beyond this manual e Press the Help key from the ECG Preview screen or Lead Status screen for a list of topics available to print e Review the other information that came with the electrocardiograph For list see Product inf
15. as many ECG or spirometry records as you like Media are not included If both an SD memory card and a USB storage device are connected files are sent to the SD card For media specifications see Standard connectivity on page 96 Battery operation Use the electrocardiograph almost anywhere On battery power you can print up to 100 ECGs continuously before needing to recharge User definable ECG report formats Customize one or two formats for efficient reporting Removable leads for ECG patient cable Replace leads individually if needed Compatibility with CardioPerfect workstation software Store and manage data electronically by transferring records to a Welch Allyn CardioPerfect workstation e via an SD memory card or removable USB storage device media not included e viaa hardwired connection cable not included e viaa wireless connection Compatibility with external printer You can connect an external printer For details see Connecting an External USB Printer Optional on page 26 4 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Pacemaker detection If the software detects the possible presence of a pacemaker it asks you whether the patient has a pacemaker If you say no interpretation if purchased is included in the report If you say yes interpretation is not included in the report and a message indicating that a pacemaker was detected is displayed on the report Support for augmented pediatric
16. collection of tests saved in the electrocardiograph s memory This directory holds up to 50 ECG and 50 spirometry tests When the directory gets full the Welch Allyn CP 200 Electrocardiograph electrocardiograph prompts you to delete the oldest tests before saving new ones When performing Auto ECG or spirometry tests you may recall patient data from this directory rather than manually entering their data at the time of the test For details see To Search by Entering a Patient s Name or ID on page 65 This section explains how to manage edit confirm print send and delete saved tests These tasks are all accomplished through the Test Directory menu as illustrated here Figure 46 Test Directory Menu Tree Search Search Results Test Directory Password is required if user login is enabled Patient Data Interpretation ee N Auto Report 2 Print r3 Send D Memory Card if Auto Report 1 Workstation Directions for Use Chapter 6 Performing Administrative Tasks n To Print Send or Delete Saved Tests 1 2 Press the Menu key Choose Test Directory If prompted to log in enter your user ID and password The following screen appears Figure 47 Test Directory Search Screen Hl 9 17AM Oct 16 08 Search Unprinted Tests o Use these criteria to find and perform actions Unconfirmed Test
17. enabled all users on the user list have access to the test directory and the scheduled patient list including searching and editing privileges Administrator level When the user login feature is enabled only administratorlevel users have access to the administrative functions For an outline of these functions see menu tree in Figure 49 on page 75 To Enable or Disable User Login 1 2 3 4 Press the Menu key Choose System Settings gt Device Administration If prompted to log in enter an administrator level user ID and password Choose User Login Follow the prompts to enable or disable user login To Change a Password You can change a password in either of two ways At any User Login screen press Change Password Follow the prompts Ask an administratorlevel user to change the password See To Review or Edit the User List on page 77 Directions for Use Chapter 6 Performing Administrative Tasks 71 To Review or Edit the User List 1 Press the Menu key 2 Choose System Settings gt Device Administration If prompted to log in enter an administratorlevel user ID and password Note f no administrator level password has been assigned the system s default user ID and password available from Welch Allyn works here These defaults exist solely to provide access to the user list in the event that user login is enabled before an administrator is assigned 3 Choose User List The user l
18. key network 36 keyboard 9 95 keys See function keys keyboard softkeys L language setting 29 leads 10 lead wires vs 12 waveform leads 102 adjusting waveforms 68 arrangements in reports 41 42 47 configurations standard or Cabrera 48 95 electrode placement 53 54 ordering 6 print timing simultaneous or sequential 46 troubleshooting problems with 90 See also patient cable electrodes augmented lead set Lead Status screen 55 login 75 M main menu 11 mains See AC maintenance tasks 79 87 Manual Save 59 Manual Send 59 mask subnet 36 measurements See extended measurements medication list choosing from 45 editing 11 33 memory card for communication with CardioPerfect workstation 3 problems writing to 92 sending tests to 59 71 slot location 8 specification 96 used with USB storage device 3 menus navigating through 12 menu trees device administration 75 ECG setup 38 system setup 28 test directory 70 miscellaneous ECG settings 48 49 muscle filter 48 68 muscle tremor interference 90 91 Index 105 N navigating through the menus 12 network key 36 network settings 32 O OK key 10 on off manual and automatic 25 options 5 ordering information 6 P pacemakers use with 4 18 95 paper See thermal chart paper parts and accessories 6 18 93 passwords 76 77 patient cable connecting 22 52 55 description amp illustration 13 ordering 6 preca
19. lead set The augmented pediatric lead set an alternate placement of the precordial leads on pediatric patients is easier to use on the small chests of infants and young children It provides optimal vectors for early development of the heart for the change of right to left ventricular dominance For electrode placement locations see Figure 33 on page 54 Directions for Use Options Chapter 1 Introduction These options are available both for initial purchases and for upgrades Spirometry With a disposable single use flow transducer the optional spirometer performs FVC and SVC tests Automatic ECG interpretation The optional MEANS interpretation algorithm developed by the University of Rotterdam in the Netherlands provides automatic analysis of ECG tests For more information see the MEANS Physicians Manual or the PEDMEANS Physicians Manual on the CD that came with your electrocardiograph The MEANS algorithm is used for adult patients 18 years and older The PEDMEANS algorithm is used for pediatric patients from 1 day through 17 years old Carts Two specially designed carts are available for convenient transport and use of the electrocardiograph as shown here with the optional cable arm and shelf Figure 1 Office Cart Figure 2 Hospital Cart Cable arm and shelf optional Cable arm and shelf optional Durable high quality rubber wheels with locks Free motion plastic wheels Bar code sca
20. leave the electrocardiograph plugged in until you see the fully charged icon i When the charge gets low the icon flashes When the charge gets too low to operate a warning message appears and the electrocardiograph beeps every 15 seconds for 1 minute then it turns off For more see Recharging a Fully Discharged Battery on page 82 Figure 18 AC Power Inlet and Green LED AC power inlet On Off key Green LED Directions for Use Chapter 2 Setting Up the Electrocardiograph 25 To Turn the Electrocardiograph On Press c5 To Turn the Electrocardiograph Off Press and hold Note If PowerSave is enabled the electrocardiograph turns off automatically after several idle minutes To learn how to enable or disable PowerSave see Reviewing the Device Configuration Settings on page 29 Verifying Proper Operation Once your electrocardiograph is set up verify proper operation by using an ECG simulator to acquire and print a standard 12 lead ECG of known amplitude See Step 2 on page 81 Note As part of your initial set up you may want to adjust the display contrast To learn how see Reviewing the Device Configuration Settings on page 29 You may also want to change other software settings as described in the following chapters e Reviewing the System Settings on page 27 e Reviewing the ECG Settings on page 37 26 Chapter 2 Setting Up the Electrocardiogr
21. multiple electrocardiographs a connected EMR System can direct work orders appropriately via a Welch Allyn HL7 interface Audio Beeper On or off When on beeps to indicate errors such as incorrect input improper external connections or a printer error Beeps may also indicate a low battery Flow Unit L sec or L min For spirometry only Determines the y axis units for flow volume curves 30 Chapter 3 Reviewing the System Settings Welch Allyn CP 200 Electrocardiograph Setting Continued Description Continued Pressure Unit Temperature Increase Display Con rast Decrease Display Con Con Prin rast act Information er Select CAPS Lock mmHg mbar inHg kPa For spirometry only Determines the units for the calibration menus atmospheric pressure values Fahrenheit or Celsius For spirometry only Determines the units for the calibration menu s temperature values Each time you select this choice the display contrast immediately increases until you reach maximum contrast Each time you select this choice the display contrast immediately decreases until you reach minimum contrast Your office Enter up to 40 characters This information will appear on the accessories Help page Internal or External When External is selected and when an external printer is connected and turned on reports will print to that printer For details see Connecting an External USB Print
22. page 24 Deletes the character to the left of the cursor See About the Main Menu on page 11 See Getting Help on page 19 See Moving Through the Menus on page 12 See Moving Through the Menus on page 12 Enters a space Applicable only for keyboards with characters above certain keys To enter a character above a key hold the Ctrl key while pressing that key To capitalize the character hold Shift Ctrl while pressing the key Capitalizes letters Also you can enter a symbol 96 etc by holding the Shift key while pressing a number key Moves through the data entry fields Lights up when the electrocardiograph is connected to AC power 10 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Figure 8 Softkeys and Function Keys Softkeys These softkeys display text or images that correspond to the unlabeled buttons below them The content changes from screen to screen Softkey buttons These buttons activate the functions displayed above them If a softkey is blank pressing Its button has no effect AUD EH ECG 55 A ECG x Function Keys Auto ECG Begins Auto ECGs normal and stat See Recording an Auto ECG on page 56 Spirometry Begins spirometry tests See spirometry manual g Rhythm ECG Begins Rhythm ECGs See Recording a Rhythm ECG on page 63 ig Stop Cancel Stops any current activity See Moving Through the Menus on page 12 x
23. see About Auto ECG Reports on page 39 As shown in the following diagram there are the two types of Auto ECG normal and stat For details see these procedures e Recording a Normal Auto ECG on page 57 e Recording a Stat Auto ECG on page 62 Figure 36 Auto ECG Testing Process Diagram Normal Stat Eg EJ Press quickly Press and hold Optional Select report format i Enter or recall patient data Optional Adjust waveforms i Press Print ECG Auto Report prints Vv Auto ECG Post Print screen Directions for Use Recording a Normal Auto ECG Chapter 5 Performing ECG Tests 57 For a normal Auto ECG you enter patient data and do other optional tasks before printing as shown in Figure 36 on page 56 To Record a Normal Auto ECG 1 Press the Auto ECG key LEM quickly Do not hold it down or a stat ECG would begin 2 If prompted choose Auto Report 1 or Auto Report 2 The following screen appears Figure 37 Enter New Patient Screen ME 9 17AM Oct 16 08 Enter New Patient Patient ID Last Name First Name Birth Date MM DD YYYY Weight Ib Height ft in Gender Search Schedule Clear Done 3 Enter or recall the patient data For details about these data fields including
24. the Equipment WARNING Only qualified service personnel should perform leakage current tests Whenever the electrocardiograph is serviced or problems are suspected Welch Allyn recommends the following test procedures 1 Verify continued electrical safety of the device using IEC 60601 1 or ANSI AAMI ES1 methods and limits Test for the following Patient leakage current Chassis leakage current Earth leakage current Dielectric strength AC and patient circuits Verify that the electrocardiograph is working properly using an ECG simulator to acquire and print a standard 12 lead ECG of known amplitude e Printing should be dark and even across the page e There should be no evidence of print head dot failure no printing breaks forming horizontal streaks e Paper should move smoothly and consistently during printing e Waveforms should appear normal with proper amplitude and without distortion or excessive noise e Paper should stop with perforations near the tear bar indicating proper cue sensor operation For tear bar location see Figure 17 on page 23 82 Chapter 7 Maintaining the Electrocardiograph Welch Allyn CP 200 Electrocardiograph Recharging a Fully Discharged Battery If the electrocardiograph does not turn on when unplugged the battery may be fully discharged Note Regardless of the battery condition you can use the electrocardiograph whenever it is plugged in To Recharge the Battery 1 Plug th
25. 0 72 73 tracking auditing edits made 78 user list 77 electrodes labeling schemes See AHA IEC ordering 6 placement locations 4 53 54 specifications 96 troubleshooting 90 electromagnetic emissions See EMC guidance and declarations electronic medical records EMR 2 EMC guidance and declarations 97 100 encryption 36 encryption wireless settings 32 Enter New Patient screen 57 equipotential stud 7 18 extended measurements 41 Welch Allyn CP 200 Electrocardiograph F features 3 filters types of 96 See also specific filter names flow task diagrams Auto ECG testing normal and stat 56 entering or searching for patient data 64 rhythm ECG testing 63 formats See Auto ECGs report settings Rhythm ECGs report settings frequency range 39 40 95 function keys 10 fuses 83 85 86 G gain settings changing 68 default choosing 48 as printed on report 39 40 gateway 36 gateway network setting 32 H hardware set up 21 25 height unit setting 29 help getting 19 history list choosing from 45 editing 11 34 Hodges QTc method 46 IEC electrode labels C1 C2 C3 etc 48 53 54 indications for use 3 inspection procedures 80 intended use 2 Internet address ii interpretation of ECGs automatic about 2 3 5 confirming 43 61 72 editing 61 72 ordering 6 as printed on reports 39 40 settings for Auto Reports 43 IP address 32 36 Directions for Use K
26. 3 5 Extended Measurements 6 Average Cycles 0 Previous Menu Vi4le gt Change any desired settings For a report example see Figure 25 on page 39 Setting Description Lead Arrangement Arrangement of the leads on the report e 3x4 3 rows x 4 columns e 3x4 41R 3 rows x 4 columns 1 rhythm lead e 3x4 amp 3R 3 rows x 4 columns 3 rhythm leads e 6x2 6 rows x 2 columns e 12x1 12 rows x 1 column e 6x2 50 mm s 6 rows x 2 columns 50 mm s e 6x2 Ext 6 rows x 2 columns extended printouts two pages 20 seconds of ECG data e 2x6 1R 2 rows x 6 columns 1 rhythm lead e 6x2 1R 6 rows x 2 columns 1 rhythm lead e No Print No report prints Rhythm Lead 1 Rhythm lead to print at the bottom of all R reports Rhythm Lead 2 Second rhythm lead to print at the bottom of 3x4 3R reports Rhythm Lead 3 Third rhythm lead to print at the bottom of 3x4 3R reports Extended On or off When on an additional page prints with the report Extended measurements Measurements include the values for several common parameters such as Q R and S amplitude and ST values The amplitudes are expressed in microvolts The durations are expressed in milliseconds The measurements cannot be edited 42 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph Setting Continued Description Continued Average Cycles If desired an additional page prints with the report Average cycl
27. CP 200 12 Lead Resting Electrocardiograph TERSA gt TTT LL a 299550545565 oa EI n TTT TETEA X Qu Qu EONA Directions for Use WelchMllyn Advancing Frontline Care ii Welch Allyn CP 200 Electrocardiograph Copyright 2008 Welch Allyn All rights are reserved No one is permitted to reproduce or duplicate in any form this manual or any part thereof without permission from Welch Allyn Caution Federal US law restricts sale of the device identified in this manual to or on the order of a licensed physician Welch Allyn assumes no responsibility for any injury or for any illegal or improper use of the product that may result from failure to use this product in accordance with the instructions cautions warnings or indications for use published in this manual Welch Allyn is a registered trademark of Welch Allyn Inc and CP 200 and CardioPerfect are trademarks of Welch Allyn Inc SD is a trademark of Toshiba Software in this product is copyright Welch Allyn or its vendors All rights are reserved The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide Under such laws the licensee is entitled to use the copy of the software incorporated within this instrument as intended in the operation of the product in which it is embedded The software may not be copied decompiled reverse engineered disassembled or otherwise reduced to human perceivable
28. For information on the following related tasks see the procedures identified here e Reviewing system settings which affect both ECG and spirometry functions See Reviewing the System Settings on page 27 e Reviewing spirometry settings Spirometry manual e Printing all settings See Reviewing the Device Information on page 31 Chapter 4 Reviewing the ECG Settings ECG Settings Menu Tree ECG Settings Welch Allyn CP 200 Electrocardiograph Edit Auto Report Auto Report Settings 10r2 Baseline Centering Lead Timing Format I Auto Report 2 Artifact Report L QTc Method Lead Arrangement Rhythm Lead 1 Rhythm Lead 2 Rhythm Lead 3 Extended Measurements Average Cycles Interp Settings r Print Interpretation Copies Copies With Interp Reason Statements r Unconfirmed Report Abnormal ECG Patient Data First Name Middle Initial r Age Birth Date r Weight Height Gender Race Medication r History Blood Pressure Comments Custom 1 Custom 1 Label Custom 2 Custom 2 Label Rhythm Report Settings Lead Arrangement Default Rhythm Speed Standard Lead Order L Augmented Lead Order Miscellaneous Lead Configuration Electrode Labels Default Gain Se
29. S OF MERCHANTABILTY AND FITNESS FOR A PARTICULAR PURPOSE WELCH ALLYN S OBLIGATION UNDER THIS WARRANTY IS LIMITED TO REPAIR OR REPLACEMENT OF PRODUCTS CONTAINING A DEFECT WELCH ALLYN IS NOT RESPONSIBLE FOR ANY INDIRECT OR CONSEQUENTIAL DAMAGES RESULTING FROM A PRODUCT DEFECT COVERED BY THE WARRANTY 94 Chapter 8 Troubleshooting Welch Allyn CP 200 Electrocardiograph Service Policy All repairs on products under warranty must be performed or approved by Welch Allyn Unauthorized repairs will void the warranty In addition whether or not covered under warranty any product repair shall exclusively be performed by Welch Allyn certified service personnel If the product fails to function properly or if you need assistance service or spare parts contact the nearest Welch Allyn Technical Support Center For phone numbers see page ii Before contacting Welch Allyn try to duplicate the problem and check all accessories to ensure that they are not causing the problem When calling please be prepared to provide e Product name and model number and complete description of the problem e Serial number of your product if applicable e Complete name address and phone number of your facility e For out of warranty repairs or spare parts orders a purchase order or credit card number e For parts orders the required spare or replacement part numbers If your product requires warranty extended warranty or non warranty repair servi
30. a Welch Allyn HL7 interface e Add Brings up the Enter New Patient screen shown in Figure 37 on page 57 Enter the patient s data as described on that page e Delete Deletes the highlighted patient name e Delete All Deletes all patient names in the list e Exit Returns to the main menu Directions for Use Chapter 6 Performing Administrative Tasks 75 Managing Data Security The CP 200 electrocardiograph incorporates security features that can keep patient data private and confidential To implement your data security plan use the Device Administration menu which is illustrated here and described in the following pages Figure 49 Device Administration Menu Tree System Settings Device Administrative level password is Administration required if user login is enabled User Login Edit User List Audit Trail Print Audit Trail Enable Disable Enable Disable 76 Chapter 6 Performing Administrative Tasks Welch Allyn CP 200 Electrocardiograph Working With the User List and User Login The user list identifies all individuals who are authorized to access patient data The user list can hold up to 25 users After the list reaches 25 users you can add names only if some names are set to inactive status New names replace inactive names If all 25 names are active you receive a message that the user list is full Two levels of access can be assigned User level When the user login feature is
31. aph Welch Allyn CP 200 Electrocardiograph Connecting an External USB Printer Optional If desired you can connect an external printer It must be a USB inkjet or laser printer that supports PCL printer control language such as the following Vendor Model PCL Version HP Deskjet 995c PCL 3 HP Deskjet 5650 PCL 3 enhanced HP Laser 1022 PCL 5E Dell Laser 1710 PCL 5E amp PCL 6 Lexmark Laser E240 PCL 6 No special software is required The external printer prints the following always in black and white Auto ECG reports Spirometry reports spirometry option only Device settings Audit trails Help pages Rhythm ECGs always print to the internal printer See the warning regarding signal I O connectors on page 16 To Connect a Printer Connect one end of a USB cable to the printer s USB connector and connect the other end to the electrocardiograph s USB connector 10101 For connector location see Figure 5 on page 8 To learn how to enable the external printer in the settings see Reviewing the Device Configuration Settings on page 29 3 Reviewing the System Settings System Settings Menu Tree cece eee eee 28 Reviewing the Device Configuration SettingS 00 cece ee eee 29 Reviewing the Device Information lille 31 Reviewing the Connectivity Settings llle 32 Reviewing the Medication List 000 ee eee ee ee 33 Reviewing the History List
32. appear in place of Manual Save in Figure 39 on page 59 Displays two softkey options e Memory Card An SD memory card or removable USB storage device must be in place Workstation Either wireless communications must be configured or a USB cable must connect the CardioPerfect workstation to the electrocardiograph s Com port B 10101 This Manual Send softkey appears only when Auto Save is enabled For more on Auto Save see Reviewing the Miscellaneous ECG Settings on page 48 Repeat Test Lets you repeat a test for the current patient Exit The ECG Preview screen appears if all leads are connected to the patient 60 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph A Caution The requirements of AAMI EC11 Section 3 2 72 Frequency and Impulse Response for an impulse triangle waveform may be impacted by up to 5 milliseconds of small amplitude dampened ringing immediately after the impulse when the muscle filter 35 Hz is turned on or a small amplitude offset when the baseline filter 0 5 Hz is turned on These requirements are unaffected by any other combination of filters turned on or off Measurements performed by the optional interpretation algorithm are unaffected by any filter selections Directions for Use Chapter 5 Performing ECG Tests 61 To Edit or Confirm a Test Directly After Printing Note A qualified physician must review and confirm all tests before patients are treated If chang
33. art paper speed settings or Rhythm ECGs report settings spirometry option about 2 3 5 ordering 6 port location 8 tests saved in test directory 70 SSID 32 36 stat Auto ECGs 56 62 Stop Cancel key 10 storage capacity for ECGs 95 storage instructions 87 ST segment analysis 58 subnet mask 32 36 supplies 6 93 symbols and markings 14 15 system settings 11 27 31 Welch Allyn CP 200 Electrocardiograph T Technical Support ii test directory saved tests 11 70 72 testing connectivity settings 32 testing the electrocardiograph 81 thermal chart paper loading 23 ordering 6 specifications 95 speed settings 39 40 68 time and date See date and time timing lead 46 troubleshooting 89 92 U ultrasound machines use with 18 Unconfirmed label 39 40 43 See also interpretation of ECGs automatic confirming upgrades 5 31 URL ii USB port Com port B 8 USB storage devices 3 96 user authorization 75 76 V V1 V2 V3 etc See AHA electrode labels versions 31 39 40 W wall poster ordering replacement 6 warning symbol defined 14 warranty 93 waveforms ECG See leads web site ii weight unit setting 29 Welch Allyn Technical Support ii Welch cups ordering 6 wireless network settings 36 wireless settings 32 workstation See CardioPerfect workstation WelchAllyn 4341 State Street Road PO Box 220 Skaneateles Falls NY 13153 0220 USA 1 800 535 6663 1 315
34. bled for entering comments Yes or no If yes this field is enabled for entering data of your choice You may define a label for the Custom 1 field if desired Yes or no If yes this field is enabled for entering data of your choice You may define a label for the Custom 2 field if desired 46 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph Reviewing the Auto Report Settings 1 Press the Menu key 2 Choose ECG Settings gt Auto Report Settings The following screen appears Figure 29 Auto Report Settings Screen for ECG Settings M 9 17AM Oct 16 08 Auto Report Settings 1 Baseline Centering 2 Lead Timing 3 Auto Report 2 4 Artifact Report 5 QTc Method 0 Previous Menu vitii 3 Change any desired settings Setting Description Baseline Centering On or off When on aligns the isolectric line of all leads Lead Timing Simultaneous or sequential Simultaneous prints ECG data that was captured simultaneously for all lead groups Sequential prints ECG data that was captured at sequential intervals for each lead group in turn Auto Report 2 On or off When on a second predefined report format is available Artifact Report On or off When on the electrocardiograph automatically prints an artifact report with the Auto ECG report whenever artifact is detected and you override the Waiting for 10 seconds of quality data message This report a 12x1 format with all
35. c Immunity The CP 200 electrocardiograph is intended for use in electrocardiograph should assure that it is used in such an environment Welch Allyn CP 200 Electrocardiograph the electromagnetic environment specified below The customer or user of the CP 200 Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment Guidance Electrostatic discharge ESD IEC 61000 4 2 6 kV contact 8kV air 6 kV contact 8 kV air Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Electrical fast transient burst IEC 61000 4 4 Surge IEC 61000 4 5 Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 2 kV for power supply lines 1 kV for input output lines 1 kV differential mode 2 kV common mode gt 95 dip in 0 5 cycle 60 dip in 5 cycles 30 dip for 25 cycles gt 95 dip in 5 seconds 2 kV for power supply lines Not applicable 1 kV differential mode 2 kV common mode gt 95 dip in 0 5 cycle 60 dip in 5 cycles 30 dip for 25 cycles gt 95 dip in 5 seconds Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or ho
36. ce please call first the nearest Welch Allyn Technical Support Center A representative will assist you troubleshooting the problem and will make every effort to solve it over the phone avoiding potential unnecessary returns In case a return cannot be avoided the representative will record all necessary information and will provide a Return Material Authorization RMA number as well as the appropriate return address An RMA number must be obtained prior to any return If you have to return goods for service follow these recommended packing instructions e Remove all hoses cables sensors power cords and ancillary products as appropriate before packing unless you suspect they are associated with the problem e Wherever possible use the original shipping carton and packing materials e Include a packing list and the Welch Allyn Return Material Authorization RMA number It is recommended that all returned goods be insured Claims for loss or damage to the product must be initiated by the sender 95 A Specifications Item Specification Dimensions 16 2 in 41 1 cm 2 6 2 in 15 7 cm 15 6 in 39 7 cm Weight 11 6 Ib 5 3 kg Keyboard type Elastomer keypad with complete alphanumeric keys Soft key menu and dedicated function keys Paper type 825 x 11 inches 21 x 28 cm Z fold thermal paper 200 sheets Thermal printer internal USB printer external Thermal paper speeds Gain settings Auto ECGs Rhythm
37. djusting Baseline Muscle waveforms while printing Leads Gain Filter Filter Speed 2 Optional Press the softkeys to adjust the waveforms See Adjusting the ECG Waveforms on page 68 3 Press or to stop printing The ECG Preview screen appears if all leads are connected to the patient 64 Chapter 5 Performing ECG Tests Recalling Saved Patient Data During an ECG or spirometry test instead of entering patient data manually you can recall saved patient data in either of two ways e Search by entering a patient s name or ID Welch Allyn CP 200 Electrocardiograph See To Search by Entering a Patient s Name or ID on page 65 e Choose a patient from the scheduled patients list See To Choose a Patient from the Scheduled Patients List on page 67 The following diagram illustrates the procedure for both types of data recall Figure 42 Patient Data Recall Process Diagram Go to Enter New Patient screen M Press Search Press Schedule Enter patient s last name or ID Choose a patient Patient data is filled in on the screen Proceed with ECG or spirometry test Directions for Use Chapter 5 Performing ECG Tests 65 To Search by Entering a Patient s Name or ID 1 From the Enter New Patient screen Figure 37 on page 57 press Search If prompted to log in enter your user ID and password Th
38. duction 15 Operation Symbols For details on the keys see Figure 1 on page 9 E Ao E B S Ej S El z Deh S Lx On standby off Navigation arrows Enter Auto ECG Rhythm ECG Spirometry Spirometry port SD memory card slot Alternating current Battery is charging Dangerous voltage AC fuse replacement information Do not reuse Do not dispose of this product as unsorted municipal waste Prepare this product for reuse or separate collection as specified by Directive 2002 96 EC of the European Parliament and the Council of the European Union on Waste Electronic and Electrical Equipment WEEE If this product is contaminated this directive does not apply For more specific disposal information see www welchallyn com weee or contact Welch Allyn Customer Service at 44 207 365 6780 S 0 2 iii dk IIE 2 Help Backspace Shift Menu Stop Cancel OK Com port B USB Com port A for patient cable Battery charge level Battery is charged Direct current Ground equipotential Sealed lead acid battery Recycle Defibrillation proof Type CF applied parts While the electrocardiograph is safety rated CF for direct cardiac contact it is not intended to be connected directly to the patient s heart Only surface contact with the patient s skin is intended Type BF applied part 16 Chapter 1 Intro
39. duction Welch Allyn CP 200 Electrocardiograph Using the Electrocardiograph Safely Before using or servicing the electrocardiograph you must read and understand the following safety related information General Warnings The following warning statements apply to electrocardiograph use in general Warning statements that apply specifically to particular procedures such as connecting the patient cable or performing an ECG test appear in the corresponding sections of the manual Warning statements indicate conditions or practices that could lead to illness injury or death A Warnings Related to the Environment WARNING To ensure patient and device safety leave 5 feet 1 5 meters of open area around the patient WARNING To avoid a possible explosion do not use the electrocardiograph in the presence of flammable anesthetics mixtures containing air oxygen or nitrous oxide WARNING When transporting the electrocardiograph on a cart tuck the patient cable away from the wheels so that it does not present a hazard Warnings Related to Accessories and Other Equipment WARNING For operator and patient safety peripheral equipment and accessories that can come in direct patient contact must be in compliance with all appropriate safety EMC and regulatory requirements See EMC Guidance and Manufacturer s Declarations on page 97 WARNING All signal input and output I O connectors are intended for connection of only devices complyi
40. e following e Awireless radio is installed in the electrocardiograph s USB slot according to the instructions that were shipped with the radio e The CardioPerfect workstation software is installed according to the instructions that were shipped with that CD e The CardioPerfect workstation connectivity kit is installed according to the instructions that were shipped with that CD To Configure the Electrocardiograph for Wireless Communication 1 Atthe electrocardiograph press the Menu key 2 Choose System Settings gt Connectivity Settings gt Connectivity Mode gt Wireless 3 Under Network Settings do one of the following e Select the Use DHCP checkbox Press Done e Enter the IP address subnet mask and gateway Press Done 4 Under Wireless Settings fill in the fields SSID encryption authentication network key 802 1X auth and EAP type per your network administrator 5 Test the connectivity settings See Test Connectivity Settings on page 32 Reviewing the ECG Settings ECG Settings Menu Tre cece eee eens 38 About Auto ECG Reports anaana ccc tenet ene 39 Reviewing the Auto Report Settings 0 00 cece eens 46 Reviewing the Rhythm Report Settings 0 0 cece eects 47 Reviewing the Miscellaneous ECG Settings 0 ccc eee ees 48 Turning the Augmented Pediatric Lead Set On and Off 05 49 37 This chapter documents the ECG settings
41. e BATH LEN E 5 ACGCOSSOTI S 1 but dep pode Hte sr x met rie Pp E de d 6 Controls Indicators and Connectors ereere dedet eui eee 7 About the Mains Men raare ee a e eR PESE eee uer eig s 11 Moving Through the Menus iliis ss 12 About the Patient Cable and Leads iliis 13 SVITIBOIS eate exstet st sed br ea ol tah of pat dide D ett desi sega dad 14 Using the Electrocardiograph Safely 0 liiis 16 General MarhitigSs sss os es en ti Rc hs Ee e apr de lb E 16 General Cautlons x eee ee eod dee RA eed etd 18 Getting Helps fits erei AS SIE VERD BA oe ede AA IP Poder 19 2 Setting Up the Electrocardiograph llllslss 21 Inspecting the Electrocardiograph iiiisell sess 22 Connecting the Patient Cable 22 Loading the Thermal Chart Paper liiis 23 Powering the Electrocardiograph 0 0000 sees 24 Verifying Proper Operation 00 0 ee 25 Connecting an External USB Printer Optional 00000000 26 3 Reviewing the System Settings 0c cece eee eee 27 System Settings Menu Tree llle 28 Reviewing the Device Configuration SettingS 0 00 eee eee 29 Reviewing the Device Information 0 002000 e eee ees 31 Reviewing the Connectivity Settings liess 32 Reviewing the Medication List llli ees 33 Reviewing the EIStory LISt oss accen Pe e Pe Y RO pa eee 34 Transferring a Configuration to Another Electrocardiograph
42. e System Settings on page 27 See Reviewing the Medication List on page 33 Edit the list of clinical conditions available to See Reviewing the History List on page 34 choose during patient data entry 12 Chapter 1 Introduction Moving Through the Menus Figure 10 Standard Menu Wl 9 17AM Oct 16 08 Edit Auto Report 1 2 Interp Settings 3 Patient Data 0 Previous Menu Files Desired Actions Welch Allyn CP 200 Electrocardiograph Figure 11 Parent Menu With Submenu Format 1 Lead Arrangement 3x4 3x4 1R 3x4 3R 6x2 50 mm s 6x2 Ext 2x6 1R Vi4lel gt Keys to Press To move up or down a list To open a standard menu Figure 10 To move from parent menu to submenu on same screen Figure 11 Ao v keyboard or softkey arrows or or p gt or item s number or letter im ae To perform an action To accept data To check or uncheck a checkbox Gi vd To return to parent menu from submenu on same screen Figure 11 m T 2 To select the highlighted submenu or v item or To make no change xX lt To move back through the menus lt q ore key To move through data entry fields To return to the ECG Preview screen from a standard menu Figure 10 Ory 3 Note Keyboard and softkey arrows work the same way Directions for Use Chapter 1 Introduction 13 About the Patient Cable and Leads The patient cable processes th
43. e electrocardiograph into AC power 2 Verify that the green LED on the keyboard lights up See Figure 18 on page 24 If the LED does not light up go to Replacing the AC Fuses on page 86 3 Keep the electrocardiograph plugged in for 12 hours The first time you turn the electrocardiograph on after a full battery discharge you are prompted to reenter the date and time If the electrocardiograph still does not turn on when it is unplugged from AC power you may need to replace the battery or battery fuse See Replacing the Battery on page 83 or Replacing the Battery DC Fuse on page 85 Directions for Use Chapter 7 Maintaining the Electrocardiograph 83 Replacing the Battery If you have recharged the battery and the electrocardiograph still does not turn on when unplugged or if the battery loses its charge quickly replace the battery as follows For part number see Accessories on page 6 1 2 3 4 5 Unplug the electrocardiograph from AC power if connected Turn the electrocardiograph upside down Unscrew and remove the battery door See Figure 50 Lift out the battery See Figure 51 Figure 50 Removing the Battery Door Figure 51 Lifting Out the Battery Inspect the fuse See Figure 52 e f the Z wire is intact go to Step 6 e f the Z wire is broken or dark replace the fuse See Replacing the Battery DC Fuse on page 85 Figure 52 Battery Fuse Plugged In w Z wire 84 C
44. e following screen appears Figure 43 Search for Patient Screen MF 9 17AM Oct 16 08 Search for Patient Patient ID Brings up any matching names that have been saved Last Name New Patient Schedule Search Enter the patient s identification number or last name partial or complete Press Search The electrocardiograph searches its own scheduled patients list then it searches the database of a connected CardioPerfect workstation if any then it searches its own test directory If one or more patients match your entry their names appear Note The other two softkeys exit this search e New Patient returns to the Enter New Patient screen See Figure 37 on page 57 e Schedule brings up the Scheduled Patients List screen Go to To Choose a Patient from the Scheduled Patients List on page 67 66 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Figure 44 Patient Search Results Screen ME 9 17AM Oct 16 08 Patient Search Results Patient ID Patient Name Your search results matching names from saved patient data Back Select 4 Take the desired action e Press Back The Search for Patient screen reappears e Highlight a patient name and press Select The next screen in your procedure appears Most of the patient s data is automatically filled in Some data fields medications blood pressure comments history height weight
45. e patient s ECG data and transmits it to the electrocardiograph To make handling convenient the ten leads are arranged to point toward the appropriate parts of the body The cable rake which slides easily prevents the chest leads from tangling Figure 12 Patient Cable and Leads Chest leads Left arm lead Electrocardiograph connector Right arm lead Right leg lead 14 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Symbols The symbols illustrated on the following pages may appear on the electrocardiograph on the packaging on the shipping container or in this manual Documentation Symbols WARNING Indicates conditions or practices that could lead to illness injury or death Caution n this manual indicates conditions or practices that could damage the equipment or other property Caution On the product means Consult accompanying documentation gt gt D Shipping Storing and Environment Symbols gt gt This end up ae Keep dry Fragile 95 Relative humidity limit AAA Temperature limits 4 Altitude limits 500 1060 hPa 20 C v Certification Symbols Complies with applicable U S and Canadian f medical safety standards C Meets essential requirements of European 0297 Medical Device Directive 93 42 EEC C iste Us 74227 European Regulatory Manager Australian registered importer N344 Directions for Use Chapter 1 Intro
46. earch by Entering a Patient s Name or ID on page 65 68 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Adjusting the ECG Waveforms The following softkeys appear on the Auto ECG Acquisition and Rhythm ECG screens Figure 38 on page 58 and Figure 41 on page 63 Use these softkeys before printing an Auto ECG or while printing a rhythm ECG Softkey Effect Leads Cycles through the leads in groups of three on the screen For rhythm reports also cycles through the lead groups that are printing if lt 12 To learn how to change the number of leads per group 3 6 or 12 on rhythm reports see Reviewing the Rhythm Report Settings on page 47 To learn how to change between standard and Cabrera lead groupings see Reviewing the Miscellaneous ECG Settings on page 48 Gain Cycles through the gain settings in mm mV 5 10 20 AUTO zooming in and out AUTO is available for Auto ECGs only not rhythm ECGs AUTO is usually the best setting but some waveforms may be easier to read on other settings To learn how to change the gain s default setting see Reviewing the Miscellaneous ECG Settings on page 48 a f 5 mm mV 10 mm mV 20 mm mV Baseline Filter Toggles between the two baseline filter settings on or off This filter reduces wandering baseline an upward and downward fluctuation of the waveforms It is preferable if possible to eliminate or reduce wandering baseline b
47. ed age will be entered in years and months Weight Yes or no If yes this field is enabled for entering patients weight For instructions on changing the weight units kg or Ib see Reviewing the Device Configuration Settings on page 29 Height Yes or no If yes this field is enabled for entering patients height For instructions on changing the height units cm in or ft and in see Reviewing the Device Configuration Settings on page 29 Gender Yes or no If yes this field is enabled Data entry choices Male Female or Unknown Race Yes or no If yes this field is enabled Data entry choices Blank Caucasian Black Hispanic Asian Unknown Directions for Use Chapter 4 Reviewing the ECG Settings 45 Field Continued Description Continued Medication History Blood Pressure Comments Custom 1 Custom 1 Label Custom 2 Custom 2 Label Yes or no If yes this field is enabled During data entry choose up to three items from the list of patient medications To learn how to edit this list see Reviewing the Medication List on page 33 Yes or no If yes this field is enabled During data entry choose up to three items from the list of patient clinical conditions To learn how to edit this list see Reviewing the History List on page 34 Yes or no If yes this field is enabled for entering blood pressure in standard format Yes or no If yes this field is ena
48. elch Allyn CP 200 Electrocardiograph Table 8 Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the CP 200 Electrocardiograph The CP 200 electrocardiograph is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or user of the CP 200 electrocardiograph can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the CP 200 electrocardiograph as recommended below according to the maximum output power of the communications equipment Separation Distance According to Frequency of Transmitter m Rated Max Output 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz Power of Transmitter W d 1 17 JP d 1 17 JP d 2 33 P 0 01 0 117 0 117 0 233 0 1 0 37 0 37 0 74 1 1 17 1 17 2 33 10 3 70 3 70 7 37 100 11 70 11 70 23 30 For transmitters rated at a maximum output power not listed above the recommended separation distan ce din meters m can be estimated using the equation applicable to the frequency of the transmitter where Pis the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer Note 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines may not apply in all situations Electromagnetic propagatio
49. er Optional on page 26 On or off Works just like a standard CAPS Lock key Directions for Use Reviewing the Device Information 1 Press the Menu key 2 Choose System Settings gt Device Info The following screen appears Figure 20 Device Info Screen Ml 9 17AM Oct 16 08 Device Info 1 About 2 Print Settings 3 Manage Settings 4 Enable Options 5 Upgrade Software 6 Service Info 0 Previous Menu Wil 3 Select the desired item Chapter 3 Reviewing the System Settings 31 Item Description About Displays the following information about the electrocardiograph e Serial number e modules configured e version numbers Print Settings Prints your ECG spirometry and system settings as well as medication amp history lists Manage Settings See Transferring a Configuration to Another Electrocardiograph on page 35 Enable Options Contact Technical Support For phone numbers see page ii Upgrade Software Contact Technical Support For phone numbers see page ii Service Info Accessible to service support only 32 Chapter 3 Reviewing the System Settings Welch Allyn CP 200 Electrocardiograph Reviewing the Connectivity Settings See also Configuring the Electrocardiograph for Wireless Communication on page 36 1 Press the Menu key 2 Choose System Settings gt Connectivity Settings The following screen appears Figure 21 Connectivity Settings Scree
50. es are needed for any saved test you can edit two types of data e patient data e interpretation statements 1 From the Auto ECG Post Print screen Figure 39 on page 59 press Edit Test The Edit Test Patient Data screen appears 2 Optional Edit the patient data 3 Press the desired softkey Softkey Effect Interp Saves any changes and displays the Edit Test Interpretation screen 1 Optional Edit the interpretation statements to be saved with the test 2 Press the desired softkey e Patient Data saves any changes and returns to the Edit Test Patient Data screen e Confirm saves any changes sets the test status to confirmed and returns to the Auto ECG Post Print screen e Cancel discards any changes and returns to the Auto ECG Post Print screen Done saves any changes and returns to the Auto ECG Post Print screen For details on interpretation see Automatic ECG interpretation on page 5 Cancel Discards any changes and returns to the Auto ECG Post Print screen Done Saves any changes and returns to the Auto ECG Post Print screen 62 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Recording a Stat Auto ECG A stat Auto ECG is an immediate printout in Auto Report 1 format Stat mode bypasses patient data entry as shown in Figure 36 on page 56 A temporary ID number is assigned to the patient to identify stat tests After printing you may enter the pat
51. es show the dominant waveforms for all 12 leads e 3x4 50 mm s 3R 3 rows x 4 columns 3 rhythm leads 50 mm s e 6x2 50 mm s 6R 6 rows x 2 columns 6 rhythm leads 50 mm s e No Print Average cycles page does not print Directions for Use Chapter 4 Reviewing the ECG Settings Reviewing the Interpretation and Copy Settings for Auto Reports 1 Press the Menu key 2 Choose ECG Settings gt Edit Auto Report 1 or 2 gt Interp Settings 3 The following screen appears Figure 27 Interpretation Settings Screen Ml 9 17AM Oct 16 08 Interp Settings 1 Print Interpretation 2 Copies 3 Copies With Interp 4 Reason Statements 5 Unconfirmed Report 6 Abnormal ECG 0 Previous Menu E Change any desired settings For a report example see Figure 25 on page 39 43 Setting Print Interpretation Copies Copies With Interp Reason Statements Unconfirmed Report Abnormal ECG Description On or off Determines whether interpretation is printed and saved with reports Number of copies to print automatically in addition to the original report 0 1 2 3 4 or 5 On or off Determines whether interpretation is printed on the automatic copies On or off Determines whether reasons criteria are printed with the interpretation statements On or off Determines whether the label Unconfirmed Report is printed on reports On or off Determines whether the label Abno
52. et type select Standard or Augmented For a description of the augmented pediatric lead set see page 4 If the Lead Status screen appears as shown here reattach any leads that are flashing Figure 34 Lead Status Screen HF 9 17AM Oct 16 08 Lead Status Check lead The term Artifact might also appear on this screen To eliminate artifact you might need to re prep the patient use fresh electrodes or minimize patient motion during the recording The most common ECG problems are poor electrode contact and loose leads When all leads have been connected for several seconds the following screen appears Figure 35 ECG Preview Screen HE 9 17AM Oct 16 08 ECG Preview HR 75 E LAC as AUTO OFF OFF 25mm s Baseline Muscle Leads Gain Filter Filter Speed Optional Use the softkeys as desired For details see Adjusting the ECG Waveforms on page 68 8 Go to the procedure for the type of ECG test you want to perform e Recording an Auto ECG on page 56 e Recording a Rhythm ECG on page 63 56 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Recording an Auto ECG An Auto ECG is a report typically showing a 10 second acquisition of 12 leads of ECG information combined with patient data interpretation and measurements matrix Two userdefined formats are available Auto Report 1 or Auto Report 2 To learn how to set up the Auto ECG report format
53. f option page 5 401161 1 Connectivity kit to the CardioPerfect workstation 100638 1 Wireless USB radio kit 102103 1 Bar code scanner kit 102014 1 Interpretation upgrade option 100623 1 Spirometry option 100400 1 Product information e Electrode placement wall poster 71300 0000 1 e P 200 12 Lead Resting Electrocardiograph Directions 708793 1 for Use e CP 200 product information multi language CD 401151 1 Directions for Use Chapter 1 Introduction 7 Controls Indicators and Connectors This section describes the controls indicators and connectors that are part of the electrocardiograph Figure 3 Top 0000 quis s b EE G2 C a3 X2 C2 ee Figure 8 on page 10 Keyboard See Figure 1 on page 9 AC power inlet Equipotential stud AC fuses Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Figure 5 Right Side Com port B USB SD memory card Spirometry port Reset 10101 slot AY button sp Figure 6 Front Com port A for patient cable G gt Figure 7 Left Side Paper tray latch Directions for Use Table 1 Keyboard A Chapter 1 Introduction Gasooseoooou 9 On Off Backspace Menu Help Navigation arrows Enter Space Control Shift Tab Green LED Function See Powering the Electrocardiograph on
54. filters disabled shows the leads with artifact so that you can remedy the problem The normal Auto ECG report with filters enabled might mask some of the artifact issues QTc Method Bazett or Hodges Computation method of correcting the waveform s QT interval based on the heart rate The corrected number expressed in milliseconds is called the OTc interval This setting affects only the OTc interval displayed in the ECG measurements portion of the ECG report Directions for Use Chapter 4 Reviewing the ECG Settings 47 Reviewing the Rhythm Report Settings 1 Press the Menu key 2 Choose ECG Settings gt Rhythm Report Settings The following screen appears Figure 30 Rhythm Report Settings Menu ML 9 17AM Oct 16 08 Rhythm Report Settings 1 Lead Arrangement 2 Default Rhythm Speed 3 Standard Lead Order 4 Augmented Lead Order 0 Previous Menu Viale gt 3 Change any desired settings Setting Description Lead Arrangement Default Rhythm Speed Standard Lead Order Augmented Lead Order Choose the number of leads you want to print at a time 3 6 or 12 For instructions on cycling through 3 lead or 6 lead groupings while printing a rhythm report see Step 2 on page 63 Choose the default rhythm speed 10 25 or 50 mm s Configure the order in which leads appear during rhythm printing when the standard lead set is in use Configure the order in which leads appear during rhyth
55. form This is not a sale of the software or any copy of the software all right title and ownership of the software remains with Welch Allyn or its vendors For information about any Welch Allyn product please call Welch Allyn Technical Support USA 1 800 535 6663 Australia 61 29 638 3000 1 315 685 4560 Canada 1 800 561 8797 China 86 216 327 9631 European Call Center 353 46 906 7790 France 4 331 6009 3366 Germany 49 747 792 7186 Japan 8133 219 0071 Latin America 1 305 669 9003 Netherlands 31 15 750 5000 Singapore 65 6419 8100 South Africa 27 11 777 7555 United Kingdom 44 207 365 6780 Sweden 46 85 853 6551 Reorder Number multi language CD 401151 Mat Number manual only 708793 Ver F Welch Allyn Welch Allyn LTD Ec neP 4341 State Street Road PO Box 220 Navan Business Park Skaneateles Falls NY 13153 0220 Dublin Road Navan County Meath Republic of Ireland Tel 353 46 90 67700 Fax 353 46 90 67755 www welchallyn com Printed in USA C 0297 WelchAllyn Contents Li STAVE OCUIGEIO Mss eere hols Ag ea ardent Siena ande qo EH Geman dss 1 About his Manual p00 ede tcs oes Be ee RO IPAE E 2 ProduGb OVEIVICOW 6 eur trae ra d acus qx aed S EN Sad du dre s 2 Intended USC us ied a beard been netten rd Mg et eds tll dede 2 Indications Tor Se Luo cer eo o Pee RR MOL EATER 3 Standard Features amp Benefits iunc be pen o dd es eee eed 3 OPTIONS ds Rott nt ae aret ad x disce A Ny aces a mI A AAN
56. ges and returns to the Test Directory Search screen Directions for Use Chapter 6 Performing Administrative Tasks 73 Softkey Effect Continued Previous Test Saves any changes and displays the previous test Appears only when previous tests are available in your search results Next Test Saves any changes and displays the next test Appears only when next tests are available in your search results Done Saves any changes and returns to the Test Directory Search screen 74 Chapter 6 Performing Administrative Tasks Welch Allyn CP 200 Electrocardiograph Managing the Scheduled Patients List The scheduled patients list identifies patients whose data has been entered into the electrocardiograph s memory for an ECG or spirometry test that day When performing Auto ECG or spirometry tests you may select patients from this list rather than manually entering their data at the time of the test To View or Edit the Scheduled Patients List 1 Press the Menu key 2 Choose Scheduled Patients If prompted to log in enter your user ID and password The scheduled patients list appears Figure 48 Scheduled Patients Screen for Editing RIEMEZY Oct 16 08 Scheduled Patients Patient ID Patient Name Today s scheduled patients Schedule Add Delete Delete ai Exit 3 Press the desired softkeys e Schedule Lets you download scheduled patients orders from an EMR system via
57. h 92 sending tests to 59 71 carts 5 6 16 caution symbol defined 14 CD product information ordering replacement 6 cleaning procedures 80 clinical conditions See history list Com ports locations 8 confidentiality 75 configuration transferring 35 configuration See ECG settings system settings configuring for wireless communication 36 confirming See interpretation of ECGs automatic confirming connectivity kit for CardioPerfect workstation 6 connectivity settings 32 36 contact information entering your 30 contact information for Welch Allyn ii contrast adjusting 91 Control key Ctrl 9 91 copies number to print 43 Customer Service ii 104 Index D database See CardioPerfect workstation scheduled patients list test directory saved tests data See patient data date and time 29 39 40 defibrillation precautions 17 18 22 demographics See patient data Device Administration menu tree 75 device configuration settings 29 device ID 29 39 40 Device Info screen 31 DHCP 32 36 digital sampling rate 95 dust cover ordering 6 E EAP type 36 ECG acquisition screen 58 ECG post print screen 59 ECG Preview screen 55 ECGs performing tests 51 68 settings 11 37 49 See also Auto ECGs Rhythm ECGs editing Auto Report ECG settings 46 history list 34 medication list 33 miscellaneous ECG settings 48 report formats 39 47 scheduled patient list 74 tests 59 61 7
58. hapter 7 Maintaining the Electrocardiograph Welch Allyn CP 200 Electrocardiograph 6 Unplug the two battery connectors See Figure 53 You may need to pull hard Use pliers gently if necessary Figure 53 Battery Connectors 7 Connect a new battery by matching connector sizes Do not force connectors to mismatch 8 Carefully tuck in all cables Place the battery into the battery compartment Fold the strap so that it will not stick out when you replace the battery door See Figure 54 Figure 54 Folding the Battery Strap Directions for Use Chapter 7 Maintaining the Electrocardiograph 85 Replace the battery door and screws Turn the electrocardiograph rightside up It turns on automatically and displays a prompt to enter date and time Enter the date and time The electrocardiograph is ready to use Discard the old battery appropriately e In the USA call 1 800 SAV LEAD for instructions on how to recycle it e International users contact your local authorities concerning recycling Replacing the Battery DC Fuse If the battery DC fuse requires replacing as described in Step 5 on page 83 follow these steps For the fuse value see Fuses on page 95 1 Remove and discard the fuse See Figure 55 You may need to pull hard Use pliers gently if necessary Connect a new fuse It goes in either way Go to Step 8 on page 84 F
59. harging a Fully Discharged Battery on page 82 Problem loading the following settings System lt ECG gt Using default settings Problem loading your settings at startup May indicate memory problems Contact Technical Support For phone numbers see page ii Shutdown was pressed while printing a Rhythm ECG To shut down press i To cancel the shutdown press X Temperature Error Printer head temp is too high Allow to cool then try again Test has not been saved Continue shutdown was pressed after printing an Auto ECG To shut down without saving the test press 4 To cancel the shutdown press X Unable to communicate with workstation e Configuration not correct e Cable and or wireless radio not properly connected e Verify communication settings on the PC e Check cable and or wireless radio connections Directions for Use Chapter 8 Troubleshooting 93 Limited Warranty Welch Allyn Inc warrants that the Cardiopulmonary line of electrocardiographs including the CP 100 and CP 200 models the Products meet the labeled specifications of the Products and will be free from defects in materials and workmanship that occur within 3 years after the date of purchase except that accessories used with the Products are warranted for 90 days after the date of purchase Such accessories include lead wires cabling electrodes
60. how to choose which fields display and print see Reviewing the Patient Data Fields Available for Auto Reports on page 44 e f you are using a bar code scanner scan the patient s bar code The patient ID appears on the screen e f you want to enter the data fill in the fields e f you want to recall saved patient data go to Recalling Saved Patient Data on page 64 When finished press the desired softkey Clear deletes the entered data and returns to the Patient ID field Done accepts the entered data and goes to the Auto ECG Acquisition screen See Figure 38 on page 58 58 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Figure 38 Auto ECG Acquisition Screen Doe Jane EE 9 17AM Oct 16 08 Auto ECG Acquisition HR 75 D dade dee d FEN PP PONES MEI Y aR opn J AUTO ON ON Softkeys for adjusting the Baseline vee Prints waveforms or printing Leads Gain Filter Filter ECG 4 Verify ECG quality on the screen WARNING Do not perform ST segment analysis on the ECG screen display since these ECG representations are scaled Make manual measurements of ECG intervals and magnitudes on printed ECG reports only 5 Optional Adjust the waveforms See Adjusting the ECG Waveforms on page 68 6 Press Print ECG 7 If prompted choose whether to wait for the electrocardiograph to acquire 10 seconds of filtered processed data before printing If you override the wait t
61. ied by Directive 2002 96 EC of the European Parliament and the Council of the European Union on Waste Electronic and Electrical mmm Equipment WEEE If this product is contaminated this directive does not apply For more specific disposal information see www welchallyn com weee or contact Welch Allyn Customer Service at 44 207 365 6780 88 Chapter 7 Maintaining the Electrocardiograph Welch Allyn CP 200 Electrocardiograph 89 Troubleshooting Problem Solving Suggestions 00 cece eee eens 90 Limited Warranty i asee aiie ee ek RR Red em xxn ace Be ar aoai ae 93 Samice aS Jee ee 94 90 Chapter 8 Troubleshooting Problem Solving Suggestions This section includes several tables e Lead quality problems Table 2 on page 90 e System failure problems Table 3 on page 91 e System messages Table 4 on page 92 Welch Allyn CP 200 Electrocardiograph If you try these suggestions and still have problems contact Technical Support For phone numbers see page ii Table 2 Lead Quality Problems Condition Causes Actions A red dot is flashing on the Lead Status screen OR Lead off information is displayed on the screen OR One or more leads prints as a square wave E el Hed E Electrode contact may be poor e A lead may be loose Note Square waves may indicate that the electrocardiograph is inoperative but they are more likely to indicate loose leads Reattach the lead
62. ient data by editing the test In stat mode Auto Send and Auto Save are always disabled even if they are enabled in the ECG settings If you want to send or save a stat Auto ECG you may do so manually after you print To Record a Stat Auto ECG 1 Press and hold the Auto ECG key Eu The electrocardiograph begins acquiring ECG data After it has acquired 10 seconds of quality data it prints a report 2 Goto Step 7 on page 58 Continue the procedure as if you have just pressed the Print ECG softkey Directions for Use Chapter 5 Performing ECG Tests 63 Recording a Rhythm ECG A Rhythm ECG is a continuous real time printout of a rhythm strip with a user defined lead arrangement For details on reviewing or changing the lead arrangement in your reports see Reviewing the Rhythm Report Settings on page 47 Rhythm ECGs are printouts only They cannot be saved or sent electronically Figure 40 Rhythm ECG Testing Process Diagram I Printing begins e e or To Record a Rhythm ECG 1 Press the Rhythm ECG key ig Printing begins The screen displays 3 leads at a time from the leads currently printing The printout includes either 3 6 or 12 leads at a time To find out how to change this number see Reviewing the Rhythm Report Settings on page 47 Figure 41 Rhythm ECG Screen Rhythm ECG HR 75 c dee dee UR PRU eee EROR aVR h Ny 10mm mV ON ON 25 mm s Softkeys for a
63. iew and confirm all tests before patients are treated If changes are needed for any saved test you can edit two types of information e patient data e interpretation statements For an example of each type of information as it appears on a report see Figure 25 on page 39 1 Select the desired test s from the test directory For instructions see To Print Send or Delete Saved Tests on page 71 Step 1 through Step 6 2 Press Edit The Edit Test Patient Data screen appears If you have selected one test the patient data displays for that test If you have selected multiple tests the patient data displays for the first test 3 Optional Edit the patient data 4 Press the desired softkey Softkey Effect Interp Saves any changes and displays the Edit Test Interpretation screen for the same test 1 Optional Edit the interpretation 2 Press the desired softkeys Patient Data saves any changes and returns to the Edit Test Patient Data screen for the same test Confirm saves any changes sets the test status to confirmed and displays patient data for the next test if any Previous Test saves any changes and displays patient data for the previous test Appears only when previous tests are available in your search results Next Test saves any changes and displays patient data for the next test Appears only when next tests are available in your search results Done saves any chan
64. igure 17 Closing the Paper Door Tips for handling thermal paper Tear bar e Store in a cool dry dark place Avoid exposure to bright light or UV sources e Avoid exposure to solvents adhesives or cleaning fluids e Do not store with vinyls plastics or shrink wraps 24 Chapter 2 Setting Up the Electrocardiograph Welch Allyn CP 200 Electrocardiograph Powering the Electrocardiograph The electrocardiograph can run on AC or battery power A WARNING To ensure that electrical safety is maintained when using AC power the device must be plugged into a hospital grade outlet WARNING Where the integrity of external protective earth conductor arrangement is in doubt use battery power Caution Medical electrical equipment needs special precautions regarding EMC A and must be installed and used according to the information provided in EMC Guidance and Manufacturer s Declarations on page 97 To Connect to AC Power Plug one end of the power cord into the electrocardiograph s AC power inlet Plug the other end into an AC outlet The green LED on the keyboard lights up indicating that power is connected See Figure 18 To Keep the Battery Charged Leave the electrocardiograph connected to AC power whenever possible Battery charge status is indicated on the screen by an icon Ill Whenever the battery is charging and is not yet fully charged this icon appears LF For maximum battery performance as often as possible
65. igure 55 Battery Fuse Removed uy EN a 86 Chapter 7 Maintaining the Electrocardiograph Welch Allyn CP 200 Electrocardiograph Replacing the AC Fuses If the green LED on the keyboard does not light up when the electrocardiograph is connected to AC power you may need to replace one or both of the AC fuses as follows For the fuse value see Fuses on page 95 1 Unplug the electrocardiograph from AC power if connected A WARNING Failure to unplug could result in electrocution Use needle nosed pliers to remove the fuse case See Figure 56 Inspect the fuses If either fuse is dark or has a broken wire replace the fuse See Figure 57 Insert the fuse case Line it up with the opening it goes in only one way Figure 56 Removing AC Fuse Case Figure 57 AC Fuses Removed Directions for Use Chapter 7 Maintaining the Electrocardiograph 87 Storing the Equipment When storing the electrocardiograph cords and accessories observe the environmental storage conditions See Specifications on page 95 Discarding the Equipment Discard the old battery appropriately e n the USA call 1 800 SAV LEAD for instructions on recycling it a e International users contact your local authorities concerning recycling Discard the electrocardiograph cords and accessories according to local laws Do not dispose of this product as unsorted municipal waste Prepare this product for reuse or separate collection as specif
66. ime AC filter Frequency range Gain Paper speed Calibration pulse See Reviewing the Patient Data Fields Available for Auto Reports on page 44 Standard See Reviewing the Interpretation and Copy Settings for Auto Reports on page 43 See Reviewing the Interpretation and Copy Settings for Auto Reports on page 43 See Reviewing the Format Settings for Auto Reports on page 41 See Reviewing the Format Settings for Auto Reports on page 41 See also Reviewing the Device Information on page 31 See Device ID on page 29 See Practice ID on page 29 See Set Date Time on page 29 See Mains Filter on page 48 Lower limit baseline filter on 0 5 off 0 3 Upper limit muscle filter on 35 off 150 See Baseline Filter on page 68 and Muscle Filter on page 68 See Gain on page 68 See Speed on page 68 Amplitude reference represents the current height of a one millivolt signal Is adjusted for the selected gain 5 mm mV 0 5 x 10 mm mV 2 1 x 20 mm mV 22 x Directions for Use Chapter 4 Reviewing the ECG Settings 41 Reviewing the Format Settings for Auto Reports 1 2 3 Press the Menu key Choose ECG Settings gt Edit Auto Report 1 or 2 gt Format The following screen appears Figure 26 Auto Report Format Screen HE 9 17AM Oct 16 08 Format 1 Lead Arrangement 2 Rhythm Lead 1 3 Rhythm Lead 2 4 Rhythm Lead
67. ime and print the available data immediately be aware that the printed data will be insufficient in quality or quantity or both The report prints Note Ifa red stripe appears along the edge of your report replace the paper See Loading the Thermal Chart Paper on page 23 After printing the Auto ECG Post Print screen appears Figure 39 on page 59 Directions for Use Chapter 5 Performing ECG Tests 59 Figure 39 Auto ECG Post Print Screen Doe Jane HF 9 17AM Oct 16 08 Auto ECG Post Print HR 75 cde se Dee EDEN PUES DENM VEMM aR o Aprn Print Edit Copy Test Manual Repeat Exit Softkeys for choosing post printing options Save Test 8 Press the desired softkey Softkey Effect Print Copy Prints a copy of the test To learn how to print multiple copies of all tests automatically see Reviewing the Interpretation and Copy Settings for Auto Reports on page 43 Edit Test Brings up the Edit Test Patient Data screen From here you can edit or confirm the patient data and interpretation statements See To Edit or Confirm a Test Directly After Printing on page 61 Manual Save Saves the test to the electrocardiograph s test directory See Managing Saved Tests In the Test Directory on page 70 This Manual Save softkey appears only when Auto Save is disabled For more on Auto Save see Reviewing the Miscellaneous ECG Settings on page 48 Manual Send May
68. in enter an administrator level user ID and password Choose Audit Trail Follow the prompts to enable or disable the audit trail To Print an Audit Trail 1 2 Press the Menu key Choose System Settings gt Device Administration If prompted to log in enter an administrator level user ID and password Choose Print Audit Trail Follow the prompts After you verify that printing was successful the audit information is deleted I Maintaining the Electrocardiograph Inspecting the Equipment socle Rm oh Rost neem nom oh mA oe 80 Cleaning the Equipment 0000 nh 80 Testing the Equipment s some caw cacak ica kg inc AE Ros max Sox de d 81 Recharging a Fully Discharged Battery 00 eee eee eee 82 Replacing the Battery ccc ccc ccees ront a She Hae ean eee aden eae dee Sa oe 83 Replacing the Battery DC Fuse 0 c ce eens 85 Replacing the AC FUSES oi kes cee nhs ee den Re ee ed RE E NA 86 Storing the Equipment scs siecle pr eee hae eee eee ee ee 87 Discarding the Equipment sss ke RR ke eR 87 79 80 Chapter 7 Maintaining the Electrocardiograph Welch Allyn CP 200 Electrocardiograph Inspecting the Equipment WARNING To ensure patient safety and proper operation perform the following inspections daily Verify that patient leads are fully inserted For details see Connecting the Patient Cable on page 22 Check for cracked or broken patient cable patient leads power co
69. ist appears 4 Press the desired softkeys Softkey Effect Add Lets you add new users For each user provide the following information User ID 1 to 10 characters Password 5 to 10 characters displayed as asterisks for security e Password Expiration Never 180 days User s Name User Level User Administrator e Active Yes user cannot be replaced No user can be replaced when list is full Edit Lets you edit the information for the highlighted user Exit Returns to the Device Administration screen 78 Chapter 6 Performing Administrative Tasks Welch Allyn CP 200 Electrocardiograph Working With the Audit Trail An audit trail a collection of information about user activity may be helpful or even required for record keeping It tracks who did what when including these types of activity e Accessing the test directory e Searching the scheduled patient list e Editing patient data e Accessing administrative functions When the audit trail is enabled the electrocardiograph collects this type of information in a file in its memory When the allotted memory begins to get full you receive prompts to print the audit trail You must print the audit trail to delete purge this information and make room for new information to be collected To Enable or Disable the Audit Trail 1 2 3 4 Press the Menu key Choose System Settings gt Device Administration If prompted to log
70. le Filter on page 68 Off 50 Hz 60 Hz Use of this filter is recommended For suggestions on eliminating AC interference see page 91 Directions for Use Chapter 4 Reviewing the ECG Settings 49 Turning the Augmented Pediatric Lead Set On and Off For a description of the augmented pediatric lead set see page 4 1 Press the Menu key 2 Choose ECG Settings gt Augmented Lead Set gt On or Off When this option is turned on the system will prompt you to select the lead set standard or augmented each time you perform a test on a new patient 50 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph 4 Performing ECG Tests Connecting the Leads to the Patient 2 000s eee eee 52 Recording an Auto ECG iui dec ls e eue rm nce ch Share era a 56 Recording a Rhythm EU assa edn moscas hmi ninii tarien RR id 63 Recalling Saved Patient Data llis ens 64 Adjusting the ECG Waveforms llle 68 52 Chapter 5 Performing ECG Tests Welch Allyn CP 200 Electrocardiograph Connecting the Leads to the Patient 1 Help the patient get comfortable Patient preparation is important for a successful ECG a Describe the procedure If desired press the Help key i and print the page entitled What Is An ECG for the patient to read b Help the patient get warm and relaxed Excessive patient movement could interfere with the operation of the electrocardiograph c Putthe
71. m printing when the augmented pediatric lead set is in use For electrode placement locations see Figure 33 on page 54 48 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph Reviewing the Miscellaneous ECG Settings 1 Press the Menu key 2 Choose ECG Settings gt Miscellaneous The following screen appears Figure 31 Miscellaneous Screen for ECG Settings ME 9 17AM Oct 16 08 Miscellaneous 1 Lead Configuration 2 Electrode Labels 3 Default Gain Setting 4 Default Baseline Filter 5 Default Muscle Filter 6 Mains Filter 0 Previous Menu These three default settings gain baseline filter and muscle filter determine the values used every time you begin a new test even if these values have been temporarily changed during ECG testing vitii 3 Change any desired settings Setting Description Lead Configuration Electrode Labels Default Gain Setting Default Baseline Filter Default Muscle Filter Mains Filter Standard I II Ill aVR aVL aVF V1 V2 V3 V4 V5 V6 or Cabrera aVL aVR II aVF Ill V1 V2 V3 V4 V5 V6 AHA or IEC 5 mm mV 10 mm mV 20 mm mV or Auto AUTO is available for Auto ECGs only not rhythm ECGs AUTO is usually the best setting but some waveforms may be easier to read on other settings For details see Gain on page 68 On or off For details see Baseline Filter on page 68 On or off For details see Musc
72. mining a patient s diagnosis WARNING To avoid serious injury or death take these precautions during patient defibrillation e Avoid contact with the electrocardiograph patient cable and patient e Verify that the patient leads are properly connected See Connecting the Patient Cable on page 22 e Place defibrillator paddles properly in relation to electrodes e After defibrillation pull each patient lead out of the patient cable and inspect the tips for charring black carbon marks If there is any charring the patient cable and individual leads must be replaced If there is no charring fully reinsert the leads into the patient cable Charring can occur only if a lead is not fully inserted into the patient cable before defibrillation WARNING To prevent the spread of infection take these precautions e Dispose of single use components for example electrodes after using them once e Regularly clean and disinfect all components that come in contact with patients See Cleaning the Equipment on page 80 e Avoid ECG testing for patients with open infectious sores WARNING Avoid positioning any leads or cables so that they could easily trip someone or become wrapped around a patient s neck WARNING Satisfactory maintenance procedures must be implemented or equipment failure and health hazards may result WARNING Only qualified service personnel should attempt to repair the electrocardiograph In case of a malfuncti
73. n Causes Actions AC interference even peaked regular voltage superimposed on the waveforms May resemble or coincide with muscle tremor interference e Electrodes that are dirty corroded loose or positioned on a bony area e Insufficient or dried electrode gel e Patient or technician touching an electrode during recording e Patient touching any metal parts of an exam table or bed e Broken lead wire patient cable or power cord Electrical devices in the immediate area lighting concealed wiring in walls or floors e Improperly grounded electrical outlet e Incorrect AC filter frequency setting or AC filter is turned off Check all electrode contacts and lead wires Verify that the patient is not touching any metal Verify that the AC power cable is not touching the patient lead cable e Verify that the proper AC filter is selected See Mains Filter on page 48 interference persists unplug the electrocardiograph from AC power and run it on the battery If this solves the problem you ll know that the noise was introduced through the power line e If interference still persists the noise may be caused by other equipment in the room or by poorly grounded power lines Try moving to another room e Table 3 System Failure Problems Condition Causes Actions Won t turn on when plugged into AC power e Faulty AC power connection e Blown AC fuses e No AC power e
74. n MF 9 17AM Oct 16 08 Connectivity Settings 1 Connectivity Mode 2 Network Settings 3 Wireless Settings 4 Auto Send ECG 5 Auto Send Spirometry 6 Auto Save ECG 7 View Available Networks 8 Test Connectivity Settings 0 Previous Menu Witla 3 Select the desired item Note that Auto Send and Auto Save cannot both be on Item Description Connectivity Mode Network Settings Wireless Settings Auto Send ECG or Spirometry Auto Save ECG View Available Networks Test Connectivity Settings Wired USB wireless or none DHCP IP address subnet mask gateway SSID authentication mode encryption authentication type network key 802 11 authentication Workstation memory card or off Automatically sends all ECGs except stat ECGs to the option of your choice Systems with the spirometry option have separate Auto Send settings for ECG mode and spirometry mode If set to memory card an SD memory card or removable USB storage device must be in place during testing If set to workstation either wireless communications must be configured or a USB cable must connect a CardioPerfect workstation to the electrocardiograph s Com port B 10101 On or off Applies to ECG mode only spirometry tests are always automatically saved When on the electrocardiograph automatically saves all ECGs except stat ECGs to its test directory When off every time you print an ECG test you are asked if you wan
75. n about a scheduled test including 1 the patient s demographics and 2 a description of the test The CP 200 electrocardiograph can download orders from an EMR via the Welch Allyn HL7 interface Typically at the start of the day a clinician downloads a list of orders for a given electrocardiograph and works through the list as patients arrive The clinician can also connect to the network and obtain an updated list of orders from which to select the current patient patient list See scheduled patients list PEDMEANS See MEANS Power Save A userselectable feature that automatically turns the electrocardiograph off after several idle minutes Rhythm ECG A continuous real time printout of ECG data See also Auto ECG scheduled patients list A list of patients whose data has been entered into the electrocardiograph s memory for an ECG or spirometry test that day When performing Auto ECG or spirometry tests you may select patients from this list rather than manually entering their data at the time of the test test directory A location in the electrocardiograph s memory that holds up to 50 ECG and 50 spirometry tests When performing Auto ECG or spirometry tests you may select patients from this directory rather than manually entering their data at the time of the test workstation See CardioPerfect workstation Index 103 3x4 6x2 12x1 etc See leads arrangements formats in Auto Reports 3x4 50 mm s 3R 6x2 50 mm
76. n is affected by absorption and reflection from structures objects and people 101 Glossary AHA An abbreviation for American Heart Association The AHA electrode labeling scheme is most commonly used in the United States audit trail A collection of information about user activity The audit trail which can be enabled or disabled may be helpful or even required for record keeping Auto ECG A report typically showing a 10 second acquisition of 12 leads of ECG information combined with patient data interpretation and measurements matrix Two userdefined formats are available Auto Report 1 and Auto Report 2 See also Rhythm ECG Auto Save A feature that automatically saves all Auto ECGs except stat ECGs to the test directory Auto Send A feature that automatically sends all Auto ECGs except stat ECGs to the option of your choice SD memory card removable USB storage device or CardioPerfect workstation average cycles Dominant waveforms for all 12 leads Printed on a separate page if enabled CardioPerfect workstation A PC using Welch Allyn CardioPerfect software Stores ECG and spirometry test data Can communicate with other electronic patient information systems such as billing and medical records confirmed unconfirmed Status of an Auto ECG report s interpretation Indicates whether the report has been reviewed and accepted by a qualified physician electrocardiogram ECG A record of the electrical current
77. ng with IEC 60601 1 or other IEC standards for example IEC 60950 as appropriate to the device Connecting additional devices to the electrocardiograph might increase chassis or patient leakage currents To maintain operator and patient safety consider the requirements of IEC 60601 1 1 Measure the leakage currents to confirm that no electric shock hazard exists In the case of a USB printer the printer non medical electrical equipment shall be situated outside the patient environment reference IEC 60601 1 1 The printer used should be approved to the appropriate safety standard for non medical electrical equipment IEC 60950 or its national variants and use of an isolation transformer is recommended If there is a requirement for the printer to be situated within the patient environment it is the responsibility of the user to ensure that the system provides a level of safety in compliance with IEC 60601 1 and 60601 1 1 WARNING The electrocardiograph has not been designed for use with high frequency HF surgical equipment and does not protect against hazards to the patient Directions for Use A Chapter 1 Introduction 17 Warnings Related to Using the Electrocardiograph WARNING This device captures and presents data reflecting a patient s physiological condition When reviewed by a trained physician or clinician this data can be useful in determining a diagnosis However the data should not be used as a sole means for deter
78. nner A bar code scanner is available for easy entry of patient ID numbers This option includes a stand for mounting the bar code scanner to the cart Wireless connectivity kit This option provides a radio and PC software to enable wireless communication between your information network and the electrocardiograph You can use the wireless link to send tests to the Welch Allyn CardioPerfect workstation retrieve patient demographic information or process orders from your EMR system via a Welch Allyn HL7 interface 5 6 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Accessories To order accessories call Welch Allyn For phone numbers see page ii Item Customer Order Number Quantity Resting tab electrodes 45008 0000 1000 Resting tab electrode adaptors 58581 0000 10 Thermal chart paper 1 case 5 pads 200 sheets each 94018 0000 1 case Welch cup RE ELEC CUP 1 Limb lead clamps IEC RE ELEC CLP 4 Limb lead clamps AHA 401432 4 Patient cable Figure 12 on page 13 e AHA 400293 1 e IEC 400294 1 e EC vacuum adapter 100920 1 e Vacuum system VAC DT100 CP Lead wires 10 wires per set e AHA banana 401129 1 set e EC banana 401122 1 set e AHA pinch 401123 1 set e IEC pinch 401124 1 set Battery Figure 51 on page 83 100660 1 Dust cover 701586 1 Carts e Utility cart 08265 0000 1 e Office cart Figure 1 on page 5 401393 1 Hospital cart Figure 2 on page 5 401394 1 e Cable arm amp shel
79. on call Technical Support and precisely describe the problem For phone numbers see page ii 18 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph General Cautions The following caution statements apply to electrocardiograph use in general Caution statements that apply specifically to particular procedures such as connecting the patient cable or performing an ECG test appear in the corresponding sections of the manual Caution statements indicate conditions or practices that could damage the equipment or other property A Caution When removing the electrocardiograph from storage allow it to thermally stabilize to surrounding environmental conditions before using it Caution To prevent possible damage to the keypad do not use sharp or hard objects to press keys Only use fingertips Caution Do not expose the patient cable to strong ultra violet radiation Caution Do not pull or stretch the patient cable Doing so could result in mechanical or electrical failures Form the patient cable into a loose loop before storing Caution Avoid positioning the patient cable where it might get pinched or stepped on If the cable s impedance is altered measurements might no longer be accurate and repair might be necessary Caution Using the equipotential terminal for anything but grounding purposes may contribute to damage of the device Caution Use only parts and accessories supplied with the device and available through
80. ontinuous ECGs per charge 12 hour recharging 0 5 Hz high performance baseline filter 35 Hz muscle tremor filter AC interference filter 50 Hz or 60 Hz ANSI AAMI EC11 UL60601 1 CAN CSA C22 2 No 601 1 IEC EN 60601 1 CAN CSA C22 2 No 601 1 1 IEC EN 60601 1 1 CAN CSA C22 2 No 601 1 2 IEC EN 60601 1 2 CAN CSA C22 2 No 601 1 4 IEC EN 60601 1 4 CAN CSA C22 2 No 601 2 25 IEC EN 60601 2 25 CAN CSA C22 2 No 601 2 51 IEC EN 60601 2 51 Com port for USB cables or removable USB storage devices gt 64 MB lt 2 GB SD memory card slot for use with cards gt 64 MB 2 GB Supported through the Welch Allyn CardioPerfect workstation software Rigorously tested for conductivity adhesion and hypoallergenic qualities and exceed all AAMI standards Meet or exceed IEC 60601 410 C to 40 C 50 F to 4104 F 15 9596 noncondensing 700 1060 hPa 20 C to 49 C 4 F to 4120 F 15 9596 noncondensing 30 7096 for printing 500 1060 hPa Class internally powered Type BF IPXO Continuous Per AAMI EC11 1991 R 2001 Diagnostic Electrocardiographic Devices Section 3 1 2 1 Disclosure of cautionary information performance characteristics paragraph c Accuracy of input signal reproduction the manufacturer shall disclose the methods used to establish overall system error and frequency response Welch Allyn has used methods A amp D as prescribed in section 3 2 7 2 and 4 2 7 2 of this same standa
81. or up to 50 ECG and 50 spirometry records full size user programmable reports and the ability to operate on either battery or AC power For centralized ECG data storage the CP 200 electrocardiograph can connect to a Welch Allyn CardioPerfect workstation which in turn can connect with other electronic patient information systems such as billing and medical records For details see the following sections e Standard Features amp Benefits on page 3 e Options on page 5 e Specifications on page 95 Intended Use The Welch Allyn electrocardiography and spirometry products subject devices are intended for use by trained operators in health facilities The subject devices provide the following diagnostic functions e Acquiring viewing storing and printing ECG waveforms using ECG front end modules patient cables and associated accessories that provide signal acquisition for up to twelve 12 leads of patient ECG waveforms through surface electrodes adhered to the body e Using optional algorithms to generate measurements data presentations graphical presentations and interpretative statements on an advisory basis These are presented for review and interpretation by the clinician based upon knowledge of the patient the result of physical examination the ECG tracings and other clinical findings e Using the optional spirometry module and associated accessories to acquire view store and print measures and wavef
82. ormation on page 6 e Contact Welch Allyn For phone numbers see page ii 20 Chapter 1 Introduction Welch Allyn CP 200 Electrocardiograph Setting Up the Electrocardiograph Inspecting the Electrocardiograph 0e eee eee eee 22 Connecting the Patient Cable llle 22 Loading the Thermal Chart Paper 0002 eee eee eee 23 Powering the Electrocardiograph 000 0s eee eee eee eee 24 Verifying Proper Operation ccc cece eee eens 25 Connecting an External USB Printer Optional 0c cee eee 26 21 22 Chapter 2 Setting Up the Electrocardiograph Welch Allyn CP 200 Electrocardiograph Inspecting the Electrocardiograph 1 Look for obvious signs of shipping damage If you find any damage contact Technical Support For phone numbers see page ii Verify that you have received all appropriate options and accessories See Options on page 5 and Accessories on page 6 Connecting the Patient Cable A WARNING Conductive parts of the patient cable electrodes and associated 1 connections of defibrillation proof Type CF applied parts including the neutral conductor of the patient cable and electrode should not come into contact with other conductive parts including earth ground WARNING To avoid injury to the patient or damage to the device never plug patient leads into any other device or wall outlet Insert all leads into their proper positions as labeled on
83. orms of pulmonary function including but not limited to maximal volume and flow of air that can be moved in and out of the patient s lungs These measures are used in the diagnosis and monitoring of lung diseases and interventions for the treatment of certain lung diseases The spirometer should only be used with patients able to understand the instructions for performing the test Directions for Use Chapter 1 Introduction 3 Indications for Use The electrocardiograph is one of the tools that clinicians use to evaluate diagnose and monitor patient cardiac function The 12 lead ECG interpretive algorithm provides a computergenerated analysis of potential patient cardiac abnormalities which must be confirmed by a physician with other relevant clinical information The optional spirometry module is indicated for use in clinical situations to assess a patient s pulmonary health status and evaluate symptoms signs or abnormal laboratory test results Standard Features amp Benefits Full alphanumeric keypad Enter or search for patient information quickly and easily Color LCD display View and adjust the ECG waveforms prior to printing to save time and paper With spirometry option also view patients spirometry efforts and results Storage for up to 50 ECG and 50 spirometry records Review edit print or save recent records Unlimited storage on removable media Use SD memory cards or removable USB storage devices to save
84. patient in a reclining position with the head slightly higher than the heart and legs WARNING ECG electrodes could cause skin irritation Examine the skin for signs of irritation or inflammation Prepare electrode locations See Figure 32 on page 53 or Figure 33 on page 54 a Shave if necessary b Clean with alcohol or acetone c Allow to dry Attach the electrodes and lead wires securely e For reusable electrodes Straps must neither slide nor be so tight as to cause discomfort The electrode paste gel or creme must cover an area the size of the electrode but no larger especially on the chest e For disposable tab electrodes Place the electrode tab between the jaws of the electrode adapter keeping the tab flat Gently tug on the adapter to ensure that it is properly placed on the electrode Each time you remove and reattach an electrode the conductive gel becomes weaker and less effective Directions for Use Chapter 5 Performing ECG Tests 53 Figure 32 Electrode Placement Locations Adult and Standard Pediatric G H Electrodes AHA IEC Locations A V1 C1 Fourth intercostal space at right sternal border red red B V2 C2 Fourth intercostal space at left sternal border yellow yellow C V3 C3 Midway between V2 and V4 green green D V4 C4 Fifth intercostal space at left of midclavicular line blue brown E V5 C5 Anterior axillary line at same horizontal level as V4 orange black F V6 C6
85. rd communications cables display and enclosure Check for bent or missing pins on all cables Check all cable and cord connections reseat if any connectors are loose Cleaning the Equipment A WARNING To prevent the spread of infection the electrocardiograph and patient cable must be kept clean especially the components that come in contact with patients A Caution Do not let soap or water come into contact with the electrocardiograph s internal printer connectors or jacks Do not attempt to clean the electrocardiograph or the patient cable by submersing them in liquid autoclaving or steam cleaning Do not pour alcohol directly on the equipment or soak any components in alcohol If alcohol or liquids spill into the electrocardiograph while cleaning arrange to have it checked before using it again For Welch Allyn phone numbers see page ii Monthly or more often if needed follow these cleaning instructions 1 2 Disconnect the power plug from the AC outlet Wipe the exterior of the patient cable and electrocardiograph and with a damp cloth using mild detergent diluted in water Use 70 isopropyl alcohol to disinfect patient cable lead wires and equipment Dry all components with a clean soft cloth or paper towel Wait at least 10 minutes to allow all traces of alcohol to evaporate before turning the electrocardiograph back on Directions for Use Chapter 7 Maintaining the Electrocardiograph 81 Testing
86. rd to verify overall system error and frequency response Because of the sampling characteristics and the asynchronism between sample rate and signal rate digital ECG systems such as the CP 100 and CP 200 may produce a noticeable modulating effect from one cycle to the next particularly in pediatric recordings This phenomenon is not physiologic Specifications are subject to change without notice 97 EMC Guidance and Manufacturer s Declarations Table 5 Electromagnetic Emissions The CP 200 electrocardiograph is intended for use in the electromagnetic environment specified below The customer or user of the CP 200 electrocardiograph should assure that it is used in such an environment Emissions Test Compliance Electromagnetic Environment Guidance RF emissions Group 1 The CP 200 electrocardiograph uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby CISPR 11 electronic equipment RF emissions Class A The CP 200 electrocardiograph is suitable for use in all establishments other than domestic and those directly connected to the public low voltage power supply network CISPR 11 that supplies buildings used for domestic purposes Harmonic emissions Class A IEC 61000 3 2 Voltage fluctuations Complies flicker emissions IEC 61000 3 3 98 Appendix B EMC Guidance and Manufacturer s Declarations Table 6 Electromagneti
87. rmal ECG is printed on reports Available only for systems using automatic interpretation 44 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph Reviewing the Patient Data Fields Available for Auto Reports You can determine which fields appear during patient data entry for Auto ECGs Note Spirometry tests use a separate set of data entry fields as described in the spirometry manual To Choose the Fields 1 Press the Menu key 2 Choose ECG Settings gt Edit Auto Report 1 or 2 gt Patient Data The following screen appears Figure 28 Patient Data Screen for ECGs HL 9 17AM Oct 16 08 Patient Data 1 First Name 5 d The Patient ID and Last Name fields always 4 Weight appear on the Enter New Patient screen as 5 Height shown in Figure 37 on page 57 Since these two 6 Gender fields cannot be disabled they do not appear 7 Race on this user selectable list 8 Medication 9 History A Blood Pressure lia zia a los tul ine 3 Change any desired settings Disabled items set to off or no neither display nor print Field Description First Name Yes or no If yes this field is enabled Middle Initial Yes or no If yes this field is enabled Age Birth Date Birth Date age or off Determines whether and how this data is labeled and entered If you ll be testing patients from 1 day through 17 years old select Birth Date for most accurate results If age is select
88. s 6R See average cycles 5 mm mvV 10 mm mV etc See gain settings 50 or 60 Hz filter See AC filter 802 11 authentication 32 802 1X auth 36 A Abnormal ECG label 43 About screen device information 31 accessories 6 18 93 AC filter 39 40 48 91 AC fuses replacing 86 AC interference 90 91 AC power See powering the electrocardiograph acquisition screen 58 administrative tasks 69 78 AHA electrode labels V1 V2 V3 etc 48 53 54 arrow keys using 12 artifact report 46 audio beeper 29 audit trail 75 78 augmented lead set 4 49 54 55 authentication 36 authentication wireless settings 32 authorized user list 75 76 Auto ECG Acquisition screen 58 Auto ECG Post Print screen 59 Auto ECGs recording 56 62 report settings 39 45 saved in test directory 70 73 automatic interpretation See interpretation of ECGs automatic shutdown See Power Save Auto Report 2 enabling 46 Auto Save 32 62 Auto Send 62 Auto Send setting 32 average cycles 42 95 B baseline centering 46 baseline filter default choosing on or off 48 enabling and disabling 68 battery maintenance 24 82 85 ordering 6 specifications 96 Bazett QTc method 46 beeper 29 buttons See function keys keyboard softkeys C C1 C2 C3 etc See IEC electrode labels Cabrera lead grouping scheme 48 95 CAPS Lock 30 CardioPerfect workstation about 2 3 connectivity kit 6 problems communicating wit
89. s W according to the transmitter manufacturer and d is the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol a Note 1 At 80 MHz and 800 MHz the higher frequency range app ies Note 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the CP 200 electrocardiograph is used exceeds the applicable RF compliance level above the electrocardiograph should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reorienting or relocating the electrocardiograph b Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m 100 AppendixB EMC Guidance and Manufacturer s Declarations W
90. s O on a batch of tests Unsent Tests o 2 All Tests ag Date From MM DD YYYY aari Date To 3 E3 E 3 MM DD YYYY Use these criteria partial or complete to find Patient ID and perform actions on a single test Last Name Print E Clear Search Directory Optional Press Print Directory to print the contents of the test directory Select or fill in the search criteria as explained in Figure 47 To clear all entries press Clear Press Search If any saved tests match your criteria the Search Results screen appears Select the desired tests e To select a continguous group of tests press and hold the Shift key while pressing an arrow key e To select an individual test press an arrow key e To select all tests press Ctrl A Press the desired softkey e Back returns to the search screen so you can create a new search e Delete deletes the selected test s e Print prints the selected test s e Send sends the selected test s to your choice Memory Card An SD memory card or removable USB storage device must be in place Workstation Either wireless communications must be configured or a USB cable must connect a CardioPerfect workstation to the electrocardiograph s Com port B 10101 72 Chapter 6 Performing Administrative Tasks Welch Allyn CP 200 Electrocardiograph To Edit or Confirm Saved Tests Note A qualified physician must rev
91. s associated with heart muscle activity Sometimes called EKG for the German term Elektrokardiogramm See also Auto ECG Rhythm ECG electrocardiograph An instrument used to create electrocardiograms ECGs EMR Electronic medical record Also refers to the software system that manages electronic medical records An EMR system can connect to medical devices to download a list of scheduled patients orders or to upload completed tests extended measurements Values for several common parameters such as Q R and S amplitude and ST values The amplitudes are expressed in microvolts The durations are expressed in milliseconds The measurements cannot be edited Printed on a separate page if enabled IEC An abbreviation for International Electrotechnical Commission The IEC electrode labeling scheme is most commonly used in Europe 102 Glossary Welch Allyn CP 200 Electrocardiograph lead 1 An electrocardiograph wire connected to an electrode which is attached to a patient s skin There are 10 lead wires 2 A waveform that represents ECG data from a particular view of the heart The data from the 10 lead wires is converted into 12 waveforms also called leads Il IIl aVR etc MEANS An acronym for modular ECG analysis system The optional MEANS interpretation algorithm developed by the University of Rotterdam Netherlands provides automatic analysis of ECG tests Also available in pediatric version PEDMEANS order Informatio
92. shutdown 0 was pressed while printing an Auto ECG To shut down without saving the test press i To cancel the shutdown press X Audit Trail is too large Please print and purge Audit information is approaching its maximum allotted storage Print and purge the audit trail See Working With the Audit Trail on page 78 Insufficient battery power to begin Please connect AC power and try again Insufficient space available Memory card error Battery low or bad Not enough space on memory card or removable USB storage device Problem writing to memory card or removable USB storage device e Recharge the battery See Recharging a Fully Discharged Battery on page 82 e Replace battery See Replacing the Battery on page 83 e Delete some tests from the card or USB storage device at a PC Use a different card or USB storage device e Verify that the write protect tab is in the unprotected position Reseat the card in its slot Use a different card or USB storage device Qut Of Paper Paper Error Printer is out of paper e Printer door is open Paper was loaded incorrectly e Load paper See Loading the Thermal Chart Paper on page 23 e Close the printer door See Loading the Thermal Chart Paper on page 23 Reload the paper See Loading the Thermal Chart Paper on page 23 Powering down Low battery Recharge the battery See Rec
93. spital environment If the user of the CP 200 electrocardiograph requires continued operation during power mains interruptions it is recommended that the CP 200 electrocardiograph be powered from an uninterruptible power supply or battery Power frequency 50 60Hz magnetic field IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment Directions for Use Table 7 Electromagnetic Immunity Appendix B EMC Guidance and Manufacturer s Declarations 99 The CP 200 electrocardiograph is intended for use in the electromagnetic environment specified below The customer or user of the CP 200 electrocardiograph should assure that it is used in such an environment Immunity Test IEC 60601 Compliance Electromagnetic Environment Guidance Test Level Level Portable and mobile RF communications equipment should be used no closer to any part of the CP 200 electrocardiograph including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vrms 3 Vrms d 1 17 P IEC 61000 4 6 150 kHz to 80 MHz Radiated RF 3 V m 3 V m d 1 17 P 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz d 2 33 P 800 MHz to 2 5 GHz where Pis the maximum output power rating of the transmitter in watt
94. t to save For a description of the test directory see Managing Saved Tests In the Test Directory on page 70 Displays all available wireless networks within range Tests the network and wireless parameters e Ping Test pings an IP address e Server Test verifies the connection to a CardioPerfect workstation Directions for Use Chapter 3 Reviewing the System Settings 33 Reviewing the Medication List The medication list determines which medications are available to choose during patient data entry 1 2 Press the Menu key Choose Edit Medication List The following screen appears Figure 22 Edit Medication List Screen HF 9 17AM Oct 16 08 Edit Medication List Medication Name ACE Inhibitors Albuterol Alpha Blockers Amiodarone Beclomethasone Beta Blocker Bitolterol v Add Delete Exit 3 Press the desired softkeys e Add Lets you add medications up to a total of 40 e Delete Deletes the highlighted medication e Exit Returns to the main menu 34 Chapter 3 Reviewing the System Settings Welch Allyn CP 200 Electrocardiograph Reviewing the History List The history list determines which clinical conditions are available to choose during patient data entry 1 Press the Menu key 2 Choose Edit History List The following screen appears Figure 23 Edit History List Screen ML 9 17AM Oct 16 08 Edit History List History Name Acute Bronchitis Acu
95. te Respiratory Failure Allergies Sneezing Asphyxia Asthma Bronchiolitis Bronchitis Add Delete Exit 3 Press the desired softkeys e Add Lets you add conditions up to a total of 40 e Delete Deletes the highlighted condition e Exit Returns to the main menu Directions for Use Chapter 3 Reviewing the System Settings 35 Transferring a Configuration to Another Electrocardiograph You can transfer your configuration from one CP 200 electrocardiograph to another If you have the spirometry option its configuration is included in the transfer To Transfer a Configuration 1 Insert a storage device SD memory card or removable USB device into an electrocardiograph that is configured as desired Press the Menu key Choose System Settings gt Device Info gt Manage Settings gt Export Files gt Export Configuration Files The files are copied to the storage device Remove the storage device and insert it into another CP 200 electrocardiograph Choose System Settings gt Device Info gt Manage Settings gt Import Files gt Import Configuration Files The files are copied to the electrocardiograph and then it reboots Figure 24 Configuration File Transfer 36 Chapter 3 Reviewing the System Settings Welch Allyn CP 200 Electrocardiograph Configuring the Electrocardiograph for Wireless Communication Before you configure the electrocardiograph for wireless communication verify th
96. the connectors Insert connectors fully so that no part of the metal ring remains exposed For example see Figure 13 To see the whole patient cable with all leads inserted see Figure 12 on page 13 WARNING Failure to insert all connectors fully may result in a loss of energy being delivered to the patient during defibrillation and damage to the patient cable itself For other warnings related to defibrillation see page 17 Plug the patient cable into the port on the front of the electrocardiograph See Figure 14 Figure 13 Inserting the Leads Figure 14 Plugging in the Connector Directions for Use Chapter 2 Setting Up the Electrocardiograph 23 Loading the Thermal Chart Paper 1 Squeeze the latch Pull the paper door to the left See Figure 15 If any paper remains in the tray remove it 2 Remove the outer packaging including the cardboard bottom from a new pack of paper Pull the top sheet back so that the paper s grid side faces up and the Welch Allyn name is on the bottom of the paper 3 Slide the paper into the tray See Figure 16 If humidity is high remove up to 10 sheets so that the paper fits properly 4 Lay the top sheet over the paper door Push the door to the right until it clicks See Figure 17 Figure 15 Opening the Paper Door Figure 16 Loading the Paper Paper tray KOON KREAN KERRY LESS OQ 054000 IN EE EN y is K ep ESSN BE See BRESSAN ieee F
97. tting Default Baseline Filter Default Muscle Filter Augmented Lead Set Mains Filter Directions for Use Chapter 4 Reviewing the ECG Settings 39 About Auto ECG Reports An Auto ECG is a report of ECG data in one of two userdefined formats Auto Report 1 or Auto Report 2 For an example see Figure 25 To learn how to set up or interpret a report see the references on page 40 Note If you want a second predefined format to be available enable Auto Report 2 To learn how see Reviewing the Miscellaneous ECG Settings on page 48 Figure 25 Auto Report Example 3x4 3R Lead Arrangement A Patient data B ECG measurements p LASS A A a 6 TN yt wn UPS es C Interpretation optional er Aa 5 M he ee er C3 web o V ast raar 2 fun o BOARN Awe UP we gt D Report status label a gt E 3 rows 4 columns I Jd E gt F Rhythm leads i J i G Software version ee eae rr o n A E v 1 3 ia H Device ID 0 Calibration M Gain K AC filter STENICE pulse Practice ID N Paper speed L Frequency range J Date and time 40 Chapter 4 Reviewing the ECG Settings Welch Allyn CP 200 Electrocardiograph Item in Figure 25 on page 39 Description A B Patient data ECG measurements Interpretation optional Report status label 3 rows 4 columns Rhythm leads Software version Device ID Practice ID Date and t
98. utions 18 See also electrodes leads patient data editing 61 enabling and disabling fields 44 entering 57 as printed on reports 39 40 recalling 65 searching for 64 67 See also CardioPerfect workstation scheduled patients list phone numbers ii ping test 32 poster ordering replacement 6 post print screen 59 powering the electrocardiograph 24 25 95 Power Save 25 29 practice ID 29 39 preview screen 55 printer external 3 26 95 printer external USB 26 30 95 printer internal thermal 81 95 print saved tests 71 Print Settings printing your settings 31 print settings report settings See Auto ECGs report settings Rhythm ECGs report settings privacy 75 pulmonary function device See spirometry option 106 Index Q QTc method 38 46 R reason statements 43 recycling instructions 87 repairs 94 replacement parts and accessories 6 93 reports See Auto ECGs Rhythm ECGs reset button 8 91 Rhythm ECGs recording 63 report settings 47 S safety 16 18 sampling rate digital 95 scheduled patients list 11 67 74 SD memory card See memory card searching for patient data 64 67 for saved tests 71 security of data 75 sequential lead timing 46 serial number displaying 31 server test 32 service policy 94 set up See hardware set up ECG settings system settings Shift key 9 simultaneous lead timing 46 softkeys 10 specifications 95 96 speed settings See thermal ch
99. y addressing the causes as explained on page 90 To learn how to change the filter s default setting see Reviewing the Miscellaneous ECG Settings on page 48 Caution You cannot perform ST segment analysis on waveforms that were recorded with the baseline filter turned on For details see the caution on page 60 ich Wandering baseline Muscle Filter Toggles between the two muscle filter settings on or off This filter reduces muscle tremor interference random irregular voltage superimposed on the waveforms It is preferable if possible to eliminate or reduce muscle tremor by addressing the causes as explained on page 90 To learn how to change the filter s default setting see Reviewing the Miscellaneous ECG Settings on page 48 Caution You cannot perform ST segment analysis on waveforms that were recorded with the muscle filter turned on For details see the caution on page 60 b bel b ll da Muscle tremor interference Speed Cycles through the paper speed settings in mm sec 10 25 50 available for Rhythm ECGs only JHH 10 mm sec V b pl 25 mm sec I 50 mm sec 69 Performing Administrative Tasks Managing Saved Tests In the Test Directory 0000c cece eeaes 70 Managing the Scheduled Patients List 0 0 ccc eee eee 74 Managing Data Security 0 cece eee eee nee 75 70 Chapter 6 Performing Administrative Tasks Managing Saved Tests In the Test Directory The test directory is the

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