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CardioSoft - Jaken Medical

1. Classification Type of protection against electrical shock class Il Degree of protection against electrical CAM USB CAM 14 Type BF shock defibrillation proof CORINA Type CF defibrillation proof Degree of protection against harmful enclosed equipment without protection ingress of water against ingress of water Degree of safety of application in the Not suitable for use in the presence of a presence of a flammable anesthetic mixture flammable anesthetic mixture with air or with air or with oxygen or nitrous oxide with oxygen or nitrous oxide Method s of sterilization or disinfection sterilization not applicable recommended by the manufacturer disinfection see Appendix A Mode of operation continuous operation 1 12 CardioSoft Revision A 2023324 053 Introduction Safety Information Equipment Symbols Note Some of the symbols may not appear on all equipment AN 1e Es POw Go us MEDICAL EQUIPMENT UL 2601 1 CANICSA 601 1 APAT Biocompatibility Consult accompanying documents Type CF signal input defibrillation proof Type BF signal input defibrillation proof Mains power switch ON OFF Potential equalization pin Caution High Voltage Signal input Signal output Fuse replace with T8 0 A 250 V fuses Medical Equipment Classified with respect to electric shock fire and mechanical hazards only in accordance with UL 2601 1 and CAN CSA C22 2 N
2. sss 2 16 Online HEM fe sate itte prebere PUMP te Ce PC Reg 2 16 Software Features 0 ccc cece eee eee enn 2 17 Revision A CardioSoft i 2023324 053 Preparing the Patient cece eee e eee 3 1 Applying Electrodes The Basics ccc eee e eee eee eee eee 3 3 Preparing the Patient s Skin 0 cece cece eee eee eee eens 3 4 Applying Electrodes 42 rb Rr rhe nb rt e rna 3 5 Lead Labels on the Acquisition Modules sse 3 5 Standard 12 Lead Electrode Placement 3 6 Standard 15 Lead Electrode Placement n a uuaa 3 7 Modified MASON LIKAR Lead Electrode Placement 00000 3 8 FRANK X Y Z Lead Electrode Placement 000 cece eee eee ee 3 9 NEHB Lead Electrode Placement 0000 e cece eee eee eee 3 10 CM5 CC5 ML CML Auxiliary Lead Electrode Placement 3 11 CM5 CC5 CH CMH Auxiliary Lead Electrode Placement 3 12 Attaching the CAM 14 Acquisition Module 0ce cece ee eee 3 13 Selecting a Patient Record and Test Type 4 1 Selecting a Patient Record from the Local Database ccc eee eae 4 3 OVEIVIOW iyen ees erbe b td ocu 4 3 Selecting a Patient Record 0c cece eee 4 4 Retrieving a Patient Record from the MUSE CV System Database 4 5 Entering a New Patient cece cece n 4 7 Patient Records of External Programs 0 0 see cece eee eee e
3. Tdst Sum tt te Sample Card Cycles Sample PWA Cycles E Ka riu pcs E uA FU Ssmi xinh INR Ubri HS AREE ESQ RESO erie Er RII TET WEBER hot OE T Eun Wa CAEDE omelets A E S aVR LENT EA AE EE EET Ie Ee XE G Aa Ss ee See ore ett A A is Click to view the other Arrhythmia Review leads Details of the displayed Arrhythmia Review strips Click icon to delete the displayed Arrhythmia Review strip Click to display the Arrhythmia Review window Click to change the gain Click to change the speed Click icon to print the displayed Arrhythmia Review strip Click to display the other Arrhythmia Review strips Click icon to include the Arrhythmia Review strip in the test report check mark or to exclude it from the test report printer crossed out cL oonnmuo3o uT7m Note Y ou can perform measurements as described under 6 38 Significant arrhythmias are displayed red Revision A CardioSoft 6 41 2023324 053 Exercise Test After the Test Post Test Review Arrhythmias descending priority patient s learned typical QRS complex asystole limit value 4 s ventricular fibrillation flutter ventricular tachycardia ventricular run minimum of 3 consecutive PVCs ventricular couplet 2 consecutive PVCs pause of 2 missed beats pause of 1 missed beat ventricular bigeminy pacer error ventricular escape beat premature ventricul
4. Insert Add new line Acronym Test a 2rep with repolarization abnormality 2nw with QRS widening and repolarization abn 2wid with QRS widening aber with premature aberrantly conducted com abn Abnormal ECG abnrhy Otherwise normal ECG accel Accelerated acumi lt ACUTE MLET acute possibly acute afib Atrial fibrillation ageun age undetermined ainj Anterior injury pattern aiohai ST elevation consider anterior injury or ac alihai ST elevation consider anterolateral injury alinj Anterolateral injury pattem almi Anterolateral infarct alt T wave abnormality consider anterolateral altwpw with fusion or intermittent ventricular pre e ami Anterior infarct anlat Anterolateral leads ansep Anteroseptal leads anter Anterior leads apck Electronic atrial pacemaker aqrst Abnormal GRS T angle consider primary arat Atrial rate arm Suspect arm lead reversal interpretatio 4 b 526A R Close Revision A CardioSoft 5 27 2023324 053 Resting ECG Post Test Review Comparing Resting ECGs You can compare the following details of two resting ECGs m the10 second ECG m themedian complexes and m theinterpretation It is also possible to compare the medians of at least 3 and up to 6 ECGs Comparing Two Resting ECGs The system offers two alternatives you can compare the present ECG with an earlier recording or you can retrieve a stored examination as described in section Selecting Patient Re
5. N o 9 PAN 9560 Electrode Placement A Vt red C1 red Fourth intercostal space at the right sternal border B V2 yellow C2 yellow Fourth intercostal space at the left sternal border C V3 green C3 green Midway between sites B and D D V4blue C4 brown Mid clavicular line in the fifth intercostal space E V5 orange C5 black Anterior axillary line on the same horizontal level as D F V6 purple C6 purple Mid axillary line on the same horizontal level as D GLA black L yellow Left arm resting ECG or left shoulder exercise test J RA white R red Right arm resting ECG or right shoulder exercise test H LLred F green Left foot resting ECG or left thigh exercise test RLgreen N black Right foot resting ECG or right thigh exercise test 3 6 CardioSoft Revision A 2023324 053 Preparing the Patient Applying Electrodes Standard 15 Lead Electrode Placement Standard leads right recommended for pediatric ECGs 33A AHA Label IEC Label Electrode Placement A V1 red C1 red Fourth intercostal space at the right sternal border B V2 yellow C2 yellow Fourth intercostal space at the left sternal border C V3 green C3 green Midway between sites B and D D V4 blue C4 brown Mid clavicular line in the fifth intercostal space E V5 orange C5 black Anterior axillary line on the same horizontal level as D F V6 purple C6 purple Mid axillary line on the same horizontal level as D G
6. folders insert chapters E insert lines k delete chapters Be sort texts alphabetically ES 11 38 CardioSoft Revision A 2023324 053 System Settings Custom Setups Factory Setup Custom Setups Factory Setup The program allows you to save load and delete your personal settings for the different test modalities From the same menu you can restore the factory defaults Y ou access the setup menu by clicking the Custom Setup button on the acquisition or pre acquisition screen or from the General tab of the System Configuration see General Tab on page 11 41 Save Delete Cancel zi Help 924A A Names of stored custom setups B Click a button to load save or delete a setup C Click to select the drive Save 1 Click the Save button 2 Inthe SaveS up window select the target drive from the list Harddrive DiskdriveA Select a linein the Setup window A In the SaveAs box enter a name Click Save Note With this command you savethe setups of all modalities not just of the selected modality Revision A CardioSoft 11 39 2023324 053 System Settings Custom Setups Factory Setup Load or Delete Load the Factory Setup 1 Select the drive 2 Select the name 3 Click Load to load the setup or click Dd ete to delete the setup Note Be sure to Save the current setup BEFORE loading one of the stored setups or your m
7. Configured Report Standard Pagewith Flow Volume Loop Volume Time Curve M easurements Interpretation appears on the Standard Page Select the number of copies to print 3 Select a format for the Configured Report click Modify to display the Report Editor see section Report Editor on page 11 10 Select the printer Click the Print button to initiate the printout Revision A CardioSoft 8 17 2023324 053 Spirometry Test Post Test Review Comparing Two Spirograms You can compare the present spirogram with another one of the same patient recorded earlier 1 Click Compare A window opens listing all the patient s spirograms Select a test 3 Click OK to clear the window Spirometry Compare T est Information Sir qetry Compare FVC Measurement 19M 2 2002 18 08 32 Test 2 9 12 2002 17 55 41 System Evaluation Measurement System Evaluation zl Test 1 Measurement FEV1 I 4 FEV1 I FEV1 FVC 83 FEVI FVC 83 gi 108 FEV3 I FEV3 I 3 84 FEV I 3 84 FEVI FEV 2 30 PEF l s 9 55 1 18 12 MEF 5 V s 12 x 4 Test Information Interpretation Modify Interpretation Mild restriction Mild restriction 204A SP A Data relating to test 1 reference test test selected first B Click tab to display the flow volume loops and tabular data C Data relating to test 2 8 18 CardioSoft Revision A 2023324 053 Spirometry Test Post Test Revie
8. Statement Library Configured Report Ns d Prompt 1 Report 1 v Modiy dis Reason for Test Modify Modify Interpretation Standard Page EE Interpretation Medication ify Type2 Alphanumeric Mo 208A SP Click to print the spirometry test setup Select documents to be included in the report Select the Configured Report format Click button to edit the Configured Report or create a new one see Report Editor on page 11 10 Select number of copies Enter Extra Question 1 20 characters max Enter Extra Question 2 20 characters max Select the answer format for the Extra Questions Click to edit the Reason for Test library Click to edit the Interpretation library Click to edit the Medication library A B C D AX c ro mnm Editing the Reason for Test Medication Library 1 Click Modify to display the edit window 2 Edit delete or add new statements Revision A CardioSoft 11 37 2023324 053 System Settings Spirometry Setup Editing the nterpretation Library In this window you can edit the library of interpretative statements Y ou can enter a maximum of 12 statements 1 Click Modify to display the Interpretation library Click aline to highlight it Click a second time to enable the edit mode and enter your changes With the icons at the bottom of the window you can open or close
9. The test can be controlled manually with the following buttons 6 14 CardioSoft Revision A 2023324 053 Exercise Test During the Test Manual Control F11 comment Press to enter comments to appear in the Tabular Summary F12 enter BP Press to enter BP readings 12 lead Press to start an ECG recording 12 leads 5 seconds from memory 5 seconds of real time data recall Press to print a 10 second delayed recall report rhythm Press to start a continuous rhythm report stop writer Press to stop the writer printer medians Press to print a medians report arrhy doc Press to enable or disable the automatic documentation of arrhythmias Note Cubic Spline FRF algorithms can delay the rhythm report by approximately 1 second when enabled 12SL Press to acquire a 12SL resting ECG with measurements and interpretation only in the pretest and recovery phases F7 grade Press to change the elevation of the treadmill belt F8 grade F5 speed Press to change the belt speed or ergometer load or load F6 speed or load hold stage Press to hold the exercise test in the current stage Note In the pretest phase Shift pretest or Shift F 1 allow you to return tothe previous stage If a bicycle ergometer test is initiated with the F 2 exercise button the dock will start even when the patient has not yet begun to pedal When the patient reaches the target HR the HR reading turns re
10. Type any Comment about the test Answer the Extra Questions Enter an Order Number This number will appear on the printed reports and on the Test Summary Note The Reason for Test library can be edited see section Editing the Reason for Test Library on page 11 4 Y ou can define two Extra Questions as needed see section Miscellaneous Tab on page 11 8 You enter the names of the physicians and of the ECG technician in the System Configuration menu see section General Tab on page 11 41 5 4 CardioSoft Revision A 2023324 053 Resting ECG Entering Test Information Medications Tab 2 1 3 Test Information Test Personnel Medications Medication Patient Informatio Help Cancel 053A R 1 Click the Medications tab 2 Enter or choose a maximum of 5 medications 3 Enter the medication dose Note You can assign drugs to specific medication groups See section Editing Medication Groups Assigning Drug Names on page 11 6 Note Entering a medication will influence the analysis with the HEART ECG analysis program The following medications may affect the diagnosis digitalis antiarrhythmics Ic diuretics antiarrhythmics III psychotropics Ca channel antagonists Verapamil steroids Ca channel antagonists Nifedipin beta blockers II nitrates beta blockers III ACE antiarrhythmics la alpha blockers antiarrhythmics Ib cytostatics If one or more of these medications are used a re
11. instruct the system to generate a random number select the dice with the Tab key and press the spacebar Enter the patient s gender with m male or f female If your patient is wearing a pacemaker apply a check mark in the Pacemaker check box using the spacebar M Click Accept to save the patient record to the database Select the test type Click Select The acquisition screen for the new test appears Note Thesystem will automatically capitalize the first letter of the first and last names The patient record cannot be created without an ID number If at all possible also enter the patient s last name first name date of birth and gender to allow the system to perform the necessary calculations when evaluating the test results Revision A CardioSoft 4 7 2023324 053 Selecting a Patient Record and Test Type Patient Records of External Programs Patient Records of External Programs The system only supports the GE Medical Systems Information Technologies Holter ECG program MARS PC as well as the external VIASYS program MASTERSCOPE Note GE Medical Systems I nformation Technologies is not in a position to guarantee full compatibility of external programs with CardioSoft In conjunction with external programs the patient record is always maintained in CardioSoft while the external program handles the test data At the end of the test CardioSoft will only receive a summary from the externa
12. ssseeses 6 53 Revision A CardioSoft iii 2023324 053 Ambulatory Blood Pressure Measurement 7 1 Ambulatory Blood Pressure Monitors 00cce ee en eee tenet eaee 7 3 Connecting the Ambulatory BP Monitor 00 cece eee eee eee eens 7 3 Setting Up the Ambulatory Blood Pressure Monitor ussueuee 7 4 Acquisition Screen ascese a E a tne n een een ees 7 4 Operating Steps scies p odes tos gauge daca Eod Br top 7 5 Post Test Review occicrrarriairra veiis tradaia tata Crair aTa ariari 7 6 Downloading Data siveco einne i E N E E a A 7 6 Test SUEnImaly c iaceret geh ec ong be ate ER nc A ae ret nae T 7 Generating or Editing the Interpretation 000 esses 7 11 Grapliicss t tone sean cia a nada Mea eis is C0 aid e Wine Ge aces 7 12 Tabular Summary 7 13 HOUT AVerages cre ir e Seco na ERE EEREN gea arent te 7 14 Statistics Summary 7 15 Report Printout ee ce ed eee tede etude betes 7 16 Spirometry Test 000s cece eect e teens 8 1 Sensols coo up ud er ery RIPE Ee ETC ERR PE ue gw ERES 8 3 Entering Test Information 00 cece eee eee eee eee 8 4 OVel VIEW us ete LUPA CAD Ed need 8 4 Patient Information Tab ississssssssssss I 8 4 Test Personnel Tabe irei i Bi hiss p RE pute e ee Ep p PE 8 5 M diCalloris o netto dose tense SUPCR GU EE ROSE INO POR BU obe 8 6 Conducting Spirometry Tests 0c cece cece eee eens 8 7 OVEIVIEW Sse deere UEM IRUR
13. A B C D E F G H Test Summpry EGG Traces Mediarls Arhythmia Review Veptor Loopg Full Discl sure ECG CN I5 eal 4 Lines IV Arrhythmia in color 516A R Click to select the lead Information about filters etc Click to open a list showing all identified arrhythmias Click to select gain and speed Click icon to activate the zoom function Click icon to print the entire full disclosure ECG or selected segments Click icon to delete the full disclosure ECG Select the number of lines and whether or not the events are to be color coded Click icons for automatic scrolling of the ECG waveform adjust the scroll speed with the slider below J Scroll box to display different time windows The markers to the right of the scroll bar allow direct access to the corresponding events c 0O nmucou gt Revision A CardioSoft 5 23 2023324 053 Resting ECG Post Test Review Printing the Full Disclosure ECG You can print either the entire full disclosure ECG or only a selected segment Selecting an ECG Segment 1 Click tomark the beginning of the segment A flag appears 2 Click again to mark the end of the segment A second flag appears Printing 1 Click the printer icon The print setup window opens x Pages to Print dm 6 Time Period min s 00 00 05 24 Speed mm s f amat one lead Enabling the Zoom Mode Lead l s
14. Save Delete 11 39 D Danger Definition 1 8 Data Backup B 31 Default Printer Set B 8 device characteristics 1 15 Disposal A 4 Drugs Assign to Medication Groups 11 6 RestingECG 5 5 E ECG Data Windows ECG Strips 6 22 Interpretation 6 24 12SL 6 23 ECG Measurement 5 15 ECG Recorder Connect B 9 ECG Recording During Defibrillation B 10 ECG Recording Exercise Test 6 15 ECG Recordings of Pacemaker Patients B 10 ECG Signal Quality Check Exercise Tests 6 8 RestingECG 5 6 ECG Strips 6 40 Edit Patient Records 9 6 Electrode Application 3 3 CM5 CC5 CH Auxiliary Lead Electrode Placement 3 12 CM5 CC5 ML Auxiliary Lead Electrode Placement 3 11 FRANK X Y ZLead Electrode Placement 3 9 Modified MASON LIKAR Lead Electrode Placement 3 8 NEHB Lead Electrode Placement 3 10 Standard 12 Lead Electrode Placement 3 5 Standard 15 L ead Electrode Placement 3 7 EMR Interface 10 3 Envelope M easurement Mode 8 7 Equipment Check Before Each Use A 4 Equipment Identification 1 15 Equipment Symbols 1 13 Event Marker 5 10 Exercise Phase 6 14 Exercise Test Setup Final Report Tab 11 23 Lead Sequence Tab 11 17 Miscellaneous 1 Tab 11 24 Miscellaneous 2 Tab 11 26 Protocol Editor Tab 11 19 Screen Tab 11 13 ST Medians 12SL Tab 11 30 TWA Tab 11 31 Writer Tab 11 12 Exercise Tests Compare 6 25 Exercise Test Operating Steps 6 13 Exercise Test Select Default Protocol 11 19 Exercise Test Softk
15. initiates the pretest phase and advances through the pretest stages to return to the preceding stage press Shift F1 or Shift F1 pretest initiates the exercise phase and advances through the individual stages of the exercise phase initiates the recovery phase and advances through the individual stages of the recovery phase terminates the test and initiates the printout of the final reports enables and disables automatic arrhythmia reporting a one page arrhythmia report is printed on the thermal writer on occurrence of an arrhythmia maintains the current stage automatic stage sequencing is stopped Press again to turn off stage hold increases the treadmill speed or ergometer workload decreases the treadmill speed or ergometer workload increases the treadmill grade decreases the treadmill grade starts the belt When restarted after FAST stop the treadmill returns to the previous speed and grade stops the belt enables entry of additional information and of values for the user defined columns of the tabular summary see Configuring the Tabular Summary on page 11 14 enables entry of the patient s blood pressure readings initiates recording of a 10 second ECG 5 seconds from memory 5 seconds from when key was pressed initiates printout of a medians report initiates recording of a continuous real time ECG rhythm strip terminate recording with stop writer records a one page rhythm strip of
16. 7E Review on page 6 41 D Current heart rate and bar graph indicating percentage of max predicted HR Turns red when max HR is exceeded E Most recent BP readings Turn red when max systolic BP is exceeded Values older than 1 minute are dimmed F Selected protocol exercise clock starts with the exercise phase and indicates its duration G Current phase phase clock each new phase pretest exercise recovery resets the clock to zero H Current stage stage clock restarts with each new stage Belt speed and grade or pedal speed RPM Watts Mets RPP SpO 6 12 CardioSoft Revision A 2023324 053 Exercise Test During the Test Pretest Phase Overview Operating Steps The pretest phase consists of stages configured in each protocol Commonly used stages are Supine Standing m Hyperventilation m Warm up Blood pressure measurements can be taken manually or automatically as configured in the Protocol Editor When manual entry is configured the window for entry of BP values will appear automatically See section Protocol Editor Tab on page 11 19 The first QRS complex of the exercise phase is saved as the baseline complex 1 Wait until the message Median update ceased Rd earn disappears the baseline ST measurement appears and the blood pressure has been taken 2 Press the 12SL button to acquire and analyze a baseline ECG 3 Press F1 pretest to advance to the next stage Note When the TW
17. 921A S 1 Click on the down arrow of the function key whose function you wish to change 2 Select a function from the list Revision A CardioSoft 2023324 053 11 29 System Settings Exercise Test Setup ST Medians 12SL Tab Click the ST Medians 12SL tab to display the window for setup of ST measurement and 12SL J x Point Formula RR 16 z ST Criteria ST Ele Screening Criteria Suppress normal statement Suppress abnormal borderline T Suppress all statements Print Setup Help UJ On mUo 922A S Click option button to select calculation method for E and J points Click option button to select calculation method for J X point Manual set post J point at D Auto select formula at C Select formula for calculation of post J point Manually select post J value Select or deselect 1 the ST Criteria Click option button to select ST Slope criteria Select the max ST elevation depression when the limit is reached a message appears on the acquisition screen Select or deselect I the 12SL Criteria 11 30 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup TWA Tab Click the TWA tab to open the window During the exercise test the TWA algorithm analyzes the data in the background In each of the selected leads the algorithm calculates the even and odd medians the TWA value
18. About This Manual About This Manual Revision History This manual is subject to the GE Medical Systems Informati on Technologies change order service The revision code a letter that follows the document part number changes with every update of the manual Table 1 Revision History part No Date Comment Revision 2023324 053 A 31 March Initial release corresponds with software version 6 0 2005 Manual Purpose This manual contains the instructions necessary to employ the product safely and in accordance with its function and intended use Where necessary the manual identifies additional sources of relevant information and or technical assistance Intended Audience This manual is geared for clinical professionals Clinical professionals are expected to have working knowledge of medical procedures practices and terminology as required for completing these examinations 1 4 CardioSoft Revision A 2023324 053 Introduction About This Manual Conventions These are the conventions used in the manual Styles Bold text indicates keys on the keyboard function keypad text to be entered or hardware items such as buttons or switches on the equipment m Italicized text indicates software terms that identify menu items on screen controls buttons or options in various windows m Toperform an operation which appears with a plus sign between the names of the two keys you press and ho
19. At thetimethe report is printed the program will replace these report items with the actual data MS Sans Bent kInstitution Name 4824807 Ward x Institution Address Street 24808 gt Telephone Institution Address City 24809 gt RESTING ECG REPORT Patient Name lt Patient Last Name 24820 gt lt Patient First Name 24863 gt Date of Birth lt Patient Date of Birth 24818 gt Patient ID Patient ID 24819 gt Age lt Patient Age 24817 gt Height lt Patient Height 24821 gt Gender lt Gender 24872 gt Weight lt Patient Weight 8248227 Race Race 24873 gt Test Date Date of Test 424836 Physician Attending MD 15646 gt Test Time Time of Test 424837 Technician Technician 15050 gt Medication Medication 415043 Comment Comment 4150467 Reason for Test Reason for Test 415033 Summary Measurements 862427 Measurements median 864567 Heart Rate HR 464417 Blood Pressure Blood Press mmHg 15038 gt Interpretation Interpretation 15167 gt Physician Technician 97A R 1 Click to select and open a report template 2 Click in the window and typethetext w Click Insert Report Items to open the list of available data fields and select an item by double clicking Highlight the text and select the font Select the font size Select the font format bold italics or underlined Nou s Select the paragraph format left flush right flush or ce
20. Enter location and cart device number Display the location name list P Select the software version of the receiving MUSE system Pre 5C or 5C and above Versions V5C and above send a more detailed data record m Note Use the GE Medical Systems I nformation Technologies network installation kit to ensure all patient isolation requirements are met A GE Medical Systems Information Technologies Service Representative is required to configure the MUSE CV system Only resting ECGs and exercise tests can be transferred to the MUSE CV system The following resting ECG data is not transferred to the MUSE CV system because MUSE does not support this type of data hospital name street medical history QT dispersion and technician arrhythmia labels for each QRS complex vector loops lead related measuring values Tabular Summary full disclosure ECG The following exercise test data is not transferred to the MUSE CV system because MUSE does not support this type of data 999 hospital name street medical history Sokolov index QT dispersion and technician full disdosure ECG arrhythmia review reason for test ST HR slope ST HR index waterfall TWA results 999999 11 56 CardioSoft Revision A 2023324 053 System Settings System Configuration Option Code Tab Click the Option Codetab to open the option code window If you have purchased additional software options enter the option code
21. Fifth intercostal space on the left posterior axillary line Same position as V7 CT C V4blue Nap white Mid clavicular line in the fifth intercostal space C4 Same position as V4 C4 Depending on the selected number of leads the leads are recorded as follows see section Modifying the Lead Sequence on page 11 7 or Modifying the Lead Sequence on page 11 17 Lead 12 Lead Monitoring 15 Lead Monitoring D channel 7 channel 13 A channel 8 channel 14 J channel 9 channel 15 3 10 CardioSoft Revision A 2023324 053 Preparing the Patient Applying Electrodes CM5 CC5 ML CML Auxiliary Lead Electrode Placement In addition to the standard electrodes apply one electrode on the sternum A1 and one in location V5R C5R A2 zd q a THe P i N 37A Electrode Electrode Placement A1 Nst Mid sternum at the second intercostal space A2 Nax In the fifth intercostal space in the right anterior axillary line V5F C5R Revision A CardioSoft 3 11 2023324 053 Preparing the Patient Applying Electrodes CM5 CC5 CH CMH Auxiliary Lead Electrode Placement In addition to the standard electrodes apply one electrode on the sternum A1 one in location V5R C5R A2 and one on the neck A3 KN UA J Ww ET i O 38A Electrode Electrode Placement A1 Mid sternum at the second intercostal space A2 In the fifth intercostal space in the right
22. Period Exercise Tes ResingECG Ambulatory Bloo HotertCa Ext Prog Spiomety Export Statistics 932A 1 Enter the date range for the statistical analysis Select the period month quarter year Click to calculate the statistics B5 WN Click to export the data to Microsoft E xcel 11 52 CardioSoft Revision A 2023324 053 System Settings System Configuration Devices Tab Click the Devices tab to open the window gometer Model Phrt 02 Monitor ae Ohmeda 3740 7 Ambulatory Bogd Pressure ooon s Ambulatory BP Devide Port ow zl Spirometry Device Type Sproso v Spirometry Device Port ow2 y Port Path to Holter ECG Program D Path to External Program Use Extemal Program for Spirometry Procedure Name for External Program TTL output Analog 1 none Pulse Width ms 50 a Analog 2 none m gt a Analog 3 none Delay ms 0 Analog 4 none hed Polarity positive ba Help 933A Select check box then select a port for the metabolic cart Click to select the BP monitor model and the port Click to select the treadmill model and the port Click to select the spirometry device type and the port none indicates that the modality is inactive Click to select the SpO monitor model and the port A B C D nm m Click to select the ergometer model and the port Click to select the amb
23. Report Formats In Test Reports with Laser Printer Stage Report for 12 and 15 leads only or Current Median 4 seconds of raw ECG 12 leads at 25 mm s or manual initiation with 12 lead or recall Current Median 2 seconds of raw ECG 12 leads at 50 mm s Note The formats may differ slightly when the Swedish Reports are selected Revision A CardioSoft 6 51 2023324 053 Exercise Test Report Formats Final Reports Format Description Configured Report Tabular Summary Graded Exercise Summary Report Selected Medians Report Sample Cardiac Cycles Trend Reports ST HR Loops ST HR Slope ECG Strips Arrhythmia Review Vector Loops TWA Beat Waterfall Swedish Median Report User configured portrait style final report User formats narrative text and selects data fields to create report template Configured Report automatically merges text and data according to templates selected For details on the Configured Report refer to section Report Editor on page 11 10 Tabular Summary of test by stage including time speed grade workload MET level heart rate blood pressure comments with optional selections for double product RPP ST level SpO and user configured entries Can also be printed as Detailed Summary in minimum of 30 second intervals For instructions on Tabular Summary configuration see section Configuring the Tabular Summary on page 11 14 One page overview of entire test w
24. but not in the patient vicinity Note For Dial Mode Hang up Prefix and Hang up Suffix please refer to theuser manual of your modem 11 54 CardioSoft Revision A 2023324 053 System Settings System Configuration MUSE Tab Click the MUSE tab to open the window Note The compatibility of CardioSoft with the following MUSE software versions is ensured 4B 5A 5B 5C 5D 5E System Configuration General Devices Modem MUSE Option Code Country Settings EMR C D r Setup for MUSE r ocation Number P i ge Location Name List MUSE FTP Proxy Server Shared Directory Data Transfer to MUSE via Shared Directory Intemet Browser z F I Use MUSE Enumeration List Synchronize Lists r Store procedure for MUSE G 36 Wo dala transfer to MUSE Cart Device Number H cr E Save MUSE data to medium 0 Drive v zl l T Data transfer to MUSE via the network MUSE FIP Server MUSE M Software Version M P 5C and above M Patient ID Length Limit N A B C D T Limit Text Entry to MUSE Length 935A Select to retrieve patient data and orders from the MUSE CV system Enter information required for communication with the MUSE CV web system Enter the MUSE Site number Click to configure the Internet browser Enter the path to the Internet browser to start the MUSE Browser Both the Internet browser Internet Exp
25. on page 11 41 Remote View Click to view exercise tests performed at remote stations F I see section Monitoring of Remote Exercise Test Workstations on page 6 53 G Quit Program Click to exit from the program Note Refer to section Country Settings Tab on page 11 58 for information on selecting the language and on toggling between text labels and icons or right click any button to toggle between text labels and icons Revision A CardioSoft 2 13 2023324 053 Product Overview Putting the System Into Service Using the Mouse Buttons Up Down Arrows Scroll Controls Topress or activate a button use the mouse to position the mouse cursor on the icon then press the left mouse button Max predicted HR 168 m 139A Click on the up down arrows to increase or decrease values or change a setting CE MODBRUCE NAUGHTON ELLESTAD MODBALKE 138A Click the up down arrows to scroll through the list line by line To cover greater distances in the list 1 Click on the scroll box 2 Holding the mouse button down move the scroll box up or down in the scroll bar 3 Release the mouse button 2 14 CardioSoft 2023324 053 Revision A Product Overview Putting the System Into Service Drop down Lists OK Cancel and Help Double clicking internal Treadmill tintemal Treadmill Series 2000 TM400 T2400 T 425 140A To choose an item from a dr
26. 2 20 characters max Select the answer format for the Extra Questions Click to edit the Reason for Test library Click to edit the Interpretation library Click to edit the Medication library Ace roc mnm Editing the Reason for Test Medication Library 1 Click Modify to display the edit window 2 Edit delete or add new statements 11 34 CardioSoft Revision A 2023324 053 System Settings Ambulatory Blood Pressure Measurement Setup Editing the nterpretation Library In this window you can edit the library of interpretative statements Y ou can enter a maximum of 12 statements 1 Click Modify to display the Interpretation library Click aline to highlight it Click a second time to enable the edit mode and enter your changes With the icons at the bottom of the window you can open or close folders insert chapters E insert lines k delete chapters Be sort texts alphabetically ES Revision A CardioSoft 11 35 2023324 053 System Settings Spirometry Setup Spirometry Setup The settings specific to the spirometry modality can be entered either from the spirometry acquisition screen where you click Setup to display the setup menu or from the General tab of the System Configuration see General Tab on page 11 41 Acquisition Tab The Acquisition tab is already on top A B CDEFGHI J K Acquisition Miscellaneous Equation
27. 2023324 053 Resting ECG Post Test Review Performing Reanalysis F Select if you wish to adjust the T wave offset mark see Adjusting the T offset Mark on page 5 19 G Measurement mark H Menu for selection of the leads to be reanalyzed Table showing time intervals and position of the cursor in mV Click the measurement mark and hold the mouse button depressed Move the measurement mark to its new position and release the mouse button Adjust the other marks in the same way Click ECG Analysis Click Reset and ECG Analysis if you wish to restore the previous analysis results Note The P onset and P offset markers may be dashed e g in the presence of atrial fibrillation This indicates that the program was unable to locate the exact beginning and end of the P wave In this case you can click the marks and drag them to the correct position the marks are now solid instead of dashed It is possible to restore the marks to the original position by clicking them again 5 18 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Adjusting the T offset Mark 1 Select the check box The medians of all leads except the selected lead disappear 2 Holding the mouse button depressed move the T offset mark to the correct position 3 Click icon to select the leads whose T offset marks you also wish to adjust Adjusting the T offset mark on this screen does not affect the position of t
28. Acceptability Volume backextrapol too large ATS Summary Statement lt 3 accepted tests Breathe OUT and IN SLOWLY and completely than breathe OUT and IN as QUICKLY and completely as possible IPT Code O 202A SP A Click option button to display the volume time curve B FEV1 value C Click option button to display the Current test the Best test or the ATS Summary D System evaluation according to the selected interpretation mode for Best fest only E Measuring values reference values and percentage deviation according to the selected equation for calculation of the reference values F ATS acceptance of the current test ATS statement below Revision A CardioSoft 8 11 2023324 053 Spirometry Test Conducting Spirometry Tests Bronchodilator Test The bronchodilator test always consists of two measurements one before and one after medication After medication measure the dilatation as follows 1 Click Start Bronchodilator Test to start the measurement 2 The system asks whether the previous measurement is to be the pre dilation test Before Bronchodilation test the question appears only if a spirogram of this patient has been recorded earlier the same day Answer the question with OK Conduct the test as a normal flow volume measurement When you select the Post Test Review you have another opportunity to select a pre dilation test for comparison with the current test Spirometry Tests w
29. Adhesive rings pkg of 500 for electrodes 217 320 217 110 927 223 00 Adhesive rings pkg of 500 for electrodes 217 321 217 007 01 ER paper pkg of 200 for electrodes 504 648 217 148 01 Electrode paper pkg of 200 for electrodes 217 144 01 02 217 043 02 ECG filing cards pkg of 50 CardioSoft C 7 2023324 053 Order Information Order Information Electrode Application Systems for CORINA 216 121 01 216 122 01 303 443 77 384 015 84 384 013 30 303 444 21 303 444 20 Electrode application system KISS 10 10 lead system without pump Electrode application system KISS 12 12 lead system NEHB without pump Swivel arm for KISS Tabletop clamp with pole Wall fixture for swivel arm Clip adapter for adhesive electrodes KISS support to mount on ergometer Electrode Application Systems for CAM USB A T KISS 2022865 001 2024038 001 2024039 001 2024040 001 303 443 77 384 015 84 384 013 30 303 444 21 303 444 20 Electrode application system KISS Multilead Additional electrodes for FRANK leads Additional electrodes for NEHB leads Additional electrodes for leads A1 to A4 Swivel arm for KISS Tabletop clamp with pole Wall fixture for swivel arm Clip adapter for adhesive electrodes KISS support to mount on ergometer Spirometry Tests 2014845 001 SpiroSoft spirometry test system Ambulatory Blood Pressure Measurement 2001762 001 TONOPORT V ambulatory BP measurement system C 8 Card
30. B 08 16 1942 Patient ID 2 4 TESTO11 Provider Harry S Winston MD Sex Male Race hite Medications utcome control MEVACOR TAB 40MG LOVASTATIN 1 pd qd p NITROSTAT SUB 0 4MG NITROGLYCERIN 1 sl prn cip max Chest distomfort gt of 3 in 15 min E Current Problems Height rs in Weight 198 Ibs ANGINA FUNCTIONAL CLASS II ICD 786 5 uu EO O Risk of CORONARY ARTERY DISEASE ICH 41 4 00 HYPERCHOLESTEROLEMIA ICD 272 0 xl Resting Eq Heart Rate at bpm BP Systolic QT Interval azo ms QT GTC sev ms Interpretation Poor data quality interpretation may be a adversely affected OUnustal P axis possible ectopic atrial bradycardiaDRight xl QRS Interval a ms Comment EKG PWavAxis 248 z 5 n EKG ORS axis Jas s zi e BP Diastolic REI fens P Duration 136 ms PP Interval f 460 ms PR Interval fiaz ms EKG T axis 5o TEET ETTAN EES RR Interval f 468 ms Additional Information _ M l View Edit ECG Prey Form Ctri PgUp Next Form Ctr Pabny 105A A Measurement results B Click button to view edit and print the test C Test interpretation window 5 Click the View Edit ECG button to view the ECG edit the report and measurement results print the ECG etc 10 6 CardioSoft Revision A 2023324 053 11 System Settings Revision A CardioSoft 2023324 053 For your notes 11 2 CardioSoft Revision A 2023324 053 System Settings Resti
31. BP monitor must be ready for operation before the exercise test is activated Otherwise the system will not recognize it and prompt the user to take manual BP measurements If a measurement takes more than 60 seconds to complete the values may appear in the tabular data for the next stage or phase If no external BP monitor is connected the system defaults to the BP monitor integrated in or connected to the ergometer Note If the systolic pressure is expected to exceed 200 mmHg select a higher deflation rate at the BP monitor to expedite the measurement The Bosotron 2 will terminate the measurement after approx 90 seconds If the Bosotron 2 identifies problems while taking a measurement the values will be displayed on the Bosotron 2 but they will not be accepted by the program Always usethe SunTech ECG electrodes when taking BP measurements with the SunTech 4240 during exercise tests B 6 CardioSoft Revision A 2023324 053 Miscellaneous Connecting Peripheral Devices Notes on Using the Colin STBP 780 BP Monitor 1 Turn off the built in interval timer select the appropriate menu item with the M odify button Additional measurements can be initiated manually 3 TheBP monitor automatically advances through all phases However please note the following TheBP monitor will advance to the next phase only after taking a correct BP measurement in the preceding phase DO NOT return tothe previous phase as
32. Baud rate 4800 The ergometer software must be version V436 or V236 ergometers with a 4 button control panel must be software version 752 or M 343 Plug the round connector of the connecting cable into the J 10 RS 232 port of the ergometer and the other end into the COM 10r COM 2 port of the system B 4 CardioSoft Revision A 2023324 053 Miscellaneous Connecting Peripheral Devices Putting the Lode Excalibur Ergometer Into Service Every time you turn on the ergometer the TERMINAL option must be selected in the ergometer menu and confirmed with Enter Then the display will show the workload and pedal speed THEN start the system Otherwise an error message will appear saying No communication with ergometer treadmill Putting the EC 1200 Ergometer Into Service The EC 1200 bicyde ergometer only supports graded phases When first activating the Protocol Editor a single line will be displayed for Basic Load Load Increase StageTime Number of Stages ECG Recording Interval and BP Interval for each phase Basic Load is theload level at the beginning of a phase When the Stage Timehas elapsed the next stage begins and the load increases by the value entered at Load Increase At Number of Stages you enter the number of stages for a phase The configured ECG Recording Interval and BP Interval ensure that ECG recordings and BP measurements are initiated at the appropriate point in time before the end of a stage T
33. CardioSoft database 2 Complete the examination then terminate CardioSoft 10 4 CardioSoft Revision A 2023324 053 EMR Interface Performing an Examination 3 Click the Retrieve Results button CardioSoft Resting ECG Walter S Caldwell Patient Hame valter Caldwell D O B 08 16 1942 Patient ID 234 TESTO11 Provider Harry S Winston MD Sex Male Race ite Reason for Test Medications J Therapy outcome control MEVACOR TAB 40MG LOVASTATIN 1 po qd a Checkup NITROSTAT SUB 0 4MG NITROGL Y CERIN 1 sl prn c p max Chest discomfort xl of 3in 15 min xl Current Problems Height 74 in Weight fi 88 Ibs ANGINA FUNCTIONAL CLASS II ICD 786 5 a I Pacemaker Risk of CORONARY ARTERY DISEASE ICD 414 00 HYPERCHOLESTEROLEMIA ICD 272 0 xl Resting ECG erp taia QT Interval QGT GTC zi BP Diastolic ORS Interval Comment em pmi P Duration a EKG PYVavAxis z a joe jM p Heart Rate BP Systolic PP Interval EKG GRS axis n Pcia a s Technician Comment not saved to note RR Interval Additional Information rem om m EY Press Retrieve Results button to retrieve the results Prey Farm GtrsPaup Next Form Ctri PaDny 109A 4 TheEMR interface will retrieve the resting ECG data and display the measurement results Revision A CardioSoft 10 5 2023324 053 EMR Interface Performing an Examination CardioSoft Resti D O
34. Click a button to add or delete a stage Caution Bruise Hazard DO NOT spedify BP intervals shorter than 2 minutes The BP readings may be incorrect and thetissue might be damaged Revision A CardioSoft 2023324 053 11 21 System Settings Exercise Test Setup Creating a New Phase Protocol Editor Protocol Phase Stage Name Stage Time BRUCE Phase Stage Hamping off SUPINE STANDING ST RECOVERY Median Report Repeat Slage Time Speed Grade 12 Lead Report km h 4 First Repeat First AGE 7 Ramping off PRETEST Ramping BP First Store Median Repeat First Repeat 03 00 02 5 03 00 03 00 02 5 03 00 03 00 00 50 01 00 New iprotocs Delete protocol Print protocol Reset protocol Cancel Help 915A S 1 Select a blank protocol e g TEST 14 2 Click the New Protocol button to display the window with all protocol templates 3 Select a template from the list Editing Stage or Phase Information 4 Click on a stage or phase to display the active data fields Enter new data for the stage or phase To delete this stage or phase dick the Dd e stage or Delete phase button To add a stage dick Add stage To add a phase select a phase Then dick Add phaseor Add graded phase The new phase is inserted below the selected phase Note New protocols can be created only when
35. Conducting Spirometry Tests C oO WD o y gt Click to start the test Click to start the bronchodilator test Click to terminate the test Click for the post test review Click to load system setups stored for different system users see section Custom Setups Factory Setup on page 11 39 Click to display the spirometry setup menu see section Spirometry Setup on page 11 36 Click to activate the online Help program 3J Click to return to the initial screen ATS acceptance of the current test ATS statement PT code information for information on entering the PT code refer to section Acquisition Tab on page 11 36 Status line with information on the test procedure Flow Volume Measurement Operating Steps Warning Incorrect Measurements Risk of Infection The pneumotach including its mouth piece is designed for single use Use a new pneumotach for each patient Check that the PT code on the pneumotach is the same as the PT code R shown on the acquisition screen Clean the nose clip after each patient and attach new foam pads With the LF 501 use a fresh mouthpiece for each new patient Explain the test procedure to the patient Attach nose clip to ensure that the entire respiratory volume passes through the sensor During the measurement the patient should sit straight and hold the SpiroSoft sensor in a horizontal position Revision A CardioSoft 8 9 2
36. Final Report Tab oett teneret ee ce te 11 23 Miscellaneous 1 Tab 11 24 Miscellaneous 2 Tab x te bee bee bcm deh dee es 11 26 ST Mediaris 12SL Tab 7 ir eigen iad nia cid eee 11 30 M urge 11 31 Ambulatory Blood Pressure Measurement Setup 11 32 ACQUiSitiOn Tab mr carson ebedi enini hia EEK ee ent tongue Lope init 11 32 Miscellaneous Tab ccc cece eee II 11 34 Spirometry Setup sssri sse eee ee hem ees 11 36 ACQUISITION Tab oe ELI LR a bead ate ded te 11 36 Miscellaneous Tab ccc cece eee eee e eee I 11 37 Custom Setups Factory Setup 0 eee e eee eee eee 11 39 System Configuration cece cece cee eee tenes 11 41 General Tab stie bte MS Goth tena BS stot d MEG Attends 11 41 Devices Tab eo Rev eR e e AERE 11 53 Modem Tabi ii eb ER RD RUE e bdo 11 54 MUSE Tabs ut bd ER Li 11 55 Option Code Tab s i ctetuer e oct Ded ope S qe ad 11 57 Country Settings Tab e c coe aea oo Le o e 11 58 EMR Tabs c isse m EE OR ARN SES EISE aca 11 59 Revision A CardioSoft V 2023324 053 Cleaning and Maintenance ssslusuee A 1 Cleaning Disinfection and Maintenance uuaa A 3 Equipment Surface or i r ep e e EET eat VETE EE EAR d A 3 Cables Electrodes n n nunnan unnan aneneen A 3 Maintenance 02255 anaa map exe ele Pd aaia A 4 Before Each WS emn ostro TRU SR E a e a a A 4 Technical Inspections A 4 Disposal at the End of Its Servi
37. Jeannote 21 081961 24364 New Patient Ole 02 04 1959 04535 Guido 22194 TEST DEMO 28 04 1968 TEST DEMO 000000 Regine 05 04 1977 16936 Jean 31 08 1949 02474 Emest 31 08 1934 03656 Help Cancel Modify Last Name ESrbEMO First Name EsrbEMO Patient ID promo E Date of Birth 1968 04 28 YYYY MM DD Gers me a Height B im Hace a Weight 156 0 Ibs Pacemaker I ea 3 048A 1 Enter the patient s last name or the patient ID to find a particular patient It is sufficient to enter the first letters or numbers Select the test type 3 Check the patient information If it needs to be modified a Typeover the current data and b dick Accept 4 Follow these steps to select a patient a Click Sdect or b press Enter 5 Asanalternative you can double click on a patient name to select the record 6 If you are working with the keyboard only a Enter the patient s name b press the Tab key twice and c confirm the selection with Enter Note Once you have selected your patient the acquisition screen for the new test will appear 4 4 CardioSoft Revision A 2023324 053 Selecting a Patient Record and Test Type Retrieving a Patient Record from the MUSE CV System Database Retrieving a Patient Record from the MUSE CV System Database When you click MUSE Browser on the initial screen the patient selection window will appear Patient record and
38. Note Depending on the selected reference value equation the program requires the gender height weight date of birth and race data for calculation of the spirometry reference value see section Reference Value Equations Interpretation M odes Measurements on page B 12 You can assign a name to the location number see section MUSE Tab on page 11 55 which would appear instead of the number e g on the Test Summary Note The Patient I nformation can be assigned to the patient file or only to the pending test 8 4 CardioSoft Revision A 2023324 053 Spirometry Test Entering Test Information Test Personnel Tab Test Information Patient Information Test Personnel Medical History Ordering MD Attending MD Ref MD Extra Questions B Technician Comment Order Number ETE Canc SAR Reason for Test 1 Click the Test Personnel tab Type the relevant information in the Medical History field Enter the Reason for Test or select one from the list box Multiple selections are permitted 4 Type the physicians and technician s names or select them from the list boxes Type any Comment about the test Answer the Extra Questions Enter an Order Number This number will appear on the printed reports and on the Test Summary Note The Reason for Test library can be edited see section Editing the Reason for Test Medication Library on pag
39. Screen Tab on page 11 13 to display the configuration window You can choose the parameters for 6 graphic trends 1 2 3 Trend Configuration xl Y axis left Y axis right Lead Trend 1 VE min e zl EN NE EBENE Trend 3 BloodPressue y s aso Ecc El E meds ies sh vo E O fstiee Esse Elbe zit Cancel 911A S 1 Select the parameter for the left Y axis Select the parameter for the right Y axis 3 Choose the ECG lead for the ST related graphic trends Revision A CardioSoft 11 15 2023324 053 System Settings Exercise Test Setup Configuring the Vital Signs Click Configure Vital Signs on the Screen Tab on page 11 13 to display the configuration window Y ou can choose m thevital signs to be displayed m theorder in which they are presented m thefont size Vital Signs Window Configuration Treadmill x Move resize vital sign gt right 8 EMEN mouse click on vital sign menu GU selection move vital sign with I left mouse button Target HR 53 96 of 160 EXERCISE 05 42 STAGE2 02 42 RAO mr 120 6 4 METS 83 RPP Cancel 912A S 1 Click Add remove fields to select the vital signs to display 2 Right click a window item to choose a different font size or move the item These are the choices in the menu move bigger font smaller font 3 Click the appropriate item in the menu to change the font size 4 Click Mo
40. Time Change 11 51 T Tabular Summary Ambulatory Blood Pressure Measurement 7 13 Exercise Tests 6 31 Tabular Summary Configuration 11 14 Target HR 6 15 Technical Inspections A 4 Test Information Enter Exercise Tests 6 4 Resting ECG 5 3 Test Summary Ambulatory Blood Pressure M easurement 7 7 Exercise Tests 6 29 Resting ECG 5 11 Spirometry Tests 8 14 Test Type Select 4 4 Test Personnel Tab Ambulatory Blood Pressure Measurement 7 9 Exercise Tests 6 6 RestingECG 5 4 Spirometry Tests 8 5 Time Set 11 51 T Offset Mark Adjust 5 19 TONOPORT Downloading BP Data 7 6 Programming 7 5 Treadmill Slope Manual Change 6 15 Treadmill Speed Manual Change 6 15 Treadmills Connect B 4 Trends Configuration 11 15 Troubleshooting B 27 Troubleshooting thermal writer 2 13 TWA 6 13 TWA Analysis Enable Disable 6 4 TWA Trends 6 33 U Units of Measure 11 58 Revision A CardioSoft Index 3 2023324 053 Index User Administration 11 43 V VCMeasurement 8 12 Vector Loops 5 22 6 49 Virus Protection B 31 Vital Signs Window Configuration 11 16 W Warning Definition 1 8 Waterfall Display 6 47 Writer Paper Load 2 13 Z Zoom Factor Select 5 14 Zoom M ode Exercise Tests 6 46 Full Disclosure ECG 5 24 10 second ECG with Analysis 5 7 10 Second ECG View 5 13 12SL ECG Acquisition 6 13 12SL Interpretation 6 48 3D Graph 5 34 Index 4 CardioSoft 2023324 053 Revision A G
41. a storage medium Tosend records via modem m click Transmission via modem m enter telephone number name and password of the workstation at the receiving end m click OK toclear the window To save records to a storage medium m click Save procedure to storage medium m click OK to clear the window 9 8 CardioSoft Revision A 2023324 053 File Management Sending Exporting Deleting Patient Records Export Click the Export button to export patient record s using different file formats A BCD E fon SERRA Data f C Mi Export Cancel 102A A Select option button to export data as a PDF file B Select option button to export data as a Microsoft Word file C Select option button to export data as a Microsoft Excel file D Select option button to export data as an XML file E Click button to display the setup screen 1 Select the export format A B C or D 2 Configurethe export settings if needed see next page 3 Click the Export button to export the data For the PDF format select the documents to print in the Print window Revision A CardioSoft 9 9 2023324 053 File Management Sending Exporting Deleting Patient Records Settings A B C D E F xi XML Miprosoft Excel XML PDF M Standan Generate automatic file name ECG fittips Trend Information Full Djsclosure 12SLItm PT p Select data types to export PDF PDF pritter name Adobe p 7 z Use curren
42. and arrhythmia recording enabled O Enable or disable FRF or Cubic Spline algorithm see note below P Select filter frequency current ECC Q Select screen gain and speed R Click to change selected leads S Lead label click the label with the right mouse button to display an up down arrow for adjustment of the ECG baseline T Select writer gain and speed for ECG recordings in real time only U Click icon to freeze and release the ECG waveforms except lead at the top Warning Misinterpretation Please bear in mind that muscle filters 20 Hz 40 Hz 100 Hz might also suppress diagnostically relevant portions of the signal as they limit the signal range Therefore muscle filters should only be enabled if necessary Revision A CardioSoft 6 9 2023324 053 Exercise Test Before the Test Note Cubic Spline and FRF are algorithms that significantly reduce artifact and baseline fluctuations without adversely affecting the ECG signal as conventional filters do Therefore the system allows you to enable and disablethe algorithms during the test as needed Note During the exercise test a new protocol selection with Sd ect Protocol will become effective in the next phase Note Pacemaker Patients It is very important that you indicate on the first database screen pictured below whether your patient has a PACEMAKER implanted A check indicates that the patient DOES have a pacemaker Select patient local database E
43. and the noise limit The data are saved at intervals of 15 minutes Verify the TWA settings on this tab before the test TWA Heart Rate Limit bpm TWA Noise Limit uV 20 TWA at Heart Rate bpm tung Reset to Defaults 923A S Print Setup Help A Select the TWA Heart Rate Limit TWA values whose HR exceeds this limit are excluded from calculation of the maximum TWA value and are identified with a question mark on the display B Select the TWA Noise Limit TWA values whose noise value exceeds this limit are excluded from calculation of the maximum TWA value and are identified with a question mark on the display C Heart rate when first reached the corresponding TWA value is stored separately D Click to reset the values to the defaults E Click down arrow to select the update factor Note During thetest TWA data records are saved at given points in time Each TWA data record provides the following information timeit was saved heart rate TWA and noise values for each lead Revision A CardioSoft 11 31 2023324 053 System Settings Ambulatory Blood Pressure Measurement Setup Ambulatory Blood Pressure Measurement Setup Acquisition Tab Acquisition Protocol Statistics Integvals Stat Night Time 22 00 08 Wake up Time 00 00 until until The settings specific to the ambulatory blood pressure measurement modality can be entered either from the ambulatory blood pressure acqu
44. anterior axillary line V5F C5R A3 On either side of the neck or anywhere above the shoulders 3 12 CardioSoft Revision A 2023324 053 Preparing the Patient Attaching the CAM 14 Acquisition Module Attaching the CAM 14 Acquisition Module 47A Attach the acquisition module to the patient as shown above Open the buckle to loosen the belt Note The functions of buttons 1 and 2 on the acquisition module vary with the test performed Resting ECG Button 1 initiates ECG analysis Button 2 initiates a rhythm report Button 3 stops the writer Exercise Test For exercise tests different tasks can be assigned to the buttons see Miscellaneous 1 Tab on page 11 24 The default functions of the buttons are Button 1 initiates 12 lead report Button 2 initiates a rhythm report Button 3 stops the writer Revision A CardioSoft 3 13 2023324 053 Preparing the Patient Attaching the CAM 14 Acquisition Module For your notes 3 14 CardioSoft 2023324 053 Revision A 4 selecting a Patient Record and Test Type evision CardioSoft 2023324 053 For your notes 4 2 CardioSoft 2023324 053 Revision A Selecting a Patient Record and Test Type Selecting a Patient Record from the Local Database Selecting a Patient Record from the Local Database Overview eat Prog Patient ID aaa E TEST DEMO First Name ITEST DEMO Patient ID promo E Date of Birth
45. appear Select Display with Frameor Display without F rame Submit query or identify the patient record to beretrieved by patient ID or name Display the individual documents of the patient record Print reports using the Acrobat Reader printer tools on screen tool bar directly above the report page DO NOT usethe Internet Explorer printer tools toolbar at the top of the screen Revision A CardioSoft 9 7 2023324 053 File Management Sending Exporting Deleting Patient Records Sending Exporting Deleting Patient Records First select the patient record s m Toselect a series of consecutive records hold down the Shift key and click the first and last file name of the series m Toselect individual records hold down the Ctrl key and click on each single record you wish to select m Toselect all displayed patient records click Sdect all Transfer to MUSE Totransfer the patient record s to a MUSE CV system click the Transfer to MUSE button Note This button is enabled only if the data transfer tothe MUSE CV system has been enabled on the MUSE tab see section MUSE Tab on page 11 55 Once transferred to the MUSE CV system the patient records cannot be edited any more Data sent to the MUSE CV system can be viewed and printed with the MUSE Browser Please note Select the Landscape format before each printout Send Click the Send button to send the patient record s via modem or save them to
46. between the patient and the computer Two different acquisition modules are available for use with the system CAM 14 and CORINA CAM 14 Always connect the CAM 14 acquisition module to the CAM USB or to the CAM USB A T interface box never directly to the PC AHA RLRA V1 v2 V3 A1 A2jAS A4 Va V5 V6 LATLL CAM USB A T CAM USB CAM USB A T KISS Interface Box N R ct czca A1 A2 As A4 cajcs ce L F ic Interface Box C Onnar ES L D 1 Attach the lead label stickers to the acquisition module Thereis one set of lead label stickers with AHA labeling and one set with IEC labeling 2 Connect the acquisition module to the CAM USB or CAM USB A T interface box Toremovethe cable from the acquisition module press in the spring lock located on the side of the cable 3 Plugtheindividual lead wires into the acquisition module and connect the electrode clips to the BNC sockets of the lead wires Observethelead labels the labels on the cable must match those on the acquisition module Having connected the electrode dips to the BNC sockets turn them 45 dockwise so that they lock into place Revision A CardioSoft 2 5 2023324 053 Product Overview PC Setup Caution Proper Leadwire Connection Improper connection will cause inaccuracies in the ECG Trace each individual leadwire from its acquisition module label to the colored connector and then to the proper
47. electrode to ensure that it is matched to the correct label location Connect the CAM USB or the CAM USB A T interface box to the USB port of your PC Do not connect the CAM USB interface box toa USB hub or an extension cable Connect the AC power adapter to the CAM USB A T interface box Pull back the coupling sleeve to disconnect Suction tubing connects here CAM USB A T KISS interface box only Trigger and analog signal outputs Note The ECG signal input is isolated and defibrillation proof if used in conjunction with the CAM 14 acquisition module USB or USB A T interface box type BF Before starting the program check that the CAM USB or CAM USB A T interface box is connected to the PC If this is not the case the system cannot read the internal serial number and all option codes will become invalid CORINA CardioSoft V6 0 only supports CORINA models 101 118 3x CORINA is powered from a special AC power adapter A second version of the acquisition module is available for use with the electrode application system 1 Turn off the PC and connect the acquisition module to the parallel port of your PC Connect the cable of the AC power adapter Connect the patient cable to the acquisition module If you purchased an acquisition module that supports the electrode application system connect the pneumatic lead to the acquisiti on module Refer to the Operator s M anual of the Electrode Application System
48. for Reference Value Calculation Interpretation Mode Measurement Mode PT Code r Ambient Conditions Atmospheric Press 600 1200 hPa so Rel Humidity 10 90 B soopefsiure 10 40 C m F np FYE Te ir Print Help 205A SP Click to print the spirometry test setup Select the Equation for Reference Value Calculation Select the Interpretation Mode Select the Measurement Mode Select the PT Code Select to print the report automatically after the test Select 4 if you want to hear a beep at the end of expiration in the ATS mode Enter the atmospheric pressure Enter the relative air humidity Enter the ambient temperature SpiroSoft only Enter the respiratory air temperature for the VC FVC test LF 501 only c To mmuoouoov A Note Check the entered ambient conditions each day The program needs this information for BTPS correction Body Temperature Pressure Saturated i e the measuring values are referred to an ambient pressure and saturation with water vapor at a body temperature of 37 C Note Exiting the spirometry setup menu with OK confirms all data and the PT code At the same time date and time in the PT Code line on the acquisition screen will be updated 11 36 CardioSoft Revision A 2023324 053 System Settings Spirometry Setup Miscellaneous Tab Click the Miscellaneous tab to open the window quisition Miscellaneous
49. is saved the ECG strip is printed or the ECG strip is saved and printed see section Writer Tab on page 11 12 Revision A CardioSoft 6 46 2023324 053 Exercise Test After the Test Post Test Review Waterfall This screen shows a graphic color representation of the median beat changes in the course of the test updated at 30 second intervals Click anywhere in the waterfall to display the median complex and measurement of the corresponding point in time associated phase stage HR BP and METS appear at the right A B C D E F Tabular Summary Trend Graph Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG n reid white bl nde ds 1 00 79A S A Click the lead label to change the displayed leads B Median complex selected in the waterfall C Click to display the Waterfall D Color code of the different amplitudes in mV E Details of the selected median complex F Click to select the color menu Revision A CardioSoft 6 47 2023324 053 Exercise Test After the Test Post Test Review 12SL This screen shows the measurements and analysis results from the 12SL ECG analysis C DE F 4 Sinus rhythm with prematu e atrial complexes a 10 12 58am Vector Loops Left axis deviation Nonspecific T wave abnormality Abnormal ECG Vent Rate 86 bpm xl 210 mmimv Ees mm s RA SE SEDA AERA SENE SENA SEDE SANA SEDE SEDA IDA SE SEDE SENE EN
50. of the scroll bar allow direct access to the corresponding events Click to open a list showing all identified arrhythmias F Click to open a list with all leads U OU P m Revision A CardioSoft 6 43 2023324 053 Exercise Test After the Test Post Test Review Click to select gain and speed Click icon to activate the zoom function Click icon to print the entire full disclosure ECG or selected segments Click icon to go to the trend display Click icon to delete the full disclosure ECG Select the number of waveforms viewed Click to show and hide the arrhythmia strip markers beginning end Select or deselect the arrhythmia color coding Click icons for automatic scrolling of the ECG waveform adjust the scroll speed with the slider below uvoz zr xX TQ 6 44 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review Printing the Full Disclosure ECG You can print either the entire full disclosure ECG or only a selected segment Selecting an ECG Segment 1 Click tomark the beginning of the segment A flag appears 2 Click again to mark the end of the segment A second flag appears Printing 1 Click the printer icon The print setup window opens Print Full Disclosure ECG a x Pages to Print E 3 6 Time Period min s 00 00 05 24 Speed mm s Format one lead Lead i 4 ie Format 2 Go p Pi 8 iV avR Vv vi
51. settings for the printout Refer to section Final Report Tab on page 11 23 for details on changing the setup permanently Print edure Date 07 12 2004 10 12 40am TEST DEMO TEST DEMO B report pages NG i Trend Reports D xl IE Tabular Summary Stages C Detail Graded Exercise Summa y Report Custom ST Level Slope ST HR Loops ST HR Slope TWA f MAX ST PEAK EXERCISE om amp YS Selected Medians Report Sample Card Cycles 25 mm s he Oi E ped Sample TWA Cycles sn 50 mm s v JSL 10 1258am v All on Waterfall Dt ectpr Loop with measurement mark Deletd selections ECG Grid 1 S Kyocera Mite FS 1010 KX LPT1 Gain 10 mm mV Sd Modify Help Print Cancel 82A S 1 Select the documents for the report Configured Report Tabular Summary Graded Exercise Summary Report etc In the Trend Reports section select the report formats to print Select the gain Select the Configured Report format see section Report Editor on page 11 10 Select the number of copies for each report section Select the printer Check the total number of pages Initiate the printout Click Delete selections to cancel the selections o Now sf Note Select the ECG Grid option if you print on plain paper Temporary changes to the selections will be lost when you close the window 6 50 CardioSoft Revision A 2023324 053 Exercise Test Report Formats
52. the respective areas as described below Patient Information The Patient Information window opens You can only enter or correct data that does not affect the calculation of reference values Complete Patient Information A Edit or complete patient information Last Name i First Name Patient ID 000022127 Date of Birth DD MMM YYYY Gender Male Height 178 cm Race Caucasian Ba Weight 780 kg Pacemaker wem 184A BP Test Information The Test Information window opens see Entering Test Information on page 8 4 Note The Test Information is not assigned to the patient but to the test data FVC Measurement Click the FVC Measure tab to display the acquisition screen with the corresponding flow volume loop and the measuring values The status lineindicates the ambient conditions set at the time of the measurement Revision A CardioSoft 8 15 2023324 053 Spirometry Test Post Test Review Generating or Editing the Interpretation Inte pretati Statenjent Libr Syste C3 Bode aluation line obstruction CJ Mild dbstruction CI Moderate obstruction C3 Seve e obstruction Cg Low vital Capacity Ca nem spirometry C3 Mild n striction C3 Moderate restriction C Seve e restriction At the end of thetest the system evaluation is automatically entered in the interpretation window Click Interpretation or Modify to open the window In theleft part of the window yo
53. the displayed protocol is blank or was deleted New phases can be created only when an existing phase is deleted first and when the protocol has less than three phases If the stage time in pretest is 0 the pretest phase will automatically begin when the patient starts pedalling 11 22 CardioSoft 2023324 053 Revision A System Settings Exercise Test Setup Final Report Tab Click the Final Report tab for configuration of the report printout Report 1 Graded Ekercise Summary Report 1 IF MAX BT C PEAKIEXERCISE Selected Medians Report 1 IF M TWA Print Setup Help ST HR Slope 4 r4 F4 BE r3 Arrhythmia Review 1 x with measurement marks 6 AI C Selected Gain 100mm mV Cancel 916A S 1 Select the documents to be included in the report 999999 999 Configured Report Graded Exercise Summary Report Sdected Medians Report Tabular Summary stagg detail Trend Reports only the selected graphs will be printed Sample Cardiac Cycles ECG Strips Arrhythmia Review All prints all stored strips or arrhythmias Seected prints ECG strips or arrhythmias from the post test review 12SL Vector Loops Waterfall TWA Beat with measurement marks median complexes with ST measurement marks Select a report format Click Modify to edit the report or create a new Configured Report see Report Editor on page 11 10 Select the number of copies Se
54. the previous 10 seconds stops the thermal writer initiates a 12SL report includes measurement report and interpretation only available during pretest and recovery phases Revision A CardioSoft 2023324 053 Product Overview Putting the System Into Service Putting the System Into Service The software is a Windows based program Its scope can be expanded by activation of individual optional programs This manual describes the program with all options included If you have not purchased one or the other option simply skip the corresponding sections Access tothe program is restricted to registered users At thetime a user is registered the password and privileges are assigned technician physician with or without the right to edit data etc Mains Connection Power Up Functional Test 1 Before powering the system up for the first time read the safety information in section Safety Information on page 1 6 2 Turn on the PC the monitor and if used the bicycle ergometer or treadmill electrocardiograph and printer The program will start up automatically When you seethe initial screen see Initial Screen on page 2 13 and no error message appears the system is operational Note Do not run morethan one additional Windows based program at the same time as CardioSoft The screen saver is automatically disabled during ECG acquisition When using the program for the first time select t
55. to display sections currently out of view Note The vector loop is saved with the 12SL report only if the message Median update ceased Ra earn has disappeared from the ST Arrhy window at the time the 12SL report is stored Note The system stores up to five 12SL reports Revision A CardioSoft 6 23 2023324 053 Exercise Test During the Test Interpretation Window The Inte pretation window allows the physician to enter an interpretation of the test Lead Check Sri amp ry Medians Watertali Tabular Summary Trends ECG Strips 1281 Interpretation 66A S Interpretation Reasons for Termihation Fatique L Resting ECG normal Chest Pain n Functional Capacity normal Arrhythmias npne HR Response to Eyercise appropriate ST Changes npne BP Response to Eercise normal resting BP appropriate response Eid Overall impression IIR ai stress te Conclusion 67A S A Click the tab to display the Interpretation window Click to enter or edit the interpretation opens the edit window C Enter or select summary statement s for the different interpretation categories and for the Overall Impression UJ Click to enter the Conclusion E Click to confirm the test results F Click to clear the window 6 24 CardioSoft Revision A 2023324 053 Exercise Test During the Test Comparing Previous Test Data At any point in the test you c
56. to display the assignment list available only when unassigned tests exist see Assignment List on page 11 47 Click to transfer resting ECGs see Receiving Resting ECGs from Other ECG Devices on page 11 45 J Click to copy patient records to another medium The patient records remain stored in the local database see Copying Patient Records on page 11 48 K Click to archive patient records not currently used on an external medium see Archiving Patient Records on page 11 49 L Click to compress patient records see Compressing Patient Records on page 11 50 M Click to change the system date and time see Changing System Date and Time on page 11 51 N Click to perform a statistical analysis of all tests performed with the system see Procedure Statistics on page 11 52 O Click to display the Custom Setup screens for m Resting ECG see Resting ECG Setup on page 11 3 m Exercise Test see Exercise Test Setup on page 11 12 m Spirometry see Spirometry Setup on page 11 36 m Ambulatory Blood Pressure see Ambulatory Blood Pressure Measurement Setup on page 11 32 m Export see Settings on page 9 11 m Custom Setup see Custom Setups Factory Setup on page 11 39 P Click to save or load the System Configuration Q Click to access the service screen requires Service password R Click to quit the program S Click to print the System Configuration Note If
57. trend of ST level and slope versus time Click ST HR Loops to display the 2 dimensional representation of ST level versus HR see section Configuring Trends on page 11 15 C Click to display more graphic trends sh backward t forward Revision A CardioSoft 6 21 2023324 053 Exercise Test During the Test ECG Strips Window The ECG Strips window displays 10 second ECG strips m Stored during the last 10 seconds of each stage m acquired manually or m acquired automatically as configured see section Protocol E ditor Screen on page 11 20 A B C 63A S A Click the tab to display the ECG Strips window B Click to display more ECG strips backward forward C Test data of the ECG strip 6 22 CardioSoft Revision A 2023324 053 Exercise Test During the Test 12SL Window The 12SL window displays the 12SL resting ECG measurements and interpretation acquired by pressing 12SL during preacquisition pretest and recovery Lead Check STiArrhy Medians Waterfall Tabular Summary Trends ECG Strips 1280 interpretation 25 Hz 0 01 40Hz FRF Interpretation 64A S Age and gender specific E mw Sinus rhythm with marked sinus arthythmi 65A S A Click the tab to display the 12SL window B Click button to display the interpretation C Click to select the recording D 12SL measurements and interpretation E Click to clear the Interpretation window F Click arrows
58. wall outlet before cleaning or disinfecting the system Use a moist cloth to wipe the surface dean do not allow liquids to enter the system All cleaning agents and disinfectants commonly used in hospitals and containing up to 70 alcohol are suitable If liquids have entered the system notify Service to have the system inspected for damage before it is used again DO NOT usedisinfectants with a phenol base or peroxide compounds to disinfect the external surfaces Disconnect the cable from the system before cleaning or disinfection To disconnect cables always pull on the plug not on the cable Rub the cables dean with soap water use a disinfectant for disinfection All cleaning agents and disinfectants commonly used in hospitals and containing up to 70 alcohol are suitable Do not immerse the cables in liquids Discard single use adhesive electrodes immediately after removing them from the patient to prevent that they are reused Immediately after removing them from the patient clean reusable electrodes as described in the instructions for use Revision A CardioSoft A 3 2023324 053 Cleaning and Maintenance Maintenance Maintenance Before Each Use Before each use visually inspect the equipment the cables and the electrodes for signs of mechanical damage If you detect damage or impaired functions which may result in a hazard to the patient or the operator the items must be repaired or replaced before
59. writer for In Test Reports Select v or deselect 1 automatic in test reports configured in the Protocol Editor see Protocol Editor Tab on page 11 19 Select v or deselect 1 display of the ST Table in the 12 lead reports Define output of manually acquired in test reports Print Print amp Save or Save Select peak exercise report type none Medians 12 Lead ECG Select rhythm lead for viewing and recording Select 12SL report format Select Medians report m Select the rhythm lead for Linked Medians at l m Select the leads for Median H1 at N Select Rhythm Recall report format Select 12 Lead report format Select H1 ECG leads 11 12 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Screen Tab Click the Screen tab to open the window Writer Screen Lead Sequence Speed mm s Gain mm mV ead Check Noise Level Print Setup Help A B D E F G H K Screen Format Bs Fi ial Reports Miscellaneous 1 Miscellaneous 2 ST Metlia Median Groups Configure Trends J Configure Vital Signs J Anterior 99A S Click to print the exercise test setup Select or deselect 1 display of the 1 mV calibration pulse Select the sensitivity level to noise noise signal ratio low middle high electrodes with a high impedance are shown yellow Select the gain for the displayed ECGs Select the speed for the displayed E
60. zoom icon 2 Position the magnifying glass on the region of interest and click The selected median is displayed at a larger scale A B C D E Comparison of Medians nF CE _30 steph 18 122002 17 33 46 523A R Acquisition date Click to select the lead Click icon to terminate the zoom function Click icon to print the median Click button to display the 3D graph A B C D E Revision A CardioSoft 5 33 2023324 053 Resting ECG Post Test Review 3D Graph Click the 3D graph button to display a three dimensional representation of the medians from all selected procedures The scroll boxes allow you to rotate the illustration horizontally and vertically A B C D Comparison of Medians m E5 3 gap red white tiue X Er 524A R Click to select the lead Click icon to terminate the zoom function Click icon to print the illustration Click to select the color Click to start and stop the continuous rotation of the illustration set the speed with the slider below A B C D E 5 34 CardioSoft Revision A 2023324 053 6 Exercise Test evision CardioSoft 2023324 053 For your notes 6 2 CardioSoft Revision A 2023324 053 Exercise Test Patient Education Patient Education Before the test you should give your patient some information about what will happen in the course of the test Click the Patient Education button on the pre acqu
61. 023324 053 Spirometry Test Conducting Spirometry Tests 4 Click Start Test then click OK to confirm that the patient is not yet breathing through the sensor Wait for the status line to turn green Have the patient close the lips around the mouthpiece and perform the following maneuver through the sensor a Exhale completely b Slowly inhale completely c Exhale as vigorously and for as long as possible forced expiratory parameters in the ATS mode the expiration should last 6 seconds see information on the ATS mode d Inhale as vigorously and deeply as possible forced inspiratory parameters 7 Click Stop Test beep The system also emits the beep when SpiroSoft terminates the measurement automatically 8 Repeat the test several times because the patient s cooperation is essential for the quality of the test 9 Click Best test to display the new best test including system evaluation of the tests completed so far Note Theflow volume measurements in the ATS mode must meet specific criteria Acceptability Criteria Theexhalation in the FEV1 maneuver must be longer than 6 seconds configurable beep see section Acquisition Tab on page 11 36 Otherwise you will see the message E xhalation too short Anexpiratory plateau must be achieved i e the expiratory volume must not vary more than 30 ml within the last second Otherwise you will see the message No endexpiratory plateau Thefo
62. 1968 04 28 YYYY MM DD Gender Height jo in feum Weight 1560 Ibs Pacemaker J_ 048A Note Before running a new test you are required to select a patient record from the database or to enter a new patient Depending on the system configuration you will be working with the local database of the system or with the database of the MUSE CV system When you select N ew Test on the initial screen a window opens where you select the patient record and test type or enter a new patient A Click next page previous page to display more patient records B The bar cursor highlights a patient record C Textboxes for the patients Last Name Patient ID D Option buttons for selection of the test type see Devices Tab on page 11 53 E Click Select to select the highlighted patient and go to the acquisition screen of the selected test type F Click New Patient to activate the area for entry of patient information G Click Delete to delete the highlighted patient record from the database H Click Cancel to clear the window Click Accept to save the new or edited patient information to the database J Area for entry of patient information Revision A CardioSoft 4 3 2023324 053 Selecting a Patient Record and Test Type Selecting a Patient Record from the Local Database Selecting a Patient Record 5 1 2 4 Resting ECG Spirometry alter ECG C Ext Prog Patient ID Date of Birth Mass 05 04 1943 12282 L sse
63. 24 for information on changing the percentage permanently Enter a designation for the Room 5 characters max Select a Location Number necessary only when you work with the MUSE CV database system Note You can assign a name to the location number see section MUSE Tab on page 11 55 which would appear instead of the number e g on the Test Summary 7 Enable amp or disable 1 TWA analysis 6 4 CardioSoft Revision A 2023324 053 Exercise Test Entering Test Information Note The Patient I nformation can be assigned to the patient file or only to the pending test Note Whether or not TWA analysis is to be performed depends on the patient s medical history and on the results of the ECG interpretation program Before initiating TWA analysis check that all TWA settings are correct see TWA Tab on page 11 31 Revision A CardioSoft 6 5 2023324 053 Exercise Test Entering Test Information Test Personnel Tab Test Information Patient Information Test Personnel Medications Medical History Reason for Test Test Type D CDM x2 Yes C No Sar Comment Order Number 052A R Click the Test Personnel tab Type the relevant information in the Medical History field Enter the Reason for Test or select one from the list box Multiple selections are permitted Select the Test Type Type the physicians and technician s names or select t
64. 3 Exercise Test After the Test Post Test Review H Number of medians shown per stage v All cardiac cycles at intervals of 30 seconds C only one cardiac cycle Click icon to activate the zoom and reanalysis function see Reanalysis on page 6 37 J Click Reset to original to discard the results of the reanalysis and return to the original measurements Sl CardioSoft Revision A 6 36 2023324 053 Exercise Test After the Test Post Test Review Reanalysis Reanalysis allows you to manually change the position of the ST measurement marks On the reanalysis screen the medians of all leads are superimposed The currently selected lead is highlighted The screen shows the measurement marks determined by the system The marks above the baseline can be edited To activate reanalysis Click the Zoom icon on the Sample Cardiac Cycles screen position it over a complex and click the left mouse button A B C est Summ v Tabular Summary Graphic Trends 8a ie Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG wate gt EXERCISE STAGE 2 3 50 85 bpm 137 87 mmHg 50 0 W Reanalyze 4l D Onlythis one C Entire stage E C All following C AI zl Rest F amp 40 mn G EL 744 8 A Click to select another lead B Details of the selected median complex C Measurement marks determined by the system D Click to Rean
65. 324 053 Revision A Spirometry Test Sensors Sensors The following sensors are available for spirometry tests m SpiroSoft respiration flow sensor for FVC measurements m LF 501 respiration flow sensor for VC and FVC measurements For information on setup and operation of the sensors refer to the separate operator manuals Check whether the system is set up for the correct sensor See section Devices Tab on page 11 53 and connect the sensor to the configured port Revision A CardioSoft 8 3 2023324 053 Spirometry Test Entering Test Information Entering Test Information Overview Depending on your system configuration the Test Information window will open automatically or you can display it with the Test I nformati on button These are the tabs of the menu m Patient Information m Test Personnd m Medications Closing a tab with Cancel or OK will bring up the acquisition screen Patient Information Tab Test Information Patient Information Test Personnel Medications Patient ID TEST DEMO 000000 Last Name TEST DEMO Moy First Name TEST DEMO 101A SP The Patient Information tab is open 1 Verify the patient s name and ID If the data is incorrect click Modify to change Enter a designation for the Room 5 characters max 3 Select a Location Number necessary only when you work with the MUSE CV database system 4 Check that the patient information is complete
66. 7 194 01 and 301 340 00 9033 015 Suction electrode small German silver 9623 003P Tab electrode SILVER MACTRODE plus pkg of 1000 9490 210 Clip adapter for SILVER MACTRODE pkg of 10 919 202 32 Clamp electrode for limbs pkg of 4 red yellow green black ECG Accessories for Acquisition of NEHB Leads 223 403 03 Patient trunk cable 12 lead NEHB IEC CardioSoft Revision A 2023324 053 Order Information Order Information ECG Accessories for Exercise Tests 223 418 01 223 418 02 223 418 06 223 418 07 384 018 08 384 018 09 923 096 72 303 441 61 919 200 31 Consumables Patient trunk cable 10 lead IEC MultiLink 2 2 m Patient trunk cable 10 lead AHA MultiLink 2 2 m Patient trunk cable 10 lead IEC MultiLink 4 5 m Patient trunk cable 10 lead AHA MultiLink 4 5 m Set of 10 leadwires IEC MultiLink for electrodes with press stud Set of 10 leadwires AHA MultiLink for electrodes with press stud Exercise test belt Patient cable hanger for ergometer Disposable electrodes for adults pkg of 200 217 083 06 Electrode gel 10 tubes 100 ml each 217 083 05 Electrode creme 10 tubes 100 ml each 217 083 18 Electrode creme 250 ml refill bottle 217 083 14 Electrode creme 5 1 container 930 115 82 Dispenser 30 ml 217 307 01 Electrode contact spray 200 ml can 217 307 05 Electrode contact spray 2 1 refill 927 224 00 Adhesive rings pkg of 500 for electrodes 217 225 217 12301
67. 8pm 68 175 102 126 7 09pm 99 171 84 113 729pm 100 148 81 103 7 49pm 102 166 88 114 8 09pm 97 161 89 113 8 29pm 103 160 93 115 8 49pm 96 160 87 111 9 09pm 97 139 88 105 9 29pm 92 147 93 111 9 48pm 93 163 103 123 10 09pm 88 137 78 98 10 55pm 92 1451 78 100 11 15pm 84 153 git 111 11 589pm 81 1441 8g 107 1243am 86 1341 78 96 1 28am 72 141 83 102 215am 72 149 88 108 2 58am 72 124 73 90 343am 68 1421 75 97 42Tam 84 148 7 101 511am n 119 68 85 5 54am 74 136 78 98 6 40am 74 126 76 92 T2Tam 68 136 821 100 8 13am 82 131 82 98 8 33am 66 133 72 92 8 53am 7 1401 88 108 9 13am 83 146 941 111 9 33am 78 136 77 96 9 53am 83 155 98 17 10 13am 86 157 107 123 10 36am 98 173 89 117 10 53am 46 173 100 124 11 13am 73 123 88 99 11 34am 4 BP Limits sys dia Day Time 135 7 85 Night Wake up Time 125 80 Limit exceeded Night Time Manual Measurement 188A BP Revision A CardioSoft 7 13 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Hourly Averages The diagram shows the Hourly Averages of all measurements taken during the monitoring period Click Tabular to view the same values in tabular format Test Summary Graphics Hourly Averages statistics Summary Day Time Night Time Wake up Time 300 250 200 150 100 0 6 00pm 8 00pm 10 00pm 12 00am 200am 4 00am 6 00am 8 00am 10 00am 12 00pm 200pm 4 00
68. A BP Revision A CardioSoft 7 15 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Report Printout Click the Print button to print the report The print setup window opens where you can temporarily adjust the settings for the printout Refer to section Miscellaneous Tab on page 11 34 for details on changing the setup permanently Selected report pages Ne Hourly Averages 1 Ne Statistics Summary 1 Help N Tabular EF Y Phases LF ECG Strips EE Cancel 191A BP 1 Select the documents to be included in the report Standard Page Test Information Statistics Summary Graphics Tabular all measured values in tabular format Hourly Averages tabular and graphics format Statistics Summary Statistics Summary as histogram minimum maximum and mean values standard deviation Phases same as Statistics Summary but divided into day time wake up time and night time ECG Strips all ECG strips in chronological order TONOPORT IVa Configured Report Select the number of copies to print 3 Select a report format dick Modify to display the Report Editor see section Report E ditor on page 11 10 Select the printer Click the Print button to initiate the printout 7 16 CardioSoft Revision A 2023324 053 8 spirometry Test evision CardioSoft 2023324 053 For your notes 8 2 CardioSoft 2023
69. A algorithm is enabled ensure that thepretest phase is long enough approx 2 minutes for update factor of 1 32 approx 1 minute for update factor of 1 8 thepatient does not run until the heart rate exceeds the TWA heart rate limit default 125 BPM see TWA Tab on page 11 31 Revision A CardioSoft 6 13 2023324 053 Exercise Test During the Test Exercise Phase Overview Operating Steps The selected protocol will control the treadmill or bicycle ergometer When you enter the exercise phase the belt speed and grade will change according to the selected protocol the exercise clock will start phase and stage clocks restart at zero and the system will start saving test data This data can be viewed on the tabs at the top of the screen see ST Arrhy Window on page 6 16 to Interpretation Window on page 6 24 Press the F 2 exercise button to enter the exercise phase Press the F 9 start treadmill button to start the treadmill or ask your patient to start pedalling Warning Fall Hazard Your patient should wait until the treadmill belt is moving before stepping onto the belt Otherwise severe injury could result from a fall For the same reason avoid rapid changes in belt speed For a FAST stop of the treadmill in an emergency press the F10 STOP tmill button twice Please note that when restarted after FAST stop the treadmill returns to the previous speed and grade
70. B 31 2023324 053 Miscellaneous Direct Fax Transmission of Printer Documents Direct Fax Transmission of Printer Documents Instead of sending documents to the printer they can be directly routed to another PC or to a fax machine A modem with a serial port is required for this purpose The modems recommended by GE Medical Systems Information Technologies include the FAX software When installing the fax software from the program disk you can configure the fax port as the standard printer With this setting every print command is sent to the fax program Enter frequently used fax numbers in the Telephone Directory Select the high printer resolution and the landscape format If the same image is transferred more than twice between two PCs you must select the portrait orientation after the second transfer Sending a Fax 1 Display the screen to print 2 Select the fax asthe printer e g fax printer CAPTURE FAX BVZP The program converts the ECG to an image file Depending on computer power this may take a few minutes The status indicator shows the page being converted The fax software is activated automatically after the conversion 3 Select the addressee from the telephone directory 4 Select Send The status window and the audible signal from the modem indicate the transfer Note All modems connected to the system must meet the requirements of IEC 60950 or UL 1950 Furthermore the regulations valid in the respec
71. B interface box exit the program and restart m Incorrect ergometer model port selected section Devices Tab on page 11 53 m Check connection cable and connectors m Turn ergometer off and on again Restart the program Revision A CardioSoft 2023324 053 Miscellaneous Troubleshooting Problem Remedy No communication with MUSE The ECG grid is not visible in the PDF file Message Not enough free memory on hard drive After connection of the CAM USB interface box to the PC no ECGs are displayed Patient record cannot be opened and is reported to be locked Note m Incorrect network address of the MUSE server or shared directory section MUSE Tab on page 11 55 m Required options Request MUSE Data or Send Data to MUSE not enabled section MUSE Tab on page 11 55 m Incorrect network configuration system administrator m Incorrect Internet Explorer setup version gt 4 0 is required also for sending data to MUSE m Set up Acrobat Distiller as follows Acrobat V6 0 m Start gt Settings gt Printer gt Adobe PDF gt menu Printer gt Document Defaults menu Adobe PDF Settings gt disable do not send fonts to distiller menu Paper Quality gt button Advanced gt Graphic and select the field Download True Type Font as Softfont Acrobat V5 0 m Start gt Settings gt Printer gt Acrobat Distiller gt menu Printer gt Document Defaults gt menu A
72. CG 5 12 Measurement Results Ambulatory Blood Pressure Measurement 7 10 Measurement Results Configuration 11 26 Measuringthe ECG 5 15 Medians Resting ECG 5 16 Medical Reimbursement Program B 30 Medication Groups Edit Ambulatory Blood Pressure Measurement 11 34 Resting ECG 11 6 Spirometry Tests 11 37 Medications Tab Ambulatory Blood Pressure Measurement 7 10 Exercise Tests 6 7 RestingECG 5 5 Spirometry Tests 8 6 Metabolic Cart Connect B 9 METS Formula 6 20 METS Formel 6 20 Modem 11 54 B 9 Modem Connection B 9 Mouse 2 14 MUSE CV System Setup 11 55 Transfer Send Patient Records 9 8 View Print Stored Reports 9 7 MUSE CV System Database 4 6 N New Patient Enter 4 7 0 Operator s Manual View Print 2 16 Option Code Enter 11 57 Options 2 17 Order 4 6 Order List 4 6 Order Number 5 4 P Patient Data Enter 4 4 Patient Education 6 3 Patient ID 4 7 Patient nformation Tab Ambulatory Blood Pressure Measurement 7 8 Exercise Tests 6 4 RestingECG 5 3 Spirometry Tests 8 4 Patient Record Selection Local Database 4 3 MUSE CV System Database 4 5 Patient Records Archive 11 49 Patient Records Compress 11 50 Patient Records Copy 11 48 Patient Records Edit 9 6 Index 2 CardioSoft Revision A 2023324 053 Index Power Inlet 2 12 Power Up 2 12 Pretest Phase 6 13 Procedure Statistics 11 52 product code LW 1 15 Program Installation B 24 Protocol Configuration P
73. CGs Select a median group Then select the leads for this group Select the ECG format for the screen display Click to configure the Tabular Summary see Configuring the Tabular Summary on page 11 14 Click to configure the Trends see Configuring Trends on page 11 15 Click to configure the Vital Signs window see Configuring the Vital Signs on page 11 16 Revision A CardioSoft 11 13 2023324 053 System Settings Exercise Test Setup Configuring the Tabular Summary You can define up to 5 columns of data in the Tabular Summary in addition to the standard 8 Select preconfigured data types or create new column headings Click Configure Tabular Summary on the Screen Tab on page 11 13 to display the configuration window Tabular Summary Configuration x Select up to 5 items to be displayed in the Tabular Summary Column 2 Column 3 Column 4 Column 5 Cancel The highlighted items are selected for display 910A S 1 Click a highlighted item to deselect it Click a deselected item to select it 3 To create your own column headings a Type the new column heading b Click a heading to select it Note You can enter the values for columns 1 through 5 either directly in the Tabular Summary or use the F11 Comment key 11 14 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Configuring Trends Click Configure Trends on the
74. CardioSoft Version 6 0 Operator s Manual 2023324 053 Revision A GE Medical Systems Information Technologies gemedicalsystems com NOTE Theinformation in this manual only applies to system software version 6 0 It does not apply to earlier software versions Due to continuing product innovation specifications in this manual are subject to change without notice CASE CardioSoft CardioSys MAC MARS MUSE and MUSE CV are trademarks owned by GE Medical Systems Information Technologies a General Electric Company going to market as GE Healthcare All other marks are owned by their respective owners 2005 General Electric Company All rights reserved T 2 CardioSoft Revision A 2023324 053 31 March 2005 CE Marking Information CE Marking Information CE Compliance The product CardioSoft bears the CE marking CE 0459 notified body GMED indicating its conformity with the provisions of the Council Directive 93 42 EEC concerning medical devices and fulfills the essential requirements of Annex of this directive The acquisition module is assigned to class Ila according to Annex IX of the Council Directive 93 42 EEC The CE marking covers only the accessories listed in the Order Information chapter The acquisition module complies with the electromagnetic immunity requirements of standard I EC 60601 1 2 Electromagnetic Compatibility Medical Electrical Equipment The radio interference emitted by the a
75. CardioSoft Revision A 2023324 053 System Settings Resting ECG Setup Final Report Tab Click the Final Report tab for configuration of the report printout with measurement marks Gain mm pf 10 B Selected report pages 1 2 j Vector Loops TIER ed Xerox DocuTech 135 3 FILE 96A R 1 Select the documents to be included in the report Configured Report 10 second ECG up to 3 different formats with or without Interpretation Medians Vector Loops 2 Select the screen format for the 10 second ECG You can choose two more formats Select a report format A Click Modify to edit the report or create a new Configured Report see Report Editor on page 11 10 5 Select the number of copies to print 6 Select the rhythm leads 7 Select the printer 8 Choose the leads if you selected the Swedish H1 format 9 Select check box if you wish to print the measurement marks 10 Select the gain Revision A CardioSoft 11 9 2023324 053 System Settings Resting ECG Setup Report Editor The Configured Report Editor allows you to create a maximum of 10 templates e g letter to referring physician Two templates Reports 1 and 2 are preconfigured and cannot be changed Click Modify on the Final Report tab to display the Configured Report Editor window You can enter text and insert report items from a list e g patient name heart rate
76. Click button for a reanalysis with the HEART ECG analysis program only see Reanalysis on page 5 17 B Click button to display the tabular summary C Click to select the gain amplitude D Click to select the speed E Click icon to copy the waveform area to the Clipboard 5 16 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Reanalysis Reanalysis allows you to manually change the position of the ST measurement marks The reanalysis can only be performed on ECGs analyzed with the HEART program see section Miscellaneous Tab on page 11 8 On the reanalysis screen the medians of all leads are superimposed The currently selected lead is highlighted The measurement marks determined by the program are shown below the ECG baseline The measurement marks above the baseline can be edited The table in the top right hand corner indicates the time intervals The T offset measurement mark can be adjusted in each individual lead see Adjusting the T offset Mark on page 5 19 Measurements can also be performed on the complex 0 01 100Hz 60Hz HEART 5 Vi VaR MW VI Ivi iva iv Iv ill Iv avr Iv v3 512A R Click to select the lead to be highlighted Click to display the medians window Click button to display the tabular summary Click button to perform the reanalysis Click to reset the measurement marks to their original positions m UO WwW o Revision A CardioSoft 5 17
77. E ES 8 7 Post Test ReVIeW 2scsseses e e nr dee y RR eee bed ees 8 14 Test Summafy 4 s ase ket btt edunt oe kde sch ba eus ton 8 14 Generating or Editing the Interpretation ssssssese eese 8 16 Report PrintOUti xen tenere aa tetti rdi ane de tcd qnc ur ce d 8 17 Comparing Two Spirograms 0000 c cece e 8 18 File Management ccc cece eee eeee eee 9 1 OVER V I OW oos a E te etn te tene e e ee Es 9 3 Selecting Patient Records 9 4 Viewing Editing Printing Patient Records cece eee eee eee 9 6 Viewing and Printing Patient Records from the MUSE CV System 9 7 Sending Exporting Deleting Patient Records 0cceeeeeee eee 9 8 iv CardioSoft Revision A 2023324 053 1 0 EMR Interface enn n n nn nnn 10 1 CM ER EPPU EI 10 3 Performing an Examination ssssssseee 10 4 1 1 System Settings ciscisciscsiesiv s 11 1 Resting ECG Setup icc sci oe Rege eH CR ERE IR ERES 11 3 Acquisition Tab isssssssssssssss tent een eens 11 3 Lead Sequence Tab ined e ee men tae Bed eden 11 7 Miscellaneous Tab 0 0 ccc cece eet IRI 11 8 Final Report Tab cscs nani us ete cmn as tego eC eor du icd 11 9 Exercise Test Setup sic det ot ede g e knee e pa Yee ERR aa ba Eu 11 12 Writer Tab once SP ER Duce PE Qd ceu Free Qr 11 12 SCreen Tab ui n cg e t opc Rege Ne od rte 11 13 Lead Sequence Tab 11 17 Protocol Editor Tab 12 ie e cesses genes pane aaia 11 19
78. E Medical Systems Information Technologies gemedical com World Headquarters GE Medical Systems Information Technologies Inc 8200 West Tower Avenue Milwaukee WI 53223 USA Tel 1414 355 5000 1 800 558 5120 US only Fax 1414 355 3790 European Representative GE Medical Systems Information Technologies GmbH Munzinger Stra e 3 D 79111 Freiburg Germany Tel 49 761 45 43 0 Fax 49 761 45 43 233 CE 0459 Asia Headquarters GE Medical Systems Information Technologies Asia GE China Co Ltd 24th Floor Shanghai MAXDO Centre 8 Xing Yi Road Hong Qiao Development Zone Shanghai 200336 P R China Tel 86 21 5257 4650 Fax 86 21 5208 2008 2019524 001 Rev B
79. ECG R S inversion area between V1 and V2 T borderline ECG Arrhythmia results of the full disclosure ECG QRS Complexes 42 PVC 1 PSVC 1 Arrhythmia results of the full disclosure ECG QRS Complexes 16 Measurement results of procedure 1 Interpretation of procedure 1 Measurement results of procedure 2 Interpretation of procedure 2 U OU Comparing Median Complexes from Multiple Resting ECGs It is possible to compare the medians of at least 3 and up to 6 ECGs 1 Click Compare A window opens listing all the patient s resting ECGs Holding the Shift key down select the procedures 3 Click OK toclear the window 521A R Revision A CardioSoft 2023324 053 5 31 Resting ECG Post Test Review The comparison screen with the medians of the selected procedures appears A B O w EF Comparison of Medians E The recordings use different lead sequences Therefore it is T mm mV 1 aVF ST values not possible to display all leads Print window Il Il aVR avL aVF No data available TE 522A R Acquisition date Click to select the gain Click to select the leads Click icon to activate the zoom function Click icon to print the screen Click to select and deselect the ST values nm UO co WwW gt 5 32 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Zoom Mode Follow these steps to activate the zoom mode 1 Click the
80. ECG and or to end the test and display the report Click to load system setups stored for different system users see section Www Custom Setups Factory Setup on page 11 39 Click to display the resting ECG setup menu see section Resting ECG H Setup on page 11 3 2 Click to return to the initial screen J Click to select a temporary lead sequence from the list K Heart rate L Lead label Click the label with the right mouse button to display an up down arrow for adjustment of the ECG baseline Status bar controls for selection of speed gain for writer and screen M filter frequency current ECC indication of AC line filter Cubic Spline if enabled N Selection of a temporary screen format click with the right mouse button to open the list select a format with the left mouse button Click icon to freeze and release the ECG waveforms except lead at the O top Measurements can be performed on frozen waveforms see Measuring the ECG on page 5 15 Warning Misinterpretation Please bear in mind that filters might also suppress diagnostically relevant portions of the signal as they limit the signal range Therefore filters should only be enabled if necessary 10 Second ECG with Analysis The system continuously saves 10 s segments of the incoming ECG signal When you click ECG Acquisition the most recent 10 seconds will be stored as the patient s reference ECG and analyzed You c
81. FEV1 FVC Knudson This reference value equation was published 1983 KNUDSON et al Am Rev Respir Dis 127 1983 725 734 The reference values are height and gender related and are defined for patients aged 5 to 90 years from the ethnic groups Caucasian Race selection Caucasian African American Race selection Black Note Agerange from 5 to 90 years For patients exceeding the range limits the limit values will be used Arangefor height is not defined The equation defines the following reference values VC same as FIVC MEF75 MEF50 MEF25 PEF MMEF FVC FEV1 FEVI FVC Forche This reference value equation was published 1994 Sollwerte f r die Lungenfunktion Arbeitskreis f r die Standardisierung der sterreichischen Gesellschaft f r Lungenerkrankungen und Tuberkulose 1994 The reference values are height and gender related and are defined for patients aged 5 to 90 years for adolescents the values are also weight related Note Agerange from 5 to 90 years For patients exceeding the range limits the limit values will be used Arangefor height is not defined The equation defines the following reference values VC same as FIVC MEF75 MEF50 MEF25 PEF FVC FEV1 FEVI FVC Revision A CardioSoft B 13 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements Finland The equation combines the reference value developed by VILJ ANE
82. GL syndrome E blocked PSVC B C modified ventricular portion left ventricular hypertrophy CJ right ventricular hypertrophy biventricular hypertrophy E other myocardial changes wa abnormal repolarization zi PT TETTNNN 92A R A B CD A Click icon to open or close folders B Click icon to insert chapters or lines C Click icon to delete chapters D Click icon to sort texts alphabetically Revision A CardioSoft 11 5 2023324 053 System Settings Resting ECG Setup Editing Medication Groups Assigning Drug Names Medications Medication Group 1 Click Modify to display the Medications library 2 Click down arrow to open the list 3 Select the medication group 4 Click the Drug Name box and enter the medication name Note Assigning the correct names to the groups is the responsibility of the physician Drug Name Medication Group tn gt iS 2e m Xo o z 3 digitalis iw Wee l 7 10 sedatives tranquil hd B LL Adueics mj m twodmdcso Tj S pschooocs m Ct ca medications HA Bs Ami o NH w 7 antihypertensives a ee 14 dilantin sj gt 93A R Help 11 6 CardioSoft Revision A 2023324 053 System Settings Resting ECG Setup Lead Sequence Tab Click the Lead Sequence tab to open the window Lead sequence is the assignment of ECG leads to the writer or screen channels You can c
83. I Tipi FD ECG Sampling Rate 100 v Vector Loops Left Sagittal Plane A samples s 95A R A Select the check boxes v to enable the following functions Preview before Analysis Full screen display of the 10 second ECG analysis only after confirmation Print after Analysis Automatic printout after acquisition of the 10 second ECG Post Test Review after Analysis Automatic display of the test report after acquisition and analysis of the 10 second ECG Start Full Disclosure after Analysis After acquisition of the 10 second ECG the System starts saving the full disclosure data Pace Enhancement All pacer pulses will be displayed with an amplitude of 0 5 mV QRS Beep The system emits a beep each time it detects a QRS complex only with CAM 14 acquisition module Axis Graph An axis graph is shown in Tabular Summary and in the Median Report Select sampling rate for full disclosure ECG Enter prompt for Extra Question 1 appears in Test Information Test Personnel Select answer format for prompt 1 Select sagittal plane right left for vector loop display 12SL analysis program Select check box to display the corresponding statements in the Test Summary ACI TIPI Acute Cardiac Ischemia Time Insensitive Predictive Instrument is a mathematically based decision aid which has been shown to be useful in critical care situations where speed of diagnosis can be crucial G HEART analysis program nmo O W 11 8
84. Iv v4 V 13 Sate ANI Mal wv v v5 Fou 7 Iv il v avF M v3 iv VE Iv 15 Cancel 5 517A R 2 Select the paper speed 3 Click the Format 1 option button if you wish to print only one lead 4 Select the lead 5 Click the Format 2 option button if you wish to print multiple leads and select the leads 6 This box indicates the number of pages to print check paper supply before printing Click button to save the print setup Initiate the printout or click Cance to close the window Note To save or print a 12 lead ECG enable the zoom function as described below With button B you are then able to save or print the ECG strip Revision A CardioSoft 6 45 2023324 053 Exercise Test After the Test Post Test Review Enabling the Zoom Mode 1 Click the zoom icon 2 Position the magnifying glass on the region of interest and click An enlarged view of the selected region appears The operating controls basically remain the same When you click the printer icon however only that page will be printed Test Summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG Wate 4 50Hz 0 01 40Hz FRF 00 33 ASAR e Lead gt BeN N Lines Arrhythmia m ee E eee BUE Aiia in coor A le OO et J 78A S Click icon to print the displayed screen B Click icon to initiate one of the following actions the ECG strip
85. LA black L yellow Left arm resting ECG or left shoulder exercise test J RA white R red Right arm resting ECG or right shoulder exercise test H LL red F green Left foot resting ECG or left thigh exercise test RL green N black Right foot resting ECG or right thigh exercise test K A3 V3R gray C3R gray Opposite of C L A2 V4R gray CAR gray Opposite of D M A1 V7 gray C7 gray Left posterior axillary line at the level of D Revision A CardioSoft 3 7 2023324 053 Preparing the Patient Applying Electrodes Modified MASON LIKAR Lead Electrode Placement Posen 6 o gt o 9 500 34A AHA Label IEC Label Electrode Placement A V red C1 red Fourth intercostal space at the right sternal border B V2 yellow C2 yellow Fourth intercostal space at the left sternal border C V3 green C3 green Midway between sites B and D D V4 blue C4 brown Mid clavicular line in the fifth intercostal space E V5 orange C5 black Anterior axillary line on the same horizontal level as D F V6 purple C6 purple Mid axillary line on the same horizontal level as D and E G LA black L yellow Slightly below the right and left clavicle J RAwhite R red H LLred F green Lower edge of the rib cage or at the level of the RLgreen N black umbilicus at the left and right mid clavicular lines Note The ECG recorded with the torso placement of the limb lead electrodes may differ from that recorded with the electrodes on t
86. MEF75 MEF50 MEF25 MMEF FIVC FIV1 FIVI FVC PIF MIF25 MIF50 MIF 75 MVV ind Definition of Spirometry Test Values forced expiratory vital capacity forced expiratory volume in the first 0 5 seconds forced expiratory volume in the first second same as FVC if exhalation time lt 1 second FEV1 as a percentage of FVC forced expiratory volume in the first 3 seconds same as FVC if exhalation time 3 seconds forced expiratory volume in the first 6 seconds same as FVC if exhalation time 6 seconds FEV1 as a percentage of FEV6 peak expiratory flow maximal expiratory flow when 7596 of FVC remain to be exhaled maximal expiratory flow when 5096 of FVC remain to be exhaled maximal expiratory flow when 2596 of FVC remain to be exhaled maximal mid expiratory flow between 25 and 7596 of FVC forced inspiratory vital capacity forced inspiratory volume in the first second FIV1 as a percentage of FVC maximal inspiratory flow maximal inspiratory flow when 2596 of FIVC have been inhaled maximal inspiratory flow when 5096 of FIVC have been inhaled maximal inspiratory flow when 7596 of FIVC have been inhaled maximal expiratory ventilation volume in one minute indirectly determined 30 F EV 1 CardioSoft 2023324 053 Revision A Miscellaneous CardioSoft Web CardioSoft Web CardioSoft Web allows you to retrieve tests via the Internet for display on any PC Installing CardioS
87. N and WANNE The reference values byVILJ ANEN were published 1982 Scand J din Invbest Vol 452 Suppl 159 1982 The reference values are height and gender related and are defined for patients aged 18 to 65 years Note Agerange from 18 to 65 years For patients older than 65 years the age is set to 65 Arangefor height is not defined The equation defines the following reference values MEF 25 MEF50 PEF FVC FEV1 FEVI FVC VC sameas FIVC The reference values by WANNE are height and gender related and are defined for patients aged 6 to 17 years Note Agerange from 6 to 17 years For patients younger than 6 years the age is set to 6 Arangefor height is not defined The equation defines the following reference values MEF50 PEF FVC FEV1 FEVI FVC VC same as FIVC Brazil The Brazil equation is based on the reference values by PEREIRA and MALLOZI The reference values by PEREIRA were published 1992 J ornal de Pneumologia 1992 18 10 22 The reference values are height and gender related and are defined for men aged 25 to 78 years and women aged 20 to 78 years B 14 CardioSoft Revision A 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements Note Agerange 25 to 78 years for men and 20 to 78 years for women For patients older than the upper limit the upper limit will be used Arrange for height is not defined The equation defines the foll
88. NERO x Type cl new procedure C Exercise Test G Resting ECG C Speomeby C Ambulator Blood Pressure C Hole ECG C Ex Prog Search for Last Name Patient ID Last Name Fist Name Date of Bith Patient ID Select TEST DEMO 009000 New Patient Delete j Mody Last Name TEST DEMO Fist Name TEST DEMO Patient ID TEST DEMO 000000 Date of Bith 1 28 1958 MM DD YYYY Gender Mele Height s0 in Recs e a Weight i560 ibs Pacemaker We recommend the following filter settings for exercise tests m FRF ON m 40Hz iiiter Screen Lead Sequence Protobcl Editor Final Report Miscellaneous 1 Miscellaneous 2 ST Medians 12SL TWA E s y i V CubicSpline FRF FAF b bd ucc 1 Anhyihria Label Ful disclosure ECG Fiker Hz 40H Y g Remote View F Save ful disclosure ECG ol Max predicted HA AHA cem F QRS Beep FD ECG Start Exercise v HR FD ECG Samping Rate Target HR 5 i Acquistion Module UR aam samples s m v ace Enhance Blood Pressure Lima 300 Butoni iztea Audble LEAD OFF Alarm 3 PE Scale Borg 0 10 Button 2 R amp hm j r Tapa toed METS Interpolation Time s Print Setup Help Cancel 6 10 CardioSoft Revision A 2023324 053 Exercise Test Before the Test Operating Steps 1 Check the applied electrodes and verify the signal quality in all leads ST measurements and arrhythmia analysis will automatically be displayed when al
89. Note The ECG signal input is isolated and defibrillation proof if used in conjunction with the CORINA acquisition module type CF 2 6 CardioSoft Revision A 2023324 053 Product Overview PC Setup Warning Patient Hazard Always connect the CAM 14 acquisition module to the CAM USB interface box never directly to the PC Always attach the CAM USB interface box to a suitable place e g on the PC Shock H azard Equipment Damage The patient signal input is a high insulation port and it is defibrillation proof CAM 14 type BF CORINA type CF This type of input guarantees patient safety and protects the equipment during defibrillation and HF surgery Nevertheless extreme care should be exercised when a defibrillator or HF surgery equipment is used on a patient connected to other devices As a general rule the distance between the ECG electrodes and the defibrillation or HF surgery electrodes should not be less than 15 cm If this is not ensured temporarily disconnect the patient cables while using the defibrillator or the HF surgery equipment It is very important that conductive parts such as connectors electrodes transducers do not come into contact with other grounded conducive parts when connected to the isolated patient input Such contact would bridge the patient s isolation and cancel the protection provided by the isolated input In particular there must be no contact of the neutral electro
90. OK toinitiate the printout Online Help On many screens you will find a Hdp button Click the button to display a context sensitive H elp window 2 16 CardioSoft Revision A 2023324 053 Product Overview Software Features Software Features Many features are available as options which can be unlocked to enhance the CardioSoft functionality Followingisa list of these optional features For details please contact your Sales Representative RESB Basic Software Package 12 lead 15 lead ECG acquisition resting ECG downloading of data from electrocardiographs MAC 1200 MAC 500 data management for all modalities RESM Resting ECG Measurement measurement of 12 15 simultaneously acquired leads tabular presentation of measured values manual editing of measuring marks direct comparison of 2 resting ECGs dns Resting ECG Interpretation interpretation of the measured resting ECG with detailed explanations medication and patient s age aretaken into account reanalysis after manual modification of the measuring marks ERGM Remote View duringan exercisetest data is continuously sent via the network thefollowing information is available at any of the workstations in the network station name 6 lead ECG leads selectable information on the exercise test and ergometer HR and blood pressure EGMO Storage of the Full Disclosure ECG continuous storage of a maxim
91. PT port of the PC Warning Patient Hazard Do not set up the printer in the patient vicinity 1 5 m Setting the Laser Printer as Default Printer Follow these steps to select the laser printer as the default printer for printing the final reports 1 Logon tothe system as an Administrator 2 Click and select the following Windows menu items Start Settings Printers A window appears displaying the printers available for the system 3 Doubleclick the printer to use Kyocera FS 1000 Kyocera F S 1010 HP 4100n HP 4200n HP 2420dn HP 4600hdn A window pops up with the printer name in thetitle bar Click and select the following Windows menu items Printer 2 Set as Default Printer 6 Closeall windows and start CardioSoft B 8 CardioSoft Revision A 2023324 053 Miscellaneous Connecting Peripheral Devices ECG Recorder Connect MAC 1200 to COM port 1 or 2 using a serial cable Connect MAC 500 to a serial port via an IR converter Modem Connect MAC 1200 MAC 500 or an ECG system via modem Metabolic Cart Connect the metabolic cart to a serial interface Revision A CardioSoft 2023324 053 B 9 Miscellaneous Application Tips Application Tips General Application When operating the system in a network environment periodically scan the system for viruses The anti virus software should be updated on a weekly basis Customers are responsible for the installation and mainte
92. Revision A 2023324 053 Exercise Test After the Test Post Test Review Tabular Summary Test I Detail EXERCISE STAGE 1 STAGE 2 STAGE 3 RECOVERY TheTabular Summary window displays test data in twotabular formats m stage format 1 line per stage or m detailed format 1 line minimum 30 seconds The Tabular Summary can be configured See Configuring the Tabular Summary on page 11 14 for details Use the detailed format to enter or edit data 1 Click the value to change 2 Enter the new value Edited values are bold To enter new data 1 Click in an empty field 2 Enter the new value summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Ful Disclosure ECG Wate 4 gt VE ST leval 00 min Vey Coen 120 80 128 84 137 87 71A S A Select to display the detailed format 1 line 30 seconds B Click the Tabular Summary tab to display the stage format 1 line stage Note Only the stage format of the Tabular Summary is transferred to the MUSE CV system METS Values Between two stages the METS value will be interpolated see METS Formula on page 6 20 The correct METS value of a stage is reached after a stage time of 120 seconds default value can be changed see section Miscellaneous 1 Tab on page 11 24 Revision A CardioSoft 6 31 2023324 053 Exercise Test After the Test Post Test Review Gr
93. Soft Revision A 2023324 053 Introduction Service Information Service Information Service Requirements Refer equipment servicing to GE Medical Systems Information Technologies authorized service personnel only Any unauthorized attempt to repair equipment under warranty voids that warranty It is the user s responsibility to report the need for serviceto GE Medical Systems Information Technologies or to one of the authorized agents Equipment Identification Month Manufactured Year Manufactured Product Code Product Sequence Number Division Every GE Medical Systems Information Technologies device has a unique serial number for identification The serial number appears on the device label Fomat A is shown below D 1 XX 0005 G XX Device Characteristics A January 1 2001 Two character Manufacturing number One or 2 letters that further B February 2 2002 product of total units manufactured describe the unit for C March 3 2003 descriptor example D April and so on P prototype not conforming E May to marketing specification F June R refurbished equipment G July S special product H August documented under Specials J September part numbers K October U upgraded unit L November M December Format B is shown below THER THE FH HHHH B D E F A Product Code B Year Manufactured 00 99 00 2000 01 2001 02 2002 and so on C Fiscal Week Manufactured D Production Sequenc
94. afety standards and or the system configuration must meet the requirements of the lE C 60601 1 1 medical electrical systems standard m The use of accessories not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system Considerations relating to the choice shall indude useofthe accessory in the patient vicinity and evidence that the safety certification of the accessory has been performed in accordance to the appropriate EC 60601 1 and or EC 60601 1 1 harmonized national standard Revision A CardioSoft 1 7 2023324 053 Introduction Safety Information Definition The terms Danger Warning and Caution are used throughout this manual to point out hazards and to designate a degree or level of seriousness Familiarize yourself with their definitions and significance Hazard is defined as a source of potential injury to a person The safety statements presented in this chapter refer to the product in general The order in which safety statements are presented in no way implies order of importance Danger indicates an imminent hazard which if not avoided will result in death or serious injury Warning indicates a potential hazard or unsafe practice which if not avoided could result in death or serious injury Caution indicates a potential hazard or unsafe practice which if not avoided may result in minor personal injur
95. age 5 Click OK toinitiate the transfer A progress indicator appears Observe the instructions displayed on screen 6 Push the Copy key on the ECG recorder or send stored ECGs see separate Operator Manuals that come with the ECG recorder Click Cancd toterminate the transfer Click the patient record Click Find to select the patient or enter a new patient 10 Click to assign the patient record tothe patient Note Some of the patient information will not betransferred e g the medication Please check the received patient records Sometimes when a patient ID has not been entered ECG recorders may send a series of blanks instead of a patient ID A device number e g 12 can be entered at the E CG recorder to do so type hospital 961296 at Hospital Practice Name Note It is possibleto simultaneously send the ECGs from up to 4 ECG recorders via modem to the system To utilizethis feature an extra PC is required as the communications server This server is part of a network through which the ECG can be routed to the system or to a MUSE CV system database F or details please contact GE Medical Systems Information Technologies Technical Support or your local Service Representative 11 46 CardioSoft Revision A 2023324 053 System Settings System Configuration Assignment List In the assignment list you will find all tests that were not automatically assigned to a patient record This list appears when
96. als in their original containers to prevent poisoning risk RF Interference Known RF sources such as cell phones radio or TV stations and two way radios may cause unexpected or adverse operation of this device Consult qualified personnel regarding system configuration Revision A CardioSoft 2023324 053 Introduction Safety Information Caution Equipment Damage Before connecting the device to the power line check that the voltage and frequency ratings of your power line match those indicated on the device label Loss of Data To avoid loss of data make a daily backup of the system and patient information Restricted Sale In the USA U S Federal Law restricts this product to sale by or on the order of a physician Password Protection If access to the system is protected with a password the password must be stored in asecure place and made available to registered system users Acquisition Module Use CardioSoft only in conjunction with the CAM 14 or CORINA acquisition module Equipment Configuration The equipment or system should not be used adjacent to or stacked with other equipment If adjacent or stacked use is necessary test the equipment or system to verify normal operation Refer to the Electromagnetic mmunity information in this product s service manual for EN 60601 1 2 2001 Edition 2 compliance information and safety information for this product
97. alyze E Click an option button to select the complexes to reanalyze F Click to reset the measurement marks to their original positions G Click to change the gain H Click icon to terminate the reanalysis function and return to the Sample Cardiac Cycles window Revision A CardioSoft 6 37 2023324 053 Exercise Test After the Test Post Test Review Performing Reanalysis Aun FW N Click a measurement mark above the baseline and hold the mouse button depressed Movethe mark toits new position and release the mouse button Adjust the other marks in the same way Select the complexes to reanalyze Click the Reanalyze button Click Rese and Reanalyze to restore the original analysis results Reset to original restores the original results for all complexes of the entire exercise test Performing Measurements on the Median Complex Amplitudes mV intervals ms and slopes mV s can be measured on all sample cardiac cycles 1 Position the cursor on the first measurement point and click A caliper appears Position the cursor on the second measurement point and click Now you will see thesecond caliper themeasuring line themeasurement results Click the right mouse button to delete the measurement 6 38 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review Sample TWA Cycles Overview This screen shows the Samp
98. an be connected to a PC meeting the minimum GE Medical Systems Information Technologies requirements Please contact the GE Medical Systems Information Technologies Customer Service for advice This combination of devices allows you totransfer resting ECGs acquired in the automatic mode to the PC induding the pertinent data 2 8 CardioSoft Revision A 2023324 053 Product Overview PC Setup Be sure to observe the safety information given in section Safety Information on page 1 6 IE C standard 60601 1 1 must be complied with in any case Installing the Hardware Key for CardioSoft Client For use of the optional software packages m CardioSoft client m CardioSoft Web a hardware key is required for workstations that are integrated in the network and have no acquisition module Depending on the hardware key used it is connected either to the printer port or to a USB port Securethe hardware key connected tothe printer port by tightening the retaining screws if the threads are different remove the screws so that the connectors engage properly n case of problems disconnect the printer and check whether they persist If they don t install a second interface card for the hardware key Connect the USB hardware key to a free USB port It is not possibleto operate both the acquisition module and the hardware key at the same workstation When using the Floating License software option the hardware key must be insta
99. an compare the current data with that of a previous test 1 Click Previous Tests Current Patient 2 Double dick the test to review Page 1 of the median complexes will appear in the lower part of the screen for reference A B C Median Tabular Summary Trends ECG Strips Interpretation 1281 cole STUFE 1 00 00 METS 1 0 E25 mes m mn YI 25 ws Ya 10 min fae z FRE 50Hz FDECG 684 8 A Details of the displayed median complexes B Click tabs to view other ECG data windows C Click Close to clear the second test window D Click to view more median complexes backward forward E Click to display the baseline medians F Click to display the peak exercise medians Click to display the medians with the most significant ST depression Revision A CardioSoft 6 25 2023324 053 Exercise Test Recovery Phase Recovery Phase Overview Press the F 3 recovery button to advance to the recovery phase The dock begins timing the recovery phase In recovery the treadmill speed and grade or the bicycle load will change according to the protocol configuration 6 26 CardioSoft Revision A 2023324 053 Exercise Test Test End Phase Test End Phase Overview 1 Press the F 4 test end button to end the test and start the test end phase 2 Click Yes to confirm the test end The Interpretation window appears with the patient s ECG waveforms below Note After you press the F 4 te
100. an repeat this operation as often as needed The new ECG segment will always overwrite the previous reference ECG Revision A CardioSoft 5 7 2023324 053 Resting ECG Recording a Resting ECG Operating Steps Lead Check i Information 1 ECG Acquisition Start Full Disclosure ECG Initial Screen 054A R MS ms E mmv v sMz z Standard zi 1 Enter the Test Information or verify the data 2 Click ECG Acquisition to initiate acquisition and analysis of the 10 second ECG Note When you select ECG Acquisition before the system had time to save 10 seconds of ECG data a bar graph will inform you of the ongoing storage process The analyzed 10 second ECG appears at the top of the screen A new tab provides the corresponding interpretation 5 8 CardioSoft Revision A 2023324 053 Resting ECG Recording a Resting ECG Stop FD Post Test Review 055A R 3 Check the 10 second ECG and data 4 Select a different screen format if necessary Display the nterpretation and check the system evaluation and ECG measurement results f necessary repeat the procedure with ECG Acquisition If you do not wish to record the ECG for a prolonged period of time see F ull Disclosure ECG on page 5 10 click Stop F D Post Test Review to terminate signal acquisition Note Clicking Stop FD Post Test Review brings up the Tes
101. analysis may become necessary after changing the medication information Revision A CardioSoft 5 5 2023324 053 Resting ECG Recording a Resting ECG Recording a Resting ECG Overview In the upper part of the screen you see the lead check information for verification of the ECG signal quality All 12 or 15 leads are shown The schematic lead check torso allows you to verify the applied electrodes The actual waveform data appears in the area below With this modality you can acquire a 10 second resting ECG with subsequent analysis and or you can record the full disclosure ECG for a period of up to 60 minutes Lead Check Test Information O ECG Acquisition 7 D Start Full Disclosue E ECG E F Custom Setup G Setup H Initial Screen 054A R T 25 mm s ania ou gt Tf O N M L K J Lead check window B Schematic representation of the applied electrodes green correct yellow lead problem high impedance white not used red electrode disconnected or lead break numbers indicate the impedance value in KQ C Click to enter test information D Click to start acquisition of the 10 second resting ECG sp 5 6 CardioSoft Revision A 2023324 053 Resting ECG Recording a Resting ECG Click to start acquisition of the full disclosure ECG F Click to terminate acquisition of the full disclosure
102. aphic Trends Test Summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure EC Wate d gt 4 lisi ML MEC E23 Custom ST Level Slope ST HR Loops min C ST HR Slope LCS 72A S Click to display the graphic trends B Click to display other leads of the trends not available on all trend screens backward forward C Click icon to display the full disclosure ECG segment corresponding to a point selected on the trend graphs The button appears only when storage of the full disclosure ECG has been selected see Miscellaneous 1 Tab on page 11 24 D Click an option button to display other trend formats Click Custom to display user configured trends Click ST Level Slope to display the trend of ST level and slope versus time Click ST HR Loops to display the 2 dimensional representation of ST level versus HR To expand the ST and HR axes click Auto Scale ST and Auto Scale HR see section Configuring Trends on page 11 15 Click ST HR Slope to display the heart rate adjusted slope for all leads Click TWA to display the TWA trends see TWA Trends on page 6 33 Note The system starts collecting trend data at the beginning of the exercise phase 6 32 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review TWA Trends Overview This screen shows t
103. ar contraction premature supraventricular contraction pacemaker capture absolute pause artifact learn phase 1 significant arrhythmias QRSL ASYSTO VFIB VTAC RUN CPLT PAU2 PAU VBIG PERR ESC PVC PSVC PCAP PAUA A L 2 The arrhythmia analysis algorithm will not output these events in the presence of supraventricular arrhythmias e g atrial fibrillation 3 not in arrhythmia window no arrhythmia strip only full disclosure ECG 6 42 CardioSoft 2023324 053 Revision A Exercise Test After the Test Post Test Review Full Disclosure ECG Overview sania Riedl FERRE EE The system will save the full disdosure ECG only if configured see section Miscellaneous 1 Tab on page 11 24 On this screen you see one lead of the full disclosure ECG The events identified by the rhythm analysis algorithm may be color coded On the display you will also see when filter or cubic spline were enabled or disabled e g in the form of FRF off FRF Spline ON Spline 10mm s 1 mm mV rie PSVC Pvc BLEEE aa eR ate Ozzr aA ro mnm Arrhythmia Arrhythmia in color TH 1 re TH THERME IESFREPEEUFEEFIGUSUNENI i Tea 1 P 77A S Click lead label to change displayed lead Marks beginning and end of an arrhythmia Click to display the Full Disclosure ECG window Scroll box to display different time windows The markers to the right
104. ar hypertrophy premature ventricular contractions atrial fibrillation 919A S Select the topic to edit Click in the blank space below the last topic to add a new one Click the text field and type the new topic A maximum of 8 topics are possible Delete or change existing statements or add new ones a maximum of 20 statements can be entered for each topic Click the up down arrows to change the order of topics Revision A CardioSoft 11 27 2023324 053 System Settings Exercise Test Setup Entering Extra Questions Click Modify to open the E xtra Questions window Extra Questions r Extra Questions Prompt Type Prompt Type Alphanumeric s Cancel dis 1 Click in the text box for the first question and type a text 20 characters max Select the answer format Alphanumeric Numeric Y es No 3 Enter the second questions in the same way 11 28 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Assigning Functions to the Function Keys You can assign different functions to function keys F 1 through F 12 of the PC keyboard Click Modify to open the Assign function to keys F1 through F 12 window The text boxes display the currently assigned functions Assign function to keys F1 through F122 Fi F3 F5 F F9 F11 pretest fspeed load v F2 F4 F6 F8 F10 Fl2 Cancel exercise
105. ary Click to edit the Medications library Revision A CardioSoft 2023324 053 System Settings Resting ECG Setup Editing the Reason for Test Library In this window you can edit the library for the Reason for Test list box You can enter a maximum of 12 statements 1 2 3 Click Modify to display the Reason for Test library Select a line Enter the text Editing the nterpretation Library In this window you can edit the library of interpretative statements 1 Click Modify to display the Interpretation library Click aline to highlight it Click a second time to enable the edit mode and enter your changes With the icons at the bottom of the window you can open or close folders insert chapters E insert lines tE delete chapters be sort texts alphabetically Etl CardioSoft Revision A 2023324 053 System Settings Resting ECG Setup 1 Interpretation x C LAH C3 LPH B C modified atrial morphology 2 P wave changes C Pmitrale CJ P destroatiiale B C intraventricular blocks Z3 LBBB incomplete intermittent C left hemiblock C RBBB incomplete intermittent bifascicular block C incomplete trifascicular block CJ infarction block B C conduction disturbances pre excitation C 1st degree AVB Z3 2nd degree AVB Wenckebach Mobitz C 31d degree AVB C SA block Cg WPW syndrome accessory path C L
106. asurements B5 WN O 0 N oU 11 194A BP Select the number of BP periods Select the beginning of the period Select the end of the period Choose whether measurements are to be taken at exactly or at approximately the selected intervals Select the BP interval Select the deflation rate Enter a name for the protocol Select the inflation pressure for the first measurement Select the length of ECG strips TONOPORT IVa only Select whether you wish to record an ECG with each with every second or with every third BP measurement TONOPORT IVa only Click OK to clear the window Revision A CardioSoft 11 33 2023324 053 System Settings Ambulatory Blood Pressure Measurement Setup Miscellaneous Tab Click the Miscellaneous tab to open the window Extra Questions r Statement Library Prompt 1 Reason for Test Interpretation Modify Medication Modify Type J Alphanumeric jourly Averages T7 Statistics Summary Ur ianumeric T7 ECG Strips Print Help 195A BP Click to print the ambulatory blood pressure measurement setup Select documents to be included in the report Select the Configured Report format Click button to edit the Configured Report or create a new one see Report Editor on page 11 10 OU OU gt Select number of copies Enter Extra Question 1 20 characters max Enter Extra Question
107. atients on page B 10 and Recording ECGs During Defibrillation on page B 10 Warning Strangulation Hazard Route cables away from the patient s throat to avoid possible strangulation Revision A CardioSoft 3 3 2023324 053 Preparing the Patient Preparing the Patient s Skin Preparing the Patient s Skin a 1 Shave any hair from each electrode site and degrease each site with alcohol 2 Mark each electrode site with a felt tip pen 3 Remove the epidermal skin layer at each site i e remove the mark left from the felt tip pen Use an abrasive pad or skin prep cream 3 4 CardioSoft Revision A 2023324 053 Preparing the Patient Applying Electrodes Applying Electrodes Lead Labels on the Acquisition Modules CAM 14 CORINA AHA Label IEC Label AHA Label IEC Label RL N RL N RA R RA R LA L LA L LL F LL F V1 C1 V1 C1 V2 C2 V2 C2 V3 C3 V3 C3 V4 C4 V4 C4 V5 C5 V5 C5 V6 C6 V6 C6 A1 A1 Nst Nst A1 A2 A2 Nax Nax A2 A3 A3 A4 A4 Caution Proper Leadwire Connection Improper connection will cause inaccuracies in the ECG Trace each individual leadwire from its acquisition module label to the colored connector and then to the proper electrode to ensure that it is matched to the correct label location Revision A CardioSoft 2023324 053 3 5 Preparing the Patient Applying Electrodes Standard 12 Lead Electrode Placement AHA Label IEC Label
108. be unlocked with a hardware key see I nstalling the Hardware Key for CardioSoft Client on page 2 9 XEMR EMR Interface software package for communication with the EMR interface FLLX Floating License software package required if more than one person will usethe program at the same time the number of licenses varies with the purchased option code requires hardware key to be connected to the server Revision A CardioSoft 2 19 2023324 053 Product Overview Software Features For your notes 2 20 CardioSoft Revision A 2023324 053 3 Preparing the Patient evision CardioSoft 2023324 053 For your notes 3 2 CardioSoft 2023324 053 Revision A Preparing the Patient Applying Electrodes The Basics Applying Electrodes The Basics Careful application of the electrodes is a prerequisite for obtaining an interference free ECG In exercise testing careful preparation of the patient s skin is a must see page 3 4 For resting ECGs use GE s electrode application system Use only the GE Medical Systems Information Technologies recommended electrodes and contact agents The signal acquisition screen will show the applied electrodes and the signal quality after the right arm electrode has been applied When the right arm electrode becomes detached the system behaves as if all electrodes were disconnected Observe the information given in sections Recording ECGs of Pacemaker P
109. by GE Medical Systems Information Technologies or by persons authorized by GE Medical Systems Information Technologies theelectrical installation of the relevant room complies with the requirements of the appropriate regulations and the product is used in accordance with the instructions given in this manual m The acquisition module is protected against the effects of cardiac defibrillator discharge to ensure recovery as required by standards m Accuracy of the Input Signal Reproduction Overall System Error is tested using the method described in AAMI EC11 3 2 7 1 The maximum overall system error is 3 596 Frequency Response is tested according to AAMI EC11 3 2 7 2 methods A and D wm Modulating Effects in the Digital System This device uses digital sampling techniques that may produce some variation in amplitude of Q R and or S waves This effect may be particularly noticeable in pediatric recordings If this phenomenon is observed the dinician should be awarethat the origin of amplitude variations is not entirely physiologic For measuring voltages of Q R and S waves it is advisable to use the QRS complexes with the largest deflection of the particular waves m Contact GE Medical Systems Information Technologies for information before connecting any devices to this system that are not recommended in this manual m Parts and accessories used must meet the requirements of the applicable EC 60601 series s
110. can be compressed with the Compress function to free storage capacity for new data If you select compressed patient records for viewing they uncompress automatically Click Compress L on the General tab to display the setup window 1 Enter a date patient records older than this date will be compressed 2 Click Compress Note When working in a network environment quit the program before archiving or compressing patient records Run a backup of all data before archiving or compressing them 11 50 CardioSoft Revision A 2023324 053 System Settings System Configuration Changing System Date and Time Click Change Systen Date Time M on the General tab to display the setup window 6 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 fio 10 274M Chrrent time zone W Europe Daylight Time oce Epp 930A Time zone Click to select the month Click to select the day Click to select the year Click to change the system time Select the Time Zone nmuoou gt Note Access to the Date Time Properties dialog is restricted to authorized system users Revision A CardioSoft 11 51 2023324 053 System Settings System Configuration Procedure Statistics Click Procedure Statistics N on the General tab to display the setup window Procedure Statistics Date from to Period Cart Device Number Calculate Statistics
111. ce Life nanana A 4 Miscellaneous 00 cece eee eee teen eens B 1 Connecting Peripheral Devices ccc eee e eee teenies B 3 Bicycle Ergometers 0 0 cece een E ees B 3 Treadmllls 5 2 3 cete RE Rae ec hoe t o mA B 4 Blood Pressure Monitor 000 c cece cette eee eee eee B 6 SpQ2 MODIEOE x i n tcrtio re ane awe eee dr a dong s e edes B 8 Laser Printer 22 0 0 ccc cece Ie B 8 ECG Recordar ne paiia LE Vbec x M nasi E UR ER MAN B 9 Modem res ELSE IE En B 9 MetaboliC Gaft 2e tse road ete S UP e Bose B 9 Application Tips og e de on DR S ER Debe eek b ne nae B 10 General Application ics eee ee eine e B 10 Recording ECGs of Pacemaker Patients iliius B 10 Recording ECGs During Defibrillation lesse B 10 Reference Value Equations Interpretation Modes Measurements B 12 Reference Value Equations ssssssssssesess se B 12 Interpretation Modes B 16 Definition of Spirometry Test Values 0000s B 20 CardioSoft Web ecce e Re eer mx rh ene wget es B 21 Installing CardioSoft Web 2 cette tees B 21 Points to N t c oeste ots Esset e pedcs e Eee batten B 22 Displaying l ests rechten te eene ede B 23 Installing the Program issssseeeeeeennnn eee ee eee B 24 Installing the Program On a Stand Alone PC issiissuussssesssuee B 24 Installing the Program In a Network Environment 0005 B 26 Tr
112. cellaneous Reference Value Equations In terpretation Modes Measurements Impaired peripheral respiration Possible causes reduced pulmonary elasticity emphysema impaired ventilatory distribution peripheral airway obstruction Criterion VC MAX 2 x MEF50 Definition Interpretative Statement T50 2 0 8s normal T50 0 8 18s mild expiratory flow limitation at deep expiration T50 gt 18 moderate to severe expiratory flow limitation at deep expiration if gt 0 8s further lung function measurement recommended f all four interpretation criteria are normal the interpretative statement Normal lu ng function values is displayed B 18 CardioSoft 2023324 05 Revision A 3 Miscellaneous Reference Value Equations Interpretation Modes Measurements CHS Interpretation mode based on the American Thoracic Society recommendations for disability testing The most important criterion used is the FEV1 FVC ratio the changes of FEV 1 and FVC arealso considered The underlying reference values are those published by KNUDSON yes Obstruction possible Moderate obstruction 211A XXX Obstruction possible or Mild or Moderate or Severe obstruction Revision A CardioSoft B 19 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements FVC FEVO05 FEV1 FEVI FVC FEV3 FEV6 FEVI FEV6 PEF
113. ck ST HR Loops to display the 2 dimensional representation of ST level versus HR To expand the ST and HR axes click Auto Scale ST and Auto Scale HR see section Configuring Trends on page 11 15 Click ST HR Slope to display the heart rate adjusted slope for all leads D Click to exclude individual leads 6 34 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review Sample Cardiac Cycles Overview This screen shows the median complexes collected at each stage beginning with the pretest phase A B C Te amp t Summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG Wate gt EXERCISE EXERCISE EXERCISE EXERCISE STAGE 1 STAGE 1 STAGE 2 STAGE 3 3 3 50 5 01 86 bpm 86 bpm 85 bom 85 bpm D 128 84 mmHg 137 87 mmHg 250w 250w 50 0 w 75 0W BASELINE TEST END E h F ag s fill cardiac cycles H iW qQ l Lees J BAS Note Reanalyze the sample cardiac cycles as described under Reanalysis on page 6 37 A Click the lead label to change the displayed leads B Click to display the Sample Cardiac Cycles C Click to view more sample cardiac cycles D Click to show and hide the measurement marks E Select the speed of the displayed medians F Select the gain for the displayed medians G Select the number of lines 1 3 6 Revision A CardioSoft 6 35 2023324 05
114. ck icon to print the segment E Click icon to copy the segment to the Clipboard F Cursor position in mV 5 14 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Measuring the ECG Amplitudes mV intervals ms and slopes mV s can be measured on all ECG waveforms Test Summary ECG Traces Medi ns Arrhythmia Review Vector Loops Full Disclosure ECG m el s mE E Vent Rate 85 QRS duration PR interval 176 QT QTC 98ms P A T axes 17 39 8 RR FP Intervall 700 705 ms 378 449 ms P Huration 118 ms Armiplitude 1 81 mV 100mris 40mmim 0 01 100Hz 50Hz 510A R 1 Position the cursor on the first measurement point and click A caliper appears 2 Position the cursor on the second measurement point and click Now you will see thesecond caliper themeasuring line and themeasurement results 3 Click theright mouse button to remove measurement points Revision A CardioSoft 5 15 2023324 053 Resting ECG Post Test Review Medians This screen shows the median complexes of all leads as well as the measurement marks that formed the basis for analysis You are free to perform additional measurements if needed A B C D E Test Summar ECG Traces Madians Arty i Review Veci r Loops Full Disclo lure ECG Measurements s Tmm mv I 25mm s a8 PR reas me OTIC 300 488me Paan zB GTOMMTESD 127134 me s 1 mm mV 0 01 100Hz 50Hz HEART 5 3 511A R A
115. cords on page 9 4 and compare it with a second ECG 1 Click Compare A window opens listing all the patient s resting ECGs Select an ECG Click OK to clear the window The comparison screen with the two 10 second ECGs appears 5 28 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review 10 Second ECG 3 1Ommim 0 05 150Hz 50Hz 519A R A Click to select the lead With J you scroll through the leads with amp you open the list Click tabs to compare the Medians and the Interpretation Acquisition date and time Click icon to activate the zoom function Click icon to copy the waveform area to the Clipboard Procedure 1 Procedure 2 Qmnmmuoo su Zoom Mode Follow these steps to acti vate the zoom mode l Click the zoom icon 2 Position the magnifying glass on the region of interest and click Identical segments of the two procedures are superimposed With the scroll boxes you can shift the segment of procedure 2 horizontally and vertically Revision A CardioSoft 5 29 2023324 053 Resting ECG Post Test Review 520A R A Click scroll box to move the segment of procedure 2 to the right and left B Click scroll box to move the segment of procedure 2 up and down Medians Click the M edians tab to display the screen for comparison of the two median complexes The scroll boxes also allow you to move the median of procedure 2 up and down and to the right and left Inter
116. cquisition module is within the limits specified in EN 55011 dass B Magnetic and electrical fields are capable of interfering with the proper performance of the device For this reason make sure that all external devices operated in the vicinity of the system comply with the relevant EMC requirements X ray equipment MRI devices radio systems cellular telephones etc are possible sources of interference as they may emit higher levels of electromagnetic radiation Keep the PC away from these devices and verify the performance of CardioSoft before use The safety and effectiveness of this device has been verified against previously distributed devices Although all standards applicable to presently marketed devices may not be appropriate for prior devices i e electromagnetic compatibility standards this device will not impair the safe and effective use of those previously distributed devices see Operator s Manual The country of manufacture appears on the device label Revision A CardioSoft CE 1 2023324 053 CE Marking Information For your notes CE 2 CardioSoft Revision A 2023324 053 Contents INGOGUCUON ER 1 1 License Agreement 222 62 cct eet eme e x p hne a 1 3 About This Manual ssssssssesssesse III 1 4 RVISION FISIOLY ise ane aes eek eo Gad Gee bead dae a ea 1 4 Manual Purpose 0 c cece ns 1 4 Intended Audience 0000 cece eee eee eee eens 1 4 Conventions de ec
117. ct the patient from the CardioSoft PC before using the high frequency surgical unit CardioSoft uses an analysis program which can be used as a tool in interpreting ECG waveforms The acquisition module is not intended for intracardiac use This manual is an integral part of the product It should always be kept near the PC Close observance of the information given in the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety Please read the manual once in its entirety because information pertinent to several chapters is given only once The GE Medical Systems Information Technologies quality management system complies with the standards DIN EN ISO 9001 and EN ISO 13485 To ensure maximum patient safety interference free operation and the specified measuring accuracy we recommend using only original GE Medical Systems I nformation Technologies accessories The user is responsible for application of accessories from other manufacturers The warranty does not cover damage resulting from the use of unsuitable accessories and consumables from other manufacturers CardioSoft Revision A 2023324 053 Introduction Safety Information m GE Medical Systems Information Technologies is responsible for the effects on safety reliability and performance of the product only if assembly operations extensions readjustments modifications or repairs are carried out
118. ction with a medical reimbursement program the functions selecting another patient admitting a new patient are not available The following patient demographics are entered in the medical reimbursement program last name first name patient I D date of birth height and weight Note GE Medical Systems I nformation Technologies is not in a position to guarantee full compatibility of medical reimbursement programs with CardioSoft B 30 CardioSoft Revision A 2023324 053 Miscellaneous System Maintenance System Maintenance Data Backup Norton AntiVirus We recommend making one backup of the operating system and daily backups of the CardioSoft software and of the patient data We recommend using Norton AntiVirus in conjunction with CardioSoft TouseAntiVirus select the following options m AUTOPROTECT Disable AUTOPROTECT and disableSTART AUTOPROTECT WHEN WINDOWS STARTS m SCRIPT BLOCKING Disable ENABLE BLOODHOUND HEURISTICS m INTERNET Disable SCAN INCOMING EMAIL RECOMMENDED Disable SCAN OUTGOING EMAIL RECOMMENDED m LIVE UPDATE Disable ENABLE AUTOMATIC LIVE UPDATE m OTHER Deselect all four check boxes in this window Periodically update the virus definition database via modem or TCP IP network using the manual Live Update feature once a week if possible Warning Patient Hazard Disconnect the patient from the system when the modem is connected Revision A CardioSoft
119. d and an audio signal sounds if configured see section Miscellaneous 1 Tab on page 11 24 Using the treadmill speed and grade buttons during a protocol puts the treadmill in manual control The system is no longer controlled automatically by the protocol The system will enter a new stage and the phase name appearing in the Tabular Summary will be Manual Revision A CardioSoft 6 15 2023324 053 Exercise Test During the Test ECG Data Windows ST Arrhy Window The ST Arrhy window displays the median complex left and the current arrhythmias right As soon as the exercise phase begins the current median complex is superimposed on the baseline complex and both measurements are displayed The system chooses the two leads with the greatest amplitude for arrhythmia analysis click E to select another lead The system starts saving arrhythmias at the beginning of the pretest 20 arrhythmias max following preset priorities see section Arrhythmia Review on page 6 41 A B CD E F G H 58A S K A Click the lead label to display the median complexes of other leads The message Scan indicates that the system has chosen the lead with the most significant ST depression Leads aVR aVL V1 are not considered B Click the tab to display the ST Arrhy window C Click Superimposition to display the median complexes from all leads superimposed click again to restore normal presentation D Click Zoom to chang
120. de and ground Note Set up the device so that the operator has a clear unobstructed view of the control panel Only persons with the required training and expertise are authorized to use medical electrical equipment such as a PC with CardioSoft Revision A CardioSoft 2023324 053 2 7 Product Overview PC Setup Connecting Further Accessories MAC 1200 MAC 500 The illustration shows further accessories and the interfaces where they are connected If your PC has more than two serial interfaces please bear in mind that devices connected to COM 1 and COM3 cannot be operated simultaneously unless an interface board with separate interrupts IRQ has been installed setup via Windows Control Panel The sameistrue for COM2 and COMA When your mouse is connected to COM 1 for instance you cannot connect another device to COM3 Connecting the ergometer to COM2 and the respiration flow sensor to COM4 is possible however Caution Radio Interference In residential areas devices and installations with radio interference protection according to EN 55011 dass A may be disturbed by radiation emitted by the PC system In this case the user is required to take appropriate measures patient BP monitor respiration sensor EKG unit printer acquisition module treadmill GE modem mouse serial serial COM parallel LPT 01A Via the serial interface the ECG systems c
121. dit the test settings 5 Enter a password Be sure to remember the password If you forget it you will have to contact the GE Medical Systems Information Technologies Technical Support or your local Service Representative 6 Select the External User check box if you wish to receive data from remote test stations at the sending stations enter the addressee s name and password Note Do not use any special characters in your passwords The minimum length of a password is 6 characters 11 44 CardioSoft Revision A 2023324 053 System Settings System Configuration Receiving Resting ECGs from Other ECG Devices With the Receive Data from ECG Device function resting ECGs acquired with other GE Medical Systems Information Technologies ECG devices can be transferred to the local database Note If an ECG is received without patient ID not even blanks the patient ID 000000 will be used Receive Data from ECG Device ECG recorder connected to modem port Accept procedure from registered physician name only ECG recorder connected to serial interface Baud Rate 19200 Part COM2 M CX Data from storage medium Modify A Receive MAC 5000 ECG from disk 3 I Automatically generate patient record and assign procedure 4 Cancel Heb 927A Click Recdve Data from ECG Device I on the General tab to display the setup window 1 Select the transmission modality ECG system connected to
122. dobe PDF Settings gt disable do not send fonts to distiller menu Paper Quality gt button Advanced gt Graphic and select the field Download True Type Font as Softfont Acrobat V4 0 m Start gt Programs gt Adobe gt Acrobat 4 0 gt Acrobat Distiller 4 0 gt Defaults gt Settings gt Fonts enable gt Embed all fonts m Free storage capacity on the hard drive where your database is stored e g by compressing exercise test data or by deleting examinations Also ensure that there is enough free storage capacity on the hard drive where your operating system is located and in the temporary directories 100 MB minimum m Remove connector of the CAM USB interface box from the PC wait about 10 seconds then reconnect When prompted to install a new USB device clear the prompt or any other message with Cancel m In a network environment the currently open patient record may be locked following the crash of the client or server e g due to power failure Please contact Customer Service for advice Disable the SpeedStep technology when running the program on a laptop B 28 CardioSoft Revision A 2023324 053 Miscellaneous Troubleshooting Remote Service Note You can send the problem screen to GE Medical Systems I nformation Technologies Using the Print key on the keyboard copy the screen tothe Clipboard Open WordPad by selecting Start gt Programs gt Accessories I
123. ds ECG Strips 128L Interpretation 61A S A Click the Tabular Summary tab to display the window stage format 1 line stage B Select to display the detailed format 1 line 30 seconds Revision A CardioSoft 6 19 2023324 053 Exercise Test During the Test METS Formula Treadmill speed x 26 8 x 0 1 grade 100 x 1 8 x speed x 26 8 3 5 METS 3 5 speed miles per hour grade percent speed x 0 1 grade 100 x 1 8 x speed 3 5 METS 3 5 speed meters per minute grade percent Bicycle Ergometer 12 x load 3 5 x weight METS weight x 3 5 load Watt weight kg Between two stages the METS value will be interpolated The correct METS value of a stage is reached after a stage time of 120 seconds default value can be changed see section Miscellaneous 1 Tab on page 11 24 6 20 CardioSoft Revision A 2023324 053 Exercise Test During the Test Trends Window The Trends window displays graphic trends of different parameters The trends are updated in 30 second intervals Lead Check STiArhy Medians Waterfall Tabular Summary Trents ECG Strips 1281 interpretation VE min R bpm mmHg Custom C ST Level Slope C ST HR Loops 62A S A Click the tab to display the Trends window B Click an option button to display other trend formats Click Custom to display user configured trends Click ST Level Slope to display the
124. e 11 37 Y ou can define two Extra Questions as needed see section Miscellaneous Tab on page 11 37 You enter the names of the physicians and of thetechnician in the System Configuration see section General Tab on page 11 41 Revision A CardioSoft 8 5 2023324 053 Spirometry Test Entering Test Information Medications teen SIAR 1 Click the Medications tab 2 Enter or choose a maximum of 5 medications 3 Enter the medication dose Note You can edit the medication library see section Editing the Reason for Test Medication Library on page 11 37 8 6 CardioSoft Revision A 2023324 053 Spirometry Test Conducting Spirometry Tests Conducting Spirometry Tests Overview We will explain a spirometry test with the SpiroSoft respiration flow sensor The operating steps for spirometry tests with the LF 501 sensor follow next Theflow volumeloop is recorded in the spirometry test all diagnostically relevant values for forced inspiration and expiration can be derived from the flow volume loop see section Definition of Spirometry Test Values on page B 20 Y ou can choose between two measurement modes m Envedope m ATS The Envdope mode permits multiple maneuvers to be performed in a test When you terminate the test the system will determine the envelope waveform and derive the measuring values If several tests exist the system will determine the best measurement which is the m
125. e Number E Manufacturing Site F Miscellaneous Characteristics Revision A CardioSoft 1 15 2023324 053 Introduction Service Information For your notes 1 16 CardioSoft Revision A 2023324 053 2 Product Overview evision CardioSoft 2023324 053 For your notes 2 2 CardioSoft 2023324 053 Revision A Product Overview PC Setup PC Setup Minimum PC Requirements processor Pentium gt 1 6 GHz RAM 256 MB hard drive 4 GB depending on the number of tests to save 300 MB of free memory minimum SW installation CD ROM drive pointer mouse graphics adapter SVGA 1024 x 768 interfaces 2 serial interfaces for mouse ergometer respiration flow sensor external BP monitor TONOPORT ambulatory BP monitor For simultaneous operation of the ergometer and the BP monitor at one interface each an interface card with separate interrupts IRQ must be installed Set the configured I RQ s of the card in the Ports menu in Windows Control Panel 1 parallel printer interface 1 USB interface for the acquisition module operating system Windows 2000 SP 4 minimum Windows XP Home SP 2 minimum Windows XP Professional SP 2 minimum safety requirements tested for compliance with EN 60950 protection class laptop or notebook also protection dass Il or internally powered device printer laser printer Kyocera F S 1000 Kyocera FS 1010 6 MB mi
126. e patient record list An asterisk identifies archived patient records Do not copy the data to the root directory e g d create a subdirectory e g d data If you want to view an archived patient record the system will indicate the storage medium Archived patient records can betransferred to the MUSE CV database system only after they have been restored Click ArchivePatient Records K on the General tab to display the setup window 6 1 2 Patient Records Archive xj Restore Food Restore all patient records from Archive all patient records that are glder than archive the date hown 01 01 1934 Archive Cancel Help 929A 1 Enter a date patient records older than this date will be archived Click the Archive button Insert the storage medium and after archiving label it with the number displayed Select the target drive or directory Click OK Observe the instructions displayed on screen Proceed in a similar way to restore archived patient records Note When working in a network environment quit the program before archiving or compressing patient records Run a backup of all data before archiving or compressing them Please note that each fileto archive must be smaller than the capacity of the storage medium Revision A CardioSoft 11 49 2023324 053 System Settings System Configuration Compressing Patient Records Older patient records that are seldom used
127. e test data In this case the patient should be selected in the medical reimbursement program The patient s height and weight should be entered in the reimbursement program but this information can also be added in CardioSoft Having selected the patient choose the test type This takes you automatically to the GE Medical Systems Information Technologies program which is controlled as described in this manual You can retrieve the patient s previous tests compare tests or perform new tests Toselect another patient however you must exit the examination program and return to the medical reimbursement program After the test and quitting the examination program the most important test results but not the signal traces will be sent to the reimbursement program Some of the reimbursement programs will also generate a bill that you may or may not accept Communication between the reimbursement program and the GE Medical Systems Information Technologies examination program m Start of the medical reimbursement program m Selection of a patient m display of the patient record a selection of a test type starting the GE Medical Systems I nformati on Technologies examination program recording of new tests ECG spirogram etc termination of the test and quitting the examination program transfer of test data to the medical reimbursement program When running the GE Medical Systems Information Technologies examination program in conjun
128. e the cursor up down to the left and to the right Enter or Return moves the cursor to the beginning of a new line Spacebar inserts a blank enables functions e g starts the sphygmomanometer generates the patient ID dice H Tab key moves the cursor to the beginning of a new line in Windows dialog boxes it moves the cursor to the next entry field Onm 2 10 CardioSoft Revision A 2023324 053 Product Overview PC Setup Softkeys Controlling Exercise Tests Softkeys for control of the exercise test are displayed at the bottom of the screen you activate these keys by clicking them with the mouse Some of the softkeys can also be activated with the function keys F1 through F 12 on the keyboard Following is a brief explanation of the key functions For detailed information on running the exercise test please refer to sectopm Before the Test on page 6 8 F1 pretest F2 exercise F3 recovery F4 test end ahy doc hold stage F5 speed F grade up 12lead medians rhythm recall stop writer F1 pretest F2 exercise F3 recovery F4 test end arrhy doc hold stage F5 speed or load F6 speed or load F7 grade F8 grade F9 start treadmill F10 stop treadmill F11 comment F12 enter BP 12 lead medians rhythm recall stop writer 12SL F3 start trill F amp grade down F10 STOP tmill F11 comment F12 enter BP 062A 125L analysis F6 speed
129. e the size of the median complex E Click the lead label to open a window for manual selection of the arrhythmia lead the system automatically selects the 2 leads with the greatest amplitudes F Arrhythmia label G Time at which arrhythmia occurred in the indicated phase H Number of ventricular ectopics per minute ST measurements K Click arrows to adjust the E J and post J reference points only in manual mode see section ST Medians 12SL Tab on page 11 30 Note Significant arrhythmias are displayed with red waveforms 6 16 CardioSoft Revision A 2023324 053 Exercise Test During the Test Medians Window The Medians window displays the current median complex The system saves new median beats at the time intervals selected in the Protocol Editor see section Protocol Editor Tab on page 11 19 Lead Check STiarhy Medidns waterfall Tabular Summary Trends ECG Strips 1251 interpretation 59A S A Click the tab to display the Medians window B Click option button to select different lead groups see Screen Tab on page 11 13 for information on assigning the leads to the groups C Click Superimposition to display the median complexes of the selected group superimposed click again to restore normal presentation D Display other median complexes sh backward eS forward E Median label the complex is updated at the time interval selected in the Protocol Editor Revis
130. easurement with the largest sum of FVC FEV1 With the ATS mode American Thoracic Society the program will first determine the best expiratory and inspiratory curves of a test based on the largest sum of FVC FEV1 or FIVC FIV1 Then the system will determine the test acceptability using the ATS criteria see Acceptability Criteria on page 8 10 The best three tests are sorted according to the largest sum of FVC FEV1 and stored see ATS Summary table In the next step the program will determine whether the best two tests meet the ATS reproducibility criteria see Reproducibility Criteria on page 8 10 The displayed overall measurement reflects the flow volume loop of the best test The FVC and FEV1 values are the best values from all tests similar totheflow volume loop the other values are taken from the best test 210A SP Envelope ATS The system offers a number of equations for calculation of the reference values see section Reference Value Equations Interpretation M odes Measurements on page B 12 you can also choose between two interpretation modes see section I nterpretation M odes on page B 16 Revision A CardioSoft 8 7 2023324 053 Spirometry Test Conducting Spirometry Tests Note For flow volume measurements the patient s cooperation is essential Theambient conditions should be checked every day before performing spirometry tests the room temperature is the factor with t
131. ee eens 4 8 Resting ECG 1 6 e tea x Rr ARrir WARE RULS 5 1 Entering Test Information 00 c cece eee eee eee e eens 5 3 Overview 2066 e n 5 3 Patient Information Tab eo e RN end 5 3 Test Personnel Tab 0 00 c ccc tenet eh 5 4 Medications T b 5 211 oet ep LEES od ERE utet ete 5 5 Recording a Resting ECG cece eect eee eee eens 5 6 OVervieW cxx o eee ut eter eO S ptumen e Re teta 5 6 10 Second ECG with Analysis 0 0 c cece eee eee 5 7 Full Disclosure ECG 2 2 cette ete 5 10 Post Test Review 0 00 cece eee 5 11 TEStSUMIMALY rained ga rope bete b ere e Eis Reha 5 11 EGGITACOS Eon cor ed roe M Uf cur Masc UNE 5 13 M dians stt D NEN OE UN CE e ATE 5 16 Arrhythmia Review isses 5 20 VECIOF HOOPS o eo aste uerb er ey uerr br besote ait ost 5 22 ii CardioSoft Revision A 2023324 053 Full Disclosure ECG eee eens 5 23 Report PUDO acoso n eai ts SM aS au Mos LAS M LL on e ot eo 5 25 Generating the Interpretation reene as a a a A E aa 5 26 Comparing Resting ECGs 00 ccs 5 28 6 Exercise TOSL coii eo cos asus dota ecd bue e 6 1 Patient Education cioe EIT RI 6 3 Entering Test Information sssssessese 6 4 OVerVieW iub cL ere e ste dee detis ine die asd 6 4 Patient Information Tab ississsssssssssss 6 4 Test Personnel Tab isse Rb eee DRE UTR equa 6 6 M dicationis 3Lab acm eruca ER RS MS 6 7 Before the Testis nope RR e a 6 8 Pre Acquisition Screen li
132. ef values Revision A CardioSoft 8 19 2023324 053 Spirometry Test Post Test Review For your notes 8 20 CardioSoft Revision A 2023324 053 9 File Management evision CardioSoft 2023324 053 For your notes 9 2 CardioSoft 2023324 053 Revision A File Management Overview Overview All patient records are saved to the local database The patient records can be viewed edited printed exported to another storage medium transferred tothe MUSE CV database system or deleted Click Local Database to open the window with all available patient records Highlight the appropriate patient s name and click Select to open the Seect Test window Revision A CardioSoft 9 3 2023324 053 File Management Selecting Patient Records Selecting Patient Records A B C DEF G H oJ Paten Datetiom to rd Ca Device Number teat 4 Furbxdahory Blood Piessae 0 i s amp D OVOZ ZTA Fs 101A V si rot posable lo deplay al tects 200 max A Selected patient only this patient s records are shown B Enter a Cart Device Number if you wish to see only the patient records acquired with the specific cart device C Click down arrow to open the list box with the option all i e all records stored in the database will be shown D Enter dates if you wish to view only the patient records acquired in that time period E Click button to update the cur
133. en 30 and 0 nedative T wave lateral because T lt 0 1 mV in V6 RA inversion area between V1 and V2 borferline ECG on mal ECG ofified atrial morphology amp m c cfc ir blocks duction disturbances pre excitation ed venie porion RS TREAT J ithythmia results of the full disclosure Eli oiiae mponanyiel changes S Complexes 117 VBIG 1 PVC 5 PAVC 3 CPLT 1 2 zi Acronyms v Cancel 525A R A Click icon to open folders individually B Click icons to simultaneously open or close all folders C Click button to open a window with acronyms and the corresponding diagnostic findings p Click icons to copy folders E individual lines t lines including the chapter E E Click icon to confirm the test results F Click icons to cut copy and paste text in the Interpretation area 5 26 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Copying Diagnostic Statements Using Acronyms 1 Click Acronyms to open the window 2 Typethe acronym 3 Click Insert gt gt to copy the corresponding full text to the Interpretation Note As an alternative you can double click a text to copy it from left to right 4 Select the check box if you wish to copy each text toa new line Note Interpretative statements transferred to MUSE that are part of the acronym list will be replaced with the appropriate acronyms
134. etarget directory CARDIO is not on thelocal hard drive but on a network server drive The link tothe network drive must be established beforeinstalling the program sothat the drive directory can be found on installation Important All program users must have access tothis drive for read and write operations Note CardioSoft must be installed at each individual workstation but not on the network server It is also necessary to install CardioSoft on the CardioSoft Web PC Thetarget directory is the same server directory in each case The installation program automatically detects the files already installed and will only add specific information on the local PC Do not use CardioSoft on the network server B 26 CardioSoft Revision A 2023324 053 Miscellaneous Troubleshooting Troubleshooting Problem Remedy Installation of acquisition module not possible module has problems sending data red bar on ECG Send exercise test data not possible Exercise test analysis does not start Incorrect heart rate or arrhythmia results Displayed data are incomplete The message The following software options are not available appears although all option codes were entered correctly System does not identify ergometer CORINA m Check AC power adapter The green LED must be illuminated when ECG acquisition is started m Check connection cable and connectors CAM USB m Normal operation green LED o
135. ever incoming ECGs cannot be assigned or you can display it manually from the General tab see General Tab on page 11 41 Assign re r Patient Patient Records 940A A These tests could not be assigned B Click button to select the correct patient for the test to be assigned C Existing tests of the selected patient Revision A CardioSoft 11 47 2023324 053 System Settings System Configuration Copying Patient Records With the Copy Patient Records function patient records can be copied to a disk or any other storage medium or they can be moved from a disk to the local database Afterwards the data record will be removed from the storage medium Click Copy Patient Records J on the General tab to display the setup window 2 ij 4 3 Copy Patient Records x Modify Patient Medium Directory Patient Records in Database Patient Records on Storage Medium Ea 928A 1 Select the patient Select the patient records to copy Select the target drive and or directory Click gt gt to copy patient records TO a disk uF WN Click lt lt to move patient records FROM a disk 11 48 CardioSoft Revision A 2023324 053 System Settings System Configuration Archiving Patient Records With the Archive Patient Records function you can export patient records not currently used to an external medium The date and test type remain included in th
136. ey Control 2 11 Exercise Test Terminate 6 27 Export settings 9 10 Extra Questions Enter Exercise Tests 11 28 F Factory Setup Load 11 40 Fax Transmission of Reports B 32 Flow Volume Measurement 8 9 ST Arrhy 6 16 FRF 6 10 Tabular Summary 6 19 Full Disclosure ECG Exercise Test Trends 6 21 Print 6 45 Revision A CardioSoft Index 1 2023324 053 Index View 6 43 Full Disclosure ECG Resting ECG Print 5 24 Save 5 10 View 5 23 Function Keys Assign Functions 11 29 Functional Test 2 12 FVC Measurement with LF501 8 13 FVC Measurement with SpiroSoft 8 9 G Graphic Trends 6 32 Graphics Ambulatory Blood Pressure Measurement 7 12 H Heart Rate Determination 5 21 Help 2 15 Hourly Averages Ambulatory Blood Pressure Measurement 7 14 l Initial Screen 2 13 Installing the Program B 24 Intended Use 1 6 Interpretation Ambulatory Blood Pressure Measurement 7 11 Resting ECG 5 26 Spirometry Tests 8 16 Interpretation M odes Spirometry B 16 K Keyboard 2 10 L Language Selection 11 58 Laser Printer Connect B 8 Lead Sequence Modify ExerciseTests 11 17 Resting ECG 11 7 LF 501 8 12 License Agreement 1 3 Local Database 4 3 9 3 Local Database List All Patient Records 9 3 Local Database Select Patient Records 9 4 10 4 Location Number 5 3 LW 1 15 M Measurement Mark for T offset Adjust 5 19 Measurement Marks Adjust 5 17 Measurement Results ExerdseTests 6 31 Resting E
137. hange the lead sequences according to your needs and save them under the same name or under a new name You may also create new lead sequences Note The Standard and Cabrera lead sequences cannot be modified 1 3 2 4 5 6 7 Label a Lm oro pe unipolar bipolar JUNa fr 25 mesa n amp s2 ct e NS CNN sz zb who Sich ns 3p m aps m ve 5 f e efas w e Print Help Cancel MAR Modifying the Lead Sequence 1 Select the number of monitored leads These are the leads to be recorded Select a Lead Sequence 3 Open the list box of the channel where you want to record another lead and select 4 Enter thelead label Configuring Leads Ex1 Ex2 Ex3 5 Chooseunipolar or bipolar Choose the 1st electrode site for Ex1 Select the 2nd electrode site for Ex1 bipolar the 2nd site for unipolar leads is always CT 8 If required change the name of the lead sequence step 2 and dick OK to save If you change any of the selections of an Ex lead the sequence name is given as Revision A CardioSoft 11 7 2023324 053 System Settings Resting ECG Setup Miscellaneous Tab Print after Analysis Prompt 1 Post Test Review after Analysis Start Full Disclosure after Analysid Screening Criteria Suppress normal statement Pace Enhance Prompt 2 Suppress abnormal borderline T QRS Beep Type 2 Alphanumeric X Suppress all statements I Asis Graph beso AC
138. he limbs Affected characteristics are the Q waves and the frontal axes whereas ST levels are unlikely to change 3 8 CardioSoft 2023324 053 Revision A Preparing the Patient Applying Electrodes FRANK X Y Z Lead Electrode Placement Torecord the orthogonal FRANK leads X Y and Z apply electrodes G A3 B A2 J A4 and I A1 in addition to the standard lead electrodes P A bu 35A AHA Label IEC Label Electrode Placement A LAblack L yellow Below the clavicle H RA white R red B A2 E orange E light blue Sternum at the level of C and D C V4blue C4 brown Mid clavicular line in the fifth intercostal space D V6 purple C6 purple Left mid axillary line on the same horizontal level as C E LLred F green Right and left thighs F RLgreen N black G A3 lorange light blue Right mid axillary line on the same horizontal level as C and D l A1 H orange H light blue Neck avoid carotid artery and jugular vein J A4 M orange M light blue Center of spine on the same horizontal level as C and D Revision A CardioSoft 3 9 2023324 053 Preparing the Patient Applying Electrodes NEHB Lead Electrode Placement For acquisition of the NEHB leads electrodes A A1 and B A2 must be applied in addition to the standard lead electrodes C equals V4 C4 ae a Si 36A AHA Label IEC Label A A1 A1 orange Nst white B A2 A2 orange Nax white Electrode Placement Attachment point of 2nd rib to right sternal edge
139. he T offset mark in reanalysis see Reanalysis on page 5 17 0 05 150Hz 50Hz HEART 5 Selectleads wan Vv VI wv E eat vv2 vv Ty Iv t war My Iv ve r Lull aVR aVF V1 3 V4 N6 Alk On Off 513A R Revision A CardioSoft 5 19 2023324 053 Resting ECG Post Test Review Arrhythmia Review This screen shows one lead of the reference ECG at a time A bar diagram below the signal trace indicates for each individual QRS complex the deviation of the RR interval from the mean RR interval Furthermore you can determine the HR over a selectable ECG segment RX RAW za 514A R A Click to select the lead With lt you scroll through the leads with amp you open the list B Click to determine the number of cardiac cycles only for atrial fibrillation or flutter C Click to select the gain amplitude D Click to select the speed Click icon to copy the waveform area to the Clipboard 5 20 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Determining the Heart Rate In anormal ECG 1 Click on a point of the ECG to mark the beginning of the interval to be measured A marker appears 2 Click on the end of the interval A line appears connecting the two end points and the corresponding heart rate is displayed 3 Click theright mouse button to remove the markers and data In the presence of atrial fibrillation or flutter In this situation you will ha
140. he TWA trends Questionable sections are represented by dashed lines Individual leads can be excluded You may then repeat the analysis without these leads This method prevents false positive TWA values particularly when permanently disturbed leads are excluded If you exclude too many complexes the system fixes the noise limit at 100 uV You can cross reference to the corresponding segment of the full disclosure ECG by first clicking on a point in the trend graph and then selecting the full disclosure icon B A Test Summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG l aje Eoia B C Custom C ST Level Slope C ST HR Loops C C ST HR Slope c TW 0 Exclude Leads D 939A S A Click to display other leads of the trends not available on all trend screens backward fen tr forward B Click icon to display the full disclosure ECG segment corresponding to a point selected on the trend graphs The button appears only when Save full disclosure ECG has been selected see Miscellaneous 1 Tab on page 11 24 Revision A CardioSoft 6 33 2023324 053 Exercise Test After the Test Post Test Review C Click an option button to display other trend formats Click Custom to display user configured trends Click ST Level Slope to display the trend of ST level and slope versus time Cli
141. he first ECG recording and BP measurement are fixed and cannot be changed Enter a minimum value of 10 seconds for the ECG Recording Interval and of 1 minute for the BP Interval The ECG Recording Interval and the BP Interval will be maintained until the end of the phase These values can thus be set independently of the StageTime Each time the program advances to the next stage both intervals are reset to synchronize them with the new stage A BP Interval must be entered in the pretest phaseto take a blood pressure measurement before the test Since no further BP measurements are required in pretest the default BP Interval is 99 minutes If you do not want to take a pretest BP measurement change this value to 00 00 00 A BP monitor connected directly to the EC 1200 will take the blood pressure at the beginning of each phase The arrow buttons W and W changethe load setting tothe value of the next or previous stage All other protocol parameters remain unchanged The load for subsequent stages increases accordingly Revision A CardioSoft B 5 2023324 053 Miscellaneous Connecting Peripheral Devices Blood Pressure Monitor Connect blood pressure monitors to COM ports A through D Model Configuration integrated in the ergometer integrated in the ergometer no BP monitor none with prompt to take BP measurement SunTech 4240 and 2120 Suntech 4240 Tango Bosotron 2 BP 511 Bosotron Colin STBP 780 Colin STBP 780 The
142. he list only shows orders for your location 1 The list shows orders for all locations 1 D The list only shows orders for exercise tests 1 The list shows all orders 7 E The list only shows orders for your patient 1 The list shows orders for all patients v1 4 6 CardioSoft Revision A 2023324 053 Selecting a Patient Record and Test Type Entering a New Patient Entering a New Patient Select patient local database Type of new procedure Search for Last Name x Exercise Test Resting ECG Spirometry t Ambulatory Blood Pressure Holter ECG 1 Ext Prog FEN rT m Last Name First Name Dle Tatjana Simone Guido Marisa Date of Birth 05 04 1943 12 05 1986 20 02 1947 21 08 1961 Patient ID New Patient 22 12 1973 B Tr Delete 31 12 1988 02 04 1959 extor Guido 22194 TEST DEMO TEST DEMO 28 04 1968 TEST DEMO 000000 Themes Regine 05 04 1977 16936 Thyssen Jean 31 08 1943 02474 Young Emest 31 08 1934 03656 Help Cancel Modify Last Name TEST DEMO First Name TEST DEMO Patient ID TEST DEMO 000800 Date of Birth 1968 04 28 YYYY MM DD Gender Maie Height eo in Race Weight 156 0 Ibs Pacamaker 7 048A Click New Patient Enter the patient s Last Name and press the Tab key to move to the next box etc Enter the Patient ID a b To do so either use the keyboard or
143. he most impact on the test results see section Acquisition Tab on page 11 36 Refer tosection Acquisition Tab on page 11 36 for information on selecting the M easurement M ode the I nterpreation M ode or the Equation for Reference Value Calculation or on entering the PT Code FVC Measure Test Information Start Test Scale Flow Volume Volume Time 178dm 34Yeas Mple System Evaluation CHS Start Broncho dilator Test Post Test Reference Values Knudson Review f Current test Best test ATS Summary Valu Act Ref FVC I 523 FEVO5 FEV I 433 FEVI FVC 83 FEV3 u O Z zr x ce FEVE I FEVI FEV6 2 PEF l s 955 MEF75 l s 8 85 Initial Screen MEFSO s 538 MEF25 l s 225 MMEF Vs 455 FIVC I 523 FIV FIVIJFVC 4 PIF s MIF 5 l s MIFSO s MIF25 Vs MW l min Breathe OUT and IN SLOWLY and completely than breathe OUT and IN as QUICKLY and completely as possible IPT Code O 201A SP S R A B C D E F G Click buttons to change the waveform scale Click option button to display the flow volume loop Click option button to display the volume time curve Reference curve Table with actual and reference values Patient data System evaluation area MILLER square only with LF 501 aE Click to enter test information CardioSoft Revision A 2023324 053 Spirometry Test
144. he size of your monitor screen General Tab on page 11 41 Disable all energy save modes BIOS Windows Connect the printer s to parallel ports only Unlock the purchased optional software programs as described in section Option Code Tab on page 11 57 Scan the hard drive for viruses once a week Do not turn off the PC until you have properly exited from the program and from Windows Run a functional test on a regular basis about once a month this indudes an inspection of the cables and other accessories for signs of damage Warning Simulated Patient Data To avoid the possibility of misinterpreting patient information enablethe simulated Test Patient data for demonstration purposes only 2 12 CardioSoft Revision A 2023324 053 Product Overview Putting the System Into Service Initial Screen CardioSoft EN Q mmo ou GE CardioSoft 6 0 GE Healthcare 2005 General Electric Company All rights reserved 06A A New Test Click to start a new test Local Database Click to display the contents of the local database for B 4 f selection of a patient and test C MUSE Browser Click to display the MUSE CV system database D Operator s Manual Click to display the Operator s Manual see Viewing and Printing the Operator s Manual on page 2 16 System Configuration Click to display the System Configuration menu E H 1 H i n see section System Configuration
145. hem from the list boxes Type any Comment about the test Answer the Extra Questions Enter an Order Number This number will appear on the printed reports and on the Test Summary Note The Reason for Test library can be edited see section Miscellaneous 2 Tab on page 11 26 You can definetwo Extra Questions as needed see section E ntering Extra Questions on page 11 29 You enter the names of the physicians and of thetechnician in the System Configuration see section General Tab on page 11 41 CardioSoft 2023324 053 Revision A Exercise Test Entering Test Information Medications Tab 2 1 3 Test Informatior 053A S 1 Click the Medications tab 2 Enter or choose a maximum of 10 medications 3 Enter the medication dose Note You can edit the libraries see section Editing the Comments Test Types Reason for Test Reasons for Termination Medications Library on page 11 26 Revision A CardioSoft 6 7 2023324 053 Exercise Test Before the Test Before the Test Pre Acquisition Screen Overview In the upper part of the screen you see the lead check information for verification of the ECG signal quality All 12 or 15 leads are shown The schematic lead check torso allows you to verify the applied electrodes The actual waveform data appears in the area below Note The softkeys displayed at the bottom of the screen that are used to control
146. ice otherwise the intervals set in the system will be used see section Editing the BP Protocol on page 11 33 The check box is accessible only when 1 or 2 BP periods have been selected at TONOPORT V B Select box to change the statistical night time C Select box to change the statistical wake up time D Click buttons to change the blood pressure limits 7 10 CardioSoft Revision A 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Generating or Editing the Interpretation Interpretation Statenjent Libjary Interpretation Normal blood pressure profile Click Interpretation or Modify to open the window In the left part of the window you see a number of folders with standard interpretation texts The system supports the creation of an interpretation by providing standard texts which can be copied to the Interpretation area on the right In the Interpretation area you can edit the texts as needed enter new text copy cut paste etc Refer to section Editing the Interpretation Library on page 11 35 for information on editing the standard texts 5 a z 2 Drambatic rise in blood pressure CI Unstable hypertension Double click text to copy line to interpretation field C Esai hypertension CI Hypotension C No circadian rhythm CJ Impaired circadian rhythm Z3 Borderline blood pressure C3 Diab tic neuropathy nu Cancel 186A BP A Click icon to open folders ind
147. ient Select check box to run a test using simulated patient data Select the function each time before starting a simulated test m Anti Aliasing Select check box to smooth the ECG signal traces m Enable Test Information Window Select check box to automatically display the Test Information window on the acquisition or pre acquisition screen Enter or select the default physician and technician names the names will appear on the Test Personnel tab Enter the name and address of the hospital or practice information appears on the printed reports m Trace Background Click to select the background for the signal traces m ECG Grid Select the grid format for the displayed ECG m Report ECG Grid Select the grid format for the printed ECG m Screen Diagonal Select the size of your PC monitor Enter the physician and technician IDs When sending data to a MUSE system be sure to match User ID numbers assigned at the MUSE system to User ID numbers assigned in CardioSoft Revision A CardioSoft 11 41 2023324 053 System Settings System Configuration b Click to enter a percentage value for the minimum free hard drive storage capacity You will be alerted when the capacity drops below this value G m User List Click to define the users groups and privileges for individuals working with the system see User Administration on page 11 43 m Modify Password Click to modify the current user s password not with Windows user list H Click
148. ient ID B 22 CardioSoft Revision A 2023324 053 Miscellaneous CardioSoft Web Displaying Tests 1 Enter the patient s last name or the first letter of the name and click Find The patient list will be displayed As an alternative you can click the initial letter in the alphabet to display the patient list eg click s to find the patient named Saunders 4 Select the patient whose records you wish to see This will bring up the list with the patient s records 5 Select the record you would like to review 1 3 2 4 Bile Edit vew Favorites Tools Help Ea 3m 3m H a Back p 6 Mo A Search Garnel meda Address amp htfp localhost sexpts CardioSoftwebj iscard dll GetPatData Patienti astName v Go Links Select Patient Last Name Find Last Name ab cd ef gh ij kl mn op qr st uv wx yz Last Name First Name Date of Birth Patient ID M dder B rbel S tterlin Franz 29 Feb 1960 21 Jun 1957 24597 14761 TEST DEMO TEST DEMO 28 Apr 1963 TEST DEMO 000000 Wraalkes Otto 01 Jan 1956 09641 Done r 210A au Local intranet Revision A CardioSoft 2023324 053 B 23 Miscellaneous Installing the Program Installing the Program Install CardioSoft on your PC only if you are familiar with the Windows operating system Conditions for operati
149. ing Peripheral Devices Note Ergometers and treadmills must be calibrated before being used with the system Refer to the appropriate service manuals for calibration information Bicycle Ergometers Connect the bicycle ergometers tothe COM 1 or COM 2 port Model Configuration Ergometer without digital communication internal interface Ergometer without digital communication internal remote start interface but with remote starting pulse Ergoline 900 900 L 900 EL variobike Ergoline 900 eBike 500 eBike EC 1200 V 3 52 and later EC 1200 V 3 52 Lode Excalibur Sport Excalibur 1 See Connecting the ERGOLINE 900 900 L 900 EL Ergometers to the System on page B 4 2 See Putting the EC 1200 Ergometer Into Service on page B 5 Revision A CardioSoft B 3 2023324 053 Miscellaneous Connecting Peripheral Devices Treadmills Connect the treadmills tothe COM 1 or COM 2 port Model Configuration Treadmills without digital communication internal treadmill interface GE Medical Systems Information Series 2000 Technologies treadmills m 1800 m 1900 m 12000 T2100 m 72100 T2100 m Trackmaster TMX 425 TMX 425 m Trackmaster TM400 TM 400 Note Other bicycle ergometers and treadmill models with an analog port can be connected to the analog output of the system Connecting the ERGOLINE 900 900 L 900 EL Ergometers to the System Set the following parameters at the ergometer m ECG type P10 m
150. int the displayed patient record click the Print button Note You can also display a patient record by double clicking When working in a network environment it is not possible to view the same patient record at multiple workstations When selecting a patient record stored on an external medium the system asks if you want to view the record only in that case it remains on the external medium or if you want to restore it to your PC Patient records transferred tothe MUSE CV system database can be viewed and printed with the MUSE Browser When you have selected the option Dd ee local test data after transfer to MUSE on the MUSE tab see section MUSE Tab on page 11 55 all test data will be automatically deleted from the local database Only the patient demographics remain stored Printing a Combined Report For the selected patient you can generate and print a Combined Report covering multiple records 1 Select the patient Select a record or select multiple records holding the Shift key depressed 3 Click Combined Report The Combined Report is displayed The Combined Report can be edited and printed but it cannot be saved 9 6 CardioSoft Revision A 2023324 053 File Management Viewing Editing Printing Patient Records Viewing and Printing Patient Records from the MUSE CV System 1 Click the MUSE Browser button on the initial screen 2 Enter the MUSE password if prompted The MUSE web page will
151. ioSoft Revision A 2023324 053 Order Information Order Information Skin Prepping Items for Exercise Tests 9612 002 3704 901 4828 004 4828 005 48218 006 9386 001 Skin prep analyzer Disposable razors 100 per pack Alcohol pumice pad 100 pads Sandpaper strips 100 per pack Adhesive remover pad 100 per pack Pot scrubber 200 pads box Revision A CardioSoft 2023324 053 C 9 Order Information Order Information For your notes C 10 CardioSoft Revision A 2023324 053 Index A Acquisition Module Keys 3 13 Acquisition Module Attach to Patient 3 13 Acronyms 5 26 5 27 Ambulatory Blood Pressure Measurement Setup Acquisition Tab 11 32 Miscellaneous Tab 11 34 Ambulatory Blood Pressure Monitors 7 3 Arrhythmia Review 6 41 RestingECG 5 20 ATS Measurement Mode 8 7 8 10 B Bicycle Ergometers Connect B 3 Biocompatibility 1 13 Blood Pressure Monitor Connect B 6 BP Protocol Configuration 11 33 Bronchodilator Test 8 12 C CardioSoft Web Installation B 21 Caution Definition 1 8 Classification 1 12 Cleaning Equipment Surface Cables A 3 Clinical Information System B 30 Combined Report 9 6 Comments Enter in Tabular Summary 6 15 Compare E xaminations RestingECGs 5 28 Resting ECGs Interpretation 5 30 Resting ECGs Medians 5 30 Resting ECGs Multiple Medians 5 31 Comparing Exercise Tests 6 25 Comparing Spirograms 8 18 Cubic Spline 6 10 Custom 11 39 Custom Setups Load
152. ion A CardioSoft 6 17 2023324 053 Exercise Test During the Test Waterfall Window This window displays a graphic color representation of the median beat changes in the course of the test updated at 30 second intervals Click anywhere in the waterfall to display the median complex and measurement of the corresponding point in time associated phase stage HR BP and METS appear at the right A B Lead Check STiAry Medians violet blue green ora nui Phase EXERCISE os Stage STAGE 6 aun 85 METS 1 00 60A S Click the tab to display the Waterfall window Click the lead label to change the displayed leads Median complex ST measurement and corresponding waterfall Color code of the different amplitudes in mV Click to select the color menu m UO WwW o 6 18 CardioSoft Revision A 2023324 053 Exercise Test During the Test Tabular Summary Window The Tabular Summary window displays test data in two tabular formats m stage format 1 line per stage or m detailed format 1 line minimum 30 seconds The Tabular Summary can be configured See Configuring the Tabular Summary on page 11 14 for details Use the detailed format to enter or edit data 1 Click the value to change 2 Enter the new value Edited values are bold To enter new data 1 Click in an empty field 2 Enter the new value ad Check STiArrhy Medians Waterfall Tabular Summary Tren
153. ion for a limited period of time click the icon and enter the expiration date Note If you are working with the simulated test data T est Patient you can activate all options with the option code 123 Revision A CardioSoft 11 57 2023324 053 System Settings System Configuration Country Settings Tab Click the Country Settings tab to open the window Note After selecting the language first load the factory settings to set all text libraries to the new language Custom Setup Factory Settings Load Select Chinese J apanese or Russian only when the operating system of your computer supports the required character sets ABC D EF GHI J K xj PSPS Unt hPa u Enable Patient ID Check J aaa ees zu A Select v to enable the race list on the patient information screen B Select to replace the icons on the control buttons with text labels C Select to enable the Patient ID Check feature select patient ID type D Select to enable the Swedish report formats E Select the language F Select the time and date format G Select the units for weight height and speed the same speed unit must be selected at the treadmill H Select the ST level unit Select the AC line filter frequency off filter off J Select the ECG lead labels IEC AAMI K Select the units for temperature and atmospheric pressure for spirometry 11 58 CardioSoft Revision A 2023324 053 System Set
154. isition screen to display a description of what the patient can expect to happen before during and after the exercise test Revision A CardioSoft 6 3 2023324 053 Exercise Test Entering Test Information Entering Test Information Overview Depending on your system configuration the Test Information window will open automatically or you can display it with the Test I nformati on button These arethe tabs of the menu m Patient Information m Test Personnd m Medications Closing a tab with Cancel or OK will bring up the acquisition screen Patient Information Tab 1 2 3 4 5 6 7 Patient Information Test Patsonnel Medications TEST DEMO 000p00 TEST DEMO TEST DEMO d 4 MODBRUCE Max predicted HR 186 22 NAUGHTON ELLESTAD xl Target HR 100 186 bpm Location Numer 0 S Kueche Room TWA Analysis v The Patient Information tab is open 051A S Cancel l Verify the patient s name and ID If the data is incorrect click Modify to change 2 Select the protocol for the next test refer to section Protocol Editor Tab on page 11 19 for information on changing the default protocol 3 Confirm or change the M ax predicted HR for the exercise test refer to section Miscellaneous 1 Tab on page 11 24 for information on changing the calculation method 4 Enter the Target HR 96 of the Max predicted HR refer to section Miscellaneous 1 Tab on page 11
155. isition screen where you click Setup to display the setup menu or from the General tab of the System Configuration see General Tab on page 11 41 The Acquisition tab is already on top BP Limits sys dia Day Time 135 LI 5 E Night Wake up Time 125 E 80 Print Help Cancel 192A BP Click to print the ambulatory blood pressure measurement setup Select box to change the statistical wake up time Select box to change the statistical night time Click to select the measurement protocol Click to edit the protocol see next section Click to change the systolic blood pressure limit for the day time Click to change the systolic blood pressure limit for the night wake up time Click to change the diastolic blood pressure limit for the day time Click to change the diastolic blood pressure limit for the night wake up time A B C D E F G H 11 32 CardioSoft Revision A 2023324 053 System Settings Ambulatory Blood Pressure Measurement Setup Editing the BP Protocol Protocol Click Modify to display the configuration menu 2 3 1 4 5 6 7 8 9 10 No of BP Periods rodi og C Ca Rrotocol Period from to BP Interval min Defl Rate Infl Press 1 7 00 00 2 22 00 00 mso H ee oou ps Be ud esso 24 ee o 3j s z pe 3 ECG Strip Length 0 to 10 s O none Ratio of ECG strips to BP me
156. ith median morphologies for 12 leads from baseline and either max ST depression or peak exercise For max ST depression report only prints when a minimum of 0 5 mm of ST depression occurs in one of the following leads II III aVF V2 V6 V1 aVR aVL excluded for ST elevation aVR is excluded Records median morphologies at baseline max ST depression peak exercise and test end for 12 leads For max ST medians column only prints when a minimum of 0 5 mm of ST depression occurs in one of the following leads Il Il aVF V2 V6 V1 aVR aVL excluded for ST elevation aVR is excluded Records median morphologies for 12 leads at user defined intervals Intervals defined in Protocol Editor for each protocol by configuration of Store Median interval 25 or 50 mm s Records plots of PVCs heart rate and blood pressure or any custom combination of parameters Trends Custom Also produces trend report of ST level and slope versus time Trends ST Level Slope Trends TWA For details on the Trend Graphs refer to section Configuring Trends on page 11 15 A two dimensional representation of ST level versus heart rate in exercise and recovery phases Records linear regression of heart rate adjusted slope for all leads plus median morphology of lead with highest slope Analysis uses leads Il Il aVF V2 V6 and CM5 All other leads are excluded Report of all 12 leads also medians and recall stored in 12 lead format st
157. ith the LF 501 TheLF 501 also supports VC measurements The ATS and Envdope measurement modes are not available VC Measurement 1 Explain the test maneuver to the patient 2 Attach nose clip to ensure that the entire respiratory volume passes through the sensor 3 Click Start Test and ask your patient to perform the following maneuver when the orange indicator on the sensor lights up Inhale exhale and inhale again completely through the sensor Then your patient may resume normal breathing Note The maneuver must be concluded within 20 seconds of clicking Start Test The program terminates the measurement when it does not detect a flow reversal within 4 s of two identified inversion points or after 5 full breaths The curve window shows the volume ti me curve expiration only and the table indicates the measuring values and the percentage deviation from the reference values Click Start Test to initiate additional measurements The next curve is represented with a different color and superimposed on the first one The best results for EVC and IVC which are not necessarily taken from the same test give VCmax 8 12 CardioSoft Revision A 2023324 053 Spirometry Test Conducting Spirometry Tests FVC Measurement 1 On the acquisition screen dick FVC Measure 2 Explain the test maneuver to the patient 3 Check the nose clip 4 Click Start Test and ask your patient to perform the following ma
158. ividually B Click icons to simultaneously open or close all folders gt Click icons to copy folders individual lines lines including the chapter E D Click icon to confirm the test results E Click icons to cut copy and paste text in the Interpretation area Note As an alternative you can double dick a text to copy it from left to right Revision A CardioSoft 7 11 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Graphics The Graphics screen shows all BP values acquired over the monitoring period For measurements taken with TONOPORT IVa the ECG strips are also displayed 8 00pm 10 00pm 12 00am 2 00am 4 00am 6 00am 8 00am 10 00am 12 00pm 2 00pm 4 00pm 6 00pm 8 00pm 187A BP A Click a tab to display the corresponding window B Click button to display the tabular summary 7 12 CardioSoft Revision A 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Tabular Summary Note Individual measurements in the Tabular Summary can be suppressed by double clicking or by clicking with the right mouse button they can be restored in the same way Suppressed measurement data are excluded from the statistical analysis Test Summary Graphics Hourly Averages Statistics Summary Day Time Night Time Wake up Time Measuring Interval from 6 48pm until 7 14pm oscillometric Time HR sys BP dia BP mn BP Comment 6 4
159. k se E Ws ene eee 1 5 Ill stiatiOns 5o pa meter b eet ar PR SP ERES 1 5 Safety Information 6 cece eee nn 1 6 Intended Use score OH ee ee ee RR 1 6 General Information sce ec erento eese e oot te Ago 1 6 Definition ope CIL debt ue ACER 1 8 Classification LE hr ED xEES RE E DES ARE 1 12 Equipment Symbols cec etre eee E o end 1 13 Biocompatibiliby 5 mcer cepe ttt te oe dtd dr tica 1 13 Technical Maintenance 1 14 Legal Notice iue it ede bd ees 1 14 Service Information 0 00 c cece cette 1 15 Service Requirements 0 0 c eee eee eee eens 1 15 Equipment Identification lisse 1 15 Product Overview ssssseeeeeeeeeeee 2 1 PG Setup ii oder mese are tutte Re tace atte deiectus e much cola d suns 2 3 Minimum PC Requirements sss I 2 3 Minimum Server Requirements sss 24 Printer Installation ssssssssssssse II 2 4 Connecting the Acquisition Module 0000 c cece eee eee ee 2 5 Connecting Further Accessories 0 0 c ccc eee ee 2 8 Keyboard os m RE Dept e anti RE Mti Ud Rode cuu 2 10 Softkeys Controlling Exercise Tests siis 2 11 Putting the System Into Service 0 cece cette eee teens 2 12 Mains Connection Power Up Functional Test 005 2 12 Initial Screens osm een eerie art aie he m mme pef 2 13 Using the MOUse see oec DER eae naan nesta an ETE LUE 2 14 Viewing and Printing the Operators Manual
160. l necessary electrodes have been applied and signals of adequate quality are obtained e g without major baseline fluctuations If all electrodes are not being used dick Relearn Medians to manually activate ST measurement and arrhythmia analysis 2 Click Select Protocol to verify that the appropriate test protocol is active or to select another protocol Click Custom Setup to select and load user specific test settings Click Setup to edit the exercise test setup Note Once you initiate the pretest phase you can no longer change the test settings 5 Press F 1 pretest to initiate the test The pretest screen will appear and the pretest phase begins Revision A CardioSoft 6 11 2023324 053 Exercise Test During the Test During the Test Acquisition Screen Overview f B Lead Check STiArhy Dieses wena reoccur ECG Strips 128L C D I E EXERCISE ye Wael LEAL EL ORI Ped DOE at ar 00 13 STAGE 1 H d A A A A O A A A CT IT 57A S MSS ms 0 mmv E5 ms E mav faH j FRF 60Hz FD ECG Note The acquisition screen has the same type of information in the pretest exercise and recovery phases A ST Arrhy window see ST Arrhy Window on page 6 16 for details B Tabs to display windows with ECG test data see ST Arrhy Window on page 6 16 to Interpretation Window on page 6 24 for details C oY Button to mark and save ECG events see section Arrhythmia
161. l program and save this summary with the patient record Before selecting the external program choose a patient in CardioSoft To change the selected patient you will have to exit the external program and select another patient in CardioSoft Dialog between CardioSoft and the external program 1 Start CardioSoft Select patient 3 Select external program on procedure selection screen the external program must already be configured Perform examination e g Holter ECG Return to CardioSoft summary and recording will be assigned to the patient record An external program can be activated only after it has been configured as described in section Devices Tab on page 11 53 Note When the configuration of external programs changes maintain the compatibility to ensure that stored tests remain accessible 4 8 CardioSoft Revision A 2023324 053 D Resting ECG evision CardioSoft 2023324 053 For your notes 5 2 CardioSoft Revision A 2023324 053 Resting ECG Entering Test Information Entering Test Information Overview Depending on your system configuration the Test Information window will open automatically or you can display it with the Test I nformati on button These arethe tabs of the menu m Patient Information m Test Personnd m Medications Closing a tab with Cancel or OK will bring up the acquisition screen Patient Information Tab Test Information Patient I
162. latory BP Monitor varia amp QY 180A BP 1 Turn the monitor off and on again 2 Wait for thetimeto be displayed then connect the monitor tothe PC Revision A CardioSoft 7 3 2023324 053 Ambulatory Blood Pressure Measurement Setting Up the Ambulatory Blood Pressure Monitor Setting Up the Ambulatory Blood Pressure Monitor Acquisition Screen A e B C D E Protocol e F oco G Period from to BP Interval min Dall Rate imti Pres Qty bin H india Sorgen 181A BP A Measurement protocol details B Click to connect the ambulatory blood pressure monitor to the system C Click to activate the programming mode D LJ Click to download the stored data to the system E mee Click to delete the data stored in the ambulatory blood pressure monitor F Click to load system setups stored for different system users Click to display the setup menu for ambulatory blood pressure G measurements see section Ambulatory Blood Pressure Measurement Setup on page 11 32 H Click to activate the online Help program Click to return to the initial screen 7 4 CardioSoft Revision A 2023324 053 Ambulatory Blood Pressure Measurement Setting Up the Ambulatory Blood Pressure Monitor Operating Steps A 1 2 3 Turn the monitor off and on again Wait for the time to be displayed then connect the monitor tothe PC Click Connect The acquisition screen indicates the memory statu
163. ld the first key while pressing the second key once This is called a keystroke combination Example Press Ctrl4Esc means to press and hold down the Ctrl key while pressing the Esc key m When instructions are given for typing a precise text string with one or more spaces the point where the space bar must be pressed is indicated as space The purposeis to ensure you press the spacebar when required Illustrations AII illustrations in this manual are provided as examples only They may not necessarily reflect your equipment setup or data displayed All names appearing in examples and illustrations are fictitious The use of any real person s name is purely coincidental Revision A CardioSoft 1 5 2023324 053 Introduction Safety Information Safety Information Intended Use General Information CardioSoft is a PC based system for electrocardiographic resting ECGs exercise tests and spirometric tests as well as for ambulatory blood pressure examinations The program is intended for use under the direct supervision of a health care practitioner The PC with CardioSoft is not intended to be used as a vital signs physiological monitor The PC with CardioSoft is not intended for use as an emergency device The PC with CardioSoft will not cause abnormal operation of a patient s cardiac pacemaker or other electronic stimulator The PC with CardioSoft is not intended for use with high frequency surgical units Disconne
164. le TWA Cycles Questionable values are identified with a question mark Two headed arrows identify the position where the TWA value was determined Individual leads can be excluded You may then repeat the analysis without these leads This method prevents false positive TWA values particularly when permanently disturbed leads are excluded Test Summary Tabular Summary Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG wate 4 gt SAGT TABET STAGES PR IE XN 86 bpm 85 bpm 85 bpm 86 bpm vw 250w 250w 75 0 Ww 250w Max TWA PEAK EX E ms L C amp 29 msi D amp rj ill cardiac cycles G Exclude Leads H 938A S A Click to view more sample TWA cycles B Click to show and hide the measurement marks C X Selectthe speed of the displayed medians D Select the gain for the displayed medians E Select the number of lines 1 3 6 F Number of medians shown per stage All cardiac cycles at intervals of 30 seconds C only one cardiac cycle Position where the TWA value was determined H Click to exclude individual leads Revision A CardioSoft 6 39 2023324 053 Exercise Test After the Test Post Test Review ECG Strips This screen displays 10 second ECG strips m Stored during the last 10 seconds of each stage m acquired manually or m acquired automatically as configured in the Protocol Editor G A CBD E F Test ummary Tabular Sum
165. le for EK 51 EK 53 EK 56 EK 512 Network connection cable Connection cable for COLIN STBP 780 Connection cable for treadmill models 1800 1900 T2000 T2100 RS422 Connection cable for LODE EXCALIBUR bicycle ergometers Patient trunk cable 10 lead IEC MultiLink 2 2 m Patient trunk cable 10 lead AHA MultiLink 2 2m Patient trunk cable 10 lead IEC MultiLink 4 5 m Patient trunk cable 10 lead AHA MultiLink 4 5 m CardioSoft Revision A 2023324 053 Order Information Order Information Acquisition Modules 901142 005 901142 008 303 443 77 384 015 84 384 013 30 303 444 21 303 444 20 2009000 001 2009500 001 2009500 009 2024264 001 101 118 31 101 118 32 101 118 33 101 118 34 200300 001 CAM 14 acquisition module with AHA electrode connectors requires CAM USB interface box 2009000 001 CAM 14 acquisition module with I EC electrode connectors requires CAM USB interface box 2009000 001 Swivel arm for KISS Tabletop clamp with pole Wall fixture for swivel arm Clip adapter for adhesive electrodes KISS support to mount on ergometer CAM USB interface box required for CAM 14 acquisition module 901142 005 901142 008 901142 007 CAM USB A T interface box with analog and trigger output required for CAM 14 acquisition module 901142 005 901142 008 901142 007 CAM USB A T KISS interface box with analog and trigger output as well as suction pump for KISS Multilead re
166. lect the gain Click button to print the exercise test settings Revision A CardioSoft 11 23 2023324 053 System Settings Exercise Test Setup Miscellaneous 1 Tab Click the Miscellaneous 1 tab to open the window Acquisition Module Blood Pressure Lint Button 1 PE Scale Button 2 Print Setup Help J K x TOF apni Label Full difclosure EC _ pus Due Save full disclosure ECG Ane peer FD ECG Stat Petet Ns fele Dam FD ECG Sampling Rate CT Pace Enhance samples s o ms Alidible LEAD OFF Alarm NY Thiet Load Rhythm gt Te oad Arsin METS Interpolation Time s 120 I Cancel 917A S Select v or deselect LI FRF Finite Residual Filter algorithm filtering of high and low frequency components without altering the QRS complexes signal delay of 1 s or Cubic Spline compensation of baseline fluctuation signal delay 2 s see section Application Tips on page B 10 Select the PE Scale Perceived Exertion The selected scale will appear in the event list box Select the muscle filter frequency and the method for calculation of the Max predicted HR m WHO max predicted HR 220 age m AHA max predicted HR for age lt 25 160 for age gt 75 115 for age between 25 and 75 160 age 25 x 45 50 Select FRF or Cubic Spline see A Select the Target HR as a percentage of the max predicted heart rate and the max blood
167. lled at the server in conjunction with Windows 2000 2003 Server only Demo Version of CardioSoft Installing CardioSoft When working with the demo version of CardioSoft the following points should be noted m TheTest Patient is always selected artificial patient signals The demo version is not intended for use on patients m The acquisition module the respiration sensor and TONOPORT cannot be connected All available software options are active The functions Copy Patient Records Receive Data from ECG Device Archive Patient Records are not available Section Installing the Program On a Stand Alone PC on page B 24 describes in detail how to install CardioSoft on a PC Revision A CardioSoft 2 9 2023324 053 Product Overview PC Setup Keyboard The keyboard is used to enter text and numbers We will explain only those functions that are different from writing with a typewriter The function keys F 1 through F 12 can be used to control the exercise test Hie S Tessie hss gt A Se I E DE SER GERD Loin d Dome 03A Note The keyboard shown above is representative of a typical keyboard It may not appear identical to the keyboard on your system Function keys F1 through F12 Backspace key erases the character to the left of the cursor Home moves to the first character of the line End moves to the last character Del deletes the highlighted character s Arrow keys mov
168. lorer version 4 0 and later and the Acrobat Reader program must already be installed The Internet browser must be set up for proper communication web address of the MUSE CV system etc Contact GE Medical Systems Information Technologies Service for details Select if SSL is configured at the MUSE Web server MUSE exercise test lists comments reason for test interpretation etc are used Yes No Click Synchronize Lists to load the lists from the MUSE Web server Revision A CardioSoft 2023324 053 11 55 System Settings System Configuration Select when data is not transferred to a MUSE CV system H Select to transfer data to a MUSE CV system via disk Select to transfer data to a MUSE CV system via a network Enter MUSE FTP server information MUSE version 5A and above J Select to transfer data to a MUSE CV system via a network using a shared directory allows transfer of data to older MUSE versions via the network a separate shared directory is required for each workstation K Select to automatically delete patient records from the local database after transfer to a MUSE CV system Select to start the modem connection before the transfer Select and enter the maximum number of characters for the patient ID Numbers and text are right aligned zeros are entered for missing digits N Select to limit entered texts such as in Patient Information Test Information to the maximum length accepted by MUSE
169. lues are height and gender related and are defined for patients aged 19 to 70 years Note Patients between 19 and 25 years of age are assumed to be 25 Arangefor height is not defined The ZAPLETAL reference values were published 1987 Progress of Respiration Research Vol 22 1987 Lung function in Children and Adolescents SBN 3 8055 4495 2 The reference values are height and gender related and are defined for patients aged 5 to 18 years Note Height range from 107 cm to 182 cm For patients exceeding the range limits the limit values will be used The equation defines the following reference values FEVI FVC calculated from single values FEV1 FVC MEF25 MEF50 MEF75 MMEF PEF VC sameas FIVC NHANESIII This reference value equation was published 1999 AM J RESPIR CRIT CARE MED 1999 159 179 187 The reference values are height and gender related and are defined for patients aged 8 to 80 years from the ethnic groups Caucasian Race selection Caucasian African American Race selection Black Mexican American Race selection Hispanic B 12 CardioSoft Revision A 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements Note Height range from 110 cm to 200 cm Agerange from 8 to 80 years For patients exceeding the range limits the limit values will be used The equation defines the following reference values FEV1 FEV6 FVC PEF MMEF FEVI FEV6
170. mary Giaphic Trends Sample Card Cycles Sample TWA Cycles 1 86 bpm 129 84 mmHg EXERCISE STAGE 1 1 509WHO 25 W 25mm s 1 mm mV 50Hz 0 01 40Hz FRF PRL eS LARA DR oy a n MEE JG oe er excl qup RUD oo is Aas ees TY J ANT ot tt E a T CG YG UY OO a Fa E SE T EA ES AEA X X X X 6 X A Details of the selected ECG strip B Click to display the ECG Strips window C Click icon to delete the displayed ECG strip D Click to change the gain E Click to change the speed F Click icon to print the displayed ECG strip G Click to display more ECG strips H from the test report printer crossed out Note T5A S Click icon to include the ECG strip in the test report check mark or to exclude it You can perform measurements as described under Performing Measurements on the Median Complex on page 6 38 6 40 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review Arrhythmia Review The system will save a 10 second ECG strip each time an arrhythmia occurs and when the Event Marker Full Disclosure button is clicked on the acquisition screen to a maximum of 20 When the event memory is full the strips will be overwritten according to preset priorities A H B C D H l LL ECG Wate 4 10 mm mv S a m 25mm s 1 mm mv 50Hz 0 01 40Hz FRF ISM sas at eee at ee E E EE A a a E Review Full Disclosurg 2 m5 mm s
171. modem port CardioSoft ECG recorder connected to modem port MAC 500 MAC 1200 f you wish to accept only procedures from registered physicians select the check box The physician s last name must be entered at theMAC 1200 before acquisition of the resting ECG The same physician s name must be registered in the user list in the physician group ECG recorder connected to serial interface MAC 500 MAC 1200 Enter the baud rate 19200 is preferred see Technical Specifications of the equipment used and the port Revision A CardioSoft 11 45 2023324 053 System Settings System Configuration 2 Select this option button to receive data from a storage medium and specify the directory 3 Select this option button to receive MAC 5000 ECGs from a disk and specify the directory 4 Select 4 to automatically assign tests toa patient or deselect LJ to enter tests in a list from which they can be assigned manually Conditions for automatically assigning tests to patients Thepatient ID is new and is transferred to the database together with the patient data of the incoming test Thepatient ID already exists and last name first name as well as the date of birth are identical with the information of the incoming test Blank data fields are considered as identical If these conditions are not met the test will appear in the list for manual assignment even though automatic assignment has been selected see next p
172. n yellow LED off m Both LEDs off no power m Green LED on yellow LED blinks CAM14 module not connected m Green and yellow LEDs on not ready m Green and yellow LEDs on beep no connection to CAM USB m f the installed manufacturer s printer driver has a spooler or print status indicator e g HP this driver must be uninstalled and all pertinent entries must be removed from the registry if applicable This should be referred to an authorized system administrator because incorrect entries in the registry may cause the system to break down Please install a standard printer driver e g the Windows driver HP LaserJet 4 for laser printers m Check network address of the remote PC on your local PC and correct if necessary m Check option code and correct if necessary m Enable the Remote View function m Not all required electrodes are applied If you wish to initiate the analysis all the same click the Relearn medians button m The program may have selected two unsuitable leads Manually select two good leads see section Miscellaneous 1 Tab on page 11 24 m The screen diagonal entered in the System Configuration section General Tab on page 11 41 is incorrect m For screens below 17 inches the Windows taskbar is always on top Windows settings Taskbar m Wrong screen resolution in Windows Please use Small Fonts m The CAM USB interface box was not connected when the program was started Connect the CAM US
173. n keypad 12 lead medians rhythm recall data is not saved 6 Click the test end menu tabs to review and edit the data 7 Click Print to print the final report see Report Printout on page 6 50 8 Click Post Test Review to review the stored test information This will end the display of the patient ECG waveforms Note If you do not want to goto Post Test Review Click New Test to start a new test or click Initial Screen to end ECG display and go tothe initial screen 6 28 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review After the Test Post Test Review Test Summary Overview Test wee r bular Summary Graphic Trents Sample Card cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG Wate 4 gt NOTE F edi patie it Information Modify Mealsurement Results 36 years Male WHO Total Exercise Time 05 00 178 cm 78 0 kg Max HR 87 bpm 47 of max predicted 194 bpm Max BP 137 87 Max Load 75 Watt Max ST Level 0108 mV in V6 EXERCISE TAGE 3 5 00 Max TWA 1 pV aVR EXERCISE 0 30 pretation Help E K Initial Screen L Modify Test Information Modify Interpretation Test Type Reasons for Termination Fatigue x2 Summary Resting ECG normal Functional Capacity normal HR Response to Exercise Location Number 0 appropriate BP Response to Exercise pormal resting BP appropriate respo
174. nance of anti virus software Check that in the setup menu of the graphics adapter the check box Center Dialog Boxes is deselected Recording ECGs of Pacemaker Patients It is not possible to display pacing pulses directly in all situations At a screen speed or writer speed of 50 mm s and a pulse duration of just 0 5 ms the width of the recorded pacing pulse would be a mere 0 025 mm When the pace enhancement is enabled see Miscellaneous Tab on page 11 8 a 6 ms impulse with the correct polarity and with an amplitude of 0 5 mV replaces the pacer pulse Depending on the polarity of the pacer pulse in leads and II the pacer pulse in lead Ill may be suppressed Note The Cubic Spline and the FRF algorithm cause a signal delay of approx 2 seconds therefore they should be disabled for adjustment of the pacemaker parameters If several adverse conditions exist at once the possibility of pacer pulses being interpreted as QRS complexes should be considered At the same time however QRS complexes might be suppressed in certain situations For safety always watch pacemaker patients closely Recording ECGs During Defibrillation The patient signal input is defibrillation proof Therefore it is not necessary to remove the ECG electrodes prior to defibrillation When using stainless steel or silver electrodes a defibrillator discharge current may cause the electrodes to retain a residual charge causing a polarization or DC
175. neuver when the orange indicator on the sensor lights up Inhale completely through the sensor Exhale maximally and as quickly as possible then inhale again completely and as quickly as possible Then your patient may resume normal breathing Revision A CardioSoft 8 13 2023324 053 Spirometry Test Post Test Review Post Test Review Test Summary A B C D E Test Suma us T Sete E vaksation Now Teu Local 3 i i Zzr Acro Tek omdtn 203A SP Click tab to display the flow volume loop and tabular data Patient Information area Test Information area Measurement Results area Interpretation anmo Ov gt Select to display and print the system evaluation or deselect 1 G Click to display patient list for a new test Click to display a list with more tests of the current patient local database Click to display a list with more tests of the current patient MUSE CV database system Click to display the print setup window K SW Click to display a list of tests to compare with the current test L EA Click to display the interpretation window where a detailed interpretation of the test can be generated 8 14 CardioSoft Revision A 2023324 053 Spirometry Test Post Test Review M Click to display the online Help program N Click to return to the initial screen The Modify buttons allow you to edit or complete the data in
176. nformation Test Personnel Medications Patient ID TEST DEMO 000000 VEN ERES VT Blood Press mmHa 0 sys oda StaX BP First Name TEST DEMO Location Number 0 t Room Help 051A R 3 4 The Patient Information tab is open 1 Verify the patient s name and ID If the data is incorrect click Modify to change 2 Enter the blood pressure readings or initiate a blood pressure measurement with Start BP Enter a designation for the Room 5 characters max Select a Location Number necessary only when you work with the MUSE CV database system Note You can assign a name to the location number see section MUSE Tab on page 11 55 which would appear instead of the number e g on the Test Summary Note The Patient Information can be assigned to the patient file or only to the pending test Revision A CardioSoft 5 3 2023324 053 Resting ECG Entering Test Information Test Personnel Tab Test Information Patient Information Test Personnel Medichtions Ordering MD Attending MD Medical History Ret MD Order Number Technician Comment Reason for Test 052A R 1 Click the Test Personnel tab Type the relevant information in the Medical History field Enter the Reason for Test or select one from the list box Multiple selections are permitted 4 Type the physicians and technician s names or select them from the list boxes
177. ng ECG Setup Resting ECG Setup Acquisition Tab The settings specific to the resting ECG modality can be entered either from the resting ECG acquisition screen where you click Setup to display the setup menu or from the General tab of the System Configuration see General Tab on page 11 41 The Acquisition tab with the acquisition settings is already on top Thermal Writer Tirermatl ite s peed mms Gain mmm ls 0 Fihythm Leads 2 eran OFF Alarm Cubic Spline Filter Hz 40 he m 91A R Click to print the resting ECG setup Click to display the other setup tabs Select v to view the calibration pulse Select the speed and gain screen Select the screen format Select 4 to hear the lead off alarm If selected the system will emit a beep when an electrode becomes disconnected Select v to enable the Cubic Spline algorithm automatic compensation of baseline fluctuation Cubic Spline causes a signal delay of approx 2 seconds Click 7 to enable the thermal writer function not available Select the thermal writer speed and gain function not available Select the number of rhythm leads to be recorded with the thermal writer function not available Select filter frequency ECC Click to edit the Reason for Test library see Editing the Reason for Test Library on page 11 4 Click to edit the Interpretation libr
178. nimum HP 4100 N HP 4200 N color laser printer HP 4600 HDN HP LJ 2420dn additional software for export functionality Adobe Acrobat 5 0 or later MS Word 2000 CardioSoft 2023324 053 2 3 Product Overview PC Setup Minimum Server Requirements The program runs in a Windows 2000 or Windows 2003 network Other networks are not supported For installation instructions refer to Installing the Program In a Network Environment on page B 26 processor Pentium 1 6 GHz RAM 256 MB hard drive gt 40 GB operating system Windows 2000 Server Windows 2003 Server protocol TCP IP cabling twisted pair Printer Installation For documentation of resting ECGs and exercise tests we recommend connecting the printer directly tothe PC rather than accessing the printer via the network as this would lead to longer waiting periods The following printer drivers are approved for use with the operating systems Windows XP Home Windows XP Professional and Windows 2000 driver HP Laserjet 2420 series PCL6 driver HP Laserjet 4100 series PCL6 driver HP Laserjet 4200 series PCL6 driver HP Laserjet 4600 series PCL6 driver Kyocera Mita FS1000 KX V1 8 0806a driver Kyocera Mita FS1010 KX V1 8 0806a 2 4 CardioSoft Revision A 2023324 053 Product Overview PC Setup Connecting the Acquisition Module The acquisition module that connects to your computer is the interface
179. ns You can edit or complete the data Any changes you make will be assigned tothis procedure not tothe patient Note The Patient I nformation can be assigned to the patient file or only to the pending test Complete Patient Information A Edit or complete patient information Last Name I First Name Patient ID 000022127 Date of Birth DD MMM YYYY Gender Male Height 178 cm Race Caucasian x Weight 78 0 kg Pacemal ker T Cerca 184A BP Test Information The Test Information window opens These arethe tabs of the menu m Patient Information m Test Personnd m Medications You can edit the data the changes you make will be assigned tothis procedure not tothe patient or display the other tabs by dicking thetab headers A Test Information ix Patient Information Test Personnel Medications Patient ID TEST DEMO 000000 Last Name First Name TEST DEMO Location Number 8 5 a Room 185A BP 7 8 CardioSoft 2023324 053 Revision A Ambulatory Blood Pressure Measurement Post Test Review Test Information Patient Information Test Personnel Medicatipns Medical History Reason for Test Help Test Personnel Ordering MD Attending MD Ref MD Technician Comment Order Number Carca 082A R Type the relevant information in the M edical History field Enter the Reason for Test or select one from the list box Multiple selection
180. nse Chest Pain none Arrhythmias none ST van Overall impression Normal stress test 70A S Click a tab to display the corresponding window Patient Information area Test Information area Measurement Results area Interpretation A B C D E n mje Click to display patient list for a new test Click to display a list with more tests of the current patient local database e m Click to display a list with more tests of the current patient MUSE CV database system 2 Click to display the print setup window E Click to display the interpretation window where a detailed interpretation im A of the test can be generated Revision A CardioSoft 6 29 2023324 053 Exercise Test After the Test Post Test Review K Click to activate the online Help program L Click to return to the initial screen The Modify buttons allow you to edit or complete the data in the respective areas m Patient Information The Patient Information window opens m Test Information The Test Information window opens m Measurement Results A window opens where you can edit the measurement results Edited measurement results are identified with the symbol You can also choose whether or not to display the system evaluation m nterpretation A window opens where you can generate the test interpretation see section Generating the Interpretation on page 5 26 6 30 CardioSoft
181. nsert the screen from the Clipboard with Edit gt Paste Select the page orientation using File Print setup gt Landscape Print the page and fax it to GE Medical Systems Information Technologies or save the page as a WordPad document and send it via e mail CardioSoft is a system with remote service capability For this feature you will receive a modem with the installed Symantec pcAnywhere software Warning Patient Hazard Disconnect the patient from the system during remote servicing or when the modem is connected 1 Administrator privileges are necessary to use the remote service feature 2 Contact your nearest Remote Service Center and arrange a time and date for remote servicing 3 Attheagreedtime start the Symantec pcAnywhere program and click Modem 4 After servicing installation of software upgrades the Remote Service program shuts automatically down and the system user is logged off Revision A CardioSoft B 29 2023324 053 Miscellaneous Medical Reimbursement Program Clinical Information System CIS Medical Reimbursement Program Clinical Information System CIS The program is supplied with a BDT interface which allows it to communicate with a medical reimbursement program or clinical information system When running the program in conjunction with a medical reimbursement program the reimbursement program will handle the patient demographics while CardioSoft handles th
182. ntered 11 10 CardioSoft Revision A 2023324 053 System Settings Resting ECG Setup 8 Click button to save the template To do so enter the template name first This name will allow you to select the template later on when configuring the printed report When editing Report 1 or 2 you must save this template under a new name 9 Click to delete the template 10 Close the Configured Report window Revision A CardioSoft 11 11 2023324 053 System Settings Exercise Test Setup Exercise Test Setup The settings specific to the exercise test modality can be entered either from the exercise test pre acquisition screen where you click Setup to display the setup menu or from the General tab of the System Configuration see General Tab on page 11 41 Writer Tab The Writer tab with the writer settings is already on top H IJKLM N Miscellaneous 2 ST Medians 125L Writer Screen Lead Sequenc E ol Editq Final Reports Miscellaneous 1 In Test Reports Wier mi R Au flepots Speed mm s 25 v IW 12 Lead ST Table f 10 Man report 12 lead recall Ediz PinttSave t Print Peak Exercise Report 12 Lead A oc IO mn m UO WD mo rc 12 Lead Median H1 Leads 3 ll ks Rhythm Recal Medians 125L Rhythm Lead Il P3 Print Setup Help Canc 98A S Click to print the exercise test setup Click to select the writer gain Click to select the writer speed Click to select
183. nterval 176ms QT QTC 378 449 ms P duration 118 ms 25mm is 10mmim 0 05 1 abe yr 058A R A Click to select the screen format With J you scroll through the formats with amp you open the list Format 1 x 10s I aVF displays 10 seconds of the first group of 6 standard leads format 1 x 10s V1 to V6 displays the second group of 6 standard leads B Click icon to activate the zoom function Position the magnifying glass on the region of interest and click An enlarged view of the selected region appears see Zoom Mode on page 5 14 C Click to change the gain amplitude D Click to change the speed E Click icon to copy waveforms to the Clipboard From the Clipboard the data can be inserted in another application e g in Word with the shortcut Ctrl V Revision A CardioSoft 5 13 2023324 053 Resting ECG Post Test Review Zoom Mode A zoom factor from 2 to 12 can be selected and the selected segment can be displayed in all leads A B CD E F a Traces Means Arthjthria Review Vedtor Loops Full Discldsure ECG Vent Rate 85 bpm QRS duration 98ms P R T axes 177 39 8 RR PP intervall 700 705 ms PR interval 176ms QT QTC 378 449 ms P duratio 118 ms Amplitude 1 67 mV 100mm s 40mm mV 0 01 100Hz 50H EN oe 059A R A Click to select the lead With J you scroll through the leads with you open the list B Click icon to terminate the zoom function C Click to select the zoom factor D Cli
184. o 601 1 All parts of the product and all accessories described in this manual that come in contact with the patient during the intended use of the product fulfill the biocompatibility requirements of the applicable standards If you have questions in this matter please contact GE Medical Systems Information Technologies or its representatives Revision A CardioSoft 1 13 2023324 053 Introduction Safety Information Technical Maintenance Legal Notice For technical data and other detailed technical information please refer to the Service Manual Comply with the instructions given in section Maintenance on page A 4 Also it is recommended to follow the policies of your institution s Biomedical Department Our equipment contains several fields which can be filled in before performing an ECG Some of these fields must be filled in before performing an exam some are optional and therefore left to the user to assess whether they are needed to perform the exam A field RACE is one of these optional fields It has been acknowledged by the medical profession as useful to analyze some pathologies You should be aware that in some jurisdictions the processing of data revealing an individual s racial origin is subject to legal requirements such as obtaining the patient s prior consent If you elect to collect this type of data it is your responsibility to ensure that you comply with all applicable legal requirements Cardio
185. odifications will be lost With some bicycle ergometers restoring the Factory Setup will delete your own exercise test protocols and phases The following parameters cannot be loaded stored or reset to the factory defaults Exercise Tests Remote View Spirometry Tests ambient conditions System Configuration all settings on the General tab Click the Custom Setup button on the acquisition or pre acquisition screen or on the General tab of the System Configuration Scroll to the bottom of the list box Select Factory Setup Click Load to load the setup 11 40 CardioSoft Revision A 2023324 053 System Settings System Configuration System Configuration Click the Systen Configuration button on the initial screen to display the General Tab x Physician z piikana Technician x ID Records not assigned H Trace Background black yellow E Receive Data hom ECG Device i DL E ae dA 3 Grid i z Archive Patient Records A Screen Diagonal n o SY Compress L CardioSoft Web Sever Langsam DATING M Ne Procedure Statistics N NE Paras canst Enable Test Information Window Eats Resting ECG O Spirometry r System Configuration 5 EEA ENS Esport Custom Setup P Q ForSeniceOny GutProgem Help R Print OK Cancel S 925A m Test Pat
186. of thetabular summary during exercise tests ITRD In Test Trend display of trends during exercise tests PRVT Previous Test Retrieval display of the previous exercise test during an exercise test TWAA T Wave Alternans T wavealternans analysis of an exercise test CardioSoft Revision A 2023324 053 Product Overview Software Features ERG2 ST Measurement Arrhythmia 6 12 Lead Exercise Test recording of either 3 6 or 12 leads of ECG data 12 lead ST measurement automatic or manual determination of the J x point presentation of the Sample Cardiac Cycles presentation of the baseline ST complex and of the current ST complex for direct comparison arrhythmia analysis and presentation during the exercise test stage report in 12 lead exercise tests 999 9 ERG3 Exercise Test Expert Mode manual editing of the E J and post J point direct cross referencing from the trends to the full disdosure ECG final report 15 lead exercise test ECGH ECG History requires hardware key display of the median beats from up to 5 selected resting ECGs for comparison or printout 3D presentation of the median beat for serial comparison CWEB Web Interface display of patient records via the internet section CardioSoft Web on page B 21 CardioSoft Client software version for editing of patient records at workstations without acquisition module the ECG History option can
187. offset voltage at the electrode skin interface This electrode polarization will block acquisition of the ECG signal for several minutes To avoid this condition use silver silver chloride electrodes B 10 CardioSoft Revision A 2023324 053 Miscellaneous Application Tips If other electrodes are used we recommend disconnecting the patient cable from the system before delivering the defibrillation shock Cubic Spline and the FRF algorithm cause a signal delay of approx 2 seconds therefore they should be disabled if the patient has to be defibrillated while the ECG is being recorded Acquisition Tab on page 11 3 We recommend using non polarizing disposable electrodes with defibrillation recovery ratings as specified in AAMI EC 12 3 2 2 4 MMS P N 900703 Silver Trace AAMI EC12 requires that the polarization potential of an electrode pair does not exceed 100 mV 5 seconds after a defibrillation discharge Note If excessive DC voltages are present at the electrode then a message will appear indicating a Lead Off condition Revision A CardioSoft B 11 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements Reference Value Equations Interpretation Modes Measurements Reference Value Equations ECCS Zapletal This equation uses reference values developed by QUANJ ER ECCS93 and ZAPLETAL The ECCS reference values were published 1993 ISBN 87 16 15024 4 The reference va
188. oft Web CardioSoft Web must be installed on a stand alone PC which is not used for data acquisition see Service Manual Note Theinstallation should be referred to the network administrator or to our Service specialists Besureto enable the password feature so that only authorized personnel has access to the data For Russian J apanese and Chinese files be sure to select the appropriate encoding in the Internet Explorer CardioSoft Web requires Windows NT 4 0 or Windows 2000 CardioSoft Web adopts the following CardioSoft System Configuration settings when started language date format time format ST level units option code for CardioSoft Web CWEB trace background color ECG grid Revision A CardioSoft B 21 2023324 053 Miscellaneous CardioSoft Web Points to Note General Exercise Tests Spirometry Tests Patient Administration The ECG traces are superimposed on a grid pattern that neither adapts to the monitor size nor to the display resolution The grid is designed for a 17 inch monitor with a resolution of 1024 x 768 pixels ST HR Slope is not shown The comparison of two spirometry tests is not shown Archived patient records do not appear in the patient record list The patient record list informs about test type date and time cart device number confirmed yes no transferred yes no 999 The patient list only indicates last name first name date of birth and pat
189. on with the MUSE CV system Install the Internet Explorer 6 0 or later and the Acrobat Reader to view tests stored in the MUSE CV system database Note Besureto install the Microsoft Internet Explorer 6 0 or later BEFORE installing CardioSoft Inthesetup menu of the graphics adapter check that the check box Center Dialog Boxes is deselected On MARS PC V5 1 install the program in the directory D CARDIO Installing the Program On a Stand Alone PC Log on as the system administrator 1 2 9 Turn on the PC and the monitor Exit ALL programs Insert the CardioSoft CD in the CD ROM drive If the CD drive does not automatically start up follow the instructions in steps 3 through 5 Select Start gt Run In the command line type X Disk1 Setup X CD ROM drive letter e g E or D Click OK Follow the displayed prompts Select Next to confirm the proposed directory when reinstalling the program be sure to select the same directory Enter the serial number see CD ROM CardioSoft will now be installed on your computer Restart Windows We recommend disabling the Windows Print Manager to speed up printing B 24 CardioSoft Revision A 2023324 053 Miscellaneous Installing the Program 10 Select Start gt Settings gt Control Pand 11 Double click Printer 12 Select the printer you will use 13 Select File gt Properties and Scheduling 14 Select Print directly
190. op down list l Click down arrow to open the list 2 Select an item from the list m Click OK to close an open window and to confirm selections m Click Canca to dose an open window without accepting the changes m Click Hdp todisplay an online help system Double d icking means that you have to press the left mouse button twice in rapid succession Revision A CardioSoft 2 15 2023324 053 Product Overview Putting the System Into Service Viewing and Printing the Operator s Manual The CardioSoft operator s manual is available on the program CD ROM Click Operator s Manual on the initial screen to display the document The system will load the Acrobat Reader program and display the title page of the operator s manual Use the controls explained below to navigate through the document Note Clicking a chapter headline in the operator manual s table of contents takes you directly to the corresponding chapter Clicking an index entry will also display the corresponding page of the manual Ej e ey amp 14A A X Pages back or forward through the document B Takes you directly to the first or last page of the document C Undoes a change of page or view To print the document 1 Select Filein the menu bar then Print 2 Inthe print dialog choose the print options thePrint Range all pages the current page or a section of the document theprint quality thenumber of copies 3 Click
191. ored during the tests manual or automatic User can select all or some of the 12 leads to be printed Report of 20 stored arrhythmias showing 2 5 seconds of raw data prior to the ectopic beat through 2 5 seconds after the last User can select all or some arrhythmias to be printed Report showing Y X Zleads and three plane vector loop display of horizontal frontal and sagittal planes using Frank X Y Z lead set Derived from associated 12SL report TWA medians report see section Sample TWA Cycles on page 6 39 Waterfall display report of all leads Special medians format for Sweden Only if Swedish Reports are enabled 6 52 CardioSoft 2023324 053 Revision A Exercise Test Monitoring of Remote Exercise Test Workstations Monitoring of Remote Exercise Test Workstations The program allows you to monitor an exercise test performed at remote stations from your PC However only one station can be viewed by one other station at a time The data in the vital signs window reflect the settings at the remote station Conditions for the remote view function 1 2 3 4 5 The Remote View function is enabled at the remote station see section Miscellaneous 1 Tab on page 11 24 The pretest phase has already started Click Remote View on the initial screen to view the remote exercise test screen Click the Setup button and enter the PC names in the left column of the window Click the arrow but
192. oubleshooting ccc oorr rre bh rra B 27 Remote Service ss sesso Eden Sac Ddeetibeto e dee Bate eden iei d B 29 Medical Reimbursement Program Clinical Information System CIS B 30 vi CardioSoft Revision A 2023324 053 System Maintenance 0 00 c eect eee eee ees B 31 DatapBackp sa ejes ism roa ien um Wat aio eae LR SUR UE B 31 Norton AntiVirus oe recette ter tate OA ERE ga e B 31 Direct Fax Transmission of Printer Documents esee B 32 ECG Measurement and Interpretation Program 00s cess eee eee ee B 33 Order Information seen C 1 Order Information sssssees II C 3 ACCESSOMES 1 tb eee e eric abe e be e PA ped C 3 Revision A CardioSoft vii 2023324 053 For your notes viii CardioSoft Revision A 2023324 053 1 Introduction evision CardioSoft 2023324 053 For your notes 1 2 CardioSoft Revision A 2023324 053 Introduction License Agreement License Agreement Opening the envelope indicates acceptance of the license agreement If you do not accept the terms of this agreement please return the closed envelope including the documentation and supplied hardware to your vendor for a full refund The object of the agreement is to grant a license for the use of the software program and product documentation GE Medical Systems Information Technologies grants you the personal non exclusive and non transferable right to use the sof
193. owing reference values PEF FVC FEV1 FEVI FVC MMEF The reference values by MALLOzI were published 1995 Tese Doutorado Escola Paulista de Medicina 1995 116p The reference values are height and gender related and are defined for men aged 6 to 24 years and women aged 6 to 19 years Note Agerange 6 to 24 years for men and 6 to 19 years for women For patients younger than the lower limit the lower limit will be used Arangefor height is not defined The equation defines the following reference values PEF FVC FEV1 FEVI FVC MMEF Revision A CardioSoft B 15 2023324 053 Miscellaneous Reference Value Equations Interpretation Modes Measurements Interpretation Modes Note The authors of the reference values developed the interpretation modes for the reference value equations Other reference value equations may lead to different interpretations Europe An interpretation mode on the basis of the ECCS reference values The flow volume loop is analyzed according to these criteria 1 Expiratory flow limitation Curve typical of restriction Expiratory stenoses Impaired peripheral respiration Expiratory flow limitation Possible causes increased airway resistance e g asthma reduced pulmonary elasticity e g emphysema airway obstruction Criterion MEF50 VC Ref Definition Interpretative Statement 70 96 normal 50 70 mild expiratory flow limita
194. pm 6 00pm 8 00pm 189A BP 7 14 CardioSoft 2023324 053 Revision A Ambulatory Blood Pressure Measurement Post Test Review Statistics Summary The Statistics Summary shows one histogram each for the systolic values left and the diastolic values right as well as the frequency distribution given as a percentage The table below indicates the maximum minimum and mean values as well as the standard deviations The percentage of readings that exceeded the set limits is shown at the bottom Similar report pages exist for the day time the night time and the wake up time Test Summary Graphics Hourly Averages Statistics Summary Day Time Night Time Wake up Time lt 110 120 130 140 150 160 170 180 190 200 gt es a 70 80 90 100 110 120 130 140 150 gt 119 129 139 149 159 169 179 189 19 209 89 99 109 119 129 139 149 159 Minimum Maximum Average SD sys BP 119 5 11am 2nd day 175 6 48pm 1st day 143 6 13 3 dia BP 61 3 53pm 2nd day 107 10 13am 2nd day 854 33 mn BP 81 3 53pm 2nd day 126 6 48pm 1st day 104 5 az Heart Rate 46 103 73 0 11 7 Day Time Valid measurements 45 of 45 1002 Night Wake up Time Valid measurements 13 of 13 1002 71 1 of systolic blood pressure readings exceeded 135 mmHg 84 6 of systolic blood pressure readings exceeded 125 mmHg 60 0 of diastolic blood pressure readings exceeded 85 mmHg 38 4 of diastolic blood pressure readings exceeded 80 mmHg 490
195. ppc ea mna aR mai c peyi eene ui i pe pee a a a ee ee ee MX CO A GG A rp ON X 80A S Analysis results Click to change the gain Click to change the speed Click to display the 12SL Report Click to select another 12SL ECG Click to view the corresponding Vector Loops see Vector Loops on page 6 49 nmuoou gt 6 48 CardioSoft Revision A 2023324 053 Exercise Test After the Test Post Test Review Vector Loops This screen shows the median complexes of the orthogonal FRANK leads X Y and Z as well as the vector loops in three planes Graphic Trends Sample Card Cycles Sample TWA Cycles ECG Strips Arrhythmia Review Full Disclosure ECG Waterfall 125L Report 4 20mm mv 125L Report Harizontal Plane Frontal Plane 81A S A Median complex B Click torso to toggle between right and left sagittal planes C Click to change the gain D Click to return to the 12SL Report window Note Y ou can perform measurements as described in section Measuring the ECG on page 5 15 The vector loop is saved with the 12SL report only if the message Median update ceased Relearn has disappeared from the ST Arrhy window at the time the 12SL report is stored Revision A CardioSoft 6 49 2023324 053 Exercise Test After the Test Post Test Review Report Printout Click the Print button to print the report The print setup window opens where you can temporarily adjust the
196. pressure Choose the arrhythmia lead selection mode Scan or Manual if Manual select leads Select the reports to be initiated with buttons 1 and 2 on the CAM 14 acquisition module Select 7 or deselect LI the following functions m display of Arrhythmia Labels m Remote View m QRS Beep with CAM 14 acquisition module only m Audible HR Alarm alert when target HR is exceeded m display of Pace Enhancement markers m Audible LEAD OFF Alarm alert when an electrode becomes disconnected m Target Load value will be calculated and indicated for bicycle ergometer protocols only 11 24 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Select the Max Load Interpolation function only possible when the exercise test is performed on a bicycle ergometer The maximum load is the load of the last completed stage plus the duration of the last stage x load increase stage time Example load of the last completed stage 125 Watts last stage aborted after 1 minute load increase 25 Watts stage time 2 minutes 125 W 1 x 25 2 137 5 W This value is also used to determine the percentage of the target load Select to Save full disclosure ECG then choose the phase when storage of the full disclosure ECG should start and the sampling rate Select the METS Interpolation Time Revision A CardioSoft 11 25 2023324 053 System Settings Exercise Test Setup Miscellaneous 2 Tab Click
197. pretation Click the Interpretation tab to display the screen for comparison of the two interpretations The following details of the two procedures are displayed m themeasurement results m thesystem evaluation and m theinterpretation 5 30 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review 10 s ECG Medians Procedure Procedure Procedure 1 Measurement Results Vent Rate 85 bpm Vent Rate 85 bpm PR interval 182 ms PR interval 176 ms QRS duration 102 ms QRS duration ms QT QTC 390 466 ms QT QTC 378 449 ms P R T axes 20 25 50 P R T axes 172 3978 P duration 126 ms P duration 118 ms RA PP interval 700 700 ms RR7PP interval 700 705 ms QTD QTcBD 112 134 ms System Evaluation System E valuation minor left axis deviation Normal sinus rhythm because QRS angle between 30 and 0 Left axis deviation negative T wave lateral Nonspecific T wave abnormality because T lt 0 1 mV in V6 Abnormal ECG R S inversion area between V1 and V2 borderline ECG Arrhythmia results of the full disclosure ECG QRS Complexes 42 PVC 1 PSVC 1 Arrhythmia results of the full disclosure ECG QRS Complexes 16 Procedure 1 Interpretation Procedure 2 Interpr tation minor left axis deviation Normal sinus rhythm because QRS angle between 30 and 0 Left axis deviation negative T wave lateral Nonspecific T wave abnormality because T lt 0 1 mV in V5 Abnormal
198. quired for CAM 14 acquisition module 901142 005 901142 008 901142 007 AC power adapter for CAM USB A T interface box or CAM USB A T KISS interface box CORINA acquisition module requires AC power adapter 200300 001 CORINA acquisition module with suction pump for KISS electrode application system requires KISS electrode application system 216 121 01 and AC power adapter 200300 001 CORINA acquisition module with analog output requires AC power adapter 200300 001 CORINA acquisition module with analog output and pump for electrode application system KISS requires electrode application system KISS 216 121 01 and AC power adapter 200300 001 AC power adapter for CORINA acquisition module Revision A CardioSoft C 5 2023324 053 Order Information Order Information CAM 14 Accessories 2016560 002 Connection cable Device to CAM 14 420101 001 14 leadwire set 420101 002 10 leadwire set 900178 003 Grabber adapter set 10 AHA 900179 203 Grabber adapter set 14 AHA 900178 103 Grabber adapter set 10 IEC 900178 203 Grabber adapter set 14 IEC 2001926 001 Blank plugs set of 4 Electrodes 217 32001 Adhesive electrode for children 22 mm diameter press stud fixation with adesive rings 217 123 01 217 32101 Adhesive electrode for adults 35 mm diameter press stud fixation with adesive rings 927 223 00 217 194 01 Chest electrode for chest belt 30 mm diameter 217 196 01 Chest belt for electrodes 21
199. r all entries from this application is CARDIO These are the details shown after double dicking the entry event category user cart device number patient ID test type test date test time 999999 Note Only the System Administrator is authorized to perform these administrative tasks Revision A CardioSoft 11 43 2023324 053 System Settings System Configuration User Name ID E Group Techrician x 2 Setup no setup 3 IN External User Noa Edit Data WE System Configuration Setup Password Cancel Help 926A Click New to display the user registration window 1 Enter the user name and an ID number If you enter the last name before the first name insert a comma in between Otherwise the name entered first becomes the first name and the name entered second becomes the last name when the user is registered in the MUSE CV system Please notethat MUSE accepts first names with a maximum length of 10 characters last names must not be longer than 16 characters When sending data toa MUSE system be sure to match User ID numbers assigned at the MUSE system to User ID numbers assigned in CardioSoft Select the user group Select the user s custom setup see 11 39 Select the user s privileges Edit Data user is authorized to edit test and patient data System Configuration user is authorized to edit the System Configuration Setup user is authorized to e
200. rced expiration must start as quickly as possible The parameter used to determine the correct start is the back extrapolated volume The volume must be less than 150 ml or less than 596 of the F VC Otherwise the message High back extrapolated volume will appear Reproducibility Criteria Aminimum of three accepted trialsis required two of these must be reproducible The reproducibility criterion is a maximum variation of 200 ml of FEV1 and FVC between thetwo best tests Otherwise you will see the message High FEV1 variability or High FVC variability CardioSoft Revision A 2023324 053 Spirometry Test Conducting Spirometry Tests The flow volume loop of the current test and of the best test are displayed The table shows the measuring values Act the reference values and the percentage deviation of the current test A B C D E F FVC Measure Scale IBEX clume Time 78 cm 34Y ars Malej System Evaluation IHS Ridference Values Knudson ON Curent test Best test C ATS Summary Value Ac Ref FVC Il 382 523 7 FEVOS I 2 88 FEVI l 340 433 5 FEVI FVC 88 83 10 FEV3 I 3 80 FEVE I 382 FEVI FEVE 89 PEF s 113 955 1 MEF 5 s 113 8 86 i MEFSD s 4 77 539 8 MEF25 s 1 72 225 71 MMEF l s 414 455 s FIVC I 390 523 7 FIT I 3 90 FIVIJFVC 102 Gen i PIF l s 10 0 FEV1 Ii MIF75 l s 8 80 MIF5O s 389 MIF25 Vs 3 02 MWY l min 102 ATS
201. rent list according to the entries made above F Click button to insert the current date at D G Columns with details of the patient records Cart Device Number ID number of the acquisition device confirmed the test results have been reviewed and confirmed by a physician transferred the patient record was transferred to the MUSE CV system Full disclosure ECG the full disclosure ECG has been stored Patient patients name when all tests in the database are listed H Click button to select all displayed patient records Click down arrow to display a list with all test types and select J Click down arrow to display a list with the different test statuses and select confirmed or unconfirmed patient records only or all patient records Click button to view the selected patient record L Click button to print the final report of the selected patient record M Click button to generate a Combined Report for the current patient see section Printing a Combined Report on page 9 6 N Click button to transfer the selected patient record to the MUSE CV database system 9 4 CardioSoft Revision A 2023324 053 File Management Selecting Patient Records O Click button to send the selected patient record s via modem or to save it to another directory P Click button to export the selected patient record s using file formats PDF Word Excel or XML Q Click button to delete the selected patient record s Select all in the Pa
202. rk problems The program must be closed at all workstations while it is being installed in the network If you want to use the program in a network environment the network administrator must first set up the network accordingly i e theworkstations must be integrated in the network theusers must beregistered with the appropriate privileges Proper communication with the server where all patient data will be stored is of utmost importance The users must have read and write privileges for the drive where CardioSoft will be installed In the network the users must be granted all read and write privileges for that drive The software supports the common Ethernet network protocols For communication with the MUSE CV database system select the TCP IP protocol When starting CardioSoft the network address of the MUSE server must be available The Remote View function is also operational when the software is installed locally You are advised to have the correct IP address or network names of the remote exercise test stations ready when setting up the network and before starting Remove View for the first time Install the recommended printer drivers only see Printer Installation on page 2 4 Other printer drivers in particular those from some printer manufacturers my cause data communication problems with the acquisition module Installing the program in a network is basically similar to installing it locally only th
203. rning the safety of connected devices the user must contact the manufacturers concerned or other informed experts as to whether there is any possible danger tothe patient the operator or the environment as a result of the proposed combination of devices Standards IEC 60601 1 1 EN 60601 1 1 must be complied with in all cases Liquids must not be allowed to enter the acquisition module or the CAM USB CAM 14 interface box If liquids have entered the devices notify service to have them inspected for damage before using them again Useonlytheoriginal GE Medical Systems Information Technologies patient cable CardioSoft Revision A 2023324 053 Introduction Safety Information Warning Patient Hazard During exercise tests a defibrillator and a pacemaker both checked for proper functioning should be kept at hand Patient Hazard The operator must be capable of using the equipment properly Interpretation Hazard A qualified physician must overread computer generated tracings Computerized interpretation is only significant when used in conjunction with clinical findings Risk of Suffocation Dispose of the packaging material observing the applicable waste control regulations and keeping it out of children s reach Risk of Poisoning Follow all manufacturer instructions for preparing and storing chemicals required for the application or maintenance of the device and store all chemic
204. rotocol Editor 11 20 PT Code 8 9 R Race Information 1 14 Real time Report Printout 6 28 Reanalysis Exercise Tests 6 37 Resting ECG 5 17 Reason for Test Edit Library Ambulatory Blood Pressure Measurement 11 34 Exercise Tests 11 26 Resting ECG 11 4 Spirometry Tests 11 37 Recording a 10 second ECG 5 7 Recovery Phase 6 26 Reference Value Equations Spirometry B 12 Remote Service B 29 Remote View 6 53 Report Editor 11 10 Report Printout Ambulatory Blood Pressure Measurement 7 16 Exercise Tests 6 50 Resting ECG 5 25 Spirometry Tests 8 17 Resting ECG Setup Acquisition Tab 11 3 Final Report Tab 11 9 Lead Sequence Tab 11 7 Miscellaneous Tab 11 8 Resting E CGs Receive from Other ECG Devices 11 45 Revision History 1 4 S Safety Information 1 6 Sample Cardiac Cydes 6 35 Sample TWA Cycles 6 39 Screen Format 5 13 Selecting the Test Type 4 4 Skin Preparation 3 4 Softkeys Controlling Exercise Tests 2 11 Software Options 2 17 Specifications 1 14 Spirometry Sensors 8 3 Spirometry Setup Acquisition Tab 11 36 Miscellaneous Tab 11 37 Spirometry Test Values Definitions B 20 SpO2 Monitor Connect B 8 Statistics Summary Ambulatory Blood Pressure Measurement 7 15 Styles 1 5 Swedish Report Formats Enable Disable 11 58 System Configuration Country Settings Tab 11 58 Devices Tab 11 53 EMR Tab 11 59 General Tab 11 41 Modem Tab 11 54 MUSE Tab 11 55 Option Code Tab 11 57 System Date and
205. rrent test S Click to display the interpretation window where a detailed interpretation K D of the test can be generated L Click to activate the online Help program M 2 Click to return to the initial screen Revision A CardioSoft 5 11 2023324 053 Resting ECG Post Test Review The Modify buttons allow you to edit or complete the data in the respective areas Patient Information The Patient Information window opens Test Information The Test Information window opens Measurement Results A window opens where you can edit the measurement results Edited measurement results are identified with the symbol In the same window you can select v and deselect the View Sysem Evaluation feature This feature also affects the printout the combined report the transfer to MUSE and data export m nterpretation A window opens where you can generate the test interpretation see section Generating the Interpretation on page 5 26 Note Changes tothe patient information will only affect the current test previous tests of the same patient remain unaffected CardioSoft Revision A 2023324 053 Resting ECG Post Test Review ECG Traces On this screen you see the reference ECG Depending on the selected screen format and speed the waveforms may take up several screens E tommy S 25v Ee Vent Rate 85 bpm GRAS duration 98ms P R T axes 17 39 8 RR PP intervall 700 705 ms PR i
206. ry tab appears Note Do not forget to deletethe data stored in the monitor This is to ensure that the monitor does not contain data from a previous test when used on a new patient When the message I nconsistent data in ambulatory BP device Procedure cannot be saved appears turn the monitor briefly off and on again 7 6 CardioSoft Revision A 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Test Summary TEST DEMO TEST 0EMO TEST DEMO 000000 Fom 183A BP Click a tab to display the corresponding window Patient Information area Test Information area Measurement Results Statistics Summary Interpretation Im UO WD gt n Click to display patient list for a new test Click to display a list with more tests of the current patient local database Click to display a list with more tests of the current patient MUSE CV database system Click to display the print setup window T Click to display the interpretation window where a detailed interpretation of the test can be generated m K Click to activate the online Help program rc 3J Click to return to the initial screen The Modify buttons allow you to edit or complete the data in the respective areas as described below Revision A CardioSoft 7 7 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Patient Information The Patient Information window ope
207. s to activate the software options The code numbers are given on the supplied option code sheets or on a disk E x General Devices Modem MUSE Option Code County Settings EMR Expiration Date RESM Rest ECG Measurement a En RESI 12 SL ECG Interpretation 123 ERGM Remote View 123 EGMO Storage of Full Disclosure ECG 123 NETS Low Volume Data Storage on Network Server 123 NET2 Medium Volume Data Storage on Network Server Es NE NET3 High Volume Data Storage on Network Server 123 E aa ARRY Arrhythmia Detection Documentation maoo ci 29 10 2004 T5 Dc 2DWF 2D Waterfall Display zoe BRWS MUSE Browser Ex E coroners Number RISK Risk Factors and Score EXPD Export Data as XML Excel 123 Ims EPDF Esport Report as PDF 123 EWRD Export Report as WORD 123 CDRW Archive to Extemal Media I I Serial DSPC Screen Display Configuration Number ib ITBL In Test Tabular Summary 123 0 ITRD In Test Trend 123 ci PRVT Previous Test Retrieval 123 TWAA T Wave Altemans BE Modify RESB Rest ECG Exercise Test Standard 387 ci Ta ERG2 Exercise Test AT ST Measurement Arrhythmia 6 12 Leads 123 Help 936A 1 Click Modify 2 When asked Changesoftware option Are you sure click Yes to clear the window 3 Enter the option codein the appropriate field or 4 Click Load toload the option code from disk 5 Select the check box when using the Floating License option 6 Toenablean opt
208. s are permitted Type the physicians and technician s names or select them from the list boxes Type any Comment about the test Answer the Extra Questions Enter an Order Number This number will appear on the printed reports and on the Test Summary Note The Reason for Test library can be edited see section Miscellaneous Tab on page 11 34 Y ou can define two Extra Questions as needed see section Miscellaneous T ab on page 11 34 You enter the names of the physicians and of thetechnician in the System Configuration see section General Tab on page 11 41 Revision A CardioSoft 7 9 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Medications cancel 053A R 1 Click the Medications tab 2 Enter or choose a maximum of 5 medications 3 Enter the medication dose Note You can edit the medication library see section Editing the Reason for Test Medication Library on page 11 37 Measurement Results In this window you can temporarily modify the statistics intervals and the blood pressure limits for this report A B C D zas ron mato Be Device Statistics Intervals BP Limits sys dia Stat Night Time EEG until 5 00 00 Day Time ps E fe Wake up Time 4 00 07 until 6 00 00 Night Wake up Time fis feo ki Cancel 193A BP A Select vi to perform the statistical analysis with the Statistics Intervals from the ambulatory BP dev
209. s of the ambulatory blood pressure monitor Date and time of the monitor A Measurement protocol B Information whether or not data is stored in the monitor D Number of BP measurements and the duration of the protocol C B C D Ambulatory BP de Memory Status Date 18 12 2002 Data stored in ambulatory BP device Time 184357 Download Protocol Duration Number of BP Measurements 790000 22 00 00 to 21 5900 exact 38 3 250 30 min Defi Rate Intl Pres Qty n 6 59 00 exact 30 3 250 18 2400h 48 182A BP Click the Clear Data button to delete data stored in the monitor Note If the stored data has not been transferred to the system download it as described in the next section Click Programming to select the protocol Select the protocol and click Programming Y ou can choose between two protocols Refer to section Editing the BP Protocol on page 11 33 for information on configuring the protocols Turn the monitor off and disconnect it from the PC Connect the monitor to the patient see TONOPORT Operator s Manual Revision A CardioSoft 7 5 2023324 053 Ambulatory Blood Pressure Measurement Post Test Review Post Test Review Downloading Data 1 Turn the monitor off and on again 2 Wait for thetimeto be displayed then connect the monitor tothe PC 3 Select the patient 4 Click Connect 5 Click Download Data After the download the Test Summa
210. s that are not connected to the same circuit must be electrically isolated for operation electrically isolated RS 232 interface this requirement does not apply in the USA ThePC must beinstalled outside the patient vicinity if it does not meet the requirements of EN 60601 1 The acquisition module is not intended for intracardiac use All bicycle ergometers and treadmills connected to the system must meet the requirements of IEC 60601 1 The CardioSoft PC and the connected bicycle ergometer or treadmill must be connected to the same electric circuit via Separate wall outlets this requirement does not apply in the USA Revision A CardioSoft 2023324 053 1 9 Introduction Safety Information Warning Shock Hazard Observe the following warnings Failure to do so endangers the lives of the patient the user and other persons present All modems connected to the system must meet the requirements of EC 60950 or UL 1950 The specific regulations valid in your country must also be observed The modem must be installed within the medical location but not in the patient vicinity Disconnect the patient from the PC while sending data via the modem Devices may only be connected to each other or to parts of systems when it has been made certain that thereis no danger tothe patient the operator or the environment as a result In those instances where thereis any element of doubt conce
211. scriptions generate bills perform tests with the CardioSoft system copy patient and test data stored in the CardioSoft system Revision A CardioSoft 2023324 053 EMR Interface Performing an Examination Performing an Examination We will acquire and analyze a resting ECG as an example A B CardioSoft Resting ECG Walter S Caldwell Patient llame Walter Caldwell D O B 08 18 1942 Patient ID 234 TESTO11 Provider Harry S Winston MD Sex Male Race hite Reason for Test Medications Therapy outcome control MEVACOR TAB 40MG LOV ASTATIN 1 po qd NITROSTAT SUB 0 4MG NITROGL Y CERIN 1 sl prn cip max Checkup Chest discomfort gt of 3 in 15 min E Current Problems MEX M IU oso C ANGINA FUNCTIONAL CLASS Ill ICD 786 5 Risk of CORONARY ARTERY DISEASE ICD 414 00 HYPERCHOLESTEROLEMIA ICD 272 0 Pacemaker Resting ECG Interpretation Heart Rate QT Interval BP Systolic atiate zi BP Diastolic QRS Interval Comment P Duration EKG PWav Axis PP Interval EKG ORS axis z Faena kopa Technician Comment not saved to note RR Interval Additional Information oe H art Test Prey Form Ctr PaUpy Next Form GtrePapn 104A A Patient data B Click to start the test 1 Click the Start test button to start the examination CardioSoft will start up and the patient data will be copied from the EMR interface to the
212. sse 6 8 During the Test 0 cece cece cece teeter nnn 6 12 Acquisition SCreer 23 3 o ecce keel Qut nte ed RU Rc ed 6 12 Pretest Phase c ood ede duet eme bed vetet Idem herd vett duet sen 6 13 Exercise RN ASC y oss 5a secs mance LM LN EIE stetur 6 14 EGGiDataWIndOWs s cie eR SEUR EIA PENE HRECERAGAN GM ina pele 6 16 Recovery Phase donee ideerrrReiuspe wale Gebr pnr Pres did dus 6 26 Test End Phase rezept ense bee we brenda INR PR tes 6 27 OVerVIeW osse ecce re esa be re ie Ne cd EL Poeta 6 27 Operating Steps ini 10 ver ect etek pg ELE RUE eue 6 27 After the Test Post Test Review 6 29 Test oUIminaly 3 sonis xxn aacahes E ERE RR CAU Oo tee ata Rc FORCE SE 6 29 Graphics Tends dx 2e iol tog rr bep ES ea bes NU Ber ERR ea bee 6 32 TWA Trend Sininen t dU RENE PER EORR MAD Soa a 6 33 Sample Cardiac Cycles isses 6 35 Sample TWA Cycles issssssssssssss I 6 39 EGG SUIDS t af coe hte fhas oe eats eck dane A Seon n vene ao fede 6 40 Arrhythmia Review isses tne n etn ete n eens 6 41 FulliDisclosure ECGs iste wins Ret elt xh Po 6 43 Watertall edi ect toe a cte ads cns ML OM nll ees vn east AC 6 47 PEE 6 48 Repor PUNOU nos oon sont tne t de mA maa neem REN 6 50 Report Formats viol i x RAIDER Rer EX Rid x eee ran 6 51 In Test Reports with Laser Printer 0 0 000 cece eee eee eee eee 6 51 Final Reports c vnus bem vr etm oaa malum ty d RR RTT nen 6 52 Monitoring of Remote Exercise Test Workstations
213. st end button the following happens The system no longer acquires and stores ECG measurement data The docks stop Workload speed and grade no longer display Interpretation Reasons for Terfnination Fatique Chest Pain none Arrhythmias none ST Changes none Resting ECG normal Functional Papacity normal HR Response to Exercise appropriate BP Response to Exercise normal resting BP appropriate response Overall impression Conclusion 67A S Operating Steps 1 Enter or select the Reasons for Termination multiple selections are permitted 2 Enter or select summary statements multiple selections are permitted Enter the Conclusion Confirm the test results Click OK to clear the window The Interpretation window and the test end menu tabs appear Revision A CardioSoft 6 27 2023324 053 Exercise Test Test End Phase ST Arrhy Patient Information Test Information Measurement Results Tabular Summary Interpretation Reasons for Termination Fatigue Summary Resting ECG normal Functional Capacity normal HR Response to Exercise appropriate BP Response to Exercise normal resting BP appropriate response Chest Pain none Arrhythmias none ST Changes none Overall impression Normal stress test 69A S Note Real time reports can be printed with the following buttons on the functio
214. t 11 19 2023324 053 System Settings Exercise Test Setup Protocol Editor Screen Stage Time Speed 12 Lead Report Median Report Repeat First Repeat STAG Ramping off 915A S Note The 12 lead and Median report formats are selected on the Writer tab The medians saved with Store M edian are included in the Medians report Phase name Selected protocol Stage name Select or deselect a ramping phase 7 continuous speed load increase selectable only when phase name e g BRUCE is highlighted separately adjustable for each phase OO Uu 7 11 20 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup qe I OO n Parameter fields corresponding to the columns from left to right Phase Stage name Stage Time Speed Grade 12 Lead Report First time of first 12 lead report 12 Lead Report Repeat print interval after first report Median Report First time of first median report Median Report Repeat print interval after first report BP First time of first BP prompt or measurement BP Repeat interval after first BP prompt or measurement Store Median First time first median stored Store Median Repeat interval after first stored median Click a button to add a new protocol delete or print an existing protocol Click button to reset changes Click a button to add a phase or a graded phase Click button to delete the selected phase
215. t Final Report Format PEE a ee EASES MLE 102A A Select the data to export as XML Excel files Select the printer driver for PDF files C Select check box if you wish to use the settings from the Final Report tab see Final Report Tab on page 11 10 and Final Report Tab on page 11 24 Otherwise the setup screen for configuration of the final report will appear D Select check box if you wish to automatically export each test after completion as a PDF or XML file and with the name selected at E E Select the patient and or test information to be included in the file name that the system will generate automatically m test type m date m patient s last name m patient s first name m patient s date of birth F Select the target folder for the data export UJ Note If the ECG grid is not visible in the PDF please change the Acrobat Distiller configuration see Troubleshooting on page B 25 When exporting data in PDF format select thetarget directory in the corresponding printer driver 9 10 CardioSoft Revision A 2023324 053 10 EMR Interface Revision A CardioSoft 2023324 053 For your notes 10 2 CardioSoft Revision A 2023324 053 EMR Interface Overview Overview The optional EMR Interface is a data management system for use in medical practice It allows you to complete the following functions review tests and measurement results write referrals and pre
216. t Summary see Test Summary on page 5 11 Revision A CardioSoft 5 9 2023324 053 Resting ECG Recording a Resting ECG Full Disclosure ECG You can acquire the full disclosure ECG over a maximum period of 60 minutes Operating Steps 02 05 PSVC YI mes FAI mv y frooHe v 60n 4 056A R 2b 1 Click Start Full Disclosure ECG toinitiate ECG storage 2 Whilethe full disclosure ECG is acquired a Youcan dick Event Marker Full Disclosureto enter event marks vertical line b Themost recent arrhythmia is always displayed 3 Click Stop FD Post Test Review to terminate the procedure Note Clicking Stop FD Post Test Review brings up the Test Summary see Test Summary on page 5 11 5 10 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Post Test Review Test Summary 057A R dst Eror Cenne 3 Wairi Notepad BEE Medes Sytema it CA 93 om A Click a tab to display the corresponding window B Patient Information area C Test Information area D Measurement Results area E Interpretation area F Click to display patient list for a new test G Click to display a list with more tests of the current patient local database H Click to display a list with more tests of the current patient MUSE CV database system Click to display the print setup window J SW Click to display a list of tests to compare with the cu
217. t the documents to be included in the report Configured Report 10 second ECG up to 3 different formats with or without Interpretation or ACI TIPI score two more formats of the 10 second ECG Medians Vector Loops 2 Select the lead format for the 10 second ECG 3 Select the number of copies to print 4 Choose the leads if you selected the Swedish H1 format 5 Select the rhythm leads 6 Select whether or not the Median H1 report is to include the measurement marks 7 Select the gain Select the printer Click the Print button to initiate the printout Revision A CardioSoft 5 25 2023324 053 Resting ECG Post Test Review Generating the Interpretation Click Interpretation Modify to open the window In the left part of the window you see a number of folders with standard interpretation texts With the Acronyms button you can open an acronym window The actual interpretation is generated in the right part of the window The system generated evaluation is already shown The system supports the creation of an interpretation by providing standard texts and acronyms which can be copied to the Interpretation area on the right In the Interpretation area you can edit the texts as needed enter new text copy cut paste etc Refer to section Editing the Interpretation Library on page 11 4 for information on editing the standard texts minbr left axis deviation because QRS angle betwe
218. test type are basically selected in the same way as from the local database see Selecting a Patient Record on page 4 4 The MUSE CV system screen has one additional button Order List see Orders from the MUSE CV System on page 4 6 Note Thisis an optional feature When you enter a new patient or edit patient information the data is first saved to the local database The data will appear in the MUSE CV system only after you have transferred the test to MUSE and confirmed the data there Please refer to section MUSE Tab on page 11 55 for configuration of the system to communicate with MUSE Revision A CardioSoft 4 5 2023324 053 Selecting a Patient Record and Test Type Retrieving a Patient Record from the MUSE CV System Database Orders from the MUSE CV System MUSE Test Information for 321 Reg No Last Name The Order List button allows you to view a list of orders for your workstation First Name Patient ID Order date time Type 321 02 Feb 2001 21 39 ASAP 12 Lead ECG This location 1 v allocations IV alltest types mo O DW T all patients Patient ID 321 Location No Hec Location for JECG i2leadECG Room an HIS OrderRet BS oK Successfully received a response from the server Cancel 159A A Orders exist for this patient B Your location number C T
219. the Miscellaneous 2 tab to open the window Setup xj Writer Screen Lead Sequence Protocol Editor Final Reports Miscellaneous 1 Miscellaneous 2 ST Medians 1251 Comments E Interpretation Mody Test Types Modify Reason for Test Library Mody Reasons for Termination Modify Extra Questions Modify Measurement Results Modify Medications Modify Function Keys Modify Print Setup Help 918A S Editing the Comments Test Types Reason for Test Reasons for Termination Medications Library 1 Click Modify to display the edit window 2 Edit delete or add new statements Configuring the Measurement Results 1 Click Modify to display the M easurement Results window 2 Select the parameters to be included in the Measurement Results Test Summary Note ST HR Index is the maximal change in ST depression as a function of change in heart rate during recovery Selection of multiple parameters may cause report header to continue on second page 11 26 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Editing the Interpretation Library Click Modify to open the Edit Interpretation Library window Functional Capa HR Response t BP Response t verall impressi Edit statements ity in library Exercise Exercise n left bundle branch block ight bundle branch block intraventricular condition delay T wave inversion left ventricul
220. the exercise test are described in section Softkeys Controlling Exercise Tests on page 2 11 A B C Lead Check sriarmy Medians 1281 NS 3 D E F EX G bpm H Custom Set Setup 5 J K 056A S W325 2510 mm mv E125 mm s 910 mmmv o A FRF 50Hz FD ECG t U S T R O N M L A Tabs showing the different ECG analysis data B Lead check status window other tabs are explained in ST Arrhy Window on page 6 16 Medians Window on page 6 17 and 12SL Window on page 6 23 6 8 CardioSoft Revision A 2023324 053 Exercise Test Before the Test C Schematic representation of the applied electrodes green correct yellow lead problem high impedance white not used red electrode disconnected or lead break numbers indicate the impedance value in kQ D Click to enter or review test information E 0 Click to select previous tests of the current patient Click to activate the Patient Education module Click to select an exercise test protocol A new protocol will become fe Ais effective in the next phase Click to relearn the median complex With Relearn Medians you can also H EX restart the learn phase when not all electrodes are applied T Click to load system setups stored for different system users J Click to edit the exercise test setup K Click to return to the initial screen L Heart rate M System messages window N Indicates AC line filter
221. this will confuse the BP monitor Setting Up the SunTech 4240 BP Monitor This BP monitor needs to be configured once 1 On the program screen select Change Test Parameters You move the cursor with the LAST and NEXT keys Confirm selections with YES 3 Select S amp BP Reading Interval and press YES to confirm the selection 4 Select MAN for PRE TEST and POST with YES or NO 1to 90 min MAN 5 Display the program screen again by pressing OK twice and select Utilities Confirm the selection with YES Choose Select System Interface and press YES to confirm the selection Select SUNTECH with YES or NO Display the program screen again by pressing OK twice The setup is now complete From now on the system will start the BP monitor Revision A CardioSoft B 7 2023324 053 Miscellaneous Connecting Peripheral Devices SpO Monitor Nellcor N 200 Nellcor NPB 290 295 Laser Printer Connect SpO monitors to the COM 1 or COM 2 port Model Configuration Ohmeda 3740 Ohmeda 3740 Nellcor N 200 Nellcor N 200 Nellcor NPB 290 295 Nellcor NPB 290 295 The system only indicates the current SpO level Configurations are performed directly at the SpO monitor Configuration by means of the DIP switches on the back of the monitor Configuration by means of the DIP switches on the back of the monitor Connect the laser printer Kyocera FS 1000 FS 1010 HP 4100n HP 4200n HP 2420dn or HP 4600hdn tothe L
222. tient list box if you would like to see all stored patient records and not just those of the selected patient To reduce the number of displayed patient records enter a Cart Device Number to view only those patient records acquired with that cart device enter atime period at Date from to to view only those patient records acquired in that period click Insert today s dateto view only today s patient records select a specific test type e g exercise tests only from the Test list select a test status confirmed unconfirmed from the Status list Click Show new list to update the list according to your selections Select a patient record by clicking Note Patient records marked with an asterisk are stored on an external medium You can select multiple patient records holding the Shift key depressed Click Select all to select all displayed patient records In a network environment do not review a patient s test at more than one workstation at a time If the ECG grid is not visible in the PDF please change the Acrobat Distiller configuration see Troubleshooting on page B 27 Revision A CardioSoft 9 5 2023324 053 File Management Viewing Editing Printing Patient Records Viewing Editing Printing Patient Records Click View The Test Summary will appear first You can edit the information Changes are saved automatically to the local database when you exit the screen To pr
223. tings System Configuration EMR Tab Click the EMR tab to open the window with XEMR option only Setjngi tor data upload Data varaler via shared drec be Fake cbocuve THOME EDGE ST bnt Data rannte via fne network Hanse S Fanaka 5939 T HL Header iy if HLF Tode pm Eno kogrg Folder CXDOCUME TAOMIMI LOCALS TNT emphamons Miele enar log Upland to EMR database CACARDIDY Pate 2 Erneninations O 941A Pit Cancel A Select to transfer data to the EMR interface via a network B Select to transfer data to the EMR interface via a shared directory C Set or select the communication folders read orders from the EMR interface write data to the EMR interface Click to view the error log Set or select the error log folder F Click to start data transfer patient data test data from CardioSoft to the EMR interface directories selected at A or B Revision A CardioSoft 11 59 2023324 053 System Settings System Configuration For your notes 11 60 CardioSoft Revision A 2023324 053 A Cleaning and Maintenance evision CardioSoft 2023324 053 A 1 For your notes A 2 CardioSoft 2023324 053 Revision A Cleaning and Maintenance Cleaning Disinfection and Maintenance Cleaning Disinfection and Maintenance Equipment Surface Cables Electrodes Warning Shock H azard Disconnect the power cord from the
224. tion 35 49 moderate expiratory flow limitation lt 35 severe expiratory flow limitation if lt 70 further lung function measurement recommended f all four interpretation criteria are normal the interpretative statement Normal lung function values is displayed B 16 CardioSoft Revision A 2023324 053 Miscellaneous Reference Value Equations In terpretation Modes Measurements Curve typical of restriction Possible causes reduced lung volume restriction elevated pulmonary elasticity fibrosis Criterion FVC Act lt xx FVC Ref and VC MAX 2 x MEF50 lt 0 8 Definition Interpretative Statement gt 70 normal 50 70 curve typical of mild restriction lt 49 9 curve typical of moderate to severe restriction if lt 70 96 further lung function measurement recommended Expiratory stenoses Possible causes Stenoses in the large airways extrathoracic flow obstruction expiratory tracheal stenosis Criterion FVC Act PEF gt 0 8 Definition Interpretative Statement 0 8 normal gt 0 8 Further examination for extrathoracic flow obstruction and expiratory tracheal stenosis recommended Watch patient cooperation f all four interpretation criteria are normal the interpretative statement Normal lu ng function values is displayed Revision A CardioSoft 2023324 053 Mis
225. tion ARRY 2014659 003 2D Waterfall Display 2DWF 2014659 004 MUSE Browser BRWS 2014659 006 Data Export in Excel or XML Format E XPD 2014659 007 Report Export as PDF File EPDF 2014659 008 Report Export as Word File EWRD 2014659 009 Display Configuration DSPC 2014659 010 In Test Tabular Summary ITBL 2014659 011 In Test Trend ITRD 2014659 012 Previous Test Retrieval PRVT 2014659 013 T Wave Alternans TWAA 2014659 020 EMR Interface XEMR 2014659 021 Floating License FLL X 45502301 Resting ECG Measurement RESM 45502601 ST Measurement Arrhythmia 6 12 L ead Exercise Test ERG2 Revision A CardioSoft C 3 2023324 053 Order Information Order Information 45503201 45505101 45504001 45504101 Cables 223 330 03 223 366 03 223 362 03 223 368 01 223 380 01 223 381 01 223 362 03 700609 001 223 372 01 223 298 04 700761 001 700607 001 700764 001 Patient Cables 223 418 01 223 418 02 223 418 06 223 418 07 Exercise Test Expert Mode ERG3 CardioSoft Web CWEB ECG History requires hardware key ECGH Cardio Mailbox requires hardware key CBOX Connection cable for M 700 Connection cable for EC1200 Connection cable for variobike 500 CardioSmart Connection cable for TM 400E Connection cable for all Ergoline and eBike bicyde ergometers Connection cable for SunTech 4240 Connection cable for Bosotron BP monitor Connection cable for T2000 T 2100 RS232 Connection cab
226. tive countries must be observed The modem must be set up within the medical location but not in the patient vicinity Warning Patient Hazard Disconnect the patient from the system when the modem is connected B 32 CardioSoft Revision A 2023324 053 Miscellaneous ECG Measurement and Interpretation Program ECG Measurement and Interpretation Program See separate manuals m HEART ECG Interpretation Program m 12 SL Physician s Guide m Stress Test Physician s Guide Revision A CardioSoft 2023324 053 B 33 Miscellaneous ECG Measurement and Interpretation Program For your notes B 34 CardioSoft Revision A 2023324 053 C Order Information evision CardioSoft 2023324 053 C 1 For your notes C 2 CardioSoft Revision A 2023324 053 Order Information Order Information Order Information Subject to change Always refer to latest list of accessories 2014655 012 CardioSoft standard software package for ECG analysis including acquisition module Accessories Optional Software Programs 45502401 Resting ECG Interpretation RESI 45502901 Remote View ERGM 45502701 Storage of the F ull Disclosure ECG EGMO 45503001 Data Storage on Network Server lt 3 000 tests NETS 2014659 001 Data Storage on Network Server lt 15 000 tests NET 2 2014659 002 Data Storage on Network Server unlimited number of tests NET 3 2014659 014 Arrhythmia Detection Documenta
227. to the printe and confirm with OK Werecommend a resolution of 1024 x 768 17 inch monitor 1280 x 1024 max For Windows 2000 select the Windows Classic color box Settings gt Control Pane gt Display gt Appearance gt Scheme Note The file V24 DLL is protected by copyright laws Copyright 1992 1996 Langner GmbH All rights reserved Permission is granted to use the file V24 DLL only in combination with this program but not with any other program Copying and making the file V24 DLL available to third parties is prohibited Properly exit from the program before turning off the PC Note When upgrading from version V4 2 it is necessary to enter the option codes again Furthermore the exercise test settings will be reset to the factory defaults Install only the recommended printer drivers see section Printer Installation on page 2 4 Check that the installed printer driver has no spooler or no automatic status indicator Other printer drivers in particular those from some printer manufacturers my cause data communication problems with the acquisition module Revision A CardioSoft B 25 2023324 053 Miscellaneous Installing the Program Installing the Program In a Network Environment Preparing the System Program Installation Note Theinstallation of the program in a network should be referred to authorized staff Incorrect installation of the program may cause loss of data and other netwo
228. tons to enter the corresponding I P address automatically If the system does not find the IP address you can enter the address manually Click OK to clear the window Click the Select Station button and select the station BRUCE Station mhd02936 83A S Revision A CardioSoft 6 53 2023324 053 Exercise Test Monitoring of Remote Exercise Test Workstations c 3 D E F Click to return to the initial screen Name of the remote station Click to change the gain Click to change the speed 6 54 CardioSoft 2023324 053 Revision A Ambulatory Blood Pressure Measurement evision CardioSoft 2023324 053 For your notes 7 2 CardioSoft Revision A 2023324 053 Ambulatory Blood Pressure Measurement Ambulatory Blood Pressure Monitors Ambulatory Blood Pressure Monitors The following ambulatory blood pressure monitors can be connected to the system TONOPORT V blood pressure only oscillometric method m TONOPORT IVa blood pressure oscillometric and auscultatory method as well as ECG For information on setup and operation of the ambulatory blood pressure monitor please refer to the TON OPORT Operator s Manual Caution Patient Hazard Disconnect TONOPORT from the patient when it is connected to the PC Note Check that the correct port for the ambulatory blood pressure monitor is configured see section Devices Tab on page 11 53 Connecting the Ambu
229. tware The software and documentation are protected by copyright laws The licensee agrees to observe the regulations stipulated by the copyright The software and all rights to it remain the property of GE Medical Systems I nformation Technologies Therefore the enclosed copy of the program may be installed on one PC only You may not transfer the software via network or other communication channels to any other PC The program and the accompanying documentation may not be modified copied merged with other programs or made available to third parties The licensee is liable for any damage to the licenser resulting from infringement of the copyright as per this license agreement The licenser notifies all users that the present state of the art does not allow for the creation of computer programs which run trouble free in all applications and combinations The licenser is not liable for product malfunctions The licenser is not obliged to make program updates available to licensees who have not signed and returned the registration card GE Medical Systems Information Technologies GmbH 2001 2005 All rights reserved Munzinger Str 3 D 79111 Freiburg Germany Telephone 49 0 7 61 45 43 0 Fax 449 761 45 43 233 GE Medical Systems Information Technologies Inc 8200 West Tower Avenue Milwaukee WI 53223 USA Tel 41 414 355 5000 800 558 5120 USA only F ax 1 414 355 3790 Revision A CardioSoft 1 3 2023324 053 Introduction
230. u see a number of folders with standard interpretation texts The system supports the creation of an interpretation by providing standard texts which can be copied to the Interpretation area on the right In the Interpretation area you can edit the texts as needed enter new text copy cut paste etc Refer to section Editing the Interpretation Library on page 11 38 for information on editing the standard texts striction 206A SP A Click icon to open folders individually B Click icons to simultaneously open or close all folders E Click icons to copy folders individual lines lines including the chapter E D Click icon to confirm the test results E Click icons to cut copy and paste text in the Interpretation area Note As an alternative you can double dick text to copy it from left to right 8 16 CardioSoft Revision A 2023324 053 Spirometry Test Post Test Review Report Printout Selected report pages Configured Report Standard Page Interpretation Help Click the Print button to print the report The print setup window opens where you can temporarily adjust the settings for the printout Refer to section Miscellaneous T ab on page 11 37 for details on changing the setup permanently Prdcedure Date 19 12 2002 17 55 41 EBT DEMO TES DEMO P LaserJet BP BMP PostScript LPT1 P Cancel 207A SP 1 Select the documents to be included in the report
231. ulatory BP device and the port none indicates that the modality is inactive Enter or select the path to the Holter ECG program Select deselect an external program for spirometry enter or select the path Specify the TTL output signal characteristics Select up to 4 analog signals of the CAM USB A T interface the CORINA acquisition module only supports the ECG lead signals The selections become effective only after you have started the exercise test mode O A c I Revision A CardioSoft 11 53 2023324 053 System Settings System Configuration Modem Tab Click the Modem tab to open the window A BC DE System Configuration x General Devices Modem MUSE Option Code County Settings HMR ee Suffix JatHo 934A A Select modem port and baud rate same baud rate at sending and receiving units B Select the modem type C Field for entry of the initialization string entered automatically for MultiTech and ELSA modems initialization string for other modem types e g MultiTech 56K AT amp FMO X3V0S0 1 D Field for entry of the dial mode pulse touch tone dialing E Field for entry of the Hang up Prefix and Hang up Suffix Warning Patient Hazard All modems connected to the system must meet the requirements of EC 60950 or UL 1950 The specific regulations valid in your country must also be observed The modem must be installed within the medical location
232. um of 15 leads color coded arrhythmias any segment of the full disclosure ECG can be zoomed and stored NETS Data Storage on Network Server storage of examination data on low volume server 3000 examinations storage of examination data in the MUSE database useofthe MUSE patient list to retrieve data Revision A CardioSoft 2 17 2023324 053 Product Overview Software Features NET2 Data Storage on Network Server storage of examination data on medium volume server lt 15 000 examinations precondition NETS required NETS3 Data Storage on Network Server storage of examination data on high volume server unlimited number of examinations pre condition NET2 required ARRY Arrhythmia Detection Documentation arrhythmia documentation during exercise tests 2DWF 2D Waterfall Display waterfall display during exercisetests and in exercisetest report BRWS MUSE Browser Internet browser for access to the MUSE CV system EXPD Data Export export of examinations in XML or Excel file format EPDF Report Export as PDF File export of report as a PDF formatted file we recommend Acrobat V5 0 at minimum EWRD Report Export as Word File export of the configured report as a Word formatted file we recommend MS Word 2000 at minimum DSPC Display Configuration configuration of the vital signs window ITBL In Test Tabular Summary display
233. use The system does not require other regular maintenance Technical Inspections For safety the devices require regular maintenance To ensure funcional and operational safety of this system Technical Inspections should be carried out on an annual basis These checks should be referred to individuals with adequate training and experience Theinspections can be carried out by GE Medical Systems I nformati on Technologies Service within the framework of a service agreement The Technical Inspections include m Visual inspection of the device and of the accessories for mechanical damage that may impair their function Verification of the safety related labeling for legibility A function test Measurement of the leakage current and of the resistance of the protective conductor according to local regulations The system does not require other regular maintenance Disposal at the End of Its Service Life Note At the end of its service life the product including accessories described in this manual must be disposed of in compliance with the applicable local waste control regulations If you have questions in this matter please contact GE Medical Systems I nformation Technologies or its representatives A 4 CardioSoft Revision A 2023324 053 B Miscellaneous evision CardioSoft 2023324 053 For your notes B 2 CardioSoft Revision A 2023324 053 Miscellaneous Connecting Peripheral Devices Connect
234. ve to define a cardiac cycle yourself 1 Click Cycles and select the number of cycles over which the HR is to be determi ned 2 Click on a point of the ECG to mark the beginning of the interval to be measured A marker appears 3 Count the number of cardiac cycles and dick again A line appears connecting the two end points and the corresponding heart rate is displayed Revision A CardioSoft 5 21 2023324 053 Resting ECG Post Test Review Vector Loops This screen shows the median complexes of the orthogonal FRANK leads X Y and Z as well as the vector loops in three planes gt UJ O Tdst Summary ECG Traces Medians Arrhythmia Review Vector Loops Full Disclosure ECG 2 mm mv Vent Rate PR interval WEms Q 98ms P R T axes 177 39 8 RR PP intervall 700 705 ms 118 ms BS bpm QRS duration 378 449 ms P duration T QTC Inverse Dower Transformation Horizontal Plane Frontal Plane 515A R A Click to adjust the gain B Median complex C Click torso to toggle between right and left sagittal planes 5 22 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Full Disclosure ECG On this screen you see one lead of the full disclosure ECG The events identified by the rhythm analysis algorithm are color coded On the display you will also see when filter or cubic spline were enabled or disabled e g in the form of Spline OFF Spline Spline ON Spline
235. veto choose another location for the item A box appears around the selected item 5 Click in the box and holding the mouse button down move it to its new position Note You can define different setups for bicycle ergometers and treadmills 11 16 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Lead Sequence Tab Click the Lead Sequence tab to open the window Lead sequence is the assignment of ECG leads to the writer or screen channels You can change the lead sequences accordi ng to your needs and save them under the same name or under a new name Y ou may also define different lead sequences for the screen display and the printouts Note The first two lead sequences are fixed and cannot be modified Sebo Writer Screen Monitored Legds Lead Sequence Lead Label T3 ET D Print Setup J Help 913A S Modifying the Lead Sequence 1 Select the number of monitored leads These are the leads to be recorded Select a Lead Sequence 3 Open the list box of the channel where you want to record another lead and select Enter the lead label Select the lead for screen display only possible after definition of the lead sequence CardioSoft 11 17 2023324 053 System Settings Exercise Test Setup Configuring Leads Ex1 Ex2 Ex3 6 Choose unipolar or bipolar Choose the 1st electrode site for Ex1 Select the 2nd electrode site for E
236. w Click Spirometry Compare FVC Measurement to display the comparison screen with the flow volume loop The screen shows the two curves and the percentage deviation from the reference values or the percentage of the reference values attained EJ GE Medical Systems IT CardioSoft Supervisor TEST DEMO TEST DEMO Spirometry 7 19 12 2002 7 17 55 41 Spirometry Compare Test Information Spirometry Compare FVC Measurement 18 11 Scale LLI FlowWolume C Volume Time 178 cr 34 Years Male Referente Values Knudson C of ref values deviation from ref values Value Ref 1 Act1 Act2 D FVC I 523 384 384 0 FEVO5 I 2 88 288 FEV1 I 4 33 348 348 0 FEVI FYC 83 90 90 0 FEV3 I 384 384 FEVE I 384 3 84 FEV1 FEVB 90 390 PEF l s 9 55 118 118 0 MEF75 l s 8 86 103 103 0 MEF50 l s 5 39 508 508 0 MEF25 l s 225 3 92 182 0 MMEF l s 455 454 454 0 FIVC I 5 23 390 390 0 FIV1 I EXE FIV1 FVC gn gn PIF l s 9 58 9 58 MIF75 l s 6 67 6 67 MIFS50 l s 912 9 12 MIF25 l s 9 43 9 43 FAQ MW l min 104 104 ATS Summary Statement Test 1 lt 3 accepted tests ATS Summary Statement Test 2 lt 3 accepted tests Ambient Conditions Atmospheric Press 970 hPa Rel Humidity 50 Ambient Temperature 21 C IPT Code O 209A SP A Click option button to display the volume time curve 0 7 Da B Change the tabular display from 96 of ref values to deviation from r
237. x1 bipolar the 2nd site for unipolar leads is always CT If required change the name of the lead sequence step 2 and click OK to save If you change any of the selections of an Ex lead the sequence name is given as 11 18 CardioSoft Revision A 2023324 053 System Settings Exercise Test Setup Protocol Editor Tab Click the Protocol Editor tab to open the window Miscellaneous 2 ST Medians 125L l H Protocol Protocol Pretest EXERCISE Exercise Recovery RECOVERY Fees Print Setup Pretest Exercise 914A S Click to print the exercise test setup Click option button to select the treadmill exercise testing device Click option button to select the bicycle ergometer exercise testing device Click down arrow to select a protocol Phase names of the protocol Click to modify or delete protocols see Protocol Editor Screen on page 11 20 anmo oov P Selecting the Default Protocol 1 Choosethetreadmill B or bicycle ergometer C exercise testing device 2 Select the default protocol D You can either select an existing protocol e g BRUCE and edit the parameters or You can create a new protocol from a blank template e g TEST 14 3 Click Modify F to edit existing protocols or create new ones This displays the Protocol Editor window Note You can select protocols for pharmacological tests e g Dobutamine at D Revision A CardioSof
238. y or product property damage Danger Explosion Hazard The acquisition module is not designed for usein areas of medical locations where an explosion hazard may occur An explosion hazard may result from the use of flammable anesthetics skin cleansing agents and disinfectants Furthermore the device is suitable for application in an oxygen enriched atmosphere only with certain restrictions The atmosphere is considered to be oxygen enriched when the room air contains more than 25 of oxygen or nitrous oxide CardioSoft Revision A 2023324 053 Introduction Safety Information Warning Shock Hazard Observe the following warnings Failure to do so endangers the lives of the patient the user and other persons present Before putting the device into operation the operator is required to ascertain that it is in correct working order and operating condition The cables in particular must be checked for damage Damaged cables and connectors must be replaced immediately When disconnecting the device from the power line remove the plug from the wall outlet before disconnecting the cable from the device Otherwise there is a risk of coming in contact with line voltage by inadvertently introducing metal parts in the Socket of the power cord Do not use extension cables with multiple portable Socket outlet MPSO All devices of a system must be connected tothe same power supply circuit Device
239. you cannot remember the supervisor password please contact the GE Medical Systems I nformation Technologies Technical Support or your local Service Representative 11 42 CardioSoft Revision A 2023324 053 System Settings System Configuration User Administration User List displays the list of all registered system users if you select the Enable Password F unction check box in the preceding window Y ou can edit user data with Modify select name first delete a user with Dede or register a new user with New If you enable Use Windows User List the user list of the specified Windows domain will appear Windows User List This feature allows you to display the user list of the Windows domain and authorize these users to access the system The local user list will be deleted 1 Click Set Administrator User Nameto log on as administrator 2 Select a user from the list 3 Register the user with the appropriate privileges Note Note down the administrator s user name and assign all privileges to the administrator The log settings are accessed from the User List The selected events will be captured in the log files The event capture feature is only available with the operating systems WINDOWS 2000 WINDOWS XP Professional The records are saved to the E vent Log You invoke the Event Log with Start gt Programs gt General Administration gt E vent Log Select the capture item in the Event Log The source fo
240. z 4 C Format 2 multiple leads Pi 8 M aR M vi M v4 MW 13 S ANI Mal wv v v5 Iu 7 iv il v avF iv v3 v VE Wi Cancel 5 517A R 2 Select the paper speed 3 Click the Format 1 option button if you wish to print only one lead 4 Select the lead 5 Click the Format 2 option button if you wish to print multiple leads and select the leads 6 This box indicates the number of pages to print check paper supply before printing Click button to save the print setup Initiate the printout or click Cance to close the window 1 Click the zoom icon 2 Position the magnifying glass on the region of interest and click An enlarged view of the selected region appears The operating controls basically remain the same When you click the printer icon however only that page will be printed Click the zoom icon again to exit the zoom mode 5 24 CardioSoft Revision A 2023324 053 Resting ECG Post Test Review Report Printout Click the Print button to print the report The print setup window opens where you can temporarily adjust the settings for the printout Refer to section Final Report Tab on page 11 9 for details on changing the setup permanently 16 Modify Median H1 Rhythm Lead I m with measurement marks IV vi x I BEVo B pes Leads v3 w V4 v Gain mm mV 10 B Kyocera Mita FS 1000 KX odity v Evo E LPT1 518A R 1 Selec

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