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MAC 1200

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1. Choices for Modem MultiTech 19 32 56 6 ELSA 28 8 33 6 56 6 dial mode phone outside line pulse 0 to 9 28 digits 0 to 9 20 digits MAC 1200 19 Preparations for ECG Recording Figure 4 1 ECG signal input Warning Shock Hazard Strictly observe the following warnings Failure to do so may endanger the lives of the patient the user and bystanders For reasons of patient safety use only the origi 20 nal GE Marquette patient cable Before con necting the cable to the device check it for signs of mechanical damage Do not use a damaged cable Ensure that conductive parts such as the patient connectors electrodes transducers that are connected to the isolated patient signal input do not come into contact with other grounded con ductive parts This would bridge the patient s isolation and cancel the protection provided by the isolated input The neutral electrode in par ticular must not come into contact with ground 4 Preparations for ECG Recording 4 4 Connecting the Patient Cable Use the 10 leadwire patient cable for acquisition of the 12 standard ECG leads e Connect the patient cable to connector 3 Figure 4 1 MAC 1200 227 492 04 D Preparations for ECG Recording 4 2 Applying the Electrodes Careful application of the electrodes and skin preparation is the key to an interference free ECG Caution Us
2. Medication Enter the patient s medications and confirm entries with Comments 4 lines of 30 characters each Location ID number of the sending system 3 digits The default value entered in System Setup will be used but this value can be changed Room Enter the hospital room number 5 characters maximum Order number Enter order number of the ECG recording if available 5 characters maximum Prompts Answer the prompts entered in the patient data setup menu section 9 7 MAC 1200 25 Recording in 12 Lead Mode 5 Recording in 12 Lead Mode Note Please bear in mind that no automated analysis of ECG signals is completely reliable Therefore a physician should always overread and reassess the system interpretation before performing patient diagnosis 5 1 Some Basic Facts In 12 Lead Mode 12 leads of ECG are acquired simultaneously for a period of 10 seconds When initiated with ECG acquisition and recording proceed automatically The system however may be set up to start recording only when specific patient data ID Secondary ID name have been entered see section 9 7 Patient Data Depending on the implemented software options the ECG is only printed out options MEAS measure ment DIAG interpretation not implemented is measured and printed out with the measure ment results with option MEAS measurement is measured interpreted analyzed and printed
3. amp F fetch factory configuration loads the factory configuration from ROM into the active con figuration memory RAM MO speaker is always off amp DO ignore DTR status transition amp QI standard AT result code VO digit result codes selected 0 to 999 227 492 04 D init string AT amp FMO amp DO amp QIVO 2 AT Command for Establishing a Communica tion Link Example of a dial string for a modem connected to a branch PBX system and dialing a modem via the public telephone network using the touch tone mode AT prefix that precedes every command line DT touch tone dial mode xxx after DT enter the characters for access to the public telephone network e g 0 0 W W placed after a number tells the modem in a PBX system to wait for the dial tone of an outside telephone line dial string ATDTOW 3 AT Command for Termination of the Commu nication The communication is terminated in two steps First of all the MAC 1200 sends an escape command to return from the on line state to the command state Then the hangup command follows escape command AT prefix that precedes every command line H hangup command hangup string ATH MAC 1200 37 Recording in 12 Lead Mode 5 6 Brief Operating Instructions 12 Lead Mode e Switch on the unit and wait for self test to end e Apply electrodes to patient Enter patient data o e Check device settings report sequence report format AC
4. V3 midway between locations V2 and V4 V4 atthe mid clavicular line in the 5 intercostal space V5 atthe anterior axillary line on the same horizontal level as V4 and V6 V6 atthe mid axillary line on the same horizontal level as V4 Connect the 10 lead patient cable as shown in Figure 4 4 e Arrange the leadwires and patient cable as shown in Figure 4 5 22 MAC 1200 227 492 04 D Preparations for ECG Recording 4 3 Artifact Due to Poor Electrode Application The resting ECG analysis system is equipped with state of the art electronic utilities that ensure artifact free recordings Among these are the automatic baseline adjustment and the anti drift system cubic spline ADS At the beginning of the recording the automatic baseline adjustment algorithm verifies the incoming signal and adjusts the baseline position accordingly During the recording the anti drift system cubic spline continuously checks the baseline position and returns it to the normal level if required Figure 4 6 For the 6 Lead Mode the anti drift system cubic spline can be enabled and disabled from the setup menu in the 12 Lead and Arrhythmia Modes it is always enabled When electrodes are not properly applied these measures may not fully compensate for artifact High polarization voltages induced by electrodes applied without conductive gel may cause the amplifier to overrange so that a straight line will be recorded instead of
5. aVR aVL aVF CABR LI aVL I aVR I a VF III HIGH C VI through V6 mm mV auto 5 20 40 mm mV 10 unequal all no Episodes 42 chron prio ventr no 7 Arrhythmia Mode 7 1 Some Basic Facts In Arrhythmia Mode the MAC 1200 continuously scans the ECG for arrhythmias From six simultaneously acquired leads the MAC 1200 automatically selects the two that provide the best signal for analysis When the analysis algorithm detects an arrhythmia the event is recorded with context Figure 7 1 The length of the recording varies with the duration of the event episode In the setup menu section 9 4 Arrhythmia Mode you determine the conditions for a recording the recorder starts each time it detects a single beat event all the recorder starts each time it detects an event different from the previous event unequal the recorder does not start at all no Some of the system settings can be customized They are labeled with configurable The following information refers to a unit with the system defaults see table at left For instructions on changing the system setup refer to section 9 4 Arrhythmia Mode MAC 1200 227 492 04 D Arrhythmia Mode RL right leg electrode disconnected RA right arm electrode disconnected LA leftarm electrode disconnected LL leftleg electrode disconnected VI chest electrode V1 disconnected V2 chest electrode V2 disco
6. In addition to the software supplied with the unit optional programs may be purchased to upgrade the MAC 1200 performance features In order to use a new option you need to activate it by entering the option code number refer to section 9 8 for details The option codes are entered into the MAC 1200 prior to shipping MEAS measurement measurement of the 10 second resting ECG interpretation interpretation of the 10 second resting ECG memory storage of a maximum of 40 10 second resting ECGs activates the three options MEAS DIAG MEMO for a maximum of 100 ECGs C500 activates the three options MEAS DIAG MEMO for a maximum of 500 ECGs EVAL activates the three options MEAS DIAG MEMO for a maximum of 4 weeks 227 492 04 D MAC 1200 3 How To Reach Us How to Reach Us Service Calls and To open a service call or obtain product support call the numbers below Product Support Service calls All products 800 558 7044 U S amp Canada 561 575 5000 outside U S Product support Monitors 800 558 7044 U S amp Canada 561 575 5000 outside U S Cardiology 800 558 5120 U S 414 355 5000 outside U S or contact your local sales and service representative Name Telephone For other product information please contact one of the offices listed on the next page Ordering Supplies Order supplies leadwires electrode paste thermal paper etc or service and Service Parts Pa
7. Recording in 12 Lead Mode Cancel START STOP Figure 5 14 Screen display after activation of 8 and e Waiting for ECG data ENTER Cancel START STOP Figure 5 15 Screen display after modem initializa tion 12Lead REC 60Hz ADS 10mm mV Standard Figure 5 16 Unit is ready to receive data Cancel START STOP Figure 5 17 Unit is receiving ECG 1 36 MAC 1200 5 5 5 Receiving Data with the CSI Commu nication Protocol see also chapter 13 Technical Specifications Receiving ECGs is only possible in the 12Lead Mode 9 Use the key combination 8 and e to display the screen for receiving ECGs Figure 5 14 The connected modem is automatically initialized The procedure can be aborted with QQ 9 Press lU to enable the receive data mode The procedure can be aborted with When you have enabled the receive data mode the standard screen display of the 12 Lead Mode displays The message 12Lead REC indicates that the unit is ready to receive data Figure 5 16 ECGs can be recorded in the 12 Lead Mode even while the unit is in the receive data mode A message displays on the screen when the unit is receiving data Figure 5 17 The reception can be aborted with The ECG which has just been received is processed for the printout The report is printed in the selected format Multiple ECGs are received and printed one after the other After printout of the la
8. ECGs will be printed when you press the e button To transmit or delete all stored ECGs position the cursor on Send 2 or Delete 3 and confirm the command with e To delete all sent ECGs identified with the letter S 5 position the cursor on field 4 and confirm the command with e To print transmit or delete an individual ECG or change the corresponding patient data position the cursor in the appropriate field e g 6 Print or 7 Change MAC 1200 29 Recording in 12 Lead Mode Memory full Delete Walker John Ves No Delete Doe John Yes No Delete Doe Jane Yes No Figure 5 3 Memory full message Note Ifyou intend to print a large number of stored ECGs we recommend to connect the unit to the power line or to check that the battery is fully charged When you terminate the memory function with OW itis not possible to save the current ECG again 30 MAC 1200 If you try to save an ECG when the memory is full you are informed of the memory status and can remove one of the stored ECGs from memory Use the cursor keys to select the ECG to be deleted After discarding the ECG the unit will automati cally save the new data Figure 5 3 The unit may be set up to automatically save ECGs without pressing prios and to remove ECGs from memory that were successfully transmitted to a host system MUSE see section 9 2 12 Lead Mode The memory program can be terminated at
9. Forest Corporate Centre Suite 7 19 Rodborough Road Frenchs Forest NSW 2086 Australia Telephone 61 2 9975 5501 Fax 61 2 9975 5503 Marquette Medical System Japan Waseda Hirai Building 7th Floor 1 18 9 Nishi Waseda Shinjuku KuTokyo Japan Telephone 81 3 3203 1631 Fax 81 3 3202 1626 Marquette Medical Systems Hk 26 F Catic Plaza 8 Causeway Road Causeway Bay Hong Kong Telephone 852 2804 2320 Fax 852 2804 1776 Southeast Asia Marquette Electronics SEA Pte 2 Leng Kee Road 04 04A Thye Hong Centre Singapore 0315 Telephone 65 471 2133 Fax 65 471 1540 MAC 1200 General Information General Information e Standards compliance European Council Directive 93 42 EEC IEC60601 1 2 EN 60601 1 2 Electromagnetic Com patibility Medical Electrical Equipment CISPRI1 EN 55011 Radio interference emission IEC 60601 protection class I MDD class IIa UL 2601 1 e The symbol N means Consult accompanying documents It indicates points which are of particular importance in the operation of the device The warranty does not cover damage resulting from the use of accessories and consumables from other manu facturers e On request GE Marquette will provide a service manual The GE Marquette quality management system complies with the standards EN ISO 9001 and EN 46001 6 MAC 1200 227 492 04 D Contents 1 INTENDED USE AND FUNCTIONAL DESCRIPTION 2 CONTROLS
10. John Print Send Delete ECG Recording of Doe John 9 Print Send Delete ECG Recording of Doe Jane Print Send Delete ECG Recording of Walker Jane Print Send Delete Figure 5 10 Memory program 1 All stored ECGs will be transmitted 2 All transmitted ECGs will be deleted 3 John Walker s ECG will be transmitted 4 ECG has been sent S Cancel START STOP Figure 5 11 Initializing the transmission 34 MAC 1200 5 5 2 Sending Data to a MUSE CV System via Modem Before sending data to the MUSE CV system the MAC 1200 automatically logs on to MUSE Then the data will be transmitted If the transmission is stopped the MAC 1200 may take a few seconds before canceling the connection because it has to log off the MUSE system first Then the communication link with the receiving modem is interrupted and the standard display reappears 5 5 3 Direct Transmission The unit must be connected to the PC or to the MUSE CV system by means of the connection cable 223 362 03 For transmission of the ECG the unit must be set up as described in section 9 10 Direct ECG Transmis sion After acquisition of the ECG the transmission is started with The MAC 1200 is also capable of transmitting stored ECGs if Memory option MEMO is in stalled Activate the memory program by simultaneously pressing e and piov press the e button first and hold it depressed Figure 5 10 To transmit all stored ECGs in one pass p
11. RS232 interface will be cleared from the recorder memory yes no 48 MAC 1200 If this menu item is set to yes and ECGs have already been sent from the recorder memory these ECGs will be deleted after the next transmission of a stored ECG Configuration of the 12SL Interpretation Use screening criteria The screening criteria can be enabled or disabled Default disabled Suppress normal statement If you select Yes the interpretation statement normal ECG will not be shown Suppress abnormal statement If you select Yes the interpretation statement abnormal ECG will not be shown Interpretation Default Yes If you select No 12 SL interpreta tion results will not be generated nor shown Print Interpretation Only available if Interpretation is set to Yes Default Yes The interpretative statements are printed on the reports When you select No the interpretation will not be printed but it can be sent to the MUSE CV Information System Override function When this function is enabled yes the recorder will print in 12 Lead Mode even when not all electrodes are applied or do not supply a good signal When electrodes are disconnected a message informing the user of poor signal quality will be printed on the recording Furthermore systems with interpretation capability will print a message indicating that the measurement results and interpretation may be incorrect 227 4
12. Sentinel RAC RAMS RSVP SAM SEER SILVERTRACE SOLAR SOLARVIEW Spectra 400 Spectra Overview Spectra Tel ST GUARD TRAM TRAM NET TRAM RAC TRAMSCOPE TRIM KNOB Trimline UNITY logo UNITY NETWORK Vari X Vari X Cardiomatic VariCath VARIDEX VAS and Vision Care Filter are trademarks of GE Marquette Medical Systems Inc registered in the United States Patent and Trademark Office 12SL 15SL Access AccuSpeak ADVANTAGE BAM BODYTRODE Cardiomatic CardioSpeak CD TELEMETRY LAN CENTRALSCOPE Corolation EK Pro EDIC Event Link Cumulus Event Link Cirrus Event Link Nimbus HI RES ICMMS IMAGE VAULT IMPACT wf INTER LEAD LIFEWATCH Managed Use MARQUETTE PRISM MARQUETTEG RESPONDER MENTOR MicroSmart MMS MRT MUSE CardioWindow NST PRO NAUTILUS OCTANET O2 SENSOR OMRS PHi Res Premium Prism QUIK CONNECT V QUICK CONNECT QT Guard SMARTLOOK SMART PAC Spiral Lok Sweetheart UNITY Universal Waterfall and Walkmom are trademarks of GE Marquette Medical Systems Inc Revision History This manual is subject to the GE Marquette change order service The revision letter which follows the document part number changes with every update of the manual Part No Revision Date Comment 227 492 04 A January 1999 Initial Release 227 492 04 B March 17 1999 ECO 061 952 227 492 04 C May 7 1999 ECO 062 136 227 492 04 D October 11 1999 ECO 062 920 2 MAC 1200 227 492 04 D MAC 1200 Option Codes MAC 1200 Option Codes
13. To ensure that the battery is always fully charged leave the MAC 1200 resting ECG analysis system connected to the power line whenever possible After 4 hours the battery has regained its full capacity The battery low indicator 22 is illuminated when battery needs to be charged With a full battery about 50 ECGs 1 page can be recorded in 12 Lead Mode When its capacity drops to about 25 recordings the battery is used up and must be replaced by a service specialist Note To prolong the battery life discharge the battery at least once per month by operating the resting ECG analysis system on battery power Note In standby mode a fully charged battery is drained within approx 4 hours Therefore when operating the device on battery power be sure to turn it off when it is not in use MAC 1200 227 492 04 D Preparations for ECG Recording Figure 3 2 Arranging device and couch Figure 3 3 AC power input O U O OUY CARCACRU RR at 3 o Figure 3 4 Power switch Note When turning off the MAC 1200 standby mode be sure to press the power switch long enough The backlighting of the display switches off automatically when no key is activated for 5 minutes adjustable Rum the full self test at least once a day to ensure that the device is functioning properly 227 492 04 D 3 3 Installation and Mains Connection Figure 3 2 shows a practical arrang
14. a new one right leg electrode disconnected right arm electrode disconnected left arm electrode disconnected left leg electrode disconnected chest electrode V1 disconnected chest electrode V2 disconnected chest electrode V3 disconnected chest electrode V4 disconnected chest electrode V5 disconnected chest electrode V6 disconnected Messages indicating disconnected electrodes MAC 1200 39 Recording in 6 Lead Mode Note The recording is started and stopped with Please note that filters may suppress diagnosti cally relevant portions of the signal because they With the system defaults the MAC 1200 will limit the transmission range Filters should j activate the following functions and settings therefore only be enabled if necessary Before and during the recording the second set of 6 leads can be selected with the e key the standard report sequence I II III aVR aVL aVF V1 V2 V3 V4 V5 V6 also available CABRERA SEQ NR 4 custom report se a b C d e quence 6 Lead 40Hz 60Hz ADS Patient Name again of 10 mm mV configurable calibration 25mm s 10mm mV I II III aVR aVL aVF pulse at the beginning of the recording The unit can be set up to automatically adapt the gain to Q h the ECG signal see section 9 3 6 Lead Mode Also the gain setting can be changed with aut 5 10 20 and 40 mm mV the AC line filter is enabled aVL the muscle fi
15. age When the date of birth is not entered the unit will set the limit at 180 bpm This value can be changed with F and S in steps of 5 bpm The minimum value for the heart rate limit is 30 bpm 227 492 04 D MAC 1200 6 Lead Mode Switch on the unit and wait for self test to end Apply electrodes to patient Select the 6 Lead Mode MJ Enter patient data Qe Check device settings report sequence AC line filter ADS cubic spline heart rate alarm limits Modify device settings if required Watch ECG on display Check that no lead failure message is displayed Start recording with OD Proceed to the next group of 6 leads with 4 Change the writer speed with es Switch on muscle filter with e Stop the recording with OD Print patient data with 41 Arrhythmia Mode Figure 7 1 Event recording Note formai After starting the program press e to select a continuous recording with a speed of 5 mm s con figurable If the unit identifies an arrhythmic event it will automatically switch to the fast paper speed With the same key Greed the trend recording can be stopped The unit can be set up to automatically start a trend recording when the Arrhythmia Mode is initiated Parameter Report sequence Muscle filter Frequency AC line filter Trend rec Arrhythmia data STD_C chest STD RED LII leads V1 M V2 V4 V6 through V6 STD LI LII I
16. any time with 227 492 04 D Recording in 12 Lead Mode 5 4 The Report Formats The length and scope of the reports depends on the The table below shows all of the 12 different report implemented software standard MEAS measure formats available with the MAC 1200 units ment DIAG interpretation length leads length leads 4x2 5R1 default 4x2 5s8 4x3 10 s 1 format yes 4x2 5R3 4x2 5 s 4x3 3x10 s 3 yes 2x5RI 2x5 s 2x6 10 s 1 2x5_50 2x5 s 2x6 no SO mm s _ yes yes 1x10R12 10 s 1x12 prs aie o 1x10R3 10 s 1x3 10s 2mm yes yes i measurement results and interpretative statements are only available from MAC 1200 with the appropriate software options Note Detailed results The printed reports are unconfirmed documents They must be overread verified and signed by a physician for confirmation In the setup menu of units equipped with the MEAS or DIAG option you can choose the Detailed results page When selected this page will be appended to the reports It contains patient data measurement results MEAS interpretative statements DIAG medians and the tabular measurement values The heart rate HR annotated on the report pages is calculated from all beats of the 10 second ECG To obtain a printout of the full patient data select the 6 Lead Mode and press e GE marquette MAC John Doe University Hosp Dr Williams male Caucasian 32 pas Bt 17215 161 13
17. are labeled L and the complex found to be the patient s typical complex is labeled QRSL Having completed the learn phase the MAC 1200 is ready to identify arrhythmias With the system defaults the MAC 1200 will activate the following functions and settings the STD C report sequence V1 through V6 configurable again of 10 mm mV configurable calibration pulse at the beginning of the recording The unit can be set up to automatically adapt the gain to the ECG signal auto the AC line filter is enabled configurable the muscle filter is disabled configurable MAC 1200 43 Arrhythmia Mode a b C d e Arrhythmia 40Hz 60Hz ADS Patient Name 25mm s T 10mm mV EHE PAL E g h V2 V4 V6 SA IN AO ET IS j k Figure 7 2 Arrhythmia mode display a Operating mode b Muscle filter enabled c AC line filter enabled d Anti drift system enabled e Patient name f Writer speed event episodes g Trending enabled h Gain i Report sequence j Right leg electrode failure message k Heart rate l Heart rate limit Note The letter A on a recording indicates the presence of artifact which does not allow the algorithm to iden tify arrhythmias Causes include wandering base lines The anti drift system largely prevents these disturbances Still you should check the electrodes and leadwires 44 MAC 1200 the anti drift system is enabled the automatic baseline adjustment is enabled the
18. on recorder model with AC filter switched on gt 140 dB ECG calibration automatic recording of a defined voltage step valid for all channels e calibration voltage referred to ECG signal input mV calibration pulse width on recording depends on paper speed 25 mm s 5 mm 50mm s 10mm 5 mm s 1 mm 227 492 04 D Technical Specifications Automatic ECG gain adjustment The gain automatically adapts to the incoming signal The maximum amplitude of the lead group or of all leads determines the gain setting e automatic adjustment range 5 to 40 mm mV amplitude range 6 channels 18 to 31 mm Baseline automatic adjustment of the baseline to the optimal recording range in dependence of the signal amplitude Anti drift system ADS cubic spline automatic compensation of baseline fluctuations caused by polarization voltage fluctuations at the lead electrodes delay in recording 4 2 s ECG storage in 12 Lead Mode storage of up to 40 ECGs e stored ECGs can be deleted individually or all in one pass printed transferred and patient data can be edited when memory is full user is informed of the possible actions Blocking rapid charge reversal of the coupling capacitors in the preamplifiers after electrode application ensures that the baseline is quickly restored to its original position after overranging Electrode monitoring audible and visual indication on the LCD of disconnected electrodes or line
19. out with the interpretative statements with option DIAG interpretation Units equipped with the optional Memory function can save up to 40 resting ECG These ECGs can be printed or sentto the MUSE CV Information System CSI protocol see section 5 3 The Memory Func tion The unit offers different report formats for printout of the ECG With the system defaults all 12 leads including the measurement and analysis results will be documented on a single page see section 5 4 The Report Formats 26 MAC 1200 Several system settings can be customized In this manual they are labeled configurable The following information refers to a unit with the system defaults see table below For instructions on changing the system setup refer to section 9 2 12 Lead Mode Parameter System defaults Report sequence STANDARD CABRERA Rhythm leads V2 V3 V4 V6 auto 5 20 40 mm mV Ix10R12 2x5R1 2x5 50 4x2 5R1 1x10R3 4x2 5R3 Gain Report format Detailed results Muscle filter Frequency Manualcopyto EKG HOST Delete ECG after No Yes transm Auto save FCG No Yes Suppr normal st No Yes Suppr abnormal No Yes st Print interpreta Yes No tion Override function Yes 227 492 04 D Recording in 12 Lead Mode 5 2 Recording On power up the unit defaults to the 12 Lead Mode system defaults configurable Before recording the ECG pa
20. slow trend recording is disabled configur able event episodes are recorded at a speed of 25 mm s the unit documents all events that are different from the previous event configurable You can set up the unit to document all events or no event at all All relevant device settings are shown on the display Figure 7 2 The arrhythmia codes annotated on the recording are explained in table 7 1 next page The heart rate limit is automatically calculated from the date of birth WHO 100 220 age When the date of birth is not entered the unit will set the limit at 180 bpm This value can be changed with F and 8 in steps of 5 bpm The minimum value for the heart rate limit is 30 bpm Final Report The arrhythmia recording can be stopped with The final report can then be printed with 9 The final report consists of the patient ID sheet with all patient data as well as with all analyzed QRS complexes type and number of detected events and the analysis dura tion in tabular form and the episodes 3 sheets max with 2 episodes each 227 492 04 D Arrhythmia Mode 7 3 Brief Operating Instructions Arrhythmia Mode e Switch on the unit and wait for self test to end Arrhythmic Events e Apply electrodes to patient asystole limit value ASYSTO 4 Select the Arrhythmia Mode 899 ventricular fibrillation flutter VFIB at i i Enter patient data une ventricular tachyc
21. the ECG see Figure 4 6 The device will then automatically block and return the baseline to its normal position A baseline is then recorded for approx 1 second It is possible to block the amplifiers manually by disconnecting the RL electrode On the display this condition is indicated by instead of the electrode label e g at i Figure 5 1 Remedy e Apply the electrodes according to instructions e Do not apply the electrodes on top of clothing e Usea contact agent with reusable electrodes e g moistened electrode paper electrode cream spray etc Wait approx 10 seconds before initiating a recording After the 10 second period the auto matic functions are enabled and the polarization voltages have stabilized provided the electrodes are properly applied In case of improper elec trode application an error message will appear on the display RL LL LA LL V1 to V6 e If required the ADS cubic spline and the filters 20 40 Hz 60 Hz can be disabled to verify the raw ECG signal remm approx 1 s Figure 4 6 Sample recording 227 492 04 D MAC 1200 23 Preparations for ECG Recording IIT adjusted New Patient Eam T LPS NEL D E qw Weight Race unknown Yes other Re WO BP EUM mmHg Diastolic BP 0 mmHg Ordering selection from a physician list of 10 names Referring selection from a physician list of 10 names Technician ID Yes s
22. 1 Detailed results The Detailed results page will be printed yes no section 5 4 The Report Formats only available with option MEAS or DIAG MAC 1200 47 System Setup Muscle filter AC line filter Elimination of muscle artifact and AC line interfer ence Default muscle filter No AC line filter Yes Note Please note that filters may suppress diagnostically relevant portions of the signal because they limit the transmission range Filters should therefore only be enabled if necessary Filter frequency Cut off frequency of the muscle filter 40 Hz 20 Hz The frequency range is indicated in the lower margin of the recording strip 0 08 40 Hz 40 Hz muscle filter enabled 0 08 20 Hz 20 Hz muscle filter enabled 0 08 150 Hz muscle filter off Manual copy to When the 9 key is pressed the unit will print a copy of the ECG EKG or send the ECG to a HOST system MUSE CV Information System No of copies If you do not want to print the ECG but only collect data select 0 message on display REC OFF When a number greater than 1 is selected multiple copies of the reports will be printed Default 1 Autosave ECG only with MEMO option After report generation the ECG will or will not be automatically saved to the internal memory yes no Delete ECG after Transmission only with MEMO option ECGs that were successfully sent to a host system via the
23. 3 mmHg Pacemaker 414 355 378 HR 1018PM i 4 4 4 4 4 4 amp 4 a a d b ee es oe ea oan Du Si j I i 1 1 1 f dele Ede de Leo DE b 1d f I f ay t LU Sp T 1 r f t LI j 1 f f f LI f f t 1 t t t 1 1 1 f f t PT pex Feb 09 1998 11 07 22 E 25mm s qme ADS 50Hz 0 08 150Hz iontz 12Lead 12SL V5 1 Figure 5 4 IxIORI2 report format 227 492 04 D MAC 1200 31 Recording in 12 Lead Mode Note Observe the safety information given in section 3 6 Connecting External Devices Print Delete Delete transmitted ECG ECG Recording of Walker John Delete Delete ECG Recording of Doe Jane Print Send Delete ECG Recording of Walker Jane Print Send Delete Figure 5 5 Memory program 1 All stored ECGs will be transmitted 2 All transmitted ECGs will be deleted 3 John Walker s ECG will be transmitted 4 ECG has been sent S Start transmission ENTER Modify settings SETUP Cancel START STOP Figure 5 6 Transmission menu 32 MAC 1200 5 5 ECG Transmission Resting ECGs acquired in 12 Lead Mode can be transferred to host systems e g to the MUSE CV Information System version 004A or higher The units can either communicate via modem or directly via a connection cable see section Direct Trans mission below 5 5 1 Transmission via Modem Depending on the modem model used the modem must be connected either with the 9 pole
24. 92 04 D System Setup 9 3 6 Lead Mode Use the cursor keys to position the bar cursor on 6 Lead and confirm the selection with b The setup menu for continuous recording of 6 leads will appear Report sequence 1 STANDARD 1 II V3 V4 V5 V6 2 CABRERA aVL I aVR II aVF III VI V2 V3 V4 V5 V6 3 SEQ NO 4 here users can define a custom report sequence Position the cursor on SEQ NO 4 e Press The display shown in Figure 9 2 will appear SEQ NO 4 Lead Label I Report sequence Figure 9 2 Creating a custom report sequence e Press V The cursor will move to the position for entry of the lead in channel 1 Follow these steps if you wish to record aVR in channel 1 for instance Enter AVR and confirm the entry with ay The cursor moves to the position for entry of the lead designation AVR appears there as well f you wish to enter another designation you can overwrite the default name 4 characters max e Confirm your entry with D and repeat the above steps for channel 2 etc You can write over SEQ NO 4 if you wish to enter another name for the report sequence 227 492 04 D IIL aVR aVL aVF VL V2 Gain auto 5 10 20 40 mm mV with auto the unit will automatically determine the appropriate gain setting for the 6 simultaneous leads Speed Changes the writer speed Default 25 mm s Muscle filter AC line filter Elimina
25. AND INDICATORS 3 _ PUTTING THE DEVICE INTO OPERATION AND PERFORMANCE TEST 3 1 SAFETY INFORMATION 3 2 POWER SUPPLY 3 3 INSTALLATION AND MAINS CONNECTION 3 4 PERFORMANCE CHECK 3 5 GENERAL DEVICE SETTINGS 3 6 CONNECTING EXTERNAL DEVICES 4 PREPARATIONS FOR ECG RECORDING 4 1 CONNECTING THE PATIENT CABLE 4 2 APPLYING THE ELECTRODES 4 3 ARTIFACT DUE TO POOR ELECTRODE APPLICATION 4 4 ENTERING PATIENT DATA 5 RECORDINGIN 12 LEAD MODE 5 1 SOME BASIC FACTS 5 2 RECORDING 5 3 THE MEMORY FUNCTION 5 4 THE REPORT FORMATS 5 5 ECG TRANSMISSION 5 6 BRIEF OPERATING INSTRUCTIONS 12 LEAD MODE 6 RECORDING IN 6 LEAD MODE 6 1 SOME BASIC FACTS 6 2 RECORDING 6 3 BRIEF OPERATING INSTRUCTIONS 6 LEAD MODE 7 ARRHYTHMIA MODE 7 1 SOME BASIC FACTS 7 2 RECORDING 7 3 BRIEF OPERATING INSTRUCTIONS ARRHYTHMIA MODE 227 492 04 D MAC 1200 10 12 12 16 17 18 19 20 26 26 27 29 31 32 38 39 39 39 41 42 42 43 45 Contents 8 ECGS OF PACEMAKER PATIENTS ECG RECORDING DURING DEFIBRILLATION 46 8 1 RECORDING ECGS OF PACEMAKER PATIENTS 46 8 2 ECG RECORDING DURING DEFIBRILLATION 46 9 SYSTEM SETUP 47 9 1 SOME BASIC FACTS 47 9 2 12 LEAD MODE 47 9 3 6 LEAD MODE 49 9 4 ARRHYTHMIA MODE 50 9 5 GENERAL DEVICE SETTINGS 51 9 6 COMMUNICATION 52 9 7 PATIENT DATA 53 9 8 OPTION CODE 54 9 9 ECG TRANSMISSION VIA MODEM 54 9 10 DIRECT ECG TRANSMISSION 55 10 LOADING CHART PAPER 56 11 CLEANING DISINFECTION AND
26. MAC 1200 resting ECG analysis system Operator s Manual Version 1 1 227 492 04 GA USA Revision D marquette A GE Medical Systems Company The information contained in this manual describes version 1 1 of the MAC 1200 resting ECG analysis system and reflects software version 5 1 1999 GE Marquette Medical Systems Inc All rights reserved Trademarked names appear throughout this document Rather than list the names and entities that own the trademarks or insert a trademark symbol with each mention of the trademarked name the publisher states that it is using the names only for editorial purposes and to the benefit of the trademark owner with no intention of improperly using the trademark 900 SC ACCUSKETCH AccuVision APEX AQUA KNOT ARCHIVIST Autoseq BABY MAC C Qwik Connect CardioServ CardioSmart CardioSys CardioWindow CASE CD TELEMETRY CENTRA CHART GUARD CINE 35 COROLAN CORO COROMETRICS Corometrics Sensor Tip CRG PLUS DASH Digistore Digital DATAQ E for M EAGLE Event Link FMS 101B FMS 111 HELLIGE IMAGE STORE INTELLIMOTION IQA LASER SXP MAC MAC LAB MACTRODE MARQUETTE MARQUETTE MAC MARQUETTE MEDICAL SYSTEMS MARQUETTE UNITY NETWORK MARS MAX MEDITEL MEI MEI in the circle logo MEMOPORT MEMOPORT C MINISTORE MINNOWS Monarch 8000 MULTI LINK MULTISCRIPTOR MUSE MUSE CV Neo Trak NEUROSCRIPT OnlineABG OXYMONITOR Pres R Cuff PRESSURE SCRIBE QMI QS Quantitative Medicine Quantitative
27. MAINTENANCE 58 11 1 CLEANING AND DISINFECTING THE RECORDER HOUSING 58 11 2 CLEANING AND DISINFECTING THE PATIENT CABLE 58 11 3 CLEANING AND DISINFECTING THE ELECTRODES 58 11 4 MAINTENANCE 59 12 TROUBLESHOOTING 60 13 TECHNICAL SPECIFICATIONS 62 APPENDIX ENTERING SPECIAL CHARACTERS 67 INDEX 68 8 MAC 1200 227 492 04 D Intended Use and Functional Description 1 Intended Use and Functional Description The MAC 1200 is an ECG acquisition and recording system designed and manufactured by GE Marquette Medical Systems tis intended to be used for resting ECG recording and realtime ECG recording with or without arrhythmia detection Itis not intended for use as a vital signs physio logical monitor The arrhythmia detection portion of the MAC 1200 is provided to the customer for the conven ience of automatic documentation It is not de signed to provide alarms for arrhythmia detec tion The MAC 1200 offers no diagnostic opinion to the user Instead it provides analytical statements when configured with the appropriate options Itis intended to be used by trained operators under direct physician supervision when ECG records are required Itis not suitable for intracardiac application tis designed for continuous operation Itis not intended for home use The MAC 1200 is designed as a portable device and can easily be moved from one patient to another or to different locations It i
28. and check the paper supply Use only the original HELLIGE CONTRAST chart paper or the GE Marquette thermal paper with queue marks or holes This paper has a spe cial coating that prevents contamination and debris collecting on the printhead and electrostatic build up Furthermore the thermosensitive layer and the printhead characteristics are exactly matched Using other paper may result in recordings of poor quality Moreover the printhead may wear out prema turely Use of other paper voids the warranty 227 492 04 D End of Paper Indication A stripe marks the last 10 pages of the Z fold pad When the writer runs out of paper during a record ing it will emit an audio signal and displays the message End of paper or paper jam if OK press Insert a new paper pad and acknowledge the message with Aging Stability The standard ECG writer paper CONTRAST is designed to guarantee full contrast for a period between 3 and 5 years if it is handled as described below before and after recording Store the paper in suitable rooms at a temperature between 18 and 24 and a relative humidity between 40 and 60 Avoid direct contact of the paper with carbon and carbonless forms chart papers and adhesives containing tributyl phosphate dibutyl phthalate or any other or ganic solvents document protectors envelopes and sheet separators containing plasticizers Caution The abo
29. anual observe the instructions for use of the respective electrode types MAC 1200 Discard disposable adhesive electrodes immedi ately after use to prevent that they are reused Clean reusable electrodes immediately after removing them from the patient Peel off the adhesive foil before cleaning the electrodes rests of the adhesive can be removed with benzine Then use warm water and a small brush to clean the electrodes of cream or gel Do not use pointed or sharp objects for cleaning Disinfect the electrodes with alcohol free disinfectant Ensure that connectors and sockets do not become wet The only approved sterilization method is gas sterilization Frequently sterilizing the electrodes with ethyl ene oxide gas reduces the life of the plastic material 227 492 04 D Cleaning Disinfection and Maintenance 11 4 Maintenance Checks before each use Before each use visually inspect the device the leads and electrodes for signs of mechanical damage If you detect damages or impaired functions that may adversely affect the safety of the patient or user do not use the device before it has been repaired 227 492 04 D Technical Inspections For safety the devices require regular maintenance To ensure functional and operational safety of the MAC 1200 units Technical Inspections should be carried out on an annual basis These checks should be performed by persons with adequate training and expe
30. ardia p tte gt 3 PVCs VTAC Check device settings ventricular run 3 PVCs RUN report sequence ventricular couplet 2 PVCs CPLT AC line filter pause of 2 missed beats PAU2 trend recordings pause of 1 missed beat PAUI 2 eisddes early PVC EPVC ventricular bigeminy VBIG r pear Pate alatan linis new form e g intermittent e Modify device settings if required bundle branch block NF e Check that no lead failure message is displayed multiform PVCs MULT e Start recording with OD supraventricular arrhythmia SVAR e Switch on muscle filter with 9 paroxysmal supraventricular Sup recone wath D tachycardia PSVT Recher TACH e Print patient data with bradycardia BRAD pacemaker malfunction PERR ventricular escape beat ESC premature ventricular contraction PVC premature supraventricular contraction PSVC aberrant beat ABR pacemaker capture PCAP pause 21 5 times the normal RR interval TL absolute pause limit value PAUA artifact A learn phase L learned QRS complex QRSL Table 7 1 Arrhythmia codes 227 492 04 D MAC 1200 45 ECGs of Pacemaker Patients ECG Recording During Defibrillation 8 ECGs of Pacemaker Patients ECG Recording during Defibrillation 8 1 Recording ECGs of Pacemaker Patients Due to the slow paper speed it is not possible to ibplay pacer pulses directly on the ECG recor
31. box selection from a list of 10 names ELLE ros Site 1 1 to 255 Location 1 1 to 600 Date current date dd mm yyyy Time hh mm current time LL 4 Mains 60 Hz 50 Hz LCD light off 5 min 1 to 99 minutes after Default mode 12 Lead 6 Lead Arrhythmia Language English English French Spanish Enable password No Yes Test DATA No Yes Restore defaults No Yes No Yes mase e 3 5 General Device Settings The table at left shows the general device settings that can be modified and the system defaults For instructions on changing the device setup refer to section 9 5 General Device Settings 18 MAC 1200 227 492 04 D Preparations for ECG Recording Warning Shock Hazard Strictly observe the following warnings Failure to do so may endanger the lives of the patient the user and bystanders Connecting peripheral devices to the RS232 interface of the resting ECG analysis system cre ates a medical system This system must meet the requirements of IEC 60601 1 1 Use only the original Marquette Hellige connec tion cables All non medical devices of a system must be connected to the same electric circuit Devices which are not connected to the same circuit must be electrically isolated use isolated RS232 inter face as per IEC 60601 1 A PC connected to the resting ECG analysis system should meet the requirements of EN 60601 If it doesn t it must be set up out
32. break each single electrode is monitored 227 492 04 D MAC 1200 Text input patient and user data as well as comments can be entered via the panel keyboard and are annotated on the recording strip Copy function after ECG recording in 12 Lead Mode copies of the ECG can be printed from memory and or transferred to a MUSE CV system configurable Test automatic performance test upon power up including verification of the signal path starting at the signal input stored test ECG data for demonstration of the device functions Power supply from the power line or from a built in rechargeable battery automatic switchover automatic battery charging during line power operation from integrated AC adapter module Mains operation e instrument design in protection class I according to IEC 60601 1 e Rated voltage range 95 to 240 V operating voltage range 85 to 264 V 49 to 65 Hz e rated current 0 2 to 0 6 A e fuse 2 x T1 25A 5x20 typical power consumption battery charging 14W e max power consumption 29 W Battery operation type nickel cadmium e rated battery voltage 18 V 65 Technical Specifications e rated battery capacity 1 3 Ah Recorder dimensions e fully charged battery sufficient for up to 50 e width 14 5 in 12 Lead Mode 1 page ECGs if unit is only height 3 7 in switched on to record the ECGs e depth 12 6 in incl handle e battery charge time approx 4 hours min charg
33. cable 223 378 01 or with the 25 pole cable 223 378 02 For transmission of the ECG the unit must be set up as described in section 9 9 ECG Transmission via Modem After acquisition of the ECG the transmission is initiated with if Manual copy is set to Host in the setup menu see section 9 2 12 Lead Mode The recorder is also capable of transmitting stored ECGs if MEMO option is installed To retrieve ECGs from memory hold 3 down while pressing ges You will see the memory menu Figure 5 5 e To transmit all stored ECGs in one pass position the cursor on All stored ECGs Send 1 Figure 5 5 to transmit individual ECGs position the cursor on the Send command of that ECG e g 3 Figure 5 5 Confirm the command with You will see the transmission menu as shown in Figure 5 6 Check the displayed telephone number and press D to initiate the transfer e fitis necessary to change the number press to display the setup menu e With DOQ the transmission can be stopped ECGs that were successfully transmitted are identified with the letter S for Sent 4 Fig ure 5 5 227 492 04 D Recording in 12 Lead Mode P the unit will automatically dial the number of the As soon as you initiate the transmission with modem at the receiving end and establish a Cancel START STOP connection Figure 5 7 Then it will send the ECG Figure 5 8 After the transmiss
34. cters 227 492 04 D Preparations for ECG Recording New patient yes existing patient data are deleted no entered data can be edited Last Name First Name Enter the patient s last and first names 18 characters maximum each and confirm entries with e Date of birth The slash key must be entered between month day year Patient ID Secondary ID 16 characters maximum each Pacemaker Influences the identification of pacer pulses in Arrhythmia Mode Enable the function Yes when recording the ECG of a pacemaker patient The recording will then be annotated with the message Pacemaker Patient Gender Race If you do not intend to enter all demographic data on select the neutral entries and unknown Height Weight Enter the patient s height in inches and weight in pounds The weight can be entered with one decimal place Systolic BP Diastolic BP Enter the blood pressure readings in mmHg Phone No Enter the patient s telephone number 227 492 04 D Ordering Physician Referring Physician Technician When you choose yes for New patient the default names entered in the General Settings will appear here When you choose other you can pick a name from the list It is also possible to choose no You can exit the menu with DOQ The Referring Physician is only relevant if you send ECGs to the MUSE CV Information System This name will not be annotated on the ECG recording
35. data and analyzes it Therefore it is recommended to wait until the patient has been lying relaxed and motionless for about 10 seconds before starting the recording 227 492 04 D MAC 1200 27 Recording in 12 Lead Mode Note Please note that filters may suppress diagnostically relevant portions of the signal because they limit the transmission range Filters should therefore only be enabled if necessary a b C d e 12Lead 40Hz 60Hz ADS 4x2 5R1 10mm mV Standard f g h aVR Bulienll Name aVF RL HR 120 Figure 5 1 12 Lead mode display a Operating mode b Muscle filter enabled c AC line filter enabled d Anti drift system enabled e Patient name f Report format or REC OFF when no recordings are made g Gain 10 mm mV automatic gain adjustment off h Report sequence i Right leg electrode failure message j Heart rate With the system defaults unchanged the unit will activate the following functions and settings after power up the 12 Lead Mode configurable the Standard report sequence I II III aVR aVL aVF VI V2 V3 V4 V5 V6 rhythm leads II V1 and V5 configurable again of 10 mm mV configurable calibration pulse at the beginning of the recording the AC line filter is on configurable the muscle filter is off Site configurable the anti drift system cubic spline is enabled wandering baselines are automatically restored to their original
36. des External equipment connection 51 48 60 F 54 57 Final report 23 49 Functional description 45 42 G 45 42 General device settings 50 General information 50 General settings system setup 23 H Heart rate limit 16 HOST system 52 25 38 I 41 ID number MUSE 45 Indicators overview Installation Intended use Interpretation enable disable 51 Interpretation print 37 12 58 L 19 Language 17 Lead fail beep 10 Lead labels 23 Limb lead electrodes application Lithium battery Location number enter 12 51 M 31 47 Mains connection 58 Maintenance 51 Master password 59 Medication Memory optional MEMO function Memory option Modem MAC 1200 34 44 41 25 227 492 04 D 46 32 35 32 22 29 57 24 66 66 50 19 18 51 44 48 51 10 17 48 48 51 51 51 21 60 51 17 58 52 25 29 26 32 Modem setup Muscle artifact Muscle filter MUSE CY Information System O Option codes Options how to activate Options overview Order number enter Ordering physician Override function Pacemaker patient Paper feed automatic Paper jam Paper inserting new pad Password protection setup menu Patient data setup Patient data entry Patient ID enter Patient name enter Performance check Physician referring ordering Power supply Prompts Protocols Receiving ECGs Recharging the battery Recording in 12 Lead mode Recording
37. ding At a paper speed of 50 mm s and a pulse duration of 0 5 ms the width of the recorded pacer pulse would be only 0 025 mm For this reason the recorder reduces the pulse amplitude and expands the pulse width so that the pacer pulse is easier to identify The MAC 1200 records the pulse with the correct polarity with a width of 5 ms and with the same amplitude in all leads depending on the polarity of the pacer pulse in leads I and II the pacer pulse in lead suppressed The amplitude of the reverse current may differ from lead to lead Figure 8 1 shows an ECG recording with pacer pulses Figure 8 1 ECG recording with pacer pulses Warning Incorrect HR No HR Alarm If several adverse conditions exist at once the possibility that the pacer pulses are interpreted and counted as QRS com plexes should be considered At the same time however QRS complexes might be suppressed in certain situations Therefore pacemaker patients should always be watched closely 46 MAC 1200 8 2 ECG Recording During Defibrilla tion The patient signal input is defibrillation proof so it is not necessary to remove the ECG electrodes before defibrillating the patient However when using stainless steel or silver electrodes the defibrillator discharge current may cause complete polarization at the electrode skin interface This condition may prevent ECG signal acquisition for several minutes With silver silver chloride electr
38. e of approx 5 years Defective AC power adapter or fuse Ground bed verify position of the leadwires switch on AC line filter The patient should be warm enough and resting comfortably place cushions under arms and knees Comfort patient or distract patient s attention enable muscle filter 20 Hz 40 Hz if necessary Notify service to check and or replace battery Notify service to check and or replace fuse The recorder does not write over Paper compartment not properly Paper door must lock into place on the entire paper width closed both sides In 12 Lead Mode the recorder does not stop and continues to feed paper This does not happen in 6 Lead Mode The paper pad was inserted the wrong way round so the recorder cannot detect the cue mark Insert the paper pad as instructed Recorder does not start after activation of the OD key or the recording is aborted Unit operated on battery power battery discharged No recording in 12 Lead Mode Failure of at least one electrode Paper jam 60 MAC 1200 Connect recorder to the power line After a few minutes the recorder is able to resume operation Always connect recorder to the power line when the battery low indicator 22 lights up The battery capacity depends on age temperature and charge level chapter 3 Putting the Recorder into Operation Check all electrodes or enable Override function section 9 2 12 Lead Mode Open
39. e Select no for prompts that you want to remove from the dialog Items Last name First name Date of birth Patient ID cannot be removed Items Height Weight Diastolic BP Systolic BP Referring Physician Medication Comments ID required Secondary ID Secondary ID required Last name required First name required Extra Questions Prompt 1 through Prompt 4 are disabled They can be enabled from the patient data setup menu 227 492 04 D Required Data Fields If for one of the data fields ID required 2nd ID required Last name required First name required you choose yes an ECG can be recorded in 12 Lead Mode only if the corresponding patient data is entered Prompt 1 to 4 You can enter any text here 10 characters max When you have entered the text you can select the format of the response field There is a choice of 3 formats alphanumeric field 17 characters max only numbers 9 numbers max yes or no To exit the menu press OD s MAC 1200 53 System Setup 9 8 Option Code In this menu you enter the option codes to enable a number of optional software functions The respective option becomes active after you have entered the code number The code numbers are listed on the option code sheet supplied with the different software options Inthe setup menu position the bar cursor on Option Code and confirm
40. e muscle filter 40 Hz 20 Hz The frequency range is indicated in the lower margin of the recording strip 0 08 40 Hz 40 Hz muscle filter enabled 0 08 20 Hz 20 Hz muscle filter enabled 0 08 100 Hz muscle filter off Trend rec The slow trend recording of 5 mm s automatically begins at program start no yes 50 MAC 1200 Arrhythmia data The recorder will document arrhythmias in the following situations each time an arrhythmia occurs each time an arrhythmia occurs that is different from the preceding event arrhythmias are not documented all unequal no Episodes Final report includes episode report with episodes listed by one of the following criteria in chronological order according to priorities see table 7 1 ventricular beats only no episodes chron prio ventr no 227 492 04 D System Setup 9 5 General Device Settings Ordering Referring Physician Technician In the field at left you see the last name of the physician or technician selected as the default name When selecting other a menu displays where you can enter up to 10 names 2 digit ID number first name last name The default name and ID is automatically selected at power up The Referring Physician is only relevant if you send ECGs to the MUSE CV system This name will not be annotated on the ECG recording Press the key to exit the menu Institution Name The name en
41. e only silver silver chloride electrodes if the 3 patient may have to be defibrillated Refer to chap 4 2 1 Applying Electrodes Limb Leads ED OG RECOMMEND HCI Refer to the illustration shown in Figure 4 2 RA white electrode on right arm LA black electrode on left arm LL red electrode on left leg RL green electrode on right leg lt eo RA LA RL e e LL Figure 4 2 Applying limb lead electrodes 227 492 04 D MAC 1200 21 Preparations for ECG Recording V5 V1 V2V3 V4 Figure 4 3 Chest electrode placement RL green right leg RA white K right arm V1 red V2 yellow V3 green V4 blue V5 orange V6 purple LA black left arm LL red LE left leg V5 V1 V2V3 V4 Figure 4 4 Connecting the patient cable 10 lead cable standard ECG leads correct wrong Figure 4 5 Arranging the patient cable 4 2 2 Applying Electrodes Thorax e Shave application points if necessary 4 2 3 Electrode Placement for Standard Leads I Il III aVR aVL aVF VI V6 For acquisition of the standard ECG leads four electrodes must be applied on the limbs and six on the chest The limb electrodes should be placed above the wrists and ankles Figure 4 3 shows the chest electrode application points V1 4 intercostal space at the right border of the sternum V2 4 intercostal space at the left border of the sternum
42. e time for one 12 Lead Mode ECG 10 minutes Weight e battery life approx 2 to 3 years replacement by e approx 12 3 Ib with battery service only lithium battery for built in clock battery life approx 5 years replacement by service only Operational readiness After successful self test approx 10 s after power up Operating position horizontal Environment Operation e temperature between 50 and 104 F e relative humidity between 25 and 95 e atmospheric pressure between 700 and 1060 hPa Transport and storage e temperature between 22 and 140 F includ ing battery e relative humidity between 25 and 95 e atmospheric pressure between 500 and 1060 hPa 66 MAC 1200 227 492 04 D Entering Special Characters Appendix Entering Special Characters The following special characters can be entered by means of the appropriate keystroke combination charac keystroke combination ter Alt Q D Alt A Alt W Alt J Alt E Z Alt T then Z Alt R Alt T then S amp Alt Y i Alt X Alt D Alt F C Alt G A Alt K U Alt L Alt X N Alt C Alt 4 V Alt B Alt N Alt M Alt I then A Alt I then E Alt I then I Alt I then O Alt I then U Alt O then A enter E I in the same manner Alt P then A enter f in the same manner y Alt U then Y enter A O in the same manner Alt H
43. election from a list of 10 names Was Iu unknown No Ma unknown No other Eme e xus Ne nem Rom N Oda o Rm m Rm e Prompt 3 No Prompt 4 No Table 4 1 Patient data entry menu 24 MAC 1200 4 4 Entering Patient Data It is possible to enter patient data and have them annotated on the recording for easy archiving of patient records e Press io to enter the patient data mode The recorder displays the menu items in a defined order In the patient data setup menu section 9 7 Pa tient Data you determine the items to be in cluded in the menu In the table at left the items that appear in the patient data menu in the default setup are marked as Yes in the Menu item displayed column the other menu items are marked as No To skip a menu item press e or the cursor key Yor LD Itis not possible to write capital and small letters do not use the Shift key For entry of numbers e g date of birth it is not necessary to press the Shift key All entries must be confirmed with Q Press Q9 or o to exit the patient data mode The table at left shows the menu items in the correct order On the display selected options are shown in brackets Refer to section 9 7 for details on setting up the patient data menu Note Please refer to the Appendix for instructions on entering special chara
44. ement of patient and recorder For interference free operation it is important that the patient cable and the power cord do not run parallel e Using the power cord connect the device to the power line Figure 3 1 Use only the original power cord or an equivalent cable The standby indicator 23 will illuminate e Check the paper supply the window in the paper door allows you to look inside the compartment If it is necessary to insert a new paper pad refer to chapter 10 for instructions 3 4 Performance Check e Press the power switch to switch on the device Figure 3 4 The amber stop indicator Q 20 will illuminate After power up the resting ECG analysis system runs an automatic self test When no problem is detected it defaults to the 12 Lead Mode If a malfunction is identified the display will show an error message Error In this situation notify service to check and repair the device The self test can be aborted with the 8 button In this case the device immediately activates the 12 Lead Mode Contrast Adjustment e To adjust the contrast simultaneously press lt and the appropriate cursor key T for more contrast w for less contrast MAC 1200 17 Preparations for ECG Recording Parameter System Options Defaults Ordering empty text box selection from a list Physician of 10 names Referring empty text box selection from a list Physician of 10 names Technician empty text
45. ering with the proper performance of the device For this reason make sure that all external devices operated in the vicinity of the monitor comply with the relevant EMC requirements X ray equipment or MRI devices are a possible source of interference as they may emit higher levels of electromagnetic radiation INTERFACING OTHER EQUIPMENT Devices may only be interconnected with each other or to parts of the system when it has been determined by qualified biomedical engineering personnel that there is no danger to the patient the operator or the environment as a result In those instances where there is any element of doubt concerning the safety of connected devices the user must contact the manufacturers concerned or other informed experts for proper use In all cases safe and proper operation should be verified with the applicable manufac turer s instructions for use and system standards IEC 60601 1 1 EN 60601 1 1 must be complied with 227 492 04 D Preparations for ECG Recording NOTES The MAC 1200 is designed to comply with IEC 60601 EN 60601 requirements It is Class I equipment equipment with a built in rechargeable electrical power source The device is not suit able for intracardiac use The device is suitable for continuous operation Choose alocation which affords an unobstructed view of the monitor s screen and easy access to the operating controls The MAC 1200 has no additional protection against in
46. esting ECGs from the resting ECG analysis system to a MUSE CV system With the A5 protocol the 10 second resting ECG can be transmitted to CardioSys and CardioSoft Baud rate HOST Transmission rate for the selected protocol We recommend the default setting of 19200 baud Modem Select the modem type You can choose among the standard modems MultiTech MT 19 32 56 6 Elsa 28 8 Elsa 33 6 Elsa 56 6 and a user defined modem When using one of the standard modems all you have to enter is the dial mode pulse or tone depending on your telephone network the telephone number 28 digits max the number to access the public telephone network e g 0 For a user defined modem enter the telephone number 28 digits max the init string 20 characters max see modem operator s manual the dial string 20 characters max see modem operator s manual the hangup mode 20 characters max see modem operator s manual SYSTEM Use this password if you cannot remember your own password 52 MAC 1200 227 492 04 D System Setup 9 7 Patient Data The patient data menu can be set up to meet individual requirements If you do not want to enter blood pressure readings for instance you can remove the corresponding prompts Use the cursor keys to position the bar cursor on Setup Patient Data and confirm the selection with e The patient data setup menu will appear
47. etup Option Code At Operating mode you will always see the currently selected mode So be sure to select the appropriate mode before entering the setup menu e To access the menu options position the bar cursor on the option with the cursor keys and confirm the selection with The operating steps to select a setting are always the same e Using the cursor keys lt and you select the option then you confirm the selection with amp The cursor will move to the next menu item Individual items can be skipped with 4 or T e Press q QQ to exit the setup mode ATE REN v Ww an rev ary 9 pat info c S Figure 9 1 System setup keys 227 492 04 D 9 2 12 Lead Mode Use the cursor keys to position the bar cursor on 12 Lead and confirm the selection with e The setup menu for automatic 12 lead recording will appear The angular brackets denote the system defaults Report sequence STANDARD I II V3 V4 V5 V6 CABRERA aVL I aVR II aVF UL V1 V2 V3 V4 V5 V6 Rhythm leads Any three of the available ECG leads can be selected as rhythm leads They are printed with report formats 4x2 5R3 and 1x10R3 Formats 2x5R1 and 4x2 5R1 will show only the first of the rhythm leads Gain 5 10 20 40 mm mV auto Report format For an overview of the available report formats refer to section 5 4 The Report Formats The default format is 4x2 5R
48. gress of water Medical technical equipment such as the MAC 1200 must only be used by persons who have received adequate training in the use of such equipment and who are capable of applying it properly Atthe end of its service life the MAC 1200 and its accessories must be disposed of in compliance with the special waste control regulations for electronic parts If you have any questions in this matter please contact GE Marquette Medical Systems 227 492 04 D Literature Medical Device Directive 93 42 EEC EN 60601 1 1990 Al 1993 A2 1995 Medical electrical equipment General requirements for safety EN 60601 1 1 9 1994 A1 12 95 General requirements for safety Requirements for the safety of medical electrical systems Requirements for the safety of medical electrical systems EN 60601 2 25 1993 Medical electrical equipment Part 2 Special requirements for the safety of electrocardiographs IEC Publication 513 1994 Fundamental aspects of safety standards for medical equipment MAC 1200 15 standby battery low Figure 3 1 Indicators 16 Preparations for ECG Recording format store s pat info 3 2 Power Supply The units are powered from the power line or from the rechargeable battery The battery charges automatically when the unit is connected to the power line and the standby indicator 23 is illuminated Figure 3 1 It is not necessary to switch on the device for charging
49. hazardous situation which if not avoided COULD result in death or serious injury 12 MAC 1200 227 492 04 D Preparations for ECG Recording WARNINGS ACCESSORIES SUPPLIES Use only the original GE Marquette cables Do not connect other signal sources to the cables The user is responsible for the use of accessories from other manufacturers ACCIDENTAL SPILLS To avoid electric shock or device malfunction liquids must not be allowed to enter the device If liquids have entered a device take it out of service and have it checked by a service technician before it is used again BEFORE USE Before putting the system into operation visually inspect all connecting cables for signs of damage Damaged cables and connectors must be replaced immediately BEFORE USE Before using the device the operator must verify that it is in correct working order and operating condition For instructions refer to section 3 2 2 Performance Check in this chapter CONDUCTIVE CONNECTIONS Do not allow electrodes to come into contact with conductive parts The neutral electrode in particular must not be connected to earth DISCONNECTION FROM MAINS When disconnecting the system from the power line remove the plug from the wall outlet first Then you may disconnect the power cord from the device MOISTURE CONDENSATION Devices intended for emergency application must not be stored or transported at temperatures w
50. hich cause moisture condensation at the application site Wait until all moisture condensation has evaporated before using the device 227 492 04 D MPSO The use of a multiple portable socket outlet MPSO for a system will result in an enclosure leakage current equal to the sum of all individual earth leakage currents of the system if there is an interruption of the MPSO protective earth conduc tor Do not use an additional extension cable with the MPSO as it will increase the chance of the single protective earth conductor interruption OPERATOR The user must have received adequate training in the use of the MAC 1200 and must be capable of applying it properly POWER SUPPLY The device must be connected to a properly installed power outlet with protective earth contacts only If the installation does not provide for a protective earth conductor disconnect the monitor from the power line and operate it on battery power if possible If the installation of this equipment in the USA will use 240V rather than 120V the source must be a center tapped 240V single phase circuit MAC 1200 13 Preparations for ECG Recording CAUTIONS MAINTENANCE Regular preventive mainte nance should be carried out annually inspections of equipment with measuring functions should be done every two years refer to chapter 11 Cleaning Disinfection and Maintenance PERFORMANCE CHECKS Check the device performance once a mo
51. in 6 Lead mode Recording in Arrhythmia mode Recording problems Referring physician Report formats 12 Lead mode Revision code Revision history 227 492 04 D Index 37 48 48 19 54 25 25 48 46 49 60 56 52 53 24 25 25 17 25 51 16 52 36 16 27 39 43 23 25 31 MAC 1200 Room number enter Safety information Saving ECGs Secondary patient ID enter Self test abort Service parts how to order Service requests where to call Setup Site number enter Software version Specifications Standard leads Supplies how to order Symbols explanation System defaults 12 Lead mode System defaults 6 Lead mode System defaults arrhythmia mode System setup 12 Lead mode System setup 6 Lead mode System setup Arrhythmia mode System setup general settings T Technical specifications Technical support Test DATA Thorax electrodes application Time Trend recording Troubleshooting Units Warning definition 69 25 12 29 25 17 47 51 62 22 11 26 42 47 49 50 51 62 52 22 51 50 60 51 12
52. ion a message on the display Figure 5 7 Initializing the transmission indicates the number of successfully transmitted ECGs As soon as you acknowledge the message QD the 12 Lead Mode acquisition screen appears ECG Transmission CSI The system identifies ECGs that were successfully sent to the host system with the letter S 4 Figure 5 5 All of these ECGs can be deleted with the command Delete transmitted ECGs 2 Figure 5 5 Figure 5 8 Display during ECG transfer T If it is not possible to transmit the ECG wrong modem setup modem off the unit will display an error message such as Transmission error CSI Figure 5 9 Try again ENTER In this situation you have the following choices Modify settings SETUP f Cancel START STOP PS you can repeat the transmission with Q amp I you can change the settings with Figure 5 9 Error message youcan stop the transmission with QQ Transmission Error CST The connection was interrupted due to a fault Check interface Fault in RS232 interface or modem Modem may be switched off No carrier Carrier signal lost or not detected Check modem setup Modem configuration error 227 492 04 D MAC 1200 33 Recording in 12 Lead Mode Note Pacemaker information telephone number and com ments entered in the patient data are not transmitted to MUSE Print Delete transmitted ECG ECG Recording of Walker
53. line filter override function 2SL interpretation configuration e Modify device settings if required e Wait for patient to lie motionless and for the unit to collect 10 seconds of ECG data e Check that no lead failure message is displayed e Start recording with QQ 38 MAC 1200 227 492 04 D Recording in 6 Lead Mode 6 Recording in 6 Lead Mode 6 1 Some Basic Facts In 6 Lead Mode the system acquires 6 leads of ECG in realtime Recordings are started and stopped with QQ Some of the system settings can be customized They are labeled with configurable The following information refers to a unit with the system defaults see table below For instructions on changing the device setup refer to section 9 3 6 Lead Mode Reportsequence STANDARD CABRERA SEQ NO 4 auto 5 20 40 mm mV 5 50 mm s Start at queue No Yes mark 227 492 04 D 6 2 Recording After switching on the unit press MJ to select the 6 Lead Mode Before recording the ECG patient data can be entered with 99 We recommend to enter the patient s name to annotate it on each page Note In 6 Lead Mode messages indicating disconnected electrodes are annotated on the recording e g Lead fail V1 Before initiating a recording check the display for error messages see table below Check all electrodes if the message persists there must be a break in the patient cable Replace the cable with
54. ls and Indicators 2 Controls and Indicators GVOGUGUVUUGUDG db s o F amp w a K v d 2E amp c v B N M 4 DI e 9 9 I T3 D amp amp Figure 2 1 Controls and indicators of the MAC 1200 resting ECG analysis system 10 MAC 1200 227 492 04 D A 0 N A ON 11 12 13 Exp A 26 del 227 492 04 D Controls and Indicators Power input Paper door windows allows you to check the paper supply Patient cable connector Serial interface see chapter 13 Technical Specifications Power switch ON STANDBY Keys to select a higher or lower HR alarm limit Backspace key to correct entered data Confirms entered data Enter Displays the setup menu Enables disables the muscle filter elimination of muscle artifact Selects the writer speed 25 50 5 mm s in 6 Lead Mode and the report formats in 12 Lead Mode Selects the gain 5 10 20 40 mm mV Press to print the report or additional copies of the ECG or to send receive ECGs lanation of symbols used on the device Consult accompanying documents Signal input Type CF signal input highly insulated defibrillation proof 14 15 16 17 18 19 20 21 22 23 24 25 26 27 MAC 1200 Selects the ECG lead in 6 Lead Mode in 12 Lead Mode on the display only Sends ECG to memory retrieves ECG from memory Selec
55. ltage protection for all lead connections and neutral electrode interference compensation via neutral electrode monitoring for open leads e electrode connections for RA LA LL LA V1 to V6 e input impedance for differential signals between any two electrode connections gt 10 MQ at 10 Hz e input impedance for common mode signals referred to neutral electrode gt 50 MQ up to 60 Hz dynamic range for differential signals between any two electrode connections for AC voltage 10 mV for superimposed DC voltage polari zation voltage 600 mV dynamic range for common mode signals referred to neutral electrode l V referred to chassis 263 V AC rms quiescent input current via any electrode connection for 1 kQ termination referred to neutral electrode 50 nA e patient leakage current rms values according to IEC class CF in normal condition lt 10 WA 227 492 04 D MAC 1200 in single fault condition e g patient in contact with line voltage lt 20 LA non destructive range for lead electrode connections and the neutral electrode connec tion referred to neutral electrode 50 V re ferred to chassis 1500 V pulse voltage resistance of all lead electrode connections and of the neutral electrode con nection referred to chassis either polarity e g defibrillation 5000 V monitoring of each electrode for open leads RA LA LL RL V1 V2 V3 V4 V5 V6 audio signal at printer start Data i
56. lter is disabled the anti drift system cubic spline is disabled configurable aVF g the writer prints at a speed of 25 mm s the speed can be changed with Sea RL HR 120 lt 180 Pressing amp will output the patient data after the i j k ECG recording f The unit will not advance the paper to the Figure 6 1 6 Lead mode display a Operating mode b Muscle filter enabled c AC line filter enabled All relevant device settings are shown on the display d Anti drift system enabled Figure 6 1 beginning of a new page each time a recording is initiated configurable e Patient name f Writer speed g Gain 10 mm mV automatic gain adjustment off h Report sequence filter settings during a recording the unit will If you change the writer speed lead group or any i Right leg electrode failure message briefly stop j Heart rate on lead Hean rare Battadusable With you advance to the next group of 6 leads of the selected report sequence 40 MAC 1200 227 492 04 D Recording in 6 Lead Mode With Y 1 you toggle between the two lead 6 3 Brief Operating Instructions sets 3 each on the display that belong to the recorded group When the anti drift system is enabled there will A be a short delay before the recording starts The ECG will then be recorded with a delay of 2 2 s The heart rate limit is automatically calculated from the date of birth WHO 100 220
57. nnected V3 chest electrode V3 disconnected V4 chest electrode V4 disconnected V5 chest electrode V5 disconnected V6 chest electrode V6 disconnected Messages indicating disconnected electrodes Note With e a single page recording can be initi ated after program start Please note that filters may suppress diagnosti cally relevant portions of the signal because they limit the transmission range Filters should therefore only be enabled if neces sary For proper functioning of the ECG analysis algorithm pacemaker patients must be identified in the patient data Pacemaker yes section 4 3 Entering Patient Data 227 492 04 D 7 2 Recording arrhy After switching on the unit press to select the Arrhythmia Mode Before recording the ECG patient data can be entered E We recommend to enter the patient s name to annotate it on each page Before initiating a recording check the display for error messages see table at left Check all electrodes if the message persists there must be a break in the patient cable Replace the cable with a new one The recording is started and stopped with the QQ key Upon program start the unit records 6 leads of ECG 1 page During the following learn phase the analysis algorithm learns the patient s typical QRS complex After the learn phase the recorder prints a report where the QRS complexes acquired in the learn phase
58. nt Send Delete Change EC ording of Doe John Print Send Delete Change ECG Recording of Doe Jane Print Send Delete Change ECG Recording of Walker Jane Print Send Delete Change Figure 5 2 ECG identified by patient name 1 All stored ECGs will be printed 2 All stored ECGs will be transmitted 3 All stored ECG will be deleted 4 All transmitted ECGs will be deleted 5 ECG has been sent S 6 John Walker s ECG will be printed 7 Select to edit the patient data Note With a fully charged battery and the unit turned off ECGs will remain stored for approx 4 weeks 227 492 04 D 5 3 The Memory Function Units equipped with the optional MEMO function permit storage of the ECG including patient measurement and interpretation data with gio A message informs the user that ECGs are being saved and indicates the number of stored ECGs 40 max To retrieve an ECG from memory hold down 8 and press corer You will see the memory program as shown in Figure 5 2 The first line refers to all stored ECGs The Print Send and Delete commands following this line will therefore print send or delete all stored ECGs With the command in the line below all ECGs that have been transmitted to another system can be deleted The individual ECGs either identified by name or if the patient name was not entered by date and time follow The cursor is positioned at All stored ECGs Print 1 which means that all stored
59. nterface one serial RS232 interface for exchange of data with suitable external devices and software handshake RS232 interface standard V 24 interface e input voltage range 15V max e output voltage range 5 V min e interface protected from electrostatic discharge for 10 kV max Transfer of ECGs with the CSI protocol between the MAC 1200 and the following units MUSE CVIS SW version 004A and later MAC 5000 SW version 001B and later MAC VU SW version 002A and later MAC 1200 SW version V5 01 and later Receiving data with the CSI communication protocol from the following units CardioSmart SW version V4 2 and later CardioSmart ST SW version V4 21 and later Sending ECGs to the following units with the AS protocol CardioSys CardioSoft SW version V1 0 and later 63 Technical Specifications Pin assignment of data port 5 3 2 2 RXDE 3 TXDE 5 circuit reference 6 modem supply 9 QS 8 remote start Remote start hardware Paper feed via remote control connection depending on selected operating mode External make contact referred to chassis via circuit reference source impedance R lt 300 Q contact dwell gt 100 ms non destructive load 10 V ESD interface protection up to 10 kV Signal Transmission Patient input to recording After lead formation and digitization simultaneous transmission of all electrode signals to the digital processing system muscle filter AC fil
60. nth strictly following the instructions outlined in section 3 2 2 Performance Check POWER REQUIREMENTS Before connecting the device to the power line check that the voltage and frequency ratings of the power line are the same as those indicated on the unit s label If this is not the case do not connect the system to the power line until you adjust the unit to match the power source VENTILATION REQUIREMENTS Set up the device in a location which affords sufficient ventilation The ventilation openings of the device must not be obstructed The ambient conditions specified in the technical specifications must be ensured at all times DEFIBRILLATOR PRECAUTIONS Patient signal inputs labeled with the CF and BF symbols with paddles are protected against damage resulting from defibrillation voltages To ensure proper defibrillator protection use only the recommended cables and leadwires Proper placement of defibril lator paddles in relation to the electrodes is required to ensure successful defibrillation DISPOSAL Dispose of the packaging material observing the applicable waste control regulations and keeping it out of children s reach ELECTROCAUTERY PRECAUTIONS To prevent unwanted skin burns apply electrocautery electrodes as far as possible from all other elec trodes a distance of at least 15 cm 6 in is recom mended 14 MAC 1200 EMC Magnetic and electrical fields are capable of interf
61. ocol Using the cursor keys position the bar cursor on Protocol Select the protocol CSI to send data to a MUSE CV system or select A5 if you will send data to CardioSys CardioSoft Use the cursor keys to position the bar cursor on Modem other and confirm the selection with Choose the modem you use from the list and confirm the selection with b If your modem is not included in the list select other and enter the required modem commands see also Modem Setup in section 5 5 When you have selected a standard modem position the bar cursor on Dial mode and select the appropriate mode Enter the telephone number of the receiving modem and the number to access the public telephone network and terminate the setup with OW 227 492 04 D System Setup 9 10 Direct ECG Transmission Select the 12 Lead Mode and press 9 Press J to display the setup menu for the 12 Lead Mode Use the cursor keys to position the bar cursor on Manual copy to HOST and confirm the selec tion with HOST 9 Press OD to clear the setup menu Use the cursor keys to position the bar cursor on Communication and confirm the selection with Select the same baud rate as at the receiving modem 9600 19200 38400 57600 Selecting the Communication Protocol Using the cursor keys position the bar cursor on Protocol Select the protocol CSI to send data to a MUSE CV system or select A5 if you will
62. odes this will not happen Set the MAC 1200 to 6 Lead Mode when you may have to defibrillate the patient while recording the ECG and disable the anti drift system as this would cause a 2 second signal delay section 9 3 6 Lead Mode If electrodes made of other materials are used disconnect the patient cable from the recorder while the shock is applied Warning Equipment Damage For reasons of patient safety use only the original GE Marquette pa tient cable Before connecting the cable to the device check it for signs of mechanical damage Do not use a damaged cable Patient Hazard Delayed ECG Display Use silver silver chloride electrodes for ECG signal acquisition if the patient may have to be defi brillated Shock Hazard The patient signal input of the recorder is protected against damage resulting from defibrillation shocks Nevertheless extreme care should be exercised when defibrillators are used on a patient connected to other devices while a shock is released During defibrillation do not touch the patient the electrodes or the leadwires Note Observe the safety information of the defibrillator 227 492 04 D System Setup 9 System Setup 9 1 Some Basic Facts e Press amp to display the setup menu The setup menu with the following options will appear Operating mode 12 Lead 6 Lead Arrhythmia General Settings Communication Patient Data S
63. osition the cursor on All stored ECGs Send l Figure 5 10 to transmit only one ECG position the cursor on the Send command of that ECG e g 3 Figure 5 10 Confirm the command with o The transmission is first initialized Figure 5 11 then it starts Figure 5 12 227 492 04 D ECG Transmission Recording in 12 Lead Mode CSI Figure 5 12 Display during ECG transfer Try again Modify settings Cancel Figure 5 13 Error message 227 492 04 D ENTER SETUP START STOP After the transmission a message on the display indicates the number of successfully transmitted ECGs As soon as you acknowledge the message with the 12 Lead Mode acquisition screen appears If it is not possible to transmit the ECG wrong modem setup modem off the unit will display an error message such as Transmission error CSD Figure 5 13 In this situation you have the following choices you can repeat the transmission with e setup you can change the settings with youcan stop the transmission with QQ 5 5 4 Direct Transmission of Data to a MUSE CV System Before sending data to the MUSE CV system the MAC 1200 automatically logs on to MUSE Then the data will be transmitted If the transmission is stopped the MAC 1200 may take a few seconds before canceling the connection because it has to log off the MUSE system first Then the standard display reappears MAC 1200 35
64. paper compartment and removed jammed sheet place beginning of paper between the marks close paper compartment and press 227 492 04 D Troubleshooting Figure 12 1 Regular AC line interference Note In the presence of very strong AC line interference in all leads the thermal printhead may interrupt the recording Activate the AC line filter 60 Hz in these situations Figure 12 2 Irregular AC interference 227 492 04 D MAC 1200 61 Technical Specifications 13 Technical Specifications Recording Direct recording of waveforms and alphanumeric characters with rectangular coordinates by means of thermal array printhead printing on thermosen sitive paper e 3 or 6 recording channels or 12 in 12 Lead Mode overlapping baseline pitch 3 channels 62 mm arrhythmia 6 channels 31 mm 6 Lead 12 channels 16 mm 12 Lead e writing width 200 mm max annotation of recorder settings date time and entered patient name in the margin of the re cording strip with appropriate software documentation of analysis results in the respective operating mode resolution of the recording vertical 8 dots mm horizontal 25 um at 25 mm s Printer paper HELLIGE CONTRAST Z fold pad 150 pages per pad equivalent to a chart length of approx 45 m paper width 8 5 inch sheet length 11 inch To prevent damage to the printhead use only the original HELLIGE CONTRASTO paper or the GE Marq
65. position the report format is 4x2 5R1 i e 12 leads and all data are printed on one page configurable the Detailed results page including the median complexes and the ST measurement results is not printed configurable pressing qm will print one copy of the ECG configurable units with MEMO option documented ECGs are not automatically saved configurable units with MEMO option after transmission to a host system via the RS232 interface the ECGs remain stored in the MAC 1200 memory config urable the Override Function is enabled configurable QTC is calculated with the Bazett formula only with option MEAS measurement or DIAG interpretation All relevant device settings are shown on the display Figure 5 1 The display shows 3 leads at a time With you can successively display all leads of the report sequence in groups of 3 The recording can be stopped with QQ For a description of the different reports refer to section 5 4 The Report Formats 28 MAC 1200 227 492 04 D Recording in 12 Lead Mode Note When the unit runs out of paper while printing all stored ECGs menu item All stored ECGs Print press dI AQ after inserting a new paper pad Then print the remaining ECGs successively or restart a printout of all recordings All stored ECGs Print Print Send Delete Delete transmitted ECG ECG Recording of Walker John Os ri
66. rience The checks can be carried out by GE Marquette within the framework of a service contract The inspections include the following checks e Visually inspect the device and the accessories for signs of mechanical damage that may impair the device functions e Check that the device labeling relevant for safety is legible e Runa performance test as described in the operator s manual Measure the resistance of the protective earth conductor and the equivalent leakage current per your national regulations The device does not require any other maintenance Disposal at the End of Its Service Life Note At the end of their service life the device described in this manual and its accessories must be disposed of in compliance with the applicable local waste control regulations If you have questions regarding the disposal of the product or of accessories please contact GE Marquette or its representatives MAC 1200 59 12 Troubleshooting Troubleshooting Symptom Periodic superimposition of AC line interference 60 Hz Figure 12 1 Superimposition of irregular AC line interference Figure 12 2 The printed date and time are incorrect The green standby indicator 23 does not light up although the recorder is connected to the power line interference from the power line Muscle artifact caused by patient movements hiccup coughing Built in lithium battery is depleted The battery has a lif
67. s not intended to be used during patient transport Equipped with the standard software the MAC 1200 supports the following operating modes 12 Lead Mode acquisition of 12 leads of ECG for a period of 10 seconds 6 Lead Mode real time recording of 6 ECG leads and Arrhythmia Mode continuous ECG analysis for arrhythmias The graphics display shows 3 leads at a time 227 492 04 D Resting ECGs can be transferred to the MUSE CV Information System via the RS232 interface The device operates from both AC and DC re chargeable batteries power sources The unit s performance features can be upgraded with the following optional programs MEAS measurement measurement of the 10 second resting ECG DIAG interpretation interpretation of the 10 second resting ECG MEMO memory storage of a maximum of 40 10 second resting ECGs C100 activates the three options MEAS DIAG MEMO for a maximum of 100 ECGs C500 activates the three options MEAS DIAG MEMO for a maximum of 500 ECGs EVAL activates the three options MEAS DIAG MEMO for a period of 4 weeks The MAC 1200 resting ECG analysis system has a setup menu to customize the system parameters Patient and user data can be entered for reliable and safe archiving of patient records The patient name is annotated on each printed report page All other data is printed on request Figure 1 1 MAC 1200 MAC 1200 9 Contro
68. send data to CardioSys CardioSoft Use the cursor keys to position the bar cursor on Modem none and confirm the selection with 227 492 04 D MAC 1200 55 Loading Chart Paper Figure 10 3 Guiding the leading paper edge over the guide roller Figure 10 4 Closing the paper compartment door 10 Loading Chart Paper e Switch on the recorder e Pull up the handle of the paper door and fold it out Figure 10 1 Remove the cardboard backing of the previous paper pad Remove the cardboard from the top of the new pad and place the pad including the cardboard backing at the bottom and with the arrow point ing towards the unit into the paper compartment Figure 10 2 e Pull the top sheet out of the compartment and guide it around the guide roller Figure 10 3 Holding the leading edge of the paper in place between the two markers on the recorder close the paper door Figure 10 4 Ensure that it locks into place on both sides When inserting an already started Z fold pad the grid side must face up and the first fold must point towards the paper compartment 56 MAC 1200 227 492 04 D Loading Chart Paper Note Having inserted a new paper pad be sure to acknowledge the end of paper message with o not with OD When closing the paper door take care that it locks into place on both sides There is a window in the paper door that allows you to look inside the compartment
69. side the patient environment If the PC fulfills the re quirements of EN 60950 it must be set up within the medically used area but outside the patient environment Do not connect PCs to the resting ECG analysis system that fulfill neither EN 60601 nor EN 60950 Modems connected to the resting ECG analysis system must meet the requirements of EN 60950 or UL1950 all modems recommended by Marquette Hellige meet these requirements The specific regulations valid in your country must also be observed The modem must be set up within the medically used area but outside the patient environment 227 492 04 D 3 6 Connecting External Devices Via the serial interface the resting ECG analysis system can be connected to a MUSE CV Informa tion System These external devices can be connected directly or via a modem Please contact GE Marquette Application Support for details Resting ECGs acquired in the 12 Lead Mode as well as the corresponding data can be transferred to these external devices see section 5 5 ECG Transmis sion The table below shows the system defaults and all possible adjustments For instructions on changing the default setup refer to section 9 6 Communication Parameter System defaults Options Choices for Modem Other none user defined MultiTech 19 32 MultiTech 56 6 Elsa 28 8 Elsa 33 6 Elsa 56 6 Choices for Modem user defined AT amp FMO amp DO amp QIVO ATDT 4 ATH
70. st ECG the receive data mode is automatically disabled The mode is also disabled when you select another operating mode The following information is annotated in the bottom line of each report the sender the software version and analysis program version used at the sending unit e g ACQ DEV M1200 V5 1M12i 12SL V1 13 227 492 04 D Recording in 12 Lead Mode 5 5 6 Cart to Cart Communication Via modem ECG data can be transmitted between two MAC 1200 units or between a MAC 1200 and any ECG recorder using the CSI protocol see sections 5 5 1 and 5 5 2 5 5 7 Modem Setup for Modem gt other If you prefer to use another modem than the standard models listed in the setup menu MultiTech Elsa you will have to enter a few parameters required for communication between the MAC 1200 and the modem For the AT commands which your modem under stands please refer to the modem user instructions Three command sequences have to be entered in all each of which defines a specific modem operating state 1 the modem is initialized init string 2 a communication link is established dial string 3 the communication is terminated hangup string These three strings are entered in the modem setup menu see section 3 6 Connecting External Devices The example below shows the command strings for the MultiTech ZDX modem 1 AT Command for Modem Initialization AT prefix that precedes every command line
71. ter pacing pulse identification automatic or manual sensitiv ity adjustment automatic baseline adjustment and drift compensation by means of the anti drift system A D S can be enabled or disabled simultaneously for all channels digital output of processed signals via thermal array printhead low cut off frequency 3 db limits 0 08 Hz equivalent to a time constant of 2 04 s high cut off frequency 3 dB limits operating mode 12 Lead 6 Lead 150 Hz IEC AHA operating mode Arrhy 100 Hz IEC e signal sampling rate 1000 s e resolution referred to the input 5 uV 64 MAC 1200 e output rate to recorder 2000 s e for all leads gain adjustment in four steps 40 20 10 5 mm mV with active muscle filter low pass characteris tic 3 dB drop of the amplitude frequency response at approx 40 or 20 Hz e with active AC line filter detection and compensation of periodic 50 or 60 Hz fre quency components depending on recorder model attenuation gt 40 dB non linear distortion below values specified in IEC and AHA recommendations coincidence error limits between any two channels 0 5 mm e detection of pacer pulses in V2 or other V leads and marking in all channels for signals referred to patient input duration 2 0 1 ms amplitude 5 mV noise in the signal transmission path below values specified in IEC and AHA requirements lt 2 5 uV rms e common mode rejection for 50 or 60 Hz signals depending
72. tered here will be printed on each report page Cart Enter any number between 1 and 9999 to identify the cart local system The cart entered here is the default number that appears in Patient Data Default 1 Site Enter any number between 1 and 255 to identify the MUSE CV Information System to which the ECGs will be sent The site entered here is the default number that appears in Patient Data Default 1 Location Enter any number between 1 and 600 to identify the location of the sending system The location entered here is the default number that appears in Patient Data Default 1 Date Time Enter date and time enter 4 digits for the year Lead fail beep Indicates when electrodes are not properly applied or disconnected yes no 227 492 04 D High HR beep An audible signal sounds when the heart rate exceeds a limit value yes no only in 6 Lead and Arrhythmia Modes The limit value 220 age can be changed manually Lead labels AAMI codes RA LA RL LL V1 to V6 or IEC codes R L F N CI to C6 Date Format month day year or day month year Time Time format 12 hours am pm or 24 hours Units Units of measurement for the patient s height and weight in Ib or cm kg Mains AC line frequency USA 60 Hz Europe 50 Hz LCD light off after If operating controls are not activated within the selected period of time the display backlighting au
73. the selection with The option code menu appears There is a choice of 6 options MEAS measurement of the 10 second resting ECG DIAG measurement and interpretation of the 10 second resting ECG MEMO program for storage of up to 40 resting ECGs C100 activates the three options MEAS DIAG MEMO for a maximum of 100 ECGs C500 activates the three options MEAS DIAG MEMO for a maximum of 500 ECGs EVAL activates the three options MEAS DIAG MEMO for a maximum of 4 weeks Position the bar cursor on the option you wish to activate Enter the 12 digit code number from the keyboard and confirm the entry with amp The unit will accept the entered number only if it corresponds to the unit s serial number The serial number is indicated at the top of the menu Ser No xxxxxxxxx This number must be the same as printed on the nameplate back of the device When you enter the code number for DIAG and MEMO the fields for C100 C500 and EVAL will disappear e Exit the menu with QQ 54 MAC 1200 9 9 ECG Transmission via Modem Select the 12 Lead Mode and press 9 Press D to display the setup menu for the 12 Lead Mode Use the cursor keys to position the bar cursor on Manual copy to HOST and confirm the selec tion with Hos 9 Press OD to clear the setup menu Use the cursor keys to position the bar cursor on Communication and confirm the selection with Selecting the Communication Prot
74. then A enter in the same manner pu 227 492 04 D MAC 1200 Index 1 12 Lead mode brief operating instructions 12 Lead mode system defaults 12 Lead mode system setup 12SL interpretation configuration 6 6 Lead mode brief operating instructions 6 Lead mode system defaults 6 Lead mode system setup A AC line frequency AC line interference Activating options Aging stability recordings Anti drift system Arrhythmia codes Arrhythmia mode Arrhythmia mode brief operating instructions Arrhythmia mode system defaults Arrhythmia mode system setup Arrhythmia recording Automatic baseline adjustment B Battery charging Baud rate Birthdate enter Brief operating instructions 12 Lead mode Brief operating instructions 6 Lead mode Brief operating instructions arrhythmia mode C Cart number enter Cart to cart communication Caution definition Cleaning Connecting external equipment Contrast adjustment Controls overview Cubic spline Danger definition Date Detailed results Disinfection Display backlighting Disposal of the device 68 Index E 38 ECG recording during defibrillation 26 ECG transmission modem 47 ECG transmission to MUSE CV system 48 ECG transmission via modem ECGs receive Electrode placement End of paper while printing 41 End of writer paper 39 Entering patient data 49 Environment operation Environment storage and transport Event episo
75. tient data can be entered E We recommend to enter the patient s name to annotate it on every report After applying the electrodes please wait about 10 seconds for the signal to stabilize stabiliza tion of polarization voltages see section 4 3 Artifact Due to Poor Electrode Application If you initiate a recording with OLT immedi ately after selection of the 12 Lead Mode a waiting period of 10 to 12 seconds ensues mes sage Collecting data RL right leg electrode disconnected Before initiating a recording check the display RA right arm electrode disconnected for error messages see table at left Check all FAS A anm electrode disconnected electrodes if the message persists there must be LL leftleg electrode disconnected VI chest electrode V1 disconnected V2 chest electrode V2 disconnected V3 chest electrode V3 disconnected V4 chest electrode V4 disconnected V5 chest electrode V5 disconnected V6 chest electrode V6 disconnected a break in the patient cable Replace the cable with a new one The MAC 1200 continuously saves 10 seconds of the incoming ECG signal The device can be set up to allow a recording only when specific patient data have been entered last name first name ID 2M ID section 9 7 Messages indicating disconnected electrodes RS Patient Data When you initiate a recording with oq the unit prints the most recent 10 seconds of ECG
76. tion of muscle artifact and AC line interfer ence Default muscle filter No AC line filter Yes Filter frequency Cut off frequency of the muscle filter 40 Hz 20 Hz The frequency range is indicated in the lower margin of the recording strip 0 08 40 Hz 40 Hz muscle filter enabled 0 08 20 Hz 20 Hz muscle filter enabled 0 08 150 Hz muscle filter off Anti drift system ADS cubic spline In case of wandering baselines the anti drift system restores the baseline to its original position signal delay with ADS approx 2 s Default No Start at queue mark Before each recording the recorder advances the paper to the beginning of a new page yes no MAC 1200 49 System Setup 9 4 Arrhythmia Mode Use the cursor keys to position the bar cursor on Arrhythmia and confirm the selection with The arrhythmia mode menu will appear Report sequence STD_C V1 V2 V3 V4 V5 V6 STD_RED I I M V2 V4 V6 STD_LI I II III aVR aVL aVF CABR LI aVL I aVR I aVF III HIGH C VI V2 V3 V4 V5 VO C chest leads RED reduced number of leads LI limb leads Gain auto 5 10 20 40 mm mV with auto the unit will automatically determine the gain setting Muscle filter AC line filter Elimination of muscle artifact and AC line interfer ence Default muscle filter No AC line filter Yes Filter frequency Cut off frequency of th
77. tomatically switches off system default 5 min adjustment range to 99 min Default mode This is the operating mode the unit defaults to after power up 12 Lead 6 Lead Arrhythmia Language Select the language for user interface and printouts MAC 1200 51 System Setup Enable password protection Select yes to protect the setup menu with a password You will be asked to enter a password and to repeat it The password protection is then active To change the password only possible when password protection is active select menu item Enable password enter the old password enter the new password repeat the new password Test DATA Used for demonstration purposes yes It must be set to no for proper clinical use Restore defaults Selecting Yes will restore the default setup including the defaults of the three operating modes The resting ECG analysis system must be switched off standby and on again for the new settings to become effective Print Setup Lists Selecting yes will display a menu with all available setup lists alllists System Setup Communication External Devices Patient Data Setup 12 Lead 6 Lead Arrhythmia The master password overriding all other passwords is 9 6 Communication Protocol The recorder offers two communication protocols CSI Client Server Interface and A5 The CSI protocol supports the transfer of r
78. ts circuit boards cables software etc and manuals from Supplies GE Marquette Supplies 2607 North Grandview Blvd Mail Code SN 471 Waukesha WI 53188 Telephone 800 558 5102 U S only 414 521 6856 outside U S Fax 800 232 2599 U S only 414 521 6855 outside U S Service parts GE Marquette Service Parts P O Box 9100 100 Marquette Drive Jupiter FL 33468 9100 Telephone 800 321 3251 U S only 561 575 5000 outside U S Fax 800 421 6841 U S only 561 575 5050 outside U S Have the following information handy before calling B part number of the defective part or E model and serial number of the equipment E part number name of the assembly where the item is used E item name and M where applicable reference designation eg R13 S12 Ordering Manuals When ordering additional operator manuals be sure to include the software version of the product 4 MAC 1200 227 492 04 D Other Questions or 227 492 04 D How To Reach Us Problems Headquarters Europe Australia Japan Hong Kong For additional information contact one of the offices listed below GE Marquette Medical Systems Inc 8200 West Tower Avenue Milwaukee Wisconsin 53223 USA Telephone 414 355 5000 800 558 5120 U S only Fax 414 355 3790 GE Marquette Hellige GmbH Postfach 60 02 65 D 79032 Freiburg Germany Telephone 49 761 4543 0 Fax 49 761 4543 233 Marquette Medical Systems Australia Pty Ltd
79. ts the 12 Lead Mode Selects the 6 Lead Mode Selects the Arrhythmia Mode Starts stops the selected operating mode exits the setup menu and patient data entry Indicators green selected mode started amber selected mode stopped Enables entry of patient data Indicator is illuminated when battery needs to be charged Indicator is illuminated when unit is connected to the power line Cursor control keys Space bar Shift key Press to access special characters Start Stop Preparations for ECG Recording 3 Putting the Device into Operation and Performance Test 3 1 Safety Information e This manual is an integral part of the device It should always be kept near the device Close observance of the information given in the man ual is a prerequisite for proper device perform ance and correct operation and ensures patient and operator safety Please note that informa tion pertinent to several chapters is given only once Therefore carefully read the manual once in its entirety e Patient safety the specified measuring accuracy and interference free operation can be guaranteed only if original GE Marquette components are used The user is responsible for application of accessories from other manufacturers This manual is in conformity with the device specifications and standards on safety of electro medical equipment valid at the time of printing All rights are reserved for devices circuits tech niques soft
80. uette thermal paper with queue holes or marks 62 MAC 1200 Paper transport e paper speed 5 25 50 mm s key selectable error limits at 25 and 50 mm s typ 1 at 5 mm s 10 max e At paper end the recorder emits an audio signal and stops recording the last pages of the pad bear a colored stripe in the lower margin Membrane keypad Pushbuttons with tactile feedback e function keys for all routine operations e alphanumeric keyboard for entry of text Display graphics display with 24 x 40 characters contrast adjustment resolution of 320 x 240 pixels with display backlighting Indicators LEDs For mains power battery status and start stop function Automatic functions They assist and facilitate operation by automatic control of lead selection paper feed calibration configurable report formatting configurable automatic baseline adjustment e anti drift system cubic spline compensating for polarization voltage fluctuations configur able 227 492 04 D Technical Specifications Detection of pacer pulses e pulse length between 0 1 and 2 5 ms pacer pulse marker independent of pulse polarity e pulse amplitude between 5 mV and 700 mV Heart rate indication derivation of the heart rate from all ECG signals display range between 30 and 300 bpm display update with every heart beat maximum every 2 seconds Signal inputs isolated patient signal input IEC type CF high vo
81. ve components may also be found in recycled papers solvents or solvent based products containing alcohols ketones esters or other substances from this chemical group We recommend archiving ECG recordings on our ECG filing cards only P N 217 043 03 If longer storage periods are required we suggest using our ARCHIVIST 30 chart paper image legibility up to 30 years or other image storage technologies A stripe marks the last 10 pages of the Z fold pad MAC 1200 57 Cleaning Disinfection and Maintenance 11 Cleaning Disinfection and Maintenance 11 1 Cleaning and Disinfecting the Recorder Housing Warning Before cleaning or disinfecting the device discon nect it from the power line Clean the recorder housing with a moist cloth Do not let liquid enter the device All cleaning agents and disinfectants that contain alcohol and are commonly used in hospitals are suitable but do not use disinfectants on a phenol base or peroxide compounds 11 2 Cleaning and Disinfecting the 58 Patient Cable Disconnect the cable from the recorder before cleaning or disinfecting it When disconnecting the cable be sure to pull on the connector not on the cable Clean the cable by rubbing it down with a cloth moistened with soap water Use a disinfectant for disinfection Do not immerse the cable in liquid 11 3 Cleaning and Disinfecting the Electrodes In addition to the information given in this m
82. ware programs and names appearing in this manual Caution indicates a potentially hazardous situation which if not avoided may result in minor or moderate injury or product property damage GE Marquette is responsible for the effects on safety reliability and performance of the device only if assembly operations extensions readjust ments modifications or repairs are carried out by persons authorized by GE Marquette the electrical installation of the relevant room complies with the requirements of the appro priate regulations and the device is used in accordance with the instructions for use The safety statements presented in this chapter refer to the equipment in general and in most cases apply to all aspects of the device There are additional safety statements in the other chapters which are e The terms danger warning and caution are used specific to the topic described The order in which throughout this manual to point out hazards and safety statements are presented in no way implies to designate a degree or level of seriousness order of importance Hazard is defined as a source of potential injury to a person DANGERS EXPLOSION HAZARD Do not use this Danger equipment in the presence of flammable anesthetics indicates an imminently hazardous situation which vapors or liquids if not avoided WILL result in death or serious in jury Warning indicates a potentially

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