STG16 User Manual - 2004 Stethographics, Inc.
Contents
1. 16 Channel STG User Manual Table of contents TGC ALOIS hai heteearcatates Tecee steeds O E O seria EE T spss terse tre EE A E E EE EE A E serve AA EE E A E PEC O E T saeco tuer vee ae material TNSUUCHONS TORS Canteen ducaceecedanduenssbseseasean denn T E dia KOOUDAIICONS a iicateathdaireeusestian tyes eda teatnacad ee uuans iste des ee tendearad ee temanctsied es eile tnalearadaecemsntiiedeau 2 Basic Operans IMS UUCHT E ena aedaunmees UN E E AE E o E E AE AA N E E AN E ANAA TT IEEE EEN 22 HOw Towpply Back Padon a Patient sar Aa 22 HOW LO VESU INITCTO POI CS saps serst a TE Dea TAO W To Andy Ze eT AGA ania eaca a teretis aera desiree E oeeccnutaetia aaa 29 Wavclorm Display Dasic TUNCHONS scssi tera a bsandera guacv A EAA EET 2 6 Christmas tre display Dasic functions jisvicetoiddianvetcalaciadina ei a E cuatiodeciann 2 7 Summary RMS Summary and Localization screens basic functions cece ceeeeee cece eeeeeees 2 8 Spectrogram screen Dasic TUNCHONS ceon e e A E e ea Deo VAM Dilden T reek shaptaaeencetatiaies Mica meonlanGsbanancaicntons 3 TOU DICSNOO MN aN G Cais i osanede teeta oan a at ue ned ero ant ete eeaanaoad Stethographics Inc Westborough MA 01581 Indications The Stethographics 16 channel Stethograph hereafter referred to as STG16 is intended for recording audio reproduction graphic display printing and storage of sounds It is also intended for automated identification of lung sounds2. At the time of publication the STG16 is available for research and educational purposes only Caution e This manual provides instructions for use and troubleshooting of the STG16 Stethographics Inc cannot be responsible for the performance of the STG16 if the user does not operate the system in accordance with provided instructions This manual should be read thoroughly understood and accessible to all personnel who will be operating and using the STG16 e Sounds are to be recorded using an approved electronic stethoscopes e Use of system for recording is not recommended in conditions where a stethoscope would not be used e The STG16 is intended for automated identification of lung sounds It provides objective evidence that can aid in clinical decision making Some care of course is necessary in proper recording under the supervision of a physician to be sure that artifacts are not introduced e Use the STG16 in a quiet room e Heart and lung sounds are low frequency sounds Playback sound quality can be improved by using headphones or amplified speakers with a good frequency response down to 20 Hz e Heart sound analysis is for educational use only e Itis strongly recommended that the users of the STG16 software use computing and networking security features to protect patient data created and stored using this software Please consult your institution s data management or computer technical service personnel to implement appropria
3. ar Move the lopped interval with the scroll bar Page Up Page Down buttons or rotate the wheel on the mouse To filter sound click FIL Double click inside the window to view the window properties Stethographics Inc Westborough MA 01581 2 6 Christmas tree display basic functions 1 On the waveform display indicate the interval of interest by positioning the cursor in the middle of this interval Click to switch to X Tree display On the pop up display choose between waveform and spectrogram and click OK To zoom data vertically click a in the left of the toolbar Click D for default zoom To zoom data horizontally both expanded waveform and the spectrum click E in the right of the A a a toolbar Click for default zoom 6 You can scroll through the data by left clicking anywhere on the screen Click to the left of the center to scroll left click to the right of the center to scroll to the right 7 Double click to view properties 2 7 Summary RMS Summary and Localization screens basic functions 1 To play data back click button with the channel number on the left of the screen Click W to stop play back 2 Toggle View gt Show Total to hide view numerical information 3 Double click to view properties 2 8 Spectrogram screen basic functions 1 Choose number of channels and channels to view on the Spectrogram properties screen under View menu 2 To play data back click button with the channel number o
4. n the left of the screen Click W to stop play back 3 To zoom data vertically i e over frequency axes click in the left of the toolbar Click for default zoom 4 To change spectrogram sensitivity click in the right of the toolbar Click D for default sensitivity 5 Double click to view properties 2 9 Saving Data The data is saved on the drive F in the Data folder The folder with the patient name and date tag contains subfolders corresponding to each protocol These subfolders have time tag Each subfolder contains 16 wave files corresponding to 16 channels and one text file with patient information 2 10 Standard Recording Protocol We suggest that patient are instructed to perform the following breathing maneuvers in the order below We also suggest that full 20 seconds of data is recorded with each maneuver P1 Normal breathing P2 Deeper than normal breathing P3 Cough then deeper than normal P4 Whisper e e e Stethographics Inc Westborough MA 01581 P5 Forced Vital Capacity Maneuver x 2 P6 Deeper than normal breathing 3 Troubleshooting Guide Symptom Possible Cause Suggested Solution STG16 computer Problem with program Problem with Contact Stethographics support program will not computer load Artifacts on Patient is moving Ask patient to remain silent and relax recording Room noise Record in a quiet room Finger noise Hold chest piece firmly Hair noise Moisten hair 4 S
5. n the oY icon to start the STG16 software 2 Click 8 and click OK on the pop up window to open the driver 3 Click and fill in the patient s information 4 Click to start recording sounds On the pop up window review patient information choose the protocol and click OK 5 Optional To define breaths at bedside use up and down arrows on keyboard up arrow start of inspiration and down arrow start of expiration while recording 6 Press letter S on keyboard when optimal tracing has been obtained This action will automatically stop recording amp save it The 20 seconds of data that you see on the screen will be saved on the F drive in the Data folder with the time tag 7 Click to proceed with as many protocols as necessary Tips 1 For better quality recording turn both headphone volume knobs to zero on the preamplifier 2 To record lung sounds from the front apply back pad to the front as shown on the figure below you will have to attach microphone 8 to the back pad first 2 2 How To Test Microphones 1 Attach the chest pieces to the back pad It should be observed that the chest pieces are delicate instruments and will last longer if they are attached to the back pad at all times Do not put pressure on the diaphragm put pressure on the edges instead Connect microphone cables to the conditioning box Start sound recording Test the microphone connections by gently touching diaphragm
6. oise in the recording 2 4 How To Analyze the Data l Aaa Click PP to start inspiration definition e Drag mouse with the left button depressed from the beginning of inspiration to the end of inspiration e Release left button green horizontal square appears on the screen e Drag mouse with the left button depressed from the beginning of expiration to the end of expiration e Release left button blue horizontal square appears on the screen e Repeat for all breathes you want to include into analysis Click to finish inspiration and expiration definition Click OK to save the inspiration expiration definition Click to analyze data Click amp to print summary sheet 2 5 Waveform Display basic functions 1 To open a data file click E locate the file and double click on any of the w wav files oe a OO To zoom data vertically click E in the left of the toolbar Click for default zoom To zoom data horizontally click E in the right of the toolbar Click D for default zoom Scroll through data with the scroll bar Page Up Page Down buttons or rotate the mouse wheel To play data back click button with the channel number on the left of the screen Click W to stop play back The play back is looped when the amp is checked To check the loop button click it once To uncheck it click it again You can change the duration of sound being looped by clicking on the time axes zoom buttons at the right of the toolb
7. orm Display amplitude of sound as function of time Open Recording Information Dialog box Hz Switch to Spectrogram Display Show spectrogram of up to 8 channels simultaneously ft Switch to Christmas Tree Display Show Waveforms or Spectrum superimposed on body plot Switch to Summary Display Show analyzed and summarized data with patient information Ri Switch to RMS Summary Display Show RMS summary and histogram L Switch to Localization Display Show sound localization 3D Switch to 3D Display Allows viewing sound localization on a 3D model Show statistics of all identified crackles and squawks by channels Cr Show printable crackle statistics Ex Show crackles statistics for copying to Excel Start inspiration and expiration definition Finish inspiration and expiration definition Analyze heart sounds f Analyze lung sounds Save analysis on heard drive in tab delimited format 4 Toggle play sound in a loop E Stop playback and recording FIL Filter sound Amplify All Channels 3 Times Some Data Can be Lost Reduce All Channels 3 Times Some Data Can be Lost Amplify Tracheal Signal Some Data Can Be Lost Reduce Tracheal Signal Some Data Can be Lost amp Print screen P Help Ca Expand signal horizontally 4 Collapse signal horizontally D Default horizontal zoom Stethographics Inc Westborough MA 01581 2 Basic Operating Instructions 2 1 Recording Steps 1 Double click o
8. s through 8 and 9 through 16 while monitoring their responses on the computer screen 2 3 How To Apply Back Pad on a Patient l 2 Ask the patient to wear a gown Adjust the stretcher if needed to a more comfortable angle 30 degrees It should be noted that the stretcher in flat position produces least amount of noise If you prefer to use a reclining chare use the plastic one Make sure that it does not produce any sound when patient sits on it Pay special attention to vital capacity maneuver Place infection control barrier wrap over patient s back skin to wrap to microphone provides best transmission Stethographics Inc Westborough MA 01581 ee eo Place microphone back pad on patients back with top two microphones approximately 3 fingers width below C7 and bottom 6 microphones near estimated lung bases Be sure that all microphones have good contact with patient s chest wall Help the patient lie down on the back pad Readyjust the back pad if necessary remembering that the back pad is covering the area of the lungs not the diaphragm Use extra pillows on the sides to secure side microphone attachments if necessary Position chest piece 8 on the skin above the heart to monitor heart sounds Position chest piece 16 on the side of the wind pipe to monitor tracheal sound Instruct patient not to move at all and not to talk Be sure that you have preempted any possible room noise to avoid extraneous n
9. te security measures The user assumes all risks responsibilities and liabilities when user identification and password protection features are bypassed disabled or ignored e Because national state provincial and local laws regulate the data privacy of patients these laws may restrict or prohibit the transmission of files that contain the individually identifiable health information of patients The user may also modify of edit this filename if desired We strongly recommend that the software user contact their institutional privacy officer or authority to understand the applicable laws and regulations before transmitting sound files with patient information e tis the responsibility of the clinician to assure that all recordings correspond to the appropriate patient data Specification Recording frequency range 20Hz to 2000Hz Sampling frequency 8 000 Hz Standard wav PCM files at resolution of 16 Bit Mono Recording time 20 seconds 2 Stethographics Inc Westborough MA 01581 Instructions for Use 1 Toolbar icons Qa DA e Gd ae tt Hz ftl Ae Le 3D i cr Ex PPS HY Al G S Fi oS oH GS PL Qe D Left to Right Si Expand signal vertically 4 Collapse signal vertically D Default vertical zoom All Display all recorded sound at default vertical and horizontal zoom if Open the driver to record sound Start Recording ll Save the data in to the default directory Open file 2 Switch to Wavef
10. upport If you have any questions or require any technical assistance e mail us at support stethographics com Stethographics Inc Westborough MA 01581
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