Home

GEMS - Surgo Surgical Supply

1. Pan RU a rd cov rct UR 13 BACKUPS c 14 Installing GEMS Elle detached op Md E MISSAM a 15 Finding your way around GEMS Life receta coupe ha een 19 mime RCM 20 GEMS LNE OPIONS dos oa a 21 Searching and Deleting ReCOLGS c oae ied 23 semis EME Schedule lest un euius 25 Arrhythmia Management Event Monitoring 27 Add New Patient or PNY SICIAN oss qiii io Raderus SER MIS a aan Male Fra dan Bg do Cro thane aerate 28 RECEIVE ECG e 30 Review ahd 0 TP 32 aae Se eee outta ne een ee eee ee pu Un ee eee eee 35 Transtelephonic Pacemaker ECG 37 FANG eee nine ere 39 ECG PEE 41 Review and Edlb EG 9 siio etes 43 Generate COON salt 45 12 Cead ECG
2. Eee EOD ET To DELETE 46 Ada NEW Paten A 47 Receive ECG uroon 49 IReviIewanddiblse ML D E 51 5enelate TEDOLL aspi uL M ee RENE 53 amp TOONS etr 54 DIS DIAY TOONS eX c 55 Recording M 62 P d T 63 REVIEWING ECG sso abita ema eid amd dde tu uuo hut 64 2 tT H 66 67 Beat Compex 68 TEXLCOMMEN cu mL 70 Editing os mE 72 MFOUDICSMOO UNG eec 73 General TMOUDIESMOOUAG RE ERE 14 A certain hardware problem that prevents ECG reCording cccccsecccceeececeeeeceeeeeceecesseeeeeseecesseeessueesaneeessaees 75 Manual Revision Date 29 Nov 04 GEMS Lite 8 T
3. Le i C A30 Phi 6 21 0 Arrhythmia ECG Brayen Bobby Not Edited 1 Receiving 2 Editing 3 Options Date Time 01 2000 09 30 23 Receiving Tech KR 3 3 Select a Description for the ECG ee 3 4 Select Symptoms Activity and Location Symptoms Dizziness items based on patient s description Activity Location mm Patient Cancel Apply 3 5 view or change the patient record click Patient 3 6 Click OK gt ECG Viewer opens in new window GEMS Lite C Program Files GEMS GEMS Lite mdb Sele New Arrhythmia ECG Appleby Sarah PES One Strip Y fi 25 mms 10 mminv None gt 40 Hz 1 gt ulo el e 3 7 Click Start Recording Patient Appleb zum Date gus um Time 32210 PM panei Rate 100sps ensure all FSKs are recorded be sure to click Start Recording before the patient starts sending the ECG from their device RECORDING gt Recording indicator appears Recording i GEMS Lite Manual Revision Date 29 Nov 04 Receive ECG 31 GEMS Lite C Program Files GEMS GEMS Lite mdb 3 8 Ask patient to begin sending ECG w New Arrhythmia ECG Appleby Sarah mx ECG is displayed
4. ensure all FSKs are recorded sure to click Start Recording before the patient starts sending the ECG from their device aVR v4 is Recording Ifthe ECG waveform does not look correct select the Configure Device button to change the driver for the 12 lead device from the Demodulator drop down list requency Demodulator a Relative Power Drag the triangle the threshold gt Recording indicator appears OHz 4000 Hz Demodulator King Df Hearts Invert Signal Eraemar ERGO a Braemar ER 00 Pacetrak Pacetrak Plus Heart Aide EZD Heart Aide EZ EZ PI King of Hearts 3000E 7 PWR Apply Manual Revision Date 29 Nov 04 GEMS Lite 50 12 Lead ECG Monitoring 3 4 Ask patient to begin sending ECG gt ECG is displayed as it comes in mi New Arrhythmia ECG Milliken Tracy Sa File Report Tools Help 12 Lead m fi 25 to mimm None 40 Hz 1 gt g A 20000 3 9 When the patient 5 ECG recording has Patient Milliken Tracy Date 1211 2002 Time 9 45 23 PM Duration 00 00 12 Sampling Rate 100sps Recording Recording 30 Arrhythmia ECG Milliken Tracy Not Edited TER Fie Report Tools Help 12 Lead ommmv None 4Hz 1 E T lt E Patient Milliken Tracy Date 12 11 2002 Time 11 50 08 AM Duratich 00 00 07 Sampli
5. minim none H 1 none BOHz notch A high pass filter removes slowly varying low frequency components of the signal which usually corrects problems with signal drift slow variation in the signal baseline The cutoff frequency determines what frequencies are considered slowly varying low frequency and hence how much of the signal is removed The lower the cutoff frequency the less of the original signal is removed It is best to use the lowest cutoff frequency that corrects the problem on screen 30 Hz Suppresses variations in the signal above 30 Hz WARNING This setting may distort import features of the genuine ECG morphology 40 Hz Suppresses variations in the signal above 40 Hz WARNING This setting may distort import features of the genuine ECG morphology 50 Hz Notch Suppresses components of the signal between 49 and 51 Hz 60 Hz Notch Suppresses components of the signal between 59 and 61 Hz Manual Rev 1 0 29 Nov 2004 Display tools 61 8 Guide to information displays miscellaneous controls ECG Viewer 8 1 Sampling Rate gt Number of samples per second taken when ECG was digitized 8 2 ECG Duration gt Length of ECG in minutes and seconds 8 3 ECG Recording Time gt Time of day ECG was recorded 8 4 ECG Recording Date Mew hath ECG Braven Bobby Seg gt Date ECG was recorded rE sil
6. ___ Association General Practitioner Select Association type Close On OK New Cancel Please note Physician does not print on the 12 Lead Report Click OK Association Physician dialog closes x 1 Demographics 2 Monitoring Information 3 Associations New association appears on Associations tab HEN PE Association Add Delete Change v Close On OK OK Help GEMS Lite Manual Revision Date 29 Nov 04 Receive ECG 49 Receive ECG 3 Receive patient Record transmission File Edit WESA Tools Help Bog fa GEMS Lite Fi Patient N Patient PatientName 5 Name Patien Phone 5 Appleby 2 ArrhyEhmia 12 Lead ECG 3 1 S el e ct P ati ent name fr om th e ati ent list ae Sarah 25234 1 1 Shee 343 5324 Hawel Hol EMEN Pacing ECG md Road Washington Disict 0 345 6345 Milliken Tracy 732 4 6 1964 Female Pacemaker Active 2343 Raven Way Las Vegas Nevada 234 343 5234 Parker Ramly 5523432 3 5 1956 Male Arrhythmia Active Tacoma Washington 32432 United States 345 6345 Salemmy Saxa 75455 3 5 1955 Female 12 Lead Active 6435 Randy Street Jackson Mississippi 53 453 3243 Thopestn Terry 2323423 4 4 1934 Male Arrhythmia Active 5345 Walter Street Salem Massachusetts 343 5323
7. gt Terminate patient call Manual Revision Date 29 Nov 04 GEMS Lite 32 Arrhythmia Management Event Monitoring Review and Edit ECG Ifthe ECG transmission you recorded contains multiple events it is split into separate Event ECGs that are listed as subsidiaries to the recorded Main ECG You should sample and measure each Event ECG not the Main ECG 4 Sample 4 1 With an Event type ECG open Click Sample gt Pointer changes to ad m 4 2 Point at the beginning of desired portion of Ga a aaa 3 ECG trace and click on it fone stip hh 0 ej z T 2 I E gt 8 second sample beginning where you Patient Braven Bobby Date 11 19 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps clicked is created The sampled part of the trace changes colour 8 gt Sample options menu appears 4 3 Choose a sample option ransmitter ID 75003804 4 3 1 To make the sample longer vert 2 Tue Nov 19 14 57 34 2000 click 8sec 16sec 24sec etc SS Sar m i Aictivatio int 16 sec 4 3 2 To place a label on the sample click one of selections to 40 sec have no label click No label Sample ECG Normal Sinus Rhythm Size or label applied accordingly Ventricular Arrhythmia Sinus Tachycardia Sinus Bradycardia Atrial Fi
8. Patient Braven Bobby Date 11 19 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps 4 em i 1 ea 1 E 1 1 zu 4 1 1 4 J 4 1 A ccc cc igi T d E EN Oh GV OSA A E E PED RED SN MEER FE EE 157 HER FEQ NER TY GE SE M ED E Hn lErransmitterib75003304dC6 I Manual vent 2 19 14 57 34 00A Arctivatio lMPreEvent 5 5 PostEvent 10s Flags1 i D 1 TT ou a D CHI v gt 100 00 00 00 4 00 000918 GEMS Lite 66 Using the ECG tools Horizontal calipers 1 Taking a horizontal caliper measurement 11 Click Horizontal Caliper Measurement m 26 Arrhythmia ECG Braven Bobby Not Edited PIE Jone Strip viji 5 homemv EJ P Pointer changes to 1 Patient Braven Bobby Date 11 19 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps 1 2 Point at beginning of measurement 1 3 Click and hold mouse button Hen gt Caliper appears vent 2 Tue Nov 19 14 57 34 2002 Arctivatio 1 4 Drag cursor to end of meas
9. graphics program of your choice SCRAPPY LOCAL i save your logo image to disk in Windows Compress ECGs Metafile wmf format or a Windows Arrhythmia 12 Lead Frequency Demodulator Driver Change Bitmap bmp TTM Pacing Cary All Demodulator Driver Change eader Company Logo Street City State Country ZIP Code Do not display deceased patients Do not display inactive patients _ Cancel On the Options screen click New Open dialog appears m T Look in y Navigate to folder you saved your logo 2 image file in History amp Desktop Click on logo image file S My Documents Comput File name aS Files of type Windows Metafile wmf My Network Open read only Open Cancel Click Open Open dialog closes 1 form appears to enter the name of the Please enter a name for the loga file logo template file that was created Enter Cancel the name of the logo file and click OK Logo image appears in Logo preview area on the Options screen C Program FileslaEMS Lite T emplatessD ema L Logo filename appears in textbox below mm 1 Save Logo preview area on the Options screen Click OK Options form closes GEMS Lite Manual Revision Date 29 Nov 04 Searching and Deleting Records 23 Searching and Delet
10. 25 mmis Ny 10 mmimv None 40 Hz gt EB 3 k Ie TATIN E 8 5 Patient Name Patient Braven Bobby Date 12 10 2002 Time 11 39 43 Duration 00 01 04 Sampling Rate 250sps gt Name of patient whose record this ECG is part of Activation CHI 0 10 50 4 5 00 00 19 68 8 6 Display Begin Time Time in seconds and hundredths from beginning of trace of first point of ECG trace visible in ECG display area 8 7 Scroll Back gt Click back arrow to move display back one page in ECG trace gt A page is the amount of trace that fits in the current width of the ECG display area 8 8 Scroll Forward gt Click forward arrow to move display back one page in ECG trace gt A page is the amount of trace that fits in the current width of the ECG display area 8 9 Display End Time Time in seconds hundredths from beginning of trace of last point of ECG trace visible in display ECG area Manual Rev 1 0 29 Nov 2004 GEMS Lite 62 Using the ECG tools Recording tools 1 Overview of recording tools on the ECG Viewer toolbar See numbered items following for details on these tools 1 1 Abort Recording gt Abandons storage of an incoming ECG signal No new ECG record 1s created in the database 1 2 Stop Recording Finishes storage of an incoming ECG signal into the database Creates a new ECG record
11. H 1 Single Lead One Strip 2 Channels 3 Channels Stacked 12 Lead 12 Lead No Rhythm 12 Lead Lateral 12 Lead Inferior 12 Lead Anterior 12 Lead Septal 12 Lead Posterior 12 Lead Limb 1 12 Lead Limb 2 12 Lead Chest 1 12 Lead Chest 2 5 5 Stacked gt Displays all leads channels in an ECG Each lead 15 shown in a single strip and the strips are stacked vertically above one another in the following order from top to bottom I 4 aVL 7 VI 10 V4 2 5 aVR 8 V2 II V5 3 6 aVF 9 V3 12 V6 gt Asingle lead ECG is displayed in the Lead II strip 2 position 5 6 12 Lead gt Displays all leads channels in a 12 lead ECG Each lead is shown in a single strip and the strips are shown in a 3x4 1 format laid out in the following pattern I Asingle lead selected by the Rhythm Lead control is repeated in the Rhythm Lead strip at the bottom gt Asingle lead ECG is displayed in the Lead II and Rhythm Lead positions GEMS Lite 58 Using the ECG tools Dele 5 10 5 11 12 Lead No Rhythm Displays all leads channels in a 12 lead ECG Each lead is shown in a single strip and the strips are shown in a 3x4 format laid out in the following pattern A single lead ECG is displayed in the Lead II position 12 Lead Lateral Displays 5 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertic
12. 100sps Presenting gt Pointer changes to 5 2 Point at beginning of measurement 5 3 Click and drag pointer to end of Ba measurement gt Caliper appears gt Caliper length and label change with changing position 5 4 Release mouse button gt Measurement units label menu appears 5 5 Choose units or label lt gt ECG Viewer remains in caliper mode until another mode selected Note Vertical Caliper Measurements tool works similarly 5 6 Click Beat Caliper tool 5 7 Move mouse close to a QRS complex and click once A vertical line caliper appears and displays the measurements on screen gt Pointer changes to gt ECG Viewer remains in Beat Caliper mode until another mode selected GEMS Lite Units Rate PR ORS QT iv No label gt 00 00 0918 lt 4 gt 00 00 27 56 RR 78 9 bpm PR 0 196 Sec QRS 0 172 Sec QT 0 432 Sec QTc 0 496 Sec i lii Manual Revision Date 29 Nov 04 Generate report 45 Generate report 6 Create print report 6 2 6 3 6 4 File Tools Help Create I With the ECG viewer window still open select Create from the Report menu 28 TTM ECG Milliken Tracy File Report Tools Help If you have just reviewed the ECG as gt gt 1 A ETINI E d esc ri b e d i t i sa se I e
13. PR alters Wally 235235 2 4 1966 Pacemaker Active 3423 Fancy Street Kansas City Kansas 43 342 6453 Weatherby Wilma 52423 5 6 1934 Female 12 Lead Active 3245 Small Vine Way Baltimore Maryland 532 3454 Y ander Henry 35345 6 3 1964 12 lead Active 345 Yellow Street Washington District of C 234 5345 3 2 Click Arrhythmia 12 Lead ECG from the New Menu TTM Pacing ECGs 2 Lead ECGs Transmit Date Patient Name Recorded Date Status Received Event 1 Channel Manual 12 9 2002 03 19 34 PM Braven Bobby 11 19 2002 02 57 45 PM Not Edited Event 1 Channel Manual 12 9 2002 03 19 34 PM Braven Bobby 11 19 2002 02 53 33 PM Not Edited Main 1 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 12 9 2002 03 24 14 PM Not Edited Joshua Event 3 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 3 25 2002 02 57 01 PM Not Edited Event 3 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 9 25 2002 02 49 52 PM Not Edited Main 12 Lead 12 9 2002 03 26 21 PM Braven Bobby 12 9 2002 03 26 21 PM Not Edited Joshua M lt gt ECG Viewer opens in new window mi New Arrhythmia ECG Milliken Tracy SEE File Report Tools Help 12 Lead v fi 25 mmis 10 mmy none 40 Hz 1 gt mj 0 00 00 Patient Milliken Tracy Date 12 1 2002 Time 9 45 23 PM Duration 00 00 Sampling Rate 100sps 3 3 Click Start Recording
14. 00 01 01 Sampling Rate 100sps gt Pointer changes to 1 3 Click gt Beat complex caliper 15 placed with i markers vertical lines automatically aligned with the following features Lead 25 mm s 1o mmm imm None 1 l l T 2 lt 8 detected in the complex fmei05518AM Puration Sampling Rete p onset of P wave 30 0 bpm 0 180 Sec 5 0 150 Sec 0 340 Sec QTc 0 240 Sec gt PQ boundary gt peak of wave labelled at top of marker gt ST boundary gt end of T wave gt A beat complex measurements bar appears at the top of the ECG display showing gt RR measurement bpm gt interval s gt QRS duration s gt QT interval s n als ae QTc interval s i RR 30 0 bpm PR 0 180 Sec QRS 0 150 Sec QT 0 340 Sec QTc 0 240 Sec Zoomed in view of a beat complex caliper GEMS Lite Manual Rev 1 0 29 Nov 2004 Editing tools 69 2 Locking or unlocking a beat complex caliper 21 2 2 2 3 2 4 Markers a beat caliper be repositioned if and only if it is unlocked Click Point and Click Single Lead mmis mmimv None None 1 k mI F T Patient Able Alfred Date 2003 Apr 15 Time 10 56 18 4M Duration 00 01 01 Samp
15. GEMS Lite Manual Rev 1 0 29 Nov 2004 28 Arrhythmia Management Event Monitoring Add New Patient or Physician Create new patient or physician record New Patient 1 Demographics 2 Monitoring Information 3 Associations Patient ID Status Active 1 1 From the New menu choose Patient or ee c Physician Middle Suffix Birth Date New Patient or Physician dialog opens at sw e 9 Demographics tab Qe Street City v State Y ZIP Code Country v Description Phone Number Extension Phone es Fax 1 2 Fill in demographics information NN Fields labelled in boldface must be filled in Eo enis vien deed Patient ID Last Name First Name Select or type information Zelect Append button to add Closing Date New Patient The patient status is set to Active upon Device Number 43545345 entering a new patient The Status can be and Chest Pain v Close On OK changed to Inactive or Deceased after the patient has been created v Append patient may be removed from the patient list when the patient status is changed if the preference is set under the Tools gt Options to Do not display Deceased Patients or Do not display Inactive Patients See page 19 13 Click Monitoring Info tab This is
16. Tue Nov 19 14 57 34 2002 PreEvent 5 s PostEvent 10 s Flags 1 Ha M anual Alctivatio ii 0 Arrhythmia ECG Braven Bobby Not Edited 1 Receiving 2 Editing 3 Options Date Time 01 2000 09 30 23 Receiving Tech Description Houtine Transmission Symptoms Dizziness WU 3 Activity Walking gt Location work CSAS Patient Cancel Apply Help 0 Arrhythmia ECG Braven Bobby Edited Not Sent 1 Receiving 2 Editing 3 Options Technician s fF Findings Editing Tech v Rate 89 to 110 Normal Sinus Rhythm PR 15 to 18 QRS 092 to 095 QT 364 to 369 Patient OK Cancel Apply Help 0 Arrhythmia ECG Sraven Bobby Edited Not Sent Use Local Settings Trigger Unknown v Invert Include In Reports Completed Patient Apply Help Manual Revision Date 29 Nov 04 Generate report 35 Generate report 8 Create and print report 8 2 8 3 8 4 File MSS Tools Help Create 85 With ECG viewer window still open select Create from the Report menu If you have just reviewed the ECG as described above it is already selected E25 Aubin ECG Bron Bot Edited All ECG samples marked all events mh Efon eji IT 5 P
17. arrhythmia diagnosis pathological diagnosis ECG information doctor s notes arrhythmia data and associated reports Data can be entered via keyboard mouse or serial port and stored to and retrieved from all computer media Information can be displayed on the computer monitor or printed to a printer GEMS LITE 15 intended to be used as a data management tool for physicians and cardiac clinics to store retrieve communicate and report ECG and ECG data acquired from a variety of ECG sources including single and multi lead ECG devices Users will be able to purchase specific modules for managing other patient cardiac related data such as pacemaker and rehabilitation data that fit their patients needs GEMS LITE 15 intended for use in clinics hospitals physician s offices or anywhere a medical doctor deems appropriate GEMS LITE does not offer diagnosis or medical alarms Information in this manual 15 subject to change without notice and does not represent a commitment on the part of the vendor The software described in this manual 1s furnished under a license agreement and may be used only in accordance with the terms of that agreement Manual Revision Date 29 Nov 04 GEMS Lite GEMS Software License Agreement Serial Number Important By operating GEMS Lite software on a computer you acknowledge that you have accepted the terms of this license Definitions Software means the full system including computer programs a
18. efforts to protect the Package from unauthorized use reproduction and distribution Duration This license and agreement is effective from the day you operate the GEMS Lite software and continues indefinitely or until you return the package and all copies of the Package and its parts to CardioComm Solutions If you breach this agreement CardioComm Solutions can terminate this license by notifying you in writing You will then be required to return the Package and all copies thereof CardioComm Solutions may also have other legal rights which it may wish to enforce against you Manual Revision Date 29 Nov 04 GEMS Lite Limited Warranty CardioComm Solutions warrants that upon delivery to you the Software and its distribution media will be free from defect in materials and workmanship and will substantially conform to the specification set forth by CardioComm Solutions Significant errors in the Software which make it unusable are covered under this limited warranty for 60 days from the date of delivery of the Package to your address CardioComm Solutions will correct or help you avoid errors with efforts we believe suitable to the problem This warranty does not cover material or data that has been lost stolen or damaged by accident misuse or unauthorized modification CardioComm Solutions makes no other warranty express or implied to you or any other person or entity Specifically we make no warranty of merchantability or that the Software is
19. fit for a particular purpose CardioComm Solutions 15 not liable for special or incidental damages even if we or our agent s have been advised of the possibility of such damages CardioComm Solutions is not liable for damages or costs incurred as the result of loss of time loss of data loss of profits or revenue or loss of the use of the Software In addition we are not responsible or liable for damages or costs incurred in connection with obtaining substitute software claims by others inconveniences or similar costs In no event will our liability for any damages to your or any other person ever exceed the price paid for the license to use the Package regardless of any form of the claim CardioComm Solutions believes that the information contained in the Related Materials is correct However CardioComm Solutions does not assume responsibility for the accuracy of the content of the manual nor use of the manual CardioComm Solutions further reserves the right to revise update or change any part of the Package without a direct or inferred obligation to notify any person of such revision updates or changes Miscellaneous This license agreement shall be construed under and governed by the laws of the Province of British Columbia and Canada In the event that one or more of the provisions or parts of any provision contained in this agreement shall for any reason be held to be invalid illegal void or otherwise unenforceable in any respect by a court o
20. in the database 1 3 Start Recording gt Begins storing an incoming ECG signal into the database 1 4 Pause Real Time Display gt Puts display of incoming ECG signal hold Incoming signal continues to arrive and to be recorded if recording 1s on 1 5 Resume Real Time Display gt Resumes paused ECG signal display Single Lead J 5 minis none none ESr 1 6 ECG Information Patent Date Apr 03 2001 Time 01 29 26 PM Duration 00h 00m 00s Sampling Rafe 1005 gt Displays information about the current n ECG including patient name date time duration of recorded ECG and device sampling rate 1 10 Configure Device zl gt Opens the ECG device configuration dialog where device drivers can be changed for different devices 1 7 Real Time Display gt Displays the incoming ECG signal 1 8 Sweep Line gt Shows position on trace of current instant of incoming ECG signal 1 9 Show Hide Sweep Line gt Toggles sweep line on and off 1 11 Set Recording Duration gt Type in a time after which recording will be automatically stopped Zero value indicates indefinite manually controlled recording GEMS Lite Manual Rev 1 0 29 Nov 2004 Editing tools Editing tools 63 1 to editing functions of ECG Viewer See sections following for details on using these tools 1 1 Add Vertical C
21. label oH s I lt 1 3 2 To place a label on the sample SS click a choice or to have no label click No label 1 4 Size or label applied accordingly 2 Repositioning sample 2 1 Click Point Click 26 Arrhythmia ECG Braven Bobby Not Edited PE Strip fi 25 mmis 10 None 1 El Patient Braven Bobby Date 11 19 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps 2 2 Position cursor over the sample end bar F gt Cursor changes to 15 2 3 Click and hold mouse button m EP gt Selected sample is highlighted with heavier NR graphic line 1 2 4 Drag right or left to desired position 2 5 Release mouse button gt Sample is left at new position CHI v I lt 00 00 0000 4 gt 00 00 09 18 GEMS Lite Manual Rev 1 0 29 Nov 2004 3 Deleting sample Editing tools 65 3 1 Click Point Click 3 2 Position cursor over sample end bar gt Cursor changes to 15 3 3 Click mouse button gt Selected sample is highlighted with heavier graphic line 3 4 Press Delete key on keyboard gt Sample 15 removed gt ECG trace in formerly sampled area reverts to normal colour Manual Rev 1 0 29 Nov 2004 26 Arrhythmia ECG Braven Bobby Not Edited PIE Strip T omemv 9 1
22. to indicate it is selected 3 4 Press Delete key on keyboard gt Caliper measurement is removed Vertical calipers 26 Arrhythmia ECG Braven Bobby Not Edited Beg Strip 25mmws 10 None 340 Hz 1 z T Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps Patient Brevrerr Bobk F De ETT QUAE ransmitter ID 75003804C6 elec vent 2 Tue Nov 19 14 57 34 2002 Alctivatio PreEvent 5 s PostEvent 10 s Flags 1 CHT v 00 00 00 00 4 gt 00 00 09 18 4 Repositioning a vertical caliper as horizontal caliper See Repositioning a horizontal caliper above 5 Deleting a vertical caliper measurement Same as horizontal caliper See Deleting a horizontal caliper above Manual Rev 1 0 29 Nov 2004 GEMS Lite 68 Using the ECG tools Beat complex callipers WARNING In the areas where Beat Complex Calipers are used the measurements that are taken are approximate and do not analyze the waveform Calipers placed by this tool can be adjusted accordingly 1 Making beat complex caliper measurement 1 1 Click Add Beat Complex Calipers 1 2 Line up the heavy line at the center of the pointer with the peak of the R wave in a QRS complex Single Lead zs mmis mmi None None 1 Ly Q I 1 lt Patient Able Alfred Date 2003 Apr 15 T ime 10 56 18 Duration
23. 0 00 07 69 RR 78 9 bpm PR 0 196 Sec QRS 0 172 Sec QT 0 432 Sec QTc 0 496 Sec i uii Manual Revision Date 29 Nov 04 Generate report 53 Generate report 6 Create print report File Tools Help Create Im 6 1 With the ECG viewer window still open select Create from the Report menu w 30 Arrhythmia ECG Milliken Tracy Not Edited Sele File Report Tools Help If you have just reviewed the ECG as 12 Lead viji 5 9 I k Qu EJT 2 described above it 15 already selected Patient Milliken Tracy Date 12 11 2002 Time 11 50 08 4M Duration 00 00 07 Sampling Rate 100sps aVR Sample ECG if Sample ECG Comment Rate 60 bpm gt The 12 Lead Report is generated and displayed in the print preview window iv 00 00 00 00 4 gt 00 00 07 69 xi 6 2 To inspect the report use the Fitted cx ae ae mr me uu Dd a DE button to select magnification and the scrollbars to see various parts of the m report page s oe 6 3 Click Print to print to the default printer The Fax Email and Send buttons are disabled GEMS Lite but such features EC XEEEEENEUT T 1 apai are available in the full version of GEMS IEEE ROY NENN Arrhythmia On the main screen under i 1 4 the Tools menu choose Upgrade to Full Ree ee
24. 02 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps No label CHT v gt 00 00 00 00 4 00 00 09 18 RR 78 9 bpm PR 0 196 Sec QRS 0 172 Sec QT 0 43 P Sec QTc 0 496 Sec QTc 0 496 Sec 6 Addtext comments 6 1 6 2 6 3 6 4 Click Add Text Comments Pointer changes to Position pointer where you wish to place text comment and click Text box appears Enter comments Click anywhere outside of text box Text box closes Comment text remains superimposed on ECG trace Text comments print on reports if within red highlighted area Manual Revision Date 29 Nov 04 im Z0 CCG Draven Nut One Strip MIT 25 mmis 10 mmi None 40 Hz 1 QUU LU t Patient Bobby Date 11 19 2002 Time 2 57 34 PM ransmitter ID 75003804 vent 2 Tue Nov 19 14 57 34 2002 PreEvent 5 s PostEvent 10 s Flags 1 Duration 00 00 19 Sampling Rate 250sps M anual Arctivatio CHT v gt 00 00 00 00 4 00 00 09 48 GEMS Lite 34 Arrhythmia Management Event Monitoring 7 Enter findings 7 1 Tiks 1 3 7 4 7 6 Tele Click E button on the toolbar to open the editing screen Arrhythmia ECG dialog appears with Receiving tab selected Receiving and Editing information should be entered into each ECG Event editing screen to print on the repo
25. 68 00003050 4 gt Manual Revision Date 29 Nov 04 GEMS Lite Review and Edit ECG 43 Review and Edit ECG 4 1 Click Sample gt Pointer changes to ad Wr 28 TTM ECG Milliken Tracy SEE File Report Tools Help 4 2 Pointat the beginning of desired portion of FSinge Led v fiommmv 1 AETIA ECG tra ce an d cli ck on it Patient Milliken Tracy Date 12 11 2002 ime 11 46 58 AM Duration 00 00 45 Sampling Rate 100sps Presenting gt 8 second sample beginning where you clicked is created The sampled part of the i trace changes colour gt Sample options menu appears 8 sec 4 3 Choose sample option 16 sec 4 3 1 Mark the area of the ECG that is the ud i Presenting portion of the ECG 4 Presentin 4 3 2 Mark the area of the ECG that is the Magnet Es Magnet portion of the ECG aa No label 4 3 3 Mark the area of the ECG that is the Final portion of the ECG gt Size or label applied accordingly Manual Revision Date 29 Nov 04 GEMS Lite 44 Transtelephonic Pacemaker ECG Monitoring 5 Take measurements 5 1 Click Add Horizontal Caliper SS 22 TIM LCG Milliken Tracy DAR Measurements Fie Report Tools Help Single Lead ai 25 mmis 10 lNone 140 1 i T 9 Patient Milliken Tracy Date 12 11 2002 Gains ime 11 46 58 AM Duration 00 00 45 Sampling Rate
26. ECGs Tye TransmitDate Patient Name Recorded Date Status Edilntias Received Event 1 Channel Manual 12 9 2002 03 19 34 PM Braven Bobby 11 19 2002 02 57 45 PM Not Edited Event 1 Channel Manual 12 9 2002 03 19 34 PM Braven Bobby 11 19 2002 02 53 33 PM Not Edited Main 1 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 12 9 2002 03 24 14 PM Not Edited Joshua Event 3 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 3 25 2002 02 57 01 PM Not Edited Event 3 Channel Manual 12 9 2002 03 24 14 PM Braven Bobby 9 25 2002 02 49 52 PM Not Edited E Main 12 Lead 12 9 2002 03 26 21 PM Braven Bobby 12 9 2002 03 26 21 PM Not Edited Joshua w GEMS Lite Manual Revision Date 29 Nov 04 GEMS Lite Options 21 GEMS Lite Options Options GEMS Lite are set using the Options form shown below 1 Setting Options 11 Click Tools Menu and select Options File Edt New Help gt Options screen appears Options 1 2 ECG Warehouse field displays the location where the ECGs are stored and 15 automatically selected to the computer name that has been installed The default setting is COMPUTER NAME LOCAL If this box is empty click Change and select Local w Options Help ECG Warehouse 5 CRAFF LOCAL i W Compress ECGs 2 Lead Frequency Demodulator Driver Change Note Changing the ECG Warehouse may j chase eo 28 Demodulat
27. Edit Patient t t x here as well by clicking the New button 1 Demographics 2 Monitoring Inforpaton 3 Associations Dr Randy Physician Follow up Click OK Association Physician dialog closes New association appears on Associations tab Add Delete Change v Close On OK OK GEMS Lite 30 Arrhythmia Management Event Monitoring Receive ECG 3 Receive patient record ECG transmission Fe GEMS Lie HP rogum SEEMS WGEMS rx bo Gender Sur Ades i Terale Pacenake Acts A324 Peach Steet 24543 Aces 224 Flichmend Wauhingron 5 i Pacemaker tirn 343 hien Aa Laa Yagi Mee 3 1 Select Patient name from the patient list Patet vina ene Whi edit 2X7u23 y THS Shee Solem minor 323 Fray Shes 43 EM ead Active 3245 way HS Vieni 345 Tekr Steet Washington Diti ol C 3 2 Click New Arrhythmia 12 Lead ECG from the New Menu gt New Arrhythmia ECG dialog opens LESSEE eet m 1 1 1 TAA OS Bien 5 45 Te OMe 11 12 2002 SEPH Biren 12 8 2000 Or 24 14 TAXE
28. GEMS Lite Global ECG Management System Arrhythmia TTM Pacing and 12 lead ECG Management System Version 3 11 User Manual Revision Date 29 Nov 04 Created and Copyright 2004 CardioComm Solutions Inc All rights reserved Manual Revision Date 29 Nov 04 GEMS Lite Trademarks Copy and use Brief Description Intended Use CardioComm Solutions is a trademark of CardioComm Solutions Inc Windows is a trademark of Microsoft Corporation Although you are encouraged to make a backup copy of the software for your own use you are not allowed to make unlimited copies The software 1s protected by the copyright laws that pertain to computer software It is illegal to make copies of the software except for backups It 1s illegal to give copies to another person or to duplicate the software by any other means including electronic transmission The software contains trade secrets and in order to protect them you may not decompile reverse engineer disassemble or otherwise reduce the software to human perceivable form You may not modify adapt translate rent lease or create derivative works based upon the software or any part thereof GEMS LITE 1s a low risk cardiology software database management system It is capable of multi tasking and employs Microsoft tools to facilitate object linking and embedding of related information into the ECG The software manages all aspects of a patient s cardiology record including
29. I e o 2 gt C4 2 N Patient Appleby Sarah finished playing back click Stop 3 5 When the patient s ECG recording has Recording d Bobby w New Arrhythmia ECG Report Tools Help File Sampling Rate 250sps bal Duretiofi 00 01 04 Y fi 25 10 Nene 1 Date 12 10 2002 Time 11 38 43 AM Patient Braven Bobby EJ IEBBEEEBECEBBETEETEEEERE LEEEEEEEEEEEELAEEEEEEH FF Sees t ie SSR E LLL LLLI e gt Recording indicator disappears gt New ECG record is displayed in window gt ECG Viewer displays ECG Editing controls EBUBENNENENERBE IEEE an L4 SRSeael eee 4 1444 44414 15 a 5H gt Terminate patient call ices 00 00 19
30. Manual Rev 1 0 29 Nov 2004 One Strip ai v 25 mmis 10 mminv 40 Hz Patient Braven Bobby x QW ball rir e E Duration 00 01 04 LL emend Rat 250sps i ae Bii RES New Arrhythmia ECG Braven Bobby Date 12 10 2002 Time 11 39 43 AM anual Activation CHI v gt 00 00 10 50 4 00 00 19 68 GEMS Lite 64 Using the ECG tools Reviewing ECG sampling 1 Taking a sample 11 Click Add Edit Samples b Pointer changes to ge 26 ECG Braven Bobby Not Edited m Strip 5 mmis 10 mmm 1 k ll t lt 1 2 Point at beginning of desired portion of Patent Brave Date 1 18 2002 Tine 25734PM Duration 000019 Samping Rete 250sps ECG trace and click on it gt A 8 second sample centered where you clicked 15 created The sampled part of trace changes colour i The sample size 6 or 8 seconds is set in ransmiter ID 75003804 16 sec vent 2 Tue Nov 19 14 57 34 2002 24 sec Arctivatio the ECG Preferences FUITE TED sec TT gt Sample options menu appears Boe ventricular Arrhythmia 1 3 Choose a sample option Sinus Tachycardia Sinus Bradycardia 1 3 1 To make the sample longer click Atrial Fibrillation 8sec 16sec 24sec 32sec and ier 40sec No
31. Start then click Shut Down The Shut Down Windows dialog appears 3 2 Click Restart 3 3 Click OK The computer will take few minutes to restart If nothing happens after an extended time you may need to turn the power off wait a few moments and turn the power back on Windows may start in safe mode at this time and it is best to follow the above procedure to restart again in normal mode 4 Ifthe system is hung and does not seem to respond to commands mouse clicks keystrokes 4 1 Press Ctrl Alt Delete 1 press all three keys simultaneously gt Windows NT Security dialog appears 4 2 Click Task Manager 4 Windows NT Security dialog closes Windows Task Manager dialog appears 4 3 Scroll through the list of programs on the Application tab You are looking for program names followed by not responding These indicate programs that have stopped responding to the system and you GEMS Lite 4 4 For each such non responding program click on it and then click End Task Not Responding dialog appears 4 5 Click End Task Normally the offending program is shut down and your system 15 back in your hands 4 6 Close the Task Manager If you have been able to shut down all non responding programs and the system appears normally responsive return to step 2 above If the system remains unresponsive 6 1 Press Ctrl Alt Delete 1 press all three keys simultaneously Windo
32. TTM Pacing ECG is a continuous recording of all 3 segments Presenting Magnet and Final and should only be paused in between segments not stopped completely Recording E Manual Revision Date 29 Nov 04 File Edit TTM Pacing ECGs Er aati 2 Lead ECGs Recorded Date Status EditInitials__ Received Arrhythmia ECG Appleby Sarah 25 mmis 10 mmmv None gt 40 Hz 1 Time 3 Di Tools Help Patient Not Edited Not Edited Not Edited Not Edited Not Edited Not Edited 11 19 2002 02 57 45 PM 11 19 2002 02 53 33 PM 12 9 2002 03 24 14 PM 9 25 2002 02 57 01 PM 9 25 2002 02 43 52 PM 12 3 2002 03 26 21 12 9 2002 03 19 34 PM 12 9 2002 03 19 34 PM 12 9 2002 03 24 14 PM 12 9 2002 03 24 14 PM 12 9 2002 03 24 14 PM 12 3 2002 03 26 21 Braven Bobby Braven Bobby Braven Bobby Braven Bobby Braven Bobby Braven Bobby Joshua Joshua mE e gt ufo mel mov Sampling Rate 100sps Date 121 200 10 Duration 00 00 RECORDING GEMS Lite 42 Transtelephonic Pacemaker ECG Monitoring tal E 3 4 Ask patient to begin sending ECG GEMS Lite C Program Files GEMS GEMS Lite mdb w New Arrhythmia ECG Appleby Sarah gt ECG is displayed as it comes in Report Tools Help File ampling Rate 100sps ration 00 00 00 Time 3 22 10 PM Date 12 11 20
33. a free text field that prints on the Patient Transmission Event Recorder report This field should be used for information such as Device loaned Symptoms etc iw Close On OK The New Physician record only has a Comments tab available GEMS Lite Manual Revision Date 29 Nov 04 Add New Patient or Physician 29 2 Associate patient and physician 2 4 2 2 2 3 2 4 2 3 Manual Revision Date 29 Nov 04 Click Add on the Associations tab Save Patient dialog opens if the patient hasn t been previously saved _ Save Patient x Add Patient record to the database Cancel New Patient 5 Name Type Association Save Patient dialog closes Select Physician dialog opens Find and select physician 235 1 Click Fill List e Select Physician gt List fills with physician names armas 2 3 2 Click on physician s name Physician N Ladies Specialy Group Prone P Mm pue uus x Sancel __ Association General Practitioners Hr eM Select Association type The default association is Follow up The dum Physician with the association Follow up will print on the report Additional Physicians can be added but only the Follow up physician will print on the report A New Physician record can be entered 1
34. able of Contents Before VOU COMACE US 76 GEMS Lite Manual Revision Date 29 Nov 04 Introduction GEMS Lite 15 the simplest answer to ECG acquisition and patient data management in the field of arrhythmia 12 lead and TTM Pacing ECG management Manual Revision Date 29 Nov 04 GEMS Lite 10 Introduction Visual task instructions We want this manual to serve you in your day to day If there s some way you think we can improve the work especially during the steepest part of your learning usefulness of this manual please drop us a line at curve We hope it becomes dog eared and coffee stained because a manual that s crisp and clean is a manual that CardioComm Solutions Inc nobody has used Address To gain as many coffee stains as possible we ve written 201 3060 Cedar Hill Road and laid out this manual using two principles Victoria B C Canada e Visual At every step of every procedure this manual Mee shows you exactly what you will see on screen and Email what you should do with it support cardiocomm com e Task instructions Each set of instructions in this pponio manual describes one of the most common or Website important tasks that users of GEMS Lite need to do www cardiocomm com The instructions are focused on your everyday activities Tech Support Additional Reference material documenting all features Toll free 1 877 744 1122 Help Desk press 3
35. alfomia 435 3435324 in 9 it Street Philadelphia Pennsylvania 534 5234 6 6 1976 Female Arrhythmia Active 234 Richmond Road Washington District o 345 6345 4 5 1954 Female Pacemaker Active 2343 Raven Way Las Vegas Nevada 234 343 5234 5523432 3 5 1958 Arrhythmia Active Tacoma Washington 32432 United States 345 6345 75466 3 5 1955 Female 12 Lead Active 6435 Randy Street Jackson Mississippi 53 453 3243 2323423 4 4 1934 Male Arrhythmia Active 5345 Walter Street Salem Massachusetts 343 5323 Walters Wally 235235 2 4 1966 Male Pacemaker Active 3423 Fancy Street Kansas City Kansas 43 342 6453 Weatherby Wilma 52423 5 6 1934 Female 12 Lead Active 3245 Small Vine Way Baltimore Maryland 532 3454 Y ander Henry 35345 6 3 1964 Male 12 ead Active 345 Yellow Street Washington District of 234 5345 3 2 Click TTM Pacing ECG from the New Menu Event 1 Channel Manual Event 1 Channel Manual Main 1 Channel Manual Event 3 Channel Manual Event 3 Channel Manual Main 12 Lead lt ECG Viewer opens in new window fox GEMS Lite C Program Files GEMS GEMS Lite mdb fal New One Strip Patient Appleb dz Helr Y fi 3 3 Click Start Recording To ensure all FSKs are recorded be sure to click Start Recording before the patient starts sending the ECG from their device Recording indicator appears A
36. alipers gt Makes the cursor a tool for adding vertical calipers a measuring tool that can be placed anywhere on an ECG to take a vertical voltage measurement 1 2 Add Horizontal Calipers gt Makes the cursor a tool for adding horizontal calipers a measuring tool that can be placed anywhere on an ECG to take a horizontal time measurement on the ECG strip e g QR interval 1 3 Add Beat Calipers gt Makes the cursor a tool for adding a beat caliper marking the P Q R S and T waves and calculating intervals 1 4 Zoom In Out gt Makes the cursor a tool for zooming in left click and out right click on the ECG display 1 5 Point Click gt Makes the cursor a tool for point and click selection of items on ECG display 1 6 Add Text Comment gt Makes the cursor a tool for adding a block of text that can be placed anywhere on an ECG to explain query or draw attention to some part of it 1 7 Add Edit Sample Makes the cursor a tool for adding or editing an ECG sample a marker that highlights and selects a portion of an ECG 1 8 Add Edit Mask gt Makes the cursor a tool for adding or editing a mask a marker that masks off a portion of the ECG that should be disregarded e g line noise recorded in a transtelephonic ECG 1 9 Open Editing Screen gt Accesses the part of the ECG record that contains context information e g receiving technician patient symptoms ECG report options
37. ally in the following pattern A single lead ECG 15 not displayed 12 Lead Inferior Displays 3 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern II III aVF A single lead ECG is displayed in the Lead II position 12 Lead Anterior Displays 4 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern 2 4 A single lead ECG 15 not displayed 12 Lead Septal Displays 2 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern 2 single lead ECG 15 not displayed GEMS Lite 5 12 5 14 5 15 5 16 12 Lead Posterior Displays 4 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern V3 2 12 Lead Limb 1 Displays 3 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern mm d un 09 tri 7 e un lt e 6 12 Lead Limb 2 Displays 3 selected leads channels of a 12 lead ECG Each lead is s
38. ample ECG Normal Sinus Rhythm ventricular Arrhythmia Sinus Tachycardia Sinus Bradycardia Atrial Fibrillation Pause ST Change No label GEMS Lite 52 12 Lead ECG Monitoring 5 Take measurements Sd 5 3 5 6 3 Click Add Horizontal Caliper Measurements Pointer changes to 1 Point at beginning of measurement Click and drag pointer to end of measurement Caliper appears Caliper length and label change with changing position Release mouse button Measurement units label menu appears Choose units or label ECG Viewer remains in caliper mode until another mode selected Note Vertical Caliper Measurements tool works similarly Click Beat Caliper tool Move mouse close to a QRS complex and click once A vertical line caliper appears and displays the measurements on screen Pointer changes to ECG Viewer remains in Beat Caliper mode until another mode selected GEMS Lite mm 20084 amp L v Tanan Kins IE yp eens Inge TEES STS aT E e Eak File Report Tools Help 12 Lead 5 9 I z T Patient Milliken Tracy Date 12 11 2002 Time 11 50 08 Duration 00 00 07 Sampling Rate 100sps a Sample ECG adi 1 i bpm Units gt V6 Sample ECG a PR QRS eo QT No label Hv 00 00 00 00 4 gt 0
39. are x Do you accept all the terms of the preceding License Agreement If you select No the setup will close To install GEMS Lite you must accept this agreement InstallShield GEMS Lite 16 Introduction gt Customer Information page of the Wizard EEE Customer Information app ears Please enter your information 2 4 Enter your customer information Please enter your name company and the nine character serial number The serial number can be found on the white label of the hardware key in the format of CCSHHHHHH For demonstration versions please enter Demo If the product have is a demo product type DEMO If the product is a full version a type in the key ID on the back of the CD or a the Security Key Your Company Serial Number 5000000 InstallShield Cancel 2 5 Click Next gt gt Language Selection page of the Wizard CXII NEN x appears Language Selection Please check the box beside the desired language English United States InstallShield Cancel 2 6 Click Next gt gt Choose Destination Location page of the TENEI X Choose Destination Location Wizard appears Select folder where setup will install files Setup will install GEMS Lite in the following folder install to this folder click Next To install to a different folder click Browse and select a
40. as it comes in Rbport Tools Help One Strip 5 T ommemv None I gt u efa li Patient Appleby Sarah Date 12 11 2002 Time 3 22 1 OPM Duration 00 00 00 Sampji Rate 100sps 3 9 Configure Device This button 15 mE available to change the device driver when i a ad le a GR ka al a a a UR a a fe ea a a a FLEEELELEE different event recorder types are being mator used Click on the button and choose the a E US Vm Va Vm ER type of device from the Demodulator list HE EE Nei AU TOUS 3 10 When the patient s ECG recording has LE pf finished playing back click Stop ini iui iu iu ui ui a naan Recording eet __________ 0 Hz 4000 Hz Demodulator King Of Hearts Invert Signal Braemar ER300 e Cancel Apply Braemar ER 00 mi New Arrhythmia ECG Braven Bobby File Report T H One Strip fi 25 None Hz I E Patient Braven Bobby 12 10 2002 0 Time 11 38 43 AM 00 01 04 Sampling Rate 250sps gt Recording indicator disappears gt New ECG record is displayed in window gt ECG Viewer displays ECG Editing controls
41. atient Bobby Date 11 19 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps within the same ECG transmission will m print the report The Patient Transmission Report is generated and displayed in the print preview window M anual Abtivatio LI I lt gt 00 00 00 00 4 gt 00 00 09 18 To inspect the report use the Fitted button to select magnification and the scrollbars to see various parts of the report page s nbn Heg uire te ETO A 18 te Se eT Click Print to print to the default printer The Fax Email and Send buttons are disabled in GEMS Lite but such features are available in the full version of GEMS Arrhythmia On the main screen under the Tools menu choose Upgrade to Full Version to automatically send an email to a sales representative 11 SI if El 5 Help Fax E Mail Print Save Send Fitted Portrak Landscape Back losc Click Close Print Preview dialog closes Manual Revision Date 29 Nov 04 GEMS Lite Transtelephonic Pacemaker ECG Monitoring This chapter describes some of the main tasks associated with Transtelephonic pacemaker ECG monitoring in GEMS Lite They are Step 1 Add a New Patient Step 2 Associate a Physician e Step 3 Receive ECG transmission Step 4 5 Review and Edit ECG Step 6 Print a Report GEMS Lite Manual Rev 1 0 29 Nov 2004 Add New Patient 1 Create new p
42. atient ID Status Active 1 1 From ms NOT menu choose Patient gt New Patient dialog opens at wee Tile Suffix Birth Date Demographics tab Other ID 44 UID Street City v State ZIP Code Country Description Phone Number Extension Phone OE Fields labelled in boldface must be filled in inf p NA RN Patient ID Last Name First Name iie JP ww Ethnicity v Group Closing Date 1 2 demographics information V Close On OK Cancel GEMS Lite Manual Rev 1 0 29 Nov 2004 48 12 Lead ECG Monitoring 2 Associate patient and physician 2 1 4 2 2 2 3 2 4 29 Click Add on Associations tab Save Patient dialog opens if the patient fuer Patient hasn t been previously saved 1 Monitoring Infomation 3 Associations Name T Association Save Patient x 2 Add Patient record to the database Click OK Save Patient dialog closes Select Physician dialog opens i Cancel Find and select physician 2 3 1 Click Fill List List fills with physician names Association Physician x Select Physician lt all Physicians gt Fill List 2 3 2 Click on physician s name Payne Dr 112Main General Al k Cancel Help
43. atient record 1 New Patient 1 Demographics 2 Monitoring Information B Associations Patient ID i Status Active Last Name First Name Middle Tite Suffix SSN Gender 55 Street City v State Y ZIP Code Country Y Description Phone Number Extension 1 1 From the New menu choose Patient gt New Patient dialog opens at Demographics tab Phone X F Fax O OE E Mail 1 2 Fill in demographics information Fields labeled in boldface must be filled in Patient ID Last Name First Name 1 New Patient Height 1 Demographics 2 Monitoring Information 3 Associations Ethnicity Closing Date Select or type information Select Append button to add Append Device KOH Serial Number 43545345 Symptoms Palpitations and Chest Pain 1 3 Click Monitoring Info tab This is a free text field that prints on the Close On Ok TTM Pacing report This field should be used for information such as Device implanted Mode etc Close On OK GEMS Lite Manual Rev 1 0 29 Nov 2004 40 Transtelephonic Pacemaker ECG Monitoring 2 Associate patient and physician 2 1 4 2 2 2 3 2 4 4 2 3 Click Add Associations tab Save Patient dialog opens if the patient 1 Demographics 2 Monitor
44. brillation Pause CHI v ST Change gt No label 00 00 00 00 4 00 00 09 18 GEMS Lite Manual Revision Date 29 Nov 04 Sd 5 3 5 6 Dels Click Add Horizontal Caliper Measurements Pointer changes to Il Point at beginning of measurement Click and drag pointer to end of measurement Caliper appears Caliper length and label change with changing position Release mouse button Measurement units label menu appears Choose units or label ECG Viewer remains in caliper mode until another mode selected Note Vertical Caliper Measurements tool works similarly These caliper measurements will print on the ECG samples on the report if within the Red highlighted area Click Beat Caliper tool Move mouse close to a QRS complex and click once A vertical line caliper appears and displays the measurements on screen Pointer changes to ECG Viewer remains in Beat Caliper mode until another mode selected These calipers do not print on reports LIRE ACTUS Tag ual no sed ANJUN LVW TITTEN PreEvent 5 s PostEvent 10 s Flags 1 ransmitter ID 75003804C6 vent 2 Tue Nov 19 14 57 34 2002 amp i a Fits 14 wt Luncu AY TT BR ppm t Units Rate PR QRS QT Review and Edit ECG 33 5 Take measurements Beg 1 25 mms 10 mmimvy None v 40 Hz 1 X T Patient Braven Bobby Date 1149 20
45. c t e Patient Milliken Tracy Date 12 11 2002 Gains 11 46 58 Duration 00 00 45 Sampling Rate 100sps Presenting The TTM Pacing Report is generated and displayed in the print preview window iv 00 00 0918 4 00 00 27 56 To inspect report use the Fitted button to select magnification and the scrollbars to see various parts of the report page s Click Print to print to the default printer Sear IN bob The Fax Email and Send buttons are disabled in GEMS Lite but such features are available in the full version of GEMS a Arrhythmia On the main screen under the Tools menu choose Upgrade to Full Version to automatically send an email to a sales representative 1 1 o Bm s Help Fax E Mail Print Save Send Fitted Portrak Landscape Back losc Click Close Print Preview dialog closes Manual Revision Date 29 Nov 04 GEMS Lite 46 12 Lead ECG Monitoring 12 Lead ECG Monitoring This chapter describes some of the main tasks associated with 12 Lead ECG monitoring in GEMS Lite They are Step 1 Add a New Patient Step 2 Associate a Physician e Step 3 Receive ECG transmission Step 4 5 Review and Edit ECG Step 6 Print a Report GEMS Lite Manual Revision Date 29 Nov 04 Add New Patient 1 Create new patient record 1 New Patient 1 Demographics 2 Monitoring Information B Associations P
46. ck 4 2 Position cursor over any part of text gt Cursor changes to M 4 3 Click mouse button gt Text is underlined to indicate it is selected 4 4 Press Delete key on keyboard gt Text comment measurement is removed Editing the ECG record 27 Arrhythmia ECG Braven Bobby Not Edited 64 File Report Tools Help Strip 10 I Time 2 58 25 Patient Braven Bobby Date 11 19 2002 Duration 00 00 19 Sampling Rate 250sps Sample ECG gt 00 00 07 29 4 gt 00 00 16 48 1 Viewing and or editing ECG annotation 1 1 Click Open Editing Screen gt ECG dialog opens 1 2 View and or edit information on ECG dialog To review measurements taken or to add Technician s findings click on the Edit Tab 1 3 To view or edit the patient record click Patient 1 4 Click OK gt ECG dialog closes GEMS Lite 27 Arrhythmia ECG Braven Bobby Not Edited MBR Fie Report Tools Help One Strip 25 mm s 10 mminv 40Hz 1 hal T E Date 11 19 2002 Patient Braven Bobby Time 2 58 25 PM Duration 00 00 19 Sampling Rate 250sps Sample ECG mi 0 Arrhythmia ECG Braven Bobby Edited Not Sent 1 Receiving 2 Editing 3 Options Technicians ting Tech RF gt Findings Rate 89 to 110 N
47. d on Ifno you were not experiencing this pe particular problem Check the online Help for further troubleshooting procedures C Download events from an event recorder S Is the device you wish to access ly connected to a remote computer on the network 1 2 Did this form appear instead of the ECG Viewer Remote connection See page 30 for an example of the ECG Viewer gt Ifyes continue to the next step lt Bac Cancel gt Ifno you were not experiencing this particular problem Check the online Help for further troubleshooting procedures 2 CardioComm for support 2 1 Please call the Help Desk at 877 744 1122 ext 3 Tell the customer support technician that you believe are having sound card problems gt The customer support technician will verify the problem with you and lead you through a step by step procedure for resolving it GEMS Lite Manual Rev 1 0 29 Nov 2004 76 Troubleshooting Before you contact us When an error message appears or the program stops responding or quits unexpectedly please do these things first 1 Write down any error message that appears Try to include all information in the message even if it looks like gobbledygook 2 Close all applications that are currently running Important Save any unsaved data before quitting your applications 3 Ifthe system seems normally responsive restart your computer 3 1 Click
48. e Version to automatically send an email to nde Jdeesdecde 4dede iuun a sales representative B 5 g ij d n E 5 2 Print Save Send Fitted Portrak Landscape Back losc 6 4 Click Close gt Print Preview dialog closes Manual Revision Date 29 Nov 04 GEMS Lite 54 Using the ECG tools Using the ECG tools This chapter shows how to use the tools that are part of the ECG Viewer ECG Viewer tools are divided into three categories e Display tools control the appearance of the ECG display Controls for the display functions are always present on the ECG Viewer e Recording tools for recording incoming real time ECGs Controls for the recording functions are present only when you are receiving an incoming ECG e Editing tools for measuring marking and annotating an ECG in the database Controls for editing functions are present only when you are viewing an already recorded ECG Each category of ECG Viewer tool is described in detail in the following pages GEMS Lite Manual Revision Date 29 Nov 04 Display tools 1 Overview of display tools on the ECG Viewer toolbar numbered items following for details on these tools 1 1 Gain gt Determines the voltage scale of the ECG display Measured in mm mV the nominal vertical distance on screen and hardcopy that corresponds to one millivolt of signal strength on the ECG trace 1 2 Speed gt Det
49. edules for Arrhythmia and TTM follow ups The scheduler is equivalent to a traditional appointment ledger You get the familiar look and feel of an appointment book and the convenient features of a centralized database for managing all appointments CardioComm GEMS GEMS Lite upgrade Mead amp Company GEMS Lite User Manual for existing customers or as optional module for new customers Contact your distributor for details on how to upgrade to GEMS Lite with Scheduler Scheduler Lite To launch Scheduler Lite 1 2 1 Open the Windows Start Menu GEMS Scheduler C Program Files GEMS LiteDatabases GEMS Lite mdb ini x select the CardioComm GEMS File Edt View folder ep ecerter 2008 1 2 2 Select Scheduler Lite E gt The Scheduler Lite application anna ne Baka inis opens QOCOTTT AbelAder TTM Pacing ECG For detailed instructions on how to use the GEMS Lite scheduler 1 3 1 Consult the GEMS Lite Online ME 0055 Bop FORD Help 3 Appointments a Manual Revision Date 29 Nov 04 GEMS Lite Arrhythmia Management Event Monitoring This chapter describes some of the main tasks associated with event monitoring in GEMS Lite They are e Step 1 Add a New Patient Physician Step 2 Associate a Physician e Step 3 Receive ECG transmission Step 4 7 Review and Edit ECG e Step 8 Print a Report
50. ermines the time scale of the ECG display Measured in mm s the nominal horizontal distance on screen and hardcopy that corresponds to one second of time on the ECG trace 1 3 Rhythm Lead gt In 12 lead view determines which channel is displayed as rhythm lead at bottom of view Irrelevant in other views Now Arrhy hmia ECG Braven Bobby Xx One Strip Nong H EI TIXI Patient Braven Bobby Date 12 10 2002 Time 11 39 43 Duf ation 00 01 04 Sampling Rate 250sps 1 4 Strip View gt Determines the overall type of view of the ECG signal 1 5 High Pass Filter gt Determines the cutoff frequency of high pass filtering applied to the ECG signal 1 6 Low Pass Notch Filter gt Determines the cutoff or centre frequency of low pass or notch filtering applied to the ECG signal 1 7 Show Hide Grid gt Causes a grid indicating regular horizontal time and vertical voltage increments to 00004080 00 001988 be shown or hidden on the ECG display 1 8 Invert Trace gt Causes the ECG signal voltage to be displayed inverted in case ECG monitor leads were reversed during recording GEMS Lite Manual Rev 1 0 29 Nov 2004 56 Using the ECG tools 2 Viewer display tools selector 2 1 1mm s gt Avery tight voltage scale The ECG trace 15 displayed over a relatively small vertical distance Corres
51. es and there are companies that provide backup services over the Internet If your workplace has a Systems Network or Database Administrator inquire about the backup procedures in place and make sure that your databases are part of them If no one is currently responsible for backups then you must take steps to implement them Caution It is tempting just to take copies of your database every so often but a casual approach to backing up data always leads to problems It s very easy to forget and that s just the time disaster chooses to strike Manual Revision Date 29 Nov 04 Backups 15 Installing GEMS Lite Please read the WARNING above before you reinstall GEMS Lite 1 Shut down all applications 1 1 2 Install GEMS Lite 2 2 2 2 3 Shut down all applications currently running on your computer Place the GEMS Lite installation CD in your computer s CD ROM drive Installation procedure should automatically start If it does not use Windows Explorer to browse to the CD ROM drive and double click on Setup exe GEMS Lite logo appears InstallShield Wizard initialization dialog appears Welcome page of the Wizard appears Each page of the InstallShield Wizard guides you through one step of the installation process At the bottom right of each Wizard page there are three buttons lt Back Next gt and Cancel These buttons respectively allow you to back up a page go on to the next pa
52. f competent jurisdiction the same shall not invalidate or otherwise affect any other provision herein This agreement is the entire understanding and agreement regarding the Package and supersedes any prior oral or written communications This agreement may be modified in a written amendment signed by an authorized CardioComm Solutions officer You acknowledge by operating the GEMS Lite system for the first time that you have accepted the terms of this agreement No part of this Package may be reproduced transcribed or translated into any language without the prior written permission of CardioComm Solutions Inc CAUTION U S Federal Law restricts this device to sale by or on the order of a physician or properly licensed practitioner GEMS Lite Manual Revision Date 29 Nov 04 Contents POUR CHUNG Cl OU cree tess hats rr Na MESSI be Fd qr 9 ARTE zc MO cR ee ee re ee ee 10 ISSgulatory NOCO S agii feas Nea A n a E 11 Jas nre GEMS Ncc E 12 Computer requirements MINIMUM saco os loue cuu gets eu dec bos ek ose but esu 12 Computer requirements recommended 12 Database
53. g on the patient name also opens the Patient form GEMS Lite Program Files 3 3 To delete a patient record File Edit New Tools Help Selected Patient Selected Etats Physicians 3 3 1 Click on the patient s name in the patient list 3 3 2 Choose Delete Selected Patient from the Edit menu Delete Selecked Patient Delete Selected EGG gt confirmation screen appears Using the Delete key on the keyboard will delete as well Once a record is deleted there is no way to retrieve It minimize the size of the patient list use the Do not display deceased inactive patients options on the GEMS Lite Options page 19 Change patient status see Adding a New Patient on Page 24 Manual Revision Date 29 Nov 04 GEMS Lite 24 Finding your way around GEMS Lite 4 Searching deleting physician 4 1 From Edit menu main screen choose Physicians gt A screen appears with a list of Physicians that have been entered into the GEMS Lite database There are no additional search capabilities in GEMS Lite other than the main Physician list Edit Physician File Edit New Help PhysicanName Address Specialty Group Phone Randeal Dr Randy Smithson Dr Sally Thomson Dr Terry White Dr Wally Yandel Dr Sam 4 2 To edit a physician record 4 2 1 Click on the physician s name in the physician list Choose Edit Item from the Edi
54. ge or cancel the entire installation process Click Next gt Software License Agreement page of the Wizard appears If you agree to the conditions of the software license agreement click Yes Manual Revision Date 29 Nov 04 GEMS Lite Setup Preparing Setup 15 x Please wait while the InstallShield Wizard prepares the setup GEMS Lite Setup is preparing the InstallShield Wizard which will guide you through the rest of the setup process Please wait InstallShield Cancel GEMS Lite Setup Welcome to the InstallShield Wizard for GEMS Lite The InstallShield Wizard will install GEMS Lite on your computer To continue click Next GEMS Lite Setup License Agreement Please read the following license agreement carefully Press the PAGE DOWN key to see the rest of the agreement Software License Agreement CardioComm Solutions Inc is willing to license the enclosed software to licensee only on the condition that licensee accepts all of the following terms Licensee must read the terms of this agreement carefully By accepting below by making productive use of the software or by registering the software licensee agrees to be bound by this agreement If licensee does not agree with the terms of this license CardioComm Solutions Inc is unwilling to license the software to the licensee and licensee must immediately return the softw
55. hown single strip and the strips are stacked vertically in the following pattern aVR aVL aVF gt 5 C Oo c T 7 eM un js lt C 12 Lead Chest 1 Displays 3 selected leads channels of a 12 lead ECG Each lead is shown single strip and the strips are stacked vertically in the following pattern lt gt D J r1 e e e C un ga un 7 5 lt 12 Lead Chest 2 Displays 3 selected leads channels of a 12 lead ECG Each lead is shown in a single strip and the strips are stacked vertically in the following pattern lt lt ON gt E AB 5 UA 3 e un D C e a lt ge Manual Rev 1 0 29 Nov 2004 Display tools 59 6 ECG Viewer display tools High Pass Filter selector WARNING Using filter changes the apparent amplitude and other features of an ECG signal If filters are used inappropriately they can create misleading ECG traces Filtering is used to remove unwanted features from the ECG signal noise signal drift and other distortions Filtering changes how the signal looks as it is displayed in the ECG Viewer but does not actually change the ECG stored in the GEMS Lite database You can apply different filters or none each time you view the ECG You can combine both high
56. ing Infomation 3 Associations hasn t been previously saved _ Ce i Save Patient LX Add Patient record to the database Click OK coca Save Patient dialog closes Select Physician dialog opens Find and select physician 2 3 1 Click Fill List List fills with physician names kal Physician E Physician N Address Specialty Group Phone 2 5 2 Click on physician s name Gord Du Ead iit hin TT oo Association General Practitioner Beceives Reports v Close On OK New Cancel Select Association type The default association is Follow up The Physician with the association type follow up will print on the report Additional physicians can be added but only the Follow up physician will print on the NTTOT z report A New Physician can be entered here as well by clicking the New button Click OK Association Physician dialog closes New association appears on Associations tab Add Delete Change v Close On OK OK GEMS Lite Manual Revision Date 29 Nov 04 Receive ECG 41 Receive ECG 3 Receive patient Record transmission GEMS Lite C Program Arrhythmiafl2 Lead ECG 3 1 Select Patient name from the patient list appteby Sarah Pacing ECG Jeach Street Oakland C
57. ing Records 3 Searching deleting a patient 3 1 The main GEMS Lite screen displays a constant list of all patients in the GEMS faa GEMS Lite C Program Fives GEMS GEMS Lite mdb Lite database al New Patient Ear Clic king decus even Bebe s 78 135 1 Demographics 2 Monitoring Information 3 Associations patient list according to the data in that 25 2 column ates Waly zs zana Me me There are no additional search capabilities vade ass cansa in GEMS Lite other than the main patient 02 SE lis Street City v State ZIP Code Country Description Phone Number Extension Phone 3 2 To edit a patient record TTM Pacing ECGs EE tutti 2 Lead ECGs Fax E Mail Transmit Date Event 1 Channel Manual 12 9 2002 03 19 34 P Event 1 Channel Manual 12 9 2002 03 19 34 Ph Height in Weight lbs Main 1 Channel Manual 12 9 2002 03 24 14 P Event 3 Channel Manual 12 9 2002 03 24 14 PH ethnicity Group Event 3 Channel Manual 12 9 2002 03 24 14 Main 12 Lead 12 9 2002 03 26 21 Closing Date Age lt 3 2 1 Click on the patient s name in the patient list 3 2 2 Choose Selected Patient from the Edit menu C The Patient form appears EBD ok Cancel Double clickin
58. lation Wizard appears 2 10 Click Finish Manual Revision Date 29 Nov 04 Setup has enough information to start copying the program files If you want to review or change any settings click Back If you are satisfied with the settings click Next to begin copying files Current Settings Customer Information User Name Your Name Company Name Your Company Serial Number 5000124 Language Information Language English Country United States Destination Location InstallShield ucrlS Lite Setup Setup Status GEMS Lite Setup is performing the requested operations Installing C Program Files GEMS WJet40SP6_W2K exe 28 InstallShield GEMS Lite Setup InstallShield Wizard Complete Setup has finished installing GEMS Lite on your computer lt Back Cancel GEMS Lite Finding your way around GEMS Lite This chapter is a primer on the names of things in GEMS e Adding a Logo to Reports Lite and their basic uses It describes e Searching for a Patient e Basic parts of GEMS Lite e Searching and Deleting a Physician e Reviewing GEMS Lite Options Manual Revision Date 29 Nov 04 GEMS Lite 20 Finding your way around GEMS Lite Parts of GEMS Lite 1 Guide to parts of the GEMS Lite main window 1 1 Title bar Displays file name of database in use m GEMS Lite C Program Files GEMS GEMS Lite mc 1 2 Menu bar Edit Mew Tools He
59. ling Rate 100sps Position cursor over a marker vertical EEA RR 30 0 bpm 0 180 Sec QRS 0 150 Sec 0 340 Sec QTc 0 240 Sec line in the caliper P onset shown in this example Mi Jb Cut Cursor changes to 4 Ey copy Delete UnLock Lock Right click mouse button Pop up menu appears Click Lock or Unlock Beat complex caliper is locked I So Att unlocked accordingly 4 00 00 10 30 4 i gt 00 00 26 02 3 Repositioning marker beat complex caliper 4 3 1 3 2 3 3 3 4 35 Markers in a beat caliper can be repositioned if and only if it is unlocked see item 2 above Click Point and Click TIAM OU E Able Alfred Date 2003 Apr 15 Time 10 56 18 Duration 00 01 01 Sampling Rate 100sps Position cursor over a marker vertical RR 30 0 bpm 0 180 Sec QRS 0 150 Sec 0 340 Sec QTc 0 240 Sec line in the caliper P onset shown in this example Cursor changes to 4 Click and hold mouse button Beat complex measurements bar appears Drag marker to desired new position on trace Release mouse button Marker 15 left at new position 4 Beat complex measurements change 1O elma 5 50 5 automatically as you drag Manual Rev 1 0 29 Nov 2004 GEMS Lite 70 U
60. lp gt Contains menu commands for every function m the product fox GEMS Lite C Program Files GEMS GEMS Lite mdb 1 3 Patient List Patan eano Jou uas sms Appleby Sarah 252342 6 6 1945 Pacemaker Active 4324 Peach Street Oakland California 435 343 5324 gt Contains all patients that have been Braven Bobby 53243 7 8 1955 Active 432 Fort Steet Philadelphia Pennsylvania 5345234 Hallywell Holly 34543 6 6 1976 Arrhythmia Active 234 Richmond Road Washington District o 345 6345 entered into the GEMS Lite database Milliken Tracy 23432 4 6 1964 Pacemaker Active 2343 Raven Way Las Vegas Nevada 234 3435234 Parker Ramly 5623432 3 5 1966 Arrhythmia Active Tacoma Washington 32432 United States 345 6345 Salemmy Sarah 75466 3 5 1955 12 Lead Active 6435 Randy Street Jackson Mississippi 53 453 3243 Thompson Terry 2323423 4 4 1934 Arrhythmia Active 5345 Walter Street Salem Massachusetts 343 5323 Walters Wally 235235 2 4 1966 Pacemaker Active 3423 Fancy Street Kansas City Kansas 43 342 6453 Weatherby Wilma 52423 5 6 1934 12 Lead Active 3245 Small Vine Way Baltimore Maryland 532 3454 Y ander Henry 35345 6 3 1964 12 lead Active 345 Yellow Street Washington District of C 234 5345 1 4 ECG List gt Displays all ECGs for the selected Patient Two tabs display the two types of ECGs Arrhythmia 12 Lead ECGs or TTM Pacing ECGs TTM Pacing ECGs EE tito 2 Lead
61. nd codes techniques tools formats designs concepts and methods together with any updates subsequently supplied by CardioComm Solutions Software Copies means copies of all or any portion of the Software including backups and duplicates Related Materials means all of the printed materials provided in this package or later supplied by CardioComm Solutions for use with the Software Package means the Software and Related Materials Permitted Uses CardioComm Solutions grants you a non exclusive license to use the Package according to the terms set forth below Under this license you may Use the Software on a single computer in accordance with the software copy protection employed by the program Use the remainder of the Package in accordance with this agreement Copy the Software for backup purposes only as long as you keep in your possession and do not permit to be copied all such Software Copies Prohibited Uses Under this license you may not Lend license rent or otherwise transfer the Package or any of its parts or copies or your rights to the Package Translate decompile or otherwise reverse engineer the Software or convert the Software into another programming language Use the Software on more than one computer at one time Make copies of the Package or any of its parts except as permitted above Remove or obscure the CardioComm Solutions copyright and notices In addition you agree to make reasonable
62. ng Rate 100sps gt Recording indicator disappears gt New ECG record is displayed in window gt ECG Viewer displays ECG Editing controls Sample ECG Sample ECG 00 00 00 00 4 gt 00 00 07 69 GEMS Lite Manual Revision Date 29 Nov 04 Review and Edit ECG Review and Edit ECG 51 4 Sample ECG 4 1 Click Sample gt Pointer changes to ad 4 2 Point at the beginning of desired portion of ECG trace and click on it gt 8 second sample beginning where you clicked 1s created The sampled part of the trace changes colour gt Sample options menu appears 4 3 Choose a sample option 4 3 1 To make the sample longer click 8sec 16sec 24sec etc 4 3 2 To place a label on the sample click one of the selections or to have no label click No label 4 3 3 Size or label applied accordingly Size or label applied accordingly Manual Revision Date 29 Nov 04 hl decade te te ee et ao FT S22 4 SEE awy LV mary Luttu File Report Tools Help 12 Lead 1 5mws T mmmv Noe LA E T EI Patient Milliken Tracy Date 12 11 2002 Time 11 50 08 Duration 00 00 07 Sampling Rate 100sps aVR v1 V4 Sample ECG i V2 V5 it aVF V3 V6 Sample ECG Comment HHH dE 8 sec 16 24 sec 32 sec 40 sec HH fv 00 00 00 00 4 00 00 07 68 S
63. not add information patient records ECGs etc to the GEMS Lite database before you complete the next step 2 Copy the backup copy of the file GEMS Lite mdb see backup instructions above into the folder C Program Files GEMS 3 Start GEMS Lite GEMS Lite 14 Introduction Backups The data in your GEMS Lite database 15 vulnerable to human error to equipment breakdowns to natural disasters and to deliberate tampering or damage You must institute regular backups to provide a means to recover should your database suffer damage or outright loss Backing up your database means making and keeping a copy of it on a regular basis For any but the least demanding uses of GEMS Lite this means daily backups Data backups can be made on floppy disks on tapes or on another computer on your network The important thing about the medium chosen disk tape other removable medium or other computer is that it 1s distant from or can be moved away from the computer whose data 15 being backed up Backups should be stored in a physically separate location so that thefts and natural disasters are less likely to wipe out your backups as well as your working copy GEMS Lite There are several commercial backup programs available that let you perform regular backups easily and automatically For example Windows includes a standard provision for backup procedures There are also independent products that perform backup servic
64. nother folder Destination Folder C Program Files GEMS Browse InstallShield 2 7 Click Next gt P Select Program Folder page of the Wizard agi x appears Select Program Folder Please select a program folder this page you choose the name of the Setup will add program icons to the Program Folder listed below may type new folder Star t P r Ogr am fi older in wh ich the name or select one from the existing folders list Click Next to continue Folders components of the GEMS Lite application ai will be grouped under You should accept Existing Folders 3Com HomeConnect the default GEMS Lite unless you have a Accessories d h f h Administrative Tools Adobe Acrobat 4 0 goo reason for CNOOSINZ anotner ASUS Dialogic System Software Icon Snatcher Intel Ultra ATA Storage Driver Macromedia Dreamweaver 3 InstallShield 2 8 Click Next gt GEMS Lite Manual Revision Date 29 Nov 04 Backups 17 gt Start Copying Files page of Wizard x Start Copying Files m appears Review settings before copying files 2 9 Click Next gt gt InstallShield begins installing the GEMS Lite application on your computer Depending on the speed of your computer it can take up to several minutes to load and install all the files An indicator shows the progress of installation activities gt Setup Complete page of the Instal
65. of the software is in the GEMS Lite Online Help Urgent press 1 Toll 1 250 744 1822 Help Desk press 3 Urgent press 1 GEMS Lite Manual Revision Date 29 Nov 04 Regulatory Notices 11 Regulatory Notices Notice European Union Marking by the CE symbol indicates compliance to Medical Devices Directive 93 42 EEC A Declaration of Conformity in accordance with the directives has been made and is on file with the Authorized Representative RMS UK Limited 28 Trinity Road Nailsea Somerset BS484NU England Manual Revision Date 29 Nov 04 GEMS Lite 12 Introduction Installing GEMS Lite Computer requirements minimum GEMS Lite 1s designed for a PC with the following minimum requirements Windows XP or Windows 2000 Service Pack 2 or higher Recommended Service Pack 4 or Windows NT 4 Service Pack 6 or Windows 98 Internet Explorer 5 5 Internet Explorer 5 0 required for PCs running Windows 98 Computer requirements recommended GEMS Lite will work better on a PC with the following recommended requirements Windows XP Windows 2000 Service Pack 2 or higher Recommended Service Pack 4 Internet Explorer 5 5 Internet Explorer 5 0 required for PCs running Windows 98 GEMS Lite Pentium II 500 128 MB Ram 50 MB free space on Hard Drive for application install 100 MB free space on Hard Drive for Database and ECG storage CD Rom drive Sound Blaster 16 sound card must be a separate
66. or Dri cause connection problems Change Header Company Baa Street City State Country hs y ZIF Code Load Hew not display deceased patients not display inactive patients Apply OF Cancel 1 3 Arrhythmia 12 Lead and TTM Pacing boxes display the currently selected device drivers The defaults should be left unless otherwise instructed 14 Header and Logo fields allow for a custom logo to be typed in and loaded into GEMS Lite See next section 1 5 Do not display deceased patients when checked patients with status Deceased are not displayed in the patient list These patients are not deleted when this preference is selected they are just not viewable in the patient list Uncheck to make patients with this status viewable 1 6 Do not display inactive patients when checked patients with status Inactive are not displayed in the patient list These patients are not deleted when this preference is selected they are just not viewable in the patient list Uncheck to make patients with this status viewable Manual Revision Date 29 Nov 04 GEMS Lite 22 Finding your way around GEMS Lite 2 Adding logo to reports 2 1 2 2 2 3 2 4 2 9 2 6 Zeke The fields under Header can be used for a text information header on reports Help ECG Warehouse Using
67. or longer WARNING This setting may distort import features of the genuine ECG morphology 2 Hz Suppresses variations in the signal that take place over 0 5 second or longer WARNING This setting may distort import features of the genuine ECG morphology GEMS Lite 60 Using the ECG tools 7 ECG Viewer display tools Low Pass Notch Filter selector WARNING Using a filter changes the apparent amplitude and other features of an ECG signal If filters are used inappropriately they can create misleading ECG traces Filtering is used to remove unwanted features from the ECG signal noise signal drift and other distortions Filtering changes how the signal looks as it is displayed in the ECG Viewer but does not actually change the ECG stored in the GEMS Lite database You can apply different filters or none each time you view the ECG You can combine both high pass and low pass or notch filtering on a single ECG 7 1 none 7 4 gt Default No low pass filtering is applied to ECG signal 7 2 15 Hz gt Suppresses variations in signal above 15 Hz WARNING This setting may distort import features of the genuine ECG gt morphology 7 3 20 Hz gt Suppresses variations in the signal above 20 Hz WARNING This setting may distort 7 6 import features of the genuine ECG gt morphology GEMS Lite Single Lead
68. ormal Sinus Rhythm PR 16 to 1 19 QRS 092 to 1095 QT 364 to 3 4 Patient OK Apply Hit v lt 00 00 07 29 4 gt 00 00 16 48 Manual Rev 1 0 29 Nov 2004 Editing tools 73 Troubleshooting Manual Rev 1 0 29 Nov 2004 GEMS Lite 74 Troubleshooting General troubleshooting If you are having trouble recording ECGs consult the manual section that follows this one in case you are encountering a certain hardware related problem detailed there GEMS Lite For troubleshooting procedures for other problems including other ECG recording problems please see the GEMS Lite online Help Manual Rev 1 0 29 Nov 2004 A certain hardware problem that prevents ECG recording You may encounter a problem when trying to record an sound card The information below helps you determine ECG particularly if you have just installed GEMS Lite whether you are experiencing this problem and gives you This problem occurs if you have hardware on your information on how to resolve it computer usually a modem that takes control of the 1 Check whether you are experiencing this problem 11 Were trying to record a new ECG To record a new ECG either you clicked New gt Arrhythmia 12 Lead then clicked OK on the Arrhythmia ECG form or you clicked New gt TTM Pacing ECG gt ECG Preference If yes continue to the next step Specify one of the following base
69. pass and low pass or notch filtering on a single ECG none Default No low pass or filtering is applied to the ECG signal 0 05 Hz Suppresses variations in the signal that take place over 20 seconds or longer 0 5 Hz Suppresses variations in the signal that take place over 2 seconds or longer WARNING This setting may distort import features of the genuine ECG morphology Manual Rev 1 0 29 Nov 2004 Single Lead mmis minim none none H 1 in 45 4 A low pass filter removes quickly varying high frequency components of the signal which usually corrects problems with noise appearing as fuzziness in the signal The cutoff frequency determines what frequencies are considered quickly varying high frequency and hence how much of the signal is removed The higher the cutoff frequency the less of the original signal is removed It is best to use the highest cutoff frequency that corrects the problem on screen A notch filter removes a narrow band of frequencies in the signal which can be used to correct problems with power line noise The notch center frequency selects which band of frequencies to remove The frequency selected should be the same as the AC power frequency in your area 60 Hz in North America 50 Hz in most of Europe 1 Hz Suppresses variations in the signal that take place over 1 second
70. play tools Rhythm Lead selector 4 1 I gt Lead I self explanatory 42 gt Lead II self explanatory 4 3 gt Lead III self explanatory 4 4 4 5 gt Lead V6 self explanatory 4 6 CHI gt Channel 1 same as Lead I 4 7 CH2 gt Channel 2 same as Lead 4 8 CH3 gt Channel 3 same as Lead III Single Lead 25 mmis minim none none H 1 5 Viewer display tools Strip View selector 5 1 Single Lead gt Displays one lead channel of an ECG The trace is wrapped across as many strips as will fit vertically in the screen area available for the ECG display usually three For a 12 lead ECG the one lead displayed is selected by Rhythm Lead control 5 2 One Strip gt Displays one lead channel in an ECG in a single strip centred vertically in the ECG display area For a 12 lead ECG the one lead displayed is selected by the Rhythm Lead control 5 3 2 Channels gt Displays 2 channel ECG Each channel shown in a single strip and the strips are stacked vertically above one another The display is blank for any other type of ECG 5 4 3 Channels gt Displays a three channel ECG Each channel shown in a single strip and the strips are stacked vertically above one another The display 15 blank for any other type of ECG Manual Rev 1 0 29 Nov 2004 Single Lead 5 mmis mimm none
71. ponds to zooming out on the voltage scale Details of the signal may be difficult to resolve 2 2 2 3 10 mm s gt The default Shows ECG trace spread out enough vertically so that obvious features of the signal are easily resolved 235 2 2 5 200 mm s gt very stretched voltage scale The ECG trace is displayed over a relatively large vertical distance Corresponds to zooming in on the voltage scale Single Lead 7 5 mmis minim none none 1 20 mm m v 50 mm m v 100 200 mmm 3 Viewer display tools Speed selector gt A very tight time scale A large amount of ECG trace 15 displayed in a relatively small horizontal distance Corresponds to zooming out on the time scale Details of the signal may be difficult to resolve 2 5 mm s 3 2 3 3 gt The default Shows a modest amount of ECG trace in a typical display width with enough detail that obvious features of the signal are easily resolved 25 mm s SA s 3 5 500 mm s gt very stretched time scale A small amount of ECG trace is displayed in a relatively large horizontal distance Corresponds to zooming in on the time scale GEMS Lite Single Lead 5 mmis vf fic minim none 1 2 5 mm s 5 mm s 10 mm s 50 mm s 100 mms 250 500 mms Manual Rev 1 0 29 Nov 2004 Display tools 57 4 ECG Viewer dis
72. rt Editing information will be printed for each sample marked in each individual event Click Editing Enter name or initials of Editing Tech The status of the ECG is considered to be Not Edited as indicated in title bar of this dialog until both the Receiving Tech initials on the Receiving tab and the Editing Tech initials on the Editing tab have been filled in If you do not care about the status of the ECG you need not enter Editing Tech initials Status is displayed in ECG list Select appropriate findings from Technician s Findings list and click Append or enter findings as free text in the text box below Enter or modify appropriate measurements Click OK Arrhythmia ECG dialog closes Click Options Click Use Local Settings to use the viewer settings for printing This includes speed gain filter grid on off invert Reporting View allows the modification of the marked strip that will be printed If a 3 channel event is recorded and only the 2 ch strip is to be printed choose One Strip from the drop down menu to override printing the strip in 3 channel mode GEMS Lite ommmv 9 ES 1 k QA lt E Date 1149 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps 26 Arrhythmia ECG Braven Bobby Not Edited Strip Patient Braven Bobby ransmitter ID 75003804 vent 2
73. sing the ECG tools 4 Deleting a beat complex caliper 4 1 Click Point and Click Single Lead 25 mmimv None None 1 hl T 2 lt Patient Able Alfred Date 2003 Apr 15 Time 10 56 18 Duration 00 01 01 Sampling Rate 100sps 4 2 Position cursor over a marker vertical RR 30 0 bpm 0 180 Sec QRS 0 150 Sec 0 340 Sec 0 240 Sec line in the caliper P onset shown in this example gt Cursor changes to 4 4 3 Click mouse button gt Beat complex measurements bar appears 4 4 Press Delete key on keyboard Caliper measurement is removed if 4 00 00 10 30 4 gt 00 00 26 02 Text comments 1 Adding text comments 11 Click the T button to add Text Comments 27 Arrhythmia ECG Braven Bobby Not Edited DER File Report Tools gt Pointer changes to a Strip 25 BI k QUAL ETN E Patient Bobby Date 11 19 2002 Time 2 58 25 PM Duration 00 00 19 Sampling Rate 250sps 1 2 Position pointer where you wish to place text comment and click gt Text box appears at cursor position 1 3 Enter comments 1 4 Click anywhere outside of text box gt Text box closes gt Text remains superimposed on ECG trace OO 00 07 71 4 gt 00 00 16 90 GEMS Lite Manual Rev 1 0 29 Nov 2004 Editing tools 71 2 Reposi
74. sound card cannot be integrated 56K Modem or Internet Access Pentium III 500 256 MB Ram 100 MB free space on Hard Drive for application install 1 GB free space on Hard Drive for Database and ECG storage CD Rom drive Sound Blaster Live Value sound card must be a separate sound card cannot be integrated 56K Modem or Internet Access Manual Revision Date 29 Nov 04 Database Management Database Management 13 WARNING Reinstalling or uninstalling GEMS Lite can delete your database You must back up your database before you uninstall or reinstall GEMS Lite using the Add Remove Programs utility in Windows or by starting the Setup procedure from the GEMS Lite installation CD Uninstalling or reinstalling GEMS Lite will remove your database If you have a copy of your database you can copy it back to your computer to restore your data following reinstallation If you do not have a copy there is no way to recover your lost data except by re entering it very tiresome Upgrading GEMS Lite will automatically convert your existing database When upgrading it is always a good idea to make a copy of your data before Manual Revision Date 29 Nov 04 To back up your database 1 Shut down GEMS Lite if it is currently running 2 Copy the file C Program Files GEMS GEMS Lite mdb into another folder on your computer or on another computer on your LAN To restore your database after reinstallation 1 Do
75. t menu The Physician form appears 4 2 2 Edit Physician Edit Mew Help Edit Item Double clicking on the physician ges Wise Gene name also opens Physician form 4 3 To delete a physician record 4 3 1 Select physician s name in the physcian s list Choose Delete Item from the Edit Menu Aconfirmation prompt will appear 4 3 2 Using the Delete key on the keyboard will delete as well Once a record is deleted there is no way to retrieve it GEMS Lite GEMS Lite C Program File Edit Mew Tools Help Selecked Patient Selected Era Physicians 34 Peach Cardiologist 756 7456 345 Walt Cardiologist 345 3634 534 West Cardiologist 453 6346 3432 6th General 645 3454 3432 4th General 343 2342 1 Physician 2 Comments Specialty BE MEME Last Name Thomson Title Dbe Suffix Street 534 West Red Stet m First Name Teny City Philadelphia v State Pennsylvania ZIP Code Country United States M Description Phone Number Extension Phone work 453 6346 Fax E Mail Group All m Cancel Help v Close On OK Manual Revision Date 29 Nov 04 Gems Lite Scheduler 25 Gems Lite Scheduler 1 Accessing the GEMS Lite Scheduler 1 1 1 2 1 3 The GEMS Scheduler Lite is a tool for managing sch
76. tioning a text comment 21 2 2 2 3 2 4 Click Point Click Position cursor over any part of text Cursor changes to 15 Click and hold mouse button Drag to desired new position on trace Release mouse button Text 1s left at new position 27 Arrhythmia ECG Braven Bobby Not Edited DER Fie Report Tools Help One Strip 25 10 E Patient Braven Bobby Date 1119 2002 Time 2 58 25 PM Duration 00 00 19 Sampling Rate 250sps A Sample ECG 1 lt gt 00 00 07 29 4 gt 00 00 16 48 3 Editing content text comment 3 1 3 2 4 3 3 4 3 4 3 5 3 6 4 4 Click Point Click Position cursor over any part of text Cursor changes to 15 Right click mouse button Pop up menu appears Click Edit Text box opens for editing Edit text Click anywhere outside of text box Text box closes Revised text remains superimposed on ECG trace Manual Rev 1 0 29 Nov 2004 27 Arrhythmia ECG Braven Bobby Not Edited DER Fie Report Tools Help zlo elpor r ASA Ill TITIN E Patient Braven Bobby Date 1119 2002 Time 2 58 25 Duration 00 00 19 Sampling Rate 250sps Sample ECG is gt 00 00 07 29 4 gt 00 00 16 48 GEMS Lite 72 Using the ECG tools 4 Deleting a text comment 4 1 Click Point Cli
77. urement Pre vent 5 s PostEvent 10 2 Flags 1 gt Caliper length and label change with changing position 1 5 Release mouse button gt Measurement units label menu appears 1 6 Click on desired units or label A i GR CH v gt Label changes accordingly a 00 00 00 00 4 gt XXE gt ECG Viewer remains in caliper mode until cu another mode 15 selected 2 Repositioning a horizontal caliper 2 1 Click Point Click m 26 Arrhythmia ECG Braven Bobby Not Edited PIE oe Strip v fi 25 mmis None 1 QNI z T BI E 2 Position Cursor Over any part of caliper Patient Braven Bobby Date 1119 2002 Time 2 57 34 PM Duration 00 00 19 Sampling Rate 250sps measurement except endpoints RR RR ORDER GR HW DER OR C C WW a gt Cursor changes to 15 2 3 Click and hold mouse button 11 2 4 Drag to desired new position on trace 2o PreEvent 5 s PostEvent 10 s Flags 1 TEEI 2 5 Release mouse button il r1 gt Caliper is left at new position a0 ppm CHI v lt gt 00 00 0000 4 gt 00 00 09 18 GEMS Lite Manual Rev 1 0 29 Nov 2004 Editing tools 67 3 Deleting a horizontal caliper measurement 3 1 Click Point Click 3 2 Position cursor over any part of caliper measurement except endpoints gt Cursor changes to 15 3 3 Click mouse button gt Caliper label is underlined
78. ws Security dialog appears 6 2 Click Shutdown Windows NT Security dialog closes Shutdown Computer dialog appears 6 3 Click Restart 6 4 Click OK Shutdown Computer dialog appears The computer should shut down and restart This will take a few minutes If nothing happens after an extended time you may need to turn the power off wait a few moments and turn the power back on Windows may start in safe mode at this time and it 15 best to follow the above procedure to restart again in normal mode 6 5 If your computer system still does not respond press the Reset button on the front panel of your computer Start GEMS Lite again If problems persist please contact CardioComm Solutions Inc Help Desk at 877 744 1122 ext 3 Manual Rev 1 0 29 Nov 2004

GEMS - Surgo Surgical Supply

Contents

Download Pdf Manuals

Related Search

Related Contents