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SPIROTRAC ® IV User Manual

1. 66 Viewing Previously Stored Challenge 66 CHAPTER 8 PRINTING 8 4 111 1 67 Printing an Active or Recalled 67 Printing a Report for Active 22 00 1 67 Printing a Report for Recalled 67 Em 69 Tm 70 CHAPTER 9 TRENDING 71 CHAPTER 10 VIEWING TEST 5 75 Viewing Active or Recalled Test 0 0 2 75 Viewing Results for Active Tests 02 2 2 22 75 Viewing Results for Recalled Tests 2 00 0 021 15 CHAPTER 11 COMMUNICATING WITH THE VITALOGRAPH 2120 AND GOLD STANDARD a 78 Putting the 2120 and Gold Standard unit into Remote Mode 78 78 Sending patient information from the PC to the 2120 or Gold Standard 78 Retrieving Tests from the 2120 Gold Standard to the PC 79
2. TO BEGIN Piel Vol I ls SAMPLE Doe John Note that it is possible to exit from testing at any time by clicking on the FVC button Wait for the EXHALE TO BEGIN message to appear on top of the graph Read the following instructions to the patient so that testing is performed properly 41 Stand up Keep the flowhead away from your mouth Inhale as deeply as possible and insert the mouthpiece into your mouth clamping it between your teeth Close your lips round the mouthpiece Exhale as much and as quickly as possible and try to keep exhaling for at least 6 seconds if inspiratory parameters selected then inhale as quickly as possible A quality summary window is displayed Either click on the Yes button to accept the test or on the No button to reject the test If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button Click on the Preview button to view the results for the individual parameters associated with the test A window like the following sample is displayed Parameter Predicted Pre Pred Post Pred Change onm c ugs occum L L L L L L L u L L Ed E gd dg d gd tt ttt Ed dE gd gg d gd ttt ttt CS ha RO T INTTR Choosing the Print button will initiate a printout of the best test to date in this test sessi
3. Type the name of the required database into the File Name field or select it from the list 119 Click on the OK button Select the Patient menu and choose Add New Patient The following window is displayed Hew Patient Details Measurements Height cm weoh ka Cancel Patient ID is the only field where an entry is mandatory C Female Type the patient s surname into the Last field and a name or initial into the First and Middle fields Type a unique code to identify the patient into the Patient ID field Type the patient s date of birth in numbers into the Month Day and Year fields Ensure that a four digit year is entered Click on the Female field if the patient is female Type the patient s height into the Height field in either metric or Imperial depending on the measurement system defined in the Windows Control Panel in International Settings Type the patient s weight into the Weight field in either metric or Imperial depending on the measurement system defined in the Windows Control Panel in International Settings Select the appropriate Race from the drop down list Click on the More button to enter additional information or continue with step 16 if patient information is complete 120 11 12 13 14 15 16 The following window is displayed if the More button is clicked Additional Patient Information Smoke status
4. 205 Ee 80 CHAPTER 12 SETTING nennen nnn nnn nnn 81 FREDO DUODS ea 81 Create Modify Reports 81 Report Header oo Iit M Rv agus 82 COS WEST UL MM eae 83 MS SU BUIO Seater et acacia anaes a dance 83 DEVICE 84 REPE 84 ZI 84 CART c 85 oT AEP OSU ie aum tub dual 87 gt T 87 p I 88 INCEMUVE DISDIAY UPPER 91 ASS MT TM 92 c 93 93 tra qos d T 94 94 SWEN LOCK OMOR a eater os 95 CHAPTER 13 DATABASE 96 Creating New Database 8
5. Vitalograph Spirotrac IV Help Jatabase Options IC Flow l min SAMPLE Doe John Exit from testing at any time by clicking on the IV button Wait for the INHALE TO BEGIN message to appear on top of the graph 4 You now read the following instructions to the patient so that testing is performed properly Stand up and keep the flowhead away from your mouth 49 Exhale fully Insert the mouthpiece into your mouth and clamp it between your teeth Close your lips round the mouthpiece Inhale as much and as quickly as possible and try to keep inhaling for as long as possible Note that for a meaningful measurement of BHT breath hold time it is necessary to hold your breath after inhalation This should be followed by exhalation through the flowhead You are prompted if you wish to accept the test Click on the Yes button to accept the test or on the No button to reject the test If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button Click on the Preview button to view the results for the individual parameters associated with the test A window like the following sample is displayed Parameter Value IU L 3 80 Choosing the Print button will initiate a printout of the best test to date in this test session Click on the Close button to return to the previous screen 50 6 Repeat step 4 t
6. 13 Purpose ofthe Manual sri sanded 13 Gont nts of the nose tta aea a nose to cw d Pesce tenen 13 Conventions used in the 14 CHAPTER 3 INSTALLING THE SPIROTRAC IV SYSTEM 15 Connecting the Spirometer to your 15 Installing the Spirotrac A D 15 Connecting the Fleisch Flowhead Stand or S Model Spirometer to your PC 16 2120S POME ett ce 18 Gold Standard Spirometer 19 Software Installation 19 Loading the Spirotrac IV Software Windows 95 Windows 98 Operating SVOM eae erent ON p An LM MALI ADU Meh M 19 Installing Spirotrac IV on a 20 Changing the Device tesis E eee tati e 24 CHAPTER 4 CHECKING ACCURACY ON SPIROTRAC IV 25 Description of the Calibration Process 25 Attaching the Syringe to the 25 Attaching the Syringe to the 5 25 Calibrating the System 26 2120 and Gold Standard 28 CHAPTER 5 SELECTING AND MAINTAINING PATIENT INFORMATION 30 Entering een 30 Selecting or Modifying I
7. 96 Selecting a Database eh IEEE 97 DIGIGUNG aI ALAN ASS c M 97 Backing up Palient eS Edu M SM DNI NNUS 98 Restoring Patient Records from Backup 100 BI tige RAW n 102 CHAPTER 14 EXPORTING 104 Selecting the Database Containing the 104 Defining the Data to be Exported 105 EX DOMING AiG WIAA RT 114 CHAPTER 15 MANUALLY ENTERING DATA INTO SPIROTRAC IV 118 Entering Data for a New 118 Entering Data for an Existing 124 Veega SING Paseos 126 Adding Deleting and Viewing Test 127 CHAPTER 16 CLEANING THE FLEISCH FLOWHEAD S MODEL VOLUMETRIC SPIROMETER OR THE 2120 SPIROMETER 130 FIGISGIY IFIOWIMG AG PH 130 Disassembling the Fleisch Flowhead for Cleaning Sterilising and Disinfecting130 Reassembling the Fleisch Flowhead 132 S Model Volumetric Spirometer 133 2120 And Gold Standard 133 CHAPTER 17 ORDERING FLOWHEAD CONSUM
8. Options menu Sub menu Name Helvetica bold font followed by the word sub menu e g Database sub menu Items in Menu Helvetica bold e g Parameters Text to be Typed onto the Screen Courier font e g a setup Window Name Helvetica bold e g Recall Tests 14 CHAPTER 3 INSTALLING THE SPIROTRAC IV SYSTEM There are four procedures to follow before you can start using Spirotrac IV for the first time These are described in this chapter in the order in which you will perform them i e spirometer to the serial port or Spirotrac A D interface card of the PC load the Spirotrac IV software check the device type and change if necessary Boa update older version databases to version IV using the Migrate utility Refer to Appendix A Trouble shooting Software Related Problems and Appendix B Trouble shooting Hardware Related Problems for assistance if problems are encountered when following these procedures After installation of the hardware and software Spirotrac IV must be calibrated as described in Chapter 4 if using with the Fleisch Flowhead or S Model Connecting the Spirometer to your PC The Fleisch Flowhead and the S Model Spirometer are connected to the PC using a Spirotrac A D interface card that must be installed in the PC before connecting the device Installing the Spirotrac A D Card Follow these steps to install the card required by the Spirotrac IV software into your PC If you are not
9. Select the Patient menu and choose Delete Patient A window showing the patient details is displayed 126 Delete Patient Details Name Last First Middle Date OF Birth Day Honth Tear Race Patient ID JOHN DOE Sex Measurements Height Weight f Male C iEenmale cm kg Cancel Delete 4 Click on the Delete button 5 Click on the OK button to confirm deletion Adding Deleting and Viewing Test Results 1 Select a database as described in Entering Data For A New Patient section 2 Type the name of the patient or select if from the list 9 Click on the View Tests button and the following window is displayed Test Type Test Type C CES masuuumauumu CINE C 4 Select the test required in the Test Type field Click the OK button 127 6 Patient Test Results Current Patient ID JOHN DUE Doe John If there are no tests click on the Add Pre Tests button otherwise select a test and follow the instructions given To enter a post test select a test from the Pre Test Result s listbox and follow the instructions given To quit click Done Pre Test Hesult s Post Test 167271998 15 27 FYC Post Add Pre Tests Add Post Tests View Tests Delete Tests Done Select the required test to be viewed and click on the View Te
10. 340h gt 347h Option B I O address 338h gt 33Fh Check if the default settings conflict with any other interface cards and if possible change the switch settings to option A or B if they do not conflict with anything else and try it out If all these address ranges are being used contact your nearest dealer Card not plugged in properly opirotrac software does not see any hardware Possible system crash Ensure the connector is clear of obstructions or dirt and that the card is inserted fully Faulty Card opirotrac software does not see any hardware Possible complete system crash Incorrect measurements volume or temperature Contact nearest dealer for replacement 137 Problem Symptoms Remedy Problem Symptom Remedy Problem Symptoms Remedy Problem Symptoms Remedy Problem Symptoms Remedy Problem Symptoms Cable not connected properly Incorrect or no measurements volume or temperature Ensure the connectors are clear of obstruction or dirt and that they are inserted fully Faulty cable Incorrect or no measurements volume or temperature Contact the nearest dealer for replacement Faulty flowhead stand Incorrect or no measurements volume or temperature Excessive calibration drift Contact the nearest dealer for replacement Tubing connected incorrectly Reversed or no volume measurements Using the ribbed and smooth feature of the tubing as a guide
11. Active tests can be printed immediately after completion by first clicking on the Preview button and then clicking the Print button from within the test screen reference Chapter 6 Printing a Report for Recalled Tests 1 Select the Reports menu and then the Report Type sub menu For customisation of reports reference Chapter 9 Report Options 2 Choose the report type required 3 Select a patient for whom tests are to be printed as described in Chapter 5 4 Select the Reports menu and choose Print or click on the Print button The following window is displayed 67 Select tests for printing The following tests may be recalled from the database for printing maximum of three tests or one POST test may be recalled Time Post Result Visit Test 1670271998 16 21 Recall POST Test Select the tests to be printed and click on the OK button If post tests with the associated pre tests are required click on Recall Post Test for the appropriate test list The following window is displayed Print HP LaserJet 5HP on Copies Draft Quality Type the number of copies of the report to be printed if more than one is required Click on the Draft Quality field if appropriate 68 8 Click on the OK button and the report is printed Three sets of results is the maximum that can be printed on a page Batch Printing Follow these steps to batch print reports 1 Select the Reports menu and th
12. Date OF Birth Day Month Year Jp pe Hace Patient ID JOHN DOE Sex Measurements Height cm Weight ko More Cancel Male European Female Make changes as required Reference the Entering Data for a New Patient section for assistance if required Note that the Patient ID field cannot be changed Click on the Save Changes button when changes are complete Click on the View Tests button and the following window is displayed Test Type Test Type C CCS CINE C Select the test required in the Test Type field Click the OK button 125 Patient Test Results Current Patient ID JOHN DUE Doe John If there are no tests click on the Add Pre Tests button otherwise select a test and follow the instructions given To enter a post test select a test from the Pre Test Result s listbox and follow the instructions given To quit click Done Pre Test Hesult s Post Test 167271998 15 27 FYC Post Add Pre Tests Add Post Teste View Tests Delete Tests e Tests Done Click on the Add Pre Tests button Reference the Entering Data for a New Patient section for details on entering test results Deleting a Patient 1 select a database as described in Entering Data For A New Patient section Type the name of the patient to be deleted or select it from the list
13. Forced expiratory flow at 75 of the FVC litres sec Forced inspiratory vital capacity litres Percentage FIVC of FVC Peak inspiratory flow litres sec or litres min Forced inspiratory flow at 25 of the FVC litres sec Forced inspiratory flow at 50 of the FVC litres sec Forced inspiratory flow at 75 of the FVC litres sec Percentage FIF 50 of FEF 50 Maximum voluntary ventilation indirectly calculated from the FEV litres min Forced mid expiratory flow time secs Forced expiratory time secs Volume expired between 0 seconds and start time according to the back extrapolated volume litres Percentage Vext of FVC 96 Inspiratory volume litres Peak inspiratory flow choice of litres sec or litres min Breath hold time secs Maximum voluntary ventilation direct from a selected test time period litres min Inspiratory Vital Volume litres Functional Residual Capacity litres Tidal Volume litres Residual Volume litres Total Lung Capacity litres Inspiratory Reserve Volume litres Exspiratory Reserve Volume litres Inspiratory Capacity litres Click on the parameters to be displayed for the various test types 90 Note that all the results of tests are calculated and stored automatically so that the user can later recall a test and display any additional parameters which have been selected from this window 3 Click on the Test Date and Test Time fields if these are to be stored automa
14. IV software sends information to the 2120 or Gold Standard PATIENT TEST PRINT POST Performing Tests The 2120 or Gold Standard spirometer can be used in place of the Fleisch flowhead or S Model for performing tests The 2120 Gold Standard unit must be connected to the PC and must be ready for Remote Mode i e the main menu is displayed Reference Chapter 6 for further information on performing tests Sending patient information from the PC to the 2120 or Gold Standard Follow these steps to send patient information from Spirotrac IV to the 2120 or Gold otandard 1 Select the Comms menu and then the Send Patient s sub menu 78 Send Patient to External Device Select one or more patients from the list to send to the external device Search Criteria Search by Id C Search by Name 2 Select a patient for whom details are to be sent to the 2120 Gold Standard 9 Click on the Transmit button The patient s details now sent to the 2120 Gold Standard Retrieving Tests from the 2120 Gold Standard to the PC Follow these steps to retrieve tests from the 2120 Gold Standard to the PC 1 Make sure the unit is ready for remote mode 2 Select the Comms menu and then the Retrieve Tests sub menu Results can be moved from the 2120 Gold Standard to Spirotrac IV i e deleted on the 2120 Gold Standard afterwards In this case select Retrieve And Delete Results can also be copied from the 2120 Gold Standard t
15. RELATED PROBLEMS Problem Remedy Problem Remedy Problem Remedy Problem Remedy Problem Remedy Problem Remedy Message TESTING BELOW 17 NOT RECOMMENDED Check cable connection from device to computer or Reset the temperature on the 2120 Gold Standard spirometer Test performed but does not show on screen Check that the correct device was selected in the Options menu Check that the flowhead tube is connected to the same colour connector at both ends Inspiratory flow does not appear on the screen Check that inspiratory parameters were selected in Parameters in the Options menu Flow and volume time curves are too small or too large Rescale the graphs by using the rescale buttons at the top right hand corner of the test screen Report does not print the chosen parameters or graphs Check that the correct report was chosen from the Reports menu Printout of graph does not fit the page Check the time scales selected in the Options menu 136 APPENDIX B TROUBLE SHOOTING HARDWARE RELATED PROBLEMS Problem Symptoms Remedy Problem Symptoms Remedy Problem Symptoms Remedy Board Address conflict Spirotrac software does not see any hardware Any board in conflict with it does not function either Possible complete system crash There are three recommended switch settings for the card Factory Default I O address 330 gt 337 Option A I O address
16. button otherwise select a test and follow the instructions given To enter a post test select a test from the Pre Test Result s listbox and follow the instructions given To quit click Done Pre Test Hesult s Post Test Done 19 Click the Add Pre Tests button Add Pre Tests 122 20 21 22 23 24 25 26 27 28 Test Parameters Measurements Height cm FEF 75 85z FEF 2 1 2 FEF 25 FEF 50 e FIF 50 FIF 54 Weight kg Technician s Initials Visit Ref Test Ref FEY 5 FEY 75 FEY 1 FEY 3 PEF FEF 25 75 FEF 75x FIVC PIF L sec FIF 25x e __ Effort Rating Date of Test Time of Test TA Good Day Month Year Cancel OF The parameter field is the only field on this window where an entry is mandatory Type the results into the parameter fields Type the patient s height at the time of the test into the Height field Type the patient s weight at the time of the test into the Weight field Click on Poor Average or Good in the Effort Rating field if Average is not appropriate Type a date into the Date of Test field in the format of mmddyy or ddmmyy depending on the set up in the Windows Control Panel in International oettings Type a time into the Time of Test field in the format of hhmm
17. choose Backup patient records The following window is displayed 98 3 4 Select Database File name Folders backup db c spiro4 database gt c Cancel spiro4 Network c3 database _ sample Save file as type Spirotrac db Backup Hestote Patient Selection Select one or more patients from the list to copy to the backup database Search Criteria Search by Id Search by Name This window displays the patients in the selected database Select the patients whose records are to be backed up Click on the Backup button and this window is displayed 99 Database not found 7 The backup database does not exist in this directory Do you wish to create IE Click Yes to backup the selected patients records Clicking No cancels the backup process Note that when backing up to a non permanent medium e g floppy disk the records are copied to a temporary database on the hard drive If the database grows too large for one diskette the temporary database will be copied to the specified drive and the user will be prompted to insert another diskette This process continues until all selected records are backed up Restoring Patient Records from Backup Follow these steps to copy back customer records from a backup diskette for use in the system 1 Select the Database menu then select the destination database Now choose Restore from backup A windo
18. e g 0930 for 9 30 a m Type a visit reference number into the Visit Ref field Type a test reference number into the Test Ref field Click on the OK button A window like the following sample is displayed showing the test the user entered 123 Patient Test Results Current Patient ID JOHN DUE Doe John If there are no tests click on the Add Pre Tests button otherwise select a test and follow the instructions given To enter a post test select a test from the Pre Test Result s listbox and follow the instructions given To quit click Done Pre Test Hesult s Post Test 167271998 15 27 FYC Post Add Pre Tests Add Post Teste View Tests Delete Tests Done 29 Click on the Add Pre Tests button to add the results of other tests or select a pre test and click on the Add Post Tests button to add a post test that is to be associated with this pre test e Tests 30 Repeat steps 17 to 29 until all the test results for the patient have been entered 31 Click on the Done button when finished Entering Data for an Existing Patient Select a database as described in Entering Data For A New Patient section 2 Type the name of the patient or select it from the list Select the Patient menu and choose Edit Patient to change information for that patient 124 5 6 A window like the following sample is displayed Change Patient Details First Middle
19. enter these demographics as current or cancel Enter as Current Type the patient s surname into the Last field and a name or initial into the First and Middle fields Type a unique code to identify the patient into the Patient ID field This is a key field therefore an ID must be entered Type the patient s date of birth in numbers into the Day Month and Year fields Click on the Female field if the patient is female Type the patient s height into the Height field in either metric or Imperial depending on the measurement system defined in the Windows Control Panel in International Settings Note that if height and weight trending is to be used entries must be made here and in step 7 Type the patient s weight into the Weight field in either metric or Imperial depending on the measurement system defined in the Windows Control Panel in International Settings Select the appropriate Race from the pull down list Click on the More button if additional information is to be entered or continue with step 14 if information entry for the patient is complete The following window is displayed if the More button is selected 31 10 11 12 13 14 15 Information Cigarettes per Day H Years Smoked H Years Since Quit Occupational Exposure pee Cpe General Comments Referring Physician Entries in this window are optional Click on the Currently Smokes field if
20. familiar with your CPU unit and have problems with the terminology used here you should refer to the relevant diagrams in your PC manuals 15 1 Make sure your PC is turned off and disconnect the mains cable from the CPU unit 2 Remove the cover of the CPU unit If unsure of the screws to remove consult the manual for your PC Find a vacant ISA slot where the card can be inserted 4 Remove the blanking plate adjacent to the slot by releasing the screw s holding the plate Take the card and plug it into the selected ISA slot inside the CPU The blanking plate removed in step 4 should now be replaced with the blanking plate attached to the card Use the screw s you took out of the original blanking plate to fix in place T Replace the cover of the CPU The Spirotrac A D card is now installed and ready for use Connecting the Fleisch Flowhead Stand or S Model Spirometer to your PC 16 13 Connect the male end of the cable into the Fleisch Flowhead stand or the back of the S model and the female end of the cable into the card at the back of the PC 17 2 Connect one end of the tube to the flowhead and the other to the flowhead stand To assist you in making the connection the tube has a rough side and a smooth side and the ports on the flowhead and flowhead stand are colour coded Simply connect the rough and smooth sides of the tube to the ports of the same colour on the flowhead as the ports on the flo
21. menu and then the Password sub menu 2 Choose Switch Lock On Off The following window is displayed Options Lock Password Enter the password 9 Type the user s password into the Enter the password field 4 Click on the OK button 95 CHAPTER 13 DATABASE MANAGEMENT In Spirotrac IV the user can create a number of databases in which to store patient information as a means of assisting in the management of this information For example if the user has several clinics a database may be set up for each clinic Then for instance if the user wishes to back up customer records on diskette it will be quicker to select patients from a list for one clinic rather than from a list of all patients Once the required databases have been created remember to check that the correct database is in use when selecting patients running tests etc It should be noted that as a database grows large the time taken to access records may increase significantly The Database menu is used to maintain the databases backup and restore patient records and to delete specified raw data Creating a New Database Follow these steps to create a new database 1 Select the Database menu and choose Create new database The following window is displayed Create New Database Enter a filename for the new database Filename 2 Type the name of the new database up to eight characters with no spaces into the Filename field 96 3 C
22. the Database menu The following window is displayed 104 Open Ei Es File name Folders Cancel sample db E cA spiro4 Network 254 database sample Read only List files of Drives DataBase Files db E 3 Type in the name of the database required into the File Name field or select one from the list if the name displayed is not correct 4 Click the OK button Defining the Data to be Exported 1 Select Patient Tests in the Options menu The following window is displayed 105 i Options Select Patient Test Information Please Select Tests by Clicking on the Check Boxes Patient Demographics Setup Test Results Setup S C Test Results Setup HVV Test Results Setup Test Results Setup Iv Test Results Setup CCS Test Results Setup Challenge Test Results Setup Select All 2 Click on the Patient Demographics check box if not enabled Click on the Patient Demographics Setup button and the following window is displayed Options Patient Demographics Patient Information Smoker Last Name Years Smoked Date of Birth Format First Name Years Quit Paradox Date Value Middle Name Cigs Per Day Sex Race Race Format Date OF Birth Bronchial Provocation Letter Code Height Refering Physician Weight General Comments Select All Cancel Click on the patient inf
23. the Device sub menu of the Options menu 2 select Screen in Patient menu it is unlikely the user will want to save these tests Enter the relevant patient data and click on the OK button 3 Select the Test menu and choose FVC or click on the FVC button FUL If the Enter Visit Reference window is displayed type a reference number into the Visit Ref field and click on the OK button 52 4 Select the Test menu and choose ATS and the screen looks like the following sample Vitalograph Spirotrac IV f 3 x Ge lel 1 Flow l s SAMPLE Doe John 5 Click on the waveform number required for the test and the ATS test is performed Post Testing Select the Test menu and choose Post Test or click the Post button Post The Recall Patient from Database screen will be displayed if a patient is not already selected Select the patient and click the OK button The tests will be retrieved from the database the last test for the patient will be highlighted Refer to the section for the appropriate test to continue as normal 53 Post testing is not available for IV testing Quick Saving The quick saving utility is useful if a number of patients are being tested over a small period of time and some interchanging of patients is required A maximum of 20 patients can be quick saved at any one time To quick save a patient simply do the following 1 Go to the main screen If tes
24. the OK button when ready to perform the test Repeat steps 17 and 18 to perform the diluent test Click on the Exit button Click on the OK button when ready to perform testing If the user clicked on the Time field in step 10 the following window is displayed 62 22 23 Start the clock Press the NOW button to start the testing clock If you are exposing the subject to a constant environment eg exercise cold air this should be done at the start of the exposure Click on the NOW button and continue with step 25 Click on the Dose button and the following window is displayed Enter the next dose Hext dose The dose will he Enter the dose to be administered Click on the OK button and a window like the following sample is displayed 63 24 25 26 Administer doze This dose is 12 00 pl Press the NOW button when you administer this dose Cancel Click on the NOW button when the dose has been administered Click on the OK button when ready to begin testing Click on the Exit button when testing is finished A screen like the following sample displays the response curve 64 27 28 Vitalograph Spirotrac BE nese ee wood imma SI ET I 1812 le eae iris 20 Dil SAMPLE Doe John Repeat steps 17 and 18 to perform the test until a window like th
25. tick symbol is either added or removed The absence of the tick signifies interpretation is not available The presence of the tick signifies interpretation is available SVC Bar Graph This option is used to indicate if the graph produced when performing SVC testing will be a bar graph or a line graph 93 1 Select the Options menu and choose SVC Bar Graph 2 If the user clicks on SVC Bar Graph the tick symbol is either added or removed The absence of the tick signifies a line graph will be produced The presence of the tick signifies a bar graph will be produced This is the most commonly used type of graph for SVC tests Passwords There are two password options Change and Switch Lock On Off Change Option This option is used to change a password 1 Select the Options menu and then the Password sub menu 2 Choose Change The following window is displayed Change Options Lock Password Old Password Hew Password Retype Mew Password 3 Type in the password used currently into the Old Password field For security purposes the password typed on the screen is displayed as asterisks 4 Type in the new password into the New Password field 94 D Retype the new password into the Retype New Password field 6 Click on the OK button Switch Lock On Off Option This option is used to restrict or allow a user s access to certain functions in Spirotrac IV 1 Select the Options
26. to return to the previous screen Choosing the Print button will initiate a printout of the test being viewed Repeat step 4 to perform another SVC test if required Click on the SVC button to quit from the SVC test You can run another type of test by clicking on the appropriate button If the Save Tests window is displayed this appears if tests are being saved manually the user can click on Poor Average or Maximum to change the effort rating Click on the tests to be saved and then click on the Save button to save the tests Tests are saved automatically by selecting ATS Best Test ERS Best Test ATS Best 3 or ERS Best 3 in Save Tests in the Options menu Performing FVC Testing including Incentive Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 40 Select the Test menu and choose FVC or click on the FVC button FUL Note The position and size of the graphs may be saved for future tests by using Save Position Size in the window control box in the top left hand corner of the graphs When performing an Incentive test and the two graphs are on the screen reduce them to icons at the bottom of the screen and then click on the Incentive button The screen can then be shown to the child and explain what is going to happen during the test before repositioning the graphs on the screen Vitalograph Spirotrac
27. 9 55 F973 62 IUG L 3 12 Test Type CCS Choosing the Print button will initiate a printout of the best test to date in this test session If Interpretation in the Options menu is selected clicking on the Interp button displays an automatic interpretation of the results Click on the Close button to return to the previous screen Repeat step 5 to perform another CCS test if required Click on the CCS button to quit from the CCS test Note The data stored for a Closed Circuit Test is the last 30 seconds of the test Other tests may be initiated by clicking on the appropriate button Performing IVC Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 2 Select the Test menu and choose IVC or click on the IVC button IUL EL 46 The screen looks like the following sample Vitalograph Spirotrac IV Patient Test Reports Comms Database Options Help EXHALE TO BEGIN Vol 1 2 4 8 10 12 14 T8 20 22 24 26 28 30 SAMPLE Doe John Exit from testing at any time by clicking on the IVC button Wait for the EXHALE TO BEGIN message to appear on top of the graph Read the following instructions to the patient so that testing is performed properly Stand up Insert the mouthpiece into your mouth clamping it between your teeth Close your lips around the mouthpiece Brea
28. ABLES ACCESSORIES AND SPARE PARTS a ce 134 Flowhead Consumables and Accessories 134 decentius c Mam kA C E M M M EM Ea 134 APPENDIX A TROUBLE SHOOTING SOFTWARE RELATED PROBLEMS 136 APPENDIX B TROUBLE SHOOTING HARDWARE RELATED PROBLEMS 137 APPENDIX TECHNICAL SPECIFICATIONS 140 CUSTOMER SERVIGE nete entities 142 GUARANTEE 143 Contents of the Package You should check the contents of the package before you start reading this manual and installing the Spirotrac IV9 software Diskettes containing the Spirotrac IV software opirotrac IV User Manual ooftware licence agreement opirotrac IV Quick Start Guide Registration and warranty card Contact your distributor if there is anything missing Hardware and Software Requirements Here is a list of the minimum hardware and software requirements to run Spirotrac IV 486 based 66MHz PC or better with a drive Minimum of 8 MBytes extended RAM Microsoft Windows 95 Windows 98 Mouse Once you are sure you meet these requirements you can start following the instructions in this manual to install and then use Spirotrac IV We also recommend the following The monitor s desktop area resol
29. C Smoker Occupational Exposure General Comments Referng Physician It is not mandatory for the user to make entries in any of the fields in this window Click on the Smoke Status field as appropriate If the Ex smoker field is clicked type the number of packets the patient smoked per day the number of years the patient smoked and the numbers of years since the patient quit smoking into the Smoked Day Years Smoked and Years Since Quit fields respectively If the Smoker field is clicked type the number of packets the patient smokes per day and the number of years the patient has smoked into the Smokes Day and Years Smoking fields Type the name of any potentially debilitating drugs or substances to which the patient is exposed at work e g isocyanates into the Occupational Exposure field Type any remarks about the patient into the General Comments field Type the name of the patient s doctor into the Referring Physician field Click on the OK button and the New Patient Details window is redisplayed Click on the OK button and the following window is displayed 121 Test Type Test Type C ccs C S C C HYY 17 Select the test required in the Test Type field 18 Click on the OK button A window like the following sample is displayed Patient Test Results Current Patient ID 58C Hame new pat If there are tests click on the Add Pre Tests
30. Export Raw Data in the Options menu to include raw data in the transfer Exporting the Data 1 Ensure a database is selected 2 Follow this step to export data for all patients or follow step 3 to export data for one patient Select All Patients in the File menu and the following window is displayed Export All Patients Filename C SPIRUASALL TAT Cancel Type in the name of the file to which the data is to be exported into the Filename field if the file displayed is not correct Click on the OK button The following window is displayed if the file already exists w C SPIRO4 ALL TAT This file already exists Append Cancel 114 Click on the Overwrite button to write over the information that is already in the file or click on the Append button to add the new information to what already exists in the file or click on the Cancel button and repeat the appropriate steps to rename the file The data is then exported Follow this step to export data for one patient Select Patient in the File menu and the following window is displayed Select Patient Patent Export Patient Data Doe John Browse Patents Search database on Patient Name C Patient ID Cancel There are three choices when searching for a patient by patient name by patient ID or by browsing through the patient records until the correct one is found By patient name Click on the Patient
31. FVC Duration 3 Choose 10 12 or 15 units in seconds for maximum MVV Duration 20 or 30 units in seconds for maximum FVC Duration 83 Device This option is used to define the required device type 1 Select the Options menu and then the Device sub menu 2 Choose the required device Choose ATS Waveform to simulate FVC tests from a choice of 24 waveforms and then view the results Calibration There are two Calibration options Device and BTPS Device The steps for calibrating a device are described in Chapter 4 BTPS This option is used to change the barometric pressure reading used by the system to calculate the BTPS correction factor This is only necessary when using the S Model Spirometer or the Fleisch Flowhead 1 Select the Options menu and then the Calibration sub menu 2 Choose BTPS The following window is displayed 84 BIPS Conversion Factor 5 Components Temperature 25 1 Barometric Pressure mmHg BIPS Conversion Factor 1 0737 Apply BTPS Calculate Cancel Note that Spirotrac IV measures the ambient temperature directly so you do not have to enter the temperature Change the value in the Barometric Pressure field 4 Click on the Calculate button and the BTPS correction factor changes to reflect the value you entered Click on the Apply BTPS field to apply the factor to the spirometer Click on the OK button to save the new BTPS correction factor Sa
32. Flow Volume graph FEF 25 50 75 COPD risk percentage risk of cardio pulmonary disease Operator s initials initials of the operator who performed the calibration Click on the OK button to save the report The new report is created NB To use this new report the user must first select the Reports menu and then select Report type Highlight the required report name ie Standard Now the new report is ready to be used Report Header Option This option is used to describe the headings to appear on reports Select the Options menu and then the Report Options sub menu Choose Report Header and the following window is displayed 82 Report Header These three lines will be placed at the top of each report Header Lined Function Report Line 2 Vitalograph 21 70 Line 3 Spirotrac Iv 3 Enter up to three lines of text in the Line 1 Line 2 and Line 3 fields to appear as the heading on reports 4 Click on the OK button CCS Test Display When performing Closed Circuit Spirometry testing two types of graphical displays can be used e Volume Time Window e Flow Volume Window selecting one of these options will determine which graphical display will appear during CCS testing Test Duration This option is used to change the maximum length of time FVC and MVV tests are run after which results are calculated 1 Select the Options menu and then the Test Duration sub menu 2 Choose MVV Duration or
33. Name option in the Search database on field Click on the required patient name from the Patient list Click on the Export Patient Data button 115 Note that double clicking on the patient name within the Patient list has the same effect By patient ID Click on the Patient ID option in the Search database on field e Click on the required patient ID from the Patient list e Click on the Export Patient Data button Note that double clicking on the patient ID within the Patient list has the same effect By browsing Click on the Browse Patients button A window like the following sample is now displayed if the user has searched for the patient by patient name patient ID or by browsing Patient Information Patient ID Date OF Birth Day Month Year 1 jp Measurements Hace lt lt lt Previous gt gt gt Next gt gt gt E Cancel 116 Note that if browsing to select a patient the user can click on the gt gt gt Next gt gt gt and lt lt lt Previous lt lt lt buttons until information for the required patient is displayed Click on the Export button and the following window is displayed Export One Patient Filename C SPIRO 45002 TAT Type in the name of the file to which the data is to be exported into the Filename field if the file displayed is not correct w CASPIRO4 002 TAT This file already exists Append Cancel Click on the Overwr
34. SPIROTRAC IV User Manual Ce Vitalograph Ltd Maids Moreton Buckingham MK18 1SW England Phone 01280 827110 Fax 01280 823302 E mail sales vitalograph co uk Internet www vitalograph co uk Vitalograph GmbH Jacobsenweg 12 22525 Hamburg Germany Phone 040 54 73 91 0 Fax 040 547 391 40 E mail info vitalograph de Internet www vitalograph de Vitalograph Inc 8347 Quivira Road Lenexa Kansas 66215 U S A Phone 913 888 4221 Fax 913 888 4259 E mail vitcs vitalograph com Internet www vitalograph com Vitalograph Irl Ltd Ennis Industrial Estate Gort Road Ennis Co Clare Ireland Phone 065 6829611 Fax 065 6829289 E mail sales vitalograph ie Internet www vitalograph co uk Copyright Vitalograph 1998 2000 Current Edition Issue 2 Cat No 081058 Aa talograpli is a registered trademark Table Of Contents Contents of the Package cerises 7 Hardware and Software Requirements 7 CHAPTER 1 INTRODUCING SPIROTRAC 9 Description Of Spirotrac ete hoe eo 9 Features of Spirotrac 9 Buttons and Icons Used Spirotrac 10 CHAPTER 2 INTRODUCING THIS MANUAL
35. Standard before Performing Tests Before any communication between the PC and the Vitalograph 2120 or Vitalograph Gold Standard can commence the unit must be in Remote Mode This is achieved by switching the unit on Once the main menu screen shown here is displayed the unit will automatically enter remote mode when the Spirotrac IV software sends information to the 2120 or Gold Standard PATIENT TEST PRINT POST Checks to Make before Performing SVC FVC CCS IVC IV and MVV Tests Before starting SVC FVC CCS IVC IV and MVV testing there are a number of checks which must be made to ensure that the options for testing are set up as required 15 Check that the accuracy of the device was checked recently see Chapter 4 2 Check that the Save Tests sub menu in the Options menu is correctly set for the way the tests are to be saved 36 3 Check that the parameters to be measured and the Test Date Test Time Visit Ref and Test Ref fields are selected as required in the Parameters sub menu in the Options menu Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests This section describes the common steps to follow when performing SVC FVC CCS IVC IV and MVV tests After following these common steps continue with the specific steps for the test to be performed e g the Performing FVC Testing section 1 Select a current patient by one of these methods select a patient for whom tests as desc
36. ac IV Setup window is displayed click the Next button If necessary make changes to the destination drive and directory by selecting the Browse button Click the Next button when finished Select what utilities are to be installed If you have a previous version of opirotrac it is recommended that the Database Upgrade Utility is installed If a utility is required after the first installation the setup program can be run again Click on the Next button 19 9 opirotrac may be linked to a Third Party Data Management System For more information contact your local Vitalograph distributor or else Click next to continue 10 Forthe purpose of software security you are required to enter in a password This is the Spirotrac Software Serial Number which is supplied by Vitalograph on the software package Enter this Serial number and click 11 Thefiles are copied to the selected drive and directory An error message is displayed if there is insufficient space on the drive If this occurs you should click on the OK button Create space by deleting or backing up files and then start installing again from step 1 12 Ifa network setup is required click the Yes button at the Network Setup prompt otherwise click the No button For more information on networking refer to the section Installing Spirotrac IV on a Network 13 message is displayed on the screen when loading is completed Click on the Finish button It is good pract
37. alibrated remotely Their respective user manuals should be consulted for details Description of the Calibration Process In accordance with the international standards governing spirometry it is recommended that calibration is checked daily Note that if the input device is changed the system must be re calibrated There are two stages to the calibration process in Spirotrac IV Firstly the system checks for the volume of two consecutive strokes within 3 of each other Six attempts at this are allowed and if this is not achieved the calibration process is stopped as it is assumed there is a problem with the equipment or the way the user is calibrating e g too quickly or slowly Secondly when two consecutive strokes within 3 are achieved the system takes the volume of the last stroke as being the measured volume and compares it with an actual volume keyed into the system by the user If the measured volume is within 3 of the actual volume ATS criteria have been met and the calibration is updated automatically If ATS criteria are not met the user is given the choice on whether or not to update the calibration in order to compensate Attaching the Syringe to the Flowhead Attach the flowhead as illustrated in the following diagram Be careful not to pinch or twist the tubing Attaching the Syringe to the S Model Refer to the S Model User Manual for instructions for attaching the syringe 25 Calibrating the System Fol
38. applicable If this is the case enter the number of cigarettes the patient smokes per day and the number of years the patient has been smoking into the Cigarettes Day and Years smoked fields respectively or Type in the number of years the patient has stopped smoking into the Years Since Quit field if applicable Type the name of any potentially debilitating drugs or substances to which the patient is exposed at work e g isocyanates into the Occupational Exposure field Type any remarks about the patient into the General Comments field Type the name of the patient s doctor into the Referring Physician field Click on the OK button and the New Patient Information window is redisplayed Click on the Enter as Current button to save the new patient information entered and to continue To enter information for another new patient click on the Save button and then the New button 32 Selecting or Modifying Information for an Existing Patient Follow these steps to select a patient for testing whose information was previously entered into Spirotrac IV 1 Select the Patient menu and choose Recall Or click the following icon The following screen is displayed Recall Patient from Database Search Criteria Type the patient s ID number or select one from the list Search by ID C Search by JOHN_DOE 2 Patients may be listed either by ID or by name Click the preferred button in the Search Crit
39. boot the PC Next it is necessary to share the directory containing the Spirotrac database This is the directory which Spirotrac was installed to the default directory is C Spiro4 To share this directory in Windows Explorer select the directory CASpiro4 or whatever the installation directory is if different Click on the right mouse button from the activated menu select Sharing Share the directory with Full access Finally it is necessary to run the Database Engine Network Configuration utility supplied with Spirotrac Paradox Engine Configuration Utility ICE XI Metwork Configuration Hesource Limits Save to SVIN INI File Click on the Network Configuration button 21 Paradox Engine Network Configuration UserName italograph Paradox Network x1 Control File Path Use Locking Protocol compatible with C Paradox 3 5 Share Local Tables Cancel Enter the letter that was set up in step 1 for the Paradox Network Control File Path the default is X Click on the OK button Click on the Resource Limits button 22 7 8 Paradox Engine Resource Limits specify the maximum value for the following items The combined resources used by all active Windows applications on your workstation cannot exceed this limit Open Tables Bo Record Buffers Record Locks per Table Open Files owap Buffer Size Khytes Cancel Help E
40. can be recalled after they were first run and secondly the number of days after which raw data will be automatically deleted from the system Recalling a test makes it current as if it had just been performed This is done in order to have a visual comparison with previous tests when performing tests 1 Select the Options menu and choose Database The following window is displayed Database Options Test Recall Tests can be recalled for up to All tests can be recalled Haw Data Automatic delete Haw data can be deleted after 21 days Enter 1 to keep raw data indefinitely 92 Click on the Tests can be recalled for up to field to recall tests within a certain time limit and then type in the number of days up to which tests can be recalled or Click on the All tests can be recalled field if you wish to recall tests without a time limit Click on the Automatic delete field to delete raw data Type in the number of days after which raw data will be deleted automatically This number should not exceed the number entered in step 2 Enter 1 in this field to keep the raw data indefinitely Note that the raw data is not deleted until the patient information is selected again Click on the OK button Interpretation This option is used to indicate if an interpretation is available during testing and on reports Select the Options menu and choose Interpretation If you click on Interpretation the
41. ced PC based spirometry is required The software application is compatible with earlier versions of Spirotrac and is able to work with existing hardware input devices using the Spirotrac A D Card including the S Model spirometer and the Fleisch Flowhead Additionally it is designed to work with 2100 Series devices using the computer s serial port for communication The 2100 Series consists of the following units 2120 Spirometer measuring device e 2130 Base Station docking station for 2120 Gold Standard Volumetric Spirometer measuring device Features of Spirotrac IV Spirotrac IV s features include Intuitive and easy to use Windows interface Integrated database for storing patient information and raw test data Powerful trending facility Built in ATS test quality criteria Challenge testing routine Data export to off the shelf spreadsheets and databases Manual data entry of results into the Spirotrac database Incentive display Buttons and Icons Used in Spirotrac IV The following buttons are visible on the Spirotrac IV main screen Enter the details of a new patient and add the patient to the database Retrieve the details of an existing patient from the database Prints reports from the database Previews test results from within a test screen Selects the SVC Slow Vital Capacity test option Selects the FVC Forced Vital Capacity test option selects the CCS Closed Circuit Spir
42. d push the flowhead mesh housing onto the larger diameter 5 When attaching the flowhead tubing ensure that the matching coloured pressure tappings on the flowhead and the spirometer are connected to each other 132 S Model Volumetric Spirometer Follow the instructions in the Vitalograph S Service Manual to clean disinfect and sterilise the S model breathing tube and bellows 2120 And Gold Standard Spirometers Refer to the relevant user manuals for cleaning information on the Vitalograph 2120 and Gold Standard 133 CHAPTER 17 ORDERING FLOWHEAD CONSUMABLES ACCESSORIES AND SPARE PARTS Flowhead Consumables and Accessories Cat No Description 20201 Disposable Mouthpieces box of 200 20242 Safety Mouthpieces box of 200 20202 Mini paediatric Mouthpieces box of 400 20303 Nose Clips pack of 10 42084 Semi disposable Mesh Filters pack of 10 20302 Mini paediatric Mouthpiece Adapter 20408 1 Litre Precision Syringe Spare Parts Cat No Description 42019 SPR Flowhead Cone Complete 42021 SPR Flowhead Cone Body 42028 SPR Rubber Retaining Strap 42029 SPR Flowhead Connection Tubing 42046 SPR Flowhead Complete 134 42055 SPR 42078 SPR 42079 SPR 42082 SPR 68087 SPR 68015 SPR 68040 SPR Element Assembly Flowhead Mesh Housing Pneumotach Resistive Element Flowhead Seal Ring Kit PC Interface Cable software Upgrade Kit Flowhead Stand Assembly 135 APPENDIX A TROUBLE SHOOTING SOFTWARE
43. data Method All patients Get confirmation for each patient Cancel 2 Select one of the following types of data for deletion e Raw data past the delete date defined previously in the Options menu Raw data past the number of days typed into the window to replace the number of days displayed there All raw data for every patient in the database Select one of the following methods of deletion 102 All patients are deleted automatically Each patient name is displayed for confirmation of deletion 4 Click on the Delete button and deletion begins 103 CHAPTER 14 EXPORTING DATA The Exporting Data function is used to export patient information and associated raw test data if selected from Spirotrac IV to an application e g Excel ina format that is understandable for use by that application There are three stages involved in exporting data 1 Selecting the database containing the data to be exported 2 Defining the content of what is to be exported i e the patient information and the format in which this information is to be exported and whether or not raw data are to be exported 9 Exporting the data Selecting the Database Containing the Data 1 Run the Data Export Utility If the Export facility has not been previously configured the message Cannot open options files is shown Ignore and click OK The Spirotrac IV Database Export Utility window is displayed 2 Select
44. e LxDxW 19 x17 x12 or 480x440x300mm Weight net 23165 or 10 5Kg Vitalogram charts Smudge resistant coated card Chart storage life More than 30 years Operating voltage 110 250v 50 or 60 Hz Storage Temperature 0 50 C Relative Humidity 10 95 2120 And Gold Standard Spirometers For specifications of the 2120 and Gold Standard spirometers refer to their respective user manuals 141 CUSTOMER SERVICE For the names and addresses of approved Vitalograph Service Agents please contact any of the following offices or your local Vitalograph distributor Vitalograph Ltd Maids Moreton Buckingham MK18 1SW England Phone 01280 827110 Fax 01280 823302 E mail sales vitalograph co uk Internet www vitalograph co uk Vitalograph GmbH Jacobsenweg 12 22525 Hamburg Germany Phone 040 54 73 91 0 Fax 040 547 391 40 E mail info vitalograph de Internet www vitalograph de Vitalograph Inc 8347 Quivira Road Lenexa Kansas 66215 U S A Phone 913 888 4221 Fax 913 888 4259 E mail vitcs vitalograph com Internet www vitalograph com Vitalograph Irl Ltd Ennis Industrial Estate Gort Road Ennis Co Clare Ireland Phone 065 6829611 Fax 065 6829289 E mail sales vitalograph ie Internet www vitalograph co uk 142 GUARANTEE Terms of Guarantee Subject to the conditions listed below Vitalograph Ltd and its associated companies hereinafter called the Company guarantee to repair or at its opi
45. e Colour Printer option in the Reports menu It is important to have the latest printer drivers installed on your computer these will be supplied with your printer 70 CHAPTER 9 TRENDING RESULTS Select a current patient as described Chapter 5 2 Select the Test menu and choose Trend or click on the Trend button A window like the following sample is displayed listing the tests you can use for trending Trend setup Test type Pernod C SYC Select period s Day Month Year C INE From I Jy C CCS CUN Select the type of test Click the Select Period button and enter the desired date from which the tests are to be retrieved if required otherwise all test results will be retrieved Click the OK button Select the tests for trending in the following window 71 Trend Tests Select those tests that you wish to trend Double clicking on a test wall display results for that test 1670271998 16 27 F C post 1670271998 16 21 F C All the tests performed for the patient are listed here sorted by date and time with the most recent test at the top of the list Double clicking on a test will view details of the parameters associated with that test A window like the following sample for FVC tests is displayed 72 Test Results Click on the Print button to print a report which lists the test parameters Click on the Done button to return to the previ
46. e following sample is displayed indicating the target value has been reached Challenge Testing The target value has been reached or exceeded Result The curnulative dose required ta produce a drap in from baseline was 26 276 pl Press the Previous button to exit testing Note testing can be stopped without reaching the target Click on the Exit button to quit from testing 65 Recall A Baseline Test For Challenge Testing Select Re activate Challenge Test from the Test menu to restart a Challenge Test after a break e g after waiting for an administered substance to take effect The Recall Patient screen will be displayed if a patient is not current Select the patient to retrieve the baseline test and continue as normal Viewing Previously Stored Challenge Tests Select View Previous Challenge Tests from the Test menu to recall Challenge Tests from the database The Recall Patient screen will be displayed if a patient is not current Select the patient to retrieve all previous tests for the selected patient 66 CHAPTER 8 PRINTING REPORTS Printing an Active or Recalled Report There are two ways in which reports can be printed either directly after testing when the tests performed for a particular patient are still active i e before another patient becomes the current patient in the system or by recalling tests done previously for the patient Printing a Report for Active Tests
47. e or cold liquid recommended 131 ee D thoroughly Flowhead Anodised Mild detergent Soak in Cold liquid element aluminium Flush with disinfectant to Autoclaving or assembly Stainless steel water Dry manufacturer s gas ethylene thoroughly recommendations oxide Flowhead Anodised Mild liquid Mild liquid Cold liquid body aluminium disinfectant wipe disinfectant Wipe autoclaving or Acetal over over Dry gas ethylene thoroughly oxide with the seal rings removed Flowhead Silicone rubber Lint free damp Mild liquid tubes cloth Do not use disinfectant wipe solvents over Dry thoroughly ensuring no liquid enters the tubes Reassembling the Fleisch Flowhead 1 After cleaning the flowhead check the flowhead body sealing O rings for damage and very lightly grease each ring before replacing them in the housing grooves Molycote 55 silicon grease or its equivalent is recommended You should also lightly grease the flowhead housing You can refer to the above diagram of flowhead parts for the correct position of the sealing rings Make sure you remove any excess grease as it can cause partial blockage of the holes in the flowhead body resulting in false readings 2 When reassembling insert the element through the side of the housing closest to the blue tapping Fit new filter meshes to the flowhead and the flowhead mesh housing 4 Push the flowhead cone onto the smaller diameter of the element an
48. ed and stored but the user has to indicate here the ones that are to appear on reports Parameter Definition SVC Vital capacity litres FVC Forced vital capacity litres FEV 5 Forced expiratory volume after 0 5 seconds litres FEV 5 FVC Percentage FEV 0 5 of FVC FEV 75 Forced expiratory volume after 0 75 seconds litres FEV 75 FVC Percentage FEV 0 75 of FVC FEV 1 Forced expiratory volume after 1 second litres FEV 1 SVC Percentage FEV 1 of VC FEV 1 FVC Percentage FEV 1 of FVC FEV1 PEF Ratio of FEV1 versus PEF FEV3 Forced expiratory volume after 3 seconds litres FEV 3 SVC Percentage FEV 3 of VC FEV 3 FVC Percentage FEV 3 of FVC PEF Peak expiratory flow litres sec or litres min 89 FEF 2 1 2 FEF 25 75 FEF25 75 FVC FEF 75 85 FEF 25 FEF 50 FEF 75 FIVC FIVC FVC PIF FIF 25 FIF 50 FIF 75 FIF 50 FEF 50 MVV Ind FET Vext Vext FVC IV PIF BHT MVV Dir IVC FRC TV RV TLC IRV ERV IC Mean forced expiratory flow in the time interval between 0 2 and 1 2 seconds of the test time litres sec Maximal mid expiratory flow the mean FEF in the time interval between 25 and 75 of the FVC litres sec Percentage FEF 25 75 of FVC Forced late expiratory flow the mean FEF in the time interval between 75 and 85 of the FVC litres sec Forced expiratory flow at 25 of the FVC litres sec Forced expiratory flow at 50 of the FVC litres sec
49. en choose Batch Print The following window is displayed Batch Print Options Last Batch Print Mone Reports tests tests Print Report to use Print Report to use E HYY tests Insp tests Print Report to use Print 21 Print all tests specific date Date After a specific date Day Month Year O Since last batch print For customisation of reports reference Chapter 12 Report Options 2 Click on the FVC tests Print field if FVC reports are to be printed and then select the FVC report type required 3 Click on the MVV tests Print field if MVV reports are to be printed and then select the MVV report type required 4 Click on the CCS tests Print field if CCS reports are to be printed and then select the CCS report type required 69 5 Click the Insp tests Print field if Inspiratory reports to be printed and then select the inspiratory report type required 6 Click on the On a specific date or After a specific date or Since last batch print field Enter a date in the Day Month and Year fields Click on the Start Batch Print button Tests on the report will be grouped by visit reference number and test age i e to produce a printout the same as if the report had been printed at the end of a test session Use Colour Printer If colour printouts are required when using a colour printer choose the Us
50. ensure that the blue tapping on the stand is connected to the blue tapping on the flowhead likewise for the silver Kinked or squeezed tubing Low or no volume measurements Remove the cause Dirty flowhead Incorrect or no measurements volume or temperature Excessive calibration drift 138 Remedy Clean the flowhead thoroughly as described in Chapter 16 Further troubleshooting information in contained in the Vitalograph 2120 and Gold Standard user manuals 139 APPENDIX C TECHNICAL SPECIFICATIONS Fleisch Flowhead Flow detection principle Flow range Resistance to flow Volume range Volume accuracy Flow accuracy Sampling rate Operating voltage Weight size LxDxW Storage S Model Measuring system Volumetric capacity Volumetric accuracy Volumetric linearity Volumetric accumulation Fleisch type pneumotachometer 0 to 18 L sec 1 2cm H20 12L sec 0 8 Litres 2 or 50 3 gt 100 Hz 12 15 volts DC 15mA 3lbs or 1 36 Kg 9 x5 x3 or 230x127x89mm Temperature 0 50 C Relative Humidity 1096 95 Linearized dry wedge type bellows 7 8L BTPS 20 C Certified to 50ml or 0 5 Certified to 0 5 of f s d x35ml Litre Static infinite 140 Dynamic 12 second optional 6 second Back pressure Static 0 235 kPa maximum Dynamic 0 013kPa L s 12L s Activation volume 0 04L allowed for in calibration Recording system 30mm second 0 0234 Sampling rate gt 100 Hz siz
51. eria box 3 Type the ID or name depending on the search criteria selected above of the patient required or scroll through the displayed list and click on the 33 correct ID or name in the list Alternatively type the first character s of the patient s ID or name 4 Click on the OK button Deleting a Patient Follow these steps to delete a patient 1 Select the Patient menu and choose Delete The following screen is displayed Select Patients to Delete Select one or more patients from the list to delete Search Criteria Search by Id Search by Name Cancel Delete 2 Patients may be listed either by ID or by name Click the preferred button in the Search Criteria box scroll through the displayed list and click on the correct ID or name in the list Click on the Delete button 3 When the following screen is displayed ensure that the patient detailed is the one to be deleted 34 Patient Record Deletion Click on the Delete button to delete the patient or click on the Yes to All button to delete all patients selected for deletion 35 CHAPTER 6 PERFORMING TESTS Before Running Tests for the First Time There are unique buttons icons and screen information used in the Test menu with which the user should become familiar before running tests for the first time Descriptions of these buttons icons and information are provided in Chapter 1 of this manual Setting Up the 2120 or Gold
52. est with the largest SVC result FVC tests The tests with the largest FVC FEV1 CCS tests The tests with the largest FVC FEV1 IVC tests The test with the largest IVC result MVV tests The test with the largest MVV result ERS Best 3 Tests to save automatically the best three tests done according to the following criteria SVC tests The test with the largest SVC result FVC tests The tests with the largest FEV 1 CCS tests The tests with the largest FEV1 IVC tests The test with the largest IVC result MVV tests The test with the largest MVV result Manual to save the tests as selected by the user from a list of the tests done IV tests are always manually saved 86 Pre Post Equation When viewing or printing a pre post comparison the percentage change between the pre result and the post result can be calculated differently Use this option to select one of the following Base on Pre value jo Change Post Pre Pre Base on Post value Change Post Pre Post Base on average values Change Post Pre 0 5 x Pre Post Predicted Values This option is used to define a set of prediction values to be used when running tests 1 Select the Options menu and then the Predicted Values sub menu The following window is displayed 87 Predicted Value Ethnic Origin Links Setup Predicted Value Ethnic Origin Links Select an Ethnic Origin to associate with a Predicted Value Set Changes
53. ests PEFL sec FIF 50 Visit Reference FEF 28 78 FIF 75x Test Reference FEF 75 85 FET Date Of Test FEF 2 1 2 Time Of Test RV FEF 25 VEXT Patient Height FEF 50x Patient Weight FEV 5 FEF 75x Effort Rating FEV 75 FIVC Grade L sec FE 1 Grade FIF 28 Select All Cancel Select the parameters to be exported then click the OK button 8 Click on the IVC Test Results check box if not enabled Click on the IVC Test Results Setup button and the following window is displayed 109 9 Options Test Selection Patent Information Tests isit Reference Test Reference Date OF Test Time Test Patient Height Patient eight Effort Rating OF Select All Cancel Select the parameters to be exported then click the OK button Click on the MVV Test Results check box if not enabled Click on the MVV Test Results Setup button and the following window is displayed 110 10 w Options MYY Test Selection HYY Patient Information Visit Reference Test Reference Date OF Test Time OF Test Patient Height Patient Weight Effort Rating OF Select All Cancel Select the parameters to be exported then click the OK button Click on the IV Test Results check box if n
54. iate x axis units from the list add a new unit using the Edit List button If necessary other units may be added to the list by clicking the Edit List button to view the following window 58 Edit List of Units e Click on either the Linear Log base 10 or Log dose doubling field to indicate if the x axis is to be linear or logarithmic Select the appropriate y axis units from the list e Click on the Options fields required Dosages are cumulative depends on the agent e g histamine has a cumulative effect Show baseline test on graph Show diluent test on graph Show target line on graph Show target intercept on graph results appear on the graph 13 Click on the OK button and the following window is displayed Challenge test clock The challenge test clock will start when the first dose ts administered You may program the clock to Display an alarm at regular intervals Alarm Display alarm every 0 minutes 0 seconds 59 14 Click on the Sound alarm field if an alarm is required to sound at a defined interval after the 1st dose is administered If the Sound alarm field was clicked make the required entries into the minutes and seconds fields 15 Click on the OK button Challenge Testing Press the Testing button when you are ready to start baseline testing 16 Click on the OK button when ready to perform baseline testing Y italograph Spirotrac Help Ee er
55. ick on the OK button and the following window is displayed Spirotrac IY Calibration 2 Do you want a printout of the Calibration Report Click on the Yes button to print the report 27 2120 and Gold Standard Spirometers The calibration procedure for the 2120 and Gold Standard Spirometers are described in their respective user manuals Each 2120 and Gold Standard Spirometer is identified by Spirotrac IV based on their individual serial numbers A calibration record for each spirometer is stored and available for printing on demand The Calibration Log is updated each time that the 2120 Gold Standard goes into remote mode when communicating with Spirotrac IV Spirotrac IV displays the following sequence of messages during this period Entering test mode Connecting to device Entering test mode Retrieving environment data Entering test mode Retrieving calibration data Entering test mode Updating Calibration log Only the information on the last calibration performed on the 2120 Gold Standard is transferred to the Calibration Log Select the Reports menu and select Calibration Log A screen like the following is displayed Calibration Log Printout 07419 Pernod 02944 Select period Day Month Year Select one or more units from the list of identfiers 28 Select the serial number s for which the report is to be printed If the report is required for a particular period click
56. in the Hace Correction Factor section apply to the currently selected Ethnic Origin Ethnic Origin Predicted Yalue Black Knudson Hispanic European Scandinavian The percentage to Asiatic multiply the predicted Native American value by Onental Unknown 00 Other Race Correction Factor Cancel 2 Select Ethnic Origin by clicking on the appropriate description in the Ethnic Origin list Select the Predicted Value set that will be associated with the Ethnic Origin from the drop down list The actual results will then be compared with the predicted results produced by this prediction set Parameters This option is used to select the parameters displayed from tests 1 Select the Options menu and choose Parameters The following window is displayed 88 Parameter T able Parameters X SYC X PEF L sec FIF 25 I C xX PEF L min FIF 80 FRC 8 FEF 2 1 2 FIF 75 FEV 57FVCX FEF 25 75 FIFSO FEF50 RV FEV 75 FEF25 75 FVC MYY Ind FEV 75 F C FEF 75 85 18 FEY FEF 25 FET 5 FEF 50 Vext IC FEVI FVCX FEF 75 Vext FYC FEV1 PEF IV Test Date FIVC FVCX C PIF Test Time 5 PIF L sec BHT Test Ref FEV3 FVEX PIF L min MYY Dir Visit Ref These parameters are always calculat
57. is selected in CCS Test Display in the Options menu Y Vitalograph Spirotrac 2 q 8 10 12 14 SAMPLE Doe John 44 Exit from testing at any time by clicking on the CCS button Wait for the EXHALE TO BEGIN message to appear on top of the graph Read the following instructions to the patient so that testing is performed properly Clip on the nose clip to seal your nose Put the Bacterial Viral Filter into your mouth biting it lightly Seal your lips around the mouthpiece Breathe and out normally This is Tidal breathing When you are happy that the patient has achieved steady tidal breathing continue with Inhale as deeply as possible Exhale as much and as quickly as possible and when fully exhaled Inhale fully as quickly as possible Return to tidal breathing ie breathe and out normally again You are prompted to accept the test Click on the Yes button to accept the test or on the No button to reject the test If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button Click on the Preview button to view the results for the individual parameters associated with the test A window like the following sample is displayed 45 Parameter Predicted Pre Pred Post Pred Change 4 29 3 12 73 FEU 1 L 3 45 2 13 62 PEF 5 8 5 2 52 29 PEF Lz 514 21 151 88 29 L 4 48 3 12 MUU ind Lz 12
58. ise to restart your computer after an installation 14 When the installation is complete the program name appears in the menu when the START button is clicked Click on the program name to run the application Instructions will be displayed for first time users as to how to connect the Vitalograph 2120 Note It is recommended that older databases are upgraded to Version IV before running Spirotrac IV see Chapter 13 Installing Spirotrac IV on a Network A Spirotrac database may be shared amongst several Spirotrac installations across a network A Spirotrac database on a PC which will run Spirotrac is chosen as the central database This PC is known as the Server Multiple other PC s which will have opirotrac installed can connect to and access this central database These PCs are known as the Clients There are a number of steps to be carried out to set up the Server and the Client PCs The Server PC 20 This is the PC which will run Spirotrac and whose database has been chosen as the central database 4 At the end of setup you will be asked whether the database is to be shared with other users Choose the Yes button to share this database You will then be asked which to letter to map the database Enter the letter of a drive that is not being used by your PC the default is X and press the OK button This will complete the installation of Spirotrac In order to finalise the installation it will be necessary to re
59. it was purchased for advice The Company does not authorise any person to create for it any other obligation or liability in connection with Vitalograph amp equipment This guarantee is not transferable and no person firm or company has any authority to vary the terms or conditions of this Guarantee To the maximum extent permitted by law the Company does not accept liability for any consequential damages arising out of the use of or inability to use any Vitalograph equipment This Guarantee is offered as an additional benefit to the Consumer s statutory rights and does not affect these rights in any way 143
60. ite button to write over the information that is already in the file or click on the Append button to add the new information to what already exists in the file or click on the Cancel button and enter a new filename to rename the file The data is then exported 117 CHAPTER 15 MANUALLY ENTERING DATA INTO SPIROTRAC IV The Manually Entering Data function is used in two ways Firstly it is used to enter information for a new patient i e patient information and test results that already existed before starting to use Spirotrac IV Secondly it is used to enter historic information for an existing patient who had subsequently been entered into Spirotrac IV The user can also delete patient information and add delete and view test results using this utility The user can specify the database into which the information will be stored if the default database is not to be used Entering Data for a New Patient 1 Run the Manual Data Entry utility and a window like the following sample is displayed 118 _f Spirotrac 1 Manual Data Entry Exit About Lurrent Database HUNE Current Patient mm Search database on fee Click on the Open Database button and a window like the following sample is displayed File name Folders c spiro4 database Cancel sample db 74 c 3 database __ sample Hetwork Read only List files of type Drives DataBase Files 46 7
61. lick on the OK button and the new database is created within Spirotrac s installation directory Selecting a Database Follow these steps to specify a database as the current database 1 Select the Database menu and choose Select database The following window is displayed Select Database File name Folders fa c spirodsdatabase Cancel sample db EX cA Em spiro4 Network 25 database sample List files of type pirotrac db 2 Type the name of the database into the File Name field or select it from the list 3 Click on the OK button and the database is selected 4 The selected database is displayed in the bottom left hand side of the opirotrac IV window Deleting a Database Follow these steps to delete a database 1 Select the Database menu and choose Delete database 97 The following window is displayed Delete Database File name Folders c spiro4 database sample db gt c Em spiro4 Network Z4 database sample List files of type Drives Spirotrac db 2 Type the name of the database into the File Name field or select it from the list Note that the user cannot delete a database that is selected as the one in which you are currently working 3 Click on the OK button and the database is deleted Backing up Patient Records Follow these steps to copy patient records onto a storage medium 1 Select the Database menu and
62. lick on the Perform diluent test Click on the Display warning on slow start of test field if this message is required to be displayed when performing the test Click on the Dose or Concentration field if administering an agent or click on the Time field if testing will involve a constant exposure to an agent Click on the Operator selects best test field or the Automatically use highest result field to indicate how the best tests will be selected Click on the OK button If the user clicked on the Dose or Concentration field in step 9 the following window is displayed and the user should continue with step 12 5 Dose Response Curve Options 0000 rUptions axis values may be entered in the range of 0 01 to 300 Select a set of units so your dosages will all Fall within this range X Dosages are cumulative X Show baseline test on graph Units it Li i nits Show diluent test on graph Linear Show target line on graph Log base 10 Show target intercept on graph Log dose doubling M If the user clicked the Time field in step 9 the following window is displayed Time Response Curve Options Options Show diluent test on graph Show target line on graph X Show target intercept on graph 12 Follow this step to make entries the Dose Response Curve screen Select the appropr
63. low these steps to calibrate 1 Select the Options menu and then the Device sub menu Make sure the correct device is selected 2 Select the Options menu and then the Calibration sub menu and choose Device 9 If required type the name of the operator up to 9 characters performing the calibration or select a name from the list 4 Type the volume of the syringe used to calibrate or select the syringe volume from the list Click on the Calibrate button Follow the instructions on the screen Make sure the plunger is out fully and click on the OK button Press in the syringe with a smooth firm stroke not too slowly Follow the instructions on the screen and click on the OK button 26 10 Repeat steps 7 and 8 If the first and second strokes do not meet the criteria described above in the Description of the Calibration Process section the following window is displayed Calibrate Fleisch flowhead Withdraw the syringe plunger to it s fullest extent Press OK and for mare Instruction If this window is displayed you can repeat steps 7 and 8 a total of six times If calibration is still unsuccessful after six attempts the system stops the process The following window is displayed on the screen when calibration is completed successfully Calibration The previous two strokes were within 0 4 The volume difference between this and the previous calibration iz 0 This meets ATS criteria Cl
64. mI FEV1 I zb ose pl cumulative Base Dil 20 40 60 80 100 SAMPLE Doe John 17 Click on the Test button 18 Wait for the EXHALE TO BEGIN message to appear on top of the graph 60 19 20 Read the following instructions to the patient so that testing is performed properly Stand up Keep the flowhead away from your mouth Inhale as deeply as possible and insert the mouthpiece into your mouth clamping it between your teeth Close your lips round the mouthpiece Exhale as much and as quickly as possible and try to keep exhaling for at least 6 seconds If using the FEV1 parameter in which case the patient can stop exhaling after 1 2 seconds or if using the PEF parameter in which case the patient can stop exhaling after a PEF manoeuvre The user can click on the Preview button for the results of the test Click on the Exit button The following screen is displayed if the Operator select best test field was clicked in step 10 Select the required test and click on the OK button 61 21 Manual Best Test Test Select the best test then press the OF button FEY 1 gt Baseline Hot available Now perform diluent testing that option was selected in step 7 Continue with step 21 if not performing diluent testing Click on the OK button to begin diluent testing Click on the Dose button Click on the NOW button when the diluent has been administered Click on
65. nformation for an Existing 33 Eu adul core usd vix 34 CHAPTER 6 PERFORMING TESTS 22 36 Before Running Tests for the First Time 2 36 Setting Up the 2120 or Gold Standard before Performing Tests 36 Checks to Make before Performing SVC FVC CCS IVC IV and MVV Tests 36 Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests 37 Performing ove LOSING Was teas 38 Performing FVC Testing including Incentive Testing 40 Tesunqgs epu mes 43 G 46 Pertorming dv Testing ea baec 49 Performing MVV 51 Displaying ATS Waveforms 4 52 POSTEOS 53 QUICK 54 CHAPTER 7 CHALLENGE 56 Performing New Challenge 56 Recall A Baseline Test For Challenge
66. nion replace any component thereof which in the opinion of the Company is faulty or below standard as a result of inferior workmanship or materials The conditions of this Guarantee are T This Guarantee shall only apply to hardware defects which are notified to the Company or to its accredited distributor within 1 year of the date of purchase of the equipment unless otherwise agreed in writing by the Company software meaning computer software or user installable modules is guaranteed for 90 days from the date of purchase The Company warrants that the software when correctly used in conjunction with the hardware will perform in the manner described in the Company s literature and user manuals The Company undertakes to rectify at no expense to the customer any software failure notified within the period stated above provided that the failure can be recreated and the software has been installed and used in accordance with the user manual Notwithstanding this clause the software is not warranted to be free of errors This Guarantee does not cover any faults caused by accident misuse neglect tampering with the equipment use of consumable items or parts not approved by the Company or any attempt at adjustment or repair other than by personnel accredited by the Company nor does it cover reinstatement of any configuration changes caused by the installation of any software If a defect occurs please contact the supplier from whom
67. nter the settings as illustrated above Click on the OK button Click on the Save to WIN INI File to save the settings The Client PC At the end of setup you will be asked whether the database is to be shared with other users This time choose the No button as this database isn t to be shared Next it is necessary to map to the directory containing the central database which was shared on the Server It is necessary to map the same network drive as the Server database was mapped e g default is X Run Windows Explorer go to Network Neighbourhood select the Server computer and select the directory which will contain the central 23 database Click the right mouse button and from the activated menu select Map Network Drive Select the drive to which it is to be mapped e g default is X Click OK Finally it is necessary to run the Database Engine Network Configuration utility supplied with Spirotrac Use the same settings used for the Server in the previous section Changing the Device Type Select the Options menu and then the Device sub menu Choose the required device and the COM port if using a 2120 or Gold Standard Choose ATS Waveform if you wish to simulate FVC tests from a choice of 24 waveforms and then view the results 24 CHAPTER 4 CHECKING ACCURACY ON SPIROTRAC IV Checking accuracy on Spirotrac IV is only applicable to the Fleisch Flowhead and S Model devices The 2120 and Gold Standard are c
68. o Spirotrac IV i e remain on the 2120 Gold Standard afterwards In this case select Retrieve Without Deleting 79 Downloading patient records and tests Hetrieving list of patients 3 Patients and results will be introduced to the Spirotrac IV database If necessary new patients will be created If the Patient ID on the 2120 Gold Standard is in the format of a name e g GARY CASEY this will still be stored in the Patient ID field in the Spirotrac database not the Name fields Since the 2120 Gold Standard does not have the facility to enter date of birth the date of birth field in Spirotrac will be guessed using the age of the patient to the 15 January of the nearest year This ensures that any predicted information is accurate to within a year The correct date of birth can be entered at any time by selecting the patient reference Chapter 5 Using Multiple 2120s Each 2120 has a serial number programmed into it This number will be used in the Auto ID which is based on date e g 190298 1 for each patient This will cater for when test results from a number of 2120s are stored in the Spirotrac IV database there will be no conflict between Auto IDs from different units e g 02419 190298P1 from one unit and 02278 190298P1 from another unit 80 CHAPTER 12 SETTING OPTIONS The Options menu can be used periodically to set up and change the options which are used in Spirotrac IV Report Options There are two Repo
69. o perform another IV test if required 7 Click on the IV button to quit from the IV test Other tests may be initiated by clicking on the appropriate button Performing MVV Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 2 Select the Test menu and choose MVV or click on the MVV button Exit from testing at any time by clicking on the MVV button 51 Wait for the EXHALE TO BEGIN message to appear on top of the graph 4 Read the following instructions to the patient so that testing is performed properly A nose clip is recommended for MVV tests Stand e Insert the mouthpiece into your mouth and clamp it between your teeth Close your lips round the mouthpiece Start inhaling and exhaling as deeply and rapidly as possible Press the spacebar to begin recording after the patient has started When the test is completed the user is prompted to accept the test Click on the Yes button to accept the test or on the No button to reject the test If the test is accepted the session will be completed If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button Displaying ATS Waveforms ATS waveforms may be displayed to simulate the results of FVC testing by selecting values on the screen instead of performing physiological tests 1 Check that the device is set at ATS Waveforms in
70. ods of testing the maximum number of blows that a patient may perform in any one session is twelve Performing SVC Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 2 Select the Test menu and choose SVC or click on the SVC button SUL The screen looks like the following sample if SVC Bar Graph was selected in the Options menu 38 Vitalograph Spirotrac IV SAMPLE Doe John Exit from testing at any time by clicking on the SVC button again Wait for the EXHALE TO BEGIN message to appear on top of the graph Read the following instructions to the patient so that testing is performed properly otand up Keep the flowhead away from your mouth Inhale as deeply as possible and insert the mouthpiece into your mouth clamping it between your teeth Close your lips round the mouthpiece Exhale normally for as long as possible You are prompted to accept the test Click on the Yes button to accept the test or on the No button to reject the test If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button 39 5 Click the Preview button to view the results for the individual parameters associated with the test A window like the following sample is displayed Parameter Predicted Pre Pred Post Pred Change Test Type SYC Click on the Close button
71. ometry test option Selects the IVC Inspiratory Vital Capacity test option Selects the IV Inspiratory Volume test option Selects the MVV Maximum Voluntary Ventilation test option Initiates Post Test facilities Incentive device used in FVC testing of children Initiates Autozoom Zoom Zoom out Selects the Quicksave facility Temporarily saves the current patient s details and creates a list The list is shown in the Quicksave window Patient is no longer the current patient until recalled from this list Selects the Trending facility Shortcut to the Help system These buttons are used during testing Not all buttons are available for all tests If the button is dimmed it is not appropriate for the test s in progress The following buttons are specific to Challenge Testing Pu Click to start the test Click when ready to administer the dose 11 Click to display the results of the test s Click to quit Challenge Testing CHAPTER 2 INTRODUCING THIS MANUAL Purpose of the Manual The purpose of the Spirotrac IV User Manual is to provide all the information required to run the Spirotrac IV software It is assumed that the user is familiar with the use of Windows software and therefore understands how to use features such as buttons menus windows and the mouse It is also assumed that the user has a knowledge of spirometry This manual is not intended to be a spi
72. on If Interpretation in the Options menu is selected clicking on the Interp button displays an automatic interpretation of the results 42 Click on the Close button to return to the previous screen 6 Repeat step 4 to perform another FVC test if required Click on the FVC button to quit from the FVC test Other tests may be initiated by clicking on the appropriate button If the Save Tests window is displayed this appears if tests are being saved manually the user can click on Poor Average or Maximum to change the effort rating Click on the tests to be saved and then click on the Save button to save the tests Tests are saved automatically if ATS Best Test ERS Best Test ATS Best 3 or ERS Best 3 is selected in the Save Tests sub menu in the Options menu Performing CCS Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 2 Select the Test menu and choose CCS or Click on the CCS button CLS Fer 3 If FRC RV or TLC are selected as parameters in the Options menu the following window will be displayed 43 Static Lung Volumes Manual Input of Static Lung Volumes Please enter a value for one of the following parameters FRC 10 Litres O BV Litres Litres Hote If one index is known the others may be calculated from the Closed Circuit Test The screen looks like the following sample if the Volume Time window
73. ormation to be exported 4 Click the OK button Click on the SVC Test Results check box if not enabled Click on the SVC Test Results Setup button and the following window is displayed 106 Options S C Test Selection SYC Patient Information Patient Visit Reference Test Reference Date OF Test Time Test Patient Height Patient Weight Effort Rating OF Select All Cancel Select the parameters to be exported then click the OK button 6 Click on the FVC Test Results check box if not enabled Click on the FVC Test Results Setup button and the following window is displayed 107 7 Options FYC Test Selection FYC Patient Information Visit Reference Test Reference Date OF Test Time Test Patient Height Patient Weight Effort Rating Grade FEV1 Grade ELM FYC Tests FE 5 5 PEFL sec FEF 25 75 FEF 75 85 2 1 2 Select All FEF 28 FEF 50 FEF 75x FIVC PIF L sec 25 FIF 50 FIF 75x Cancel Select the parameters to be exported then click the OK button Click on the CCS Test Results check box if not enabled Click on the CCS Test Results Setup button and the following window is displayed 108 w Options Test Selection CC Patient Information T
74. ot enabled Click on the IV Test Results Setup button and the following window is displayed 111 11 w Options IY Test Selection Iv Patient Information Visit Reference Test Reference Date OF Test Time OF Test Patient Height Patient eight Effort Rating OF Select All Cancel Select the parameters to be exported then click the OK button Click on the Challenge Test Results check box if not enabled Click on the Challenge Test Results Setup button and the following window is displayed 112 w Options Challenge Test Selection Patient Information Challenge Tests Visit Reference 1 Test Reference PEF L sec Date OF Test Time OF Test Patient Height Patient Weight OF Select All Cancel Select the parameters to be exported then click the OK button 12 Click the OK button 13 Select File Format in the Options menu to define the format of the file to be exported and the following window is displayed w Options File Format Field Delimiter Record Delimiter None Pad text with NULL characters Select a character to format the data into fields when it is being exported 113 Select a character to format the data into records when it is being exported Click on the Pad text with NULL Characters field if required This will align results when they are exported Click on the OK button 14 Select
75. ous window Select the tests to be trended by either clicking on at least two individual tests or by clicking on the Select All button to select all tests Note that clicking on a selected test deselects it Click on the Trend button A window like the following sample is displayed trending a parameter against the date 73 Trend Graph 2 FVC tests 16 02 1998 to 16 02 1996 Test Date Display Age at Test Parameter 2 Oreray Parameters Css fae a Click any of the Overlay Parameters to be trended and they will be displayed on the graph as well or click on the Next and Previous buttons to replace the current parameter with the next on the list The parameters available depend on what is specified in Parameters in the Options menu The user can also trend height and weight values If the user clicks the Age at Test button the test date on the X axis is replaced with the patient s age for example if the user wishes to trend yearly checkups Click on the Print button to print a report and a standard Windows print screen is displayed Click on the OK button to print the report Click on the Done button and the Cancel button when trending is finished 74 CHAPTER 10 VIEWING TEST RESULTS Viewing Active or Recalled Test Results There are two ways in which results can be viewed either directly after testing when the tests performed for a particular patient are
76. ribed in Chapter 5 are to be saved and continue with step 2 or Enter information for a patient whose tests will not be saved by selecting screen from the Patient menu The following window is displayed Screen Patient 29 Mame screening patients Last Eo 2 none of the tests performed are saved to the test database If you wish First zu de to this patient s tests then use the database eene capabilities of Spirotrac Age yrs Type in entries into the Last First Age and Height fields and click on Female if appropriate Click on the OK button Continue with step 2 2 Click on the relevant test button e g FVC 37 the Recall Tests window is displayed tests may be selected for recall Click on the OK button These tests are for visual purposes they will not be involved in the saving of tests If the Enter Visit Reference window is displayed see below type a reference number into the Visit Ref field and click on the OK button Enter isit Reference Visit references may contain up to five characters Visit Hef 3 Continue with the steps in the section describing the test to be performed Note 1 When viewing graphs on screen click and hold the mouse button to superimpose crosswires onto the graph Move the mouse while holding down the mouse button to facilitate measurement against the scales on the edges of the graph In each of the following meth
77. rometry reference document For details of spirometry workshops please contact your local Vitalograph agent Contents of the Manual This manual is organised into Parts subdivided into Chapters Part I Getting Started Chapters 1 3 Contains preliminary information to introduce the software and this manual and provides the information to enable the installation of Spirotrac IV Part II Using Spirotrac IV Chapters 4 13 Describes the most commonly used functions in Spirotrac IV e g calibrating performing tests printing reports trending results Part Export and Manual Entry Utilities Chapters 14 and 15 Describes the export data and manual data entry functions Part IV Maintenance Chapters 16 and 17 Describes the maintenance functions to be performed periodically on the hardware Part V Appendices Appendices A C Provides solutions to software problems hardware problems and lists technical specifications 13 Conventions used in the Manual The Spirotrac IV User Manual uses a number of conventions Key on the Keyboard all upper case e g ENTER Program Name in inverted commas e g Program Manager Icon Helvetica font followed by the word icon e g Manual Data Entry icon Button Helvetica font followed by the word button e g click on the OK button Field Name Helvetica font followed by the word field e g Name field Menu Name Helvetica bold font followed by the word menu e g
78. rt options Create Modify Reports and Report Header Create Modify Reports Option This option is used to define the combination of report types and attributes to appear in a specified report 1 Select the Options menu and then the Report Options sub menu 2 Choose Create Modify Reports and the following window is displayed Create Modify Reports Report Attributes gt Standard Report Graphs Interpretation Fe _ ees COPD Risk Tecumseh Vol Time Graph Flow olume Graph C Flow olume Graph Vol Time Graph Vol Time Flow ol Graphs Patient Race Predicted Graphics No Graphs Calibration Summary _ iz Operator s initials Vol Time Graph C Vol Time Flow Vol Graphs Physician name 3 Enter the name of the report to be created into the Report Name field and continue with step 4 81 If the user wishes to base the new report on an existing report then from the list of report names select the name of the report to be modified Enter a name for the new report Click on the report graphs that are to appear on the report Click on the report attributes required Clicking on these attributes has the following effect Interpretation includes an interpretation comment if this was enabled in Options menu Predicted Graphics draws the points through which the graph is predicted to be plotted Volume Time graph FEV 0 5 1 3
79. still active i e before another patient becomes the current patient in the system or by recalling tests done previously for the patient Viewing Results for Active Tests Active tests can be viewed immediately after completion by simply clicking on the Preview button reference Chapter 6 The parameters displayed will depend on which parameters were selected in the Options menu reference Chapter 12 Viewing Results for Recalled Tests 1 Select the Test menu and then the View Tests sub menu 2 Select a patient for whom tests are to be viewed as described in Chapter 5 3 Choose the test type required SVC FVC CCS IVC IV or MVV 75 5 Select tests for viewing Time Post Result Visit 16 02 1998 16 21 Select the test s for viewing and click the OK button The following is an example for an FVC test Test 76 6 Vitalograph Spirotrac IV Results can be viewed by clicking the Preview icon To return to the main screen click on the test icon in the above example FVC 77 CHAPTER 11 COMMUNICATING WITH THE VITALOGRAPH 2120 AND GOLD STANDARD Putting the 2120 and Gold Standard unit into Remote Mode Before any communication between the PC and the Vitalograph 2120 or Vitalograph Gold Standard can commence the unit must be in Remote Mode This is achieved by switching the unit on Once the main menu screen shown here is displayed the unit will automatically enter remote mode when the Spirotrac
80. sts button 128 Patient Test Results Ex Measurements Height cm Weight kg Technicians Initials FEF 25 752 5 321 FIF 254 740 Visit Hef Test Ref FEF 75 8542 905 FIF 504 FEF 2 1 2 7 362 FIF 75x FEF 25x 191 FEF 504 848 5 FEY 75 1 FEY 3 FEF 75x 830 1781 3188 PEF 2271 PIF L sec TA To add test results reference the Entering Data for an Existing Patient section Follow this step to delete results Select the results to be deleted e Click on the Delete Tests button and the Delete Test Results window is displayed E Check these are the results to be deleted and click on the Delete button e Click on the OK button to confirm deletion Follow this step to view results e Select the results to be viewed Click on the View Tests button and the Patient Test Results window is displayed Click on the OK button when finished viewing the test results 129 CHAPTER 16 CLEANING THE FLEISCH FLOWHEAD S MODEL VOLUMETRIC SPIROMETER OR THE 2120 SPIROMETER Fleisch Flowhead Disassembling the Fleisch Flowhead for Cleaning Sterilising and Disinfecting i Disconnect the flowhead from the flowhead tubes Filter Mesh Fleisch Mesh Element Housing Filter Mesh 4 O Ring Filter Mesh Housing 2 Grip the Fleisch element in one hand and pull the cone off wi
81. th the other 3 Remove the filter mesh housing from the other end in the same way 4 To remove the flowhead body from the element of the Fleisch flowhead place on a hard surface with the largest diameter at the top Push down on the flowhead body with thumbs and forefingers until it reaches the table 130 5 Separate the parts with a pulling and twisting action Element Housing O Ring O Ring Fleisch Element Discard or clean soiled filter meshes Clean as described in the following table Important Ensure that no liquid remains in the holes grooves or pressure tappings of the body or enters the pressure tubes Part Material Cleaning Disinfecting Sterilising Flowhead Polystyrene high stand upper density foam casing painted with epoxy paint Flowhead Acetal cone Flowhead Anodised mesh aluminium housing Flowhead Acetal and mesh polyester Lint free damp cloth Do not use solvents Mild detergent flush with clean water Dry thoroughly Mild detergent Flush with clean water Dry thoroughly Disposable or mild detergent Flush with clean Mild liquid disinfectant wipe Over Mild disinfectant Flush with clean water Dry thoroughly Mild disinfectant Flush with clean water Dry thoroughly Disposable or mild disinfectant Flush with clean water Cold liquid recommended Cold liquid recommended Autoclaving or gas ethylene oxide Disposabl
82. the Select Period box Enter the starting date for the report the report will cover the period from this date to the present time then click the OK button 29 CHAPTER 5 SELECTING AND MAINTAINING PATIENT INFORMATION Before running a test on a patient whose results are to be stored first use the Patient menu to specify information about the patient to be tested This can be done in two ways by entering information on the screen for a new patient by selecting patient information that was previously entered into the system The Patient menu can also be used to modify or delete previously entered patient information recalled from the system as required Remember that to move between fields on the screen either use the mouse or press TAB to move forward and SHIFT and TAB to move backwards Pressing ENTER does not move the cursor between fields Check that the correct database has been selected before entering a new patient Entering a New Patient Follow these steps to enter information for a new patient l Select the Patient menu and choose New Or click the following icon The following window is displayed 30 Hew Patient Information x Hame Last First Middle 11 Patient 2 of birth Day Month Year Age pS Dex r Measurements Male Height jo cm Female Weight jo kg You may choose to create a new Cancel patient save these demographics
83. the in and out normally This is tidal breathing When you are happy that the patient has achieved tidal steady breathing continue with Exhale as deeply as possible Inhale as much as possible speed is not important and when fully inhaled Return to tidal breathing Breathe in and out normally again You are prompted to accept the test Click on the Yes button to accept the test or on the No button to reject the test If the Enter Test Reference window is displayed type the reference number into the Test Ref field and click on the OK button Click on the Preview button to view the results for the individual parameters associated with the test A window like the following sample is displayed Parameter Predicted Pre Pred Post Pred 4Change Test Type VC Choosing the Print button will initiate a printout of the of the test being viewed Click on the Close button to return to the previous screen Repeat step 4 to perform another IVC test if required Click on the IVC button to quit from the IVC test Other tests may be initiated by clicking on the appropriate button Note The data stored for an IVC Test is the last 30 seconds of the test 48 Performing IV Testing 1 Follow the steps in the Common Steps for Performing SVC FVC CCS IVC IV and MVV Tests section 2 Select the Test menu and choose IV or Click on the IV button Iu The screen looks like the following sample
84. tically with a test 4 Click on Visit Ref to enter a reference number for a group of tests for the patient Click on Test Ref to enter a reference number for each individual test Click on the OK button Incentive Display This option is used to set up the volume represented by the bar along which the puck moves when a child performs a FVC Incentive test The first time the test is performed the bar represents a percentage of the predicted volume of the lungs Afterwards the bar represents a percentage of the best FVC of the tests done in order to encourage the child to try harder Note If the required patient information is not entered ie parameters necessary to calculate the predicted values the incentive device will not be displayed 1 select the Options menu and choose Incentive Display The following window is displayed Incentive Display Incentive Setup Enter values between 10 and 150 First Test 100 Of predicted Other Tests 95 best test performed 2 Type in a figure to represent a percentage of the predicted value that will be used to determine the length of the bar in the window for the first test 91 3 Type in a figure to represent the percentage of the best FVC of the tests done Since this determines the length of the bar in subsequent tests it encourages the child to try harder 4 Click on the OK button Database This option is used to indicate firstly the number of days that tests
85. ting the relevant test icon must be clicked e g if FVC testing click the FVC button to end the testing 2 Select the Patient menu and choose Quick Save or click on the Quick Save button The following screen will be displayed QuickS ave Quicksave Save Current Patient in Quicksave List Recall Patent from List and Make Current Cancel Return to Main Screen View Criteria O View by ID View by name The current patient can be quick saved by clicking the Save Current button 4 Another patient can now selected for testing 54 When the first patient is required again select the Patient menu and choose Quick Save or click on the Quick Save button The following screen will be displayed QuickS ave Quicksave Save Current Patient Quicksave List Recall Patent from List and Make Current Cancel Return to Main Screen Doe John View Criteria View by ID View by name Save Current Cancel The second patient can now be quick saved if required soon by clicking on the Save Current button The first patient is recalled by clicking on the Recall button You can now continue with the first patient 55 CHAPTER 7 CHALLENGE TESTING This chapter describes the steps to follow for performing challenge testing Performing A New Challenge Test 1 Check that the Test Date Test Time and Visit Ref fields are selected as required in the Parameters sub menu in the Options men
86. u 2 Select a patient as described in Chapter 5 3 select the Test menu and choose Challenge Test then New Challenge Test If the Enter Visit Reference window is displayed type a reference number into the Visit Ref Field and click on the OK button The following window is displayed Challenge Test Design General Basic Information Bronchoconstricting agent Parameter FEVI Target percentage drop from baseline 20 20 X Perform diluent test X Display warning on slow start of test Record dose as ____ Best test Dose Operator selects best test Concentration Automatically use highest result C Time 56 10 11 This is the first of three windows used to define the challenge test to be performed Select the appropriate agent from the list which applies to the Bronchoconstricting agent field or add a new agent using the Edit List button There must be an entry in this field Select the parameter to be measured from the list available for the Parameter field There must be an entry in this field Enter the percentage drop in result from the baseline test result that is expected in the test if the default is not appropriate Click on the Perform diluent test field to perform a control test with a diluent Note that while the diluent test is optional a baseline test must always be performed The user may also use the diluent test as the baseline but to do so do not c
87. ution is set to 800 x 600 pixels minimum this is in order to enhance graphic viewing during testing Any system sounds on your PC should be disabled certain PCs can not access the serial port COM port efficiently when sound is enabled A symptom of this is no real time curves appearing while testing with a serial device e g 2120 The same be said for any Windows messaging applications WinPopup MS Exchange etc these should not be running while testing or downloading uploading with Spirotrac If you are using a screen saver ensure that it does not activate while testing set the screen saver interval for at least 10 minutes When using Spirotrac IV with Vitalograph 2120 or Gold Standard Ensure that the software version on the Vitalograph 2120 is Version 2 00 or later This information can acquired by selecting the About section of the Setup menu on the Vitalograph 2120 Ensure that the software version on the Vitalograph Gold Standard is Version 2 00 or later This information can acquired by selecting the About section of the Setup menu on the Vitalograph Gold Standard CHAPTER 1 INTRODUCING SPIROTRAC IV Description of Spirotrac IV Spirotrac is a Microsoft Windows based computerised spirometry system designed for lung function testing in a variety of environments e g occupational health centres hospitals pharmaceutical research centres physicians and GPs offices and wherever else advan
88. ve Tests This option is used to define how tests are to be saved i e automatically or manually 1 Select the Options menu and then the Save Tests sub menu 2 Choose one of the following ATS Best Test to save automatically the best test done i e for SVC tests The test with the largest SVC result FVC tests The flow results and raw data from the test with the largest FVC FEV1 and the largest volume results from any test CCS tests The flow results and raw data from the test with the largest FVC FEV1 and the largest volume results from any test 85 IVC tests The test with the largest IVC result MVV tests The test with the largest MVV result ERS Best Test to save automatically the best test done i e for SVC tests The test with the largest SVC result FVC tests The raw data from the test with the largest PEF if FVC from that test is within 5 of the best FVC otherwise from the test with the largest FVC All parameters are taken from all tests i e the largest for each CCS tests The raw data from the test with the largest PEF if FVC from that test is within 5 of the best FVC otherwise from the test with the largest FVC All parameters are taken from all tests i e the largest for each IVC tests The test with the largest IVC result MVV tests The test with the largest MVV result 9 ATS Best 3 Tests to save automatically the best three tests done according to the following criteria SVC tests The t
89. w like the following sample is displayed 100 Select Database File name Folders backup db c spiro4 database gt 3 cA C3 spiro4 c3 database sample List files of type pirotrac db Select the location from which the backup is to be restored Click on the OK button and a window like the following sample is displayed Backup Hestote Patient Selection Select one or more patients from the list to restore from the backup database Search Critena Search by Id Search by Name The window displays a list of patients in the backup file Select the patients whose data is to be restored Click on the Select All button for all patients or click on the Restore buttons if not all patients were selected 101 Deleting Raw Data Follow these steps to delete the raw data used for producing graphs After deletion the test results are retained and may be trended but cannot be used for printing graphs or for pre or post testing 1 Select the Database menu and choose Delete raw data A window like the following sample is displayed Delete Raw data from database Deleting raw data removes the detailed volume information used when reproducing graphs Deleted tests retain the test results and may be trended but may not be recalled for printing or for pre post testing Type of Delete Delete all raw data past its delete date Delete all raw data more than 0 days old Delete all raw
90. whead stand 2120 Spirometer 1 Make sure that the PC is turned off 2 Connect the serial cable supplied to the Vitalograph 2120 and following the instructions supplied with it ensure that the power supply is connected to the cable unless the 2120 battery is already charged 3 Connect the 9 pin D serial connector on the other end of the 2120 cable to the appropriate serial COM port on the back of the PC If the PC has a 25 pin serial port connector use a 9 pin to 25 pin port adapter 18 Gold Standard Spirometer Make sure that the PC is turned off Connect the serial cable supplied to the Vitalograph Gold Standard Connect the 9 pin D serial connector on the other end of the Gold Standard cable to the appropriate serial COM port on the back of the PC If the PC has a 25 pin serial port connector use a 9 pin to 25 pin port adapter Software Installation Loading the Spirotrac IV Software Windows 95 Windows 98 Operating Systems If applicable it would be advisable for your IT administrator to carry out the installation The process is easy 1 Oy Qu em qe Click on the Start button Select Settings from the main menu then select Control Panel Double click the Add Remove Programs icon Click the Install button or press Enter Click on the Next button or press Enter The install program should be detected automatically if not type a setup in the box provided and click the finish button The Spirotr

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SPIROTRAC ® IV User Manual