Pagewriter Cardiograph Operating Guide...patient module display- You can get better ECGs by viewing the patient module display before recording the ECG and adjusting the leads as necessary

Model MI700A

Pagewriter XLi Cardiograph Operating Guide

The Keyboard and Front Panel

Low Battery

Battery Level

AC%

Changes the paper speed of the ECG. I t switches between 5, 10, 25, and 50 mm/second for Manual and between 25 and 50 Auto. Changes the limb and chest lead sensitivity between 5, 10, and 20 mm/mV. Changes the chest Bead sensitivity between full and half size with respect to the value set by the key. Turns artifact and baseline wander filters on and off depending on which filter or filters are set in configuration. Allows patient identification entry, review, and edit.

These five keys (f1 - f5) directly beneath the display window perform different functions at different times. For this reason, they are called "softkeys." When the key is active, a label describing its function appears above it in the display window. Changes the softkey selection between two main displays. Starts an Auto EGG recording. Starts a Manual EGG recording. Halts any cardiograph function. Prints a copy of an Auto ECG which has just been acquired. Advances the paper to the beginning of the next page. Switches the cardiograph between On and Stadby. When the. cardiograph is in standby, it is raot operational; but i t is powered. Light indicates that the cardiograph must be plugged in and recharged. Lights indicate the remaining capacity level of the battery. When the battery is fully charged, all the lights are on.

Light will be on when the power cord is plugged into a wall outlet and the AC switch is on. This indicates that the battery is charging. The AC switch is on the back of the cardiograph. Pressed with @ at power-on for cardiograph self-test. Select leads on preview screen. When typing information, @ @ move the cursor in patient ID entry and configuration. Shift - @ and arrow keys will adjust the contrast on the cardiograph display. The Enter key.

Safety Summary

Safety Symbols The following symbols are used on the cardiograph or

Marked an the the carta Cardiograph Caution - See operating instructions

-l@t Type CF, defibrillation protected % Alternating current

0 Equipotential (this is on the ground lug)

B The maximum weight tha t the cart can hold.

Please see Chapter 4, Maintariltaing %he Cardiograph, for further information about operaling your cardiograph safely.

Conventions Used in This Manual

Warning Warning statements describe conditions or actions that @ can result in personal injury or lass of life.

Caution Caution statements describe conditions or actions tha t can result in damage t o the equipment or software.

Note Notes contain additional information on cardiograph

represents the temporary key labels that appear on the display.

@ represents keys on the front panel.

Documentation Map Documentation Map

If you want to: Use this mmud:

Verify that all equipment is included Packing Lis-t

Record ECGs Operaiing Guicle

Enter patient ID

Make copies of ECGs

Store ECGs

Transmit or receive ECGs

Troubleshoot problems

Maintain the cardiograph

Set up the cardiograph

Install battery

Install software

Load paper

Change applications

Install or use Preview Plus

Configure the cardiograph User 'ti Reference Guide

Prepare patient

Maintain the cardiograph

Install and use the modem

Order supplies

Use filters

Underst and analysis Physician's Guide

Contents

1. Getting Acqueaiglted About Your Cardiograph . . . . . . . 1-2 About This Manual . a a a . a 1- 3

2, Recording an ECG '

Recording an ECG . . . - - . 2-1 Preparing the Patient + - a 2-2 Checking Signal Quality . . . . . . . . 2-3

Using the Preview Screen (Optional) a 2- 5 Choosing a Report Format . . . .. . . 2-6

Auto Report Formats . a a . 2- 6 Changingthe Report Format . 2- 7

Entering Patient ID . a a 2-8 Reviewing and Changing Patient ID - 2- 9

Recording an Auto ECG . * a a 2-10 Recording an ECG From the Patient

Module . 2-12 Recording a Manual ECG . . . . . . . 2- 13 Understanding the h i n t e d Report . . . 2- 14

3 e Making Copies of Auto ECGs Copying ECGs Automatically . . . . . 3- 1 Copying ECGs Manually . . . . . . . 3- B ECG Report with Analysis a a a a 3-2

4, Storing Auto ECGs MmudEy Storing Auto ECGs . . . . . 4- 1 Printing a Stored ECG a - 4-3

Printing More than One ECG . . . . 4-41. Reviewing and Changing Stored Patient ID

i[nformation . a a a 4- 6 Deleting a Stored ECG - . 4- 8

Deleting More than One ECG . . . . 4- 9 Using ECG-Log and Store-Log . . . . . 4- 9 Using CheckDisk a * 4- 10 Reformatting Flexible Disks . . . . . . 4- 11

5. n a n s i t t i n g and Receiving Auto EGGS Transmitting ECGs . - - * 5- 1

Transmitting More than? One ECG a a 5-3 Receiving ECGs + a * 5- 3

6. nonblleshooting Checking ECG Technique . . . . . . . Identifying ECG Problems . . . . . . .

If the Recording Won't Start . . . . . Preview Screen Problem . a

Error Messages . . . . . . . . . . . .

'9, M~ntGnirag the Cardiograph Care and Cleaning . . . . . . . . . .

Cleaning the Cardiograph . . . . . . Cleaning the Keyboard . . . . . . Cleaning the Digital Array Printhead

and Paper Sensor a a a - Cleaning the Electrodes and Cables .

Caring for the Battery . . . . . . . . Storing the Battery . . . . . . . . . Replacing the Battery . . . . . . .

Disk Handling and Maintenance Instructions . . . . . . . . . . .

Safe ty . . . . . . . . . . . . . . . CalEng for Service . . . . . . . .

United States of America 7-12 Canada 7-12 Other International Areas 7-12

A. Patient ID Code Tables

B. Setting up Your Cardiograph for the First Time Checking the Voltage Setting . . . . . . B- l Connecting the Cables . . . . . . . . B-2 Installing and Using the Battery . . . . B-4 Loading the Paper - a . a . B-8 Installing Software . . . . . . . . . . B-10 Adjusting the Contrast on the Displays B-11 Setting the Date a n d ' ~ i m e . B-11

C. Specifications Basic Controls . a a . C- l Patient Safety . . C- 1 Instrument Test . . . . . . . . . . . C-2 Power and Environment . . . . . . . . 42-2

D. Installing Applications Installing Applications D- l Changing Applications . . . . . . . . D-2 Configuring your Cardiograph to Start Up

in a Chosen Application - D-3

E, Using XLi Preview Hus Reading the Preview Plus Screen . . . . E- 2 Observing a Patient's ECG Continuously E- 3 Recording Timed Auto ECGs . . . . . E-4 Recording Delayed Manual ECGs . . . . E- 5 Reformatting a Stored EGG . . . . . . E- 7

Index

Figures

1-1. The PageWriter Xki HP MI700A Cardiograph. a a

2-1. The Patient Module. a - 2-2- The Preview Screen. a - 2-3. The ECG Report. - 7-1. Removing the Keyboard, . , . . . . 7-2. Cleaning the Digital Array Printhead. 7-3. Replacing the Battery. . . . . . . . 7-4. The Battery Assembly. . B-I. Connecting the Power Cord and Patient

Module Data Cable. a a a

B-2. Connecting the Patient Module Lead Wires and Data Cable. . - -

B-3. Installing the Battery. . . . . . . . . B-4. TheBatteryAssembly .. a

B-5. Loading the Paper. a a - - B-6. Inserting the Disk. . . . . . . . : . E-1. A Preview Plus Screen. - a

E-2. A Reformat Report Screen. . . . . .

2-1. Patient Module Display Symbols . 2-4 . . . . . . . . . 2-2. Report Annotations 2- 15 . . . . . . . . . 2-3. Calibration Signals 2-16

6-1. ECG Problems . a a 6- 2 A-1. Patient ID Fields , a a A-2 A-2. Medication and Diagnostic Codes . . . A- 3 A-3. Race Codes a * a a A- 3

Getting Acquainted

Figure 1-1. The Pagewriter XLI HP M1700A Cardiograph.

A. Patient Module B. Preview Screen (optional) C. Cardiograph D. Disk Drive E. Cart

Getting Acquainted 1-1

A b u t Your Your PageWrit er Xki cardiograph:

Cardiograph Acquires up t o 16 leads simultaneously. Analyzes and interprets the complete ECG.

m Allows you to check lead quality on the preview screea or patient module before printing the ECG.

rn Allows you to s tar t an ECG recording from the cardiograph or from the patient module. Provides select able formats (Auto and Manual). Stores EGGS on a removable flexible disk. Allows you t o upgrade software simply.

r Operates on rechargeable batteries as well as AC power (with battery installed).

rn Has a digital array printer with continuous-feed paper. - r ~ Displays signal quality and leads off conditions. m Provides the ability t o transmit Auto ECGs via

modem, fax modern, or direct connection,

1-2 Getting Acquainted

About This Manual Keep this Operating Guide with your cardiograph in the place provided on the cart. This guide contains concise operating instructions for experienced Pagewriter XLi cardiograph users. If you are unfamiliar with using this cardiograph, please view the videotape tutorial, Using the Hewlett-Packard Page Writer X L Cardiographs. For additional help on using your cardiograph, refer to the Page Writer XEi User's Reference Guide.

This manual describes how t o perform the following tasks:

Recording an EGG as Editing patient ID

Making copies of Auto ECGs as Storing Auto ECGs

Deleting Auto ECGs rn Transmitting and receiving Auto ECCs

Troubleshooting rn Caring for and maintaining the cardiograph

Preparing your cardiograph for use

Getting Acquainted 1-3

Recording an ECG

This chapter contains the following information about recording an ECG on your Pagewriter XLi cardiograph.

Preparing the patient FB Checking signal quality

Using the optional preview screen im Choosing a report format

Entering patient ID Recording an ECG

B Understanding the printed report

Recording an ECG To record an ECG:

1. If the cardiograph is not on, press 2. Apply electrodes to the patient. 3. Press or to record the ECG.

The rest of this chapter will include details on recording ECGs,

Recording an ECG 2-1

Preparing the For electrode placement information, refer t o the label

Patient on the top of your cardiograph. For tips OW proper ECG technique, see the videotape Using the Hewlett-Packard Page Writer X L Cardiographs. Also refer t o the Page Writer XLi User js Refiaence Guide.

Note Computerized ECG analysis should always be reviewed 3 by a qualified physician.

Proper patient preparation and electrode placement are the most important elements in producing a high quality ECG trace. Prepare the patient by:

1. Gently scrubbing the electrode site with gauze. 2, Attaching the electrodes secrare'ly. 3. Reassuring and relaxing the patient.

2-2 Recording an ECG

Checking Signal Quality

Figure 2-1. The Patient Module.

A. Lead Wises B. Patient Module Data Cable C. Start and Stop Button D, Color Scale E. Patient Module Display I?. Shorting Plugs

@ - @ and keys will adjust the contrast on the patient module display-

You can get better ECGs by viewing the patient module display before recording the ECG and adjusting the leads as necessary. Noise bars for each lead extend downward t o show noislz levels. Collos scales on either side of the patient module display indicate by the length.' of the noise bar, the severity of the noise. See Table 2-1.


Table 2-1. Patient Module Display Symbols

Yellow zone bar: Moderate noise level.

Red zone bar: High noise level. ECG report quality will be affected. Check patient preparation.

Optional lead not installed. (Shorting plug present)

Patient ID number appears on the patient module display when you

press @ any time you have already recorded an ECG. K you .

want to use this ID, press @ t o record the ECG. If you do not want this ID, enter a new patient ID number from the front key panel of the cardiograph.

***************t Cardiograph is busy.

Press @ again and the ECG will be recorded. If you want to enter a patient ID number, enter the number from the front


Using the Preview Screen (Optional)

Figure 2-2. The Pkev"sew Screen.

A, Brightness knob B. Contrast knob

The preview screen is another way besides the patient module display t o ensure tha t you record a good quality ECG. When the cardiograph is on, the preview screen is operating, ,

Before you connect the leads, the screen shows the selected three Bead group. Each lead is shown as a dotted line indicating that the lead is o K

H As you connect the leads t o the patient, lead waveforms are displayed on the screen.

B YOU can select diflereaat lead groups t o display by pressing the @ and Q keys on the cardiograph's key panel.

H When you press the key? EECG information is acquired. A fixed display of the Auto ECG waveform then appears.

B You may halt the recording if you see artifact or other ECG waveform problems on the fixed display,

m When vou mess the 'kev, there is a continuous display of three lead waveforms ow the screen.

B You can adjust the contrast and brightness on the screen with the two knobs on the lower right corner of the preview screen frame.

Note If the preview screen is dark when you turn on the cardiograph, turn the contrast and brightness knobs for the proper brightness.

Choosing a Report Format

Auto Report Formats If-lead Auto reports may be displayed in 3 x 4 or 6 x 2 formats. The 3 x 4 format displays shorter segments of waveform information than the 6 x 2 format. Rhythm strips may be added t o display a longer segment of one or three leads in the 3 x 4 format,

2-6 Recording an EGG

Changing the Report To change the report format:

Format ' 1. press . You will see a display similar t o the one shown below.

2. Press to select between Auto or Manual report menus.

soft ke ys change features of ) when setting the report

to select the report presentation. The selections are:

See the Page Writer X k i User's Reference Guide for more explanation of the report formats.

4. Press to select which leads will. be recorded.


Entering Patient ID You do not have t o enter any patient identification information to record an ECG. However, you must enter a patient ID number to store an Auto ECG. Another reason to enter patient ID information is that some ID fields affect the interpretation of Auto ECGs.

Note Your cardiograph may be configured so that patient ID is automatically checked for each time you star t an ECG* If you do not want patient ID, press or (depending on which report type was originally selected) again to override the request for patient ID.

To enter patient identification:

1. Press @. If you have already entered a patient ID number or have not turned off the cardiograph since recording an ECG, the question New Patient?

When you press 9 all of the patient ID information will be cleared. The question Pat iene ID#? appears. If you have not already entered another patient ID number, this display also appears when you press a.

3- Type the patient ID number and press th softkey, The next display requests the

4. Type the patient's name and press the The next display requests the patient's age. It also allows you t o choose the age designation (Years, Months, Weeks, Days, Hours or Year of Birth).

until the age designati

the age and press the


The numbers in parentheses indicate acceptable entries. BB Each time you press the oftkey, the display

moves t o the next pa . To return t o a preceding field, press ntil i t appears.

a There are many more patient ID fields in which you can supply other types of patient information. All of the fields are shown in Table A-1 at the end of this guide. You can stop entering patient ID information any time by pressing E x i t . This saves all entries including the currently displayed information.

Reviewing and To review and change the current patient ID Changing Patient ID information:

1. Press the @ key. The message N e w Patient? appears.

2. Press No . The current patient ID appears and you can change any field.

Tips To enter information more quickly, you can suppress 3 the request for information in unused ID fields. See the Page Writer XLi User9s Rejerence Guide for more information about configuring your cardiograph t o suppress display of unused ID fields.


Recording an Auto To record an Auto ECG:

ECG I. Turn on the power on the cardiograph. 2. Apply electrodes to t he patient. 3. Check each lead for signal and electrode connection

quality by observing the patient module display or the preview screen.

4. Press on the front panel. -

Note Your cardiograph may be configured so that patient ID is automatically checked for each time you start an ECG. If you do not want to enter patient ID, press again t o override the request for patient ID.

B If you entered the current patient's ID behre you pushed the key, the ECG will be recorded without further prompts.

H If you have not entered any patient ID information since turning on the cardiograph, the message No I D # entered. Continue? will appear. Press

to record the EGG without patient ID. Press start entering patient ID.

ta If you have entered patient ID information since the cardiograph was turned on, the question Continue using I D # ? appears.

If you have entered a patient identification number and want to take more ECGs from the same patient, press Yes . If you are taking an ECG from another patient press No.

The status messages Acquiring ECG, a variable signal quality message, and Print ing Auto report . . . appear. If you have not entered the patient ID yet and Autostore has been turned on in configuration, the following display appears.


See Chapter 4, Storing Auto ECGs, for information about storing the ECG.

Only Auto ECGs can be interpreted.

If you wish t o suppress analysis or do not wish t o have the electronic analysis information appear on the printed copy, you may configure the cardiograph for these options. Refer to the Pagewriter XLi Reference Guide for these procedures:


Recording an ECG To start an ECG from the patient module:

From the patient H To record an Auto ECG. ~ u t s must appear on $Re

Module ,

cardiograph's main display over the soft key on the cardiograph. To record a Manual EECG, Manual a r on the cardiograph's main display over the soft key on the cardiograph.

1. Turn on the power on the cardiograph. 2. Apply electrodes t o the patient. 3. Check each lead for signal and electrode connection

quality by observing the symbol on the patient module display or preview screen.

4. Enter patient ID information a t the front key panel. 5. Press the @ button on the patient module.

The ECG recording starts.

Ir'ou can halt the recording any t h e by pressing this button again. To restart the recording, press @ from the patient module.

The patient ID number appears on the patient nodu le display when you press @ any time you have already recorded an ECG. If you want t o use this ID, press @ t o ricord the ECG.


Recording a 'To record a Manual ECG:

Manual ECG 1. Turn on the power on the cardiograph. 2. Apply electrodes to the patient. 3. Check each lead for signal and electrode connection

quality by observing the preview screen or the patient module display.

4, Press on the front panel.

Note Your cardiograph may be configured so tha t patient ID is automaticaUy checked for each time you start an ECG- If you do not want to enter patient ID, press again to override the request for patient ID.

The status message Printing Manual r e p o r t . . . appears. The cardiograph will print the ECG continuously until you press the key or the @ button on the patient module.


Understanding the Printed Report

P 7 I QRS ' 7 1 - BORDERLINE ECC -

I a QR V I V4

I I a V L v 2

I l l

I I

n-

Figure 2-3. The ECG Report,

T ~ b l e 2-2. Report Annotations

Systolic/DiastoIic Blood Pressure (BP)

User-defined labels such as, smoker/nonsrnoker, temperature, or insurance number.

Referring physician.

Indication that ECG has not been overread. Calibration signal. See Table 2-3. Pacemaker pulse symbol, ( I ) , if present.

Sequence number - t he total number of ECGs that have been recorded.

Adult or Pediatric criteria version number.

* Artifact filter (F) * Frequency range * AC line filter ( "$8) * Baseline Wander filter (W)


The following table shows how the calibration pulse indicates ECG sensittivitgr.

Table 2-3. Calibration Signals


Making Copies of Auto ECGs

This chapter contains information about copying ECGs aut omatically and manually.

Copying ECGS Your cardiograph can be configured t o automatically

Automatically provide additional copies of each Auto ECG after you print it initially. For information on configuring your cardiograph for AutoCopy, refer t o the Page Writer XLi User's Reference Guide.

If you wish t o print a stored ECG, refer t o Printing a Stored ECG in the next chapter,

Copying ECGS If you require additional copies of an Auto ECG, you

Manually may manually copy the ECG.

Note You must copy the EGG before the cardiograph has been

To copy an Auto ECG you have just recorde'd:

1. Press on the front key panel. The message Copying auto report appears and the copy will be printed.

Making Copies of Auto ECGs 3-1

Note You can only make copies of Auto ECGs.

ECG Report with You can copy an ECG with different degrees of analysis

Analysis on the copy. For information about these reports, refer t o the Page Writer XLi User's Reference Guide,

1. Your cardiograph may be configured so that the following display appears after you press

2. Press the key representing the type of analysis you want on the copy.

3. After you make your choice, the message Copying i of 1 appears and the copy is printed.

For further information about various analysis reports, refer to the Page Writer X L i User% Reference Guide.

3-2 Making Coples of Auto ECGs

Storing Auto ECGs

This chapter contains the following information about stored ECGs.

a Manually storing Auto ECGs m Printing stored ECGs

Reviewing and changing stored patient ID information Deleting a stored EGG Using ECG-Log and Store-Log

e Using CheckDisk II Reformatting flexible disks

Manually Storing Auto ECGs

Note Use only 1.44 MB high density flexible disks in the cardiograph.

EGGS can be stored automatically or manually. T60 store an ECG you have just acquired:

1. Insert an ECG disk in the disk drive.

Note 3 Check the Babel of the flexible disk that y m insert in the disk drive to be sure that it is an ECG disk and not a configuration or system disk.

Storing Auto ECGs 4-1

. ,

2. Press until the following display appears.

The cardiograph will prompt you to ient ID information if you have not

already done so. s A new flexible disk is prepared for use by

formatting it for ECG storage. If the flexible disk you inserted in the disk drive is new and has not yet been formatted, a question will appear you want the flexible disk formatted. Pres you want the disk formatted. This will tak 90 seconds. You may also insert a formatted flexible disk at this time. Hf the flexible disk you insert is full, insert another flexible disk.

4. The message Storing E@6 . . . appears. This indicates the EGG has been stored on the disk. It remains stored until you delete it.

Caution Do not remove the flexible disk from the cardiograph while the disk drive light is on. Removing the flexible disk while the light is on can destroy information on the disk.

m The EGG'S date and time are used to distinguish te multiple ECGs with the same ID number.

I You can configure the Pagewriter XLi cardiograph to store all ECGs automatically. This storage function is called AtntoStore. For further information about configuring the cardiograph for Autostoke, see the Page Writer XLi User9s Rejerence Guide.

4-2 Storing Auto ECGs

Caution After pressing do not turn off the cardiograph until you see t age S t ~ r e complete or the ECG will be lost.

Printing a Stored Be sure that the flexible disk in the cardiograph's disk

ECG . drive is the disk that contains the ECG that you wish to print, Refer to Using ECG-Log and Store-Log later in this chapter for instructions on obtaining a list of ECGs on the flexible disk.

Stored ECGs are identified by patient ID number plus the date and time that the ECG was acquired. To print a stored ECG:


T r a n s m i t S t o r e

2. Press F i l e s . The display becomes:

The message Reading the disk . . . splay appears similar to the one shown

below:


rect patient ID Or:

B If you know the ID number of the ECG vou want t o - print, press then

@ Type the patient ID number, then press The most recent EGG with tha t patient ID number appears. If you want a different ECG for tha t

the list by pressing

i t h the following steps, The messages Reading 1 of % ECG(s) 1 of 1 ECG(s) appear and the selected

ECG will be printed.

Note If you PageWriter XLi is equipped with software version Aa03 (or later version), you ran print ECGs on an HP PCL LaserJet. You must configure the cardiograph for transmitting ECGs t o an HP LaserJet printer. For further information on this, refer t o the Pagewriter XLi User's Reference Guide.

Printing More than To print more than one ECG: One ECG I* As you scroll through the list of stored ECGs, press

for each EGG you want t o print. A selected patient ID number is shown with stars, for example, *I23456 9-23-90 %i : 25 :5iAM*et. %f you do not want t o print an ECG that you have already selected, pres again when its number is displayed. The no longer appear on the ""unselected9'

All selected EGGS will be printed.

To print a11 ECGs:

1. Press until the following display appears,


2. Press The display becomes:

3. Press The message Reading the disk . . . appears, followed by a display similar t o the one shown below:

ct Print PT

4. Press More . The following display appears.

5. Press 811.

6. Press Print .

All the ECGs on the flexible disk currently in the cardiograph's disk drive will be printed.


- --

Tips B EGGS are stored in the order in which they are recorded.

a The most recently stored ECG patient ID number is first when you start selecting patient IDS.

t o display ECGs stored prior t o the most recently stored EGG.

rn If you have changed flexible disks, only the ECGs on the disk in the disk drive will be available for printing.

Reviewing and TQ review and change the patient ID information of a

Changing Stored stored ECG:

Patient ID 1. Press until you see the following display.

Information

2. Press The following display appears.

3. Press Edit. The message Reading the d i sk . . . appears, followed by a display similar t o the one shown below.


Lge Press or until the correct patient -- IU number appears,

5. Press Or:

If you know the number of the ECG you want t o edit, press then

Type the patient ID number and press The most recent ECG with that patien number appears. If you want a different ECG for that pat st scroll throu pressing nd then press

60 Press Edit. The message Reading the disk ... appears.

7. When the message Pa t i en t ID#? 123456 appears, the ID has been retrieved and can be edited.

Move through fields by pressing

If the field was originally typed in and you wish to change the information, type the corrections. Move the cursor t o the information you wish t o change with the and Q keys and type the new information. You can also move the cursor t o the end of the line and backspace to where you wish to change information. . . . . . . . . . . . .

. . . . . . . . . . .

8 - When you are finished, press :~ i i t . . . :. .............

Analyze modified ECG? appears. if you wish to have the ECG

essage S to re modified ECG? appears. Choose o store the revised ECG. You must have a

patleaat ID to store the ECG. 1% you have deleted the . patient ID number, you will be prompted to enter new patient ID.

Caution The original ECG report will be lostwhen the ECG is reanalyzed and stored.


Deleting a Stored . To delete a stored ECG:

EGG 1. Press until the following display appears.

2. Press The display becomes:

3. Press Delete. The message Reading the disk . . . and a display similar to the following appear.

4. Press or until the correct patient ID number appear . Or:

- a. If you know ber of the ECG you want to delete, press

be Type the pa

The question Start Deleting i FS .


6. Press Yes if you want t o continue. The message Deleting I of 1 ECGs appears and the ECG is removed from the Aexible disk. The following display will appear to confirm that the ECG is deleted.

7. Press Exit t o continue.

Deleting More than @ You can ore than one ECG to delete and

One ECG

m To delete all stored ECGs, follow t in deleting a single ECG but press

instead of in step 4.

Using ECG-Log The cardiograph automatically maintains two ECG logs.

and Store-Log The ECG-Log is a list of the last 60 Auto and Manual ECGs recorded on the cardiograph. I$ shows the time and date the ECGs were recorded and if they were stored. When more than 60 ECGs are listed, the oldest ECGs disappear faom the list.

The Store-Log lists a11 Auto ECGs stored on the flexible disk currently in the disk drive, lit shows if ECGs on the disk were transmitted, analyzed, or edited.

For further inbrmation about using these logs, refer t o the Page Writer X h i User9s Reference Guide.


Using CheckDisk CheckDisk allows you to see how much space is available on a flexible disk.

1- Press until you see the following display,

You will then see a message that ntage of storage space available on

the flexible disk. For example, you may see a message such as, Disk 25% f u l l .

Note The number of ECGs tha t can be stored on the flexible d disk varies. See the Page Writer XL i L'ser9s Reference Guide for more information. on how many ECGs can be stored on a flexible disk.

4-"%1 Storing Auto ECGs

Reformatting TO reformat a flexible disk:

Flexible Disks 1. Press until you. see the following display.

2. Press Uou will then see a message that indica ntage of storage space available on the flexible disk.

3. Press Erase t o reformat the flexible disk.


Transmitting and Receiving Auto ECGs

This chapter contains information about transmitting and receiving ECGs. The cardiograph must be configured for these functions before using them. For more information about configuring your cardiograph for transmitting ECGs, refer to-the Page Writer XLi User's Refirence Guide.

Transmitting ECGs

Note If you are using an external modem, the cardiograph 3 must be plugged into AC power with the AC switch on to operate the modem. For information about instding the modem for transmitting ECGs, refer to the Page Writer XLi User js Reference.

You can only transmit Auto ECGs that are stored on a flexible disk.

To transmit an ECG:

1. Press until the following display appears,

Transmitting and Receiving Auto EGGS 5-1

2. Press The following display appears.

Reading the d i s k appears, then lay appears.

until the correct patient ID

want to transmit, press

Type the patient ID number. Press most recent ECG with that patient appears. If you want a different ECG for that pa must scroll through the list by pressing

The following display appears.

6. Press the key under the number of the intended receiving site. This number corresponds to the receiving site previously configured. Messages such as, Calling site, Connected to s i t e . , Transmitting . . . , and Transmitting 1 of 1 ECG(s) might appearo

5-2 Transmitting and Receiving Auto ECGs

7. When the ECG has been successfully transmitted, i ECG(s) Transmitted appears,

a.

8. Press to continue.

Transmitting More FJ To transmit several ECGs, follow the same steps as

than One ECG above, but select each ECG you wish to transmit. After selecting the ECGs, press

rn Ig, transmit all stored EC above; but, in step 3, pres

m To transmit d l ECGs that have not been previously transmitted, ut, in step 3, press

In step 5, Manual allows you to transmit to a site that has not been configured.

Note See the Page Writer XLi User's Reference Guide for more information about transmitting ECGs.

Receiving ECGS The cardiograph can receive ECGs whenever it is turned on and idle. If the cardiograph is turned off, it cannot receive ECGs. All EGGS are printed as they are received. You cannot edit or store received ECGs.

You can stop receiving the ECGs any time by pressing

Far information about configuring your cadiograph to receive ECGs, refer to the Page Writer XLi User% Reference.

Transmittlna and Recels%ina Auto ECGs 5-2

?dour cardiograph is designed for reliable operation. If you have problems with an ECG, there are several things you may check before calling for service. This chapter tells how to solve basic ECG problems.

Checking ECG Many problems in taking an ECG may be related to

Technique electrode placement or application. You can improve the quality of ECGs you record by carefully preparing the patient.

a Be sure the electrode site is clean and not covered by hair or clothing.

m Apply the electrodes securely. They must neither slide nor be so tight that they cause discomfort. The electrode paste, gel, or cream must cover an area the size of the non-adhesive electrode, but must not extend beyond it, especially on the chest.

Refer to Checking Sigaaal Quality in Chapter 2 for ireformation about ensuring a good recording by using the preview screen and the patient module dispIay.

Identifying ECG . The following table shows symptoms and solutions to

Problems problems that can occur when recording an ECG,

Table 6-1, ECG Problems

filter in global configuration,

ossibly a poorly grounded Route electrode wires along the

contact & skin preparation. not pulIing on the electrodes.

key when it has been

Respiratory interference. Move electrodes away from areas

Table 6-1. E66 Problems (continued)

Tense, uncomfortable patient.

teach electrodes high om the

s 1 s t resort, press the

Repair or replace faulty leads.

Note key can be configured to enable the baseline er and/or the artifact filter. See Pagewriter

Guide for information on key.

Troubleshooting 6-3

If the Recording If YOU press or and t h e recording doesn't won't Start start investigate the following possibilities:

s Is the cardiograph turned on? rn IS the patient module connected to the cardiograph? FB Is the battery adequately charged? B If the message Check paper supply. Continue?

appears, the cardiograph will not record an ECG until you have loaded the paper or cleared a paper jam. See Appendix B for details on loading the paper.

It is also possible tha t the paper sensor lens is dirty. To clean the paper sensor lens, follow the instructions in the next chapter.

B Is there an error message?

If the cardiograph still won't operate, call your local Hewlett-Packard service representative.

Preview Screen If the preview screen is dark when you turn on t h e

pb~biem cardiograph, turn the contrast and brightness knobs.

Error Messages The error messages that appear on the display will instruct you as t o what action t o take. If i t is something that you can correct, the message will instruct you what t o do. If an error number appears, perform the following steps.

1. Turn off the cardiograph from the front panel. 2. Pause and then turn the cardiograph on again. .

f i r further information about error messages, see the Page Writer XLi User's Reference Guide. If you see the message 6503, the software must be re-installed. To re-install the software:

1. Turn off the cardiograph from the front panel. 2. Insert the system disk or the custom configuration

disk. 3. Turn the cardiograph on again. 4. Remove the disk when the disk drive light turns off.

If the cardiograph still won't operate, call your local Hewlett-Packard service representative.

Troubleshootine 6-5

Maintaining the Cardiograph

This chapter contains the following information about maintaining and deaning your Pagewriter XLI cardiograph.

Cleaning the cardiograph Cleaning the electrodes and cables

H Maintaining, storing, and replacing the battery Caring for the flexible disks Safety Calling for service

Care and Cleaning The cardiograph and its accessories are designed to be . cleaned by common cleaning solutions and non-caustic

detergents. The following are some approved cleaning solutions for all of the outside surfaces of the cardiograph and the patient module.

a Mild soap and water Chlorine bleach (30ml/l water) Ammonia-based, household cleaners Isopropyl Alcohol (except patient cable)

Maintaining the Cardiograph 7 4

Cleaning the Cardiograph

1. Unplug the power cord and ensure that the cardiograph is off at the front panel.

2. Wipe the external surfaces of the cardiograph, the patient cable, and reusable electrodes with a soft cloth dampened in any of the approved cleaning solutions listed above. Avoid the lead wire inputs and cable connections.

Caution Do not use any strong solvents or abrasive cleaning materials. Do not spill any liquids on the surface of the cardiograph. Do not use the following to clean the cardiograph: B Acetone

Iodine-based cleaners B Phenol-based cleaners B Ethylene Oxide Sterilization

7-2 Maintaining the Cardiograph

Cleaning the Keyboard

Figure 7-1. Removing the Keyboard.

A. Notches

If the keyboard requires cleaning, you can remove it from the cardiograph and immerse it in lukewarm water.

To clean the keyboard:

1. Carefully insert a small screwdriver into the notches at the bottom edge of the keyboard and pry the keyboard up.

2. Rinse off the keyboard and dry it. 3. Snap it back into the cardiograph.

Do not wash the keyboard in hot water such as in a dishwasher.

Maintaining the Cardiograph 7-3

Cleaning the Digital Array Pnnthead and Paper Sensor

Figure 7-2. Cleaning the Digital Array Printhead.

A. Piinthead B. Paper Sensor

If the print quality is uneven, it may be due to a dirty printhead. How frequently you must clean the printhead varies by how many ECGs are printed on the cardiograph.

If the paper fails to stop at the end of a page, the paper sensor lens may be dirty.


To clean the printhead:

1. From the front of the cardiograph, unlatch and open the paper door. The printhead is t o the right under the paper blade and behind a brush. See Figure 7-2.

2. Lightly wipe the printhead with a foam swab dipped in 90% alcohol.

3. Allow the printhead to dry.

To clean the paper sensor lens:

1. From the front of the cardiograph, unlatch and open the paper door. The paper sensor lens is to the right under the printhead. See Figure 7-2.

2. Lightly wipe the paper dust off of the paper sensor lens with a dry foam swab. Do not use alcohol.

Cleaning the Clean the electrodes and patient cables with a soft - Electrodes and cloth moistened with soapy water. You also can use

Cables a disinfectant or cleaning agent such as ~ety lc ide@, CidexQ, L ~ ~ ~ ~ Q , VVescodyne@, or ~es-phene@. Wring any excess moisture from the cloth before cleaning.

Caution a Do not clean the patient cable with isopropyl alcohol.

R Do not autoclave the cable or use ultrasonic cleaners.

FB The patient cable is not immersible.

Do not use abrasive materials to clean metal surfaces-scratches on electrodes can cause artifacts.

Avoid wetting the connectors.


Caring for the kead-acid batteries operate best when they are kept

Battery fully charged. The battery is being charged whenever the cardiograph is plugged into AC power and the AC switch in back of the cardiograph is on. When charging the battery, check to be sure that the A@ light is lit on the front panel. Leave the cardiograph plugged into AC line power when not in use so it can be continuously recharging.

Note To verify battery capacity, turn on the cardiograph while it is connected to AC power and the AC switch is on* The cardiograph must be connected t o A$: power when verifying battery capacity.

Storing the Battery To prepare the battery for storage, charge it in the cardiograph for 48 hours, Then store i t in a cool, dry location. Recharge a lead-acid battery in storage for at least 24 hours every six months. This ensures tha t the battery does not completely discharge while in storage. The battery's shelf life is longer with cooler temperatures, but do not store below freezing level.

Note If the equipment will be stored for longer than one month, remove the battery from the unit.

Replacing the Battery

Caution The cardiograph must be connected t o AC power during battery replacement. Make sure the AC switch at the back of the cardiograph is on while you replace the battery. Otherwise, the configuration information and operating software will be lost. See the Page Writer XLi User's Reference Guide for information about saving your configuration on a flexible disk,


Battery life varies by how the battery is maintained and how much it is used. If the battery has been fully charged and requires recharging after a few ECGs, consider replacing it. Use only lead-acid batteries with HP part number M1721A.

Figure 7-3. Replacing the Battery.

A. Battery Door B. Thumbscrews


Figure 7-4. The Battery Assembly.

A* Battery B. Slot C. Battery Door

'To replace the battery:

1. Plug in the cardiograph and turn on the AC switch at theback of the cardiograph.

2. From the back of the cardiograph, loosen the Iarge thumbscrews on the battery door as in Figure '7-3.

Warning The battery is heavy and can cause injury if it is dropped. 0 When removing the battery hom the drawer, hold it from underneath to prevent dropping it.

3. Slide the battery and battery door out of the cardiograph,

4. Separate the battery door from the battery.


5. Install the new battery on the battery door as shown in Figure 7-4. Make sure that the tab om the door fits into the slot on the battery.

6. Slide the battery assembly into the cardiograph and finger-tighten the screws on the battery door.

7. Press the switch to On. 8. Check tha t the battery and AC indicator lights are

on.

After you install the new battery, charge it for a t least 24 hours before extensively using it on battery power. To charge the battery, plug the cardiograph into the wall outlet for 24 hours with the AC switch on.

Warning Properly dispose of or recycle depleted batteries 9 according to local regulations. Da not disassemble, puncture or incinerate the disposed batteries.

Note To verify battery capacity, turn on the cardiograph while i t i s connec t ed toACpowerand theACswi t ch i son . The cardiograph must be connected t o AC power when verifying battery capacity.


Disk Handling and The following instructions will prevent ECG disk damage

Maintenance and data loss.

Instructions FBI Never manually open the silver shutter on the disk. Do not expose the disk to direct sunlight, extremes sf temperature or humidity, magnetic fields, or dust.

H Place the disk in a protective cover when the disk is not inside the drive.

H Store disks in a clean, dry place, Do not eject the disk, move the cardiograph, or turn off the cardiograph when the disk is active in the drive. The disk is active when the drive access light is on.

H Clean the disk drive with a wet-dry cleaning kit regularly. Wet-dry cleaning kits are available from local computer stores,

rn Glean the disk drive every six months unless t he working environment is particularly dusty or dirty. Clean the drive more often in dusty or dirty environments.

TraceMaster X G Management System users:

If you transfer ECGs to the TraceMaster System by disk, clean the TraceMaster drive every six months unless the working environmentis particularly dusty or dirty. Clean the drive more often in dusty or dirty environments.

mr Replace disks regularly. The recommended replacement interval is every three months. If t he disks are used for more than 50 ECGS per day7 replace the disks more frequently.

arr For best results, use only Hewldt-Packard recommended disks. (HP part number M1700-89004)

sl For more information, contact your Hewlett-Packard service representative.


Your cardiograph isolates all connections t o the patient from ground. This reduces the possibility of hazardous currents passing from the cardiograph through the patient's heart t o ground. To ensure the patient's safety and your own, observe the following reminders.

FS When operating your cardiograph from AC power, be sure it and all other electrical equipment on or near the patient are effectively grounded.

Use three-wire power cords with three-prong grounded plugs. Also make sure the outlet accepts the three-prong plugs and is grounded. Never adapt a three-prong plug to fit a two-slot outlet.

Do not use this cardiograph near flammable anesthetics. It is not intended for use in explosive environments.

s Only qualified personnel may service the cardiograph.

rn Do not touch the patient, patient cable or cardiograph during defibrillation procedures.

Be sure tha t no electrodes on the patient contact any other conductive parts including earth-grounded parts.

i Do not block the ventilation slots. They are on the sides and bottom of the cardiograph.

s The Hewlett-Packard warranty is only assured if you use Hewlett-Packard approved accessories and replacement parts. Refer t o the Page Writer XLi User's Reference Guide for a list of orderable supplies.

Maintalsaing the Cardiograph 7-1 1

Patient D Code Tab

This chapter contains information for configuring the patient HE) entry on your Pagewriter XLi cardiograph. Table A- l shows the fields in the sequence that they may appear during patient ID entry. The patient ID number is the only field that must be filled in for storage of Auto ECGs. Refer t o the Page W t e r XEI, User9s Reference Guide for further information on Fatient ID.

Note Your cardiograph may be configured so that patient ID is automatically requested each time you start an ECG. If you do not want to enter patient ID, press or

again t o override the request for pati

Patient ID Code Tables A 4

Type the patient name.

Choose Male or Female

Type the systolic blood pressure value.

Type the diastolic blood pressure value.

Race codes. See Table A-3. Medication codes. See Table 8-2.

Diagnosis codes. See Table A-2. Type the criteria version number. For transmitting to ECG Management System or for future criteria updates.

requested the ECG.

Table A-I. Patient ID Fields

A-2 Patient ID Code Tables

Table A-2. Medication and Diagnostic Codes

. Angina pectoris

C a l c i u m b locker . Myocardial infarction

. Post op bypass

Procainamide A r t i f i c i a l p a c e m a k e r

C a r d i o m y o p a t h y

. Congenital HD cyanotic

H y p e r t e n s i v e HB P o t a s s i u m c h l o r i d e P u l m o n a r y d i s e a s e

P s y c h o a c t i v e d r u g R h e u m a t i c HD

. Barbiturate . Aortic valvular disease

. Phenothiazine . Mitral valvular disease

N o k n o w n Rx . No known Dx

Table A-3. Race Codes

Patient ID Code Tables A-3

Race Statement

Aleutian or Eskimo American Indian Black Hawaiian Hispanic

Oriental Pacific Islander

White Other Race

Code

1 2 3 4 5 6 7 8 9

Setting up Your Cardiograph for the First Time

This chapter contains information on setting up your Pagewriter XLi cardiograph. Before using your cardiograph for the first time you must prepare i t by performing the following tasks:

ta Check the voltage setting a Connect the cables sa Install the battery ta Load the paper M Install the software m Adjust the contrast on the displays if necessary s Set the date and time

Checkinn t he Your cardiograph can be set t o operate a t nominal line

Voltage Setting voltages of 100, 120, 220;230, or 240 Volts. The line voltage was set a t the factory to the setting for your area. HoweverI it is a good idea t o check this setting. lkf the voltage setting is incorrect, call Hewlett-Packard service or have a qualified service engineer change i t t o the correct setting for your area.

Caution The cardiograph can. be damaged if plugged into the incorrect volt age.

Setting up Your Cardiograph for the First Time B-1

Connecting the Cables

Figure B-1. Connecting the Power Cord and Patient Module Data

Cable.

A. Patient Module Data Cable B. AC Switch C. Voltage Setting D. Power Cord

I. Connect the power c ~ r d and patient module da t a cable to the cardiograph as shown in Figure B-1.

2. Plug the power cord into the wall outlet.

B-2 Setting up Your Cardiograph for the First Time

Figure 8-2. Connecting the Patient Module Lead Wires and Data

Cable.

A, Patient Module Data Cable B. Lead Wires C. Shorting plugs

Connect the lead wires to the patient module by matching colors and labels on the patient module and the lead wires. The lead wires have colored labels on the end nearest the electrode. If you are using the patient module from the front of the cardiograph, lead the patient module data cable through the hooks underneath the cardiograph on the cart. The cable will snap into the two small hooks. Attach the patient module data cable t o the patient module as shown in Figure 6-2.


- Installing and Using the Battery

Figure 8-3. installing the Battery.

A. Battery Door Be Thumbscrews

B-4 Setting up Yapst Cardbgraph for the First Time

Your cardiograph does not operate without the battery installed even if it is plugged into AC power. For information about replacing the battery, refer t o Chapter 7, Maintaining the Cadiogragh.

Use only lead-acid batteries in the cardiograph (WP part number M1721A).

To install the battery:

1. Plug in the cardiograph and turn on the AC switch at the back of the cardiograph.

2. From the back of the cardiograph, loosen the large thumbscrews on the battery door as in Figure B-3.

~

Warning The battery is heavy and can cause injury if it is dropped. 9 When removing the battery from the drawer, hold it from underneath to prevent dropping it.

3. Install the battery on the battery door as shown in Figure B-4. Make sure tha t the tab on the door fits into the slot on the battery.


Figure 8-4. The Battery Assembly

A. Battery B. slot C. Battery Door

4. Slide the battery assembly into the cardiograph and - finger-tighten the screws on the battery door,

5. Press the switch to On. 6. Check that the battery and AC indicator lights are


After you install the battery, charge it for a t least 24 hours before extensively using i t on battery power. To charge the battery, plug the cardiograph into the w d l outlet for 24 hours with the AC switch on.

Caution If the equipment will be stored for longer than one month, remove the battery from the unit.

Note To verify battery capacity, turn on the cardiograph while it is connected t o AC power and the AC switch is on. The cardiograph must be connected t o AC power when verifying battery capacity.

Setting up Yaur Cardiograph for the First Time B-7

Loading the Paper

- Figure B-5. Loading the Paper.

A. Paper Door Latch B. Paper Sensing Hole C. Paper D. Cardboard Backing

The cardiograph uses continuous-feed paper. For best results use Hewlett-Packard paper in the cardiograph.

Caution Do not expose the paper to light. Cover it for storage.

B-8 Setting up Your Cardicsgreph for the First Time

To load the paper:

1, From the front of the cardiograph, release the latch on the left side and slide the paper door t o your left.

2. Remove the outer packaging on the paper. Keep the cardboard backing on the bottom of the paper stack.

3. Place the paper stack in the compartment so that the top side of the paper feeds grid side up over the top panel. The paper sensing hole will be in the lower corner of the paper, and the cardboard backing will be on the bottom.

4. Pull a half sheet out and over the paper door. Make sure that the paper is parallel with the sides of the paper door. See Figure'B-5.

5. Slide the paper door back into place. The door is latched when it snaps into place.

Setting up Yaur Cardiograph for the First Time B-9

Installing Software

Figure B-6. inserting the Disk.

A. Disk Drive B. Qect Button

To' install the software:

1. Turn the cardiograph to Standby from the front panel.

2. Insert the application disk, labeled "System Disk", in the disk drive in the front of the cardiograph.

3. Turn on the cardiograph. 4. The name of the system configuration being installed

appears on the display. If you do not want to load this system configuration, remove the disk and turn the cardiograph t o Standby. Find the desired application disk and start over at step 1.

5. You may be prompted to choose which language to install as well as whether to select 50 or 60 Hz.


6. After the system configuration has been installed, remove the disk and store it safely.

The software is now installed.

After the software is installed, it does not need t o be re-installed unless battery power is lost or you want to update the software with an upgrade from Hewlett-Packard.

Adjusting the To adjust the contrast on the cardiograph's display:

Contrast on the I. Press while pressing the A key or the r key

Displays repeatedly until you see the desired contrast.

The A key makes the display darker and the v key makes the display lighter.

To adjust the contrast on the patient module's display:

1. Press @ while pressing the r key or the r key repeatedly until you see the desired contrast.

The key makes the display darker and the v key makes the display lighter.

Setting the Date TO set the date on the display:

and Time 1. Press until a display similar to Lhe following is visible.


2. Press the key below the date. The date change display appears:

3. You can then change the month, day, and year by typing the correct month, day, and year. Tc move to the next field, press the 4 ss b softkeys,

4. Press when the date is correct, Pressing

will restore the date to what it was before you changed it.

'To set the time on the display:

1. Press the key below the time, The time change display appears:

2. You can then change the time by ty correct hour, minute, and second. Press the soft key to change between AM an8 P M settings if the date

en set to AM/PM. when the time is correct.

Your cardiograph is ready to record an ECG after you connect the leads to the patient.

B-12 Slatting up Your Cardiograph for the First Time

Specifications

Conforms t o applicable IEC, VDE, UL, CSA, AHA, AAMI specifications.

Basic Controls ECG Controls: On/Standby, Auto, Manual, Speed, ECG Size, V-lead Size, Copy, Filter, Paper Feed.

ECG Format Selections: Auto (with 0, 1, or 3 rhythm leads); Manual (with 3, 6, or 12 leads). Removable, washable keyboard with full alphanumeric capability.

Display: 640 x 400 pixel liquid crystal display for ECG preview. 2-line, 40 character liquid crystal for operator interaction.

Patient Module: Start/Stop button plus 14 signal quality indicators.

Patient Safety Patient Isolation: Less than 10 pA leakage with 120 V ac, 60 Hz or 240 V ac, 50 Hz at input connector. Input Impedance: Greater than 25 Mohm at fQ Hz, typically 100 Mohm a t DC.

Defibrillator Protection: Protected against damage from 400 joule defibrillator discharges.

Instrument Test Self-test performed each time cardiograph turned on, Displays status message to operator. Extended tests for main instrument, patient module, storage, printing and display functions. Error codes are logged for reporting to service personnel.

Power and Line Power: 100/120/220/240 V ac, 50/60 Hz, 150 VA

Environment m a x Environmental Operating Conditions: 5" to 45" C (41" to 113" F), 20 to 80% relative humidity, to 4,550 m. (15,000 ft.) altitude.

Environmental Storage Conditions: -10" to 50" C (14" to 122" F), 10 t o 85% relative humidity, to 4,550 rn. (50,000 ft.) altitude.

Cardiograph Dimensions: 39.5 by 56.5 by 14 cm (15.5 by 22.25 by 5.5 in)

Cardiograph Weight: 21.7 kg (48 ib)

Cart Dimensions: 85 by 43 by 91.5 cm (33.5 by 17 -by 36 in)

Cart Weight: 19.2 kg (38 ib).

Cart Construction: Welded steel frame. High-impact molded plastic trays.

Wheel Size: &inch front casters and 8-inch non-swivel rear wheels.

C-2 Specifications

ing App icatisns

This chapter contains information about installing applications on your PageWriter XLi cardiograph.

Installing To install an application perform the following steps.

Applications 1. Turn the cardiograph t o Standby from the front panel.

2. Insert the particular application disk in the disk drive in the front of the cardiograph. For example, insert the M11754A SAECG application disk in the cardiograph.

3. Turn the cardiograph on. The message Load SAECG application? appears.

4. Press Yes . The copyright display appears briefly and then the following display appears.

The asterisks gradually extend across the display until. the software instauation is complete, The fol7owing display appears,

A u t 0 3x4 Report Format

Installing Applications D-"il

Changing When the Pagewriter XLi cardiograph has an installed

Applications application, you can change to another application without turning your cardiograph off-

To change to another application from XEi, perform the following steps.

1. Press until the Applications display appears.

2. Select the application you wish t o use, To select Preview Plus, press The following display appears.

To change t o anat her application from an application such as Preview Plus or SAECG, perform the following steps.

- 1. Press until appears on the display.

2 - Press and the following display appears.

3. Select the a ~ ~ l i c a t i o n vou wish t o use. To select l *

Preview Plus, press The following display appears.

D-2 Bnstalling Applications

Configuring your You can configure your cardiograph t o start up in an

Cardiograph to application you choose. Refer t o Table 5-1 in Chapter

Start Up in a 5, Configuring Your Cardiograph in the Pagemiter XEi User's Reference Guide for information on the Power on

Chosen Application default.

Application

Reading the Preview Plus Screen

Figure El shows a sample Preview Plus screen. The screen shows the waveform as well as settings and information about how to start Preview Plus functions. The heart sate is displayed in. the upper right corner of the screen and is updated every second.

T imed i n $ e ~ a l Set at 3 r i m

~lgbse E-I. A Preview P$US Screen.

E-2 Using XLI Preview Plus

Observing a 'Blou can monitor a patient's ECG continuously on the

Patient's ECG Continuous! y

preview screen, even when printing an ECG. To turn on the Continuous Preview application, perform the following steps from the Preview Plus application.


The message Continuous Preview

I I

3. Press Yes . When you record an Auto or a Manual EGG, a copy will be printed.

Note Blbu cannot store EGGS when continuous preview is o n If you wish to store an Auto ECG you have just recorded, turn off Continuous Preview and store the ECG as described in Chapter 4, Storing Auto ECGs.

To turn off Continuous Preview, perform the following steps.

1. Press until the hllowing display appears.

Reformat Timed

The message Csnt inuous Preview

Using XLi Preview Plus E-3

Recording Timed To record a patient9s ECG automatically a t regular

Auto ECGs intervaIs, perform the following steps from the Preview Plus application.

1. Press until the hllowing display appears.

Ref omat Timed

The message Interval i n minutes?

3. Type the interval a t which you wish the cardiograph to record Auto ECGs.

4. Press The interval is now set. 5. Press @ - @ to begin the series of Auto ECGs.

An ECG will be recorded immediately and at each interval thereafter. The Next ECG time will be counted down on the preview screen and the next timed Auto ECG will be recorded whew the interval ends.

6. Press when you wish to stop the series of ECGs.

Note You cannot record timed Auto ECGs when delayed M a m d is on.

E-4 Using XLi Preview Plus

Recording Delayed Ordinarily when you wish t o print an ECG, the ECG

Manual ECGs waveform information is being printed at the same time as it is occurring. When you set your cardiograph to ""Delayed Manual", the EGG waveform information printed is six seconds old. This allows you to capture waveform information that is currently displayed on the preview screen. To set your cardiograph for recording a delayed Manual ECG, perform the' following steps from the Preview Plus application.

Is Press until the following display appears.

The message 6-Second Delayed

and the cardiograph will begin to save ECG information.

4. When you see an ECG sample that you wish to print, press

5. Press stop the printing.

Note When delayed Manual is on you can press $ Pressing will discontinue the delayed Manual mode and an Auto EGG will be recorded.

Note d elayed Manual ECGs you can use

Q7 Q? m e n the cmdiograp d Manual and not printing, p u can use 9 QJ Q y 9

and

Using Xbi Preview Plus E-5

To return to non-delayed ECG mode, perform t h e following steps.


2. Press The message 6-Second Delay #mua pear.

3. Press


Reformatting a Stored ECG

Note Only ECGs stored at 500 samples per second can be

To reformat a stored ECG for printing, perform the following steps.

1. Insert the correct ECG storage disk in the cardiograph.

2 , Press The following display appears.

Prev-b Ref ormat Timed

You can then select an EGG t o

4. Select the EGG you wish to reformat. A screen similar to the one in Figure E-2 appears.

Using Xbi Preview Plus E-7

Print speed 58 m/sec Limb SEW it iw it9 *3B m/BRV 2@ m h U Chest Sealing *Pull ha l P Fmquency Response 48 Hz *la8 Hz 358 Hz Lead Sat %R-anda~d Cab~era

*C%w4,3W

I HI IIII aVR aWL aVF * W l WZ V3 8841 U5 V6 I III I 1 1 aVR aWL aVF U1 *UZ U3 V4 W5 Ub I I I I I I aVR aUL aUF UB U2 *V3 V4 V5 W6

12/86/91 85: 13' t o select cho ice

Figure E-2. A Reformat Report Screen.

You. can now select format and features you wish to appear on the report.

- a, Use the arrow keys on the cardiograph to move the selection hightight to another setting.

to select the setting. The asterix will t setting,

to print the reformatted ECG.

Note YOU can not store the reformatted ECG. It will be stored in the format in which it was origindy recorded.

Note All other Preview Plus applications will be turned off when you print the reformatted ECG.


6 6583, 6-5 6-Second Delayed Manual?, E 5 6-second sample, E-5

A A C , v ' filter, 2-14, 6-2 interference, 6-2 power, 7-6 power, using with modem, 5-4 switch, v, 7-6, B-2

acquiring an ECG, 2-6 Acquiring ECG, 2-10 adjusting the contrast, cardiograph, B-11 adjusting the contrast, patient module, B-1 l age, 2-14 Age?, A-1 age designation, 2-8 All, 4-5

alternating current, vi @ - @ and 0, 2-3 analysis

computerized, 2-2 ECG with, 3-2 reports, 3-2 suppressing, 2-1 1

type of, 3-2 Analyze modif isd ECG?, 4-7 anesthetics, flammable, 7-11 application

changing, D-2 disk, B-10 installing, D- 1

Applications display, D-2 Applications display, D-2 ar t ifact, 2- 6

filter, v, 2-14 muscle, 6-2

Auto report formats, 2-6

, v,, 2-1, 2-6, 2-8, 2-40 autoclave, 7-5 Autocopy, 3-1 Auto ECG, v

interpreting, 2-4 1 recording an, 2-10 recording interval, E-4

AutoStore, 2-10, 4-2

B baseline wander, 6-2 baseline wander filter, v , 2-14, 6-2 battery, 7-6, B-6 . capacity level of, v

charging, 7-6, 7-9, B-6 disposing of, 7-9 door, 7-7 installing, B-4 life, 7-6 replacing, 7-6 storing, 7-6 thumbscrews, 7-7

battery door, B-4, B-5 Battery Level, v brightness, 2-6 brightness knob, 2-5, 6-4

cable patient module, B-2

cables cleaning, 7-1, 7-5 connecting, B-2

calibration pulse, 2-16 signal, 2-14, 2-16

calling for service, 7-12-13 C a l l i n g s i t e , 5-2 cardboard backing, for paper, B-8 cardiograph, 1-1

cleaning, 7-1, 7-2 dimensions, C-2 self-test, v setting the date and time, B-11 setting up, B-1 ventilation slots, 7-1 1 weight, C-2

cast, 1-1, B-3 construction, @-2 dimensions, C-2 weight, C-2

cart ID, 2-15 caution, vi changing

applications, D-2 patient ID, 2-9 patient ID, stored, 4-6

charging the battery, 7-6, 7-9, B-6 CheckDisk, 4-10, 4-11 checking signal quality, 2-3 Check paper supply. Continue?, 6-4 chest lead sensitivity, v, 2-15 Choose d e s i r e d malysis f o r copy.,3-2 Choose s i t e , 5-2 choosing

language, B-10 report format, 2-6

cleaning cables, 7-1, 7-5 .

cardiograph, 7-1, 7-2 electrodes, 7-1, 7-2, 7-5 keyboard, 7-3 paper sensor, 7-4 patient cable, 7-2 printhead, 7-4 solvents, recommended, 7-2

codes diagnostic, A-3 medical, A-3 race, A-3

color scale, 2-3 configuration, 2- 10

loss, 9-6 configuration disk, 4- 1 configuring

for receiving, 5-1, 5-3 for transmitting, 5-1

Connected to s i t e . , 5-2 connecting the cables, B-2 Continue us ing I D # ? , 2-10 Continuous Preview, E-3 ContPrev, E 3 contrast, 2-6

adjusting, 2-3, B-1 1 knob, 2-5, 6-4

, v, 3-1 copying

ECG automatically, 3-1 ECG manually, 3-1

Copying 1 of 1, 3-2 Copying au to r e p o r t , 3-1 copyright display, D- 1 Criteria Version") A-l criteria version number, 2-14 custom configuration disk, 6-5

date and time, 4-3 defibrillator protection, vi, C-l Delayed, E 5 , E-6 delayed Manual ECG, E-5 Delete, 4-8 deleting

ECGs, 4-9 stored ECG, 4-8

Deleting 1 of i ECGs, 4-9 department, 2-14 Department?, A-P diagnoses (Dx) , 2-14 diagnostic codes, A-3 Diastolic BP?, A-% disk, 4-9

configuration, 4-1 custom configuration, 6-5 ECG, 4-1 full, 4-2 handling, 7-10 inserting in disk drive, B-10 label, 4-1 maintenance, 7-10 reformatting, 4-1 1 storage, 4-2 system, 4-1, 6-5, B-10 unformatted, 4-2

Disk 0% f u l l . , 4-11 Disk 25% f u l l . , 4-10, 4-11 disk drive, 1-1, 4-1, 4-2, 7-10, B-10

light, 4-2, 6-5 display window, v disposing of the battery, 7-9 documentation. map, vii dotted line, on preview screen, 2-5 Dx?, A-l Dx codes, A-3

E ECG analysis, computerized, 2-2 Auto, v copying automatically, 3-1 copying manually, 3- I date and time, 4-2 deleting a stored, 4-8 list, 4-3, 4-4 Manual, v not overread indication, 2-14 observing continuously, E-3 printing a stored, 4-3 printing continuously, 2-13 problems, 6-2 quality, 2-2 receiving, 5-3 recording an, 2-1 reformatted, E-8 report, 2-14 review, 2-2 selecting, 4-4 sensitivity, 2- 16 sequence number, 2-14 stored, 4-1, 4-2 storing an, 4-1 unselecting, 4-4

. with analysis, 3-2 ECG disk, 4-1, E'7 ECG format

selecting, E-8

receiving, 5- 1 transmitting. 5-1 - r

, v ECG technique, checking, 6-1 -.

Edit, 4-6, 4-7 eject button, B-10 electrode, 2-1, 2-10, 2-12, 2-83, B-3

cleaning, 7-1, 7-2, 7-5 placement, 2-2

scratches, 1-5 entering patient ID, 2-8 equipotential, vi Erase, 4-11 error codes, C-2 error messages, 6-5 Exit, 4-7, 5-3 Extended, 3-2 extended test, C-2

F, 2-14 Files, 4-3, 4-6, 4-8 filter

AC, 6-2 artifact, v baseline wander, v, 6-2

, V, 6-2, 6-3 Find, 4-4, 4-7, 4-8, 5-2 flammable anesthetics, 7-1 1 foam swab, 7-5 format

Auto, 2-7 Manual, 2-7

Format, 2-51 formatted disk, 4-2 formatting a disk, 4-2 frequency range, 2-14 front key panel, 2-12, 2-13, 3-1 front panel, iv, 2-10, 6-5

G good quality, 2-5 green zone bar, 2-4 grid

paper, B-9

Low Battery, v

maintenance instructions, 7-10 Manual, 2-12

, V, 2-1, 2-6, 2-8 Manual ECG, v

recording a, 2-13 Measure, 3-2 medical codes, A-3 medications (Rx), 2-14

, V, 4-2, 4-6, 4-10 modem

external, 5-1 More, 4-4, 4-7, 4-8, 5-2 muscle artifact, 6-2

N Name?, A-1 NewGroup, 5-3 N e w P a t i e n t ? , 2-8, 2-9 Next, 4-4, 4-7, 4-8, 5-2 NO I D #, 2-4 Is I D entered. Continue?, 2-10 noise

bars, 2-3 indicator, high, 2-4 indicator, moderate, 2-4 severity, 2-3

non-delayed ECG mode, E-6 None, 3-2

0 observing an ECG continuously, E 3 On, v

, V, 2-1, 7-9, B-6 operating conditions, C-2 operator, 2-14 Operator?, A-1

p pacemaker pulse symbol, ( I ) , 2-14 , V, B-8, B-9

paper, B-8 blade, 7-5 door, 7-5, B-9 door latch, B-8 grid, B-9 loading, B-8, B-9 sensing hole, B-8 sensor lens, 6-4 sensor lens, cleaning, 7-4 speed, v stack, B-9 storage, B-8

patient cable, 7-5 cleaning, 7-2

patient ID, 2-4, 2-8-9, 2-12, 2-13, 4-7 changing, 2-9 codes, A-1 edit, v editing stored, 4-6 entry, v, A-l number, 2-14, 4-3 review, v reviewing, 2-9 reviewing stored, 4-6

Pa t ien t ID#?, 2-8 Patient ID?, A-1 Pa t i en t ID#? 123456, 4-7 patient isolation, C-1 patient module, 1-1, 2-3

data cable, 2-3, B-2 display, 2-3, 2-10, 2-12, 2-13 display symbols, 2-4

patient name, 2-14 patient preparation, 2-2 power cord, B-2 Prev -+, E 5 Preview Plus, E 5 Preview Plus screen, E-2 preview screen, v, 1-1, 2-13

adjusting contrast, 2-6 checking signal quality, 2-10, 2- 12 problem, 6-4 using, 2-5

Previous, 4-4, 4-7, 4-8, 5-2 Print, 4 3 printhead

cleaning, 7-4 dirty, 6-3, 7-4

printing reformatted ECG, E-8 stored ECG, 3-1, 4-3

Pr in t ing 1 of 1 ECG(s) , 4-4 Pr int ing Auto repor t . . . , 2-10 Pr int ing Manual report . . . , 2-13 print quality

poor, 6-3 uneven, '7-4

Q quality print, 7-4

R race,2-14 Race?, A-l race codes, A-3 Reading 1 of 1 ECG(s), 4-4 Reading the disk, 5-2 Reading t h e disk . . . , 4-3, 4-5, 4-6, 4-7, 4-8 reanalyzing an ECG, 4-7 Reasons, 3-2 receiving ECGs, 5-3 recharging the battery, v recording

Auto ECG, 2-10 delayed Manual ECG, E 5 EGG, 2-1 Manual ECG, 2-13 timed Auto ECG, K4

recording interval, Auto ECGs, E-4 red zone bar, 2-4

referring physician, 2-14 Reformat, 6 7 reformatted ECG

can't store, E 8 printing, E-8 viewing, E-8

reformatting a disk, 4-11 reformatting a stored ECG, E-7 re-installing software, 6-5 release latch, B-9 replacing the battery, 7-6 report

annotations, 2-14 Auto, 2-7 Auto formats, 2-6 format, 2-6 Manual, 2-7 presentation, 2-7' quality, 2-4

Report, 2-7, 2-12 report format

changing, 2-7 choosing, 2-6

Requested by?, A-1 respiratory interference, 6-2 restarting the recording, 2-12 reviewing patient ID, 2-9

- rhythm strips, 2-6 Room?, A-% . room no., 2-14 h?, A-1 Rx codes, A-3

S safety symbols, vi Select, 4-4, 4-7, 4 8 , 5-2 selecting

ECG format, E 8 ECGs, 4-4 language, El-10

self-test, v, C-2 sensitivity

chest lead, v, 2-15 ECG, 2-16 full size, v half size, v limb lead, v, 2-15

service, calling for, 7-12-13 setting

date and time, B-11 voltage, B-B

sex, 2-14 Sex?, A-l shorting plugs, 2-3, B-3 signal quality, 2-5, 2-10, 2-12, 2-13

checking, 2-3 software

installing, B-10 loss, 7-6

solvents, recommended, 7-2 V

Y, v, D-1 start button, 2-3, 2-4, 2-12, 2-13 S t a r t De le t ing i ECG(s)?, 4-8 starting the recording, 2-12

CG?, A-1 , V, 2-7, 2-13, 5-3

storage conditions, C-2 storage space available, 4-10, 4-11 Store, 4-2 S to r e complete, 4-2 stored ECG, 4-1, 4-2 Store-Log, 4-3, 4-9 S to r e modified ECG?, 4-7 storing

battery, 99-6 ECG, 2-8 paper, B-8

S to r ing ECG . . . , 4-2 storing ECGs

automatical%yo 4-2 manually, 4-1

symbols

patient module display, 2-4 system

configuration, 6- 10 disk, 4-1, 6-5, B-10

Systolic BP?, A-1 systolic/diastolic blood pressure (BP), 2-14

T Timed, E-4 timed Auto ECG, E 4 Transmit, 5-2 transmitting

EGGS, 5-3 Transmitting 3 of 1 ECG(s), 5-2 transmitting ECGs, 5-1 Transmitting . . . , 5-2 tremor, 6-2 troubleshooting, 6- 1-5

U unselected ECG, 4-4 &I, v @ and 0, 2-5 @ Q Q Q , v User A field, 2-14 User A?/Uses B?, A-1 User B field, 2-14

V ventilation slots, 7-11 viewing reformatted EGG, G8

, v voltage setting, B-2

checking, B-l

W, 2-14 wandering baseline, 6-2 weight, 2-14 Wight? , A-1 wheel size, C-2

X X, 2-4 Xki cardiograph, 1-1

Y yellow zone bar, 2-4

Documents

Pagewriter Cardiograph Operating Guide...patient module display- You can get better ECGs by viewing the patient module display before recording the ECG and adjusting the leads as necessary