PageWriter 10/10i Agilent M2662A Handheld Electrocardiograph User Manual
PageWriter 10/10i Agilent M2662A Handheld Electrocardiograph User Manual Agilent Part No.
Printing History Printing History 0 March 2000 Edition1 September 2000 Edition 2 Manufacturer Agilent Technologies, Inc. Healthcare Solutions Group 3000 Minuteman Road Andover, MA. 01810 Medical Device Directive This product complies with the requirements of the Medical Device Directive 93/42/EEC and carries the 0123 mark accordingly. Authorized EU-Representative Agilent Technologies Deutschland GmbH Herrenbergerstr.130 D71034 Boeblingen Germany iv Revision 0.
Conventions Used in This Manual Conventions Used in This Manual 0 WARNING Warning statements describe conditions or actions that can result in personal injury or loss of life. CAUTION Caution statements describe conditions or actions that can result in damage to the equipment or loss of data. NOTE Notes contain additional information on usage. TEXT Key Softkey represents the labels that appear on the display. represents keys on the key panel.
Notice Notice 0 The material contained in this document is subject to change without notice. Agilent Technologies makes no warranty of any kind with regard to this material, including, but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Agilent Technologies Inc. shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing, performance, or use of this material.
Notice Intended Use The M2662A Handheld Electrocardiograph is intended for: • Acquisition, digitization, recording, and retrieval of conventional diagnostic 12-lead simultaneous ECG waveforms and ECG data • Recording of limited patient information through keypad • Performing basic auto-measurements of ECG waveforms and preliminary interpretation of measurements (measurements and diagnostic statements are offered to the physician on an advisory basis only; the physician is asked to review and validate or ch
Notice WARNING The printer and its accessories (e.g. the infrared to parallel converter) may not meet the leakage current requirements specified in IEC 60601-1 safety standards. According to IEC 60601-1-1 safety standard, do not place the printer and its accessories within 1.5 m (4.5 ft.) of the patient. WARNING If you use the cardiograph during defibrillation, please check the electrode instructions first.
Safety Summary Safety Summary 0 Safety Symbols Marked on the Cardiograph The following safety symbols are used on the cardiograph or the power adapter: Symbol Definition Caution - See operating instructions. Type CF defibrillator-proof. IPX1 IEC drip-proof equipment. Start/Stop. Indicates power control for cardiograph. Displays cardiograph’s Configuration menu. Indoor use only. Recyclable material. Must be recycled or disposed of properly. Atmospheric pressure range. Temperature range.
Safety Summary Symbol Definition Relative humidity range. Shelf life. Long-term storage conditions. Short-term transport storage. Fragile. Please see “Patient and Operational Safety Notes” in Chapter 1, “Getting Acquainted”, and Chapter 8, “Maintaining the Cardiograph”, for further information about operating your cardiograph safely. x Revision 0.
Printing History............................................................................................................................. iv Conventions Used in This Manual.................................................................................................. v Notice............................................................................................................................................ vi Intended Use ........................................................................
Contents Chapter 3 Understanding the ECG Measurements Program and Report Understanding the ECG Analysis Program ................................................................................ How the M2662A Measures ECGs............................................................................................. Waveform Recognition............................................................................................................... Comprehensive Measurements ......................................
Chapter 7 Troubleshooting Checking ECG Technique .......................................................................................................... Identifying ECG Problems.......................................................................................................... If the Recording Won’t Start....................................................................................................... Error Messages...............................................................................
Contents Appendix A Setting Up Your Cardiograph The Battery ................................................................................................................................ A-2 Installing and Charging the Battery ........................................................................................... A-2 Removing the Battery ................................................................................................................ A-3 Connecting the Cables ...........................
1 Getting Acquainted • the features of the M2662A cardiograph • patient and operational safety issues • AC/battery operation You should become familiar with the material in this chapter, especially the safety information, before using the cardiograph. NOTE See Appendix A, “Setting up Your Cardiograph”, for information on installing the battery and connecting the cables. Each of these tasks must be done prior to operating the cardiograph for the first time.
The Keyboard and Front Panel The Keyboard and Front Panel 0 Figure 1-1 The Keyboard and Front Panel of the Cardiograph C B A D F E Key Description Displays the configuration menu, unless an ECG report is in- A process. Use Exit or play. B to return to the normal ECG dis- The five keys (F1-F5), located directly beneath the display, perform different functions at different time. They are called “softkeys.
Navigating the Menus Chapter 1 Getting Acquainted Key Description D To view lead groups, use the group, and the The or key to move to the next lead key to move to the previous lead group. key moves the cursor down on configuration displays. The or moves the cursor up. The key is used to end patient information entry or cardiograph configuration. E This key starts an ECG recording or halts any cardiograph activity and restores the normal ECG display.
About Your Cardiograph About Your Cardiograph 1 Your cardiograph: • • • • • • • • • NOTE Acquires 12 leads ECG signal simultaneously. Displays signal quality and leads off conditions. Provides selectable formats (Auto and Rhythm). Reports measurement and interpretation (for PageWriter 10i only) of Auto ECGs. Stores up to 30 ECGs. Operates on a rechargeable battery as well as AC power. Uses external PCL-3 compatible printers via infrared interface.
Patient and Operational Safety Notes • • • • • • • • Chapter 1 Getting Acquainted Reusable Electrodes Accessory Set Battery Assembly Power Cord AC/DC Adapter Patient Cable 6 Welsh Bulb Electrodes 4 Limb Plate Electrodes and Straps User Manual Quick Reference Guide Disposable Electrodes Accessory Set • • • • • • • • Battery Assembly Power Cord AC/DC Adapter Patient Cable Disposable Electrode Starter Set Tab Electrode Adapters User Manual Quick Reference Guide Patient and Operational Safety Notes 1 Yo
Patient and Operational Safety Notes WARNING The Agilent patient cable supplied with this cardiograph is an integral part of the cardiograph’s safety features. Using any other patient cable may compromise defibrillation protection as well as performance. Only qualified personnel may service the cardiograph. WARNING Do not use this cardiograph near flammable anesthetics. It is not intended for use in explosive environments. Do not touch the patient, patient cable or cardiograph during defibrillation.
AC and Battery Operation The infrared port located on the side panel of the cardiograph is classified as a Class I LED device according to IEC 825-1 (EN 60825-1). Although this device is not considered harmful, avoid direct eye exposure to the infrared LED beam and do not attempt to view the infrared LED beam with any type of optical device. Using the Cardiograph During Defibrillation Be aware of the following conditions when using the M2662A cardiograph during defibrillation.
AC and Battery Operation The following is a list of AC and battery operating instructions: • A fully charged battery (without AC power) will operate continuously for about 3 hours. A weak or faulty battery will reduce this time. • The battery status may be identified from the upper screen. means no battery or bad battery. indicates the battery needs to be charged. Once the is displayed, the cardiograph can operate continuously for 20 minutes before it automatically is turned off.
2 Recording an ECG This chapter describes how to: prepare the patient for an ECG check the signal quality of the patient leads enter patient information understand the printed report choose the report format record an Auto or Rhythm ECG make a copy of an Auto ECG Chapter 2 Recording an ECG • • • • • • • Samples of the different Auto and Rhythm ECG report formats are also shown. NOTE If the cardiograph has not been set up, refer to Appendix A, “Setting Up Your Cardiograph”, for instructions.
Preparing the Patient Preparing the Patient 1 For electrode placement, refer to the following diagram: Figure 2-1 NOTE Proper patient preparation and electrode placement are the most important elements in producing a high quality ECG trace. Prepare the patient by performing the following steps: 1. Reassure and relax the patient. A calm and quiet patient produces the best ECG. 2. Make sure the electrode site is not covered by hair or clothing. 3.
Preparing the Patient If ECG connector is exposed to high-humidity environment (90-95%RH), it is possible that the device will indicate leads-off conditions even with all electrodes securely attached. NOTE The patient cable should be routed away from power cords and any other electrical equipment to minimize AC line frequency interference on the ECG trace.
Understanding When a Signal is Acquired Notes for Customers Using Disposable Electrodes 2 Disposable electrodes have conductive material on the adhesive side only. The electrode tab must be placed between the jaws of the electrode adapter clip, and remain flat. Do not attempt to place the jaws of the electrode adapter so close to the circular part of the electrode that the tab of the electrode is bent, or contact is made with the conductive gel.
Checking Signal Quality Checking Signal Quality 2 You can produce better ECGs by previewing the lead traces on the screen before you record the ECG. By observing the traces and adjusting the leads accordingly, you can make the best possible ECG.
Entering Patient Information Entering Patient Information 2 Your cardiograph allows entry of numeric patient ID, patient age, and sex. To display the ID Entry screen, press ID Entry Patient ID Age Sex 1 2 3 4 5 F1 F2 F3 F4 F5 The patient ID entry can be configured as Auto or Manual. If your cardiograph is configured as Auto, the cardiograph will automatically produce a unique patient ID like 2000040600000001 (YYYYMMDDXXXXXXXX), which appears in the Patient ID field.
Understanding the Printed Report 3. Move the cursor to the Age field by pressing and type the patient age. 4. Move the cursor to the Sex field by pressing select the patient sex. , and press Change (F3) to 5. Press Exit (F5) or an ECG. to end the Patient Information entry and start recording The cardiograph provides Auto and Rhythm reports. This section focuses on the Auto report. The Rhythm report features closely resemble those of the Auto report.
Choosing a Report Format The Auto ECG Report 2 Figure 2-2 The Auto ECG Report A D B C G F E H J I 2 Table 2-4 Auto Report Annotations Description A Patient ID B Patient Name C Patient Age and Sex D Date and Time E Basic Measurements F Interpretation G Leads Off Status 2-8 Revision 0.
Choosing a Report Format Table 2-4 Auto Report Annotations (Continued) Description Calibration Signal. See Table 2-6. I Filter Settings: * Artifact Filter (F) * AC Filter( ) * Frequency Response *Baseline Wander (W) J Cardiograph settings for speed, and for limb and chest lead sensitivity. Chapter 2 Recording an ECG 2 H Basic Measurements The basic measurements table gives standard interval and duration measurements in milliseconds, and limb lead axis measurements in degrees.
Choosing a Report Format 2 Calibration Signals The following table shows how the height of the calibration pulse indicates ECG sensitivity. Table 2-6 Calibration Signals ECG Size (mm/mV) Display Label Limb Leads V-leads V1 - V6 0.5 5 5 0.5 ½V 5 2.5 1.0 10 10 1.0 ½V 10 5 2.0 20 20 2.0 ½V 20 10 2-10 Calibration Pulse Auto Rhythm Revision 0.
Choosing a Report Format Rhythm Report Formats 2 Rhythm ECG reports may display any one of the 12-leads. Refer to Figure 2-8 for an example of Rhythm report format. Auto and Rhythm Report Examples 2 Figure 2-3 An Standard Auto 3x4 ECG (3x4) 2-11 Chapter 2 Recording an ECG When you make a Rhythm report, your cardiograph only records the ECG signal for the lead you select, though the ECG signal for other leads is displayed on the LCD screen.
Choosing a Report Format Figure 2-4 An Standard Auto 3x4 ECG with One Rhythm Strip (3x4 1R) Figure 2-5 An Auto 3x4 ECG with Three Rhythm Strips (3x4, 3R) 2-12 Revision 0.
Choosing a Report Format An Auto 6x2 ECG (6x2) Figure 2-7 An Auto 12x1 ECG (12x1) Chapter 2 Recording an ECG Figure 2-6 2-13
Choosing a Report Format Figure 2-8 A Rhythm 1-Lead ECG Changing the Report Format 2 The bottom of the cardiograph display is similar to that shown below. Auto Report 3x4 1R Format II Leads 25mm/s Speed 1.0 Size To change the report format: 1. Press Report to select Auto, Rhythm or Copy menus. Note that the data displayed will change as you press Report . 2. Press Format to select the report presentation. The selections are: •Auto Formats: 3x4, 3x4 1R, 3x4 3R, 6x2, 12x1 2-14 Revision 0.
Recording an Auto ECG 3. You can change the leads, chart speed, and sensitivity by selecting Leads , Speed , or Size keys. •The Leads key sequence is: 3x4 1R: I⇒II⇒III⇒aVR⇒aVL⇒aVF⇒V1⇒V2⇒V3⇒V4⇒V5⇒V6 3x4 3R: II-aVF-V2⇒I-II-III⇒aVR-aVL-aVF⇒V1-V2-V3⇒V4-V5-V6 •The Speed key sequence is: 25 mm/sec⇒50 mm/sec Chapter 2 Recording an ECG •The Size key sequence is: 1.0⇒1.0 ½V⇒2.0⇒2.0 ½V⇒0.5⇒0.
Making Copies of Auto ECGs 8. A message Store ECG? will display on the screen. Press Yes to store the ECG or press No to discard the ECG. Making Copies of Auto ECGs 2 If you require additional copies of an Auto ECG, you may print a copy of the last ECG that was recorded. Unless you save the ECG, you must print an additional copy before turning off the cardiograph, acquiring another ECG, changing the patient ID, and changing the cardiograph configuration.
Recording a Rhythm ECG Recording a Rhythm ECG 2 To record a Rhythm ECG, perform the following steps: 1. If the cardiograph is not On, press . 2. Prepare the patient and apply the electrodes. 4. Select the lead, chart speed, and sensitivity by pressing Lead , Speed , or Size keys as necessary. 5. Press on the front panel. Enter or edit patient information as prompted on the screen. 6. The cardiograph continuously acquires the ECG for 60 seconds. 7.
3 Understanding the ECG Measurements Program and Report This section explains how the Agilent M2662A cardiographs measures and analyzes ECG data. Understanding the ECG Analysis Program 2 The ECG Analysis Program produces precise, accurate and consistent ECG measurements. The PageWriter 10i cardiograph further provides interpretive statements which highlight key areas of concern for your review.
How the M2662A Measures ECGs 4. Interpretation (PageWriter 10i only) - uses the extended measurements, with information about the patient such as age and sex, to select those interpretive statements from the criteria program which summarize the findings for the ECG. Agilent provides two standard criteria programs, adult and pediatric, in the PageWriter 10i cardiograph.
How the M2662A Measures ECGs Waveform Recognition 3 The first step of the measurement program involves waveform recognition and beat detection. A boundary indicator waveform in which QRS complexes and pacemaker spikes are enhanced is derived from all leads over the ten-second analysis period. After the approximate QRS complex and pacemaker spike locations are known, another boundary indicator waveform that enhances P and T wave detection is derived.
How the M2662A Measures ECGs In each lead, the measurements for all the beats belonging to the selected beat group are averaged. The lead measurements are representative of the dominant waveform present in each lead. Atrial Rhythm Analysis 3 Atrial rhythm is determined by examining leads V1, aVF, II and III in succession until the program can report conclusively that there are multiple P waves, that there are no P waves, or that there is one P wave per QRS complex.
4 Configuring Your Cardiograph Your cardiograph may be customized to meet your particular requirements. This chapter describes how to navigate the menus and configure your cardiograph. Adjusting Display Screen Contrast 3 Hold the key and press the the cardiograph display. or key to darken or lighten the contrast on Navigating the Configuration Menus 3 Use the following techniques to navigate the configuration menus: 1. To select from the Configuration Menu, press down, or press highlighted.
The Configuration Menu The Configuration Menu 3 The configuration menu allows you to choose the screens from which you can set your cardiograph’s configuration. 1. Press to display the Main Configuration Menu screen. 06-Apr-2000 10:12:08 Manage Stored ECGs View Stored ECGs Transmit and Fax ECGs Print the Log of ECGs Stored Configure the Cardiograph Select F1 F2 F3 Exit F4 F5 2. Highlight Configure the Cardiograph from the menu and press Select . The Configuration Menu appears.
The Configuration Menu You can set the filters to be used for both Auto and Rhythm reports. Auto Report: • The 0.5 Hz Baseline Wander filter suppresses the greatest amount of baseline wander. However, this filter may alter the ECG's ST segment. • The 0.15 Hz Baseline Wander filter provides some baseline wander suppression without distorting the ECG’s ST segment. • The 0.05 Hz Baseline Wander filter delivers the highest fidelity signal, but provides the least baseline wander suppression.
The Configuration Menu Table 4-1 Configurable Filters Choicesa Parameter Comments Wander Filter 0.05 Hz 0.15 Hz 0.5 Hz Select one baseline wander filter Noise Filter 40 Hz 100 Hz 150 Hz Select one noise filter Artifact Filter On or Off Enable or disable artifact filter a. Default values are shown in boldface type. 4. Press the key to move to the next menu item. The setting for the Setup ID Entry is highlighted. 5. Press Change (F3) to set the Patient ID entry to Auto or Manual.
The Configuration Menu 9. To change or erase data on the Date/Time menu, press the the characters in the hilighted field and type the new data. key to erase all 10. To exit the Date/Time menu and save the configuration, press the Press the key. key to move to the next menu item. The Interpretation menu item is highlighted. This selection allows you to enable or disable the interpretation function. When the interpretation function is disabled, the interpretative statement will not be reported.
5 Storing ECGs This chapter contains information about storing and managing ECGs using the internal memory. Information about using and printing the Log of ECGs Stored is also included. Advantages of Storage 4 Storing ECGs allows you to recall the ECGs later as needed. Individual ECGs or groups of ECGs can be recalled for printing or transmitting. ECGs are stored at a resolution of 500 samples per second.
Storing ECGs Storing ECGs 4 To store the ECG, perform the following steps: 1. After an ECG is acquired or printed, the following message will appear on the screen: Store ECG? Patient ID: 000301001 Yes F1 No F2 F3 F4 F5 2. Press Yes (F1) to store the ECG or No (F5) to continue without storing the ECG. If you select No , you cannot store or transmit the ECG later. 3. If you select Yes , the message “Storing ECG...” appears on the screen until storage is complete. 4.
Managing Stored ECGs 5. Press Yes (F1) to delete one or more old ECGs. The Manage Stored ECGs screen will appear. The ECGs will be listed the most recent first and oldest last. See the next section, “Managing Stored ECGs”, for information on deleting ECGs. 6. Press No (F5) to return to the “Store ECG?”screen. Press No (F5) to continue without storing the ECG. Managing Stored ECGs 4 Your cardiograph allows you to print and delete stored ECGs.
Managing Stored ECGs 3. Press Select (F3) to display the Manage Stored ECGs menu. Manage Stored ECGs Patient ID 23456 56321 45687 78668 78654 78652 √=Transmitted Print Select All F1 F2 ECGs stored: 15 1/3 Date and Time 01-Mar-2000 16:50 01-Mar-2000 15:29 26-Feb-2000 08:52 25-Feb-2000 10:42 25-Feb-2000 10:36 25-Feb-2000 10:31 #=Printed *=Selected Select Delete Exit F3 4. Select the desired ECG from the list by pressing down, or by pressing highlighted.
View Stored ECGs The cardiograph cannot record an ECG or perform other functions while printing a stored ECG. NOTE Deleting Stored ECGs To permanently delete a previously selected ECG, press Delete (F4). CAUTION You cannot retrieve a deleted ECG. View Stored ECGs 4 1. Press the key. The main menu appears. 06-Apr-2000 10:12:08 Manage Stored ECGs View Stored ECGs Transmit and Fax ECGs Print the Log of ECGs Stored Configure the Cardiograph Select F1 F2 F3 Exit F4 F5 2.
View Stored ECGs 3. Press Select (F3) to display the View Stored ECGs menu. View Stored ECGs ECGs stored: 15 1 of 3 Patient ID Date and Time *23456 01-Mar-2000 16:50 56321 01-Mar-2000 15:29 45687 26-Feb-2000 08:52 78668 25-Feb-2000 10:42 78654 25-Feb-2000 10:36 78652 25-Feb-2000 10:31 √=Transmitted #=Printed *=Selected View Exit F1 F2 F3 F4 4. Select the desired ECG from the list by pressing down, or by pressing highlighted. or or F5 to move the cursor to move the cursor up until the ECG is 5.
Printing the Log of ECGs Stored Printing the Log of ECGs Stored 4 To print the Log of ECGs Stored, perform the following steps: 1. Press the key. The main menu appears. 06-Apr-2000 10:12:08 Manage Stored ECGs View Stored ECGs Transmit and Fax ECGs Print the Log of ECGs Stored Configure the Cardiograph Select F1 F2 F3 Exit F4 F5 2. Select Print the Log of ECGs Stored from the menu. 3. Press Select (F3) to print the Log of ECGs Stored.
Printing the Log of ECGs Stored Figure 5-1 Log of ECGs Stored B C D E Date: 06-Apr-2000 A F 10:12:08 G H I J M2662A Agilent PageWriter 10i Log of ECGs Stored Seq # Date Time Patient ID Mode 23 ECGs stored, 7 storage spaces available K Table 5-1 L The Log of Stored ECGs Description A Log Title B Date and time of the report C Sequence number of the ECG D Date the ECG was taken E Time the ECG was taken F Patient identification number G Mode used to record the ECG (6 for Rhyt
6 Transmitting and Faxing Auto ECGs The cardiograph can transmit Auto ECGs to the Agilent M1765A ECG Manager and to a Group III facsimile machine. NOTE You cannot transmit Rhythm ECGs. You can only transmit Auto ECGs that have been stored. Three typical ECG transmission situations are: • An ECG transmitted from the cardiograph at the bedside to the Agilent M1765A ECG Manager for printing, overreading and storing.
Transmitting ECGs To transmit an ECG, perform the following steps: 1. Press the key. The main menu appears. 06-Apr-2000 10:12:08 Manage Stored ECGs View Stored ECGs Transmit and Fax ECGs Print the Log of ECGs Stored Configure the Cardiograph Select F1 F2 F3 Exit F4 F5 2. Select Transmit and Fax ECGs from the menu. 3. Press Select (F3) to display the Transmit and Fax Stored ECGs menu.
Transmitting ECGs An asterisk appears to the left of selected ECGs. The Select softkey changes to Unselect when a selected ECG is highlighted. Follow the same procedure to select another ECG. 6. Press Select All (F2) to select all ECGs for transmission. The Select All softkey changes to Unselect All when all ECGs are highlighted. NOTE You cannot transmit Rhythm ECGs. If you choose Rhythm ECGs to transmit, the cardiograph will ignore these ECGs automatically. 7.
Transmitting ECGs Changing a Telephone Directory Entry You may need to add, delete, or change one of the entries stored in the telephone directory. To edit the telephone directory, perform the following steps: 1. Select Change Entry (F1) from the Telephone Directory menu. The softkeys will change as shown below: Setup Telephone Directory Telephone Number 9,1,5553331212 9W1,5554441212 P9W1,5556661212 Type Fax Modem DirectSCP Fax Speed 19200 9600 57600 19200 Change F1 F2 F3 Done F4 F5 2.
Transmitting ECGs Use Table 6-1 to select the appropriate transmission type and transmission speed for the remote site. Table 6-1 Remote Sites and Transmission Types Remote Site Transmission Type Recommended Speed Group III Facsimile Machine Fax 19200 PC with ECG Manager ModemSCP DirectSCP 19200 57600 4. If you are using DirectSCP transmission, leave the telephone number blank. For other transmission types, type the phone number by selecting F1 to F5.
Transmitting ECGs NOTE See your modem documentation for more details on special dialing commands. 5. Move the cursor to the Type field. Select the transmission type by pressing Change (F3) until the appropriate transmission type appears. See Table 6-1 for available transmission types. 6. Move the cursor to the Speed field. Select the transmission speed by pressing Change (F3) until the appropriate transmission speed appears. See Table 6-1 for recommended transmission speed. 7.
7 Troubleshooting Your 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 you how to solve basic ECG problems. Checking ECG Technique 6 • Review “Preparing the Patient” in Chapter 2, “Recording an ECG” to ensure the electrodes are properly attached to the patient.
Identifying ECG Problems Identifying ECG Problems 7 The following table shows symptoms and solutions to problems that can occur when recording an ECG. Table 7-2 ECG Problems and Solutions Problem Power line AC Interference Wandering Baseline Tremor or Muscle Artifact Likely Cause Possible Solution Poor electrode contact. Dry or dirty electrodes. Use new electrodes. Abrade skin. Reapply electrodes. Lead wires may be picking up interference from poorly grounded equipment near the patient.
Identifying ECG Problems Table 7-2 ECG Problems and Solutions (Continued) Problem Intermittent or Jittery Waveform Likely Cause Possible Solution Poor electrode contact. Dry electrodes. Clean the electrode sites. Reapply electrodes. Faulty lead wires. Replace faulty patient cable. Chapter 7 Troubleshooting If the Recording Won’t Start If you press possibilities: and the recording doesn’t start, investigate the following • Is the cardiograph turned on? The screen should be on.
Error Messages Error Messages 7 The error messages that display on the screen will instruct you as to what action to take. If it is something that you can correct, the message will instruct you what to do. If an error number displays, perform the following steps: 1. Turn the cardiograph off from the front panel. 2. Wait 20 seconds or more and then turn the cardiograph on again.
Identifying Storage Problems Table 7-3 Printing Problems and Solutions (Continued) Message Likely Cause Possible Solutions Not in IrDA Mode Unit in Nindy (test) mode Turn off the unit. Hold F2 and upper arrow and turn on again. Printing Stopped The printing. Print again. key pressed during The following table shows symptoms and solutions to problems that can occur when storing an ECG.
Identifying Transmission Problems Table 7-4 Storage Problems and Solutions (Continued) Message Likely Cause Possible Solutions Unable to store ECG A fault exists in the storage hardware. Call Agilent service Unable to retrieve ECG A fault exists in the storage hardware. Call Agilent service Identifying Transmission Problems 7 The following table shows symptoms and solutions to problems that can occur when transmitting an ECG.
Identifying Transmission Problems Table 7-5 Transmission Problems and Solutions(Continued) Message Likely Cause Possible Solutions No power to modem, or poor modem cable connection Check that the modem is turned on. Check the data communication cable connections between the modem and the cardiograph. Check cable Poor cable connection between cardiograph and the Agilent M1765A ECG Manager system Check all cable connections. Replace cable.
Identifying Transmission Problems Table 7-5 Transmission Problems and Solutions(Continued) Message Likely Cause Possible Solutions Transmission stopped unexpectedly. X of N ECGs sent. Modem was disconnected. Press any key to continue. Problem with telephone line Check that the modem is connected to the telephone line. Verify that the telephone line is working. Transmission stopped unexpectedly. X of N ECGs sent. Remote site stopped communication (nn). Press any key to continue.
8 Maintaining the Cardiograph This chapter describes how to do regular checks to ensure the performance and safety of the cardiograph and its accessories. This chapter also provides information on supplies and how to order them.
Maintenance Checks Do not clean the patient cable with alcohol. Alcohol can cause the plastic to become brittle and may cause the cable to fail prematurely. CAUTION Do not autoclave the cable or use ultrasonic cleaners. Do not immerse the patient cable. Do not use abrasive materials to clean metal surfaces—scratches on them can cause artifacts on the ECG. Do not wet the connectors, especially the 15-pin patient cable connector. Cleaning the Cardiograph 8 1.
Maintenance Checks Cleaning the Electrodes and Cables 8 The patient cable can be cleaned only with mild disinfectant or soap and water. The patient cable cannot be cleaned with isopropyl alcohol. Clean the electrodes and patient cables with a soft cloth moistened with soapy water.
Maintenance Checks Patient Cable Test 8 Tool (M2662-00003)* 8 This tool is used to short the lead wires together to test lead wire integrity. To test the leads, plug all ten lead wire posts into the holes of the tool and print an ECG. If all leads print clear, solid flat lines, the lead wires are intact. Front End Test 8 Tool (M1770-87909)* 8 To test the instrument signal path, plug the larger connector into the patient cable connector on the front of the cardiograph. Print an ECG.
Caring for the Battery Caring for the Battery 8 The life of the nickel-metal hydride battery used in the cardiograph varies by how the battery is maintained and how much it is used. A depleted battery requires 4 hours of continuous charge to full capacity. If the battery has been fully charged and requires recharging after a few ECGs, consider replacing it. Use only Agilent battery, part number M3941A/M3951A.
Cardiograph Repair and Service Storing the Battery 8 The battery should be removed from the unit and placed in storage if the cardiograph will not be used for more than one month. NOTE To prepare the battery for storage, charge it in the cardiograph to full capacity. Then remove it from the cardiograph and store it in a location within -20 to 30°C (-4 to 86° F) and 45-85% RH. Recharge the battery in storage to full capacity every 90 days.
Supplies Supplies 8 Agilent Technologies offers a full range of supplies for cardiographs. The following list is a collection of the most frequently ordered items. Pricing and availability of these and other supplies are available from Agilent’s Medical Supplies Centers. • USA: Call 1-800-225-0230 • Outside USA: Please contact your local Agilent Medical Sales Office.
Supplies Electrodes 8 40490E 40494E 40421A 40424A 14030A 13943D 13946B M2253A M2254A Welsh electrode; 15 mm base 5 cc bulb; screw connection (IEC) Electrode, limb clamp (4 per pack) Welsh electrodes; 15mm base 5cc bulb; push-in connection(AHA) (6 per box) Limb Plate Electrode(AHA) (4 per pack) 15" (38 cm) Limb Strap Solid Gel Disposable Diagnostic Electrode (1,000 pieces) (United States and Canada only) Universal ECG Adapter (10) Disposable Electrode Adapter clips for disposable Electrodes Service Manu
Calling for Service Calling for Service 8 8 Asia Pacific Australia (+61)1800-033-397 India 91-11 682-6000 P.R.China 800-810-0038 86-10 6564-5399 Singapore 800-47-22731 Taiwan 886-2-8712-2899 North Americas United States of America: Agilent Technologies Medical Products Group Headquarters 3000 Minuteman Road Andover, Massachusetts 01810 Medical Customer Information 1-800-934-7372 Canada: Agilent Technologies (Canada) Ltd.
A Setting Up Your Cardiograph This chapter describes how to • Install the battery • Connect the power adapter and patient cable • Connect the cardiograph to a printer • Connect the modem and transmission cables You may want to configure the cardiograph to suit your specific application. See Chapter 4, “Configuring Your Cardiograph” for more information. NOTE It is highly recommended that you set the date and time of your cardiograph.
The Battery The Battery 8 Use only Agilent batteries (part number M3941A/M3951A) in the cardiograph. Installing and Charging the Battery 8 Agilent recommends charging the new battery to full capacity prior to the first use.To install and charge the battery: NOTE Do not remove the shrinkwrap surrounding the battery. 1. Make sure the cardiograph is disconnected from AC power. 2. Turn the cardiograph bottom-side up. 3. Use a screw driver to loosen the screw on the battery door. Lift off the door.
The Battery Removing the Battery 8 To remove the battery: 1. Make sure the cardiograph is turned off and disconnected from AC power. 2. Turn the cardiograph bottom-side up. 3. Loosen the screws on the battery door. Lift off the door, as shown in the following figure. Figure A-2 Removing the Battery Door NOTE After replacing a battery, you should check the date and time configuration of your cardiograph.
Connecting the Cables Do not remove the “Do not Remove!” sticker. Otherwise the warranty will be void. CAUTION Connecting the Cables 8 1. Plug the patient cable into the patient cable connector of the cardiograph, as shown below. 2. Turn the thumb screws to secure the cable. 3. Plug one end of the AC/DC Power Adapter into the yellow power connector of the cardiograph. Plug the other end of the AC/DC Power Adapter into the power cord. 4. Plug the power cord into a wall outlet.
Connecting the Printer WARNING The connector of the AC/DC Power Adapter provided with the cardiograph may resemble those for other instrument e.g. printer, modem. Only use the designated AC/DC Power Adapter (M3952A or M3953A) for the M2662A cardiograph. Failure to do so may damage the cardiograph or cause human injury. WARNING The AC/DC Power Adapter supplied with this cardiograph is an integral part of the cardiograph’s safety features.
Connecting the Printer 4. Make sure that the infrared adapter/interface is positioned within the 30°-wide range of the cardiograph’s infrared port. 5. Turn on the printer and the infrared adapter. 6. Turn on the cardiograph and start recording an ECG. Allow 1.5 minutes for the printer to print out an ECG report. The indicator on the infrared adapter/interface lights up when the printer receives data from the cardiograph.
Connecting the Direct Transmission Cable Connecting the Direct Transmission Cable 8 You can transmit ECGs directly to the Agilent M1765A ECG Manager by directly connecting the cardiograph to the ECG Manager system. Perform the following steps to connect the direct transmission cable. 1. Plug one end of the direct transmission cable into the cardiograph connector labeled RS232. Turn the thumb screws to secure the cable. 2.
Printing to Another Agilent Cardiograph Printing to Another Agilent Cardiograph 8 Using a variation of a null modem cable * you can print ECGs directly to other Agilent cardiographs, such as the M1700A, M1770A, and M1771A. The M1770A and M1771A cardiographs must have the Storage and Transmission option. 1. Plug one end of the cable into the connector labeled RS232 on the PageWriter 10/10i cardiograph. 2. Turn the thumb screws to secure the cable. 3.
Transmitting or Faxing ECGs by Modem Transmitting or Faxing ECGs by Modem 8 You can also use a modem to transmit or fax ECGs by telephone to the Agilent M1765A ECG Manager, or to a group III fax machine. Before using the modem you must connect the cables. The following figure shows how to connect the cables for transmitting ECGs using a modem. Figure A-6 Connecting the Modem Cables C A E B E TO PHO 8.5 RS 232 D Appendix A Setting Up Your Cardiograph A. M2662A cardiograph B. Modem power cord C.
Transmitting or Faxing ECGs by Modem 4. Refer to your modem manual for instructions on connecting the modem to the modem data cable, the modem power cable, and the telephone line. 5. Turn the modem on. 6. Turn the cardiograph on. WARNING Equipment connected to the cardiograph’s RS232 connector can cause ground leakage current exceeding the maximum specified in IEC 60601-1 safety standards.
B Specifications Basic Controls 8 ECG Controls 8 • • • • • On/Off Menu Start/Stop F1..F5 Arrow ECG Format Selections 8 • Auto (3x4 with 0, 1, or 3 rhythm leads, 6x2 or 12x1) • Rhythm (1 lead) Storage 8 30 ECGs stored, maximum capacity 64 Kb each. Hardware Interface 8 • 9-pin Male subminiature D, EIA-232 port, +/- 10V • Communications Protocols: DT, SCP Display 8 240 x 128 pixel STN (Super Twisted Nematic) high contrast liquid crystal display for ECG preview.
ECG Reproduction Quality Battery 8 • Rated 7.2V DC 2450mAh • Rechargeable NI-MH Battery Pack ECG Reproduction Quality 8 Meets or exceeds AAMI EC11-1991 standard for Diagnostic Electrocardiograph Devices. Meets frequency response standard by methods A, D, and E when configured with 0.15-150 Hz filters.
Power and Environment Power and Environment 8 AC/DC Power Adapter 8 • • • • • Use only M3952A/M3953A Class I Rated Input: 100 to 240 V AC, 50/60 Hz, 0.75 ~ 0.35 A Rated Output: 12 V DC, 2.
Glossary calibration pulse: a 200 ms, 1 mV square or caused by AC power line interference. This filter is built into the cardiograph and cannot be disabled. stepped wave pulse which appears on the printed report, showing the sensitivity at which the ECG was recorded. AC line interference: electrical signals originating from the alternating current carried by power cords or other electrical equipment. AC line interference may obscure important details of the ECG trace.
leads off: one or more lead names appearing in the rhythm strip: the ten second recording of a upper-left corner of the screen and printer report indicates that those leads are not making a good connection with the patient. Leads off is also seen on the screen and printed report as a dotted line trace. particular lead that is printed at the bottom of an Auto ECG report. measurements: the amplitudes, durations, areas, and intervals that characterize the ECG waveform.
Index Numerics 3x4 Auto report, 2-11 3x4, 1R Auto report, 2-12 3x4, 3R Auto report, 2-12 6x2 Auto report, 2-13 B baseline wander, Glossary-1 baseline wander filter, Glossary-1 battery, 8-7 discarding, 8-6 storing, 8-6 battery saver, Glossary-1 C calibration pulse, Glossary-1 caution, ix changing a report format, 2-14 configuration, Glossary-1 connecting the power cord, A-4 conventions, manual, v Copy key, 1-3, 2-16 copying Auto ECGs, 2-16 cycle power, Glossary-1 D defibrillation, recovery time, viii E EC
Index report format changing, 2-14 rhythm strip, Glossary-2 S safety symbols, ix SCP, 6-5 Select softkey, 1-3, 4-1, 4-2, 5-4, 5-6, 5-7, 6-3 sending ECGs direct, 6-5 fax, 6-5 modem, 6-5 service, 8-9 shock hazard, ix softkey, Glossary-2 speed, 2-15, 2-17 standard cardiology protocol, 6-5 standard leads, Glossary-2 storage problems, 7-5 storing the battery, 8-6 storing ECGs, 5-1, 5-2 supplies, 8-7 T transmission by cable, Glossary-1 direct, Glossary-1 directSCP, Glossary-1 modem, A-9 transmission problems, 7-
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0123 M2662-91100 Copyright © 2000 Agilent Technologies Inc.
