GE MAC 5000 Operator’s Manual

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MAC® 5000

Resting ECG Analysis System

Operator’s Manual

Software Version 008B

2020300-016 Revision A

127(Listed below are GE Medical Systems Information Technologies trademarks. All other trademarks

contained herein are the property of their respective owners.

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12SL, 15SL, Access, AccuSpeak, ADVANTAGE, BAM, BODYTRODE, Cardiomatic, CardioSpeak, CD TELEMETRY®-LAN, CENTRALSCOPE, Corolation, EDIC, EK-Pro, Event-Link Cirrus, Event-Link Cumulus, Event-Link Nimbus, HI-RES, ICMMS, IMAGE VAULT, IMPACT.wf, INTER-LEAD, IQA, LIFEWATCH, Managed Use, MARQUETTE PRISM, MARQUETTE® RESPONDER, MENTOR, MicroSmart, MMS, MRT, MUSE CardioWindow, NST PRO, NAUTILUS, O2SENSOR, Octanet, OMRS, PHiRes, Premium, Prism, QUIK CONNECT V, QUICK CONNECT, QT Guard, SMART-PAC, SMARTLOOK, Spiral Lok, S wee the art, UNITY, Univer s al, Wate r fa ll, and Walk mom ar e tra dema rks of GE M edic al S ystems Information Technologies.

T-2 MAC 5000 System Revision A

2020300-016 24 May 2004

Contents

CE Marking Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CE-1

Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CE-1

Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CE-1

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Manual Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Revision History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4

Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-6

Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-18

Underwriters Laboratories, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-18

Legal Notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-19

Responsibility of the Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-19

General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-20

Equipment Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-24

Service Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-27

Service Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-27

Equipment Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-27

2 Equipment Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

Equipment Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3

Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3

Back View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4

Internal View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4

Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-5

Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-6

Keyboard–Exercise Test Keys (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-8

Acquisition Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-9

Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12

Prepare the Equipment for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-12

Software Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-14

Selecting Menu Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-18

Entering Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-20

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3 Preparing the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

Prepare the Patient’s Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3

Apply the Electrodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

Resting Electrodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-5

Exercise Electrodes (with Exercise–Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-9

4 Entering Patient Information . . . . . . . . . . . . . . . . . . . . . . 4-1

Enter Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Enter the Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-3

Using a Patient Card Reader (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4

Connect and Configure the Card Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4

Slide Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4

Using a Bar Code Reader (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5

Connect and Configure the Bar Code Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5

Scan the Bar Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5

Receive Orders from a MUSE CV System (Option) . . . . . . . . . . . . . . . . . . . . . . . . 4-6

Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-6

Load the Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7

Select the Orders to Receive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7

Select an Order to Complete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7

Complete the Order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7

Enter Orders Manually (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8

Manually Create an Order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-8

Selecting and Completing Manually Created Orders. . . . . . . . . . . . . . . . . . . . . . .4-8

5 Recording an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Hookup Advisor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3

Record a Resting, Pediatric, Vector Loops, or 15 Lead ECG . . . . . . . . . . . . . . . . 5-5

Record the ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5

Record a Signal Averaged ECG (Options) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Record a Master’s Step Test (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7

Run the Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-7

Using ACI-TIPI (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9

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6 Exercise Stress Test (Option) . . . . . . . . . . . . . . . . . . . . . 6-1

Start an Exercise Stress Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-3

Exercise Test Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-3

Test Phases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

Pretest Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-5

Exercise Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-7

Recovery Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-9

Test End Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-9

7 Editing Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Operating Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

Advance to Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

Advance to Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8

Advance to Test End . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-9

Save Current Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10

8 Printing an ECG Report . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Print Stored ECG Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3

Print Another Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4

9 Transmitting an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

Transmit Stored ECGs by Modem (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

Transmit Stored ECGs Locally . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-5

Transmit Stored ECGs by Wireless (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7

Transmit Stored ECGs to the Serial Port in XML Format . . . . . . . . . . . . . . . . . . . . 9-8

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10 Receiving an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

Receive ECGs by Modem (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3

Receive ECGs Locally . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4

Retrieve Confirmed ECGs from a MUSE CV System via Modem (Option) . . . . . 10-5

Select an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6

Display or Print the ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6

Retrieve Confirmed ECGs from a MUSE CV System via Wireless (Option) . . . . 10-7

Display or Print the ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-8

11 Editing an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

Edit Demographic and Interpretive Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

Store the Edited ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5

12 Deleting an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1

Delete Stored ECGs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-3

Delete Stored ECG Orders (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4

13 Completing Other Tasks . . . . . . . . . . . . . . . . . . . . . . . . . 13-1

Prepare a Disk for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3

Lock and Unlock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-3

Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-3

Eject a Disk From the Drive Slot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-4

Display Stored ECGs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5

Print the ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5

Display Medians or Rhythm Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5

Display Measurement and Analysis Statements . . . . . . . . . . . . . . . . . . . . . . . . .13-5

Display the Next Selected ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5

Return to the Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6

Display ECGs From a Different Disk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6

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14 System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-1

Using the System Setup Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-3

Select the System Setup Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-3

Define the System Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-3

Save Your Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-3

Program the System to Automatically Do a Task 14-4

Power Up the System into a Specific Resting Function . . . . . . . . . . . . . . . . . . . .14-4

Preview ECG Data Before Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-4

To Print a Resting ECG Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-4

Print a Signal Averaged ECG Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-5

Store an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-5

Transmit an ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-5

Enable or Disable the ACI-TIPI Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-5

Define the Basic System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-7

Miscellaneous Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-7

Patient Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-8

Screen Colors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-10

Transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-11

Date and Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-12

Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-13

Power Up Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-13

Order Manager Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-13

PS/2 Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-14

Define the ECG Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-15

ECG Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-15

ECG Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-16

Patient Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-18

Writer Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-18

Resting, Pediatric, 15 Lead, and Vector Loops ECG Reports . . . . . . . . . . . .14-19

Analog Outputs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-22

Define the Exercise Test Setup (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-23

Miscellaneous Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-23

Patient Data/Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-23

Writer Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-24

12 and 15 Lead Exercise Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-25

Final Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-27

Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-27

Inputs / Outputs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-28

Define the Signal Averaged ECG Setup (Option) . . . . . . . . . . . . . . . . . . . . . . . . 14-30

Card Reader Option Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-31

Automatic Configuration of Card Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-31

Manual Configuration of Card Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-32

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Bar Code Reader Option Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-33

Automatic Configuration of Bar Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-33

Manual Configuration of Bar Code Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-34

Creating Bar Codes and Magnetic Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-34

Master’s Step Setup (Option) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-37

Miscellaneous Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-38

Print Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-38

Save Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-38

Restore Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-38

Appendix A –Maintenance . . . . . . . . . . . . . . . . . . . . . . . .A-1

General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3

Inspecting and Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4

Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-4

Visual Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-4

Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-4

Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6

Changing the Paper Tray Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-6

Replacing Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-7

Storing Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-7

Maintaining the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-10

Battery Gauge Icon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-10

Charging the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-10

Periodic Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-12

Replacing the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-12

Replacing Acquisition Module Leadwire Adapters . . . . . . . . . . . . . . . . . . . . . . . A-14

Handling a Disk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-15

Appendix B – Troubleshooting . . . . . . . . . . . . . . . . . . . . .B-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-3

First Things to Ask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-3

Visual Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-3

Equipment Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-4

Reducing ECG Data Noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-4

There is No ACI-TIPI Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-4

No BP Readings from External Device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-4

Treadmill / Ergometer Does Not Move . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-5

System Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6

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Appendix C – Editing Acronyms . . . . . . . . . . . . . . . . . . . .C-1

Resting ECG Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-3

Appendix D – Report Formats . . . . . . . . . . . . . . . . . . . . . .D-1

Format Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3

4 by 2.5s + 1 Rhythm Lead Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-3

Key to Bottom of Exercise Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-4

Additional Report Names . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-4

In-Test Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-5

Exercise Final Report Names . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-6

Appendix E – Master’s Step Data . . . . . . . . . . . . . . . . . . .E-1

Master’s Step Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3

ST-T Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-5

Positive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E-5

Borderline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E-5

Negative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E-5

Calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E-5

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index-1

Revision A MAC 5000 System vii

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For your notes

viii MAC 5000 System Revision A

2020300-016

CE Marking Information

Compliance

The MAC 5000 system bears the CE mark “CE-0459”, notified body GMED, indicating its conformity with the provisions of the Council Directive 93/42/EEC, concerning medical devices and fulfills the essential requirements of Annex I of this directive.

Any other directive(s) and all the standards the product complies to are listed in the general information of the operator manual for the product following this page.

The country of manufacture can be found on the equipment labeling. The safety and effecti veness of this device has been verified against

previously distributed devices. Although all standards applicable to presently marketed devices may not be appropriate for prior devices (i.e. electromagnetic compatibility stand ards), this device will not impair the safe and effective use of those previously distributed devices.

Recommendations

Users should be a ware of k nown RF sources , such as rad io or TV stat ions and hand-held or mobile two-way radios, and consider them when installing a medical device or system.

Be aware that adding accessories or components, or modifying the medical device or system may degrade the EMI performance. Consult with qualified personnel regarding changes to the system configuration.

Operating the MAC 5000 system near radio frequency (RF) electromagnetic interference (EMI) above the conditions defined in the EMC Standard EN60601-1-2 for Radiated Immunity (field strengths above 3 volts per meter) may cause waveform distortions.

Medical Electrical Equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in the accompanying service manual.

Portable and mobile RF communications equipment can affect medical electrical equipment.

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CE Marking Information

The use of accessories, transducers and cables other than those specified, with the exception of transducers and cables sold by the manufacturer of the MAC 5000 system as replacement parts for internal components, may result in increased emissions or decreased immunity of theMAC 5000 system.

The MAC 5000 system should not be used adjacent to or stacked with other equipment and that if adjacent to or stacked use is necessary, the MAC 5000 system should be observed to verify normal operation in the configuration in which it will be used.

Review the AAMI Committee Technical Information Report (TIR) 18, “Guidance on Electromagnetic Compatibility of Medical Devices for Clinical/Biomedical Engineers”. This guidance document provides a means to evaluate and manage the EMI environment in the hospital.

The following actions can be taken to reduce the risk of medical device EMI and achieve EMC:



Assess the EMC environment of the healthcare facility (e.g., identify radio transmitters in around the facility) and identify areas where critical medical devices are used (e.g., ER, ICU, CCU, NICU).



Increase the distance between sources of EMI and susceptible devices.



Remove the devices that are highly susceptible to EMI.



Lower power transmitted from electrical and electronic equipment (EMI sources) under hospital control (i.e. paging systems).



Label devices susceptible to EMI.



Educate healthcare facility staff (nurses and doctors) to be aware of, and to recognize, potential EMI related problems.

CE-2 MAC 5000 System Revision A

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1 Introduction

Revision A MAC 5000 System 1-1

2020300-016

For your notes

1-2 MAC 5000 System Revision A

2020300-016

Manual Informatio n

Purpose

This manual contains the instructions necessary to operate the MAC 5000 system in accordance with its function and intended use.

Intended Audience

This manual is intended for the person who uses, maintains, or troubleshoots this equipment.

Revision History

Each page of the document has the document part number and revision letter at the bottom of the page. The revision letter identifies the document’s update level.

Introduction: Manual Information

Conventions

Styles

Table 1. Revision History, PN 2020300-016

Revision Date Comment

A 24 May 2004 Initial release of manual.

127(

Provides additional user information.

Bold text Indicates keys on the keyboard, text to be entered, or hardware

items such as buttons or switches on the equipment.

Italicized text Indicates software terms that identify menu items, buttons, or

options in various windows.

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Introduction: Manual Information

Ctrl+esc Indicates a keyboard operation. A (+) sign between the names of

two keys indicates that you must press and hold the first key while pressing the second key once. For example, “Press Ctrl+esc” means to press and hold down the

Ctrl key while pressing the esc key.

<Space> Indicates you must press the spacebar. When instructions are

given for typing a precise text string with one or more spaces, the point where the spacebar must be pressed is indicated as: <Space>. The purpose of the < > brackets is to ensure you press the spacebar when required.

Enter Indicates you must press the “Enter” or “Return” key on the

keyboard. Do not type “enter”.

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Safety Information

Definitions

The terms danger, warning, and caution are used throughout this manual to point out hazards and to designate a degree or l evel of seriousness. Familiarize yourself with their definitions and significance.

Hazard is defined as a source of potential injury to a person. DANGER indicates an imminent hazard whi ch, if not avoided , will result

in death or serious injury. WARNING indicates a potential hazard or unsafe practice which, if not

avoided, could result in death or serious injury. CAUTION indicates a potential hazard or uns afe practice which, if not

avoided, could result in minor personal injury or product/property damage.

Introduction: Safety Information

NOTE provides application tips or other useful information to assure that you get the most from your equipment.

The safety information given in this manual is classified as follows.

:$51,1*

Accidental Spills — If liquids have entered a device, take it out of service and have it checked by a service technician before it is used again.

To avoid electric shock or device malfunction liquids must not be allowed to enter the device.

:$51,1*

Battery Operation — If the integrity of the protective earth conductor is in doubt, operate the unit from its battery.

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Introduction: Safety Information

:$51,1*

Cables — To avoid possible strangulation, route all cables away from patient's throat.

:$51,1*

Connection To Mains — This is class I equipment. The mains plug must be connected to an appropriate

power supply.

:$51,1*

Defibrillator Precautions — Do not come into contact with patients during defibrillation. Otherwise, serious injury or death could result.

Patient signal inputs labeled with the CF and BF symbols with paddles are protected against damage resulting from defibrillation voltages.

To ensure proper defibrillator protection, use only the recommended cables and leadwires.

Proper placement of defibrillator paddles in relation to the electrodes is required to ensure successful defibrillation.

:$51,1*

Electrodes — Polarizing electrod e s (stainless steel or silver constructed) may cause the electrodes to retain a residual charge after defibrillation. A residual charge will block acquisition of the ECG signal.

Whenever patient defibrillation is a possibility, use nonpolarizing (silver/silver chloride construction) electrode s for ECG monitoring.

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Introduction: Safety Information

:$51,1*

Magnetic And Electrical Interference — Magnetic and electrical fields are capable of interfering with the proper performance of the device.

For this reason make sure that all external devices operated in the vicinity of the device comply with the relevant EMC requirements. X-ray equipment or MRI devices are possible sources of interference as they may emit higher levels of electromagnetic radiation.

:$51,1*

Explosion Hazard — Do NOT use in the presence of flammable anesthetics vapors or liquids.

:$51,1*

Interpretation Hazard — Computerized interpretation is only significant when used in conjunction with clinical findings.

A qualified physician must overread all computergenerated tracings.

:$51,1*

Operator — Medical technical equipment such as the MAC 5000 System must only be used by qualified and trained personnel.

:$51,1*

Shock Hazard — Improper use of this device presents a shock hazard. Strictly observe the following warnings.

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Introduction: Safety Information

Failure to do so may endanger the lives of the patient, the user, and bystanders.

When disconnecting the device from the power line, remove the plug from the wall outlet first, before disconnecting the cable from the device.

Otherwise there is a risk of coming in contact with line voltage by inadvertently introducing metal parts in the sockets of the power cord.

Devices may be connected to other devices or to parts of systems only after making certain that there is no danger to the patient, the operators, or the environment as a result. Standards IEC 60601-1-1/EN 606 01- 1-1 must be complied with in all cases.

:$51,1*

Site Requirements — Do not route cables in a way that they may present a stumbling hazard.

For safety reasons, all connectors for patient cables and leadwires are designed to prevent inadvertent disconnection, should someone pull on them.

For devices installed above the patient, adeq uate precautions must be taken to prevent them from dropping on the patient.

:$51,1*

Treadmills — Avoid rapid changes in treadmill speed and/or grade during a stress test.

&$87,21

Accessories (Supplies) — To ensure patient sa fety, use only parts and accessories manufactured or

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Introduction: Safety Information

recommended by GE Medical Systems Information Technologies.

Parts and accessories used must meet the requirements of the applicable IEC 60601 series safety standards and essential performance standards, and/or the system configuration must meet the requirements of the IEC 60601-1-1 medical electrical systems standard.

&$87,21

Proper Leadwire Connection — Improper connection will cause inaccuracies in the ECG.

Trace each individual leadwire from its ac quisition module label to the colored connector and then to the proper electrode to ensure that it is matched to the correct label location.

&$87,21

Accessories (Equipment) — The use of ACCESSORY equipment not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system.

Consideration relating to the choice shall include: Use of the accessory in the PATIENT VICINITY; and Evidence that the safety certification of the ACCESSORY

has been performed in accordance to the appropriate IEC 60601-1 and/or IEC 60601-1-1 harmoni zed na tion al standard.

&$87,21

Battery Power — If a device equipped with an optional battery pack will not be used or not be connected to the power line for a period of over six months, remove the battery.

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Introduction: Safety Information

&$87,21

Before Installation — Compatibility is critical to safe and effective use of this device. Please contact your local sales or service representative prior to installation to verify equipment compatibility.

&$87,21

Disposables — Disposable devices are intended for single use only. They should not be reus ed as performance may degrade or contamination could occur.

&$87,21

Disposal — At the end of its service life, the product described in this manual, as well as its accessories, must be disposed of in compliance with local, state, or federal guidelines regulating the disposal of such products.

If you have questions concerning disposal of the product, please contact GE Medical Systems Information Technologies or its representatives.

&$87,21

Equipment Damage — Devices intended for emergency application must not be exposed to low temperatures during storage and transport to avoid moisture condensation at the application site.

Wait until all moisture has vaporized before using the device.

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Introduction: Safety Information

&$87,21

Electric Shock — To reduce the risk of electric shock, do NOT remove cover (or back).

Refer servicing to qualified personnel.

&$87,21

Operator — Medical technical equipment such as this electrocardiograph system must only be used by persons who have received adequate training in the use of such equipment and who are capable of applying it properly.

&$87,21

Power Requirements — Before connecting the device to the power line, check that the voltage and frequency ratings of the power line are the same as those indicated on the unit's label. If this is not the case, do not connect the system to the power line until you adjust the unit to match the power source.

In the U.S.A., if the installation of this equipment will use 240V rather than 120V, the source must be a centertapped, 240V, single-phase circuit.

This equipment is suitable for connection to public mains as defined in CISPR 11.

&$87,21

Restricted Sale — U.S. federal law restricts this device to sale by or on the order of a physician.

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Classification

Introduction: Safety Information

&$87,21

Serviceable Parts — This equipment contains no user serviceable parts. Refer servicing to qualified service personnel.

&$87,21

Supervised Use — This equipment is intended for use under the direct supervision of a licensed health care practitioner.

The unit is classified, according to IEC 60601-1, as:

Type of protection against electrical shock Class I internally powered equipment Degree of protection against electrical

shock Degree of protection against harmful

ingress of water Degree of safety of application in the

presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide

Method(s) of sterilization or disinfection recommended by the manufacturer

Mode of operation Continuous operation

Type CF defibrillation-proof applied part

Ordinary Equipment (enclosed equipment without protection against ingress of water)

Equipment not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide

Not applicable

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Introduction: Safety Information

4P41

Underwriters Laboratories, Inc.

Legal Notice

Our equipment contains several fields which can be filled in before performing an ECG. Some of these fields must be filled in before performing an exam, some are optional and therefore left to the user to assess whether they are needed to perform the exam. A field RACE is one of these optional fields. It has been acknowledged by the medical profession as useful to analyze some pathologies. You should be aware that, in some jurisdictions, the processing of data revealin g an individual’s racial origin is subject to legal requirements, such as obtaining the patient’s prior consent. If you elect to collect this type of data, it is your responsibility to ensure that you comply with all applicable legal requirements.

Medical Equipment With respect to electric shock, fire and mechanical hazards only in accordance with UL 2601-1, and CAN/CSA C22.2 NO. 601.1.

Responsibility of the Manuf acturer

GE Medical Systems Information Technologies is responsible for the effects of safety, reliability, and performance only if:



Assembly operations, extensions, readju stments, modifications, or repairs are carrie d out by persons aut horized b y GE Medica l Systems Information Technologies.



The electrical installation of the relevant room complies with the requirements of the appropriate regulations.



The equipment is used in accordance with the instructions for use.

General Information

Intended Use

The intended use of this device is to record ECG signals from surface ECG electrodes. This device can record, analyze, print, and store electrocardiographic information from adult and pediatric populations.

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Introduction: Safety Information

This data can then be computer analyzed with various algorithms such as interpretive ECG and signal averaging for presentation to the user.

This device is intended for use under the direct supervision of a licensed health care practitioner.

This device is not intended for use with high frequency surgical units. Disconnect the patient from the device b efore using the high frequency surgical unit.

This equipment uses a computerized ECG analysis program which can be used as a tool in ECG tracing interpretation. It is recommended that all ECGs are confirmed by a qualified physician or cardiologist.

To ensure accuracy, only use printed tracings and not the display for physician interpretation .

This equipment will not cause abnormal operation of a patient’s pacemaker or other electronic stimulator.

The Acute Cardiac Ischemia–Time Insensitive Predictive Instrument (ACI-TIPI) Option is intended to be used in a hospital or clinical environment by competent health professionals. ACI-TIPI uses recorded ECG data to produce a numerical score which is the predicted probability of acute cardiac ischemia. Like any computer-assisted ECG interpretation program, the GE Medical Systems Information Technologies ACI-TIPI evaluation and probability score is intended to supplement, not subst itute for, t he physician ’s decision pro cess. It sho uld be used in conjunction with knowledge of the patient’s history, the results of a physical examination, the ECG tracing, and other clinical findings.

ACI-TIPI is intended for adult patient populations. This system is not intended to be used as a vital signs physiological

monitor.

Recording ECGs During Defibrillation

This equipment is protected a gainst the effects of cardiac defibrill ator discharge to ensure recovery, as required by test standards.

The patient signal input of the acquisition module is defibrillation-proof. Therefore, it is not necessary to remove the ECG electrodes pri or to defibrillation.

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Introduction: Safety Information

When using stainless steel or silver electrodes a defibrillator discharge current may cause the electrodes to retain a residual charge causing a polarization or dc offset voltage. This electrode polarization will block acquisition of the ECG signal. To avoid t his conditio n, use non-pol arizing electrodes (which will not form a dc offset voltage when subjected to a dc current) such as silver/silver-chloride types if there is a situation where there is a likelihood that a defibrillation procedure will b e necessary.

If polarizing electrodes are used, we recommend disconnecting the leadwires from the patient before delivering the shock.

Electrode defibrillation recovery is the ability of the electrode to allow the ECG trace to return after defibrillation. We recommend using nonpolarizing disposable electrodes with defibrillation recovery ratings as specified in AAMI EC12 3.2.2.4. (MMS P/N 9623-105 Silver MacTrodes, MMS spec. TP9623-003). AAMI EC12 requires that the polarization potential of an electrode pair does not exceed 100mV, 5 seconds after a defibrillation discharge.

Accuracy Of the Input Signal Reproduction



Overall System Error is tested using the method described in AAMI EC11 3.2.7.1. Overall System Error is +5%.



Frequency Response is tested using the method described in AAMI EC11 3.2.7.2 methods A and D.

Modulating Effects in Digital Systems

This device uses digital sam pling techniques that may produc e some variation in amplitudes of Q, R, and/or S waves from one heart be at to the next, which may be particularly noticeable in pediatric recordings. If this phenomenon is observed, the clinician should be aware that the origin of amplitude variations is not entirely physiologic. For measuring voltages of Q, R, and S waves, it is advisable to use the QRS complexes with the largest deflection of the particular waves.

Installation and Connection

If the installation of this equipment, in the USA, will use 240 V rather than 120 V, the source must be a center-tapped, 240 V, single-phase circuit.

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Parts and Accessories

Introduction: Safety Information

Contact GE Medical Systems Information Technologies for information before connecting any devices to this equi pment not recommended in this manual.

To ensure patient safety, use only parts and access ories manufactured or recommended by GE Medical Systems Information Technologies.

Parts and accessories used must meet t he requireme nts of t he appli cable IEC 601 series safety standards, and/or the system configuration must meet the requirements of the IEC 60601-1-1 medical electrical systems standard.

The use of ACCESSORY equipment not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system. Consideration relating to the choice shall include:



use of the accessory in the PATIENT VICINITY; and



evidence that the safety certification of the ACCESSORY has been performed in accordance to the appropriate IEC 60601-1 and/or IEC 60601-1-1 harmonized national standard.

Equipment Symbols

Type BF equipment. The acquisition module is protected from defibrillation shocks.

Alternating current. Equipotential.

Charge the battery. The flashing amber LED next to this symbol indicates you must connect the system to AC power to re-charge the battery.

Do NOT throw the battery into the garbage.

Recycle the battery.

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Introduction: Safety Information

Consult accompanying documents.

This position of the switch removes battery power from the equipment.

MEDICAL EQUIPMENT

UL 2601-1 CAN/CSA 601.1

4P41

Classified with respect to electric shock, fire, mechanical, and other

specified hazards only in accordance with UL 2601-1, CAN/CSA C22.2 No. 601-1, CAN/CSA C22.2 No. 601-2-25, EN 60601-2-25, EN 60601-1-1, IEC 60601-1-2: 2001.

To reduce the risk of electric shock, do NOT remove cover (or back). Refer servicing to qualified personnel.

098A, 096A, 108A, 101A, 102A, 103A, 100A, 181A, 099A

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Service Information

Service Requirements

Refer equipment servicing to GE Medical Systems Information Technologies authorized service personnel only. Any unauthorized

attempt to repair equipment under warranty voi ds that warranty. It is the user’s responsibility to report the need for service to GE Medical

Systems Information Technologies or to one of their authorized agents.

Equipment Identification

Every GE Medical Systems Information Technologies device has a unique serial number for identification. The serial number appears on the device label

Introduction: Service Information

### ## ## #### # #

ABCDEF

A B Year Manufactured (00-99)

C Fiscal Week Manufactured D Production Sequence Number

Product Code

00 = 2000 01 = 2001 02 = 2002 (and so on)

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Introduction: Service Information

E Manufacturing Site F Miscellaneous Characteristic

1. The product code for MAC 5000 systems is AAY.

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2 Equipment Overview

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For your notes

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Equipment Overview: Equipment Description

Equipment Descrip ti on

Front View

115A

Name Description

A display screen View the waveform and text data. B disk drive slot Insert a diskette to store ECG orders or recorded ECG data. C keyboard Press the keyboard keys to control the system or to enter data.

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Back View

Equipment Overview: Equipment Description

C D

A B

117A

Name Description

A back panel connectors Connect peripheral devices here. B green AC power light Indicates the system is connected to AC power. C amber battery light Indicates the battery is re-charging. D internal access button Press to open the system to change paper or the battery.

Internal View

D E

116A

Name Description

A battery Recharge when the battery icon flashes onscreen. B writer door Open to replace paper or the battery. C acquisition module connector Connect the acquisition module cable here. D paper tray Place paper here. E STD or A4 Indicates the size of paper (standard or A4) the tray holds.

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Connectors

Back Panel

Equipment Overview: Equipment Description

ABC D E F G H I

118A

:$51,1*

Leakage Current — Keep leakage current within acceptable limits when connecting auxiliary equipment to this device.

Total system leakage current must not exceed 100 microamperes.

Name Description

A A Connect an optional card reader or optional bar code reader. B 1 Connect a GE Medical Systems Information Technologies

KISS pump.

C 2 Connect a local transmission cable, serial line, modem, or

client bridge (wireless option). D ANA/TTL Connect a device requiring analog data or TTL trigger. E EXT.VID. Connect an external video display. F IR Point at a MAC 5000 or MUSE CV system’s IR transceiver to

transmit or receive ECG data. G card slot Insert the system card into this slot to run the system. H ground lug Connect non-grounded peripheral devices to ensure

equipotential. I main AC power Insert the main AC power cable.

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Equipment Overview: Equipment Description

Back Panel (Exercise Option)

118A

:$51,1*

Leakage Current — Keep leakage current within acceptable limits when connecting auxiliary equipment to this device.

Total system leakage current must not exceed 100 microamperes.

Keyboard

Name Description

A 1 Connect a T2000 treadmill or external blood pressure device

cable to this port. B ANA/TTL Connect an analog treadmill, ergometer cable or TTL trigger to

this port.

127(

Ergoline bicycle ergometers require connections to both ports.

127(

Your keyboard may be slightly different than that shown.

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Equipment Overview: Equipment Description

B C

D E F G

N M L K J I

152B

Name Description

A function keys Selects screen menu functions. B Power Powers the system on or off. C delete Erases typed characters. D Copy Prints another ECG report. E ECG Acquires an ECG. Press to acquire a 12SL resting ECG, including measurements and interpretation. F Rhythm Prints continuous ECG data. This data cannot be stored or transmitted. G Stop Stops the writer from printing. H arrow pad Moves the cursor left, right, up, or down. Press the center to select a highlighted m enu or screen item. I return Enters information into the system. Throughout the manual, this key is referred to as “the return key.” J information Provides additional user information. K space bar Adds a space between typed characters or highlights screen items. L option Used to create special characters on non-English keyboards. M esc Returns you to a previous menu. N shift Creates a capital letter. Press shift + p to type a capital P.

Keyboard–Exercise Test Keys (Option)

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Equipment Overview: Equipment Description

Your keyboard may be slightly different than that shown.

ABCD E F G

HIJKL

152B

Name Description

A Pretest Press to advance to the pretest phase*. B Exercise Press to advance to the exercise phase*. C Recovery Press to advance to the recovery phase*. D Test end Press and hold to end the test and start the test end phase. E Speed W+/– Press to manually change the belt speed or ergometer load. F Grade up/down Press to change the elevation of the treadmill belt. G Start/STOP

Press to start or stop the treadmill during the test.

tmill

H Recall Press to print a 10-second delayed recall report. I 12 ld Press to print a 12 lead report (10 seconds of acquired data). J Medians Press to print a medians report. K Comment Press to enter comments about the test. Comments are

printed on many of the final reports. L Enter BP Press to enter BP readings or to trigger a reading from an

external device.

*Or advance to next stage within the selected phase.

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Acquisition Module

Equipment Overview: Equipment Description

N R C1 C2 C3 A1 A2 A3 A4 C4 C5 C6 L F

231

B C

161B

:$51,1*

Burn Protection — To ensure defibrillator protection and protection against high-frequency burns, use only the CAM-14 acquisition module with this equipment.

Otherwise, serious injury could result.

&$87,21

Proper Leadwire Connection — Improper connection will cause inaccuracies in the ECG.

Trace each individual leadwire from its ac quisition module label to the colored connector and then to the proper electrode to ensure that it is matched to the correct label location.

Name Description

A leadwires Attach to the patient’s electrodes. The acquisition module uses either 10 or 14 leadwires. B rhythm button Press to print a rhythm strip. C stop writer button Press to stop the writer from printing.

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D acquisition module cable Insert into the system’s internal acquisition module connector. E ECG button Press to record an ECG.

Leadwire Labels

10 Leadwire AHA

RL RA V1 V2 V3

Equipment Overview: Equipment Description

Name Description

127(

If you enable the Preview before analysis function, press (E) to view the data. Then, either pres s (E) again to analy ze the data or pres s (C) to discard the data.

One of the following leadwire labels may appear on the acquisition module.

14 Leadwi re IEC

V5 V6 LA LL

N R C1 C2 C3

C5 C6 L F

14 Leadwire AHA

RL RA V1 V2 V3

13 Leadwire AHA Pediatric

RL RA V1 V2 V3

V3R V4R

10 Leadwire IEC

N R C1 C2 C3

Leadwire Adapters

13 Leadwi re IEC Pediatric

V5 V6 LA LL

N R C1 C2 C3

C3R

C4R

C5 C6 L F

14 Leadwire AHA AUX

V5 V6 LA LL

RL RA V1 V2 V3

A1 A2

V5 V6 LA LL

14 Leadwire IEC AUX

C5 C6 L F

204B

N R C1C2C3

A3A1 A2 A4

C5 C6 L F

205B

The MULTI-LINK leadwires require an adapter to connect to an electrode.

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Equipment Overview: Equipment Description

4 mm pin

Grabber

MACTRODE clip

Leadwire end

119B

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Equipment Overview: Getting Started

Getting Started

Prepare the Equipment for Use

Modem Option

See the MAC 5000 Field Servi ce Ma nual for in formatio n about mount ing and connecting the modem option.

MobileLink Wireless Option

See the MobileLink Installation and Troubleshooting Guide for information about mounting, configuring, and connecting the wireless option.

Connect External Devices (Exercise Option)

Your MAC 5000 system can connect at port 1 with the following devices:



GE Medical Systems Information Technologies Series T2000 treadmills,



SunTech Tango blood pressure device,



Colin STBP-780 blood pressure device, or



Ergoline 900/900L integrated blood pressure device.

127(

Before using external devices the MAC 5000 must be properly set up (see Chapter 14, “System Setup” ) and exercise protocols must be properly defined (see Chapter 7, “Editing Protocols” ).

Your MAC 5000 system can connect at the ANA/TTL port with the following devices:



The Ergoline 800 ergometer.



The Ergoline 900 ergometer.



The Lode ergometer.

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Equipment Overview: Getting Started

127(

Other bicycle ergometers and treadmill models with an analog port can be connected to the analog output of the MAC 5000.

A TTL QRS trigger signal for external devices can be connected to the ANA/TTL port.

Connect the Acquisition Module Cables

Insert Disk into Disk Drive

Verify Correct Operation

156A

Plug the cables into the front of the acquisition module. Refer to

“Acquisition Module” on page 2-9 for more information.

Insert a disk with enough available capacity into the disk drive before using the device. Use a computer to check the content s/available capacity of a disk.

Press power to turn on the MAC 5000 System.



If the system starts up wit hout displaying error messages, the system is operational.



If the system displays error messages, turn the system power off, then on again. If error messages persist, contact GE Medical Systems Information Technologies Service.

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Software Description

Start Up Screen

Equipment Overview: Getting Started

B C D E

Press ECG to record an ECG

MAC5000 XXXX

III

aVR

aVL

aVF

***

BPM

157A

Name Description

A software version Displays the system’s software version during the first few seconds of power up. B user prompts Provides additional information. C Hookup Advisor Displays quality of patient hookup. This can be turned on or off. D function icon Indicates the Main Menu function the system is using. This is the Resting ECG function. E battery status icon Indicates how much charge the battery has available. F menu Provides access to additional settings or functions.

Main Menu

Use the Main Menu to select the different functions available on this system. The functions di sp laye d in yo ur Main Menu may vary due to the installation of purchased software options.

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Start Up Screen (Exercise Option)

AB C D E F G H I J K L

EXERCISE

0:20

STAGE 1

0:20

Waiting for Stable Heart Rate

Name Description

A system messages Error or informational messages appear in this area.

BRUCE

10 Watts

Patient Data

120/80

MD1207-028D

155

B current heart rate bar

graph

C workload level Indicates the units of measurement and can be changed. D phase and stage

clocks

E current phase and

stage name F protocol name The name of the selected protocol is displayed. G Rhythm formats Use System Setup (see Chapter 14, “System Setup” ) or Ld Select to change the leads

H medians Current, pretest. I systolic/diastolic

blood pressures J current heart rate Determined by the three leads displayed on your screen during the PRE-TEST phase.

The top horizontal line is the maximum predicted heart rate (220 - age) . The line below that is the target heart rate (a percentage of 220 - age). At the start of EXERCISE phase, a third line representing the resting heart rate will appear.

The top clock displays the total time in a phase. The bottom clock displays the time in a stage. During the TEST-END phase, the top clock displays total time in the EXERCISE phase and the bottom clock displays total time in the RECOVERY phase.

Top is phase name, bottom is stage name.

displayed and printed.

The BP numbers become dim if the BP has not changed in over one minute.

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K function icon Indicates the Main Menu function the system is using. This is the Exercise function. L battery status icon Indicates how much charge the battery has available.

Main Menu

Equipment Overview: Getting Started

Name Description

Use the Main Menu to select the different functions available on this system. The functions di sp laye d in yo ur Main Menu may vary due to the installation of purchased software options.

1. Select More from the start up scre en.

2. Select Main Menu to begin di splaying the Main Menu functions.

Main

Resting ECG PediatricECG Vector Loops 15 Lead ECG

Exercise12

File Manager SystemSetup

Exercise15

Master’s Step

Receive

Hi-Res

MUSE

RemoteQuery Ord Mgr Int.

Return

EditProtocol

PHi-Res

182A

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Main Menu Functions

Function Description

076A

Resting ECG

077A

Pediatric ECG

078A

Vector Loops

085A

15 lead ECG

Equipment Overview: Getting Started

Records a 12-lead ECG.

Records a 15-lead pediatric ECG. The standard 12 leads and the V3R, V4R, and V7 leads are used.

Records a 15 lead vector cardiogram. The standard 12 leads and the X,Y,Z leads are used.

Records an adult 15 lead ECG. The standard 12 leads and three user-defined leads are used.

EditProtocol

251A

Exercise12

252A

Exercise15

253A

Master’s Step

079A

Hi-Res

084A

PHi-Res

EditProtocol creates new or edits existing exercise test protocols. Also, a protocol can be saved,

printed, or erased.

250A

Exercise12 conducts the 12-lead exercise test and allows you to print reports. This is a purchased option.

Exercise15 conducts the 15-lead (12 standard, 3 user defined leads) exercise test and allows you to print reports. This is a purchased option.

Runs the Master’s Step exercise protocol. (Japan only.)

Records a signal-averaged high-resolution ECG. This is a purchased option.

Records a p-wave signal-averaged high-resolution ECG. This is a purchased option.

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Equipment Overview: Getting Started

Function Description

Prints, edits, displays, transmits, and deletes ECG data stored to a disk.

080A

File Manager

082A

Defines the operating parameters of the system.

System Setup

Receives ECG data from other devices.

081A

Receive

Requests, displays, and prints confirmed ECGs retrieved from a MUSE CV system. This is a purchased option.

083A

MUSE

Remote Query

Acquires, prints, and stores ECG orders received from a MUSE CV system with a Hospital

086A

Information System (HIS) interface.

Ord Mgr Int.

Return to the previous screen.

271A

Return

Selecting Menu Functions

The following shows two methods for selecting a menu function.

Pressing a Function Key

To select More, press the function key directly below More.

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Using the Arrow Pad

Equipment Overview: Getting Started

162A

To select More:

1. Press the right arrow on the arrow pad until More is high l i gh t ed .

176A

2. Press the middle of the pad to select More. To select a menu function:

1. Use the arrow keys to highlight the desired item.

2. Press the middle of the pad to select the highligted item.

3. Select the appropriate function.

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Equipment Overview: Getting Started

Entering Data

Type Data into a Highlighted Field

1. Press the right or down arrow to highlight the First name field.

Last name

First name

Selecting Items from a List

163A

2. Type the patient’s first name.

3. Press the middle of the pad or the return key to enter the information. The cursor goes to the next data field.

1. Press the right arrow to highlight Gender.

2. Press the middle of the pad to lock the list in place.

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Equipment Overview: Getting Started

Male

Female

167A

4. Press the down arrow to highlight Male or Female.

5. Press the middle of the arrow pad to confirm the selection. The cursor goes to the next data field.

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3 Preparing the Patient

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For your notes

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Preparing the Patient: Prepare the Patient’s Skin

Prepare the Patient’s Skin

127(

To use the KISS Electrode Application System, see the KISS operator’s manual for instructio ns. (The KISS s ystem is not available for sale in the United States.)

Careful skin preparation is the key to an interference-free ECG. The signal quality is shown on the Hookup Advisor indicator.

1. Shave any hair from each electrode site and degrease each electrode site with alcohol. If c onducti ng a st ress te st, proc eed to st eps 2 and 3 . If you are not conducting a stress test, skip ahead to step 4.

2. Mark each electrode site with a felt tip pen.

3. Remove the epidermal skin layer at each electrode site (i.e. remove the mark left from the felt tip pen) . Use a n abra sive pad or sk in prep cream.

4. Apply electrode to prepared area.

5. Look at the lead-check screen for indication of lead problems.

127(

Use only electrodes and contact agents recommended by GE

39A

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Preparing the Patient: Prepare the Patient’s Skin

Medical Systems Info rmation Technologies. The sig nal quali ty on the lead-check screen will not be indicated until the RA/R electrode has been applied. When RA/R becomes disconnected, the system will report that all electrodes are off the patient.

:$51,1*

Shock Hazard — Ensure that conductive parts of the electrodes or lead wires do not come in contact with other conductive parts.

This would cancel the p rot ectio n prov id ed by the i so lat ed signal input.

:$51,1*

Conductive Parts — Keep the conductive parts of lead electrodes and associated parts away from other conductive parts, including earth.

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Preparing the Patient: Apply the Electrodes

01B

Apply the Electrodes

Resting Electrodes

Standard 12 Lead Placement

&$87,21

Proper Leadwire Conenection — Improper connection will cause inaccuracies in the ECG.

Trace each individual leadwire from its ac quisition module label to the colored connector and then to the proper electrode to ensure that it is matched to the correct label location.

AHA

Label

IEC Label Electrode Placement

A V1 red C1 red Fourth intercostal space at the right sternal border. B V2 yellow C2 yellow Fourth intercostal space at the left sternal border. C V3 green C3 green Midway between location B and D.

D V4 blue C4 brown Mid-clavicular line in the fifth intercostal space.

E V5 orange C5 black Anterior axillary line on the same horizontal level as D. F V6 purple C6 purple Mid-axillary line on the same horizontal level as D and E. G LA black L yellow Left deltoid. H LL red F green Above left ankle. (Alternate placement, upper leg as close to torso

as possible.)

I RL green N black Above right ankle. (Alternate placement, upper leg as close to

torso as possible.)

J RA white R red Right deltoid.

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Preparing the Patient: Apply the Electrodes

Standard 15 Lead Placement

A V1 red C1 red Fourth intercostal space at the right sternal

B V2 yellow C2 yellow Fourth intercostal space at the left sternal

C V3 green C3 green Midway between location B and D.

D V4 blue C4 brown Mid-clavicular line in the fifth intercostal space.

AHA Label IEC Label Electrode Placement

border.

E V5 orange C5 black Anterior axillary line on the same horizontal

088A

level as D.

F V6 purple C6 purple Mid-axillary line on the same horizontal level as

D and E. G LA black L yellow Left deltoid. H LL red F green Above left ankle. (Alternate placement, upper

leg as close to torso as possible.) I RL green N black Above right ankle. (Alternate placement, upper

089A

leg as close to torso as possible.) J RA white R red Right deltoid. K V4R gray C4R gray Right anterior chest opposite of D. L V8 gray C8 gray Under left midscapular line. M V9 gray C9 gray Left paraspinal border.

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Frank X,Y,Z Placement

Preparing the Patient: Apply the Electrodes

AHA Label IEC Label Electrode Placement

A LA black L yellow Just below the clavicle of the left arm. B E orange E light blue Mid-sternum on the same horizontal level as C

and D. C V4 blue C4 brown Mid-clavicular line in the fifth intercostal space.

NEHB Placement

D V6 purple C6 purple Mid-axillary line on the same horizontal level as

C. E LL red F green Left leg, lower abdominal quadrant.

02B

F RL green N black Right leg, lower abdominal quadrant. G I orange I light blue Right mid-axillary line on the same horizontal

level as C and D. H RA white R red Just below the clavicle of the right arm. I H orange H light blue Back of neck, avoid the caroti d artery and

jugular vein. J M orange M light blue Center of spine on the same horizontal level as

03B

C and D.

To acquire a NEHB ECG , use t he S tanda rd 1 2 Lea d ele ctro de pl a cemen t and items A and B shown below.

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Preparing the Patient: Apply the Electrodes

AHA Label IEC Label Electrode Placement

A A1 orange Nst white A ttachment point of the 2nd rib to the right

sternal edge. B A2 orange Nax white 5th intercostal space on the left posterior

axillary line. (Same position as V8 or C8.)

C V4 blue Nap white Mid-clavicular line in the fifth intercostal space.

33A

(Same position as C4.)

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Pediatric Placement

Preparing the Patient: Apply the Electrodes

AHA Label IEC Label Electrode Placement

A V1 red C1 red Fourth intercostal space at the right sternal

border. B V2 yellow C2 yellow Fourth intercostal space at the left sternal

border.

C V3 green C3 green Midway between location B and D. D V4 blue C4 brown Mid-clavicular line in the fifth intercostal space.

E V5 orange C5 black Anterior axillary line on the same horizontal

04B

F V6 purple C6 purple Mid-axillary line on the same horizontal level as

G LA black L yellow Left deltoid. H LL red F green Above left ankle. (Alternate placement, upper

I RL green N black Above right ankle. (Alternate placement, upper

05B

J RA white R red Right deltoid. K V4R gray C4R gray Mid-clavicular line in the fifth right intercostal

L V3R gray C3R gray Halfway between A and K. M V7 gray C7 gray Same horizontal level of D in the left posterior

Exercise Electrodes (with Exercise–Option)

level as D.

D and E.

leg as close to torso as possible.)

space.

axillary line.

In addition to the standard electrodes, apply one electrod e on the sternum (A1) and one in location V5R/C5R (A2). It is recommended that arm electrodes be placed on the patient’s torso, just under the clavicles.

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Preparing the Patient: Apply the Electrodes

CM5, CC5, ML Lead Placement

Electrode Electrode Placement

A1 Mid-sternum at the second intercostal space. A2 In the fifth intercostal space in the right anterior axillary line (V5R/C5R).

254A

In addition to the standard electrodes, apply one electrod e on the sternum (A1), one in location V5R/C5R (A2), and one on the neck (A3).

CM5, CC5, CH Lead Placement

Electrode Electrode Placement

A1 Mid-sternum at the second intercostal space. A2 In the fifth intercostal space in the right anterior axillary line (V5R/C5R). A3 On either side of the neck or anywhere above the shoulders.

255A

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4 Entering Patient

Information

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For your notes

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Entering Patient Information: Enter Patient Information

Enter Patient Information

127(

Before entering patient data, be sure that the unit is powered on and that a diskette is in the disk drive.

Enter the Information

Select F1 (Patient Data) for each new patient.

&$87,21

Accurate Patient Data — Patient data may be retained from a previous patient. Be sure to check the patient info screen for each new patient. Data assigned to the wrong patient causes erroneous patient data that can affect diagnosis and treatment of the patient(s).

Make sure that you enter patient data for the correct patient.

127(

Our equipment contains several fields which can be filled in before performing an ECG. Some of these fields must be filled in before performing an exam, some are optional and ther efor e left to the user to assess whether they are needed to perform the exam. A field RACE is one of these optiona l fields. It has be en acknowl edged by the medical profession as useful to anal yze so me pathol ogies. You sh ould be aware that, in some jurisdictions, the processing of data revealing an individual’s racial origin is subject to legal requirements, such as obtaining the patient's prior consent. If you elect to collect this type of data, it is your responsibility to ensure that you comply with all applicable legal requirements.

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Entering Patient Information: Using a Patient Card Reader (Option)

Using a Patient Card Reader (Option)

Connect and Configure the Card Reader

1. Connect the card reader to the A port on the back panel of the MAC

5000.

2. Configure the card reader. See “Card Reader Option Setup ” on

page 14-31.

Slide Card

Slide the patient data card through the optional card reader when you are prompted.

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Entering Patient Information: Using a Bar Code Reader (Option)

Using a Bar Code Reader (Option)

Connect and Configure the Bar Code Reader

1. Connect the bar code reader to the A port on the back panel of the

MAC 5000.

2. Configure the bar code reader. See Chapter “Bar Code Reader Option

Setup” on page 14-33.

Scan the Bar Code

Scan the patient’s bar code with the bar code reader when you a re prompted.

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Do not use the bar code reader f or scanning the bar code t hat appears on the ECG printout. The bar code on ECG printout is of a different format and not readable by the bar code reader.

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Entering Patient Information: Receive Orders from a MUSE CV System (Option)

Receive Orders from a MU SE C V Syst em (O p tion )

Preparation

The MUSE CV System can communicate orders to a MAC 5000 System in the following ways:



via modem,

Line

MAC 5000



via infrared, and

MAC 5000



via wireless communication (MobileLink or MobileLink UHS

Modem

264A

1-3ft

30.4-91.4cm

MUSE CV infrared de vice

265A

wireless system). Instructions for mounting, configuration, and connecting the client bridge to the MAC 5000 can be found in the MobileLink or MobileLink UHS Installation and Troubleshooting Guide.

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Performance of the MobileLink wireless system may vary due to changes in RF (radio frequency) properties of your site or environmental conditions. If you are experiencing intermittent connectivity in certain areas of your facility, re-i nitiat e the proce ss of receiving from the MUSE system. Consult your hospital IT department or your local GE Medical Systems Information

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Entering Patient Information: Receive Orders from a MUSE CV System (Option)

Technologies networking professional regarding modificatio n of your wireless LAN to improve system performance.

Load the Orders

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Before receiving orders from the MUSE CV system, be sure that the unit is powered on and that a diskette is in the disk drive.

1. Select Ord Mgr Int. The Order Manager interface opens.

2. Select Load Orders.

3. Choose to delete the old orders or load the new orders.

4. Enter the location(s) from which the device should retrieve the

orders.

Select the Orders to Receive

1. Select one or more orders.

2. Select Return. The system stores the orders.

Select an Order to Complete

1. Select Select.

2. Select an order.

3. Select Continue to proceed with selecting this order. The system will

then go to the ECG test. or Select Cancel to abort the selection of this order. You can then select

a different order to complete.

Complete the Order

1. Select Patient Data. The patient data window for this patient

displays.

2. Enter patient data or modify the patient data that is diaplayed.

3. Select Return to proceed with completing this order. The system will

then go to the ECG test.

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Entering Patient Information: Enter Orders Manually (Option)

Enter Orders Manually (Option)

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Before manually creating orders, be sure that the unit is powered on and that a diskette is in the disk drive.

Manually Create an Order

1. Select Ord Mgr Int. The Order Manager interface opens.

2. Select Create Order. A window opens to enter the manual order.

3. Enter the patient data.

4. Select Return to close the window. The system saves the order.

Selecting and Completing Manually Created Orders

Manually created orders are selected and completed the same way downloaded orders are selected and completed.



Refer to “Select an Order to Comp lete” on page4-7 for information on selecting an order.



Refer to “Complete the Order” on page 4-7 for information on completing an order.

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5 Recording an ECG

Revision A MAC 5000 System 5-1

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For your notes

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Hookup Advisor

Recording an ECG: Hookup Advisor

The MAC 5000 System offers the Hookup Advisor feature, which is a tool for monitoring the quality of resting ECG signals, and is available in the resting, pediatric, 15 lead, vector loops, and Master’s Step applications. It can reduce or eliminate the occurrenc e of poor techni cal qua li ty ECGs, save time, and prevent the need for retakes.

When Hookup Advisor is enabl ed, a t hree -circl e indi cator a ppe ars on t he display.



Red indicates a lead-fail condition or extreme baseline shifts. The red indicator is always the leftmost circle of the of the indicator.



Yellow indicates muscle artifact, power line interference, baseline wander, or electrode noise. The yellow indicat or is al ways the middl e circle of the of the indicator.



Green indicates generally acceptable signal quality. The green indicator is always the rightmost circle of the of the indicator.

Hookup Advisor indicator

Press ECG to record an ECG

***

BPM

III

aVR

aVL

aVF

157A

When the lead quality is Red or Yellow, a message describing the lead problem or status is disp layed on the screen.

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Recording an ECG: Hookup Advisor

Hookup Advisor is enabled and configured in the ECG Acquisition menu (System Setup > ECG > ECG Acquisition). Refer to “ECG Acquisition” on page 14-15 for more information. In addition to enabling/disabling the Hookup Advisor feature, you can set the level at which the MAC 5000 System acknowledges poor signal quality. The acknowledgement level can be set to Yellow (default), Red, or Never.

Hookup Advisor continuously reviews the ECG data for acceptable lead quality.



If Pre-acquisition is enabled in the system setup, the lead quality (circle) indicator will reflect the entire previous 10 seconds of ECG data. Any displayed messages will be updated on a real-time basis to reflect adjustments/improvements to the lead quality. Once any lead quality problems have been remedied, the message Please wait... will be displayed until the entire 1 0 second period is free from lead quality problems.



When Pre-acquisition is not enabled, the Hookup Advisor level and messages will respond to a fixed poor lead quality problem within 2 – 3 seconds.

When an ECG is a cqu ired , Hook up Advi sor will ru n a c omple te and m ore comprehensive assessment of the full 10 seconds of ECG data and possibly prompt the user regarding any poor lead quality conditions.



If Preview before analysis is turned off in the system setup, a lead quality message and prompt may be displayed, depending on the current lead quality level and the Prompt level in the syste m setu p. If a message and prompt is displayed, the lead quality indicator will reflect the overall 10-second lead quality.



If Preview before analysis is enabled, the system setup Prompt level is disregarded and the system immediately displays the Preview screen. Any lead quality messages will be displayed in this screen along with the overall 10-second lead quality indicator.

In either case, users may then either:



Select Continue to continue (print the ECG), or



Select Cancel to cancel.

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Recording an ECG: Record a Resting, Pediatric, Vector Loops, or 15 Lead ECG

Record a Resting, Pediatric, Vector Loops, or 15 Lead ECG

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Before recording an ECG, be sure that the unit is powered on and that a diskette is in the disk drive.

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See “Enable or Disable the ACI-TIPI Option” on page 14-5 to enable or disable ACI-TIPI.

Record the ECG

Press the ECG button to initiate the recording of the ECG.

Print Another Report

Store the ECG

Transmit the ECG

Press the copy button to initiate another printout of the ECG report.

If the Saving file to Disk message app ea rs, the E CG is be ing sav ed to the diskette.

If the Saving file to Disk message did not appear, sele ct Store to save the ECG to diskette.

If the Establishing network connection message appeared, the ECG is preparing to transmit.

If the Establishing network connection message did not appear, you will need to manually initiate the transmission. Refer to Chapter 9,

“Transmitting an ECG” for more information.

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Recording an ECG: Record a Signal Averaged ECG (Options)

Record a Signal Averaged ECG (Options)

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Before recording a signal averaged ECG, be sure that the unit is powered on and that a diskette is in the disk drive.

1. Select Hi-Res or PHi-Res to enable the system to record a signal

averaged ECG.

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To record a PHi-Res ECG, GE Medical Systems Information Technologies recommends a target noise level of 0.3MV or less.

2. Select Template to initiate the signal averaged ECG recording.

3. Change the seed beat:

a. Select Display. b. Select SelectQRS. c. Select a new seed beat.

4. Select Average to average the ECG data.

5. Select Store to store the ECG data.

6. Select Transmit to transmit the ECG data. Refer to Chapter 9,

“Transmitting an ECG” for more information.

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Recording an ECG: Record a Master’s Step Test (Option)

Record a Master’s Step Test (Option)

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Before recording a Master’s Step test, be sure that the unit is powered on and that a diskette is in the disk drive.

1. Select Master’s Step.

2. Enter the patient’s demographics either manually with the keyboard

or by using the card reader/bar code reader.

3. In the Setup menu, confirm that the following parameters are

correct:



Number of Steps,



Test Type,



Post J (ms),



Step Counter Display,

Run the Test



Sound Option



Continuous Recording, and



Post Exercise ECG Time.

Press the return key.

4. Press the ECG button to record a pre-exercise ECG.

1. Remove the leadwires from the patient (to prevent the patient from

tripping on the leadwires ) . Keep the electrodes on the patie nt.

2. Press Continue to begin the exercise t est.

3. When the patient finishes the exerci se, immediately reattach the

leadwires to the electrodes. Check the waveform quality on the screen to confirm that all leadwires are correctly reattached.

4. The MAC 5000 automatically records additional ECGs requested.

5. Once you record all ECGs, a final report prints.

6. Select Store to store the ECG data.

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Recording an ECG: Record a Master’s Step Test (Option)

7. Select Transmit to transmit the ECG data. Refer to Chapter 9,

“Transmitting an ECG” for more information.

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Recording an ECG: Using ACI-TIPI (Option)

Using ACI-TIPI (Option)

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Before using the A CI-TIPI opt ion, be sur e that th e unit is po wered on and that a diskette is in the disk drive.

Refer to Chapter 14, “System Setup” for information on enabling the ACI-TIPI option.

You must have a report “with interpretation” selected in System setup in order to obtain an ACI-TIPI report.

1. Enter the patient’s demographics either manually with the keyboard

or by using the card reader/bar code reader.

2. Press the ECG button.

3. Enter the ACI-TIPI data.



Age (18-40, 41-50, >50),



Gender (Male/Female), and



Chest or Left Arm Pain (Chief Complaint, Secondary Complaint, Not Present).



Chief Complaint: Select this option if the complaint of chest or left arm pain is the primary reason the patient came to the hospital.



Secondary Complaint: Select this option if the complaint of chest or left arm pain is secondary– the patient came to the hospital because of other symptoms.



Not Present: Select this option if the patient has no chest or left arm pain or equivalent discomfort.

Select Return.

4. Print, store, and transmit the ECG based on instructions given on

page 5-5.

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Recording an ECG: Using ACI-TIPI (Option)

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6 Exercise Stress Test

(Option)

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For your notes

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Exercise Stress Test (Option): Start an Exercise Stress Test

Start an Exercise Stress Test

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Before recording an ECG, be sure that the unit is powered on and that a diskette is in the disk drive.

You may store data during an exercise test to diskette (see “Final Report” on page 14-26). The data is stored to the protocol diskette. Make sure there is sufficient free space on the diskette before starting the test.

Preparation

1. Select Exercise12 or Exercise15 to enter stress test mode.

2. Select Patient Data. The Patient Data Entry screen opens.

3. Enter patient data.

4. Prepare the patient for the test, and attach leadwires. Refer to

Chapter 3, “Preparing the Patient” for more information.

Legal Notice

Exercise Test Keys

5. Select Protocol to open the list of available stress test protocols.

6. Select the desired protocol.

Our equipment contains several fields which can be filled in before performing an ECG. Some of these fields must be filled in before performing an exam, some are optional and therefore left to the user to assess whether they are needed to perform the exam. A field RACE is one of these optional fields. It has been acknowledged by the medical profession as useful to analyze some pathologies. You should be aware that, in some jurisdictions, the processing of data revealin g an individual's racial origin is subject to legal requirements, such as obtaining the patient’s prior consent. If you elect to collect this type of data, it is your responsibility to ensure that you comply with all applicable legal requirements.

The Exercise test keys perform the functions listed in the table.

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Exercise Stress Test (Option): Start an Exercise Stress Test

Key Function

Pretest Press to advance to the pretest phase. Exercise Press to advanc e to the exercise phase. Recovery Press to advanc e to the recovery phase. Test end Press and hold to end the test and start the test end phase. Speed W +

Press to increase or decrease the belt speed or ergometer load.

Speed W – Grade Press to change the elevation of the treadmill belt. Start tmill Press to start the treadmill during the test. STOP tmill Press stop the treadmill during the test. Recall Press to print a 10-second delayed recall report. 12 ld Press to print a 12 lead report. Medians Press to print a medians report. Comment Press to enter comments that will be stored with the record and printed

on some of the final reports.

Enter BP Press to enter BP readings or to trigger a reading from an external

device.

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Test Phases

Pretest Phase

Overview

Exercise Stress Test (Option): Test Phases

The pretest phase consists of stages configured in each protocol. Commonly used stages are:



Supine



Standing



Hyperventilating

You can configure the Protocol Editor to take blood-pressure measurements manually or automatically. (See Chapter 7, “Editing

Protocols” ).

Operating Steps

The system will beep and display a message prompt in the header of the display when it is ti me to take a manual blood pressure measurement.

A set of medians is saved at the end of the Pretest phase as baseline medians.

1. On the stress keypad, press 12 ld to acquire and print a baseline

ECG.

2. Press Pretest to advance to the next PRE-TEST stage.

3. If you are using a treadmill to conduct the exercise test, tell the

patient to place his/her feet on the treadmill frame, not on the belt.

:$51,1*

Fall Hazard — Severe injury can result from a fall. Patients should wait until the treadmill belt is moving

before stepping onto t he belt. Step onto the belt with one foot at a time. Avoid rapid changes in belt speed.

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Exercise Stress Test (Option): Test Phases

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Pinch Point Hazard — Hair, jewelry, and loose clothing can catch in moving parts.

Keep these and other items away from moving parts. Otherwise, serious injury could result.

Press Start tmill (on the treadmill controller keyboard) to start the treadmill belt moving. During the exercise test, you can:



Press STOP tmill once (on the treadmill controller keyboard) to stop the treadmill GRA DUAL L Y.



Press and hold STOP tmill (on the treadmill controller keyboard) to stop the treadmill belt QUICKLY.



Press the emergency stop button (usually mounted on the treadmill) to stop the treadmill QUICKLY.



Press Speed W + or Sp eed W – and Grade keys (on the treadmill controller keyboard) to manually control the test. However, once you press these keys, you control the speed and grade during the remainder of the EXERCISE and RECOVERY phases, not the protocol.

Pretest Phase Buttons

Menu Function

Patient Data Enter a patient’s name, ID number, etc. Enter the patient’s age to allow your system to

New Protocol Select a different exercise test protocol.

Measurements Will allow the system to reestablish the median complex, set the J point, then select the

Leads Select the leads used for 3 or 6 Rhythm leads, All Leads, Lead Check, or Lead

calculate the maximum and target heart rates.

This function is only available if the test will be printed only (not stored to a diskette).

three leads used to calculate heart rate.

Placement.

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Median Select a lead to act as the median lead. This can be a fixed lead or scanned for lead with

Writer Change the writer’s arrhythmia documentation (doc.), cubic spline (baseline control),

Exercise Phase

Overview

Exercise Stress Test (Option): Test Phases

Menu Function

most ST depression.

paper speed, gain, filter, and writer on/off settings.

The selected protocol controls the treadmill or ergometer. When you enter the exerc ise ph as e:



The belt speed and grade or the ergometer workload change according to the selected protocol,



The exercise clock (top) starts, and



The system starts to save the test data.

Operating Steps

:$51,1*

Fall Hazard — Severe injury can result from a fall. Patients should wait until the treadmill belt is moving

before stepping onto t he belt. Step onto the belt with one foot at a time. Avoid rapid changes in belt speed.

1. Press the Exercise button to begin the exercise phase.

During the test you can manually perform operations from the function keyboard.

2. Press the Start tmill button if treadmill or ergometer has no t been

started yet. If you are using an ergometer, the ergometer workload is

automatically controlled. The exercise test advances automatically through the exercise st ages

unless the operator manually overrides the test.

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Exercise Phase Buttons

Exercise Stress Test (Option): Test Phases

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When the stages in the treadmill protocol have durations other than infinite, the exe rcise test advances from stage to stage automatically. However, you can press Exercise (on th e treadmill controller keyboard) at any time t o manually advance to the next EXER CISE stage.

3. You can manually change a treadmill’s speed and grade however this

puts you in the manual mode for the remainder of the test.



Press Speed W + (to increase speed) within 5 seconds of your last workload change.



Press Speed W – (to decrease speed) within 5 seconds of your last workload change.



Press Grade + (to increase grade) within 5 seconds of your last workload change.



Press Grade – (to decrease grade) within 5 seconds of your last workload change.

Menu Function

Event Press to display a list of predefined events. Stage Hold In exercise phase, press to hold current stage. Measurements Will allow the system to reestablish the median complex, set the J point, then select the

three leads used to calculate heart rate.

Leads Select the leads used for 3 or 6 Rhythm leads, All Leads, Lead Check, or Lead Placement. Median Select a lead to act as the median lead. This can be a fixed lead or scanned for lead with

most ST depression.

Writer Change the writer’s arrhythmia documentation (doc.), cubic spline (baseline control), paper

speed, gain, filter, and writer on/off settings.

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Recovery Phase

Overview

Operating Steps

Recovery Phase Buttons

Menu Function

Exercise Stress Test (Option): Test Phases

In recovery, the treadmill speed and grade or the ergometer load changes based on the protocol configuration.

Press the Recovery button to advance to the recovery phase.



The clock begins timing the recovery phase. A maximum 12-lead measurement is taken (if that is part of the

selected protocol).

Event Press to display a list of predefined events. Edit Press during Recovery or Test end will allow user to enter or edit patient data, reason for

Measurements Will allow the system to reestablish the median complex, set the J point, then select the

Leads Select the leads used for Rhythm Lead 1, 2, and 3, All Leads, Lead Check, or Lead

Median Select a lead to act as the median lead. This can be a fixed lead scanned for lead with most

Writer Change the writer’s arrhythmia documentation (doc.), cubic spline (baseline control), paper

Test End Phase

Overview

test termination, or comments.

three leads used to calculate heart rate.

Placement.

ST depression.

speed, gain, filter, and writer on/off settings.

After you press and hold Test end button, the foll owing happens:



The system no longer acquires and stores ECG measurement data,

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Operating Steps

Exercise Stress Test (Option): Test Phases



The treadmill and clocks stop, and



Workload/speed/grade no longer display.

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The button for Test end MUST be held for more than one s econd to activate. This is done to prevent the tes t from being stopped by an accidental key press.

1. Press and hold the Test end button to end the test and st art th e tes t

end phase.

2. Select Reason for termination or Comments to enter information

about this exercise test.

3. Select Continue to return to the TEST-END menu.

A final report prints automatically if you selected this option in the

Edit Protocol function (Select Main Menu END phase screen

→ Report column → Style column → Final.)

→ Edit Protocol → TEST-

Test End Phase Buttons

Menu Function

Edit Press during Recovery or Test end to edit patient data, enter reasons for termination of test,

Reports Press during Test end to select a final report to print.

To change the type of reports that are printed automatically, see “Final Report” in chapter 14.

4. To edit Patient Data, Reason for termination, or Comments, select

Edit. You can edit this information until you select New Patient or Main Menu.

Select Reports to print a report containing the revised information.

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You can store the final exercise report to a diskette. You must define the type of final report you want stored to your

system. (Select System Setup, Exercise Report, then Final Report.

or comments regarding test.

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Exercise Stress Test (Option): Test Phases

Menu Function

Leads Select the leads used for Rhythm Lead 1, 2, and 3, All Leads, Lead Check, or Lead

Placement.

Median Select a lead to act as the median lead. This can be a fixed lead scanned for lead with most

ST depression.

Writer Change the writer’s arrhythmia documentation (doc.), cubic spline (baseline control), paper

speed, gain, filter, and writer on/off settings.

More Select to see More menu options. Main Menu Return to the system Main Menu. New Patient Remain in the exercise application and start a test for a new patient.

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7 Editing Protocols

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For your notes

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Operating Steps

Editing Protocols: Operating Steps

You can edit an existing ergometer or treadmill protocol, or you can create a new protocol. These protocols are used to run an exercise test.

127(

Before editing a protocol, be sure that the unit is powered on and that a diskette is in the disk drive.

Follow these steps to ed it an existing protocol or create a new prot ocol:

1. Select Edit Protocol.

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If using a blank diskette or one without stored protocols, default protocols will be written to the diskette.

2. Select a protocol to edit, or select ‹‹ spare ›› if you want to create a

new protocol. The following table describes the items you can change on the screen.

Variable Protocols

Menu Item Description

Protocol name Displays the name of the protocol you are editing. You may type

a different name to begin creating a new protocol.

Menu name Type the name of this protocol as you would like it to appear on

your screen menu.

Exercise Test Type Select Treadmill in MPH or Km/h, Analog Treadmill in MPH or

Km/h, Ergometer in Watts or KPM. This is the type of exercise

test you want to perform. Select Treadmill if using with a T2000 treadmill.

Ramp Protocol Select Yes if you want the ergometer workload (or treadmill

speed and grade) to change every 6 seconds. Select No if you want the ergometer workload (or tr eadmill speed and grade) to change every stage.

Name of PRETEST phase

Type the name of your PRETEST phase as you would like it to appear on your reports.

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Editing Protocols: Operating Steps

Variable Protocols

Menu Item Description

Name of EXERCISE phase

Name of RECOVERY phase

Name of FINAL phase

Type the name of your EXERCISE phase as you would like it to appear on your reports.

Type the name of your RECOVERY phase as you would like it to appear on your reports.

Type the name of your FINAL (TEST-END) phase as you would like it to appear on your reports.

Peak report style Choose one of the following reports to print a time of peak

exercise (during transition to RECOVERY phase from

EXERCISE phase): No report, 12/15 Ld, Medians, and 5 second Rhythm.

3. Select Return when you are finished changing the Protocol name,

Menu name, etc. The first phase screen (usually called PRETEST)

appears. The table below explains each column of the PRETEST phase screen.

Pretest Phase Screen

Column What Does This Column Allow You to Do?

Stage Create multiple stages for each phase, except TEST-END where

only one stage is allowed.

Duration Set the duration of each stage. You may choose from 00:00-

99:59 (minutes and seconds), or infinite duration. The last stage always has an infinite duration. This means that your MAC 5000 remains in the last stage for an infinite duration, or until you stop the exercise test.

Ergometer

Set the ergometer workload in Watts or KPM. Select from 0 to 1000 Watts (5 watt increments.)

Select from 0 to 6000 KPM (25 KPM increments.)

Treadmill Set the treadmill speed in MPH or Km/h:

Select from 0.0 to 25.0 MPH (0.1 MPH increments) Select from 0.0 to 40.0 Km/h (0.1 Km/h increments) Set the treadmill grade: Select from 0.0 to 40.0 percent (0.1 percent increments)

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Editing Protocols: Operating Steps

Pretest Phase Screen

Column What Does This Column Allow You to Do?

Report Print reports during a stage automatically.

Style sets the type of report that prints. You may choose No

Report, 12 Ld, Medians, or a 5 second Rhythm report. First indicates when the first report prints. Repeat indicates the frequency the reports print after the first

report prints.

BP Set blood pressure prompting during a stage.

First indicates when the first blood pressure prompt occurs. Repeat indicates the frequency of blood pressure prompts after

the first prompt occurs.

Median Set how often Median complexes are saved during a stage for

the final report.

First indicates when the first Median is saved. Repeat indicates how often Median complexes are saved after

the first Median complex is saved.

4. To edit Stage information, use the arrow pad to select the desired

stage, then press the Edit function key. A box will pop up that will allow the stage information to be edited.

Pretest Protocol Information

You want to… How do you change this item?

Edit stage information.

Use the arrow pad to select the stage you want to edit. A pop-up box appears showing the current information for this stage. Edit the information for this stage in the pop-up box. Press return.

Add another stage to the phase.

Change the Duration of a stage.

When you add a stage, it is placed below the highlighted stage. Use the arrow pad to highlight a stage. Press Add to add a stage.

Use arrow pad to select the Duration field. Use the keyboard to enter the new stage duration. Type in the duration time or press delete to set to infinite duration. Press enter.

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Editing Protocols: Operating Steps

Pretest Protocol Information

You want to… How do you change this item?

Change the Ergometer workload or Treadmill speed and grade during a stage.

Change the Report Style printed automatically during a stage.

Change the Report, Median and BP First/ Repeat values for a stage.

Use the arrow pad to select the ergometer work load, treadmill speed, or treadmill grade field. Use the keyboard to enter the new value for this stage. Type in the value or press the deletekey to indicate no workload value. Press the return key.

:$51,1*

Fall Hazard — Severe injury can result from a fall. Patients should wait until the treadmill belt is moving before stepping onto the belt. Step onto the belt with one foot at a time. Avoid rapid changes in belt speed.

Use the arrow pad to select the Report Style field. Use the arrow pad to select the stage Report Style you want to change. A pop-up box appears showing the types of reports available. Use the arrow pad to select the report you want to print automatically for this stage. Press the return key.

Use the arrow pad to select the appropriate field. Type in your own time value or press the delete key to indicate no Report, Median, or BP for this stage. Press the return key.

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GE MAC 5000 Operator’s Manual

Specifications and Main Features

Frequently Asked Questions

User Manual

1 Introduction

Manual Informatio n

Styles

Definitions

Classification

Underwriters Laboratories, Inc.

Legal Notice

Intended Use

Recording ECGs During Defibrillation

Accuracy Of the Input Signal Reproduction

Modulating Effects in Digital Systems

Installation and Connection

Parts and Accessories

Equipment Symbols

Service Information

2 Equipment Overview

Equipment Descrip ti on

Front View

Back View

Internal View

Connectors

Back Panel

Back Panel (Exercise Option)

Keyboard

Acquisition Module

Leadwire Adapters

Getting Started

Prepare the Equipment for Use

Modem Option

MobileLink Wireless Option

Insert Disk into Disk Drive

Verify Correct Operation

Software Description

Start Up Screen

Start Up Screen (Exercise Option)

Pressing a Function Key

Resting Electrodes

CM5, CC5, ML Lead Placement

CM5, CC5, CH Lead Placement

Enter the Information

Using a Patient Card Reader (Option)

Connect and Configure the Card Reader

Slide Card

Using a Bar Code Reader (Option)

Connect and Configure the Bar Code Reader

Scan the Bar Code

Preparation

Load the Orders

Manually Create an Order

Selecting and Completing Manually Created Orders

5 Recording an ECG

Record a Resting, Pediatric, Vector Loops, or 15 Lead ECG

Print Another Report

Store the ECG

Transmit the ECG

Record a Signal Averaged ECG (Options)

Record a Master’s Step Test (Option)

Run the Test

Start an Exercise Stress Test

Preparation

Legal Notice

Exercise Test Keys

Test Phases

Pretest Phase

Overview

Operating Steps

Pretest Phase Buttons

Exercise Phase

Overview

Operating Steps

Exercise Phase Buttons

Recovery Phase

Overview

Operating Steps

Recovery Phase Buttons

Test End Phase