HP PageWriter 100 User manual
PageWriter 100
HP M1772A Cardiograph
User’s Guide
HEWLETT
m
HP Part No. M1772-91900
Printed in USA February 1996
Edition 3
E0296
PACKARD
Notice
The information in this document is subject to change
without notice.
Hewlett-Packard makes no warranty of any kind on
this material, including but not limited to, the implied
warranties of merchantability and fituess for a particular
purpose. Hewlett-Packard shall not be liable for errors
contained herein or for incidental or consequential
damages in connection with the furnishing, performance,
or use of this material.
This document contains proprietary information which is
protected by copyright. All rights are reserved. No part
of this document may be photocopied, reproduced, 01
translated to another language without the prior written
consent of Hewlett-Packard Company.
Before using the instrument, read this guide and become
thoroughly familiar with the contents.
Responsibility of the Manufacturer
Hewlett-Packard only considers itself responsible for
any effects on safety, reliability and performance of the
equipment if:
assembly operations, extensions, re-adjustments,
modifications or repairs are done by persons
authorized by Hewlett-Packard, and
the electrical installation of the relevant room complies
with the IEC or national requirements, and
the instrument is used according to the instructions
for use presented in this manual.
Warning
@
As with all electronic equipment, radio frequency
interference between this cardiograph and any existing
RF transmitting or receiving equipment at the installation
site, including electrosurgical equipment, should be
evaluated carefully and any limitations noted before
the equipment is placed in service. Monitoring during
electrosurgery should not be attempted and monitoring
electrodes should be removed from the patient to
preclude the possiblity of burns. Radio frequency
generation from electrosurgical equipment and close
proximity transmitters may seriously degrade cardiograph
performance. Hewlett-Packard assumes no liability
for failures resulting from RF interference between HP
medical electronics and any radio frequency generating
equipment at levels exceeding those established by
applicable standards.
This is to certify that this equipment is in accordance
with the Radio Interference Requirements of the EMC
Directive.
Warning
Use of accessories other than those recommended by
Hewlett-Packard may compromise product performance
and/or product safety.
THIS PRODUCT IS NOT INTENDED FOR HOME
USE.
@ Copyright 1994, 1995 Hewlett-Packard Company.
Printing History
September 1994
April 1995 Edition 2
Edition 1
February 1996
Edition 3
iv
Safety Summary
Safety Symbols
The following safety symbols are used on the
Marked on the cardiograph.
Cardiograph
Caution - See operating instructions.
!
A
Meets IEC type CF leakage current requirements
and is defibrillator protected (Isolated ECG
input).
Alternating current.
Equipotential (identifies independent protective
earth conductor to the cardiograph).
Fuse.
Indicates power control for cardiograph.
Hz
Please see “Patient and Operational Safety Notes” in
Chapter 1, Getting Acquainted, for further information
about operating your cardiograph safely.
Indicates operating frequency in cycles per second.
V
Conventions Used
in This Manual
Warning
Caution
Note
9
IF)
I
Yb
Warning statements describe conditions or actions that
can result in personal injury or loss of life.
Caution statements describe conditions or actions that
can result in damage to the equipment or software.
Notes contain additional information on cardiograph
usage.
@ Represents keys on ‘the front panel.
vi
Contents
1. Getting Acquainted
The Keyboard and Front Panel
About Your Cardiograph
Accessories
About This Manual
Patient and Operational Safety Notes . .
AC and DC (Battery) Operation
2. Recording an ECG
Preparing the Patient
Understanding When a Signal is Acquired
Recording an Auto ECG
Correcting a Leads Off Condition
Auto Report Filters
Making Copies of Auto ECGs
Recording a Manual ECG
Changing Manual Report Settings . .
Restoring the ECG Trace After
Defibrillation or Reconnecting Leads
Manual Report Filters
Understanding the Printed Report
Choosing a Report Format
Auto Report Format
Manual Report Formats
An Auto Report Example
Manual Report Examples
............
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.........
........
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........
.....
.......
.....
.......
.......
.......
......
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....
...
...
1-4
1-6
1-6
1-7
1-8
1-10
2-2
2-3
2-4
2-4
2-5
2-6
2-7
2-8
2-8
2-9
2-10
2-13
2-13
2-13
2-14
2-15
Contents-1
3. Troubleshooting
Checking ECG Technique
Identifying ECG Problems
If the Recording Won’t Start
If the Cardiograph Won’t Print a
Manual Report
4. Maintaining the Cardiograph
Care and Cleaning
Cleaning the Cardiograph
Cleaning the Electrodes and Cables . .
Cleaning the Digital Array Printhead
and Paper Sensor
Loading the Paper
Storing the Paper and Patient ECG
Records
Caring for the Battery
Storing the Battery
Replacing the Fuses
Supplies ...............
Calling for Service
United States of America
Canada ..............
Other International Areas
..........
..........
............
..........
..........
.......
.......
.........
.......
........
.........
.....
......
......
......
3-1
3-2
3-3
3-5
4-1
4-1
4-2
4-3
4-5
4-6
4-8
4-9
4-9
4-11
4-14
4-14
4-14
4-14
Contents-2
A. Setting up Your Cardiograph for the First Time
Checking the Voltage Setting
The Battery .............
Installing the Battery
Removing the Battery
Connecting the Cables
Loading Paper
............ A-9
........
........
........ A-7
......
A-2
A-4
A-4
A-5
;a, , . .,I< :., .*.
1,: ;’
.:
B. Specifications
Basic Controls . . . . . . . . . . . .
Frequency and Impulse Response . . . .
Instrument Test . . . . . . . . . . .
Patient Safety . . . . . . . . . . . .
Power and Environment . . . . . . . .
Glossary
Index
I,‘.
B-1
B-1
B-2
B-2
B-2
Contents-3
Figures
Tables
1-1. The PageWriter 100 Cardiograph.
1-2. Bottom View of Cardiograph . . . . .
1-3. The Keyboard and Front Panel of the
Cardiograph. . . . . . . . . . .
2-1. The Auto ECG Report. . . . . . . .
2-2. An Auto 3x4 ECG with One Rhythm
Strip(3x4, 1R). . . . . . . . . .
2-3. A Manual S-Lead ECG. . . . . . . .
2-4. A Manual 6-Lead ECG. . . . . . . .
4-1. Cleaning the Digital Array Printhead. .
4-2. Loading the Paper. . . . . . . . . .
4-3. The AC Fuse Holders. . . . . . . . .
A-1. Rear View of Cardiograph . . . . . .
A-2. Removing the Battery Door. . . . . .
A-3. The Battery Compartment. . . . . .
A-4. Connecting the Power Cord. . . . . .
A-5. Connecting the Patient Cable. . . . .
A-6. Loading the Paper. . . . . . . . . .
. .
1-2
1-3
1-4
2-10
2-14
2-15
2-16
4-3
4-5
4-10
A-3
A-5
A-6
A-7
A-8
A-9
Contents-4
2-1. Leads Off Labels . . . . . . . .
2-2. Auto Filter Settings . . . . . . .
2-3. Manual Filter Settings . . . . .
2-4. Auto ECG Report Annotations . .
2-5. Calibration Signals . . . . . . .
2-6. Manual Lead Groups . . . . . .
2-5
2-5
2-9
2-11
2-12
2-13
.:.. ‘,
3-1. ECG Problems and Solutions . . . .
3-2
Contents-5
Getting Acquainted
Getting Acquainted
This chapter describes to the new user the many
features of the PageWriter 100 cardiograph, patient and
operational safety, and AC/battery operation. The user
should become familiar with this material, especially the
safety information, prior to using the cardiograph.
1
Note I
!i?
See Appendix A, Setting up Your Cardiograph for the
First Time for information on checking the voltage
switch setting, installing the battery, connecting the
cables, and loading paper. Each of these tasks must be
done prior to operating the cardiograph for the first
time.
Getting Acquainted 1-1
Figure 1-l. The PageWriter 100 Cardiograph.
1-2 Getting Acquainted
A. Patient Cable
B. Cardiograph
Figure 1-2. Bottom View of Cardiograph
A. AC Fuse Holders
B. Mounting Point for M1705B Cart
(Mounting screw included with cart)
C. Battery Door
Getting Acquainted 1-3
The Keyboard and Front Panel
- /qEigi!~,II,~,
Figure 1-3. The Keyboard and Front Panel of the Cardiograph.
1-4 Getting Acquainted
-
M1772-01
,
A
Instructions
Attention:
Ij
This text describes how the front-panel lights indicate the
operating status of the cardiograph:
A flashing
When the light stays on, the acquisition is complete.
Auto
light indicates that the ECG is being acquired.
B AC
C Low Battery
D l-1
(g giiqz-SpeedJ
0 pzzSize_)
(TJ (\/)
(zJ=
A flashing
A flashing Manual lead group light indicates an electrode
connection problem.
Light will be on when the power cord is plugged into AC power.
This also indicates that the battery, if installed, is charging.
This light indicates that the cardiograph must be plugged in to
recharge the battery.
Switches the cardiograph between On and
means the,cardiograph is off but it is still keeping the battery
charged as long as the cardiograph is plugged into AC power.
Sequentially changes the chart speed from 5, j 10, =+ 25, 3 50,
=+ 5 mm/second.
Sequentially changes the limb and chest lead sensitivity from 5, z+
10, 3 20, * 5 mm/mV.
Reduces the chest lead sensitivity to 50% of the value set by
g?CTiZSize).
Turns the Baseline Wander and Noise filters on or off. See “Auto
Report Filters” in Chapter 2, and “Manual Report Filters” in
Chapter 2 for more information.
Advances the paper to the beginning of the next page.
Starts an Auto ECG recording.
Starts a Manual ECG recording.
Sequentially changes the lead group used to generate a Manual
ECG from I II III, 3 aVR aVL aVF, j II aVF V2, j Vl-V6, j
I II III.
Halts any cardiograph function.
Prints a copy of the last Auto ECG. If you want additional copies
of an Auto ECG, you must print them before recording another
Auto or Manual ECG.See “Making Copies of Auto ECGs” in
Chapter 2,
Chart Speed
Recording
an
light indicates a paper supply problem.
ECG
for more information.
Standby.
Standby
Getting Acquainted 1-5
About Your Cardiograph
Your PageWriter 100 cardiograph:
l
Acquires 12 leads simultaneously.
n
Provides selectable Manual formats.
n
Operates on a rechargeable battery. AC power charges
the battery.
n
Has a digital array printer with continuous-feed paper.
n
Has a 200 sheet Z-fold paper capacity.
Accessories
Your cardiograph was shipped with one of three
accessory sets, according to your geographic option:
No Electrodes - Options: ABB, ABD, ABE, ABF,
ABH, ABS, ABU, ABX, ABZ, ACQ
n
Power cord
n
Patient Cable
n
1 package of paper
n
Page Writer 100 User’s Guide
n
Using the HP Page Writer 100 Cardiograph operator
training video
For electrodes, contact your local Hewlett-Packard Sales
Office or your authorized Hewlett-Packard Dealer or
Distributor.
Reusable Electrodes - Options: ABG, ABK, ABM,
ABZ, AB4, AKV
n
Power cord
n
Patient Cable
n
1 package of paper
n
6 Welsh bulb electrodes
n
4 limb electrodes and straps
n
1 tube Red&@ creme
n
Page Writer 100
n
Using the HP Page Writer 100 Cardiograph operator
User's
Guide
training video
1-6 Getting Acquainted
3 ,, I’
Disposable Electrodes - Options: ABA, ABC
I Power cord
n
Patient Cable
n
1 package of paper
n
Disposable electrode starter set
n
Tab electrode adapters
n Page
n
Writer 100 User’s Guide
Using the HP Page Writer 100 Cardiograph operator
training video
About This Manual
This guide contains concise operating instructions
for cardiograph users. This manual describes how to
perform the following tasks:
n
Recording an ECG
H Troubleshooting
n
Caring for and maintaining the cardiograph
n
Preparing your cardiograph for use
Getting Acquainted 1-7
Patient and Operational Safety Notes
Your cardiograph isolates all connections to the patient
from electrical ground and all other conductive circuits
in the cardiograph. This reduces the possibility of
hazardous currents passing from the cardiograph through
the patient’s heart to ground. To ensure the patient’s
safety and your own, observe the following reminders.
When operating your cardiograph from AC power, be
sure it and all other electrical equipment connected to
or near the patient are effectively grounded.
Use only grounded power cords (three-wire power
cords with grounded plugs). Also make sure the
outlet accepts the plug and is grounded. Never
modify a grounded plug to fit an ungrounded outlet,
i.e. removing the ground prong or ground clip to
fit an ungrounded outlet. Should an ungrounded
plug adapter be necessary, use a ground strap to
connect the equipotential connector at the rear of the
instrument to the power source ground.
The patient cable should be routed away from power
cords and any other electrical equipment. Failure to do
so can result in AC line frequency interference on the
ECG trace.
Warning
1-8 Getting Acquainted
The HP patient cable supplied with this cardiograph, or an
approved HP substitute patient cable, is an integral part
of the cardiograph’s safety features. Using any other
patient cable may compromise defibrillation protection as
well as performance.
Only qualified personnel may service the cardiograph.
. -. ‘, I. 1 L , :
,
I./,
,’
Warning
Caution
Do not use this cardiograph near flammable anesthetics.
It is not intended for use in explosive environments.
Do not touch the patient, patient cable or cardiograph
during defibrillation procedures. Death or injury may
occur from the electrical shock delivered by the
defibrillator.
Be sure that the electrodes or leadwire tips do not come
in contact with any other conductive parts, including
earth-grounded parts, especially when connecting or
disconnecting electrodes to/from a patient.
The use of multiple instruments connected to the same
patient may pose a safety hazard due to the summation
of leakage currents from each of the instruments. Any
such combination should be evaluated by local safety
personnel before being put into service.
Do not pull on the paper while a report is being printed.
This can cause distortion of the waveform and can lead to
potential misdiagnosis.
Do not block the ventilation slots located on both sides
and to the rear of the cardiograph. Lack of ventilation
may cause cardiograph to overheat and components to
fail.
n
The Hewlett-Packard warranty is only assured if
you use Hewlett-Packard approved accessories and
replacement parts.
Getting Acquainted 1-9
AC and DC (Battery) Operation
Your cardiograph requires the battery to be installed for
proper operation-even if the cardiograph is plugged into
AC power, it cannot print an ECG report without the
battery. For information about replacing or installing
the battery, refer to Appendix A, Setting up Your
Cardiograph for the First Time.
The following is a list of AC and battery operating
instructions:
m A fully charged battery (without AC power) will print
approximately 40 Auto ECGs, or approximately 40
minutes of continuous Manual ECG information.
m The Low Battery light indicates the battery needs to
be charged. If the Low Battery light begins to flash,
this indicates the cardiograph is about to shut down
due to a very low battery. Plug the cardiograph into
AC power.
n
From the time the Low Battery light first comes on to
when the cardiograph automatically turns itself to
Standby (off), there is typically enough reserve battery
capacity to print two Auto ECG reports or 2 minutes
of Manual ECG data. A weak or faulty battery will
reduce this time.
Note I
!I@
1-10 Getting Acquainted
H A discharged battery requires at least 5 minutes
charging time, with the cardiograph in Standby (off),
to print an Auto ECG.
n
A discharged battery requires at least 10 minutes
charging time, with the cardiograph in Standby (off),
to print a l-minute Manual ECG.’
If the cardiograph is turned on while the battery is being
charged, these charging times are doubled (10 minutes
for an Auto ECG and 20 minutes for a l-minute Manual
ECG).
n
The PageWriter 100 cardiograph has a battery-saving
feature: it will turn itself to Standby (off) after
30 minutes of instrument inactivity. This prevents
the cardiograph from being accidentally left on for
extended periods of time.
This feature is not active if all the limb electrodes
are connected to a patient or if the cardiograph is
plugged into AC power.
I A new. battery or a battery that has been stored for
an extended period of time requires charging (with the
cardiograph in Standby (off)) for 16 hours.
n
The battery, if installed, is being charged any time the
AC light is on.
n
A fully depleted battery will charge to 90% of full
capacity in 7 hours, and 100% capacity in 16 hours,
as long as the cardiograph is in Standby (off) for the
entire time.
m When the cardiograph is not in use, it should be
connected to AC power and left in Standby (off). This
will maintain a full battery charge and prolong battery
life.
Note I
rg
The cardiograph’s battery charging circuit delivers less
power than the cardiograph uses while printing an ECG.
If a Manual ECG is being recorded, the battery charge
level will continue to drop until the instrument shuts
itself down or is turned to Standby (off) by the operator.
Getting Acquainted 1-1 1
Recording an ECG
Recording an ECG
This chapter describes how to prepare the patient for an
ECG, record an ECG, understand the printed report,
and change the ECG report format. Samples of the Auto
and different Manual report formats are also shown.
2
Note
1 Q If the cardiograph has not been setup, refer to
Appendix A for instructions.
The basic steps and procedures for recording an ECG
are as follows:
1. If the cardiograph is not On, press (On/Standby).
2. Prepare the patient and apply the electrodes, as
described in the “Preparing the Patient” section.
3. Press (Auto) or (jZZZ) to record the ECG.
4. Check the quality of the recorded ECG on the printed
report.
The rest of thjs chapter discusses the details of setting
up and recording ECGs and understanding the printed
report.
Recording an ECG 2-1
Preparing the Patient
Note
Note
1
Yb
1
Yb
For electrode placement information, refer to the
diagram on the top of your cardiograph. For tips on
proper ECG technique, see the videotape Using the HP
Page Writer 100 Cardiograph.
Proper patient preparation and electrode placement are
the most important elements in producing a high quality
ECG trace.
Prepare the patient by performing the following steps.
1.
Reassure and relax the patient. A calm and quiet
patient produces the best ECGs.
2.
Make sure each electrode site is not covered by hair or
clothing.
Gently clean and abrade the surface of the skin with
3.
dry gauze.
4.
Place electrodes on patient. See the notes below
regarding your type of electrodes.
The patient cable should be routed away from power
cords and any other electrical equipment. Failure to do
so can result in AC line frequency interference on the
ECG trace.
2-2 Recording an ECG
Notes for Customers Using Reusable Electrodes
Each electrode must be attached securely. Straps must
neither slide nor be so tight as to cause discomfort.
The electrode paste, gel, or creme must cover an area the
size of the electrode, but must not extend beyond it,
especially on the chest.
Notes for Customers Using Disposable Tab Electrodes
Disposable electrodes have conductive material on one
side only, the adhesive side. The electrode tab must be
placed between the jaws of the electrode adapter and
remain flat. Do not attempt to place the jaws of.the
electrode adapter so close to the circular part of the
electrode that the tab of the electrode is bent or contact
is made with the conductive gel. Gently tug on the
electrode adapter to ensure that the electrode adapter is
properly placed on the electrode.
Good and accurate placement on the first attempt
should be your goal for each electrode. Each time an
electrode is lifted off the skin and attached again, the
conductive gel becomes weaker and less effective.
Understa
------ --
Jnding
When a Signal is
Acquired
Note I
VI
Your PageWriter 100 cardiograph attempts to acquire
a.good signal for an Auto report before you press the
(Auto) key. Hewlett-Packard cab this Pre-acquisition.
Pre-acquisition is activated when the cardiograph is
turned on and remains active until an Auto report
begins to print. Pre-acquisition is deactivated by
printing an Auto report to allow for copies of the Auto
report to be printed (see “Making Copies of Auto
ECGs”). Pre-acquisition is also deactivated whenever an
electrode is disconnected.
Pre-acquisition is reactivated when a Manual report is
finished printing.
When Pre-acquisition is active, it is important for the
patient to stay still and relaxed. This will help ensure a
good signal is captured prior to printing an Auto report.
Pre-acquisition is not used for Manual ECG reports.
Manual ECG reports display ECG data in real-time.
Recording an ECG 2-3
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