Philips M1754 User manual
Cardiograph
Signal-Averaged ECG
M1754A
INSTRUCTIONS FOR USE
M1754A Signal-Averaged
ECG (SAECG) Instructions for Use
Philips Cardiograph
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Notice
About This Edition
Publication number M1754-91908
Edition 3
Printed in USA
Edition History
October 1991 Edition 1
June 1992 Edition 2
January 2002 Edition 3
Copyright
Copyright © 2001
Philips Electronics North America Corporation
All rights are reserved.
Reproduction in whole or in part is prohibited
without the prior written consent of the
copyright holder.
Philips Medical Systems
Andover, MA 01810 USA
This informatio n is s ub ject to change without
notice.
Warranty
Philips makes no warranty of any kind with
regard to this material, included, but not limited
to, the implied warranties or merchantability
and fitness for a particular purpose .
Philips shall not be liable for errors co nta ined
herein or for incidental or conseque ntial
damages in connection with the furni s hi ng,
performance, or use of this material.
This product may contain rem anufactured parts
equivalent to new in performance or have had
incidental use.
Philips assumes no li abilit y for f ailures resultin g
from RF interference between Philips medical
electronics and any radio frequency generating
equipment at levels exceeding those established
by applicable standards.
Classified by Underwriters Laborato ries , Inc.
with respect to electrical shock, fire, and
mechanical hazards only in accordance with UL
2601-1.
CAUTION
The manufacture r, importe r and seller are
responsible for the effects on safety, reliability
and performance only if: assembly operations,
extensions, re-adjustments, modi fications or
repair are carried out by persons authorized by
them, and the electrical installation of the
relevant room complies with all local
regulations and the equipment is used in
accordance with the instructions for use . Us e of
accessories other than those recommended by
Philips may compromise product performance.
THIS PRODUCT IS NOT INTENDED FOR
HOME USE.
Responsibility of Manufacturer
Philips only considers it s elf responsib le for any
effects on safety, reliability and performance of
the PageWriter cardiograph and the battery
support system if:
assembly operations, extensions, readjustments,
modifications or repairs are don e by persons
authorized by He wl ett Packard, and
the electrical installation of the relevant room or
vehicle complies with the IEC or national
requiremen ts , and
the instrument is used according to the
instructions for use presented in this manual.
WARNING
As with electroni c e quipment, Radio
Frequency (RF) interference between the
defibrillator and any existing RF transmitting or
receiving equipment at the installat io n site,
including electrosurgica l equipment, should
evaluated carefully and a ny limitations noted
before the equipm ent is placed in servic e.
Monitoring during quiescent periods of
electrosurgery is possible but electromagnetic
interference generated by electrosurgical tools
during operation is sufficient to mask cardiac
signals.
Radio frequency generat io n from
electrosurgical equi pment and close prox imity
transmitters may seriously degrade performance
of the PageWriter cardiograph.
ii
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1Printing History
October 1991 Edition 1
June 1992 Edition 2
January 2002 Edition 3
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1Safety Summary
Safety Symbols Marked on the Cardiograph
The following symbols are used on the cardiograph or the cart.
Caution - See operating instructions
Type CF, defibrillation protected
Alternating current
Equipotential (this is on the ground lug)
The maximum weight that the cart can hold.
Conventions Used in This Manual
Notes contain additional information on M1754A usage.
VRIWNH\V
represents the temporary key labels that appear on the display.
represents keys on the front panel.
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iv
Contents
1. Getting Started
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Installing M1754A SAECG Software . . . . . . . . 1-1
Selecting the SAECG Application . . . . . . . . . . . 1-3
Preparing the Patient and Applying Electrodes . 1-4
2. Acquiring a Signal-Averaged ECG
Selecting the Template Beat . . . . . . . . . . . . . . . . 2-1
Editing the Final Report . . . . . . . . . . . . . . . . . ... .2-5
Adjusting the QRS Onset and Offset . . . . . . . . . 2-5
Editing and Printing a Stored SAECG . . . . . . . . 2-7
3. Understanding the Printed SAECG Report
4. Configuring the M1754A SAECG Application
Configuring Your Cardiograph to Start Up
in the SAECG Application . . . . . . . . . . . . . . 4-1
Configuring the SAECG Application . .. . . . . . . 4-3
Patient ID Fields . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Configuration Tables . . . . . . . . . . . . . . . . . . . . . 4-5
Acquisition Fields . . . . . . . .. . . . . . . . . . . . . . . . 4-5
Measurement Fields . . . . . . . . . . . . . . . . . . . . . . 4-6
5. Troubleshooting
Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Glossary
Index
contents 1
Figures
1-1. Placing Electrodes for an SAECG. . . . . . . . 1-5
2-1. A Template Screen. . . . . . . . . . . . . . . . . . . .2-2
2-2. An Averaging Screen . . . . . . . . . . . . . . . . . 2-4
2-3. A Measurements Screen . . . . . . . . . . . . . . . 2-5
3-1. The SAECG Report. . . . . . . . . . . . . . . . . . . 3-2
Tables
1-1. SAECG Electrode Positions . . . . . . . . . . . . 1-5
3-1. SAECG Report Annotations . . . . . . . . . . . . 3-3
4-1. Acquisition Configuration Fields . . . . . . . . 4-5
4-2. Measurements/Processing Configuration
Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
5-1. SAECG Testing Problems . . . . . . . . . . . . . 5-2
contents 2
1Getting Started
1Introduction
This guide contains information about using the M1754A Signal-Averaged ECG
(SAECG) cardiograph application to acquire a Signal-Averaged ECG for use in the
detection of late potentials. There are also instructions on configuring the
cardiograph for M1754A SAECG application operation.
Refer to the Page Writer XLi Cardiograph Operating Guide for operating and
installation instructions for your cardiograph.
1Installing M1754A SAECG Software
Be sure that the M1700A XLi software has been installed before installing any other
applications in your cardi ogr aph. To ins t all th e M175 4A S AECG so ft ware, perform
the following steps.
1. Turn the cardiograph to Standby from the front panel.
2. Insert the M1754A SAECG application disk in the disk drive in the front of the
cardiograph.
3. Prepare the SAECG patient module and attach it to the cardiograph.
a. Put shorting plugs in the LA and LL positions.
b. Attach lead wires to the remaining positions on the SAECG patient module.
1-1
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The SAECG patient module can also be used for XLi applications. If you wish to
routinely acquire XLi ECGs as well as SAECGs, you may attach lead wires in place
of the shorting plugs for the LA and LL leads on the SAECG patient module. Then
attach the LA and LL electrodes on the normal positions.
You will achieve shorter averaging times if you use shorting plugs in the LA and LL
lead positions.
4. Turn the cardiograph on. The message Load SAECG application? appears.
5. Press . The copyright display appears briefly.
<H V
(c) 1991 Hewlett-Packard, Corazonix Corp
SAECG (M1754A - A.01.00)
Then the following display appears.
******
SAECG (M1754A - A.01.00)
The asterisks gradually extend across the display until the software install a tion
is complete. The following display appears.
Auto 3x4
Report Format 01/26/92 01:23AM
You can now select the SAECG application as described in the next section.
T o conf i gure your cardiograph for your requirements, refer to Chapter 4.
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1Selecting the SAECG Application
When the SAECG application is installed, you can either use your cardiograph to
acquire a standard (XLi) ECG or you can acquire Signal-Averaged ECGs. To select
SAECG opera t i on from the Prev iew Plus application, perform the following steps.
1. Press until you see the following display.
0HQX
Prev+
2. Press .
3. In the Applications menu, press .
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• If you haven't already attached the SAECG patient module, you will be instructed
to do so.
The following display appears.
SAECG
Start 01/26/92 01:23AM
4. Attach the electrodes to the patient as described in the next section.
5. Check the signal quality by viewing the preview screen and the SAECG patient
module display.
The next chapter, Chapter 2, describes how to acquire the ECG and create the final
SAECG report.
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1Preparing the Patient and Applying Electrodes
To prepare the patient and apply the electrodes, perform
the following steps.
1. Relax the patient.
• Check that the patient is comfortable.
• Reassure the patient that the procedure is safe.
It is essential to relax the patient as much as possible during the procedure. This is
because the quality of the ECG signal depends on reducing tension in the patient.
2. Prepare the electrode positions.
• Shave the electrode positions if necessary.
• Cleanse the skin with your institution's cleansing soluti on .
• Rub the skin gently with a gauze pad until the skin is slightly red.
Electrode site preparation is especially important for the detection of the low level
signals involved in late potentials.
1-4
3. Place the electrodes as shown in Figure 1-1.
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AHA IEC Position
Y+
YZ+
ZX+
X-
RL
LA
LL
Y+
In the lower, left abdominal region on the left iliac
crest
Y-
On the superior aspect of the manubrium.
Z+
At the fourth in tercostal space, at the le ft s ternal
margin (V 2 po s ition)
Z-
On the back, directly opposite the Z+ electrode
X+
At the same level as the Z axis along the mid-axillary
line on the pati en t’s left si d e
X-
At the same level as the Z axis along the mid-axillary
line but on the patient’s right side
N
Opposite the Y+ electrode on the right iliac crest
L
On the left fo re arm (if used)
F
On the left leg (i f u se d )
1-5
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