Philips PageWriter 100 User manual

C a r d io g ra p h

PageWriter 100

M1772A

I N S T R U C T I O N S F O R U S E

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PageWriter 100 M1772A Cardiograph

About This Edition

Edition 5

Printed in the USA

Publication number M1772-91900

The information in this guide applies to the M1772 PageWriter 100 Cardiograph. This information is subject to change without notic

Philips 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.

Edition History

Edition 1, September 1994

Edition 2, April 1995

Edition 3, February 1996

Edition 4, November 1999

Edition 5, January 2002

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 3000 Minuteman Road Andover, MA 01810-1099 USA

[phone]

WARNING

Radio Frequency (RF) interference from nearby transmitting devices may seriously degrade performance of the PageWriter 100 Cardiograph. Electromagnetic compatibility with surrounding devices should be assessed prior to using the cardiograph.

CAUTION

Use of accessories other than those recommended by Philips may compromise product performance.

THIS PRODUCT IS NOT INTENDED FOR HOME USE.

IN THE U.S., FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF A PHYSICIAN.

Medical Device Directive

The M1772 PageWriter 100 Cardiograph complies with the requirements of the Medical Device Directive 93/42/EEC and carries the

0123 mark accordingly.

Authorized EU-representative:

Philips GmbH

Health Care Solutions, 71034

Boeblingen

Germany

Fax: [phone]

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Conventions Used in This Manual

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Caution statements describe conditions or actions that can result in damage to the equipment or software.

Notes contain additional information on cardiograph usage.

.H\ Represents keys on the front panel.

Safety Summary

Safety Symbols Marked on the Cardiograph

The following safety symbols are used on the cardiograph.

Caution - See operating instructions.

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).

PageWriter 100 M1772A Cardiograph

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	Fuse.
	Indicates power control for cardiograph.
Hz	Indicates operating frequency in cycles per second.

Please see "Patient and Operational Safety Notes", in Chapter 1, Getting Acquainted, for further information about operating your cardiograph safely.

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PageWriter 100 M1772A Cardiograph

Contents-1

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PageWriter 100 M1772A Cardiograph

Contents-3

Contents-4

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		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.
127(		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.

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A.Patient Cable

B.Cardiograph

1-2	Getting Acquainted

1

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A.AC Fuse Holders

B.Mounting Point for M1705B Cart (Mounting screw included with cart)

C.Battery Door

PageWriter 100 M1772A Cardiograph

1-3

The Keyboard and Front Panel

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A	Instructions	This text describes how the front-panel lights indicate the
		operating status of the cardiograph:

Attention: A flashing Auto light indicates that the ECG is being

		acquired. When the light stays on, the acquisition is com-
		plete.
		A flashing Chart Speed light indicates a paper supply
		problem.
		A flashing Manual lead group light indicates an electrode
		connection problem.
B	AC	Light will be on when the power cord is plugged into AC
		power. This also indicates that the battery, if installed, is
		charging.

1-4	Getting Acquainted

The Keyboard and Front Panel

C	Low Battery	This light indicates that the cardiograph must be plugged
		in to recharge the battery.
D	2Q 6WDQGE\	Switches the cardiograph between On and Standby.	1
		Standby means the cardiograph is off but it is still keeping
		the battery charged as long as the cardiograph is plugged
		into AC power.

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Sequentially changes the chart speed from 5, => 10, => 25, => 50, => 5 mm/second.

Sequentially changes the limb and chest lead sensitivity from 5, => 10, => 20, => 5 mm/mV.

Reduces the chest lead sensitivity to 50% of the value set by (&* 6L]H .

Turns the Baseline Wander and Noise filters on or off. See

“Auto Report Filters” , and “Manual Report Filters” for more information.

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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, => aVR aVL aVF, => II aVF V2, => V1-V6, => 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” , Recording an ECG for more information.

PageWriter 100 M1772A Cardiograph

1-5

About Your Cardiograph

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Your PageWriter 100 cardiograph:

λ

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Acquires 12 leads simultaneously.

Provides selectable Manual formats.

Operates on a rechargeable battery. AC power charges the battery.

Has a digital array printer with continuous-feed paper.

Has a 200 sheet Z-fold paper capacity.

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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, AKD, ACB, AC4, AB9, ABN

λPower cord

λPatient Cable

λ1 package of paper

λPageWriter 100 Instructions for Use

For electrodes, contact your local Philips Sales Office or your authorized Philips Dealer or Distributor.

Reusable Electrodes — Options: ABG, ABK, ABM, ABZ, AB4, AKV, ACQ, AB2, AC6, ACJ.

λPower cord

λPatient Cable

λ1 package of paper

λ6 Welsh bulb electrodes

λ4 limb electrodes and straps

λPageWriter 100 Instructions for Use

1-6	Getting Acquainted

About This Manual

	Disposable Electrodes — Options: ABA, ABC
	λ	Power cord
	λ	Patient Cable	1
	λ 1 package of paper

λDisposable electrode starter set

λTab electrode adapters

λPageWriter 100 Instructions for Use

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This guide contains concise operating instructions for cardiograph users. This manual describes how to perform the following tasks:

λRecording an ECG

λTroubleshooting

λCaring for and maintaining the cardiograph

λPreparing your cardiograph for use

PageWriter 100 M1772A Cardiograph

1-7

Patient and Operational Safety Notes

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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.

λWhen 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.

λThe 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.

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1-8	Getting Acquainted

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Patient and Operational Safety Notes

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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.

λThe cardiograph’s warranty is only assured if you use approved accessories and replacement parts.

PageWriter 100 M1772A Cardiograph

1-9

AC and DC (Battery) Operation

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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:

λ A fully charged battery (without AC power) will print approximately 40 Auto ECGs, or approximately 40 minutes of continuous Manual ECG information.

λ 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.

λ 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.

		λ A discharged battery requires at least 5 minutes charging time,
		with the cardiograph in Standby (off), to print an Auto ECG.
		λ A discharged battery requires at least 10 minutes charging time,
		with the cardiograph in Standby (off), to print a 1-minute
		Manual ECG.
127(		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 1-minute Manual ECG).

1-10	Getting Acquainted

AC and DC (Battery) Operation

λ 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			1
		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.
		λ 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.
		λ The battery, if installed, is being charged any time the AC light
		is on.
		λ 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.
		λ 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.
127(		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.

PageWriter 100 M1772A Cardiograph

1-11

AC and DC (Battery) Operation

1-12	Getting Acquainted

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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.

127(		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 2Q 6WDQGE\ .
	2.		Prepare the patient and apply the electrodes, as described in the
			“Preparing the Patient” section.
	3.		Press $XWR or 0DQXDO to record the ECG.
	4.		Check the quality of the recorded ECG on the printed report.

The rest of this chapter discusses the details of setting up and recording

ECGs and understanding the printed report.

PageWriter 100 M1772A Cardiograph

2-1

Preparing the Patient

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For electrode placement information, refer to the diagram on the top of your 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.

3.Gently clean and abrade the surface of the skin with 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.

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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.

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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

2-2	Recording an ECG

Understanding When a Signal is Acquired

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.

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		Your PageWriter 100 cardiograph attempts to acquire a good signal for			2
		an Auto report before you press the $XWR key. This is called 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.
127(		Pre-acquisition is not used for Manual ECG reports. Manual ECG
		reports display ECG data in real-time.

PageWriter 100 M1772A Cardiograph

2-3