Philips PageWriter XLi User reference guide

PageWriter XLi

User’s Reference Guide

Notice

About This Edition

Edition 8

Printed in the USA Publication number M170092909

The information in this guide applies to the PageWriter XLi cardiograph. This information is subject to change without notice. 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.

Edition History

Edition 1 May 1990

Edition 2 July 1991

Edition 3 January 1992

Edition 4 April 1993

Edition 5 July 1993

Edition 6 June 1994

Edition 7 January 1995

Edition 8 April 2000

Copyright

Copyright © 2000 Hewlett-Packard Co. 3000 Minuteman Road Andover, MA 01810-1099 USA

[phone]

This document may not be photocopied, reproduced, or translated to another language without prior written consent of HewlettPackard.

WARNING

As with electronic equipment, Radio Frequency (RF) interference between the 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.

Radio frequency generation from electrosurgical equipment and close proximity transmitters may seriously degrade performance.

Like all electronic devices, this cardiograph is susceptible to electrostatic discharge (ESD). Electrostatic discharge typically occurs when electrostatic energy is transferred to the patient, the electrodes, or the cardiograph. ESD may result in ECG artifact that may appear as narrow spikes on the cardiograph display or on the printed report. When ESD occurs, the cardiograph’s ECG interpretation may be inconsistent with the physician’s interpretation.

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.

CAUTION

Use of accessories other than those recommended by Hewlett-Packard 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 PageWriter XLi Cardiograph complies with the requirements of the Medical Device Directive 93/42/EEC and carries the

0123 mark accordingly.

Authorized EUrepresentative: Hewlett-Packard Deutschland GmbH Herrenbergerstrasse 130 D-71034 Boeblingen Germany

Fax: [phone]

ii

Safety Summary

Safety Symbols Marked on the Cardiograph

The following symbols are used on the cardiograph.

Caution - See operating instructions

Type CF, defibrillation protected

Alternating current

Equipotential (this is on the ground lug)

The following symbols appear on the cardiograph packaging.

		Keep dry
		Temperature and relative humidity
		ranges
		Fragile
		Conventions Used in This Manual
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		RU ORVV RI OLIH

iii

&$87,21		Caution statements describe conditions or actions that can result in damage to
		the equipment or software.
127(		Notes contain additional information on cardiograph usage.

Softkey represents the temporary key labels that appear on the keyboard display.

Key represents keys on the front panel.

iv

Documentation

Map

Documentation Map

If you want to:	Use this manual:
Verify that all equipment is included	Packing List
Record ECG’s	Operating Guide
Enter patient ID
Make copies of ECG’s
Store ECG’s
Transmit or receive ECG’s
Troubleshoot problems
Maintain the cardiograph
Set up the cardiograph
Install the battery
Install the software
Load paper
Change applications
Install or use Preview Plus
Configure the cardiograph	User’s Reference Guide
Prepare the patient
Maintain the cardiograph
Install and use the modem

v

Documentation Map

If you want to:	Use this manual:
Configure and use Special Applications	User’s Reference Guide
Order supplies
Use filters
Understand analysis	Physician’s Guide

vi

Contents

Safety Summary ......................................................................................................................	iii
Safety Symbols Marked on the Cardiograph ....................................................................	iii
Conventions Used in This Manual ....................................................................................	iii
Documentation
Map ...........................................................................................................................................	v
Introduction
About This Manual ...............................................................................................................	1-1
Acquiring an ECG
ECG Technique .....................................................................................................................	2-1
Relaxing the Patient ........................................................................................................	2-2
Preparing the Patient .......................................................................................................	2-2
Preparing the Skin at the Electrode Positions .................................................................	2-3
Securing the Electrodes ..................................................................................................	2-4
Monitoring ECG Quality ......................................................................................................	2-6
Quality Messages on the Cardiograph’s Display ............................................................	2-7
Understanding the PageWriter XLi Special Applications
Overview ..............................................................................................................................	3-1
Indications for Use ..........................................................................................................	3-1
Understanding TPI Variables ..........................................................................................	3-2
Understanding ACI TIPI Variables ................................................................................	3-3
Using the TPI and ACI-TIPI Applications .....................................................................	3-3
Analyzing an ECG with the Predictive Instruments .......................................................	3-4
Generating Reports with the Special Applications Off ..................................................	3-5
Generating Reports with the Special Applications On ...................................................	3-6
Auto Analysis and the Default Choice ...........................................................................	3-7
Generating a STAT ECG Report ....................................................................................	3-8

Choosing Report Features

vii

Contents
ECG Formats ........................................................................................................................	4-1
The Auto Report .............................................................................................................	4-1
Auto Report Information ................................................................................................	4-1
Manual Formats ..............................................................................................................	4-6
The Manual Lead Sets ....................................................................................................	4-6
ECG Storage
Advantages of Disk Storage .................................................................................................	5-1
Storing Reports with the Special Applications Off ........................................................	5-2
Storing Reports Using Auto Analysis and the Default Choice .......................................	5-2
Automatically Storing Reports Using Forced Auto-Store ..............................................	5-2
Disk Handling and Maintenance Instructions .......................................................................	5-3
Using the ECG-Log and Store-Log ......................................................................................	5-4
Printing ECG Logs ..........................................................................................................	5-7
Configuring Your Cardiograph
Using Configuration Menus ..................................................................................................	6-1
Selecting Configuration Parameters .....................................................................................	6-3
Understanding Global Configuration ....................................................................................	6-4
Interpretation Parameters. .............................................................................................	6-10
Line Frequency .............................................................................................................	6-11
Selecting Custom Lead Groups ....................................................................................	6-11
Selecting AutoCopy ......................................................................................................	6-11
Selecting ECG Management Parameters ......................................................................	6-12
Selecting Battery Timeout Periods ...............................................................................	6-12
Setting a Password ........................................................................................................	6-13
Turning Off Unused ID Fields ............................................................................................	6-13
Storing the Configuration Information .........................................................................	6-14
Using a Stored Configuration .......................................................................................	6-15
Printing the Configuration ............................................................................................	6-16
Setting Up Your Cardiograph for Transmitting ECGs
Transmitting ECGs Directly .................................................................................................	7-3
Configuring the Cardiograph to Transmit ECGs Directly ..............................................	7-4

viii

	Contents
Transmitting ECGs by Telephone to Another Site ...............................................................	7-5
Installing the Modem (For United States use only) ........................................................	7-5
Connecting a Telephone to the Same Line as the Modem .............................................	7-7
Configuring the Cardiograph for Modem Usage ............................................................	7-7
Entering the Phone Number ............................................................................................	7-9
Configuring the Cardiograph for AutoDial ....................................................................	7-9
Installing the Modem on the Cart .................................................................................	7-10
Transmitting ECGs by FAX to Another Site ......................................................................	7-11
Installing the FAX/Modem ...........................................................................................	7-12
Connecting a Telephone to the Same Line as the FAX/Modem ..................................	7-14
Configuring the Cardiograph for FAX Usage ..............................................................	7-14
Entering the Phone Number ..........................................................................................	7-15
Transmitting an ECG via FAX .....................................................................................	7-16
Printing an ECG on an HP LaserJet Printer ........................................................................	7-17
Setting up the LaserJet Printer ............................................................................................	7-18
Configuring the Cardiograph to Print ECGs on the HP LaserJet .................................	7-18
Receiving ECGs ..................................................................................................................	7-20
Configuring the Cardiograph to Receive ECGs Directly .............................................	7-20
Configuring the Cardiograph to Receive ECGs via Modem ........................................	7-21
Receiving an ECG via FAX ..........................................................................................	7-21
Configuring the Cardiograph to Receive via FAX .......................................................	7-22
Receiving ECG Reports from an HP 5600C ECG Management System .....................	7-22

Receiving ECGs from an HP M1730A or M3700A TraceMaster ECG Management System 7-23

Troubleshooting
Troubleshooting Leads Off ...................................................................................................	8-1
Troubleshooting ECG Noise .................................................................................................	8-1
Understanding Error Messages .............................................................................................	8-3
Calling for Assistance .....................................................................................................	8-3
Solving Equipment Problems ...............................................................................................	8-3
Supplies
Availability ...........................................................................................................................	9-1

ix

Contents
Lead Systems
Frank Leads ..........................................................................................................................	A-1
Special Lead Configurations ................................................................................................	A-2
V3R, V4R, V7 and V8 ...................................................................................................	A-2
VX1, VX2, VX3 and VX4 .............................................................................................	A-2

Glossary

x

1 Introduction

1

About This Manual

This guide contains reference information and configuration instructions for experienced PageWriter XLi cardiograph users. If you are unfamiliar with using this cardiograph, please view the videotape tutorial Using the HewlettPackard PageWriter XL Cardiographs. For additional help on using your cardiograph refer to the HP PageWriter XLi Operating Guide.

1-1

About This Manual

1-2	Introduction

2 Acquiring an ECG

			One of the most important aspects of recording a clear ECG is good ECG
			technique. This chapter includes a review of recommended ECG technique as
			well as information about using the patient module.			2
127(			Computerized ECG analysis should always be reviewed by a qualified
			physician.
			ECG Technique
			ECG technique is very important, both to avoid difficulty when taking the
			ECG and to achieve the best quality result. There are three key aspects of
			good ECG technique:

l Helping the patient to relax.

l Preparing the patient for electrode connection.

l Using the patient module to check lead connections.

For best results, perform the following steps in the order given. More details on good technique follow this list.

lCheck that the patient is comfortable and relaxed. Reassure the patient that the procedure is painless.

lIf possible, place the patient away from electrical fixtures and their power cords, and away from the cardiograph’s power cord if AC power is on.

lExpose the patient’s forearms, lower legs, and chest.

lBeginning with the right leg position, apply electrolyte and attach electrodes.

2-1

ECG Technique

127(		Disposable electrodes, when used properly, may be used for acceptable ECGs.
		For best results, prepare the skin and carefully follow manufacturer’s usage
		instructions.

Relaxing the Patient

The more the patient relaxes, the less the ECG will be affected by noise. Your good technique helps the patient relax. You can help the patient to relax by the following:

l Make sure the patient is lying down and comfortable. The patient’s arms and hands must be relaxed. If the table is too narrow, place the patient’s hands under the buttocks to prevent muscle tension in the arms.

l When possible, take the ECG in a quiet room or area where others can’t see the patient. Privacy is important to relaxation. Draw the curtains around the bed area when taking the ECG in a room with other people.

l Gain the patient’s confidence by explaining the test and that it won’t hurt.

l Your calm, relaxed attitude will help put the patient at ease.

l Don’t let the patient move unnecessarily. It’s also best to avoid all conversation during the actual ECG recording to keep the patient as still as possible.

Preparing the Patient

Selecting the Electrode Positionsm, Table 2-1, shows the proper electrode positions for taking an ECG. Put the electrodes in the correct anatomical locations according to information in Figure 2-1.Additional information concerning other lead systems may be found in Appendix A.

The tip of each lead wire is lettered and color coded for easy lead identification. For example, make sure that the RA lead wire and electrode connect to the right arm and the RL lead wire and electrode connect to the right leg.

2-2	Acquiring an ECG

	ECG Technique
	Table 2-1 Standard 12-Lead Electrode Positions
Lead	Position
RL	On the right leg (inside calf, midway between knee and ankle)
LL	On the left leg (inside calf, midway between knee and ankle)
RA	On the right arm (on the inside)
LA	On the left arm (on the inside)
			2
V1	Fourth intercostal space, at right sternal margin
V2	Fourth intercostal space, at left sternal margin
V3	Midway between V2 and V4
V4	Fifth intercostal space at left midclavicular line
V5	Same transverse level as V4, on anterior axillary line
V6	Same transverse level as V4, at left midaxillary line

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Preparing the Skin at the Electrode Positions

Since dry skin is a relatively poor electrical conductor, you must prepare the skin to assure good contact between the skin and the electrode. Before

2-3

ECG Technique
		securing the electrodes, you must lower the skin resistance at the electrode
		site by:
		l Making sure that all electrodes are clean and bright. (Dirty or
		corroded electrodes prevent a good electrical connection.)
		l Avoiding bony areas. Select flat, fleshy sites. You don’t have to shave
		hair from the skin unless the hair is very thick.
		l Rubbing the skin briskly with the edge of the electrode or a gauze pad
		until the skin is slightly red, but not bruised.
		l Applying electrolyte to the prepared areas on the skin. Rub some
		electrolyte into the skin, but leave a slightly moist residue. Do not
		spread electrolyte on the chest area between electrodes. This will
		cause distorted waveforms on the ECG.
127(		Do not use alcohol or acetone pads in place of the electrolyte because they
		impair the electrode contact with the skin.
		Securing the Electrodes
		We have included two types of electrodes in the accessory box:
		l Metal plate limb electrodes, held in place on the patient by rubber
		straps.
		l Welsh cup chest electrodes, held in place by suction.
		Securing the electrodes is a key part of good ECG technique and getting a
		good ECG trace. To avoid jittery waveforms, make sure that the electrodes are
		secure. Do not overtighten limb plate electrodes, since this might cause
		discomfort which results in muscle artifact on the waveforms.
		Fasten the electrodes to the chest positions by squeezing the rubber bulb of
		the suction cup. See Figure 2-3. The bulb should be partially deflated when
		the electrode is firmly attached to the chest.
		A good test for firm electrode contact is to grasp the electrode and try to move
		it. If it moves easily, the electrode connection is too loose. If it digs into the
		flesh, the electrode is too tight. Do not allow the chest electrodes to move in
		any way. Check the patient module display for indications that the
		connections are good. Ideally, the noise bar should remain in the green zone.

2-4	Acquiring an ECG

ECG Technique

Do not leave suction electrodes connected to the chest for prolonged periods. The suction can cause intradermal hemorrhaging.

2

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2-5

Monitoring ECG Quality

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Monitoring ECG Quality

There are three ways that the PageWriter XLi helps you monitor the quality of your ECG recordings.

lUsing the patient module display

lUsing the preview screen

lObserving quality messages on the cardiograph’s display

2-6	Acquiring an ECG

Monitoring ECG Quality

You can stop the recording before or during printing if you see artifact or other ECG waveform problems on the screen. Modify lead placement or improve patient preparation and resume recording the ECG.

For further instructions on using the patient module display and the preview screen, refer to the PageWriter XLi Operating Guide.

Quality Messages on the Cardiograph’s Display

After you start an Auto ECG recording, the cardiograph’s display will show
messages which indicate the quality of the recording. If there is minimal noise	2
and all electrodes are securely attached, the message "‘ECG ok’’ will appear.

Some messages indicate problems with the leads. They list the condition and the action to take. There are four conditions which affect the ECG:

lLeads off

lAC noise

lArtifact

lBaseline wander

If any of these conditions are severe, the message directs you to retry the recording. Correct the problem and then resume recording the ECG.

2-7

Monitoring ECG Quality

2-8	Acquiring an ECG

3Understanding the PageWriter XLi Special Applications

Overview

The ACI TIPI (Acute Cardiac Ischemia - Time Insensitive Predictive Instrument) and the TPI (Thrombolytic Predictive Instrument) are software products that enhance the computer-assisted ECG analysis capabilities of the PageWriter XLi Cardiograph. These "Predictive Instruments" generate 0- 100% Predicted Probability scores of ACI (Acute Cardiac Ischemia) and patient outcome with and without thrombolytic therapy for acute myocardial infarction (AMI). These predicted probabilities are based on ECG features,

patient age, gender, blood pressure, chest pain status and time since ischemic 3 symptom onset. The cardiograph can be configured to automatically print

these probabilities on the Auto ECG report.

Indications for Use

The ACI-TIPI is intended for use as an aid to clinicians in the diagnosis and triaging decision process of patients with ACI, which includes unstable angina pectoris and acute myocardial infarction (AMI).

The TPI is intended for use as an aid to clinicians identifying which patients with AMI are appropriate candidates for thrombolytic therapy. TPI is intended for adult patients, aged 35-75, diagnosed with symptoms of acute myocardial infarction.

These programs can be used in real-time and retrospective settings since they rely on information that is readily available in the emergency department (ED), or by retrospective review of the patient’s medical record. The emergency physician’s real-time decision making process is aided by having the predictive instruments incorporated into the electrocardiograph. The predictive scores, once acquired, can then be used along with actual patient outcome to help improve patient management practices retrospectively.

3-1

Overview
		The predictive instruments provide the physician with tools to:
		l Aid diagnosis and triage of some patients with symptoms suggestive
			of ACI
		l Identify those patients most likely to benefit from thrombolytic
			therapy
		l Facilitate the earliest possible administration of thrombolytic therapy
127(		For intended use and contraindication information, consult the Predictive
		Instrument Physician’s Guide for important information.
		Understanding TPI Variables
		There are nine predictors of thrombolytic-related benefits and risks which
		include six clinical factors and detailed information on three ECG features.
		The six clinical factors are:
		l Time since ischemic onset
		l	Patient age
		l	Patient gender
		l Patient Blood Pressure (systolic and diastolic)
		l Patient’s history of diabetes
		l Patient’s history of hypertension
127(		For each of the clinical factors listed above, patient data must be entered in
		order to produce a TPI report.

3-2	Understanding the PageWriter XLi Special Applications

Overview

The three ECG features are:

l the presence or absence of pathological or significant Q waves l the presence and degree of ST segment elevation or depression l the presence and degree of T wave elevation or inversion

Understanding ACI TIPI Variables

Seven variables are used to predict Acute Cardiac Ischemia. These variables include four clinical factors and detailed information on three ECG features.

		The four clinical factors are:
		l the presence or absence of chest pain or pressure, or left arm pain
		l whether chest pain or pressure, or left arm pain is the patient’s most
			important presenting symptom
		l	patient age
		l	patient gender
						3
127(		For each of the clinical factors listed above, patient data must be entered in
		order to produce the ACI-TIPI report.

The three ECG features are:

lthe presence or absence of pathological or significant Q waves

lthe presence and degree of ST segment elevation or depression

lthe presence and degree of T wave elevation or inversion

The exclusionary cases for both the TPI and ACI-TIPI applications are listed in the Predictive Instrument Physician’s Guide. Please refer to this document for this information.

Using the TPI and ACI-TIPI Applications

To use the TPI and ACI-TIPI applications, you must configure the cardiograph and enable the applications. There are several types of reports that are produced by the cardiograph. These reports are summarized in Table 3-1.

3-3

Overview

Table 3-1 PageWriter XLi Reports

Report Type	Contents of Report	Notes
Standard 09 (Std 09)	ECG waveforms, mea-
	surements, ECL 09 Adult
	Interpretation
Standard P4 (Std P4)	ECG waveforms, mea-
	surements, ECL P4 Pediat-
	ric Interpretation
ACI-TIPI (T0)	ECG waveforms, TIPI
	Analysis,
	No Risk Management
	Report
Risk Management	Risk Management Report	Only available when
	—1 page summarizing	T0 is enabled
	clinical information and	The ACI-TIPI
	can be used by the Clini-	Report will also be
	cian to document clinical	printed.
	decisions
TPI (H0)	ECG waveforms, TPI
	Analysis

Analyzing an ECG with the Predictive Instruments

The flexibility of the PageWriter XLi allows you to configure the Predictive Instruments based on the type of patients presenting in your clinical setting. Using the Configuration Menu, you can set up your cardiograph to provide the desired analysis.

When first turned on the PageWriter XLi cardiograph will have the Special

Applications turned off. The Special Application choices are part of the

Global Configuration Menu and enable access to the following settings.

3-4	Understanding the PageWriter XLi Special Applications

Overview

	Table 3-2 Special Applications Settings
Parameter		Choices	Default value when Special Apps =
			off
Research Leads		Off/VX1-VX4/V4R-V8	Off
Default Adult Criteria		09/P4	09
Default Pediatric Criteria		09/P4	P4
Patient ID Criteria		On/Off	Off
ACI-TIPI		On/Off	Off
Risk Mgmt.		On/Off	Off
Risk Range		0%-100%	-
TPI		On/Off	Off
					3
Screening		On/Off	Off
Leads		Normal/Cabrera	Normal
Storage Mode		Standard/Special	Normal
VCG		Off/vcg1/vcg2/vcg3/vcg4	Off
Default Storage Criteria		Def Adult/Ped, TIPI, TPI	Def Adult/Ped

It is important to understand that it is possible to set the Default Adult Criteria and the Default Pediatric Criteria to be either 09 or P4. This flexibility is designed for unusual clinical settings, and you should always be aware of just how your cardiograph is set up.

Generating Reports with the Special Applications Off

This method of working enables any kind of report to be generated, however it does not allow for generation of multiple simultaneous reports. Through the top level "Auto Analysis" menu, you can specify the kind of report to be made. There are five choices available: Adult, Pediatric, TIPI, or TPI, or Default.

3-5

Overview

For each of these report options, here are the resulting reports given that

Special Applications are Off and the Auto button has been pressed:

lAdult - The XLi will do an 09 report (regardless of patient age).

lPediatric - The XLi will do a P4 report (regardless of patient age).

lTIPI - The XLi will do a TIPI report. A Risk Management report will not be generated.

lTPI - The XLi will do a TPI report. TPI screening will not occur.

lDefault - The XLi will do an 09 report if the age is unspecified or above 15 years. The XLi will do a P4 report if the age is 15 years or less.

1.	From the main display, press the			F1	key until ’Auto Analysis’ appears.
2.	Press the		key to select the desired report format.
		F3

Generating Reports with the Special Applications On

It is possible to configure the PageWriter XLi to produce multiple reports. When the setting for Special Applications is turned to On, and the Auto button is pressed, there are five choices of reports available - Adult, Pediatric, ACITIPI, TPI or Default. The first four choices and their resulting outcomes are described below:

lAdult - The XLi will do the Default Adult Criteria Report (regardless of the patient’s age).

lPediatric - The XLi will do the Default Pediatric Criteria Report (regardless of the patient’s age).

lACI-TIPI - The XLI will do a TIPI report. Also, if the Risk Management Report is set to on in the Special Applications Menu and the ACI-TIPI Report risk factor falls within the limits set up, a Risk Management Report will be produced.

lTPI - The XLi will do a TPI report. TPI Screening will not occur.

3-6	Understanding the PageWriter XLi Special Applications

Overview

Auto Analysis and the Default Choice

If the Default choice is selected from the Auto Analysis menu, multiple reports may be produced when the Auto button is pressed, depending on what has been enabled in the Special Applications in the Global Configuration Menu.

l TPI - If TPI is on and TPI Screening is off, a TPI report will be generated. If TPI is on and TPI Screening is On and the TPI Analysis Criteria are met, a TPI report will be generated. If both TPI and TPI Screening are on, but the TPI Analysis Criteria are not met, a TPI report will not be generated.

l ACI-TIPI - If ACI-TIPI is on, this will be the next report produced. If the Risk Management Report is also on and the ACI-TIPI calculated risk is between the low and high risk limits as set up in the Special Applications, then a Risk Management report will be produced.

l Standard ECG (consisting of one of the following):
Patient ID Criteria Off - The XLi will do the Default Adult Report if	3
the patient’s age is specified as over 15. If the patient’s age is 15 years
or under, the Default Pediatric Report will be produced.
Patient ID Criteria On and Patient ID Criteria Loaded - This custom
interpretation report will be generated.
Patient ID Criteria On but Patient ID Criteria Not Loaded - A Null
report will be produced.
Patient ID Criteria On but Patient ID Criteria Not Entered by the
User - The XLi will do the Default Adult Report if the patient’s age is
specified as over 15. If the patient’s age 15 years or under, the Default
Pediatric Report will be produced.

lVectorcardiography - If VCG is on and at least one of the X, Y or Z leads is included as a rhythm lead in the report type, and Research leads is set to off, then the XLi will produce a VCG report.

3-7

Overview

Generating a STAT ECG Report

If your cardiograph has been configured with the Special Applications On, and with TPI and/or TIPI interpretations enabled, you may omit these interpretations by running a "STAT" ECG. A STAT ECG is guaranteed to generate a single standard report (typically 09 Adult Criteria or P4 Pediatric Criteria) without the need for Patient ID information. A STAT ECG is initiated by pressing the AUTO key twice in succession. A STAT report is produced even if "Print Auto = OFF" in the global configuration menu.

3-8	Understanding the PageWriter XLi Special Applications

4 Choosing Report Features

This chapter describes the various ECG reports and how to print the Extended

Measurements report.

ECG Formats

The Auto Report

Twelve-lead Auto reports display a ten second ECG in an Auto 3 x 4, Auto 3 x 5, Auto 4 x 4 or Auto 6 x 2 format. The Auto 3 x 4 format displays consecutive 2.5 second segments of 12 leads, three leads at a time. The Auto 3 x 5 format displays consecutive 2 second segments of 12 leads with the 5th lead column showing the extended pediatric leads, V3R, V4R, and V7. The Auto 4 x 4 format displays consecutive 2.5 second segments of 12 leads with the 4th row consisting of the extended research leads VX1-VX4 or V3R, V4R, V7, and V8. The Auto 6 x 2 format displays consecutive 5 second

segments of 12 leads, six leads at a time. One or three leads can be displayed 4 as rhythm strips at the bottom of Auto 3 x 4 and Auto 3 x 5 reports. The

rhythm strips show the same 10 second segments as in the Auto 3 x 4 or Auto 3 x 5 section of the report. The Auto 4 x 4 report can show 1 rhythm strip.

Auto Report Information

The Auto report may be printed with patient ID information only or with various types of analysis information included. You can select which information appears on the printed report. See Chapter 6, Configuring Your Cardiograph, for information on choosing which features will be printed on the report.

4-1

ECG Formats

Basic Measurements Report. The Basic Measurements report has patient ID information and basic measurements for the ECG. These measurements, which include heart rate, interval and axis measurements, are in the table below with their abbreviations on the report.

Table 4-1 Basic Measurements

Symbol	Description	Units
Rate	heart rate	beats per minute
PR	PR interval	milliseconds
QRSD	QRS duration	milliseconds
QT	QT interval	milliseconds
QTc	QT interval corrected for rate	milliseconds
P	Frontal P axis	degrees
QRS	Frontal mean QRS axis	degrees
T	Frontal T axis	degrees

4-2	Choosing Report Features