Sonosite Mircomaxx User Manual

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MicroMaxx

Ultrasound System

User Guide

MicroMaxx Ultrasound System

User Guide

SonoSite, Inc.

21919 30th Drive SE Bothell, WA 98021 USA T: 1-888-482-9449 or 1-425-951-1200 F: 1-425-951-1201

SonoSite Ltd

Alexander House 40A Wilbury Way Hitchin Herts SG4 0AP UK T: +44-1462-444800 F: +44-1462-444801

Caution:

Federal (United States) law restricts this device to sale by or on the order of a physician.

MicroMaxx, SiteLink, SonoCalc, SonoMB, SonoRES, and SonoSite are registered trademarks or trademarks of SonoSite, Inc.

CompactFlash is a registered trademark of Symbol Technologies.

DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communications of medical information.

Non-SonoSite product names may be trademarks or registered trademarks of their respective owners.

The SonoSite product(s) referenced in this document may be covered by one or more of the following patents: 5722412, 5817024, 5893363, 6135961, 6203498, 6364839, 6371918, 6383139, 6416475, 6447451, 6471651, 6569101, 6648826, 6575908, 6604630, 6817982, 6835177, 6962566, 7169108, D456509, D4618 95, D509900, D538432, D544962, D558351, D559390. Patents pending. Other international patents may also apply.

P06435-07 07/2008

Introduction 1

About the User Guide 1 Intended Uses 1 Conventions 4 Symbols and Terms 4 Upgrades and User Guide Updates 4 Customer Comments 4 Contact Information 5 About the System 6 About the System Software 8

Getting Started 9

Healthy Scanning Guidelines 9 System Preparation 11

Installing or Removing Battery 11 Installing or Removing CompactFlash Card 12 Using AC Power/Charging Battery 13 Turning System On/Off 14

Connecting or Removing Transducer 15 System Controls 16 Screen Layout 19 General Interaction 20

Touchpad 20

On-Screen Menus 21

Menu Controls 21

Annotation and Text 22 Forms 23 System Setup 24

Set Security Settings 25

Audio and Battery 31

Cardiac Calculations 32

Connectivity 33

Date and Time 35

Delta Key and Annotation 36

Display Information 38

IMT Calculations 39

OB Calculations Authors 40

OB Custom Measurements 42

OB Custom Tables 43

Presets 45

System Information 47

Network Status 48

iii

Imaging 49

Patient Information 49

Transducer, Exam Type, and Imaging Mode 52

Transducer Preparation 55

General Use 56 Invasive or Surgical Use 56

Modes 57

2D Imaging 57 M Mode Imaging 61 Color Doppler Imaging 63 Pulsed Wave (PW) and Continuous Wave (CW) Doppler Imaging 65

Clips 68

Clip Acquisition Delay 69

Image and Clip Storage 70

Save to CompactFlash 70 Print to Local Printer 72

Image and Clip Review 72

Patient List 72

Patient Images and Clips 73 Annotations 74 ECG Monitoring 76 Footswitch 77 Bar Code Scanner 78 Needle Guidance 78

Measurements and Calculations 79

Measurements 79

2D Measurements 79

M Mode Measurements 83

Doppler Measurements 85 Calculations 89

Percent Reduction Calculations 90

Volume Calculation 92

Volume Flow Calculation 94

Small Parts Calculations 96

Gyn Calculations 97

OB Calculations 100

Vascular Calculations 108

IMT Calculations 110

Transcranial Doppler Calculations (TCD) 114

Cardiac Calculations 117 Patient Report 135

Connectivity and Configuration 141

System Connectivity Setup 141

System Configuration for SiteLink 141

Configuring SiteLink for Ethernet 142 Configuring SiteLink for Wireless 143

System Configuration for DICOM 147

Creating Backup for DICOM Settings 147 Configuring Locations 148 Configuring Archivers 154 Configuring Printers 157 Configuring Worklist Servers 161 Configuring Procedures 164 Importing and Exporting Configurations 165 Reviewing the Network Log 166

DICOM Usage 167

DICOM Image Archive and Print 169 Patient Information 171 DICOM Worklists 172

Troubleshooting and Maintenance 175

Troubleshooting 175 Software Licensing 177

Upgrading the System and Transducer Software 177 Upgrading Triple Transducer Connect (TTC) 183

Obtaining a License Key 184 Installing a License Key 185 Maintenance 186

Recommended Disinfectant 186 Safety 186 Cleaning and Disinfecting Ultrasound System 187 Cleaning and Disinfecting Transducers 188 Sterilizing Transducers 190 Cleaning and Disinfecting Transducer Cables 190 Cleaning and Disinfecting Battery 192 Cleaning Footswitch 192 Cleaning and Disinfecting ECG Cables 192

References 201

Display Size 201 Caliper Placement 201 2D Measurements 201 Sources of Measurement Errors 203 Acquisition Error 203 Algorithmic Error 203 Terminology and Measurement Publications 203 Cardiac References 204 Obstetrical References 210

Gestational Age Tables 211

Growth Analysis Tables 214

Ratio Calculations 215 General References 216

Specifications 219

System Dimensions 219 Display Dimensions 219 Transducers 219 Imaging Modes 220 Image Storage 220 Accessories 220

Hardware, Software, and Documentation 220

Cables 221 Peripherals 221 Temperature and Humidity Limits 221 Electrical 222 Battery 222 Electromechanical Safety Standards 222 EMC Standards Classification 223 Airborne Equipment Standards 223 DICOM Standard 223 HIPAA Standard 223

Safety 225

Ergonomic Safety 225 Electrical Safety Classification 225 Electrical Safety 226 Equipment Safety 228 Battery Safety 228 Biological Safety 230 Electromagnetic Compatibility (EMC) 230

Manufacturer’s Declaration 232 The ALARA Principle 235

Applying ALARA 235

Direct Controls 236

Indirect Controls 236

Receiver Controls 236 Acoustic Artifacts 236 Guidelines for Reducing MI and TI 237 Output Display 239

Mechanical and Thermal Indices Output Display Accuracy 240

Factors that Contribute to Display Uncertainty 240

Related Guidance Documents 241 Transducer Surface Temperature Rise 242 Acoustic Output Measurement 243

In Situ, Derated, and Water Value Intensities 243

Tissue Models and Equipment Survey 244

About the Acoustic Output Table 245

Acoustic Output Tables 246 Acoustic Measurement Precision and Uncertainty 283

Labeling Symbols 283

Glossary 287

Terms 287 Acronyms 289

vii

viii

Chapter 1: Introduction

Please read the information in this user guide before using the SonoSite® MicroMaxx® ultrasound system. It applies to the ultrasound system and transducers.

About the User Guide

The MicroMaxx Ultrasound System User Guide provides information on preparing and using the ultrasound system, on upgrading the system and transducers, and on cleaning and disinfecting the system and transducers. It also provides references for calculations, system specifications, and additional safety and acoustic output information.

The MicroMaxx Quick Start Cards, located in the back of the user guide, provide an overview of basic system functions.

The user guide is designed for a reader familiar with ultrasound techniques; it does not provide training in sonography or clinical practices. Before using the system, you must have ultrasound training.

See the applicable SonoSite accessory user guide for information on using accessories and peripherals. See the manufacturers’ instructions for specific information about peripherals.

Intended Uses

The intended uses for each exam type are contained here. See the intended transducer for exam type in Table 2, “Transducer, Exam Type, and Imaging Mode” on page 53.

Introduction

Abdominal Imaging Applications

This system transmits ultrasound energy into the abdomen of patients using 2D, M Mode, color Doppler (Color), color power Doppler (CPD), Tissue Harmonic Imaging (THI), and pulsed wave (PW) Doppler to obtain ultrasound images. The liver, kidneys, pancreas, spleen, gallbladder, bile ducts, transplanted organs, abdominal vessels, and surrounding anatomical structures can be assessed for the presence or absence of pathology transabdominally.

Cardiac Imaging Applications

This system transmits ultrasound energy into the thorax of patients using 2D, M Mode, color Doppler (Color), Tissue Harmonic Imaging (THI), pulsed wave (PW) Doppler, pulsed wave tissue Doppler (TDI PW), and continuous wave (CW) Doppler to obtain ultrasound images. The heart, cardiac valves, great vessels, surrounding anatomical structures, overall cardiac performance, and heart size can be assessed for the presence or absence of pathology.

The patient’s electrocardiogram (ECG) may be obtained and is used for timing of diastolic and systolic function.

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The ECG is not used to diagnose cardiac arrhythmias and is not designed for long term cardiac rhythm monitoring.

Chapter 1: Introduction 1

Gynecology and Infertility Imaging Applications

This system transmits ultrasound energy in the pelvis and lower abdomen using 2D, M Mode, color power Doppler (CPD), color Doppler (Color), Tissue Harmonic Imaging (THI), and pulsed wave (PW) Doppler to obtain ultrasound images. The uterus, ovaries, adnexa, and surrounding anatomical structures can be assessed for the presence or absence of pathology transabdominally or transvaginally.

Interventional and Intraoperative Imaging Applications

This system transmits ultrasound energy into the various parts of the body using 2D, color Doppler (Color), color power Doppler (CPD), Tissue Harmonic Imaging (THI), and pulsed wave (PW) Doppler to obtain ultrasound images that provide guidance during interventional and intraoperative procedures. This system can be used to provide ultrasound guidance for biopsy and drainage procedures, vascular line placement, peripheral nerve blocks, spinal nerve blocks and taps, ova harvesting, amniocentesis and other obstetrical procedures, and provide assistance during abdominal, breast, neurological surgery, and vascular intraoperative procedures.

Obstetrical Imaging Applications

This system transmits ultrasound energy into the pelvis of pregnant women using 2D, M Mode, color Doppler (Color), color power Doppler (CPD), Tissue Harmonic Imaging (THI), and pulsed wave (PW) Doppler to obtain ultrasound images. The fetal anatomy, viability, estimated fetal weight, gestational age, amniotic fluid, and surrounding anatomical structures can be assessed for the presence or absence of pathology transabdominally or transvaginally. CPD and color Doppler (Color) imaging is intended for high-risk pregnant women. High-risk pregnancy indications include, but are not limited to, multiple pregnancy, fetal hydrops, placental abnormalities, as well as maternal hypertension, diabetes, and lupus.

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2 Chapter 1: Introduction

To prevent injury or misdiagnosis do not use this system for Percutaneous Umbilical Blood Sampling (PUBS) or in vitro Fertilization (IVF) The system has not been validated to be proven effective for these two uses.

CPD or Color images can be used as an adjunctive method, not as a screening tool, for the detection of structural anomalies of the fetal heart and as an adjunctive method, not as a screening tool for the diagnosis of Intrauterine Growth Retardation (IUGR).

Pediatric Imaging Applications

This system transmits ultrasound energy into the pediatric patients using 2D, M Mode, color Doppler (Color), color power Doppler (CPD), pulsed wave (PW) Doppler, pulsed wave tissue Doppler (TDI PW), and continuous wave (CW) Doppler to obtain ultrasound images. The pediatric abdominal, pelvic and cardiac anatomy, pediatric hips, neonatal head, and surrounding anatomical structures can be assessed for the presence or absence of pathology.

Prostate Imaging Applications

This system transmits ultrasound energy into the prostate of an adult male using 2D, M Mode, color power Doppler (CPD), color Doppler (Color), and pulsed wave (PW) Doppler to obtain ultrasound images. The prostate gland can be assessed for the presence or absence of pathology.

Superficial Imaging Applications

This system transmits ultrasound energy into various parts of the body using 2D, M Mode, color Doppler (Color), color power Doppler (CPD), and pulsed wave (PW) Doppler to obtain ultrasound images. The breast, thyroid, testicle, lymph nodes, hernias, musculoskeletal structures, soft tissue structures, and surrounding anatomical structures can be assessed for the presence or absence of pathology. This system can be used to provide ultrasound guidance for biopsy and drainage procedures, vascular line placement, peripheral nerve blocks, and spinal nerve blocks and taps.

Transcranial Imaging Applications

This system transmits ultrasound energy into the cranium using 2D, color Doppler (Color), color power Doppler (CPD), and pulsed wave (PW) Doppler to obtain ultrasound images. The anatomical structures and vascular anatomy of the brain can be assessed for presence or absence of pathology. Two exam types support transcranial imaging: TCD and Orb. Imaging can be used temporally, trans-occipitally, or trans-orbitally.

Introduction

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To avoid injury to the patient, use only an orbital exam type (Orb) when performing imaging through the eye. The FDA has established lower acoustic energy limits for opthalmic use. The system will not exceed these limits only if the Orb exam type is selected.

Vascular Imaging Applications

This system transmits ultrasound energy into the various parts of the body using 2D, M Mode, color Doppler (Color), color power Doppler (CPD), and pulsed wave (PW) Doppler to obtain ultrasound images. The carotid arteries, deep veins, and arteries in the arms and legs, superficial veins in the arms and legs, great vessels in the abdomen, and various small vessels feeding organs can be assessed for the presence or absence of pathology.

Chapter 1: Introduction 3

Conventions

These conventions are used in this user guide:

•A WAR NIN G describes precautions necessary to prevent injury or loss of life.

•A Caution describes precautions necessary to protect the products.

• Numbered steps in the procedures must be performed in a specific order.

• Bulleted lists present information in list format but do not imply a sequence.

• The system handle is on the front of th e system , and the battery c ompar tment is on t he back of th e

system.

Symbols and Terms

Symbols and terms used on the system and transducer are explained in Chapter 2, “Getting Started”;

Chapter 5, “Connectivity and Configuration”; “Glossary” on page 287; and Chapter 9, “Safety.”

Upgrades and User Guide Updates

SonoSite may offer software upgrades, new features, and improvements to the system performance. User guide updates accompany the upgrade software and provide detailed information on the enhancements.

Customer Comments

Questions and comments are encouraged. SonoSite is interested in your feedback regarding the system and the user guide. Please call SonoSite at 1-888-482-9449. If you are outside the USA, call the nearest SonoSite representative. You can also e-mail SonoSite at comments@sonosite.com.

4 Chapter 1: Introduction

Contact Information

For SonoSite technical support, contact us at the following numbers or addresses:

Technical Support (USA, Canada): 1-877-657-8118

Technical Support fax: 1-425-951-6700

Technical Support e-mail: service@sonosite.com

SonoSite website: www.sonosite.com and select Support

International Technical Support: Contact your local representative or call

Europe Service Center: +44-(0)1462-444-800

Introduction

(USA) +425-951-1330

e-mail: uk.service@sonosite.com

Chapter 1: Introduction 5

About the System

The ultrasound system is a portable, software-controlled, ultrasound system using all-digital architecture. The system has multiple configurations and feature sets used to acquire and display high-resolution, real-time ultrasound images. All are described in this user guide but not every option may apply to your system. Features are dependent on system configuration, transducer, and exam type.

Figure 1 System Front View

Table 1: System Front Features

Number Feature

1 Control panel

2Handle

3Display

4 CompactFlash® slots: front for image storage, back for system and transducer

updates, import/export OB tables, custom annotations, and user names/passwords, and Digital Imaging and Communications in Medicine (DICOM®) configurations

6 Chapter 1: Introduction

Figure 2 System Back View

23 4

Table 2: System Back Connectors

Number Feature

1 DC input connector

2 I/O connector

3Battery

4ECG connector

Introduction

Currently, the system supports the following transducers:

• C11e/8-5 MHz

• C60e/5-2 MHz

•D2/2 MHz

• HFL38/13-6 MHz

•ICT/8-5 MHz

•LAP/12-5 MHz

• L25e /13-6 MHz

•L38e/10-5 MHz

•P10/8-4 MHz

•P17/5-1 MHz

•SLA/13-6 MHz

•SLT/10-5 MHz

• TEE/8-3 MHz

Chapter 1: Introduction 7

The ultrasound system may include one or more of the following docking systems:

• Mobile Docking System enhanced (MDSe)

• Mobile Docking System (MDS)

•MDS Lite See the applicable SonoSite accessory user guide. See Chapter 8, “Specifications” for a complete list of all system accessories.

System peripherals include medical grade (conforming to the requirements of EN60601-1) and non-medical (commercial) grade products. See Chapter 8, “Specifications” for a complete list of compatible peripherals. System setup instructions for the use of peripherals are covered in “System

Setup” on page 24.

Manufacturer’s instructions accompany each peripheral. Instructions for the use of accessories and peripherals with the system are covered in the applicable SonoSite accessory user guide.

About the System Software

The ultrasound system contains software that controls its operation. A software upgrade may be required. SonoSite provides you with a CompactFlash card containing the software. Typically new software provides new capabilities. A single CompactFlash card can be used to update one or more systems. Software upgrades use the back CompactFlash slot on the right hand side of the system. CompactFlash cards installed in the front CompactFlash slot do not upgrade the system.

8 Chapter 1: Introduction

Chapter 2: Getting Started

This chapter contains information on healthy scanning practices, basic operation, and changing system settings.

Healthy Scanning Guidelines

These guidelines are intended to assist you in the comfort and effective use of your ultrasound system.

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Use of an ultrasound system may be linked to musculoskeletal disorders

Use of an ultrasound system is defined as the physical interaction between the operator, the ultrasound system, and the transducer.

When using an ultrasound system, as with many similar physical activities, you may experience occasional discomfort in your hands, fingers, arms, shoulders, eyes, back, or other parts of your body. However, if you experience symptoms such as constant or recurring discomfort, pain, throbbing, aching, tingling, numbness, burning sensation, or stiffness, do not ignore these warning signs. Promptly see a qualified health professional. Symptoms such as these can be linked with musculoskeletal disorders (MSDs). MSDs can be painful and may result in potentially disabling injuries to the nerves, muscles, tendons, or other parts of the body. Examples of MSDs include carpal tunnel syndrome and tendonitis.

While researchers are not able to definitively answer many questions about MSDs, there is a general agreement that certain factors are associated with their occurrence including: preexisting medical and physical conditions, overall health, equipment and body position while doing work, frequency of work, duration of work, and other physical activities that may facilitate the onset of MSDs chapter provides guidelines that may help you work more comfortably and may reduce your risk of MSDs

Getting Started

a,b,c

. This

e,f

a. Magnavita, N., L. Bevilacqua, P. Mirk, A. Fileni, and N. Castellino. “Work-related Musculoskeletal Complaints in

Sonologists.” Occupational Environmental Medicine. 41:11 (1999), 981-988.

b. Craig, M. “Sonography: An Occupational Hazard?” Journal of Diagnostic Medical Sonography. 3 (1985),

121-125.

c. Smith, C.S., G.W. Wolf, G. Y. Xie, and M. D. Smith. “Musculoskeletal Pain in Cardiac Ultrasonographers: Results

of a Random Survey.” Journal of American Society of Echocardiography. (May1997), 357-362.

d. Wihlidal, L.M. and S. Kumar. “An Injury Profile of Practicing Diagnostic Medical Sonographers in Alberta.”

International Journal of Industrial Ergonomics. 19 (1997), 205-216.

e. Habes, D.J. and S. Baron. “Health Hazard Report 99-0093-2749.” University of Medicine and Dentistry of New

Jersey. (1999).

f. Vanderpool, H.E., E.A. Friis, B.S. Smith, and K.L. Harms. “Prevalence of Carpal Tunnel Syndrome and Other

Work-related Musculoskeletal Problems in Cardiac Sonographers.” Journal of Medicine. 35:6 (1993), 605-610.

Chapter 2: Getting Started 9

Position the System

Promote comfortable shoulder, arm, and hand postures:

• Use a stand to support the weight of the ultrasound system. Minimize eye strain:

• When the exam/procedure allows, position the system within reach.

• Adjust the angle of the system/display to minimize glare from overhead or outside lighting. Minimize neck strain:

• If using a stand, adjust the stand height such that the display is at or slightly below eye level.

Position Yourself

Support your back during an exam:

• Use a chair that has support for your lower back.

• Use a chair that adjusts to your work surface height and promotes a natural body posture.

• Use a chair that allows for quick height adjustments.

• Always sit or stand in an upright manner. Avoid bending or stooping. Minimize reaching and twisting:

• Use a bed that is height adjustable.

• Position the patient as close to you as possible.

• Face forward. Avoid twisting your head or body.

• Move your entire body front to back and position your scanning arm next to or slightly in front of

you.

• Stand for difficult exams to minimize reaching. Promote comfortable shoulder and arm postures for your scanning arm:

• Keep your elbow close to your side.

• Relax your shoulders in a level position.

• Support your arm using a support cushion or pillow, or rest it on the bed. Minimize neck bending and twisting:

• Position the ultrasound system/display directly in front of you.

• Provide an auxiliary monitor for patient viewing. Promote comfortable hand, wrist, and finger postures for your scanning arm:

• Hold the transducer lightly in your fingers.

• Minimize the pressure applied on the patient.

• Keep your wrist in a straight position.

10 Chapter 2: Getting Started

Take Breaks

Locking levers

Minimizing scanning time and taking breaks can be very effective in allowing your body to recover from physical activity, which can help you avoid any MSDs. Some ultrasound tasks may require longer or more frequent breaks. One way of taking a break is to stop and relax. However, simply changing tasks can help some muscle groups relax while others remain or become active.

Vary your daily activities:

• Plan your work so there are breaks in between ultrasound exams.

• Work efficiently when performing an ultrasound exam by using the software and hardware features correctly. Learn more about these features in Chapter 3 of this guide.

• Keep moving. Avoid sustaining the same posture by varying your head, neck, body, arm, and leg positions.

Exercise

Targeted exercises can strengthen muscle groups, which may help you avoid MSDs. Contact a qualified health professional to determine stretches and exercises that are right for you.

System Preparation

Installing or Removing Battery

The battery comprises six lithium-ion cells plus electronics, a temperature sensor, and battery contacts.

Getting Started

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Figure 1 Insert Battery into System

To avoid injury to the operator and to prevent damage to the ultrasound system, inspect the battery for leaks prior to installing.

To avoid data loss and conduct a safe system shutdown, always keep a battery in the system.

Chapter 2: Getting Started 11

Install Battery 1 Disconnect the power supply from the ultrasound system.

2 Turn the system upside down. 3 Place the battery into the battery compartment, at a slight angle. See Figure 1

on page 11. 4 Slide the battery forward until it locks into place. 5 Push down on the two locking levers to secure the battery.

Remove Battery

1 Push up on the two locking levers. 2 Slide the battery back. 3 Lift the battery from the compartment.

Installing or Removing CompactFlash Card

Images and clips are saved to a CompactFlash card and are organized in a patient list. The images and clips in the patient list are organized alphabetically by the patient name and ID. Images and clips are archived from the ultrasound system to a PC using a USB, Ethernet connection, wireless, or CompactFlash card. Images and clips on the CompactFlash card cannot be viewed directly from a CompactFlash reader.

Install CompactFlash Card

Caution:

1 Verify the ejector pin is pushed in completely. 2 Insert the CompactFlash card into the front slot on the ultrasound system. See

Figure 1 on page 6.

• The front slot is used to store images.

• The back slot is used to update systems/transducers and to import/export DICOM configuration information, OB Tables, and annotation labels.

• The CompactFlash card is ready to use when the save icon and the image and clip counters are displayed on the screen.

If the CompactFlash icon and image and clip counters are not displayed in the system status, the CompactFlash card may be defective. Turn the system off and replace the CompactFlash card. The CompactFlash card may be restored if it is formatted on a PC. Formatting the card erases all data. If the card is physically damaged, formatting will not restore it.

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12 Chapter 2: Getting Started

To prevent loss of data, (for example, images/clips), or damage to the CompactFlash card, always turn off the ultrasound system before removing the CompactFlash card.

Remove CompactFlash Card

1 Turn off the ultrasound system before removing the card. 2 Press the ejector pin in the front card slot to position it to the outside of the

system. See Figure 1 on page 6. 3 Push in the ejector pin to eject the CompactFlash card. 4 Remove the card. 5 Push in the ejector pin to avoid damaging the ejector pin.

Using AC Power/Charging Battery

The battery charges when the system is connected to the AC power supply.

• If the system is off or in the sleep state (display off), a completely discharged battery fully charges in 2.5 to 3.5 hours.

• If the system is on and in the freeze state, a completely discharged battery fully charges in 5 to 6 hours.

• If the system is in the imaging state, the battery is trickle charged at a very low rate and may take over 24 hours to charge.

• To minimize recharging time, turn off the system.

Getting Started

Chapter 2: Getting Started 13

The system can run on AC power and charge the battery in two ways.

• Connected directly to the system

• Connected to a mini-dock/docking system (See the Mini-Dock User Guide, MDS User Guide, MDSe User Guide, or MDS Lite User Guide.)

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Caution:

Operate System Using AC power

The equipment shall be connected to a center-tapped single phase supply circuit when users in the United States connect the equipment to a 240V supply system.

Verify that the hospital supply voltage corresponds to the power supply voltage range. See “Electrical” on page 222.

1 Connect the DC power cable from the power supply to the connector on the

system. See Figure 2 on page 7.

2 Connect the AC power cord to the power supply and connect to a

hospital-grade electrical outlet.

Turning System On/Off

Caution:

Turn System On/Off

Do not use the system if an error message appears on the display. Note the error code and turn off the system. Call SonoSite or your local representative.

1Locate the Power key on the top left side of the system. See Figure 3 on

page 16.

2 Press the Power key once to turn on and once to turn off.

Wake Up System

14 Chapter 2: Getting Started

To conserve battery life, the system is configured to go into sleep mode. The system goes into sleep mode when the lid is closed or if the system has not been touched for a preset amount of time. Press any key, touch the touchpad, or open the lid to wake up the system. To adjust the time for sleep delay, see “Audio and B attery ” on page 31.

Connecting or Removing Transducer

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Caution:

Figure 2 Connect the Transducer

Connect Transducer to System

To avoid injury to the patient, do not place the connector on the patient. Operate the ultrasound system in a docking system or on a flat hard surface to allow air flow past the connector.

To avoid damaging the transducer connector, do not allow foreign material in the connector.

1 Turn the system upside down (if not in docking system). 2 Pull the transducer latch up and rotate it clockwise. 3 Align the transducer connector with the connector on the bottom of the

system. 4 Insert the transducer connector into the system connector. 5 Turn the latch counterclockwise. 6 Press the latch down, securing the transducer connector to the system.

Getting Started

Remove Transducer

1 Pull the latch up and rotate it clockwise. 2 Pull the transducer connector away from the system.

Chapter 2: Getting Started 15

System Controls

Update

M Mode

Doppler

Color

Zoom

THI

Depth

Record

Enter

Delete

PictoText

Shift

Caps

Tab

Freeze

Caliper

Calcs

Save

3 4

8 9 11 12 13

18 19

Figure 3 System Controls

Table 1: System Controls

Number

1 Power Turns system on and off.

2 Alphanumeric Use to enter text and numbers.

16 Chapter 2: Getting Started

4 THI Turns Tissue Harmonic Imaging on and off.

System Control

Description

Annotation

Text Turns the keyboard on and off for text entry.

Picto Turns the pictographs/pictograph marker on and off.

Arrow Displays an arrow that can be moved and rotated within the

image area.

Table 1: System Controls (Continued)

Number

System Control

Depth

Description

Depth Up Decreases imaging depth.

Depth Down Increases imaging depth.

6 Zoom Magnifies image 2x.

Gain

Adjusts the gain applied to the near field of the image.

Near

Adjusts the gain applied to the far field of the image.

Far

Adjusts the overall gain applied to the entire image.

Gain

Note: Some keyboards may have the words instead of symbols.

8AC power

indicator

9Caliper

Calcs

A steady green light indicates AC power is connected. A flashing green light indicates the system is in sleep mode.

Activates a measurement caliper on the screen. Turns the calculation menu on and off.

Getting Started

10 Touchpad Use to select, adjust, and move objects on the screen.

11 Select Use to switch between frozen images in duplex and dual screens,

color and Doppler menus, calipers for measurement (Calipers), pictograph marker position/angle (Picto), and arrow position/ orientation (Arrow).

12 Print Prints the active image to the printer.

13 Save Saves an image to the CompactFlash card and saves

measurements/calculation to the report when configured in system setup.

14 Menu controls Controls features on the on-screen menu which are adjusted

based on the system state.

Chapter 2: Getting Started 17

Table 1: System Controls (Continued)

Number

System Control

Forms

Description

Setup Access to the system settings.

Report Access to the patient report and EMED worksheets.

Review Access to the patient list and saved patient images, and archive

functions.

Patient Access to patient information.

16 (Delta key) Use as a shortcut to existing functionality in the system.

17 Save Clip Saves a clip to the CompactFlash card.

Record Turns DVD/VCR record on and off.

18 Freeze Stops the live imaging and displays a frozen image.

Cine (back/ forward)

Review images stored in the cine buffer; back/forward through last-in, first-out sequence. All mode images can be stored and reviewed in the cine buffer.

19 Update Toggles between dual and duplex screens and image modes in

M Mode and Doppler, for example, between D-line and Doppler spectral trace.

Modes

M Mode Turns M Mode on and toggles between M-line and M Mode trace.

Doppler Turns Doppler on and toggles between D-line and Doppler trace.

Color Turns CPD/Color on and off.

2D Turns 2D on.

18 Chapter 2: Getting Started

Screen Layout

Figure 4 Screen Layout

Table 2: Screen Layout

Getting Started

Number Item Description

1 Mode Data Displays current imaging mode information, for example, Gen,

Res, THI, and PW.

2Orientation

Marker

Provides indication for image orientation. In dual and duplex images, the orientation marker is green on the active screen.

3 Text Displays text entered using keyboard.

4 Picto Displays pictograph to indicate anatomy and transducer

position. Opens pictograph on-screen menu allowing anatomy and screen location selection.

5 Calcs Menu Displays available calculations.

6 Image Displays ultrasound image.

7Measurement

Displays current measurement and calculation data.

and Calcs Data

8 On-screen Menu Access to controls for each system state.

Chapter 2: Getting Started 19

Table 2: Screen Layout (Continued)

Number Item Description

9 Patient Header Displays current patient name, ID number, institution, user, and

10 System Status Displays information related to system status, for example, exam

11 Depth Marker Displays marks in .5 cm, 1 cm, and 5 cm increments depending

General Interaction

To uc h pa d

The touchpad is used to select, adjust, and move objects on the screen. For example, it controls the caliper position, CPD/Color box position and size, floating cursor, and more. The arrow keys control much of the same functionality as the touchpad.

date/time.

type, transducer, AC connected, battery charging, and CompactFlash card.

on the depth.

20 Chapter 2: Getting Started

On-Screen Menus

The on-screen menus, located at the bottom of the screen, provide controls that can be adjusted based on the system state. For example, in 2D, the following options may be available:

Table 3: On-Screen Menus

Icon Description Values Types

Gen Controls 2D image optimization Res, Gen, Pen Cycle

Dynamic Range

Dual Displays side-by-side images On-Off

U/L D/L D/R U/R

Brightness Controls display brightness 1-10 Up-Down

Menu Controls

The menu controls consist of six sets of 2-button groups at the top of the control panel. They adjust the values of each control displayed in the on-screen menu. The buttons function in one of four ways, depending on context.

Table 4: Menu Control Options

Control Description

Cycle Moves through a list of values, then begins again when the bottom or

Adjusts the image by varying the range of displayed grays.

Flips the image up/left Flips the image down/left Flips the image down/right Flips the image up/right

top of the list is reached.

Getting Started

(+3)–(-3) Up-Down

Cycle

Up-Down Stops at the top and bottom of a value list, not allowing user to go from

the first to last or last to first value in one button press.

On-Off Turns available features on or off depending on their current state.

Action Performs some action related to an object on the screen.

Chapter 2: Getting Started 21

Annotation and Text

5 6 8 9

Keyboard Controls

Figure 5 Keyboard Controls

Table 5: Keyboard Controls

Number Key Description

1 Tab Moves cursor among fields in the forms and tabs between text

2 Caps Locks keyboard in caps mode.

3 Shift Allows entry of capitalized characters and international characters.

position in dual screens.

4 Text Turns the keyboard on and off for text entry.

5 Picto Turns pictographs on and off.

6 Arrow Displays an arrow that can be moved and rotated within the image

area.

7 Spacebar Turns the keyboard on for text entry or adds a space with access to

additional on-screen menus (symbols, delete line and done.)

8 Delete Removes all text from the screen during text entry and when in

non-measurement modes.

9 Arrow keys Moves highlighted selection in calculations menus, moves cursor

one space when entering text, moves caliper position, and moves among pages in image review and reports.

10 Backspace Removes one character to the left of the cursor in text entry mode.

11 Enter Moves cursor among fields in forms and saves calculations to

report.

22 Chapter 2: Getting Started

Symbols

Note: Not all of the symbols/special characters are available in fields and forms.

Symbols/special characters can be entered in selected fields and forms:

• Patient Information: Last, First, Middle, ID, Accession, Indications, Procedure ID, User, Reading Dr., Referring Dr., and Institution.

• Connectivity (DICOM and SiteLink) Configure: Alias, AE Title.

• Delta Key, Annotations: Text.

• Text mode (Imaging): Annotation field.

Figure 6 Symbols/Special Characters

Getting Started

Forms

Enter Symbol/ Special Character

A floating cursor is available in the setup, patient, and report forms. The floating cursor allows interaction through the touchpad and the Select key. For example, in the patient form, placing the floating cursor over the last name field and pressing the Select key activates that field. Additionally, the floating cursor can be used to interact with the list and check boxes.

1 Select the desired field and then select Symbols. 2 Click the desired symbol/character.

In the Symbols dialog box, the keyboard controls may also be used.

3Click OK.

Chapter 2: Getting Started 23

System Setup

System setup is used to customize the system. Press the Setup key to access and set up the following system functions:

Administration Configure system to protect patient data by requiring users to log on

Audio, Battery Configure for type of Key click, Audio alert, Sleep delay, and Power

Cardiac Calculations Customize predefined labels to display in Tissue Doppler Imaging

Connectivity Configure Printer, Video Mode, Serial Port, CF Capacity Alert, and

Date and Time Configure Date and Time functions.

Delta Key, Annotations Configure existing system functionality as a shortcut, customize

Display Information Configure information displayed on image: Patient Header, Mode

and enter passwords.

delay.

(TDI) calculation menu and on report page.

Transfer Mode: DICOM or SiteLink setup (DICOM and SiteLink are optional features).

predefined labels, and set preference for managing text when unfreezing images.

Data, and System Status.

IMT calculations Customize predefined labels to display in the IMT calculation menu

and on the report page.

OB Calculations Select OB calculation table authors and import/export additional OB

tables.

OB Custom Measurements

Presets Configure Preset functions: Doppler Scale, Duplex, Live Trace,

System Information Displays system hardware and software versions, and license

Network Status Displays system IP address, Location, WLAN Profile, Active WLAN

Customize system for user-defined measurements to display in the OB calculations menu and on the report page (OB Custom Measurements are an optional feature).

Thermal Index, Save Key, Dynamic Range, Units, and Footswitch settings.

information.

SSID, Ethernet MAC address, and Wireless MAC address.

24 Chapter 2: Getting Started

Set Security Settings

Security Setup

WAR NIN G:

SonoSite provides a comprehensive set of tools on the system that allows its customers to meet the applicable security requirements listed in the HIPAA standard. SonoSite's customers are ultimately responsible for ensuring the security and protection of all electronic protected health information collected, stored, reviewed, and transmitted on the system.

Health care providers who maintain or transmit health information are required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the European Union Data Protection Directive (95/46/EC) to implement appropriate procedures: to ensure the integrity and confidentiality of information; to protect against any reasonably anticipated threats or hazards to the security or integrity of the information or unauthorized uses or disclosures of the information.

Getting Started

Figure 7 Setup: Administration and Administrator Information

Administrator Login 1 Press the Setup key.

2 Select Administration. 3In Administrator Login, type Administrator in the Name field. 4 Call SonoSite for the password: 1-877-657-8118 (USA and Canada

only).

5 Select Login.

Chapter 2: Getting Started 25

Change Administrator Password

1In User Information, enter your new password in the Password

field.

2 Enter the password again in the Confirm field.

To ensure passwords are secure, it is recommended that passwords contain characters from the following categories:

• Upper case characters: A-Z

• Lower case characters: a-z

• Numbers: 0-9 The password is case-sensitive.

3In Password changes, click on the check box to allow users access

to change their password or leave unchecked to restrict access. (Optional)

4 Select Save.

User Login Setting 1In the User Login list, select On or Off.

• Selecting On restricts access to the system and requires the user to enter a user name and password.

• Selecting Off allows access to the system and does not require the user to enter a user name and password.

2After making changes in the Administration setup, reboot the

system to log off as administrator.

26 Chapter 2: Getting Started

User Setup

Figure 8 Setup: User List Information

Add New User 1 Select New.

Getting Started

2In User Information, enter information in Name, Password, and

Confirm fields.

To ensure passwords are secure, it is recommended that passwords contain characters from the following categories:

• Upper case characters: A-Z

• Lower case characters: a-z

• Numbers: 0-9 The name and password are case-sensitive.

3In Sonographer, enter the user’s initials to display the information

in the patient header and the sonographer field in the Patient Information form. (Optional)

4In Administration Access, click the check box to allow users access

to all administration privileges or leave unchecked to restrict access. (Optional)

5 Select Save.

Modify User Information 1In the User List, select desired user name.

2 Enter the new name. 3 Enter the new password and confirm. 4 Select Save.

Any change to the user name replaces the old name.

Delete User 1In the User List, select the desired user name.

2 Select Delete.

A dialog box is displayed.

3 Select Ye s to delete or No to cancel.

Chapter 2: Getting Started 27

Change User Password 1In the User List, select the desired user name.

Done Select Done from the on-screen menu to return to live imaging.

Export or Import User Accounts

Note: Export and import are used to configure multiple systems and to back up user account information.

Export User Account 1 Insert the CompactFlash card in the back slot of the system. See

Import User Account 1 Insert the CompactFlash card in the back slot of the system. See

2 Enter the new password and confirm. 3 Select Save.

“Installing or Removing CompactFlash Card” on page 12.

2 Press the Setup key. 3 Select Administration. 4 Select Export from the on-screen menu.

All user names and passwords are copied to the CompactFlash

card. 5 Remove the CompactFlash card.

“Installing or Removing CompactFlash Card” on page 12.

2 Press the Setup key. 3 Select Administration. 4 Select Import from the on-screen menu.

• A dialog box is displayed.

• After all user names and passwords are imported, the system restarts.

• All user names and passwords currently on the system are replaced with the imported data.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

28 Chapter 2: Getting Started

Export and Clear Event Log

The Event Log collects errors and events and can be exported to a CompactFlash card and read by a CompactFlash reader.

Figure 9 Event Log

View Event Log 1 Press the Setup key.

Getting Started

2 Select Administration. 3 Select Log from the on-screen menu.

The Event Log is displayed.

4 Select Back to return to the previous menu.

Export Event Log Note: The Event log and the DICOM network log have the same filename

(log.txt). When you export either one to the same CompactFlash card, it will overwrite the existing log.txt file.

1 Insert the CompactFlash card in the back slot of the system. 2 Select Log and then Export from the on-screen menu. 3 View the files on a CompactFlash reader.

The log is a text file that can be opened by a text file application, for example, Microsoft Word or Notepad. The log file is named log.txt.

Clear Event Log 1 Select Clear from the on-screen menu.

2 Select Ye s to delete or No to cancel.

Chapter 2: Getting Started 29

Figure 10 User Login and Change Password

Note: User Login is displayed when system access is turned on.

User Login In User Login, enter Name and Password and select OK.

Guest Login In User Login, select Guest.

In Guest mode the user is able to scan but is restricted from accessing system setup and patient information.

Change Password

1In User Login, select Password. 2 Enter your old password, new password, confirm the new password and then

select OK. To ensure passwords are secure, it is recommended that passwords contain

characters from the following categories:

• Upper case characters: A-Z

• Lower case characters: a-z

• Numbers: 0-9 The password is case-sensitive.

30 Chapter 2: Getting Started

Audio and Battery

Figure 11 Setup: Audio, Battery

Key Click 1 Press the Setup key.

Beep Alert 1 Press the Setup key.

Getting Started

2 Select Audio, Battery. 3In the Key click list, select On or Off.

2 Select Audio, Battery. 3In the Beep alert list, select On or Off.

Sleep Delay 1 Press the Setup key.

2 Select Audio, Battery. 3In the Sleep delay list, select Off, 5, or 10 minutes.

Power Delay 1 Press the Setup key.

2 Select Audio, Battery. 3In the Power delay list, select Off, 15, or 30 minutes.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

Chapter 2: Getting Started 31

Cardiac Calculations

Figure 12 Setup: Cardiac Calculations

Set Cardiac Calculations 1 Press the Setup key.

2 Select Cardiac Calculations. 3In the TDI Walls lists, select the desired labels for each of the walls.

The labels selected are displayed in the TDI calculation menu and on the report.

4 Select Done from the on-screen menu.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

32 Chapter 2: Getting Started

Connectivity

Figure 13 Setup: Connectivity, DICOM and SiteLink

Printer 1 Press the Setup key.

Video Mode 1 Press the Setup key.

Getting Started

2 Select Connectivity. 3In the Printer list, select the desired printer from the list of

recommended printers.

2 Select Connectivity. 3In the Video Mode list, select NTSC or PA L for the desired

mini-dock video output.

Serial Port 1 Press the Setup key.

2 Select Connectivity. 3In the Serial Port list, select the desired peripheral: VCR, DVD,

Computer (PC), or Bar Code Scanner.

Note: Because these peripherals use the same RS-232 connector on the mini-dock, you can connect only one of these peripherals at a time.

4 Restart the system to activate connectivity to the new peripheral. 5 Attach a serial cable (RS-232) to the serial port from the mini-dock

or docking system to the desired peripheral.

• If PC is selected, the system allows report data to be sent as ASCII text from the system to a PC.

• Special third party software must be on the PC to acquire, view, or format the data into a report.

• Check the compatibility of your software with SonoSite Technical Support.

Chapter 2: Getting Started 33

Transfer Mode 1 Press the Setup key.

2 Select Connectivity. 3In the Transfer Mode list, select DICOM or SiteLink. 4 Select DICOM Setup or SiteLink Setup as appropriate.

• If the transfer mode is changed, a dialog box is displayed to restart the system.

• For more information on setting up DICOM or SiteLink, see

Chapter 5, “Connectivity and Configuration”.

• The settings for SiteLink Image Manager and system configurations must correspond. See the SiteLink Image Manager User Guide.

Location 1 Press the Setup key.

2 Select Connectivity. 3In the Locations list, select the desired DICOM or SiteLink location.

• If the Location is changed, a dialog box is displayed to restart the system.

•See Chapter 5, “Connectivity and Configuration” for configuring locations in DICOM or SiteLink.

CF Capacity Alert 1 Press the Setup key.

2 Select Connectivity. 3 Select CF Capacity Alert.

When CF Capacity Alert is selected, the system alerts the user if the Compact Flash card is near capacity at End Exam then deletes archived patient exams if desired.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

34 Chapter 2: Getting Started

Date and Time

Figure 14 Setup: Date and Time

Getting Started

WAR NIN G:

Date 1 Press the Setup key.

Time 1 Press the Setup key.

Reset Select Reset from the on-screen menu to return settings for this setup

An accurate date and time are critical for accurate obstetrics calculations. Verify that the date and time are accurate before each use of the system. The system does not automatically adjust for daylight savings time changes.

2 Select Date and Time. 3In the Date field, enter the current date (year, month, and day).

2 Select Date and Time. 3In the Time field, enter the current time in 24 hour format (hours

and minutes).

page to factory default.

Chapter 2: Getting Started 35

Delta Key and Annotation

Figure 15 Setup: Delta Key, Annotations

Delta Key 1 Press the Setup key.

Annotations 1 Press the Setup key.

2 Select Delta Key, Annotations. 3In the Delta Key list, select desired functionality for the Delta key.

The Delta key now controls this function.

2 Select Delta Key, Annotations. 3In the Exam list, select the desired exam type. 4 Select the Group A, B, or C for the predefined labels you want

associated with that exam. The preset labels show for the selected group.

5 Add a label to a group by selecting the group then entering the

label name in the Te xt field and selecting Add.

6 Rename an existing label by highlighting it, typing the new name

in the Tex t field, and selecting Rename.

7 Move a label within a group by highlighting it and selecting the up

or down arrow.

8 Delete a label from a group by highlighting it and selecting Delete.

Symbols can be used when naming labels. For more information on using symbols, see “Symbols” on page 23.

36 Chapter 2: Getting Started

Unfreeze Preset options for saving text when an image is unfrozen or when

image layout changes. 1 Press the Setup key.

1 Select Delta Key, Annotations. 2In the Unfreeze list, select the desired text state: Keep All Text,

Keep Home Text, or Clear All Text.

• Home text runs to the right of the home cursor position. For more information on setting the home cursor position, see

“Home/Set” on page 74.

• The default is Keep All Text.

Import Imports and replaces all predefined label groups for all exams with

those from the CF card.

Export Saves and exports all predefined label groups for all exams to the CF

card.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

Getting Started

Chapter 2: Getting Started 37

Display Information

Figure 16 Setup: Display Information

Patient Header 1 Press the Setup key.

Mode Data 1 Press the Setup key.

2 Select Display Information. 3 Select the desired check boxes to display information in the patient

header.

2 Select Display Information. 3 Select the desired check boxes to display imaging information on

the screen.

System Status 1 Press the Setup key.

2 Select Display Information. 3 Select the desired check boxes to display the system status on the

screen.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

38 Chapter 2: Getting Started

IMT Calculations

Figure 17 Setup: IMT Calculations

IMT Calculations 1 Press the Setup key.

Getting Started

2 Select IMT Calculations. 3In the IMT Calculations list, select the desired labels.

• Selecting a label places the measurement on the Calculation menu and into the report.

• Selecting None removes a label.

4 Enter the desired Region width.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

Chapter 2: Getting Started 39

OB Calculations Authors

Figure 18 Setup: OB Calculations

Gestational Age Growth Analysis

More Select More to display the list of user-defined custom measurements

Export 1 Insert a blank CompactFlash card in the back slot of the system.

1 Press the Setup key. 2 Select OB Calculations. 3In Gestational Age or Growth Analysis lists, select the desired OB

authors.

• Selecting an author places the measurement on the calculation menu.

• Selecting None removes the measurement from the calculation menu.

and to associate a custom table for the custom measurement. This option is only available when a user-defined custom table has been created for the custom measurement.

2 Press the Setup key. 3 Select OB Calculations. 4 Select Export from the on-screen menu.

All user-defined tables and measurements are copied to the CompactFlash card.

40 Chapter 2: Getting Started

Import 1 Insert the CompactFlash card in the back slot of the system.

2 Press the Setup key. 3 Select OB Calculations. 4 Select Import from the on-screen menu. 5 Select Ye s to import data or No to cancel.

• After all user-defined tables and measurements are imported, the system restarts.

• All user-defined tables and measurements currently on the system are replaced with imported data.

6 Select Done from the on-screen menu to return to live imaging.

Table s Select Tables from the on-screen menu to display system OB tables or

to create custom OB tables. See “OB Custom Tables” on page 43.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

Getting Started

Chapter 2: Getting Started 41

OB Custom Measurements

Figure 19 Setup: OB Custom Measurements

OB Custom Measurements

Delete OB Custom Measurement

Table s Select Tables from the on-screen menu to display system OB tables or

1 Press the Setup key. 2 Select OB Custom Meas. 3 Select New. 4In the Name field, enter a unique name. 5In the Type list, select the desired measurement type. 6 Select Save.

• The new measurement is displayed in the calculations menu and the OB report.

• Up to five custom measurements may be saved.

1 Press the Setup key. 2 Select OB Custom Meas. 3In the Custom Measurements list, highlight the last

measurement. 4 Select Delete Last. 5 Select Ye s to delete the measurement or No to cancel.

If associated tables and report data exist for the measurement, they

are removed from the system.

to create Gestational Age tables for a custom OB measurement. See “OB

Custom Tables” on page 43.

42 Chapter 2: Getting Started

OB Custom Tables

Figure 20 Setup: OB Custom Table

Gestational Age Table Measurements: The system provides gestational age measurements by selected authors for the age table measurements listed in Tab le 6 .

Growth Analysis Table Measurements: The system provides growth graphs or curves for the growth table measurements listed in Tab le 6.

Table 6: OB Custom Table Measurements

Gestational Age Table Measurements GS, CRL, BPD, OFD, HC, TTD, AC, FTA, FL,

Getting Started

5 additional custom measurement labels

Growth Analysis Table Measurements BPD, HC, AC, FL, EFW

WAR NIN G:

View OB Tables 1 Press the Setup key.

Prior to use, verify custom table data entries are correct. The system does not confirm the accuracy of the custom table data entered by the user.

2 Select OB Custom Meas. or OB Calculations. 3 Select Tables from the on-screen menu. 4 Select the desired table (Age or Growth) and measurement/author.

Chapter 2: Getting Started 43

Create New OB Custom Table s

1 Press the Setup key. 2 Select OB Custom Meas. or OB Calculations. 3 Select Tables from the on-screen menu. 4 Select the desired table (Age or Growth). 5 In the measurement list, select the desired measurement for the

custom table. 6 Select New from the on-screen menu. 7In the Author field, enter a unique name. 8 Enter the data. 9 Select Save from the on-screen menu.

Two custom tables may be created for each OB measurement.

• To display the measurement for the custom table in the calculation menu, see “OB Calculations Authors” on page 40 and select More.

• Growth analysis tables cannot be created for custom OB measurements.

Edit OB Custom Tables 1 Press the Setup key.

2 Select OB Custom Meas. or OB Calculations. 3 Select Tables from the on-screen menu. 4 Select the desired custom OB table. 5 Select Edit and enter data and then select Save from the on-screen

menu.

Delete OB Custom Tables 1 Press the Setup key.

2 Select OB Custom Meas. or OB Calculations. 3 Select Tables from the on-screen menu. 4 Select the desired custom OB table. 5 Select Delete from the on-screen menu to remove the custom

table from the system.

44 Chapter 2: Getting Started

Presets

Getting Started

Figure 21 Setup: Presets

Doppler Scale 1 Press the Setup key.

2 Select Presets. 3In the Doppler Scale list, select cm/s or kHz.

Duplex 1 Press the Setup key.

2 Select Presets. 3In the Duplex list, select the desired image display.

• Full 2D, Full Trace

• 1/3 2D, 2/3 Trace

• 1/2 2D, 1/2 Trace

Live Trace 1 Press the Setup key.

2 Select Presets. 3In the Live Trace list, select Peak or Mean.

Thermal Index 1 Press the Setup key.

2 Select Presets. 3In the Thermal Index list, select TIS, TIB, or TIC.

The Thermal Index default setting is based on exam type.

•OB: TIB

•TCD: TIC

•All others: TIS

Chapter 2: Getting Started 45

Save Key 1 Press the Setup key.

2 Select Presets. 3In the Save Key list, select Image Only or Image/Calcs to

designate the function of the Save Key.

• Selecting Image Only allows the Save Key to save the image to the CompactFlash card.

• Selecting Image/Calcs allows the Save Key to save the image to the CompactFlash card and to save the current calculation to the report.

Dynamic Range 1 Select the desired exam type. See “Exam” on page 51.

2 Press the Setup key. 3 Select Presets. 4In the Dynamic Range list, select the setting: -3, -2, -1, 0, +1, +2,

+3. Negative numbers show higher contrast images and positive

numbers show lower contrast images.

Units 1 Press the Setup key.

2 Select Presets. 3In the Units list, select the desired units for patient height and

weight: in/ft/lbs or cm/m/kg. Units settings available in cardiac exams only.

Footswitch (Left/Right)

1 Press the Setup key. 2 Select Presets. 3In the Footswitch (L) and Footswitch (R) list, select desired

functionality for the left and right footswitch: Save Clip, Record,

Freeze, Save Image, Print.

Reset Select Reset from the on-screen menu to return settings for this setup

page to factory default.

46 Chapter 2: Getting Started

System Information

Figure 22 Setup: System Information

System Information 1 Press the Setup key.

Getting Started

2 Select System Information.

To install a license key see “Installing a License Key” on page 185.

Change to Default Settings

1 Turn the system off. 2 Connect the system to AC power. See “Operate System Using AC

power” on page 14.

3 Simultaneously press and release 1 and the Power key.

• The system beeps several times, and the system displays the default settings.

• Default settings are set at the factory and cannot be changed by the user.

Chapter 2: Getting Started 47

Network Status

Figure 23 Setup: Network Status

Network Status 1 Press the Setup key.

2 Select Network Status.

48 Chapter 2: Getting Started

Chapter 3: Imaging

Patient Information

The patient information form allows information to be entered into the system for the patient exam.

• Information which can be entered includes patient demographics, exam information, and clinical information.

• This information is automatically placed on the last page of the patient report.

• Once a patient is entered, all saved images are linked to that patient.

• To end the exam, a New Patient can be created or End Exam can be selected.

• Patient information can be edited during the exam by pressing the Patient key. However, if the patient name, ID, or Accession changes, a new patient is created.

Imaging

Figure 1 Patient Information Form

New Patient 1 Press the Patient key.

2 Select New from the on-screen menu.

• This clears the existing patient information.

• Selecting new patient erases any previously entered information, including any calculations and report pages. To save this information, save the screen for each item, for example, report pages, patient information, calculations, and graphs.

Chapter 3: Imaging 49

New Patient (continued)

3 Enter information into appropriate fields.

The patient information fields vary based on the selected exam type.

•Patient

• Patient: Enter Last, First, Middle Names, and ID.

• Accession: Enter number, if applicable.

• Date of birth: Enter (YYYY/MM/DD).

• Gender: Select Female, Male, other, or leave blank.

• Indications: Enter desired text.

• Symbols: See “Symbols” on page 23.

•More

• User: Enter initials.

• Reading Dr. and Referring Dr.: Enter names.

• Institution: Enter name. All patient information can be edited up until the first image is saved. After the first image is saved, the Patient Name, ID, and Accession number cannot be modified. Modifying these fields closes the current patient exam and starts a new exam.

Select Back from the on-screen menu to save information and return to previous menu.

50 Chapter 3: Imaging

New Patient (continued)

•Exam

• Typ e: Select desired exam type.

• LMP or Estab. DD: Select LMP or Estab. DD then enter either last menstrual period or established due date (YYYY/MM/DD). (Estab.DD only in OB exam.) The date for LMP must precede the current system date.

• Twi ns: Select the Twins check box to display Twin A and Twin B measurements on the calculation menu (only in OB exam and report).

• Previous Exams (only in OB exam).

• Enter data from previous exams. Data from five previous exams may be entered.

•For twins, select Twin A/B from the on-screen menu to enter data for each twin.

The date for a previous exam must precede the current system date. Select Back from the on-screen menu to save information and return to

previous menu.

• BP: Enter blood pressure (only in cardiac, vascular, and IMT exams).

• HR: Enter the Heart Rate (only in cardiac, vascular, and IMT exams). If the heart rate is obtained and saved using M Mode, the values override the number entered on the patient information screen.

• Height: Enter the patient height in feet and inches or meters and centimeters (only in cardiac exam).

• Weight: Enter the patient weight in pounds or kilos (only in cardiac exam).

• BSA (Body Surface Area): This number is automatically generated after height and weight are entered (only in cardiac exam).

• Ethnicity: Select the applicable ethnic origin (only in IMT exam).

Imaging

End Exam 1 Press the Patient key.

2 Select End Exam from the on-screen menu to close the current patient

exam. Selecting End Exam, selecting New Patient, or modifying patient name

or ID erases any previously entered information, including any calculations and report page. To save this information, save the screen for each item, for example, report pages, patient information, and calculations.

Cancel Select Cancel from the on-screen menu to undo any changes to the patient

information form and return to the previous imaging state. Pressing Cancel does not close the current patient exam.

Chapter 3: Imaging 51

Done Select Done from the on-screen menu to save information and return to the

previous imaging state.

• Information is saved when exiting the patient information form unless Cancel is selected from the on-screen menu.

• If any changes are made to the current patient’s name, ID, or accession number, that patient exam is closed and a new one is started.

Transducer, Exam Type, and Imaging Mode

The system has various configurations and options. All are described in this user guide and may not apply to your system. System features depend on your configuration, transducer, and exam type.

WAR NIN G:

The following table describes the abbreviations for exam types.

The diagnostic capability differs for each transducer, exam type, and imaging mode. Verify your system’s capabilities prior to diagnosis.

Transducers have been developed to specific criteria depending on their application. This criteria includes biocompatability requirements.

Table 1: Exam Type Abbreviations

Abbreviation Exam Type

Abd Abdomen

Bre Breast

Crd Cardiac

Gyn Gynecology

Hep Hepatic

IMT Intima Media Thickness

Msk Muscle

Neo Neonatal

Nrv Nerve

OB Obstetrical

Orb Orbital

52 Chapter 3: Imaging

Table 1: Exam Type Abbreviations (Continued)

Abbreviation Exam Type

Pel Pelvic

SmP Small Parts

Sup Superficial

TCD Transcranial Doppler

Vas Vascular

The following table describes the transducer’s exam type and imaging mode that may be available with your system.

• The optimization settings for 2D are Res, Gen, and Pen.

• The optimization settings for color power Doppler (CPD) and color Doppler (Color) are low, medium, and high (flow sensitivity) with a range of PRF settings for Color depending on the application.

Table 2: Transducer, Exam Type, and Imaging Mode

Imaging Mode

Imaging

Trans-

ducer

Exam

Typ e

2D/ MM

THI

2DMB2D

CPD Color PW

TDI PW

C11e Abd X — — X X X X — —

Nrv X — — X X X X — —

C60e OB X X — X X X X — —

Gyn X X — X X X X — —

Abd X X — X X X X — —

D2 Crd — — — — — — — — X

HFL38 Bre X — X X X X X — —

SmP X — X X X X X — —

Vas X — X X X X X — —

IMT X — X X X X X — —

Nrv X — X X X X X — —

Chapter 3: Imaging 53

Table 2: Transducer, Exam Type, and Imaging Mode (Continued)

Imaging Mode

Tra ns-

ducer

Exam

Typ e

2D/ MM

THI

2DMB2D

CPD Color PW

TDI PW

ICTe Gyn X — — — X X X — —

OB X — — — X X X — —

L25e Msk X — X X X X X — —

Vas X — X X X X X — —

Nrv X — X X X X X — —

Sup X — X X X X X — —

L38e Bre X — — X X X X — —

SmP X — — X X X X — —

Vas X — — X X X X — —

IMT X — — X X X X — —

Nrv X — — X X X X — —

LAP Abd X — — — X X X — —

Pel X — — — X X X — —

P10 Crd X — — X — X X X X

Neo X — — X X X X — —

Abd X — — X X X X — —

Vas X — — X X X X — —

Nrv X — — X X X X — —

P17 Abd X X — X X X X — —

OB X X — X X X X — —

Crd X X — X — X X X X

TCD X — — X X X X — —

Orb X — — X X X X — —

54 Chapter 3: Imaging

Table 2: Transducer, Exam Type, and Imaging Mode (Continued)

Imaging Mode

Trans-

ducer

Exam

Typ e

2D/ MM

SLA Msk X — — X X X X — —

Sup X — — X X X X — —

Vas X — — X X X X — —

Nrv X — — X X X X — —

SLT Abd X — — — X X X — —

Hep X — — — X X X — —

TEE Crd X — — — — X X X X

Transducer Preparation

WAR NIN G:

Caution:

Some transducer sheaths contain natural rubber latex and talc, which can cause allergic reactions in some individuals. Refer to 21 CFR 801.437, User labeling for devices that contain natural rubber.

Some gels and sterilants can cause an allergic reaction on some individuals.

To avoid damage to the transducer, use only gels recommended by SonoSite. Using gels other than the one recommended by SonoSite can damage the transducer and void the warranty. If you have questions about gel compatibility, contact SonoSite or your local representative.

THI

2DMB2D

CPD Color PW

TDI PW

Imaging

SonoSite recommends you clean transducers after each use. See “Cleaning and

Disinfecting Transducers” on page 188.

Acoustic coupling gel must be used during exams. Although most gels provide suitable acoustic coupling, some gels are incompatible with some transducer materials. SonoSite recommends Aquasonic

gel and a sample is provided with the system.

Chapter 3: Imaging 55

General Use

Apply Gel Apply a liberal amount of gel between the transducer and the body.

Invasive or Surgical Use

WAR NIN G:

Install Transducer Sheath

To prevent contamination, the use of sterile transducer sheaths and sterile coupling gel is recommended for clinical applications of an invasive or surgical nature. Do not apply the transducer sheath and gel until you are ready to perform the procedure.

Note: SonoSite recommends the use of market-cleared, transducer sheaths for intracavitary or surgical applications.

1 Place gel inside the sheath. 2 Insert the transducer into the sheath.

To lessen the risk of contamination, install the sheath only when you are ready to perform the procedure.

3 Pull the sheath over the transducer and cable until the sheath is fully

extended. 4 Secure the sheath using the bands supplied with the sheath. 5 Check for and eliminate bubbles between the face of the transducer and

the sheath.

If any bubbles are present between the face of the transducer and the

sheath, the ultrasound image may be affected. 6 Inspect the sheath to ensure there are no holes or tears.

56 Chapter 3: Imaging

Modes

2D Imaging

The system has advanced image optimization technology that greatly simplifies user controls. To achieve the best possible image quality, it is important to properly adjust the display brightness, gain, depth settings, and exam type.

It is also important to select an optimization setting that best matches your needs. The system has a high-performance, liquid crystal display (LCD). To optimize image quality, adjust the

display for viewing angle, and brightness. Each time you turn the system on, the 2D image is displayed. It displays echoes in two dimensions on

the display by assigning a brightness level based on the echo signal amplitude. This is the system’s default imaging mode. When imaging in another mode, you may return to 2D imaging by pressing the 2D key. If the system does not return to 2D imaging after pressing the 2D key, ensure the system is in live imaging.

Imaging

Figure 2 2D Image

Optimize Select the desired optimization setting from the on-screen menu.

• Res provides the best possible resolution.

• Gen provides a balance between resolution and penetration.

• Pen provides the best possible penetration. Some of the parameters that are optimized to provide the best image include: focal zones, aperture size, frequency (center and bandwidth), and waveform. They cannot be adjusted by the user.

Dynamic Range

Select the desired dynamic range setting from the on-screen menu to adjust grayscale range: -3, -2, -1, 0, +1, +2, +3.

• The positive range increases and the negative range decreases the number of grays displayed.

• A beep sounds when the minimum or maximum of the range is reached.

Chapter 3: Imaging 57

Dual Images 1 Select Dual from the on-screen menu to display side-by-side 2D images.

2 Press the Update key to display the second screen and to toggle

between the screens. With both images frozen, press the Update key to toggle between the

images.

3 Select Dual from the on-screen menu or press the 2D key to return to

full screen 2D imaging.

LVO ( Left Ventric ular Opacification)

This feature depends on transducer and exam type. Use LVO for cardiac exams in 2D mode when using an imaging contrast

agent. LVO lowers the mechanical index (MI) of the system to enhance visualization of the contrast agent and endocardial border. 1 On a 2D image, select LVO On on page 2 of the on-screen menu to turn

on LVO.

2 Select LVO Off to turn off this option.

Orientation Select from four image orientations: Up/Right, Up/Left, Down/Left,

Down/Right.

Brightness Select the desired brightness setting from the on-screen menu to adjust

display brightness: 1-10.

• A beep sounds when the minimum or maximum of the range is reached.

• The display brightness affects battery life. To conserve battery life, adjust brightness to a lower setting.

Biopsy This feature depends on transducer type. Biopsy is not available when ECG

cable is connected. Select Biopsy from the on-screen menu to display biopsy guidelines. Select

again to turn off. On the P10 and P17 transducers, the biopsy guides are displayed when the

bracket is installed correctly. If the bracket is not installed correctly, the biopsy feature is not available, and a dialog box is displayed to check installation of the bracket. See “Needle Guidance” on page 78 and Biopsy User Guide for more information.

Guide This feature depends on transducer and exam type.

Select Guide from the on-screen menu to turn on the guideline and select again to turn off.

SonoRES (S) This feature is optional and depends on transducer and exam type. When

both 2D image enhancements are available, SonoRES® image enhancement capability and SonoMB™ multi-beam technology share the same on-screen menu. See “Transducer, Exam Type, and Imaging Mode” on page 53.

Select S from the on-screen menu to turn on SonoRES.

• When SonoRES is on, an S is displayed in the upper left corner of the screen.

• SonoRES is available only in 2D imaging and M Mode.

58 Chapter 3: Imaging

SonoMB (MB) This feature depends on transducer and exam type. When both 2D image

enhancements are available, SonoRES and SonoMB share the same on-screen menu. See “Transducer, Exam Type, and Imaging Mode” on page 53.

SonoMB is on when available.

• When SonoMB is on, MB is displayed in the upper left corner of the screen.

• SonoMB is available only in 2D imaging.

• If SonoMB is available on the transducer, ECG monitoring is not available.

ECG This feature is optional and requires a SonoSite ECG cable.

1 Connect the ECG cable. See Figure 2, “System Back View” on page 7. 2 Select ECG from the on-screen menu to display the ECG trace. See “ECG

Monitoring” on page 76.

If SonoMB is available on the transducer, ECG monitoring is not available.

Clips This feature is optional.

Select Clips from the on-screen menu to display the clips menu. See “Clips” on page 68.

Gain Tu rn th e Near, Far, or Gain knobs (on the lower left side of the control panel)

to increase or decrease the amount of gain applied to the near field, far field, or the overall image. Near and far correspond to the time gain compensation (TGC) controls found on other ultrasound systems.

Auto Gain This feature depends on transducer type.

Select Auto Gain from the on-screen menu. Auto Gain automatically adjusts gain each time it is selected.

Imaging

Depth The vertical depth scale is marked in .5 cm, 1 cm, and 5 cm increments,

depending on the depth. Press the Depth ke y up to de crea se or dow n to increase the displayed depth.

• As you adjust the depth, the maximum depth number changes in the lower right corner of the screen.

• A beep sounds when the minimum or maximum of the range is reached.

Tissue Harmonic Imaging

This feature is optional and depends on transducer and exam type. 1 Press the THI key to turn on THI.

THI is displayed in the top left portion of the screen next to the optimization setting.

2 Press the THI key again to turn off THI.

The THI icon is removed from the screen.

Chapter 3: Imaging 59

Zoom 1 Press the Zoom key.

A region of interest (ROI) box is displayed on the screen.

2Use the Touchpad to position and size the ROI box within the image

area.

3 Press the Zoom key again.

The image is magnified by a factor of two inside the ROI box.

4 Press the Zoom key again to exit zoom.

To exit any zoomed state and return to 2D live in 1x, press the 2D key.

Zoom Pan Note: Panning is available on a frozen, zoomed image. You cannot pan on a

frozen image in Dual.

1 On a frozen 2D image, press the Zoom key.

A zoom box is displayed on the screen. 2Use the Touchpad to position the zoom box within the image area. 3 Press the Zoom key again.

The image is magnified by a factor of two at the position of the zoom

box. 4Use the Touchpad to pan the image up/down and left/right. 5 Press the Zoom key again to exit zoom.

Freeze 1 Press the Freeze key.

The cine icon and frame number are displayed in the system status area

of the screen. 2 Press the Freeze key again to return to live imaging.

The cine icon is removed from the system status area of the screen and

live imaging resumes.

Cine Buffer On a frozen image, press the Cine keys to view individual frames in the cine

buffer.

• The frame number changes dynamically as the cine key is pressed.

• The total number of frames in the buffer is displayed in the system status

under the freeze icon.

60 Chapter 3: Imaging

MMode Imaging

The following instructions cover Motion mode (M Mode) imaging. See “2D Imaging” on page 57 for instructions about depth and optimization.

MMode M-Line

Figure 3 M Mode M-Line

M-Line 1 Press the MMode key for the M-line.

Imaging

If M Mode does not come on, make sure the system is in live imaging.

2Use the Touchpad to position the M- line over the area of interest on the

image.

• Depth changes are not available in M Mode trace.

• Adjust the depth prior to activating the M Mode trace.

Chapter 3: Imaging 61

MMode Trace

Figure 4 M Mode Trace Image

MMode Tra ce

Sweep Speed Select the desired sweep speed from the on-screen menu (slow, med, fast).

Gain Turn the Near, Far, or Gain knobs (on the lower left side of the control panel)

Freeze 1 Press the Freeze key.

Cine Buffer On a frozen image, press the Cine keys to view the trace at different points in

1 Press the MMode key again to acquire the M Mode trace.

The time scale at the top of the trace has small marks at 200 ms intervals

and large marks at one second intervals. 2 Press the Update key to toggle between the M-line and trace. 3 In duplex, press the MMode key to return to the full screen M-line.

You can choose from one of three layouts. For duplex imaging, see

“Duplex” on page 45.

2 Press the Freeze key again to return to live imaging.

• The cine icon is removed from the system status area of the screen and live imaging resumes.

• On the frozen M Mode image, press the MMode key to display the associated frozen 2D image with the M-line, or press the Update key to display the 2D live image with the M-line.

time.

2D Imaging Press the 2D key to return to 2D imaging.

62 Chapter 3: Imaging

Color Doppler Imaging

Note: Color power Doppler (CPD) and color Doppler (Color) are optional features and depend on transducer and exam type.

The following instructions cover CPD and Color imaging.

Figure 5 Color Image

CPD or Color 1 Press the Color key for CPD or Color.

Imaging

A ROI box is displayed in the center of the 2D image.

2 Select CPD or Color from the on-screen menu.

• The current setting is displayed in the upper left corner of the screen and in the on-screen menu.

• In Color or CPD mode, the Color indicator bar is displayed in the upper left corner of the screen. The Color bar displays velocity in cm/s in Color mode only.

ROI Box 1Use the To u c hp a d to position or change the size of the ROI box.

While moving or changing the size of the ROI box, a green outline of the new position or the new size is displayed as it moves on the display.

2 Press the Select key to toggle between the position and size of the ROI

box. The ROI box indicator on the left side of the screen is highlighted green

to show which function the touchpad is controlling.

Color Suppress

1 Select Color Suppress from the on-screen menu to hide or show color

information when in Color or CPD mode.

2 Select Hide or Show while in live or frozen imaging.

• The setting shown on the on-screen menu is the current state.

• Color Suppress returns to default state when returning to live imaging from a frozen state.

Chapter 3: Imaging 63

Flow Sensitivity

Select the desired flow sensitivity from the on-screen menu.

• Low optimizes the system for low flow states.

• Med optimizes the system for medium flow states.

• High optimizes the system for high flow states.

The current setting is displayed in the top left portion of the screen and in the on-screen menu.

PRF Scale Note: This menu option is available in Color and in CPD on select transducers.

Select the desired pulse repetition frequency (PRF) setting from the on-screen menu.

• A beep sounds when the minimum or maximum of the range is reached

• There is a wide range of PRF settings for each flow sensitivity selection.

Wall Filter Note: This menu option is available in Color and in CPD on select transducers.

Select the desired wall filter setting from the on-screen menu: low, med, high.

Steering Note: This menu option is available only on select transducers.

Select the desired steering angle setting from the on-screen menu. This automatically changes pulsed wave (PW) Doppler angle correction to

the optimum setting.

• Steering angle of -15 degrees has an angle correction of -60 degrees.

• Steering angle of 0 degrees has an angle correction of 0 degrees.

• Steering angle of +15 degrees has an angle correction of +60 degrees.

If two modes are active (CPD/Color and PW/CW Doppler) press the Select key to toggle between the on-screen menus.

Varianc e Note: This menu option is available only for cardiac exams.

Select Variance from the on-screen menu to turn on.

Invert Select Invert from the on-screen menu to switch the displayed direction of

flow. Invert is only displayed when Color is selected.

Gain Turn the Gain knob (on the lower left side of the control panel) to increase

or decrease the amount of color gain applied to the CPD or Color ROI box. While in CPD or Color imaging, Near and Far knobs affect only the 2D image.

2D Imaging Press the 2D or Color key to return to 2D imaging.

If two modes are active (CPD/Color and PW Doppler) press the Select key to toggle between on-screen menus.

64 Chapter 3: Imaging

Pulsed Wave (PW) and Continuous Wave (CW) Doppler Imaging

Note: PW Doppler and CW Doppler are optional features and depend on transducer and exam type.

The following instructions cover PW and CW Doppler imaging.

Doppler D-Line

Figure 6 Doppler with D-Line Image and ROI Box

D-Line 1 Press the Doppler key for the D-line.

2Use the To u ch p a d to position the D-line over the area of interest on the

image.

3 Press the Select key to set the D-line and to toggle between the D-line

and angle correction.

• An indicator on the left side of the screen is highlighted green to show which function the touchpad is controlling.

• If PW or CW Doppler mode does not come on, make sure the system is in live imaging.

• The color ROI box is tied to the D-line.

Imaging

PW/CW Doppler

Note: CW Doppler is available only in cardiac exams.

1 Press the Doppler key. 2 Select PW from the on-screen menu to toggle between PW Doppler and

CW Doppler.

Chapter 3: Imaging 65

Angle Correction

Note: This menu option is available only in PW Doppler.

There are two ways to adjust the angle correction in PW Doppler imaging. Select Angle Correction from the on-screen menu to adjust the angle

correction to 0, +60, or -60 degrees. OR 1 Press the Select key to highlight angle correction and to toggle

between the D-line and angle correction. An indicator on the left side of the screen is highlighted green to show

which function the touchpad is controlling.

2Use the To u ch p a d to adjust the angle in two degree increments from

-74 to +74 degrees.

3 Press the Select key again to set the desired angle.

Gate Size Note: This menu option is available only in PW Doppler.

Select the desired gate size setting from the on-screen menu.

• A beep sounds when the minimum or maximum of the range is reached.

• Gate size options vary with transducer and exam type.

Tissue Doppler Imaging (TDI)

Doppler Gate Depth

Note: This menu option is available only in PW Doppler and cardiac exams.

Select TDI from the on-screen menu to turn on tissue Doppler imaging.

• TDI displays in the upper left corner of the screen when TDI is on.

• The default for TDI is off.

Note: This menu option is available only in TCD/Orb exams.

1 Locate the Doppler gate depth indicator at the bottom right of the

screen. Doppler gate depth measures the depth of the center of the gate in the

Doppler image.

2Use the To u ch p a d to select the desired depth.

Steering Note: This menu option is available only on select transducers.

Select the desired steering angle setting from the on-screen menu. This automatically changes PW angle correction to the optimum setting.

• Steering angle of -15 degrees has an angle correction of -60 degrees.

• Steering angle of 0 degrees has an angle correction of 0 degrees.

• Steering angle of +15 degrees has an angle correction of +60 degrees.

The angle correction can be adjusted manually after steering has been selected. (See “Angle Correction.”)

If two modes are active (CPD/Color and PW/CW Doppler) press the Select key to toggle between on-screen menus.

66 Chapter 3: Imaging

Doppler Spectral Trace

Figure 7 Doppler Trace Image

Spectral Tra ce

1 Press the Doppler key again to acquire the Doppler trace. 2 Press the Update key to toggle between the 2D/D-line and trace. 3 In duplex, press the Doppler key to return to the full screen D-line.

• The time scale at the top of the trace has small marks at 200 ms intervals and large marks at one second intervals.

• You can choose from one of three screen layouts. For duplex imaging see “Duplex” on page 45.

Scale Select the desired scale/pulse repetition frequency (PRF) setting from the

on-screen menu. A beep sounds when the minimum or maximum of the range is reached.

Line Select the desired baseline position from the on-screen menu.

Baseline can be adjusted on a frozen trace if Live Trace is not displayed.

Invert Select Invert from the on-screen menu to vertically flip the spectral trace.

Invert can be adjusted on a frozen trace if Live Trace is not displayed.

Volume Select the desired Doppler volume setting from the on-screen menu to

increase or decrease Doppler speaker volume (0-10). A beep sounds when the minimum or maximum of the range is reached.

Wall Filter Select the desired wall filter setting from the on-screen menu: low, med,

high.

Sweep Speed Select the desired sweep speed from the on-screen menu: slow, med, fast.

Imaging

Live Trace Select Trace from the on-screen menu to display a live trace of the peak or

mean. See “Live Trace” on page 45.

Gain Turn the Gain knob to increase or decrease the amount of Doppler gain.

Chapter 3: Imaging 67

Clips

Freeze 1 Press the Freeze key.

The cine icon is displayed in the system status area of the screen.

2 Press the Freeze key again to return to live imaging.

The cine icon is removed from the system status area of the screen and live imaging resumes.

Cine Buffer On a frozen image, press the Cine keys to view the trace at different points in

time.

2D Imaging Press the 2D key to return to 2D imaging.

Note: This feature is optional.

Time/ECG Select Clips from the on-screen menu.

• Select Time from the on-screen menu if desired acquisition is based on

number of seconds. Select the desired time duration: 2s, 4s, 6s.

• Select ECG from the on-screen menu if desired acquisition is based on the

number of heart beats. Select the desired number of beats: 1, 2, 3, 4, 6, 8,

10 beats.

Preview On/Off Select PrevOn from the on-screen menu to turn on the preview feature and

select PrevOff to turn off preview feature.

• When Prev/On is selected, the Save Clip key automatically plays the

acquired clip on the screen rather than storing to the CompactFlash card.

• Only in Prev/On can the clip be trimmed, saved, or deleted.

• When Prev/Off is selected, the clip is automatically saved and the trim and

delete features are not available.

Prospective/ Retrospective

Save Clip 1 Select Clips from the on-screen menu.

68 Chapter 3: Imaging

Select Pro from the on-screen menu to acquire clips prospectively or select Retro to acquire clips retrospectively.

• If Pro is selected, a clip is acquired after the Save Clip key is pressed.

• If Retro is selected, a clip is acquired from pre-saved data before the Save

Clip key is pressed.

2 Select clip settings as desired.

To trim a clip, Prev/On must be selected at this point.

3 Press the Save Clip key.

The clip is saved to CompactFlash card or plays back depending on the preview setting selected.

Trim Clip Frames from the left and right ends of the clip can be removed.

Delete Clip Select Delete from the on-screen menu to delete a clip before saving to

Clip Acquisition Delay

Delay Note: This menu option is displayed within the ECG on-screen menu and is only

Line Select the desired position of the delay line on the ECG trace. The delay line

1 Select Clips from the on-screen menu. 2 Select PrevOn from the on-screen menu. 3 Press the Save Clip key.

The clip is taken when a beep sounds and the clip is displayed in preview mode.

4 Select Left: x from the on-screen menu to remove frames from the left

side of the clip. The number displayed represents the beginning frame number.

5 Select Right: x from the on-screen menu to remove frames from the

right side of the clip. The number displayed represents the ending frame number.

6 Select Save from the on-screen menu.

Patient List.

available with the Save Clip option.

Select Delay from the on-screen menu.

indicates where the clip acquisition is triggered.

Imaging

Gain Select the desired gain from the on-screen menu to increase or decrease

ECG gain: 0-20.

Save Saves the current position of the delay line on the ECG trace.

You can change the position of the delay line temporarily. Entering a new patient or cycling the system power will revert the delay line to the most-recently saved position.

Chapter 3: Imaging 69

Image and Clip Storage

Save to CompactFlash

Images and clips are saved to the CompactFlash card.

• The images/clips in the patient list are organized alphabetically by the patient name and ID. If a name is not entered in the patient name field, a patient exam is created and identified as (_No_Name_). If an ID number is not entered in the ID field, the ID number is identified as (_No_ID_).

• To review saved images/clips, see “Image and Clip Review” on page 72. The images/clips saved on the CompactFlash card cannot be opened and viewed on a PC.

• Images may be archived from the ultrasound system using DICOM Image Transfer or to a PC using SiteLink Image Manager. See “Connectivity and Configuration” on page 141 or the SiteLink Image Manager User Guide.

• The number of images/clips saved to the CompactFlash card varies depending on the storage capacity of the card.

• The CompactFlash card is for temporary storage of images and clips. Patient exams should be archived regularly, and old exams deleted from the CompactFlash card. The CF Capacity Alert can be activated to alert when the CF card is near capacity. See“CF Capacity Alert” on page 34. Storing large numbers of patient exams on the CompactFlash card may increase the time required to save an image or clip.

WAR NIN G:

Caution:

To prevent loss of data, (for example, images/clips), or damage to the CompactFlash card, always turn off the ultrasound system before removing the CompactFlash card.

If the CompactFlash icon and image and clip counters are not displayed in the system status, the CompactFlash card may be defective. Turn off the system and replace the CompactFlash card. The CompactFlash card may be restored if it is formatted on a PC. Formatting the card erases all data. However, if the card is physically damaged, formatting does not restore it.

70 Chapter 3: Imaging

Save 1 Verify the CompactFlash card is inserted into the front slot on the

ultrasound system. See Figure 1 on page 6.

2Turn on system.

The CompactFlash card is ready to use when the CompactFlash card icon and image and clip counters are displayed. The counters indicate the following states:

• Percent of storage remaining

• Number of stored images

• Number of stored clips

• It may take a few seconds for the image memory counter to display the available memory.

• If the CompactFlash card is inserted into the back slot, the CompactFlash icon and number of stored images and clips are not displayed.

If the CompactFlash card is storing images or clips, the CompactFlash card animation is displayed. While the CompactFlash card animation is being displayed:

• Image review is not available

• Card should not be removed

• System should not be turned off

Save Image Press the Save key to save an image to the CompactFlash card.

• After the audible beep is heard, the next image may be saved. It may take a few seconds for the image to be stored. During this time the CompactFlash card animation is displayed.

• When an image is stored, the image and clip counter increases by one.

• Ensure there is sufficient memory available on the CompactFlash card before saving additional images.

• A maximum of 200 images can be saved for an individual patient exam.

Imaging

Save Clip Press the Save Clip key to save a clip to the Compact Flash card.

• While the clip is being acquired, the stored clips counter is highlighted. After the audible beep is heard (counter is no longer highlighted), the next clip may be saved. It takes several seconds for the clip to be stored, during which time the CompactFlash card animation is displayed.

• The longer the clip and the more frequently clips are saved, the longer it takes to store all clips.

• When a clip is stored, the clip counter increases by one.

• Ensure there is sufficient memory available on the CompactFlash card before saving.

Chapter 3: Imaging 71

Print to Local Printer

Ensure the printer is properly set up for operation with the system. See “Printer” on page 33 for system setting and the applicable SonoSite accessory user guide for hardware setup.

Print Image Press the Print key.

Image and Clip Review

The patient list displays all the patients who have images/clips saved on the CompactFlash card. Image/clip review is comprised of two parts: the patient list and the patient images. The patient images display images/clips for the current patient or the patient selected from the patient list.

Patient List

Figure 8 Patient List

Patient List Press the Review key. If there is a current patient, select List from the

on-screen menu. The number of saved images and clips is displayed on the patient list.

Select All, Deselect

Review Images Select Review from the on-screen menu to review the images for the

Archive Note: SiteLink and DICOM are optional features.

72 Chapter 3: Imaging

Select All from the on-screen menu to highlight all the entries within

the patient list.

• Deselect removes the highlight from all the entries and highlights the previously selected patient.

• Review is disabled when all entries in the list are selected.

currently selected patient.

Select Archive from the on-screen menu to send the selected patient exams to a PC using SiteLink or to a DICOM printer or archiver. See

“Transfer Mode” on page 34.

Print All Images 1 Verify a printer is selected. See “Printer” on page 33.

Delete Select Delete from the on-screen menu to delete the selected patient

Done Select Done from the on-screen menu to exit the patient list and

Patient Images and Clips

Patient Images Press the Review key.

2 Press the Review key. 3 Select List from the on-screen menu. 4 Highlight the desired patient.

An individual patient or all patients may be selected.

5 Select Print from the on-screen menu to print all images.

Each image displays briefly on the screen before printing starts.

exam. A confirmation screen is displayed.

return to the previous imaging state.

Imaging

If there is not a current patient, highlight the desired patient and select Review from the on-screen menu.

Next or Previous Image/Clip

Play If a clip, select Play from the on-screen menu to review the clip.

Playback Speed Select the desired playback speed from the on-screen menu:

Patient List Select List from the on-screen menu to display the patient list.

Print Image 1 Verify a printer is selected. See “Printer” on page 33.

Delete Select Delete from the on-screen menu to delete the displayed

Done Select Done from the on-screen menu to exit patient images/clips

Select the (1/x) from the on-screen menu to view image/clip.

Select Pause to freeze the clip.

• The load time varies depending on the length of the clip.

• The clip plays automatically after loading.

1x, 1/2x, 1/4x.

2 Select Print from the on-screen menu to print the displayed

image.

image/clip. A confirmation screen is displayed.

and return to the previous imaging state.

Chapter 3: Imaging 73

Annotations

Annotations are available in both live imaging and on a frozen image. You cannot annotate on a saved image. Text entry and predefined labels are available within the image area.

Figure 9 Image with Predefined Labels

Enter Text 1 Press the Tex t key.

2Use the Touchpad or a rro ws t o pos itio n the tex t c urs or a nywh ere with in

the image area.

3 Use the keyboard to enter, delete, or modify text.

• Press the Backspace key to delete characters to the left of the cursor.

• Press the Spacebar key to add spaces between words or replace characters with blank spaces to the right of the cursor.

• Press the Arrow keys to move the cursor to the left, right, up, or down.

• Press the Enter key to move the cursor to the next line.

• Select Delete Word from the on-screen menu to remove the word.

• Press the Tex t key to turn off text entry.

Text can be inserted on the following imaging layouts: full screen 2D, full screen trace, dual, or duplex.

Home/Set 1 Press the Te xt key.

2Use the Touchpad or arrows to position the text cursor to the desired

location.

3 Select Home/Set from the on-screen menu.

The new location is now the home position for the text cursor.

4 To reset the home position, reposition the cursor and select Home/Set

from the on-screen menu.

74 Chapter 3: Imaging

Home 1 Press the Tex t key.

2 Select Home from the on-screen menu to move the cursor to the

original home position (upper left).

• The home position can be set to a new location. To change the home position, see “Home/Set” on page 74.

• The factory default home position is different depending on the imaging screen layout.

Label 1 Press the Tex t key.

2Use the Touchpad to set the cursor on the desired location on the

image. 3 Select Label from the on-screen menu. 4 Select the desired label group (1/x) to insert the appropriate label.

• There are three label groups. See “Annotations” on page 36.

• Predefined labels can be inserted on the following imaging layouts: full screen 2D, full screen trace, dual, or duplex.

Symbols Select Symbols from the on-screen menu to enter special characters. See

“Symbols” on page 23.

Delete Word Select Delete Word from the on-screen menu repeatedly to clear the screen

of text a word at a time. Words are deleted in sequence, right to left, and bottom to top.

Delete Press the Delete key to clear the screen of all text at once.

Preset delete options to save or delete text when unfreezing an image. See

“Unfreeze” on page 37 for information on presetting options when

unfreezing an image.

Imaging

Arrow 1 Press the Arrow key.

Use the arrow as a pointer to bring attention to a specific part of the

image. 2Use the Touchpad to move the arrow over the image. 3 Press the Select key to switch the arrow’s orientation and then use the

Touchpad to adjust the arrow’s orientation. 4 Press the Select key again to set the arrow’s orientation and then use

the Touchpad to move the arrow over the image. 5 Press the Arrow key to set the arrow.

• The arrow changes from green to white.

• To remove the arrow from the image, press the Arrow key and then select Hide from the on-screen menu.

Chapter 3: Imaging 75

Pictograph 1 Press the Picto key to turn on the pictograph. The on-screen options for

ECG Monitoring

pictograph are:

• Show/Hide

• Number (for example, 1/18)

• Location on screen (U/L, D/L,D/R, U/R)

• Done

2 Select the desired pictograph.

• The first number changes to show which pictograph in a set of pictographs has been selected. The second number shows the total number of pictographs available.

• The pictograph set that is available depends on transducer and exam type.

3Use the Touchpad to position the pictograph marker. 4 Press the Select key and then use the Touchpad to rotate the

pictograph marker.

5 Select one of four image positions from the on-screen menu to move

the pictograph to the desired location: U/L, D/L, D/R, U/R.

• In Duplex, the pictograph is restricted to the upper left position.

• In Dual, all four positions are available.

6 Select Hide from the on-screen menu to remove the pictograph.

Note: ECG Monitoring is an optional feature and requires a SonoSite ECG cable.

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Caution:

76 Chapter 3: Imaging

To prevent misdiagnosis, do not use the ECG trace to diagnosis cardiac rhythms. The SonoSite ECG option is a non-diagnostic feature.

To prevent misdiagnosis, do not use the SonoSite ECG option for long term cardiac rhythm monitoring.

Use only accessories recommended by SonoSite with the system. Your system can be damaged by connecting an accessory not recommended by SonoSite.

ECG This menu option is displayed only when the ECG cable is connected. If

Show/Hide Select Show/Hide from the on-screen menu to turn on/off ECG trace.

Gain Select the desired gain from the on-screen menu to increase or decrease ECG

Position Select the desired position of the ECG trace from the on-screen menu.

Sweep Speed Select the desired sweep speed from the on-screen menu: slow, med, fast.

Footswitch

Note: The footswitch is an optional feature and requires a SonoSite footswitch.

SonoMB is available on the transducer, ECG monitoring is not available. 1 Connect the ECG cable to the ECG connector on the mini-dock or

docking system.

• When the ECG cable is connected, ECG monitoring turns on automatically.

• An external ECG monitor may cause a lag in the timing of the ECG trace, corresponding with the 2D image.

• Biopsy guidelines are not available when ECG is connected.

2 Select ECG from the on-screen menu.

gain: 0-20.

Imaging

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Connect Footswitch

To avoid contamination, do not use the footswitch in a sterile environment. The footswitch is not sterilized.

1 Connect cables:

• Y adapter cable to the ECG connector on the mini-dock or docking system.

• Footswitch cable to Y adapter cable

2 Select the desired functionality for the left and right footswitches. See

“Footswitch” on page 46.

Chapter 3: Imaging 77

Bar Code Scanner

Connect Bar Code Scanner

Needle Guidance

Note: The biopsy and needle guide features depend on transducer type.

The ultrasound system is equipped with a needle guidance feature. For detailed instructions on the use of the system, needle guidance accessories, and a list of compatible transducers, see the user guides for Biopsy and L25 Bracket and Needle.

1 Ensure that the mini-dock is connected to the system. 2 Connect cables:

• Bar code scanner interface cable to bar code scanner adapter

• Bar code scanner adapter to mini-dock

• Power supply cable to bar code scanner interface cable

• Power cord to bar code scanner power supply

• Power cord to power strip

• Connect system power cord to a hospital-grade electrical outlet.

3 Select Bar Code Scanner for serial port connectivity. See “Serial Port” on

page 33.

78 Chapter 3: Imaging

Chapter 4: Measurements and Calculations

Measurements

Measurements and calculations are performed on frozen images. The following sections explain how to perform basic measurements in each imaging mode. Based on the measurements performed, the SonoSite system automatically calculates specific information and displays the results. Some of the options described in the user guide may not apply to your system. System features are dependent on your configuration, transducer, and exam type.

2D Measurements

The basic measurements that can be performed in 2D are:

• Distance in cm

•Area in cm

• Circumference in cm

and Calculations

Measurements

Figure 1 2D Measurement with Two Linear and One Trace

Chapter 4: Measurements and Calculations 79

Distance Measurement

1 On a frozen 2D image, press the Caliper key.

• A set of calipers and the following on-screen menu options are available:

Ellipse (circumference/area)

Manual trace

Delete

• The two calipers are connected by a dotted line. When the calipers get close together, they decrease in size and the caliper line is removed.

2Use the Touchpad to position the first caliper. 3 Press the Select key to activate the other caliper.

The result is displayed in the measurement and calculation data area and is updated as the caliper moves. The measurement is complete when you finish moving the calipers.

4 Press the Caliper key to activate each additional caliper set.

• The active caliper is highlighted green.

• Up to eight calipers are available for distance measurements.

• A combination of distance, area/circumference, and trace measurements can be performed at the same time.

• The number of measurements available depends on the order and types of measurements. See “Area/ Circumference Measurement” on page 81 and “Manual Trace” on page 82 for more information.

5 Select Switch from the on-screen menu to move between caliper

sets.

6 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

80 Chapter 4: Measurements and Calculations

Area/ Circumference Measurement

1 On a frozen 2D image, press the Caliper key. 2 Select Ellipse from the on-screen menu. 3 Press the Select key to activate the calipers and use the Touchpad to

adjust the size and position of the ellipse.

• The active caliper is highlighted green.

• The result is displayed in the measurement and calculation data area and is updated as the caliper moves. The measurement is complete when you finish moving the calipers.

4 Press the Caliper key to activate additional caliper sets.

• A combination of distance, area/circumference, and trace measurements can be performed at the same time.

• The number of measurements available depends on the order and types of measurements.

• If you exceed the allowed combination of measurements for an image, Ellipse is not shown on the on-screen menu.

5 Select Switch from the on-screen menu to move between

measurements.

6 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

and Calculations

Measurements

Chapter 4: Measurements and Calculations 81

Manual Trace 1 On a frozen 2D image, press the Caliper key.

2 Select Manual from the on-screen menu. 3Use the Touchpad to position the caliper at the trace start point. 4 Press the Select key to start the tracing function. 5Use the Touchpad to complete the trace and select Set from the

on-screen menu. The result is displayed in the measurement and calculation data area.

6 Press the Caliper key to activate additional caliper sets.

• A combination of distance, area/circumference, and trace measurements can be performed at the same time.

• The number of measurements available depends on the order and types of measurements.

• If you exceed the allowed combination of measurements for an image, Manual is not shown on the on-screen menu.

7 Select Switch from the on-screen menu to move between

measurements.

8 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

Edit Measurement

Delete Measurement

1 Select Switch from the on-screen menu until the desired

measurement is highlighted.

2 Move the caliper to the desired position.

• The result displayed in the measurement and data area is updated.

• Trace measurements in 2D or Doppler can not be edited once set.

1 Select Switch from the on-screen menu until the desired

measurement is highlighted.

2 Select Delete from the on-screen menu.

The highlighted measurement is removed from the screen and the most-recent previous measurement is highlighted.

82 Chapter 4: Measurements and Calculations

M Mode Measurements

The basic measurements and calculations that can be performed in M Mode are:

• Distance in cm

• Time in seconds

• Heart Rate (HR) in beats per minute (bpm) The time scale at the top of the trace has small marks at 200 ms intervals and large marks at one

second intervals.

Figure 2 M Mode Trace Image with Heart Rate

and Calculations

Measurements

Distance Measurement

1 On a frozen M Mode trace, press the Caliper key.

A single caliper is displayed on the screen and the following on-screen menu options are available:

Heart rate (HR)

Delete

2Use the Touchpad to position the first caliper. 3 Press the Select key to display the second caliper.

• The active caliper is highlighted green.

• Up to four distance measurements can be performed on an image.

•Select Switch from the on-screen menu to move between measurements.

4 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

Chapter 4: Measurements and Calculations 83

Heart Rate (HR) Fetal Heart Rate (FHR)

1 On a frozen M Mode trace, press the Caliper key for HR or press the Calcs

key for FHR (OB exam only). The following on-screen menu options are available:

Heart rate (HR)

Delete

Save

2Select HR from the on-screen menu or select FHR from the calculation

menu. A vertical caliper is displayed on the screen.

3Use the Touchpad to position the first vertical caliper at the peak of the

heart beat.

4 Press the Select key.

• A second vertical caliper is displayed on the screen.

• The active caliper is highlighted green.

5Use the Touchpad to position the second vertical caliper at the peak of

the next heart beat.

6Select Save from the on-screen menu to save the HR measurement to the

patient report.

• This overwrites the previous heart rate value entered under exam/patient information.

7 If desired, press the Save key to save the image with the measurements

displayed.

Delete Measurement

84 Chapter 4: Measurements and Calculations

Select Delete from the on-screen menu. This removes the HR measurement from the screen.

Doppler Measurements

Inspect the auto trace to confirm that the system-generated boundary is correct. If you are not satisfied with the auto trace, obtain a high-quality Doppler trace or use the manual measurement tool.

Figure 3 Doppler Trace with Two Velocity Measurements

Velocity (cm/s), Pressure Gradient

Note: The Doppler scale must be set to cm/s for the following measurements. See “System Setup” on page 24.

1 On a frozen Doppler spectral trace, press the Caliper key.

A single caliper is displayed on the screen with the following on-screen menu options:

PHT (cardiac exam only)

Manual (trace)

Auto

Delete

2Use the Touchpad to position the active green caliper to a peak systolic

wave form. This is a single caliper from the baseline.

3 If desired, press the Save key to save the image with the measurements

displayed.

4 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

and Calculations

Measurements

Chapter 4: Measurements and Calculations 85

Velocities, Elapsed Time, +/x Ratio, Resistive Index (RI), Acceleration

1 On a frozen Doppler spectral trace, press the Caliper key.

A single caliper is displayed on-screen with the following menu options:

Manual (trace)

Auto

Delete

2Use the Touchpad to position the first caliper to a peak systolic wave

form.

3 Press the Caliper or Select key.

A second caliper is displayed on the screen.

4Use the Touchpad to position the second caliper at the end diastole on

the wave form.

5 If desired, press the Save key to save the image with the measurements

displayed.

6 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

86 Chapter 4: Measurements and Calculations

Trace Measurements

Manual Tra ce

Automatic Tra ce

1 On a frozen Doppler spectral trace, press the Caliper key. 2 Select Manual from the on-screen menu.

A single caliper is displayed on the screen.

3Use the Touchpad to position the caliper at the beginning of the

desired wave form and press the Select key. If calipers are not placed in the correct position, the calculation is not

performed accurately.

4Use the Touchpad to move the caliper to trace the wave form.

If an error is made, do one of the following to remove the caliper points:

•Use the Touchpad to backtrack caliper over caliper points.

• Press Backspace key.

• Select Undo from the on-screen menu.

5 Select Set from the on-screen menu to complete the trace and display

the results.

6 Press the Save key to save an image of the trace with the results

displayed.

7 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

1 On a frozen Doppler spectral trace, press the Caliper key. 2 Select Auto from the on-screen menu.

A vertical caliper is displayed.

3Use the Touchpad to position the first caliper at the beginning of the

wave form.

4 Press the Select key.

• A second vertical caliper is displayed.

• If calipers are not placed in the correct position, the calculation is not performed accurately.

5Use the Touchpad to position the second caliper at the end of the wave

form.

6 Select Set from the on-screen menu to complete the trace and to

display the results.

7 To save the highlighted measurement to a calculation, press the Calcs

key, select the appropriate measurement label, then select Save from the on-screen menu.

The measurement is saved to the patient report only if a label can be applied to it.

and Calculations

Measurements

Chapter 4: Measurements and Calculations 87

The following table shows the auto trace results displayed by exam type:

Table 1: Auto Trace Results by Exam Type

Auto Trace Results Cardiac

TCD/

Orb

Vascular OB/Gyn Abdomen Neo

Velocity Time Integral (VTI) X — — — — —

Peak Velocity (Vmax) X—XXX—

Mean Pressure Gradient

X—————

(PGmean)

Mean Velocity on Peak Trace

X—————

(Vmean)

Pressure Gradient (PGmax) X — — — — —

Cardiac Output (CO) X — — — — —

Peak Systolic Velocity (PSV) — X — — — X

Time Average Mean (TAM)* — X — — — X

+/× or Systolic/Diastolic (S/D) — X X X X X

Pulsatility Index (PI) — X X X X X

End Diastolic Velocity (EDV) — X X X X X

Acceleration Time (AT) — — — — X —

Resistive Index (RI) — X X X X X

Time Average Peak (TAP) — X — — — X

Gate Depth — X — — — X

Note: The automatic trace tool must be used to calculate the TAM*

88 Chapter 4: Measurements and Calculations

Calculations

Calculations may be performed and results saved to the patient report. Measurements may also be viewed, repeated, and deleted. Some measurements can be deleted from the report pages. See

“Patient Report” on page 135.

Perform Measurement

View or Repeat Saved Measurement

Delete Measurement

1 Select a measurement from the calculations menu by highlighting the

desired measurement then pressing the Select key.

2 Perform the measurement.

• The measurement is displayed in the measurement and calculation data area and is updated as the caliper moves.

• The measurement is complete when you finish moving the calipers.

3Select Save from the on-screen menu to save the measurement to the

patient report.

1 From the calculations menu, select the desired measurement.

The saved measurement is displayed at the bottom of the calculation

menu. 2 Press the Select key or the Caliper key to select the measurement. 3 Repeat the measurement.

• The new results are displayed in the measurement and calculation data area.

• You can compare the active measurement to the saved measurement.

4 To save the new measurement, select Save from the on-screen menu or

press the Enter key. This saves the new measurement to the patient report and overwrites

the previously saved measurement.

1 From the calculations menu, select the desired measurement. 2Select Delete from the on-screen menu.

• This removes the last saved measurement from the patient report.

• Some measurements can be deleted from the report pages. See

“Patient Report” on page 135.

and Calculations

Measurements

Chapter 4: Measurements and Calculations 89

Percent Reduction Calculations

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Percent reduction calculations may be performed and saved to the patient report. The following table shows the transducers and exam types that provide vascular percent reduction calculations.

Table 2: Transducer and Exam Types for Percent Reduction

Transducer Exam Types

C11e Abdomen

C60e Abdomen

HFL38 IMT, Small Parts, Vascular

L25e Vascular, Muscle

L38e IMT, Small Parts, Vascular

P17 Abdomen

P10 Vascular, Abdomen

SLA Vascular, Muscle

Verify that the patient information, date, and time settings are accurate.

Before starting a new calculation, start a new patient exam to delete the previous measurements. See “New Patient” on page 49.

SLT Hepatic, Abdomen

Figure 4 Percent Area Reduction Measurement

90 Chapter 4: Measurements and Calculations

Sonosite Mircomaxx User Manual

Specifications and Main Features

Frequently Asked Questions

User Manual

Contents

Chapter 1: Introduction

About the User Guide

Intended Uses

Conventions

Symbols and Terms

Upgrades and User Guide Updates

Customer Comments

Contact Information

About the System

About the System Software

Chapter 2: Getting Started

Healthy Scanning Guidelines

System Preparation

Installing or Removing Battery

Installing or Removing CompactFlash Card

Using AC Power/Charging Battery

Turning System On/Off

Connecting or Removing Transducer

System Controls

Screen Layout

General Interaction

To uc h pa d

On-Screen Menus

Menu Controls

Annotation and Text

Forms

System Setup

Set Security Settings

Audio and Battery

Cardiac Calculations

Connectivity

Date and Time

Delta Key and Annotation

Display Information

IMT Calculations

OB Calculations Authors

OB Custom Measurements

OB Custom Tables

Presets

System Information

Network Status

Chapter 3: Imaging

Patient Information

Transducer, Exam Type, and Imaging Mode

Transducer Preparation

General Use

Invasive or Surgical Use

Modes

2D Imaging

MMode Imaging

Color Doppler Imaging

Pulsed Wave (PW) and Continuous Wave (CW) Doppler Imaging

Clips

Clip Acquisition Delay

Image and Clip Storage

Save to CompactFlash

Print to Local Printer

Image and Clip Review

Patient List

Patient Images and Clips

Annotations

ECG Monitoring

Footswitch

Bar Code Scanner

Needle Guidance

Chapter 4: Measurements and Calculations

Measurements

2D Measurements

M Mode Measurements

Doppler Measurements

Calculations

Percent Reduction Calculations