Welch Allyn RScribe User Manual

Welch Allyn®
RScribe™
12-LEAD electrocardiograph SYSTEM USER MANUAL
Manufactured by Welch Allyn, Inc. Skaneateles Falls, NY U.S.A.
CAUTION: Federal law restricts this device to sale by or on the order of a physician.
©2019 Welch Allyn This document contains confidential information that belongs to Welch Allyn, Inc. No part of this document may be transmitted, reproduced, used, or disclosed outside of the receiving organization without the express written consent of Welch Allyn, Inc. Welch Allyn is a registered trademark of Welch Allyn, Inc. AM12, RScribe, WAM, and ELI are trademarks of Welch Allyn, Inc. SCF (Source Consistency Filter) is a copyright of Welch Allyn, Inc. Microsoft and Windows are registered trademarks of Microsoft Corporation. Adobe and Acrobat are registered trademarks of Adobe Systems Incorporated. DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communications of medical information. Citrix and Citrix XenApp are registered trademarks of Citrix Systems, Inc. Software V7.0.0 2017-03
For patent information, please visit www.welchallyn.com/patents For information about any Welch Allyn product, visit: https://www.welchallyn.com/en/about-us/locations.html Customer Service and Technical Support: https://www.welchallyn.com/en/other/contact-us.html 1.888.667.8272,
mor_tech.support@hillrom.com
9515-217-50-ENG Rev B Revision Date 2019-08
901127 ELECTROCARDIOGRAPH
EU IMPORTER
Welch Allyn, Inc. 4341 State Street Road Skaneateles Falls, NY 13153 USA
www.welchallyn.com
Welch Allyn Limited Navan Business Park, Dublin Road, Navan, Co. Meath C15 AW22 Ireland
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TABLE OF CONTENTS
NOTICES ................................................................................................................................................................. 4
MANUFACTURERS RESPONSIBILITY .................................................................................................................................... 4
RESPONSIBILITY OF THE CUSTOMER .................................................................................................................................... 4
EQUIPMENT IDENTIFICATION ............................................................................................................................................. 4
COPYRIGHT AND TRADEMARK NOTICES ............................................................................................................................... 4
OTHER IMPORTANT INFORMATION ..................................................................................................................................... 4
NOTICE TO EU USERS AND/OR PATIENTS: ........................................................................................................................... 4
WARRANTY INFORMATION ................................................................................................................................... 5
YOUR WELCH ALLYN WARRANTY ....................................................................................................................................... 5
USER SAFETY INFORMATION ................................................................................................................................. 7
WARNINGS ................................................................................................................................................................. 7
CAUTION....................................................................................................................................................................... 9
NOTES ........................................................................................................................................................................ 10
EQUIPMENT SYMBOLS AND MARKINGS .............................................................................................................. 12
SYMBOL DELINEATION ................................................................................................................................................... 12
PACKAGE SYMBOL DELINEATION ...................................................................................................................................... 13
GENERAL CARE .................................................................................................................................................... 14
PRECAUTIONS .............................................................................................................................................................. 14
INSPECTION ................................................................................................................................................................. 14
CLEANING AND DISINFECTING ......................................................................................................................................... 14
DISPOSAL .................................................................................................................................................................... 14
ELECTROMAGNETIC COMPATIBILITY (EMC) ......................................................................................................... 15
REGULATORY RADIO COMPLIANCE ................................................................................................................................... 19
INDUSTRY CANADA (IC) EMISSIONS .................................................................................................................................. 20
EUROPEAN UNION ........................................................................................................................................................ 21
INTRODUCTION ................................................................................................................................................... 23
MANUAL PURPOSE ....................................................................................................................................................... 23
AUDIENCE ................................................................................................................................................................... 23
INTENDED USE ............................................................................................................................................................. 23
INDICATIONS FOR USE ................................................................................................................................................... 24
SYSTEM DESCRIPTION .................................................................................................................................................... 24
ACQUISITION MODULE TYPES ......................................................................................................................................... 25
LEAD FAIL ................................................................................................................................................................... 26
RSCRIBE SOFTWARE INSTALLATION PROCESS ...................................................................................................................... 27
FEATURE ACTIVATION .................................................................................................................................................... 31
RSCRIBE LOGIN AND MAIN DISPLAY ................................................................................................................................. 32
RSCRIBE PROGRAM ICONS AND DESCRIPTIONS ................................................................................................................... 33
USER ROLES AND PERMISSIONS ....................................................................................................................................... 34
RSCRIBE WORKSTATION SPECIFICATIONS .......................................................................................................................... 35
WAM SPECIFICATIONS .................................................................................................................................................. 37
WAM AND AM12 ACCESSORIES .................................................................................................................................... 40
RSCRIBE NETWORK OPERATION IN A DISTRIBUTED CONFIGURATION ...................................................................................... 41
TABLE OF CONTENTS
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USING RSCRIBE .................................................................................................................................................... 43
SCHEDULE AN EXAM ...................................................................................................................................................... 43
START A RESTING EXAM .................................................................................................................................................. 43
ACQUIRING A STAT ECG EXAM ...................................................................................................................................... 43
REVIEWING AND SIGNING AN EXAM AND PRINTING A REPORT................................................................................................. 43
REAL-TIME DISPLAY....................................................................................................................................................... 43
RECORDING AN ECG ..................................................................................................................................................... 44
PREVIEW ACQUISITION SCREEN ....................................................................................................................................... 44
PAIRING WAM WITH RSCRIBE ........................................................................................................................................ 46
MWL/PATIENTS ................................................................................................................................................... 47
MWL ........................................................................................................................................................................ 47
EDIT ORDER ................................................................................................................................................................ 47
NEW ORDER ................................................................................................................................................................ 48
DELETE AN EXISTING ORDER ........................................................................................................................................... 48
EXIT MWL/PATIENTS ................................................................................................................................................... 48
RECORD AN ECG .................................................................................................................................................. 50
PATIENT PREPARATION .................................................................................................................................................. 50
PATIENT HOOKUP ......................................................................................................................................................... 50
PATIENT DEMOGRAPHIC ENTRY ....................................................................................................................................... 52
STAT ECG .................................................................................................................................................................. 52
START A RESTING EXAM ................................................................................................................................................. 52
ECG ACQUISITION, PRINTING, AND STORAGE .................................................................................................................... 54
DISPLAY OVERVIEW....................................................................................................................................................... 54
ACQUIRE ECGS ............................................................................................................................................................ 56
CONTEXT MENUS ................................................................................................................................................. 60
CONTEXT MENU SETTINGS ............................................................................................................................................. 60
EXAM SEARCH ..................................................................................................................................................... 65
SELECTING ECG REPORTS TO REVIEW ............................................................................................................................... 65
ADVANCED SEARCH....................................................................................................................................................... 66
EDIT A RESTING ECG REPORT ......................................................................................................................................... 67
REPORT PRINT PREVIEW ................................................................................................................................................ 69
ICON TOOL BAR............................................................................................................................................................ 70
SECTIONS .................................................................................................................................................................... 70
SYSTEM SETTINGS ................................................................................................................................................ 71
MANAGE USER ACCOUNTS AND PERSONNEL ...................................................................................................................... 71
NEW USER .................................................................................................................................................................. 72
MANAGE/CREATE GROUPS ............................................................................................................................................ 72
MODALITY SETTINGS ..................................................................................................................................................... 73
WAVEFORMS TAB ......................................................................................................................................................... 74
ACQUIRE TAB ............................................................................................................................................................... 76
FULL DISCLOSURE TAB ................................................................................................................................................... 77
RESTING ECG TAB ........................................................................................................................................................ 79
CFD CONFIGURATION ................................................................................................................................................... 81
ELI LINK CONFIGURATION .............................................................................................................................................. 82
UNLOCK EXAMS ........................................................................................................................................................... 83
MANAGE ARCHIVE STORAGE .......................................................................................................................................... 83
AUDIT TRAIL LOGS ........................................................................................................................................................ 85
TABLE OF CONTENTS
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SERVICE LOGS .............................................................................................................................................................. 85
CONFIGURE WORKFLOW ................................................................................................................................................ 86
USER PREFERENCES ....................................................................................................................................................... 87
RSCRIBE WILL PRESENT THE DEFAULT SETTINGS ON ANY OF THE WORKSTATIONS THAT THE USER LOGS INTO. ....... 87
REPORT CONFIGURATION TOOL ....................................................................................................................................... 88
USER ROLE ASSIGNMENT TABLE ...................................................................................................................................... 89
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NOTICES

Manufacturer’s Responsibility

Welch Allyn, Inc. is responsible for the effects on safety and performance only if:
Assembly operations, extensions, readjustments, modifications, or repairs are carried out only by persons
authorized by Welch Allyn, Inc.
The device is used in accordance with the instructions for use.

Responsibility of the Customer

The user of this device is responsible for ensuring the implementation of a satisfactory maintenance schedule. Failure to do so may cause undue failure and possible health hazards.

Equipment Identification

Welch Allyn, Inc. equipment is identified by a serial and reference number on the back of the device. Care should be taken so that these numbers are not defaced. Software equipment is accompanied by an identification card; carefully store this card as the information is needed for activation, upgrade and customer service.

Copyright and Trademark Notices

This document contains information that is protected by copyright. All rights are reserved. No part of this document may be photocopied, reproduced, or translated to another language without prior written consent of Welch Allyn, Inc.

Other Important Information

The information in this document is subject to change without notice.
Welch Allyn, Inc. makes no warranty of any kind with regard to this material including, but not limited to, implied warranties of merchantability and fitness for a particular purpose. Welch Allyn, Inc. assumes no responsibility for any errors or omissions that may appear in this document. Welch Allyn, Inc. makes no commitment to update or to keep current the information contained in this document.

Notice to EU Users and/or Patients:

Any serious incident that has occurred in relation to the device, should be reported to the manufacturer and the competent authority of the Member State in which the user and/or patient is established.
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WARRANTY INFORMATION

Your Welch Allyn Warranty

WELCH ALLYN, INC. (hereafter referred to as “Welch Allyn”) warrants that components within Welch Allyn products (hereafter referred to as “Product/s”) will be free from defects in workmanship and materials for the
number of years specified on documentation accompanying the product, or previously agreed to by the purchaser and Welch Allyn, or if not otherwise noted, for a period of thirteen (13) months from the date of shipment.
Consumable, disposable or single use products such as, but not limited to, PAPER or ELECTRODES are warranted to be free from defects in workmanship and materials for a period of 90 days from the date of shipment or the date of first use, whichever is sooner.
Reusable product such as, but not limited to, BATTERIES, BLOOD PRESSURE CUFFS, BLOOD PRESSURE HOSES, TRANSDUCER CABLES, Y-CABLES, PATIENT CABLES, LEAD WIRES, MAGNETIC STORAGE MEDIUMS, CARRY CASES or MOUNTS, are warranted to be free from defects in workmanship and materials for a period of 90 days. This warranty does not apply to damage to the Product/s caused by any or all of the following circumstances or conditions:
a) Freight damage; b) Parts and/or accessories of the Product/s not obtained from or approved by Welch Allyn; c) Misapplication, misuse, abuse, and/or failure to follow the Product/s instruction sheets and/or information guides; d) Accident; a disaster affecting the Product/s; e) Alterations and/or modifications to the Product/s not authorized by Welch Allyn; f) Other events outside of Welch Allyn’s reasonable control or not arising under normal operating conditions.
THE REMEDY UNDER THIS WARRANTY IS LIMITED TO THE REPAIR OR REPLACEMENT WITHOUT CHARGE FOR LABOR OR MATERIALS, OR ANY PRODUCT/S FOUND UPON EXAMINATION BY WELCH ALLYN TO HAVE BEEN DEFECTIVE. This remedy shall be conditioned upon receipt of notice by Welch Allyn of any alleged defects promptly after discovery thereof within the warranty period. Welch Allyn’s obligations under the foregoing warranty will further be conditioned upon the assumption by the purchaser of the Product/s (i) of all carrier charges with respect to any Product/s returned to Welch Allyn’s principal place or any other place as specifically designated by Welch Allyn or an authorized distributor or representative of Welch Allyn, and (ii) all risk of loss in transit. It is expressly agreed that the liability of Welch Allyn is limited and that Welch Allyn does not function as an insurer. A purchaser of a Product/s, by its acceptance and purchase thereof, acknowledges and agrees that Welch Allyn is not liable for loss, harm, or damage due directly or indirectly to an occurrence or consequence there from relating to the Product/s. If Welch Allyn should be found liable to anyone under any theory (except the expressed warranty set forth herein) for loss, harm, or damage, the liability of Welch Allyn shall be limited to the lesser of the actual loss, harm, or damage, or the original purchase price of the Product/s when sold.
WARRANTY INFORMATION
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EXCEPT AS SET FORTH HEREIN WITH RESPECT TO REIMBURSEMENT OF LABOR CHARGES, A PURCHASER’S SOLE EXCLUSIVE REMEDY AGAINST WELCH ALLYN FOR CLAIMS RELATING TO THE PRODUCT/S FOR ANY AND ALL LOSSES AND DAMAGES RESULTING FROM ANY CAUSE SHALL BE THE REPAIR OR REPLACEMENT OF DEFECTIVE PRODUCT/S TO THE EXTENT THAT THE DEFECT IS NOTICED AND WELCH ALLYN IS NOTIFIED WITHIN THE WARRANTY PERIOD. IN NO EVENT, INCLUDING THE CLAIM FOR NEGLIGENCE, SHALL WELCH ALLYN BE LIABLE FOR INCIDENTAL, SPECIAL, OR CONSEQUENTIAL DAMAGES, OR FOR ANY OTHER LOSS, DAMAGE, OR EXPENSE OF ANY KIND, INCLUDING LOSS OF PROFITS, WHETHER UNDER TORT, NEGLIGENCE OR STRICT LIABILITY THEORIES OF LAW, OR OTHERWISE. THIS WARRANTY IS EXPRESSLY IN LIEU OF ANY OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTY OF MERCHANTABILITY AND THE WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE.
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USER SAFETY INFORMATION

WARNING:
Means there is the possibility of personal injury to you or others.
Caution:
Means there is the possibility of damage to the device.
Note:
Provides information to further assist in the use of the device.
NOTE: This manual may contain screen shots and pictures. Any screen shots and pictures are provided for reference only. Consult the actual screen in the host language for specific wording.
WARNINGS
1. This manual gives important information about the use and safety of this device. Deviating from operating
procedures, misuse or misapplication of the device, or ignoring specifications and recommendations could result in increased risk of harm to users, patients and bystanders, or damage to the device.
2. Device captures and presents data reflecting a patient’s physiological condition that when reviewed by a trained
physician or clinician can be useful in determining a diagnosis; however, the data should not be used as a sole means for determining a patient’s diagnosis.
3. Users are expected to be licensed clinical professionals knowledgeable about medical procedures and patient
care, and adequately trained in the use of this device. Before attempting to use this device for clinical applications, the operator must read and understand the contents of the user manual and other accompanying documents. Inadequate knowledge or training could result in increased risk of harm to users, patients and bystanders, or damage to the device. Contact Welch Allyn service for additional training options.
4. To maintain designed operator and patient safety, peripheral equipment and accessories used that can come in
direct patient contact must be in compliance with UL 60601-1, IEC 60601-1, and IEC 60601-2-25. Only use parts and accessories supplied with the device and available through Welch Allyn, Inc.
5. Patient cables intended for use with the device include series resistance (9 Kohm minimum) in each lead for
defibrillation protection. Patient cables should be checked for cracks or breakage prior to use.
6. Conductive parts of the patient cable, electrodes, and associated connections of type CF applied parts, including
the neutral conductor of the patient cable and electrodes, should not come into contact with other conductive parts including earth ground.
7. Do not attempt to clean the patient cables by submersing into a liquid, autoclaving, or steam cleaning as this
may damage equipment or reduce its usable life. Wipe the exterior surfaces with a warm water and mild detergent solution and then dry with a clean cloth. Use of unspecified cleaning/disinfecting agents, failure to follow recommended procedures, or contact with unspecified materials could result in increased risk of harm to users, patients and bystanders, or damage to the device.
8. The device is part of an integral personal computer-based diagnostic system. The user must adhere to all
warnings in order to ensure safe and reliable performance.
9. If operated on AC (~) power, the personal computer must be connected with its original power cable to an
electrical installation that complies with applicable regulations for environments where patients are treated.
10. The personal computer used and any peripheral devices connected to it must be approved to the appropriate
safety standard for nonmedical information technology equipment per IEC 60950, or its national variants. The personal computer and any peripheral devices connected to it, being non-medical electrical equipment, must be
USER SAFETY INFORMATION
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situated outside the patient environment per IEC 60601-1–1. To ensure the safety of the patient it must not be possible for the operator to touch the patient and the computer at the same time. In general, at least 1.5 meters (5’) of open area must surround the patient to achieve this.
11. If the personal computer is situated within the patient environment, ensure that its level of safety is that of
medical electrical equipment per IEC 60601-1. This may be accomplished by powering the computer and any other equipment connected to it through an isolation transformer or by operating on battery power.
12. If the personal computer is situated within the patient environment, to maintain designed operator and patient
safety when a LAN network connection is being used, the network cable must be connected to the device through an Ethernet isolator module that complies with IEC 60601-1-1 (available from Welch Allyn).
13. ECG electrodes could cause skin irritation; patients should be examined for signs of irritation or inflammation.
Electrode materials and ingredients are specified on the packaging or are available from the vendor upon request.
14. To avoid the possibility of serious injury or death during patient defibrillation, do not come into contact with
device or patient cables. Additionally, proper placement of defibrillator paddles in relation to the electrodes is required to minimize harm to the patient.
15. Proper clinical procedure must be employed to prep the electrode sites and to monitor the patient for excessive
skin irritation, inflammation, or other adverse reactions. Electrodes are intended for short-term use and should be removed from the patient promptly following testing. Do not mix electrodes made of dissimilar metals.
16. To avoid potential for spread of disease or infection, single-use disposable components (e.g., electrodes) must
not be reused. To maintain safety and effectiveness, electrodes must not be used beyond their expiration date.
17. A possible explosion hazard exists. Do not use the device in the presence of flammable anesthetic mixture.
18. Possible malfunction risks may be present when installing third-party software. Welch Allyn, Inc. cannot verify
the compatibility of all possible hardware/software combinations.
19. The device has not been designed for use with high-frequency (HF) surgical equipment and does not provide a
protective means against hazards to the patient.
20. When the 40 Hz filter is used, the frequency response requirement for diagnostic ECG equipment cannot be
met. The 40 Hz filter significantly reduces high-frequency components of the ECG and pacemaker spike amplitudes, and is recommended only if high-frequency noise cannot be reduced by proper procedures.
21. The quality of the signal produced by the device may be adversely affected by the use of other medical
equipment, including but not limited to defibrillation and ultrasound machines.
22. Use only recommended alkaline battery cells with WAM. Use of other cells may present a risk of fire or
explosion.
23. The WAM low battery warning function is designed for alkaline battery cells only. Use of other cells may
result in failure of the low battery warning possibly resulting in a malfunction of the device.
24. Test RScribe functions after each Microsoft critical and security update with a simulator prior to patient use.
25. Damaged or suspected inoperative equipment must be immediately removed from use and must be
checked/repaired by qualified service personnel prior to continued use.
USER SAFETY INFORMATION
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26. To prevent emission of substances that may damage the environment, dispose of the device, its components and
accessories (e.g., batteries, cables, electrodes), and/or packing materials that are past the shelf life in accordance with local regulations.
27. When necessary, dispose of the device, its components and accessories (e.g., batteries, cables, electrodes),
and/or packing materials in accordance with local regulations.
28. Proper functioning backup items such as a spare patient cable, display monitor, and other equipment are
recommended on hand to prevent delayed treatment due to an inoperable device.

Caution

1. Do not pull or stretch patient cables as this could result in mechanical and/or electrical failures. Patient cables
should be stored after forming them into a loose loop.
2. Proper functioning backup items such as a spare patient cable, front-end device, display monitor, and other
equipment are recommended on hand to prevent delayed treatment due to an inoperable device.
3. Windows compatibility, updates and anti-virus policy: The RScribe software has been fully tested with
Windows 7 Professional Service Pack 1, Windows 8.1 Professional, and Windows 10 Pro operating systems. The RScribe software has also been tested with Windows Server 2008 R2 Service Pack 1 and Windows Server 2012 R2. Although it is unlikely that Windows updates and security patches affect RScribe functionality, Welch Allyn recommends turning automatic Windows update off, and periodically running it manually. A functional test should be executed after update, which includes acquiring a recording, editing measurements and printing a report, as well as importing an order and exporting results, if activated. Compatibility of RScribe with corporate anti-virus software packages has been evaluated. Welch Allyn recommends excluding the RScribe database folder (Normally C:\ProgramData\MiPgSqlData on a stand-alone system or the server) from the folders to be scanned. In addition, anti-virus patch updates and system scans should be scheduled for time periods when the system is not actively in use or performed manually.
4. No other non-recommended PC application software should be running while the RScribe application is being
used.
5. It is recommended that all resting ECG workstations and review stations be periodically updated with Microsoft
critical and security updates to protect from malware attacks and to fix critical Microsoft software issues.
6. To prevent delivery of malware into the system Welch Allyn recommends that institution operating procedures
are written to prevent malware to be transmitted into the system from removable media.
7. The WAM will only work with receiving devices that are equipped with the appropriate option.
8. This WAM is not recommended for use in the presence of imaging equipment such as Magnetic Resonance
Imaging (MRI) and Computed Tomography (CT) devices, etc.
9. The following equipment may cause interference with the WAM RF channel: microwave ovens, diathermy units
with LANs (spread spectrum), amateur radios, and government radar.
10. AA batteries are known to leak their contents when stored in unused equipment. Remove battery from WAM
when not used for an extended period of time.
USER SAFETY INFORMATION
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11. Be careful to insert the correct lead wire into the connector block with the appropriate input connector by matching
the lead wire labels to the WAM or AM12 lead labels.
Notes
1. Local Administrator permissions are required for software installation, application configuration, and software
activation. Local User privileges are required for application users. Roaming and temporary accounts are not supported.
2. 8-hour timeout expiration is automatically controlled by the system. Each operation that occurs (e.g. Exam
Search, Patient Search, editing exams, starting an exam, etc.) will reset the timeout start time. When there is no interaction with the system for the timeout duration, the user is prompted to enter login information.
3. When the server is unavailable in a distributed configuration, the client workstation will notify the user with a
prompt to proceed in Offline Mode or cancel. Scheduled orders are not available. An exam can be conducted with manually entered demographics and will be stored locally. When the server comes available, the user is prompted with a list of unsent exams and a selection to send exams to the modality manager database.
4. Patient movements may generate excessive noise that may affect the quality of the ECG traces and the proper
analysis performed by the device.
5. Proper patient preparation is important to proper application of ECG electrodes and operation of the device.
6. There is no known safety hazard if other equipment, such as pacemakers or other stimulators, is used
simultaneously with the device; however, disturbance to the signal may occur.
7. If an electrode is not properly connected to the patient, or one or more of the patient cable lead wires is damaged,
the display will indicate a lead fault for the lead(s) where the condition is present.
8. A thick baseline presentation on the display while using the AM12 may be due to a calibration error. Review the
LED indicator on the AM12 to ensure the unit is connected, or disconnect and reconnect to the PC USB port to re-calibrate.
9. The WAM will automatically start flashing LEDs if the batteries have been discharged below 1.0 volts.
10. During normal WAM/AM12 operation, the green LED will display continuously.
11. If the WAM battery cover is opened during transmission, the device will stop transmitting. The battery must be
reinserted and the cover must be applied to resume operation.
12. The WAM will automatically turn off (LEDs off) if the battery has been severely discharged.
13. The WAM will automatically turn off when the electrocardiograph is powered down.
14. The WAM will automatically turn off after being disconnected from the patient. This will happen regardless of
RScribe battery/AC power state.
15. A thick baseline presentation on the display while using the WAM may be due to the WAM being turned off,
having no battery, not being paired correctly, operating out of range, or due to a calibration error. Review the LED indicator and auditory advisory on the WAM to ensure the unit is turned on, has proper battery level, is paired correctly, and is within recommended proximity of the electrocardiograph, or power cycle the WAM to re-calibrate.
16. As defined by IEC 60601-1 and IEC 60601-2-25, the device is classified as follows:
- Type CF, defibrillation-proof applied parts.
USER SAFETY INFORMATION
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If not specifically indicated otherwise, personal computer equipment used with the device can be regarded as:
- Class I (if the computer has a three-prong power inlet) or class II (if it has a two-prong inlet)
- Ordinary equipment.
- Equipment not suitable for use in the presence of a flammable anesthetic mixture.
- Continuous operation.
17. To prevent possible damage to the device during transport and storage (while in original packaging) the
following environmental conditions must be adhered to:
Ambient temperature: -20 C to 65 C (-4 F to 149 F) Relative humidity: 10% to 95%, non-condensing
18. Allow the device and any computer equipment used to stabilize within its intended operating environment
for a minimum of two hours prior to use. Refer to the computer equipment user manual for allowable environmental conditions. The allowable environmental conditions for the AM12 and WAM acquisition modules are as follows:
Ambient temperature: 10 C to 40 C (50 F to 104 F) Relative humidity: 10% to 95%, non-condensing
19. The WAM is UL classified:
WITH RESPECT TO ELECTRIC SHOCK, FIRE AND MECHANICAL HAZARDS ONLY IN ACCORDANCE WITH UL2601-1, IEC60601-1, CAN/CSA CC22.2 No. 601.1, IEC60601-2-25,
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EQUIPMENT SYMBOLS AND MARKINGS

Symbol Delineation

NOTE: Refer to the manual(s) accompanying the device that pertain to the computer hardware for additional definitions of symbols that may be present.
WARNING The warning statements in this manual identify conditions or practices that could lead to illness, injury, or death. In addition, when used on a patient applied part, this symbol indicates defibrillation protection is in the cables. Warning symbols will appear with a grey background in a black and white document.
CAUTION The caution statements in this manual identify conditions or practices that could result in damage to the equipment or other property, or loss of data.
PC
USB connection to PC
Defibrillator-proof type CF applied part
Do not dispose as unsorted municipal waste. Requires separate handling for waste disposal according to local requirements
Indicates compliance to applicable European Union directives
Non-ionizing electromagnetic radiation
Follow instructions/directions for use (DFU) -- mandatory action. A copy of the DFU is available on this website. A printed copy of the DFU can be ordered from Welch Allyn for delivery within 7 calendar days.
Consult directions for use (DFU). A copy of the DFU is available on this website. A printed copy of the DFU can be ordered from Welch Allyn for delivery within 7 calendar days
Medical Device
Model Identifier
Reorder Number
EQUIPMENT SYMBOLS AND MARKINGS
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Package Symbol Delineation

This side up
Fragile
Keep Dry
Keep Away from Heat
Acceptable Temperature Range
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GENERAL CARE

Precautions

Turn off the device before inspecting or cleaning. Do not immerse the device in water. Do not use organic solvents, ammonia based solutions, alcohol, or abrasive cleaning agents which may
damage equipment surfaces.

Inspection

Inspect your equipment daily prior to operation. If you notice anything that requires repair, contact an authorized service person to make the repairs.
Verify that all cords and connectors are securely seated. Check the case and chassis for any visible damage. Inspect cords and connectors for any visible damage. Inspect keys and controls for proper function and appearance.

Cleaning and Disinfecting

1. Disconnect the power source. Remove cables and lead wires from device before cleaning.
2. For general cleaning of cables and lead wires, use a soft, lint-free cloth lightly moistened with a mild soap
and water solution. Wipe and air dry.
3. For disinfecting the exterior surfaces of the device, patient acquisition module, cables, and lead wires, wipe
exterior using:
Clorox Healthcare® Bleach Germicidal Wipes (use according to instructions on product label), or
a soft, lint-free cloth with a solution of Sodium Hypochlorite (10% household bleach and water solution) minimum 1:500 dilution (minimum 100 ppm free chlorine) and maximum 1:10 dilution as recommended by the APIC Guidelines for Selection and Use of Disinfectants
WARNING: Prevent liquid from penetrating the device and do not attempt to clean/disinfect
the device or patient cables by submerging into a liquid, autoclaving, or steam cleaning. Never expose cables to strong ultra-violet radiation. Do not sterilize the device or ECG lead wires with Ethylene Oxide (EtO) gas.
WARNING: Use of unspecified cleaning/disinfecting agents or failure to follow recommended procedures
could result in increased risk of harm to users, patients and bystanders, or damage to the device.

Disposal

This product and its accessories must be disposed of according to local laws and regulations. Do not dispose of this product as unsorted municipal waste. For more specific disposal information see www.welchallyn.com/weee.
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ELECTROMAGNETIC COMPATIBILITY (EMC)

Electromagnetic compatibility with surrounding devices should be assessed when using the device. An electronic device can either generate or receive electromagnetic interference. Testing for electromagnetic
compatibility (EMC) has been performed on the device according to the international standard for EMC for medical devices (IEC 60601-1-2). This IEC standard has been adopted in Europe as the European Norm (EN 60601-1-2).
The device should not be used adjacent to, or stacked on top of other equipment. If the device must be used adjacent to or stacked on top of other equipment, verify that the device operates in an acceptable manner in the configuration in which it will be used.
Fixed, portable, and mobile radio frequency communications equipment can affect the performance of medical equipment. See the appropriate EMC table for recommended separation distances between the radio equipment and the device.
The use of accessories, transducers, and cables other than those specified by Welch Allyn may result in increased emissions or decreased immunity of the equipment.
ELECTROMAGNETIC COMPATIBILITY (EMC)
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Guidance and Manufacturer’s Declaration: Electromagnetic Emissions

The equipment is intended for use in the electromagnetic environment specified in the table below. The customer or the user of the equipment should ensure that it is used in such an environment.
Emissions Test
Compliance
Electromagnetic Environment: Guidance
RF Emissions CISPR 11
Group 1
The equipment uses RF energy only for its internal function. Therefore, its RF emissions are very low and not likely to cause any interference in nearby electronic equipment.
RF Emissions CISPR 11
Class A
The equipment is suitable for use in all establishments other than domestic and those directly connected to the public low­voltage power supply network that supplies buildings used for domestic purposes.
Harmonic Emissions IEC 61000-3-2
Complies
Voltage Fluctuations/ Flicker Emissions IEC 61000-3-3
Complies

Guidance and Manufacturer’s Declaration: Electromagnetic Immunity

The equipment is intended for use in the electromagnetic environment specified in the table below. The customer or the user of the equipment should ensure that it is used in such an environment.
Emissions Test
Compliance
Compliance Level
Electromagnetic Environment: Guidance
Electrostatic discharge (ESD) IEC 61000-4-2
+/- 6 kV contact +/- 8 kV air
+/- 6 kV contact +/- 8 kV air
Floors should be wood, concrete, or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%.
Electrical fast transient/burst IEC 61000-4-4
+/- 2 kV for power supply lines +/- 1 kV for input/output lines
+/- 2 kV for power supply lines +/- 1 kV for input/output lines
Mains power quality should be that of a typical commercial or hospital environment.
Surge IEC 61000-4-5
+/- 1 kV differential mode +/- 2 kV common mode
+/- 1 kV differential mode +/- 2 kV common mode
Mains power quality should be that of a typical commercial or hospital environment.
Voltage dips, short interruptions, and voltage variations on power supply input lines IEC 61000-4-11
<5% UT (>95% dip in UT) for 0.5 cycle 40% UT (60% dip in UT) for 5 cycles
<5% UT (>95% dip in UT) for 0.5 cycle 40% UT (60% dip in UT) for 5 cycles
Mains power quality should be that of a typical commercial or hospital environment.
Power frequency (50/60 Hz) magnetic field
3 A/m
3 A/m
Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment.
NOTE: UT is the AC Mains voltage prior to application of the test level.
ELECTROMAGNETIC COMPATIBILITY (EMC)
Page | 17

Guidance and Manufacturer’s Declaration: Electromagnetic Immunity

The equipment is intended for use in the electromagnetic environment specified in the table below. The customer or the user of the equipment should ensure that it is used in such an environment.
Emissions Test
IEC 60601 Test Level
Compliance Level
Electromagnetic Environment: Guidance
Conducted RF IEC 61000-4-6
3 Vrms 150 kHz to 80 MHz
3 Vrms 150 kHz to 80 MHz
Portable and mobile RF communications equipment should be used no closer to any part of the equipment, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter.
Recommended separation distance
P
Vrms
d
 
 
3
5.3
P
mV
d
 
 
/3
5.3
80 MHz to 800 MHz
P
mV
d
 
 
/3
7
800 MHz to 2.5 GHz
Where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m).
Field strengths from fixed RF transmitters, as determined by an electromagnetic site surveya, should
be less than the compliance level in each frequency rangeb.
Interference may occur in the vicinity of equipment marked with the following symbol:
Radiated RF IEC 61000-4-3
3 V/m 80 MHz to
2.5 GHz
3 V/m 80 MHz to
2.5 GHz
a. Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios,
amateur radios, AM and FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the equipment is used exceeds the applicable RF compliance level above, the equipment should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the equipment.
b. Over the frequency range 150 kHz to 80 MHz, field strengths should be less than [3] V/m.
ELECTROMAGNETIC COMPATIBILITY (EMC)
Page | 18

Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Equipment

The equipment is intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the equipment can help to prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the equipment as recommended in the table below, according to the maximum output power of the communications equipment.
Rated Maximum Output Power of Transmitter W
Separation Distance According to Frequency of Transmitter (m)
150 KHz to 800 MHz
800 MHz to 2.5 GHz
Pd 2.1
Pd 3.2
0.01
0.1 m
0.2 m
0.1
0.4 m
0.7 m
1
1.2 m
2.3 m
10
4.0 m
7.0 m
100
12.0 m
23.0 m
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1: At 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by the
absorption and reflection from structures, objects, and people.
ELECTROMAGNETIC COMPATIBILITY (EMC)
Page | 19

Regulatory Radio Compliance

Federal Communications Commission (FCC)

This device complies with part 15 of the FCC Rules. Operation is subject to the following two conditions:
This device may not cause harmful interference. This device must accept any interference received, including interference that may cause undesired
operation. This equipment has been tested and found to comply with the limits for a Class B digital device, pursuant to Part 15 of FCC Rules. These limits are designed to provide reasonable protection against harmful interference in a residential installation. This equipment generates, uses, and can radiate radio frequency energy. If not installed and used in accordance with the instructions, it may cause harmful interference to radio communications. However, there is no guarantee that interference will not occur in a particular installation. If this equipment does cause harmful interference to radio or television reception, which can be determined by turning the equipment off and on, the user is encouraged to try and correct the interference by one or more of the following measures:
Reorient or relocate the receiving antenna Increase the distance between the equipment and the receiver Connect the equipment to an outlet on a circuit different from that to which the receiver is connected Consult the dealer or an experienced radio/TV technician for help
The user may find the following booklet prepared by the Federal Communications Commission helpful: The Interference Handbook This booklet is available from the U.S. Government Printing Office, Washington, D.C.
20402. Stock No. 004-000-0034504. Welch Allyn is not responsible for any radio or television interference caused by unauthorized modification of the devices included with this Welch Allyn product, or the substitution or attachment of connecting cables and equipment other than specified by Welch Allyn. The correction of interference caused by such unauthorized modification, substitution, or attachment will be the responsibility of the user.
WLAN
B&B electronics1 WLNN-SP-MR551 (Radio module 9373) FCC ID: F4AWLNN551
1
Manufacturer also called B+B SmartWorx
ELECTROMAGNETIC COMPATIBILITY (EMC)
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Industry Canada (IC) Emissions

RF Radiation Hazard Warning

Using higher gain antennas and types of antennas not certified for use with this product is not allowed. The device shall not be co-located with another transmitter.
Cet avertissement de sécurité est conforme aux limites d'exposition définies par la norme CNR-102 at relative aux fréquences radio.
This device complies with RSS 210 of Industry Canada.
Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of this device.
L’utilisation de ce dispositif est autorisée seulement aux conditions suivantes: (1) il ne doit pas produire de brouillage et (2) l’ utilisateur du dispositif doit étre prêt à accepter tout brouillage radioélectrique reçu, même si ce
brouillage est susceptible de compromettre le fonctionnement du dispositif.
This Class B digital apparatus complies with Canadian ICES-003.
Cet appareil numérique de la classe B est conform à la norme NMB-003 du Canada.
WLAN
B&B electronics1 WLNN-SP-MR551 (Radio module 9373) IC: 3913A-WLNN551
1
Manufacturer also called B+B SmartWorx

Declaración de conformidad Mexico

La operación de este equipo está sujeta a las siguientes dos condiciones:
1. es posible que este equipo o dispositivo no cause interferencia perjudicial y
este equipo o dispositivo debe aceptar cualquier interferencia, incluyendo la que pueda causar su operación no deseada.
ELECTROMAGNETIC COMPATIBILITY (EMC)
Page | 21

European Union

Czech
Welch Allyn tímto prohlašuje, ze tento WLAN device je ve shodě se základními požadavky a dalšími příslušnými ustanoveními směrnice 2014/53/ES.
Danish
Undertegnede Welch Allyn erklærer herved, at følgende udstyr WLAN device overholder de væsentlige krav og øvrige relevante krav i direktiv 2014/53/EF
Dutch
Bij deze verklaart Welch Allyn dat deze WLAN device voldoet aan de essentiële eisen en aan de overige relevante bepalingen van Richtlijn 2014/53/EC.
English
Hereby, Welch Allyn, declares that this WLAN device is in compliance with the essential requirements and other relevant provisions of Directive 2014/53/EC.
Estonian
Käesolevaga kinnitab Welch Allyn seadme WLAN device vastavust direktiivi 2014/53/EÜ põhinõuetele ja nimetatud direktiivist tulenevatele teistele asjakohastele sätetele.
Finnish
Welch Allyn vakuuttaa täten että WLAN device tyyppinen laite on direktiivin 2014/53/EY oleellisten vaatimusten ja sitä koskevien direktiivin muiden ehtojen mukainen.
French
Par la présente, Welch Allyn déclare que ce WLAN device est conforme aux exigences essentielles et aux autres dispositions de la directive 2014/53/CE qui lui sont applicables
German
Hiermit erklärt Welch Allyn die Übereinstimmung des Gerätes WLAN device mit den grundlegenden Anforderungen und den anderen relevanten Festlegungen der Richtlinie 2014/53/EG. (Wien)
Greek
ΜΕ ΤΗΝ ΠΑΡΟΥΣΑ Welch Allyn ΔΗΛΩΝΕΙ ΟΤΙ WLAN device ΣΥΜΜΟΡΦΩΝΕΤΑΙ ΠΡΟΣ ΤΙΣ ΟΥΣΙΩΔΕΙΣ ΑΠΑΙΤΗΣΕΙΣ ΚΑΙ ΤΙΣ ΛΟΙΠΕΣ ΣΧΕΤΙΚΕΣ ΔΙΑΤΑΞΕΙΣ ΤΗΣ ΟΔΗΓΙΑΣ 2014/53/ΕΚ
Hungarian
Alulírott, Welch Allyn nyilatkozom, hogy a WLAN device megfelel a vonatkozó alapvetõ követelményeknek és az 2014/53/EC irányelv egyéb elõírásainak.
Italian
Con la presente Welch Allyn dichiara che questo WLAN device è conforme ai requisiti essenziali ed alle altre disposizioni pertinenti stabilite dalla direttiva 2014/53/CE.
Latvian
Ar šo Welch Allyn deklarē, ka WLAN device atbilst Direktīvas 2014/53/EK būtiskajām prasībām un citiem ar to saistītajiem noteikumiem.
Lithuanian
Šiuo Welch Allyn deklaruoja, kad šis WLAN device atitinka esminius reikalavimus ir kitas 2014/53/EB Direktyvos nuostatas.
Malti
Hawnhekk, Welch Allyn, jiddikjara li dan WLAN device jikkonforma mal-htigijiet essenzjali u ma provvedimenti ohrajn relevanti li hemm fid-Dirrettiva 2014/53/EC
Portuguese
Welch Allyn declara que este WLAN device está conforme com os requisitos essenciais e outras disposições da Directiva 2014/53/CE.
Slovak
Welch Allyn týmto vyhlasuje, ze WLAN device spĺňa základné požiadavky a všetky príslušné ustanovenia Smernice 2014/53/ES.
Slovene
Šiuo Welch Allyn deklaruoja, kad šis WLAN device atitinka esminius reikalavimus ir kitas 2014/53/EB Direktyvos nuostatas.
Spanish
Por medio de la presente Welch Allyn declara que el WLAN device cumple con los requisitos esenciales y cualesquiera otras disposiciones aplicables o exigibles de la Directiva 2014/53/CE
ELECTROMAGNETIC COMPATIBILITY (EMC)
Page | 22
Swedish
Härmed intygar Welch Allyn att denna WLAN device står I överensstämmelse med de väsentliga egenskapskrav och övriga relevanta bestämmelser som framgår av direktiv 2014/53/EG.
Page | 23

INTRODUCTION

Manual Purpose

This manual is intended to provide the user with information about the RScribe resting electrocardiograph’s display screen, menu structure, icons, and navigation tools pertaining in the following sections:
Using RScribe Preparing the Patient Using MWL/Patients Record an ECG Context menus Exam Search System Settings
NOTE: This manual contains screen images that are for illustration, and might be different in the actual product. Consult the actual screen in the host language for specific wording.

Audience

This manual is written for clinical professionals with a working knowledge of medical procedures and terminology as required for monitoring cardiac patients.

Intended Use

The RScribe Electrocardiograph is a multi-channel electrocardiograph product used for acquiring, analyzing, displaying and printing resting ECG’s. The RScribe is a 12-channel diagnostic electrocardiograph intended for recording and printing ECG’s of adult and pediatric patients. The acquired ECG will be displayed for quality check purpose, analyzed using the Welch Allyn VERITAS resting interpretation, optionally printed, stored and/or transmitted to a ECG Management System or Hospital Information System. The device is not intended to be used as a vital signs physiological monitor.
It is a system comprised of a Welch Allyn ECG amplifier (Wireless Acquisition Module [WAM] or AM12 Patient Cable) and an off-the-shelf personal computer with Welch Allyn software application that allows clinicians to collect ECGs on patients during routine visits. The patient populations for which the device will be used may be healthy or diseased of any age. ECG’s are taken with the patient in the supine position. The RScribe is intended to be used by a licensed health care practitioner in a hospital, medical clinic and offices of any size, including Clinical Research Organizations.
INTRODUCTION
Page | 24

Indications for Use

The RScribe electrocardiograph is a non-invasive prescription device.
The device is indicated for use to acquire, analyze, display, transmit and print electrocardiograms. The device is indicated for use to provide interpretation of the data for consideration by a physician. The device is indicated for use in a clinical setting, by a physician or by trained personnel who are acting
on the orders of a licensed physician. It is not intended as a sole means of diagnosis.
The interpretations of ECG offered by the device are only significant when used in conjunction with a
physician over-read as well as consideration of all other relevant patient data.
The device is indicated for use on adult and pediatric populations. The device is not intended to be used as a vital signs physiological monitor. The device is not designed for out of hospital transport. The device is not designed for use in highly invasive environments, such as an operating theatre.

System Description

RScribe is a multi-lead, diagnostic, computer-based resting electrocardiograph capable of acquiring, viewing, transmitting, printing, and storing ECG data.
RScribe models ordered with the VERITAS™ resting ECG interpretation algorithm option are capable of specific
age and gender interpretation criteria. The VERITAS algorithm provides an over-reading physician with a silent second opinion through diagnostic statements displayed on the ECG report. For additional information on the VERITAS algorithm, please refer to the Physician’s Guide to VERITAS with Adult and Pediatric Resting ECG Interpretation (see Accessories).
RScribe can be configured with bidirectional connectivity and DICOM® protocol support. The RScribe application is integrated with a patient and exam management system that handles the scheduling of
exams, database storage and maintenance, exam and patient search, printing, communication with external systems and dispatches the modality dependent acquisition and review functions. RScribe can be configured for data distribution. When so configured, the database resides on a server supporting a number of networked client workstations.
The RScribe Review software offers authorized users with the ability to schedule new exams when not linked to an external scheduling system, view reports, enter conclusions, and generate printed or electronic reports for completed exams.
The RScribe server, workstations, and review stations can be set up as Citrix® Application Servers for remote access from client computers with Citrix XenApp™ installed.
The RScribe supports print formats that include:
Standard or Cabrera, 3+1, 3+3, 12, 6+6 channel in automatic mode; Single channel on one page (60 min of acquired ECG for rhythm strip (Full Disclosure) printing.
The RScribe packing list includes:
Acquisition module with lead wire set and accessory starter kit Software CD Physician’s Guide to VERITAS and User Manual PDFs on CD
INTRODUCTION
Page | 25

Acquisition Module Types

Two acquisition module types, the Wireless Acquisition Module (WAM) or AM12 patient cable, for ECG acquisition are used with RScribe.

WAM with Lead Wires

Figure 1 WAM with Lead Wires
Replaceable
Lead Wires
Power On/Off
12-Lead ECG button Rhythm button Battery compartment
LED Indicators
The WAM incorporates frequency-hopping technology in the 2500 MHz frequency range with 40,000 Hz ECG acquisition and is operated by two buttons located on the front of the device when used with RScribe:
1. Power On/Off
2. Acquiring a 12-lead ECG
NOTE: Rhythm button is non-functional for use with RScribe.
The WAM uses one AA alkaline, 1.5V battery for approximately 8-hours of continuous operation.
WARNING: Use of other cells may present a risk of fire or explosion.
USB Transceiver Key (UTK)
The UTK connected to the RScribe USB port receives ECG signals from the paired WAM for presentation of the electrocardiogram. The UTK connected to USB cable (6400-015) from the PC port is positioned in an unobstructed location.
INTRODUCTION
Page | 26

WAM LED Indicators

LED
+ Audio
MODE
GREEN off YELLOW off
Intermittent beeping
WAM is on but not paired to an electrocardiograph, is out of range of the paired electrocardiograph.
YELLOW solid or flashing GREEN off
One or more leads are not connected properly.
GREEN solid YELLOW off
No lead fail condition is detected; battery is OK.
GREEN solid YELLOW off
Intermittent beeping
WAM is collecting a 10-second ECG.
Blinking LED (yellow or green depending on lead fault status)
WAM has detected a low battery condition. Replace the battery within 15 minutes. GREEN off YELLOW off
1 second audio on, then device turns off.
WAM has detected a very low battery status and powered off.

AM12 with Lead Wires

Figure 2 AM12 with Lead Wires
Replaceable
Lead Wires
LED
Indicators
12-Lead ECG button Rhythm button
USB cable
The AM12 is available for a traditional wired connection with direct USB connection and 40,000 Hz ECG acquisition. The 12-Lead ECG button can be used to acquire a 12-lead ECG at the patient’s side.
NOTE: Rhythm button is non-functional for use with RScribe.

Lead Fail

Lead fail is done automatically through visual communication with the LEDs located on the front of the WAM and AM12. A yellow LED (solid or flashing) indicates a lead fail condition is present. A solid green LED indicates proper lead connection as well as adequate WAM battery voltage for ECG acquisition.
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