Philips M1772A, Instructions For Use Manual

Page 1: ...I N S T R U C T I O N S F O R U S E C a r d i o g r a p h PageWriter 100 M1772A ...

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Page 3: ...PageWriter 100 M1772A Cardiograph 3DJH ULWHU 0 DUGLRJUDSK ...

Page 4: ...tten consent of the copyright holder Philips Medical Systems 3000 Minuteman Road Andover MA 01810 1099 USA 978 687 1501 WARNING Radio Frequency RF interference from nearby transmitting devices may seriously degrade performance of the PageWriter 100 Cardiograph Electromagnetic compatibility with surrounding devices should be assessed prior to using the cardiograph CAUTION Use of accessories other t...

Page 5: ...the equipment or software 127 Notes contain additional information on cardiograph usage Represents keys on the front panel Safety Summary Safety Symbols Marked on the Cardiograph The following safety symbols are used on the cardiograph Caution See operating instructions Meets IEC type CF leakage current requirements and is defibrillator protected Isolated ECG input Alternating current Equipotentia...

Page 6: ...perational Safety Notes in Chapter 1 Getting Acquainted for further information about operating your cardiograph safely Fuse Indicates power control for cardiograph Hz Indicates operating frequency in cycles per second RQYHQWLRQV ...

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Page 10: ...Contents 4 ...

Page 11: ...hould become familiar with this material especially the safety information prior to using the cardiograph 127 See Appendix A Setting up Your Cardiograph for the First Time for information on checking the voltage switch setting installing the battery connecting the cables and loading paper Each of these tasks must be done prior to operating the cardiograph for the first time ...

Page 12: ...1 2 Getting Acquainted LJXUH 7KH 3DJH ULWHU DUGLRJUDSK A Patient Cable B Cardiograph Bottom View of Cardiograph ...

Page 13: ...PageWriter 100 M1772A Cardiograph 1 3 1 1 LJXUH RWWRP 9LHZ RI DUGLRJUDSK A AC Fuse Holders B Mounting Point for M1705B Cart Mounting screw included with cart C Battery Door ...

Page 14: ...tus of the cardiograph Attention A flashing Auto light indicates that the ECG is being acquired When the light stays on the acquisition is com plete A flashing Chart Speed light indicates a paper supply problem A flashing Manual lead group light indicates an electrode connection problem B AC Light will be on when the power cord is plugged into AC power This also indicates that the battery if insta...

Page 15: ...lead sensitivity to 50 of the value set by Turns the Baseline Wander and Noise filters on or off See Auto Report Filters and Manual Report Filters for more information Advances the paper to the beginning of the next page Starts an Auto ECG recording Starts a Manual ECG recording Sequentially changes the lead group used to generate a Manual ECG from I II III aVR aVL aVF II aVF V2 V1 V6 I II III Hal...

Page 16: ...was shipped with one of three accessory sets according to your geographic option No Electrodes Options ABB ABD ABE ABF ABH ABS ABU ABX ABZ AKD ACB AC4 AB9 ABN l Power cord l Patient Cable l 1 package of paper l PageWriter 100 Instructions for Use For electrodes contact your local Philips Sales Office or your authorized Philips Dealer or Distributor Reusable Electrodes Options ABG ABK ABM ABZ AB4 A...

Page 17: ...sable electrode starter set l Tab electrode adapters l PageWriter 100 Instructions for Use ERXW 7KLV 0DQXDO This guide contains concise operating instructions for cardiograph users This manual describes how to perform the following tasks l Recording an ECG l Troubleshooting l Caring for and maintaining the cardiograph l Preparing your cardiograph for use ...

Page 18: ...h grounded plugs Also make sure the outlet accepts the plug and is grounded Never modify a grounded plug to fit an ungrounded outlet i e removing the ground prong or ground clip to fit an ungrounded outlet Should an ungrounded plug adapter be necessary use a ground strap to connect the equipotential connector at the rear of the instrument to the power source ground l The patient cable should be ro...

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Page 20: ...e Low Battery light begins to flash this indicates the cardiograph is about to shut down due to a very low battery Plug the cardiograph into AC power l From the time the Low Battery light first comes on to when the cardiograph automatically turns itself to Standby off there is typically enough reserve battery capacity to print two Auto ECG reports or 2 minutes of Manual ECG data A weak or faulty b...

Page 21: ... with the cardiograph in Standby off for 16 hours l The battery if installed is being charged any time the AC light is on l A fully depleted battery will charge to 90 of full capacity in 7 hours and 100 capacity in 16 hours as long as the cardiograph is in Standby off for the entire time l When the cardiograph is not in use it should be connected to AC power and left in Standby off This will maint...

Page 22: ...AC and DC Battery Operation 1 12 Getting Acquainted ...

Page 23: ...has not been setup refer to Appendix A for instructions The basic steps and procedures for recording an ECG are as follows 1 If the cardiograph is not On press 2 Prepare the patient and apply the electrodes as described in the Preparing the Patient section 3 Press or to record the ECG 4 Check the quality of the recorded ECG on the printed report The rest of this chapter discusses the details of se...

Page 24: ...able should be routed away from power cords and any other electrical equipment Failure to do so can result in AC line frequency interference on the ECG trace 1RWHV IRU XVWRPHUV 8VLQJ 5HXVDEOH OHFWURGHV Each electrode must be attached securely Straps must neither slide nor be so tight as to cause discomfort The electrode paste gel or creme must cover an area the size of the electrode but must not e...

Page 25: ...u press the key This is called Pre acquisition Pre acquisition is activated when the cardiograph is turned on and remains active until an Auto report begins to print Pre acquisition is deactivated by printing an Auto report to allow for copies of the Auto report to be printed see Making Copies of Auto ECGs Pre acquisition is also deactivated whenever an electrode is disconnected Pre acquisition is...

Page 26: ...the cardiograph one or more leadwires not being connected to electrodes or poor contact between the patient and one or more electrodes The cardiograph signals a leads off condition only during the acquisition of an Auto ECG The operator can check for a leads off condition anytime an ECG report is printed by checking for traces consisting of dashed lines or by checking the upper left corner of the ...

Page 27: ...ighest fidelity signal but unless ECG signal conditions are excellent it can record noise Table 2 2 shows when each filter is enabled 7DEOH XWR LOWHU 6HWWLQJV Designator AHA IEC Meaning RL N Right leg electrode not connected or only right leg electrode is connected and all other limb electrodes are not connected RA R Right arm electrode is not connected LA L Left arm electrode is not connectd LL F...

Page 28: ...ay copy the last ECG that was recorded To copy your most recent Auto ECG press the key 127 You must copy the ECG before the cardiograph has been turned to Standby off and before another ECG has been acquired You may change the speed 25 or 50 mm sec prior to printing a copy of an ECG You can only print copies of Auto ECGs RS ...

Page 29: ...e front panel 6 Inspect the ECG as it prints If any of the traces consist of a dotted line signifying leads off press and refer to Correcting a Leads Off Condition If you would like to try to improve one or more leads press and adjust the electrodes accordingly After making adjustments press Manual to restart the recording The cardiograph will print the ECG continuously until you press the key 127...

Page 30: ...h can be changed by pressing the appropriate key There is no need to press prior to changing settings 5HVWRULQJ WKH 7UDFH IWHU HILEULOODWLRQ RU 5HFRQQHFWLQJ HDGV After an application of a defibrillator pulse reconnecting one or more leads or any other time the ECG trace is off center during a Manual report the trace can be quickly restored by pressing the key again KDUW 6SHHG 6L H 9 HDGV LOWHU 6WR...

Page 31: ... filter light is on It delivers the least amount of noise l The 0 05 150 Hz filters 0 05 Hz Baseline Wander and 150 Hz Noise are enabled only when the Filter light is off It delivers the highest fidelity signal but unless ECG signal conditions are excellent it can record noise Table 2 3 shows when each filter is enabled 7DEOH 0DQXDO LOWHU 6HWWLQJV Default Filter light on Filters Off Filter light o...

Page 32: ...Understanding the Printed Report 2 10 Recording an ECG 8QGHUVWDQGLQJ WKH 3ULQWHG 5HSRUW LJXUH XWR 5HSRUW ...

Page 33: ...XWR 5HSRUW QQRWDWLRQV Description A Calibration signal See Table 2 5 B Sequence number the total number of ECGs the cardiograph has recorded C Filter settings AC filter Frequency range Baseline Wander filter W D Cardiograph settings for speed and for limb and chest lead sensitivity ...

Page 34: ...how the height of the calibration pulse indicates ECG sensitivity 7DEOH DOLEUDWLRQ 6LJQDOV ECG Size mm mV Calibration Pulse ECG Size mm mV V Leads Indicator Limb Leads V Leads V1 V6 Auto Manual Limb Leads V Leads 5 off 5 5 5 on 5 2 5 10 off 10 10 10 on 10 5 20 off 20 20 20 on 20 10 ...

Page 35: ...gure 2 2 is an example of the auto report format 0DQXDO 5HSRUW RUPDWV Manual ECGs reflect the ECG waveform as it occurs and there is no significant delay in the recording Alternate lead groups can be selected while recording a 3 or 6 lead ECG by pressing until the light above the desired lead group is lit The following table shows the available lead group choices The following list shows the avail...

Page 36: ...Choosing a Report Format 2 14 Recording an ECG Q XWR 5HSRUW DPSOH The following figure is an example of the Auto ECG report format LJXUH Q XWR ZLWK RQH 5K WP VWULS 5 Q XWR ...

Page 37: ...Choosing a Report Format PageWriter 100 M1772A Cardiograph 2 15 2 0DQXDO 5HSRUW DPSOHV The following figures show examples of manual ECG report formats LJXUH 0DQXO HDG ...

Page 38: ...Choosing a Report Format 2 16 Recording an ECG LJXUH 0DQXDO HDG ...

Page 39: ...eral things you can check before calling for service This chapter tells how to solve basic ECG problems KHFNLQJ 7HFKQLTXH Many problems in taking an ECG may be related to electrode application Review Preparing the Patient in Chapter 2 Recording an ECG to assure the patient leads are properly attached to the patient ...

Page 40: ...trodes Abrade skin Use new electrodes Route electrode wires along the limbs and away from any other electrical equipment Fix other equipment Unplug cardiograph from AC power and operate on battery only Move cardiograph further away from patient Unplug cardiograph from AC power and operate on battery only Move other instruments further away from patient Unplug electric bed Wandering Baseline Patien...

Page 41: ...emor or Muscle Artifact Poor electrode placement Poor electrode contact Patient is cold Tense uncomfortable patient Tremors Clean the electrode site Reapply electrodes Be sure that the limb electrodes are placed on flat non muscular areas of the body Warm the patient Reassure and relax the patient Make sure the Filter light is on Attach limb electrodes high on the extremities near the trunk Make s...

Page 42: ...aining the Cardiograph for more information l Is the paper door completely closed Open the paper door slightly and close it tightly Listen for the door safety latch to lock l Is there an electrode connection problem A flashing Manual lead group indicates an electrode connection problem Check that each electrode is attached securely If the cardiograph still won t operate perform the following steps...

Page 43: ...0 M1772A Cardiograph 3 5 3 Clean the paper sensor lens See Chapter 4 Maintaining the Cardiograph and Figure 4 1for more information l Is the cardiograph out of paper Load paper See Loading the Paper in Chapter 4 Maintaining the Cardiograph ...

Page 44: ...Identifying ECG Problems 3 6 Troubleshooting ...

Page 45: ...ensure that the cardiograph is in Standby mode all lights are off 2 Wipe the external surfaces of the cardiograph with a soft cloth dampened with mild soap and water or isopropyl alcohol Avoid applying cleaning fluids to the cable connectors 87 21 Do not use any strong solvents or abrasive cleaning materials Do not spill any liquids on the surface of the cardiograph Immediately have the cardiograp...

Page 46: ...e Dial Liquid Antibacterial Soap ammonia 409 may discolor cable 10 solution of Clorox in water may discolor cable Murphy Household Cleaner or Ves phene II Wring any excess moisture from the cloth before cleaning 87 21 Do not clean the patient cable with alcohol Alcohol can cause the plastic to become brittle and may cause the cable to fail prematurely Do not autoclave the cable or use ultrasonic c...

Page 47: ...JLWDO UUD 3ULQWKHDG DQG 3DSHU 6HQVRU A Printhead B Paper Sensor If the print quality is uneven it may be due to a dirty printhead How frequently you must clean the printhead depends on how many ECGs you print and the quality and type of paper you use If the paper fails to stop at the end of a page the paper sensor lens may be dirty ...

Page 48: ...the paper door The printhead is to the right under the paper blade and behind a brush See Figure 4 1 2 Wipe the printhead with a foam swab dipped in 90 isopropyl alcohol Scrub until all visible residues are removed 3 Dry the printhead with a clean lint free tissue To clean the paper sensor lens 1 From the front of the cardiograph unlatch and open the paper door The paper sensor lens is to the righ...

Page 49: ...aper LJXUH RDGLQJ WKH 3DSHU A Paper Door Latch B Paper Sensing Hole C Paper D Cardboard Backing E Key The cardiograph uses continuous feed Z fold paper For best results use the paper brand as supplied with your cardiograph See Supplies for ordering information 3DJH GYDQFH ...

Page 50: ...o the beginning of the next page Storing the Paper and Patient ECG Records Recordings on standard chemical thermal paper decompose naturally over time With proper storage and handling recordings on these papers have been shown to be readable for approximately 5 years Proper storage and handling before and after recording includes 1 Store the paper under cool and dry conditions Temperatures must no...

Page 51: ...e l Liquid or vaporous solvents such as alcohols ketones esters ethers etc Note that many of these solvents are found in felt tip and other marking pens l Petroleum based solvents such as toluene benzene and gasoline l Bright light or UV sources such as sunlight flourescent and related light sources l Chemicals containing castor oil ammonia some chemicals found in common hand and face creams or ci...

Page 52: ...Because it is not always possible to allow a full charge cycle between uses the PageWriter 100 was designed to charge a depleted battery to 90 of its capacity in approximately 7 hours 87 21 Repeated undercharging of the battery will damage the battery and reduce battery life 127 It is recommended that the cardiograph be plugged into AC power whenever possible to maximize battery life Battery life ...

Page 53: ... replace the AC fuses 1 Unplug the cardiograph from AC power 2 Turn the cardiograph bottom side up 3 Locate the two AC fuse holders on the bottom of the cardiograph as shown in Figure 4 3 4 Using a screwdriver turn the fuse cap 1 2 turn counter clockwise As the fuse cap is untwisted it extends above the surface of the cardiograph case 5 Pull the fuse cap straight up approximately 2 1 2 cm 1 inch u...

Page 54: ...Replacing the Fuses 4 10 Maintaining the Cardiograph 9 Repeat the operation for the other AC fuse LJXUH 7KH XVH ROGHUV A AC Fuse holders 2 ...

Page 55: ...230 l Worldwide Please contact your local Sales Office your authorized Dealer or Distributor or visit our Medical Supplies website at www medical philips com cms Paper M2481A Paper 8 5 x 11 1600 sheets with header M2483A Paper 210 x 300 mm 1600 sheets with header M2485A Paper PTP brand Anti fade 8 5 x 11 1600 sheets with header M2486A Paper PTP brand Anti fade 210 x 300 mm 1600 sheets with header ...

Page 56: ...elsh electrodes 15mm base 5cc bulb push in connection AHA 6 per box 40424A Limb plate electrode AHA 4 per pack 14030A 15 rubber strap for limb plate elec trode 40494E Limb clamp electrode clothespin style 4 per pack 40420A Disposable diagnostic pre gelled elec trode snap style 1 000 pieces 13943B Disposable diagnostic solid gel elec trode tab style 1 000 pieces 13943D Disposable diagnostic solid g...

Page 57: ...e 300 pieces Lead Adapters 13946B Universal tab electrode adapter alliga tor clip 10 per pack 40475A Snap electrode adapter for 1 8 post leads AHA spring clip 10 per pack M2254A Universal tab electrode adapter 10 per pack 40498E Grabber electrode adapter for 4 mm banana leads IEC 10 per pack Cart M1705B Cart Fuses 2110 0620 AC fuse 0 4 Amp 250 V 2110 0930 Battery fuse Electrodes ...

Page 58: ...r Service 4 14 Maintaining the Cardiograph Calling for Service For telephone assistance call the Response Center nearest to you or visit our website at www medical philips com cms and follow the link for services ...

Page 59: ...al Response Center Tel 800 548 8833 Tel 305 269 7500 Eastern Region Central Western Regions Tel 800 361 9790 Tel 800 268 1221 Australia France Tel 131147 Tel 0803 35 34 33 Germany Italy Tel 0 18 05 32 62 77 Tel 800 825087 Netherlands United Kingdom Tel 0 20 547 2555 Tel 44 344 36633 Belgium Finland Tel 02 404 9102 Tel 09 6158 0400 ...

Page 60: ...Calling for Service 4 16 Maintaining the Cardiograph Spain Tel 34 91 631 31 00 ...

Page 61: ...UGLRJUDSK IRU WKH LUVW 7LPH Before using your cardiograph for the first time you must prepare it by performing the following tasks l Check the voltage setting l Install the battery l Connect the cables l Load the paper ...

Page 62: ...See Figure A 1 2 Verify that the correct voltage is visible on the voltage select switch If the voltage setting is incorrect slide the voltage switch so the correct voltage is visible The cardiograph operates with any line frequency from 50 to 60 Hz 3 Remove and discard the label that covers the AC power receptable See for the location of the AC power receptable The purpose of the label is to remi...

Page 63: ...potential Connector B AC Power Receptacle C Voltage Select Switch 127 The equipotential connector is only used when the cardiograph must be plugged into an ungrounded outlet See Patient and Operational Safety Notes in Chapter 1 Getting Acquainted for more information about using the equipotential connector ...

Page 64: ...he optional M1705B cart The mounting thumbscrew is supplied with the cart 1 Make sure the cardiograph is unplugged from AC power 2 Turn the cardiograph bottom side up 3 Slide the battery door in the direction of the arrow until it unlatches approximately 1 2 inch as shown in Figure A 2 Lift off the door 4 Install the new battery in the battery compartment as shown in Figure A 3 and plug the batter...

Page 65: ...ble for at least 16 hours To charge the battery plug the cardiograph into the wall outlet with the switch set to Standby off LJXUH 5HPRYLQJ WKH DWWHU RRU A Battery Door 5HPRYLQJ WKH DWWHU To Remove the Battery 1 Unplug the cardiograph from AC power 2 Turn the cardiograph bottom side up 3 Slide the battery door in the direction of the arrow until it unlatches approximately 1 2 inch as shown in Figu...

Page 66: ...6 If the battery has been removed for storage replace the battery cover by placing the battery door into its slots and sliding the door in the opposite direction of the arrow until it latches as shown in Figure A 2 51 1 3URSHUO GLVSRVH RI RU UHF FOH GHSOHWHG EDWWHULHV DFFRUGLQJ WR ORFDO UHJXODWLRQV R QRW GLVDVVHPEOH SXQFWXUH RU LQFLQHUDWH WKH GLVSRVHG EDWWHULHV LJXUH 7KH DWWHU RPSDUWPHQW A Battery...

Page 67: ...into the wall outlet 51 1 I RX PXVW XVH DQ XQJURXQGHG SOXJ DGDSWHU WR SOXJ WKH SRZHU FRUG LQWR WKH ZDOO RXWOHW RX PXVW DOVR XVH D JURXQG VWUDS WR FRQQHFW WKH HTXLSRWHQWLDO FRQQHFWRU DW WKH UHDU RI WKH FDUGLRJUDSK WR WKH SRZHU VRXUFH JURXQG LJXUH VKRZV WKH ORFDWLRQ RI WKH HTXLSRWHQWLDO FRQQHFWRU 5HIHU WR 3DWLHQW DQG 2SHUDWLRQDO 6DIHW 1RWHV LQ KDSWHU HWWLQJ FTXDLQWHG IRU PRUH LQIRUPDWLRQ DERXW XVLQJ...

Page 68: ...ables A 8 Setting up Your Cardiograph for the First Time LJXUH RQQHFWLQJ WKH 3DWLHQW DEOH A Patient Cable Connect the Patient cable to the front of the cardiograph as shown in Figure A 5 and screw in both thumb screws ...

Page 69: ...RDGLQJ WKH 3DSHU A Paper Door Latch B Paper Sensing Hole C Paper D Cardboard Backing E Key The cardiograph uses continuous feed Z fold paper For best results use the paper brand as supplied with your cardiograph See Supplies in Chapter 4 for ordering information 3DJH GYDQFH ...

Page 70: ... the top side of the paper feeds grid side up over the top panel The paper sensing hole will be in the lower corner of the paper 4 Pull a sheet halfway out and over the paper door Make sure that the paper lays on the black roller evenly within the channel of the paper door See Figure A 6 5 Slide the paper door back into place Make sure that the door is latched 6 Press to turn On the cardiograph if...

Page 71: ...rmat Controls Chart Speed ECG size V Leads sensitivity ECG Format Selections Auto 3x4 with 1 rhythm lead Manual with 3 or 6 leads UHTXHQF DQG PSXOVH 5HVSRQVH Sinusoidal 0 67 to 40 Hz 10 Triangle 0 10 Impulse 0 3 mV sec Displacement Less than 0 10 mV Slope Less than 0 30 mV sec Each meets or exceeds AAMI EC11 1991 standard for Diagnostic Electrocardiographic Devices ...

Page 72: ...able Defibrillation Protection Protected against damage from 400 joule defibrillator discharges 3RZHU DQG QYLURQPHQW Line Power 100 to 120 VAC 50 to 60 Hz at 115 VAC power switch setting 220 to 240 VAC 50 to 60 Hz at 230 VAC power switch set ting 50 VA Maximum Fuse 0 4 A for both the 115 and 230 VAC switch settings Environmental Operating Conditions 10 to 40 C 50 to 104 F 15 to 80 relative humidit...

Page 73: ...WLIDFW ECG waveform distortion that may diminish ECG quality ECG artifact or noise may be caused by electrical interference poor electrode connections or patient movement XWR Twelve lead ECG recorded and analyzed over a ten second period and printed in a predetermined format The PageWriter 100 prints Auto reports in a 3x4 format with one rhythm strip EDVHOLQH ZDQGHU A slow upward or downward motio...

Page 74: ...y ECG waveforms and identifying information IURQW SDQHO Cardiograph area that includes the control keys HUW A unit of frequency equal to one cycle per second OHDGV Lead names and identifying colors recommended by the Inter national Electrotechnical Commission standard IEC limb elec trodes are labelled R L F and N Chest electrodes are labelled C1 C6 OHDGV RII A trace consisting of a dotted line 0DQ...

Page 75: ...VLWLRQ Term for acquiring 10 seconds of ECG prior to the operator pressing UK WKP VWULS Term for ten second recording of a particular lead that is printed at the bottom of an Auto ECG report See Manual and Auto ECG 6WDQGE PRGH The cardiograph is off but the battery is kept charged while the unit is plugged into AC power VWDQGDUG OHDGV The conventional twelve lead order is I II III aVR aVL aVF V1 V...

Page 76: ...Glossary Glossary 4 ...

Page 77: ...t off 24 B baseline wander 75 Baseline Wander filter 35 baseline wander filter 75 battery 52 53 63 capacity 24 charging 24 door 17 fuse 57 installing 64 operation 23 removing 65 saving 24 storing 53 battery saver 24 75 C calibration pulse 76 Calibration Signals 35 Carrying Case 56 Cart mounting point 17 cart M1705B 57 case carrying 56 Chart Speed 18 Checking ECG Technique 41 Choosing a Report Form...

Page 78: ...y 57 fuse holders AC 53 54 fuses replacing 53 H Hertz 76 I Identifying ECG Problems 41 identifying ECG problems 41 IEC leads 76 IEC patient cable 55 installing battery 64 L leads AHA 75 IEC 76 standard 77 leads off 30 76 loading paper 49 69 Low Battery light 23 M Maintenance 45 Manual 18 27 30 ECG 37 filters 34 Manual ECG 76 Manual Lead Groups 38 Manual report 3 lead 39 6 lead 39 and defilibration...

Page 79: ...nt problems 44 Printed Report understanding 34 printhead cleaning 48 R recording Auto ECG 30 ECG 27 Manual ECG 32 removing battery 65 replacing fuses 53 report ECG 76 report format choosing 37 rhythm strip 77 S safety 21 25 72 self test 72 setting AC voltage 62 setting up 61 shut off automatic 24 specifications 71 standard leads 77 Standby mode 77 Stop 19 32 33 37 Storing 50 storing ECG paper 50 p...

Page 80: ...Index 4 ...

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