Life Sensing Instrument TM8B TM8B Dual ECG Transmitter User Manual HTS820TC manualr

Life Sensing Instrument Company Inc. TM8B Dual ECG Transmitter HTS820TC manualr

Contents

System users manual

TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 1 TABLE OF CONTENTS SUBJECT PAGE Preface 2 Safety Summary 3 Arrhythmia Monitoring 4 Dual Lead Transmitter 5 Attaching Transmitter to Patient 7 Alarm Indications, Operator Alerts 8 Alarm and Alert Matrix 10 Patient Name, Room, ID Entry 11 Changing Patient Display Color 12 Alarm Limit Settings 13 ECG Size Adjustment, Low QRS Alert 19 Relearn of ECG Rhythm 20 FILTER and MONITOR 21 Back-Up Transmitter 22 Discharging a Patient 23 Report Generation 24 Pacemaker Patients 25 Remote Record 26 Alarm Volume Control 26 Setting Charting Intervals 27 Date and Time Setting 28 Automatic Recording, All Record 29 Long and Short Record 30 Manual Recording (STORE EVENT ) 31 Silencing Alarms 32 System Status 33 Store All 35 View Events, List Events 35 Delete a Stored Event 37 Multi-View, Multi Lead Telemetry 38 Full Disclosure 39 View Trends 41 Cleaning the Display 42 Loading Paper and Recordings 43 Faxing Documents CARDIAC REHAB 44 Revision 3.016R Date July 2002
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 2 PREFACE This manual describes the operation and use of the TrensCenter Telemetry System. It is intended for use by clinicians trained in the use of clinical monitoring systems familiar with the associated terms and procedures. The system is intended to be used in any area of the hospital where cardiac monitoring is required. The system is intended to be used in accordance with accepted hospital and clinical protocols and the instructions contained in this manual. Use of the system with other than supplied accessories or parts may result in inaccurate patient information or damage to the monitor. The manual contains detailed descriptions of all controls and indicators. Each control of the system is depicted in this manual by the use of hand symbols: When a specific control function is described, a hand symbol will point to the location of that control key or button. When multiple control functions are described on a single display, the hand symbols will be numbered in the order that they are referenced in the text. Example: • - †. Those controls appearing on a keyboard or keypad are referred to as keys. Additionally, Button Controls are as shown below: NOTE statements are for general information applicable to the current subject and appear in bold italic type style. Note statements appear as shown below: NOTES Note Information. CAUTION statements in the manual identify conditions or operations that could result in damage to the system or other property. Caution statements appear in UPPERCASE as shown below: CAUTION CAUTION INFORMATION. WARNING statements in the manual identify conditions or operations that could result in personal injury. Warning statements appear in UPPERCASE BOLD type style as shown below: WARNING! WARNING INFORMATION.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 3 SAFETY SUMMARY 1) Do Not autoclave the patient transmitters. 2) Frequent electrical and visual checks should be made on electrode wires. Broken or frayed electrode wires or loose fittings may cause interference or loss of signal. Particular attention should be paid to the point where the electrode wire enters the snap fittings since flexure will eventually cause breakage of strands at this point. 3) Do Not operate this product in the presence of flammable anesthetics. Explosion may result. 4) If the system is connected to accessory equipment, leakage current requirements must be maintained. 5) To insure patient safety, use only software, accessories and parts recommended by the manufacturer. 6) A product that has been dropped or severely abused should be checked by qualified service personnel to verify proper operation. 7) Component replacement or adjustment must be made by qualified service personnel only. 8) Patient transmitters have limited range. Ensure that patients remain within the area covered by the antenna system. 9) The system is intended as a complement to, not a substitute for, patient observation by trained health care personnel. Do not rely entirely on the alarm, arrhythmia or paging structure of the system. 10) WARNING PACEMAKER PATIENTS. Heart Rate Counts on patients with pacemakers may be erratic. Follow the instructions contained in the Paced Patients section of this manual. Keep pacemaker patients under close observation. 11) Do not place any item on top of the receiver enclosure that would obstruct air flow since heat may build up and cause damage to receivers. 12) Do not allow objects to rest on keyboard since erroneous data may be entered into patient chart and certain keys may cause adverse operations.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 4 ARRHYTHMIA MONITORING Monitoring systems are aids to the nursing staff and are not intended to replace the vigilance of the staff to react to a displayed waveform on the monitor and take the appropriate action for the patient’s well being even though the monitor has not alarmed. Qualified and trained monitoring technicians working in concert with arrhythmia detection systems produce the best results in detecting and alerting the nursing staff to patients’ problems. No arrhythmia detection algorithm is currently available from any supplier that can guarantee 100% accuracy. There is no method in use to simulate the infinite number of variations in patient waveforms. No arrhythmia system can, without some human intervention both at the monitor and the patient, detect and identify every type of morphology change that may occur in the total patient population. The arrhythmia algorithm contained in the central station has been in use since the 1960’s in many clinical environments. The algorithm has been tested against the AHA, MIT, and Beth Israel data bases and was found to be well over 90% accurate. This is well within the government standards. The algorithm looks at five parameters of each and every ECG complex to decide if it is substantially different from the previously learned complexes from the subject patient. A decision is then made as to whether the ECG complex is normal or abnormal. If the ECG complex is determined to be abnormal, it is totaled in the abnormal counter. Should the number of abnormals exceed the operator set limit, an abnormal alarm will be generated and a sample of the abnormal will be stored for later recall. The total number of abnormals can be viewed and recorded on the report screen. (See the report generation section of this manual). ST segment monitoring is accomplished by establishing a zero reference on the P-R interval during the learn process. A measurement is then taken 90ms from the peak of the “R” wave. Should the ST level exceed the operator set limit for a period of 15 seconds, an alarm notification will be presented on the display and a sample of the ECG will be stored. Since patient artifact is present in telemetry, no quantitative measurements are presented. If ST changes are present, revert to a proven method of ST detection such as a 12 lead EKG machine.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 5 TM 8 DUAL LEAD TRANSMITTER The TM8 Dual Lead Transmitter is a crystal controlled transmitter operating in the VHF (174-216 Mhz) range. The transmitter utilizes 5 independent patient lead wires with snap electrode adapters for disposable electrodes. The ECG viewed from ECG1 is dependent upon the placement of the White (-) and the Red (+) electrodes. The ECG viewed from ECG2 is dependent upon the placement of the Black (-) and Brown (+) electrodes. Both ECG leads are transmitted all the time. Should an electrode become detached, a lead fault message will be displayed at the central station. The central station will switch to the other lead. A switch on the transmitter permits remote activation of the central station recorder. The TM8A transmitter uses 2 each 1.5 volt “AAA” batteries. Average battery life is 7 to 10 days. When the batteries reach an unsafe operating level, a low bat message will be displayed at the central station. Approximately 1 hour battery life is left when the low bat message is first displayed. The TM8 transmitter utilizes 5 electrodes to provide Lead II and a Modified Chest Lead (MCL) for review at the central station. For optimum monitoring the electrodes should be placed in the following locations:
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 6 TM8 DUAL LEAD TRANSMITTER WHITE Lead II negative electrode, RIGHT CLAVICLE OR RIGHT STERNAL BORDER. RED Lead II positive electrode, LOWER LEFT RIB CAGE. BLACK MCL negative electrode, LEFT CLAVICLE OR LEFT STERNAL BORDER. BROWN MCL positive electrode, PLACE ON ANY OF 6 V-LEAD POSITIONS. GREEN Reference electrode, LOWER RIGHT RIB CAGE. The patient lead wires have a small ring on the bottom of the cable that plugs into the transmitter. When installing lead wires, press down until the cables snap into the transmitter. If only one lead of ECG is required remove the brown and black lead wires from the transmitter. Refer to the section on MULTI-VIEW WAVEFORMS to disable lead fault on second channel. WARNING! ONLY USE THE SAFETY LEAD WIRES SUPPLIED WITH THE TRANSMITTER.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 7 Attaching the Transmitter to the Patient Gently abrade the electrode sites with an alcohol prep pad until slight redness is observed. Dry the site before applying the electrodes. Attach the electrodes to the lead wires. Insert the batteries in the transmitter as follows: Hold the transmitter in one hand. Using the other hand thumb and index finger, grasp the battery cap and turn counter clockwise until the cap can be removed. Insert both batteries with the positive ends up. See the battery direction indicator on the battery cap. Repeat the above instructions for the battery cap but rotate the cap clockwise. CAUTION MAKE SURE THE BATTERIES ARE INSTALLED CORRECTLY. IF THE BATTERIES ARE INSTALLED INCORRECTLY, THE TRANSMITTER WILL NOT FUNCTION. MAKE SURE THAT THE BATTERY CAP IS TIGHT. IF THE CAP IS NOT TIGHTENED PROPERLY, THE TRANSMITTER MAY BE INTERMITTENT AND THE WATER PROOFING SEAL MAY LEAK CAUSING DAMAGE TO THE TRANSMITTER Attach the electrodes to the patient on the prepared sites. Apply pressure to the outer edges of the electrode, not the center. Applying pressure to the center may cause the electrode conductive jelly to ooze out resulting in a loose electrode. If it is desirable to start the recorder from the transmitter, press and hold the remote record control for approximately 2 seconds. This will generate a 20 second strip at the central station. See the Remote Record section of this manual.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 8 ALARM INDICATIONS RATE ALARM: Rate Alarm messages indicate the heart rate has exceeded the high or low limits. For adjustments, see page 26. ABNORMAL ALARM: Abnormal Alarm messages indicate the abnormals per minute have exceeded the high alarm limit. For adjustments, see page 31. VTACH ALARM: VTACH Alarm messages indicate that there has been an episode of consecutive abnormals. For adjustment, see page 32. VFIB ALARM: VFIB Alarm messages indicate the system has detected an episode of VFIB. ASYSTOLE ALARM: Asystole Alarm messages indicate that the system has detected an episode of Asystole.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 9 OPERATOR ALERTS Operator Alerts LEAD FAULT messages indicate an electrode is detached or is not making good contact. See pages 11, 66, 5. SIGNAL LOSS messages indicate the central station is not receiving from the patient transmitter or there is too much noise on the trace for the system to analyze. Check to make sure the patient is within the designated monitoring area, the batteries are good, or there is AC interference on the baseline. LOW BAT messages indicate the batteries have approximately one hour before they reach a level where the transmitter will no longer function. Replace the batteries as soon as possible when the message appears. LOW QRS messages indicate the QRS complex is too small for reliable monitoring. See page 11 and page 36. Check Recorder Problems with the recorder are reported by the label of the control immediately to the left of the ALL RECORD button. The default label for this button is STATUS. If there is a problem with the recorder, the label changes to CHECK RECORDER as above. Check the recorder to insure that it is not out of paper or that the paper is jammed. See LOADING PAPER AND RECORDINGS section of this manual. Page 75 and page 76.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 10 ALARM AND ALERT MATRIX RECORD STORE ALTERNATE SOUND WARBLE SOUND 3-BEEP SOUND COLOR RATE l l l RED ABNORMAL l l RED VTACH LESS 4 SECS l l RED VTACH MORE 4 SECS. l l l l RED VFIB l l l l RED ASYSTOLE l l l l RED ST CHANGE l l RED LEAD FAULT l AMBER SIGNAL LOSS l RED LOW BAT l AMBER LOW QRS l RED
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 11 NEW PATIENT NAME ENTRY At the MAIN Screen, touch the area under the SETUP Column of the channel number desired as shown above. A keyboard is displayed beneath the patient waveforms. The above example shows the keyboard in ALPHA mode. If a typewriter keyboard is desired, touch the QWERTY key•. The keyboard changes to a typewriter keyboard and the key toggles to ALPHA. The input focus is now at the NAME Window‚. Type in the patient name by touching the letters on the keyboard. Observe the name displayed in the NAME Window. In this example, the name CALDWELL has been entered. When correct, touch the ENTER Keyƒ. After entering the patient name, you are now prompted to enter the patient room number. The input focus has tabbed to the ROOM Window•. Type in the room number by touching the numbers on the keyboard. Observe the numbers in the ROOM Window. In this example, RM2709 has been entered. When the room number is correct, touch the ENTER Key‚. After entering the patient room number, you are now prompted to enter the patient ID number. The input focus has tabbed to the PATIENT ID Window•. Type in the ID number by touching the numbers on the keyboard. Observe the numbers in the PATIENT ID Window. In this example, a patient ID number of 123456789 has been entered. When the patient ID number is correct, touch the SETUP key.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 12 CHANGING PATIENT DISPLAY COLOR At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired as shown above. The panel beneath the patient waveforms contains a color selection keypad. In this example, the display color for patient HAYES is Color Number 1 and the Color Number 1 Key is depressed. Changing the display color to Color Number 17 is accomplished by touching the Color Number 17 Key on the keypad. The patient Label (Channel Number), waveform, ID Number, Name and Room Number are now displayed in Color Number 17. Touch RETURN to return to the MAIN screen. The patient’s display color has been updated.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 13 ALARM SETTINGS At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired as shown above. The SETUP Screen is displayed. Touch the ALARM Key•. The key displays as recessed and the label changes to ALARM ON. Touch the ARRHY Key‚. The key displays as recessed and the label changes to ARRHY ON. Touch the ALARMS Buttonƒ to go to the ALARMS Screen. The alarm limit ranges and default values for the TRENSCenter Cardiac MONITOR are described in the following table: LOW HIGH DEFAULT HEART RATE LOW 30 100 50 HEART RATE HIGH 110 250 150 SPO2 82 99 90 SYSTOLIC LOW 0 100 50 SYSTOLIC HIGH 110 250 180 DIASTOLIC LOW 20 70 50 DIASTOLIC HIGH 70 140 120 TEMP LOW 88 98 95 TEMP HIGH 95 109 101 RESP LOW 0 9 1 RESP HIGH 10 50 30 ABNORMAL 0 50 6 VTACH 2 8 4 ST 1 4 1
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 14 Alarm Settings - Heart Rate HEART RATE ALARM: Heart Rate Low Limit range is 30 - 100. Heart Rate High Limit range is 110 - 250. The Heart Rate Alarm Limits are set by touching, in turn, the keys directly below the LOW• and HIGH‚ Column heading labels. Note that the key will be displayed as recessed as soon as you touch it, indicating that it is active. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. Limit settings may also be made by touching the numbers on the numeric keypad. Touch ENTER to confirm the process. Upon touching ENTER, note that the key is no longer recessed. Touch the HEART RATE Key to enable the limit settings. Alarm Settings - Systolic Blood Pressure SYSTOLIC BLOOD PRESSURE ALARM: Systolic Low Limit range is 0 - 100. Systolic High Limit range is 110 - 250. The Systolic Blood Pressure Alarm Limits are set by touching, in turn, the keys in the second row below the LOW• and HIGH‚ Column heading labels. As was the case in the previous example, the key will be displayed as recessed as soon as you touch it, indicating that it is active. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. Limit settings may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process. Upon touching ENTER, again note that the key is no longer recessed. Touch the BP SYST Key to enable the limit settings.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 15 Alarm Settings - Diastolic Blood Pressure DIASTOLIC BLOOD PRESSURE ALARM: Diastolic Low Limit range is 20 - 70. Diastolic High Limit range is 70 - 140. The Diastolic Blood Pressure Alarm Limits are set by touching, in turn, the keys in the third row below the LOW• and HIGH‚ Column heading labels. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. Limit settings may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the limit. Touch the BP DIAST key to enable the limit settings. Alarm Settings - Respiration Rate RESPIRATION RATE ALARM: Respiration Low Limit range is 0 - 9. Respiration High Limit range is 10 - 50. The Respiration Rate Alarm Limits are set by touching, in turn, the keys in the fourth row below the LOW• and HIGH‚ Column heading labels. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. Limit settings may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process. Touch the RESP key to enable the limit settings.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 16 Alarm Settings - Body Temperature BODY TEMPERATURE ALARM: Temperature Low Limit range is 88 - 98. Temperature High Limit range is 95 - 109. The Body Temperature Alarm Limits are set by touching, in turn, the keys in the fifth row below the LOW• and HIGH‚ Column heading labels. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. Limit settings may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process. Touch the TEMP Key to enable the limit settings. Alarm Settings - Abnormals ABNORMALS ALARM: Abnormal Limit Range is 0 - 50. The Abnormal Default Value is 6. Note the ABN Key•. The Abnormal Alarm Limit is set by touching the numeric key‚ immediately to the right of the ABN Key. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. The abnormal limit setting may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process..
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 17 Alarm Settings - VTACH VTACH ALARM: VTACH Limit Range is 2 - 8. The VTACH Default Value is 4. Note the VTACH Key•. The VTACH Alarm Limit is set by touching the numeric key‚ immediately to the right of the VTACH Key. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. The VTACH Limit setting may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process. Alarm Settings - SPO2 SPO2 ALARM: SPO2 Limit Range is 82 - 99. The SPO2 Default Value is 90. Note the SPO2 Key•. The SPO2 Alarm Limit is set by touching the numeric key‚ immediately to the right of the SPO2 Key. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. The SPO2 Limit setting may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 18 Alarm Settings - ST ST ALARM: The ST Limit Range is 1 - 4. The ST Default Value is 1. Note the ST Key•. The ST Alarm Limit is set by touching the numeric key‚ immediately to the right of the ST Key. To increase the limit, touch the UP ARROW Key. To decrease the limit, touch the DOWN ARROW Key. The ST Limit setting may also be made by touching the numbers on the numeric keypad. Touch the ENTER Key to confirm the process.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 19 ECG SIZE ADJUSTMENT At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired as shown above. The SETUP Screen is displayed. Note the SIZE Label•. The ECG display size is adjusted by touching the numeric SIZE Key‚ immediately to the right of the SIZE Label. The normal size setting is 1 as shown above. The ECG may be displayed at half normal size, normal size, twice normal size and four times normal size. In this example, touching the Size Key four times would cycle the ECG display size through 2, 4, ½, and back to 1. Low QRS Alert If the size of the QRS is too small for the system to count, a LOW QRS message will be displayed. The electrodes must be repositioned to acquire a larger QRS. Normal monitoring should be accomplished through the use of Lead II (white electrode on right clavicle or mid sternum, red or black electrode on lower left rib cage). If the QRS is too small in Lead II, try a MCL lead (White electrode on left clavicle, red or black electrode in the V1 position (right of sternum, 4th or 5th intercostal space). If neither of these lead placements work, check the patient’s 12 Lead Electrocardiogram to check which side of the heart is putting out the most voltage. Apply the electrodes there to simulate Lead I, II or III.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 20 RELEARN OF ECG RHYTHM At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired. If the system is counting a normal complex as an abnormal, such as, Bundle Branch Block, Aberrancy or Paced Patients, touch the RELEARN key. The system will look at the next 60 complexes to establish a new normal complex for that patient.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 21 FILTER AND MONITOR At the MAIN Screen, touch the area under the SETUP Column of desired channel number. The SETUP Screen is displayed. The FILTER selection is used to present a clean waveform by removing the artifact from the baseline of the ECG. Note the key labeled MONITOR. This is a two-state selection key to toggle between FILTER Mode and MONITOR Mode. In the above example, FILTER Mode is available for selection and MONITOR Mode is the active state. FILTER Mode is the default. Note that the key is recessed. Touch the MONITOR Key to go the next display. MONITOR Mode removes the artifact filter and allows more signal to be displayed. This might be used when a pacer spike is present and a larger spike is required for display. The key label has toggled to FILTER and the key is displayed as recessed. Filter mode is used to remove the artifact from baseline of the ECG to allow better viewing.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 22 BACK-UP TRANSMITTER At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired. The SETUP Screen is displayed. The control for the receiver should show PRIMARY, as above. If it is necessary to use the Auxiliary (Back-up) Transmitter, touch the PRIMARY key. The key label changes to AUXILIARY. The system is now set up to use the Back-up Transmitter for that channel.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 23 DISCHARGING A PATIENT At the MAIN Screen, touch the area under the SETUP Column of desired channel number. The SETUP Screen is displayed. NOTES Discharging a patient erases all data for that patient. Touch the DISCHARGE Key as shown above to go to the next screen. You are prompted to confirm that you want to discharge the patient. If the patient is, in fact, to be discharged, touch the Yes Key•. If the DISCHARGE Key was touched in error, touching the No Key‚ will return you to the SETUP display.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 24 REPORT GENERATION At the MAIN Screen, touch the area under the SETUP Column of the patient channel number desired. The SETUP Screen is displayed. Touch the REPORT Button to go to the next display. The Reports Screen is displayed. In this example, a VTACH event is the reason for the report. The time of the report is displayed at left, as are the patient vitals. The Top and Bottom ARROW Keys are for moving to the beginning or end of the report. The Double Triangle ARROW Keys are for moving from page to page. The inside Up and Down ARROW Keys are for moving from line to line. To print the report, touch inside the report window.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 25 PACEMAKER PATIENTS At the MAIN Screen, touch the area under the SETUP Column of desired channel number. The SETUP Screen is displayed. Note the PACER Key. The system defaults to patients without pacemakers and the PACER Key is displayed as not being recessed. If a patient is admitted with a pacemaker, touch the PACER Key. The key becomes recessed. This will insure a more reliable heart rate count. Touch the FILTER button to the left of the screen. The button will change to MONITOR. This should enhance the pacer spike on the display. NOTES Do not monitor a non-pacer patient in the pacer mode. This could result in inaccurate heart rate count.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 26 REMOTE RECORD At the MAIN Screen, touch the area under the SETUP Column of desired channel number. The Setup Screen is displayed. The Remote Record Control may be turned on or off for each individual patient. Note the REMOTE REC Key above. The default is Remote Record Disabled and the REMOTE REC Key is not recessed. Touch the REMOTE REC Key to activate remote recording. The key is now recessed. To deactivate, touch the REMOTE REC Key. The key returns to non-recessed position. This prevents remote activation of the recorder. ALARM VOLUME CONTROL Alarm Volume Control The alarm volume can be increased or decreased at the MAIN Screen by touching the VOL UP• or VOL DOWN‚ Buttons. The volume controls are touch and release controls. Touch the button once and release, touch again to continue adjusting the volume. The volume controls are available at all screens in the same screen position as shown above. When the minimum and maximum levels are reached the controls will turn light blue.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 27 SETTING CHART INTERVALS At the MAIN Screen, touch the area under the SETUP Column of desired channel number. The SETUP Screen is displayed. Note the key immediately to the right of the CHART Label. This key is a touch and release control used to set the charting interval. The numeric value displayed on this control is the current number of minutes between automatic charting of patient vitals. This control changes the charting interval from minimum to maximum and back to minimum. The TrensCenter will automatically store all the patient vitals and trace data.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 28 DATE AND TIME SETTINGS At the MAIN Screen, note the two buttons at the lower left corner. The leftmost button is the DATE Button•. Immediately to the right of the DATE Button is the TIME Button‚. To change the date setting, touch the DATE Button. The DATE/TIME Screen will be displayed. Setting the Date Touch the NEW DATE Key. Use the UP and DOWN ARROW Keys for YEAR, MONTH and DAY to increase or decrease the displayed date on the NEW DATE Key‚. When the displayed date on the NEW DATE Key is correct touch the SET Keyƒ to complete the date setting. The NEW DATE key is no longer recessed and the DATE Key in the lower left corner of the screen displays the revised date. Setting the Time Touch the NEW TIME Key. Use the UP and DOWN ARROW Keys for HOUR and MINUTE to increase or decrease the displayed time on the NEW TIME Key•. When the displayed time on the NEW TIME Key is correct, Touch the SET Key‚ to complete the time setting. The NEW TIME key is no longer recessed and the DATE Key in the lower left corner of the screen displays the revised date.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 29 AUTOMATIC RECORDINGS At the MAIN Screen, touch the area under the SETUP Column of desired channel number. Automatic recordings are available for all patients at the end of the shift or at any preset interval. To set the time of the first recording, touch the setting key to the right of the START Label•. This setting key is a touch and release control to adjust the starting time. To set the hourly interval between recordings, touch the key to the right of the INT Label‚. With settings of START 7 AM and INT 8, recordings would be generated at 7 AM, 3PM and 11PM. ALL RECORD All Record To record a rhythm strip on all patients, make sure that the ECG waveforms are free of artifact. At the MAIN Screen, Touch the ALL RECORD Button as shown above. The system will record a 20 second strip for all patients. The length of the strip is determined by the settings in the REPORT configuration screen.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 30 SETTING LONG AND SHORT RECORDINGS At the MAIN Screen, touch the area under the SETUP Column of desired channel number. Note the LONG RECORD Key. There are two recording activation modes, long and short. The default is LONG RECORD and the LONG RECORD Key is not recessed. To select SHORT RECORD mode, touch the LONG RECORD Key. The key label changes to SHORT RECORD and the key displays as recessed. In the LONG RECORD mode, the recorder will only record arrhythmia alarm events which have a duration longer than 6 seconds. In the SHORT RECORD mode, the recorder is activated by any arrhythmia alarm event including ABNORMAL alarms. The LONG RECORD mode is used to prevent running of paper for repeat alarms.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 31 MANUAL RECORDING To manually record an ECG strip, touch the Heart Rate Button. Touch again to stop the recorder. To store a strip for later recording, touch the waveform directly under the MANUAL STORE EVENT window. To freeze the waveform and store it for further examination, touch the area under the STORE Column at the MAIN Screen of the patient channel desired. The manually stored waveform is displayed on the EVENTS Screen. Touch the waveform and DELETE if the waveform is not important. Touch the waveform and RECORD to make a permanent copy of the waveform.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 32 SILENCING ALARMS The SILENCE Button is used to temporarily silence the alarm tone. This button is a touch and release control. Touch once to silence alarms. This silences any alarms that are currently active. Any new alarm that occurs after the SILENCE Button has been touched will reactivate the audible alarms. The SILENCE function will time out after two minutes and resume the alarm in progress if the alarm still exists.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 33 SYSTEM STATUS At the MAIN Screen, touch the STATUS Button as shown above. The STATUS Screen is displayed•. Touch the GENERAL Key‚. System information is displayed in the STATUS Windowƒ. The information in this window gives a “snapshot” of system resource utilization. The STATUS Button is available from all screens. Checking Settings Touching the SETTINGS Key displays the settings controls. There is a chart recorder speed control. This is used to change the recorder speed to 50 mm/s. The Recorder control turns off the printer if only a laser printer is to be used. The trends control selects trend information in two dimensional or three dimensional mode. The TOUCH OFF control disables the touch screen for cleaning.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 34 Checking Sound Status If you are not at the STATUS Screen, touch the STATUS Button at the lower right of the screen. Touch the SOUND Key as shown above. Sound equipment and usage information is displayed in the STATUS Window. In this example, sound hardware has not yet been installed. Checking Hardware Status Touch the HARDWARE Key. System hardware configuration is displayed in the left column of the STATUS Window as is hardware condition status. Channel condition status is reported in the right column.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 35 STORE ALL EVENTS Events may be stored for all active channels. At the MAIN Screen, note the STORE ALL Button. The STORE ALL Button is a touch and release control. Touch the STORE ALL Button to store manual events for all patients. Touching this control is functionally the same as touching the STORE Column area for each patient. VIEW EVENTS Touch the patient waveform under the VIEW STORED EVENTS Column of the patient channel desired. The EVENTS Screen is displayed. Both manually stored and learned events are displayed as above. If alarmed events have occurred, they are displayed as well.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 36 LIST EVENTS Touch the area under the VIEW STORED EVENTS Column of the desired patient channel. If alarms have occurred for the patient, a message displayed in RED inside a RED RECTANGLE will appear as shown above listing the number of EVENTS. If the message is in AMBER, someone has looked at and edited the events. The EVENTS Screen is displayed. Touch the LIST EVENTS key to view the listing of events. The EVENTS Listing is displayed. Touch the ARROW Keys to go to the beginning or end of the listing (top ARROW and bottom ARROW Keys). Touch the Double Triangle ARROW Keys to navigate between pages. Touch the inner arrow keys to navigate on a page. To print the strip of the event, touch the area under the CATEGORY Column of the desired event and then touch the PRINT Keyƒ. The COLUMN Headings indicate the sort order of the listing. In the example above, the listing is sorted by DATE/TIME…. The listing may also be sorted by TYPE, CATEGORY, REASON, and PRIORITY. The sort order toggles between ascending or descending by touching the desired COLUMN Heading. Touch the EVENTS key† to go back to the previous display of the EVENTS Screen.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 37 DELETE A STORED EVENT Touch the area under the VIEW STORED EVENT Column of the patient channel desired. The EVENTS Screen is displayed. To delete a stored event, touch the event waveform to be deleted, the selected waveform is highlighted in reverse video as above•. Next touch the DELETE Key‚. The DELETE Key deletes all highlighted(touched) waveforms.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 38 MULTI-VIEW (MULTI-LEAD) TELEMETRY Touch the area under the VIEW WAVES Column of the patient channel desired as shown above. The button labeled MCL OFF indicates that the secondary lead (MCL) is not activated. To turn on MCL, touch the MCL OFF button. The button turns blue and MCL lead is displayed if the electrodes are attached. This function is controlled through the initial setup of the system. The FAULT button determines whether a lead fault condition is reported on the main screen. With the FAULT on (button in blue) a lead fault message will appear on the main screen. With the button in white a lead fault will not be reported. If an electrode becomes detached and the lead fault is on, the lead fault message will indicate whether it is LEAD II or MCL lead. If the system designates LEAD FAULT II, check the WHITE and RED electrode. If the system designates LEAD FAULT MCL, check the BROWN and BLACK electrodes. If both waveforms are good, check the GREEN electrode. If the lead fault occurs on the Primary Lead, the system will switch automatically to the secondary lead. When the lead fault is corrected, the system will automatically switch back to the Selected Lead. The bottom buttons are for selecting which lead is to be displayed on the main screen. In this situation LEAD II will be displayed. Touch MCL to make it the displayed lead.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 39 FULL DISCLOSURE At the MAIN Screen, touch the area under the SETUP Column of desired channel number. Note the DISCLOSURE Button above the Screen Label. Touch the DISCLOSURE Button to go to the next display. The DISCLOSURE Screen is displayed•. Note the HOURS Key‚ and the MINUTES Keyƒ. In this example, the MINUTES Key has been selected and is displayed as recessed. To view a minute by minute “snapshot” of the Chart for the selected patient, use the ARROW Keys with the MINUTE Key selected, as in this example. To go backward from the displayed time, touch the Left ARROW Key. To go forward, touch the Right ARROW Key. The MINUTE Key allows you to move forward and backward by minute. The HOURS key allows you to move forward and backward by hour.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 40 Full Disclosure The above example displays the expanded waveform in the 1 second zoomed view. To return to the two minute view, touch the waveform again. Touch the arrows to move forward or backward in time. The 1 second button will allow scrolling of the waveform. The 10 second button will move the waveform in 10 second increments. Full Disclosure Interval Markings To measure the intervals of the ECG touch the INTERVAL button. Touch the P button to set the onset of the P wave. Use the left and right arrow keys to adjust the position of the red cursor. Continue touching the Q, R, S, T, and R’ keys to adjust the cursor. The interval values will be displayed above the waveform.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 41 VIEW TRENDS At the MAIN Screen, touch the area under the SETUP Column of desired channel number. Note the TRENDS Button. Touch the TRENDS Button to go to the next display. The TRENDS Screen is displayed. Trends can be displayed for all patient vitals. Touch the desired vitals key. It will display as recessed and a red check mark will display. In the above example, the HEART RATE Key and the ABNORMAL Key have been selected to display the heart rate and diastolic trends. These keys display as recessed and are marked with a red check mark. The Double Triangle ARROW Keys are for moving forward and back by one hour intervals. The Left and Right ARROW Keys are for moving forward and back by one minute intervals. The 50-200 scale on the left is the scale for heart rate, systolic and diastolic blood pressure, O2 saturation and body temperature. The 0-30 scale on the right is the scale for respiration rate and abnormals count. The trends information in this example is displayed in 3D mode. Touch the 1 Hour key to change to 12 or 24 hour interval.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 42 CLEANING THE DISPLAY Touch the STATUS button on the main display. Touch SETTINGS button . Touch the TOUCH OFF button. This will de-activate the touch screen for cleaning.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 43 LOADING PAPER AND RECORDINGS A red strip will appear on the chart paper when approximately 20 feet of paper is left on the roll. Change the paper at this time to ensure that there is enough paper to document an event should an alarm occur. To load the paper, push on the top left of the recorder. There is a sign , PUSH TO OPEN, with an arrow indicating the correct place to touch. Remove the old paper core. Remove the sticker from the new roll of paper. Turn the paper roll so the paper is rolling off the bottom of the roll. Insert the paper roll between the two holders. Close the recorder door. Touch a patient record control to make sure that the recorder is printing. If the recorded strip is blank, open the door and turn the paper roll over. Make sure the paper is straight to avoid a paper jam. If a jam occurs or paper runs out, a CHECK RECORDER message will be displayed. See SYSTEM STATUS section of this manual. The recorder has a standard 10 second delay in manual record. The delay is adjustable from 0 to 20 seconds. In the event of a sustained alarm, the recorder will turn on and print 5 seconds of ECG prior to the alarm, the entire event and 10 seconds of ECG after the alarm. This ensures capture of the onset, alarm information and the ECG status following the alarm. The recorder annotates all pertinent information concerning the status of the strip. The data is Channel Number, Name, Room Number, Heart Rate, Time, Date, Reason for Recording, Gain, Filter or Monitor and Primary Lead Selection and is configurable. There are several reasons printed on the recorder. A table of definitions follows: MANUAL: Created by activation of the channel RECORD control. REMOTE: Created by activation of the REMOTE RECORD control on the transmitter. ALL: Created by activation of the ALL RECORD control or the AUTO RECORD. RATE: Created by a high or low RATE ALARM. VTACH: Created by a VTACH ALARM. VFIB: Created by a VFIB ALARM. ASYSTOLE: Created by an ASYSTOLE ALARM. ABN: Created by an ABNORMAL ALARM.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 44 SETUP THE FAX FROM THE TRENSCENTER The TrensCenter is now capable of sending fax messages directly from the unit to any fax machine. The operation is very simple however several things must be taken into consideration. 1. Facility must have access to single analog phone line. 2. Requires setup of the address book in the Windows operating system. To set up the Windows address book: Click on the Inbox Icon on the Desktop. Click on the Address Book Icon. Click on the Address Book Icon. Click on New Entry.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 45 Click on Fax. Type in name and phone number. Click on Apply. Click on OK. Continue adding new contacts until all Physicians or other facilities are entered.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 46 FAX FROM THE TRENSCENTER To turn on the fax, touch STATUS touch SETTINGS. The following screen will appear. Touch FAX OFF. The button label will change to FAX ON. Any button labeled PRINT will now be a fax control. The print can be events, reports, full disclosure or anything that has a print button. When the print is touched the system will bring up the system address book and the user will select to whom the fax should be sent. Click on Address Book.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 47 FAX CONTINUED Click on the recipient in the left column and click on the To control. To send to multiple locations, click on the recipient and the To control. Click on OK. The system will continue on through several screens asking for type cover sheet you want. Continue clicking on NEXT until the last page is displayed and click on FINISH.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 48 CARDIAC REHAB TABLE OF CONTENTS Subject Page Entering patients in to Database 49 Entering Insurance Information 50 Entering Order of Exercise 52 Admitting a Group 53 Admitting Individual Patients 54 Monitoring Patients 55 Configuring Quick Comments 58 Entering Quick Comments 59 Entering Additional Comments 60 Non-ECG Monitoring 62 Discharging 62 Edit and Print Last Session 63 Adjusting Volume Control 65 Rehab Reports 65 Exporting Data to Orion Outcomes 67 Archiving Patient Data 69
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 49 ENTERING PATIENTS ITO THE DATABASE NOTE:Ensure all settings in the Rehab Configuration Screens have been made before entering the original patient database. To enter patients into the Rehab Database, Touch DATABASE control at the bottom center of the screen. The Database screen will appear. To add new patients to the database touch the NEW control. This will present a new database screen with all entries blank. Type in the patient first name and ENTER, the cursor box will move to the patient last name. Continue entering data until all information is entered. NOTE: Ensure that a last name is entered for all patients. When entering the number for GROUP and COLOR enter the number desired and hit ENTER. The group information will be displayed. If the days and time are not correct move the cursor back to group, with arrows or mouse, and enter the desired group number. Use the same technique for the color of the waveform desired. NOTE: To use the patient resting heart rate to determine the high target enter a number less than 40. If the number entered is 20, the system will determine the target by adding the resting rate and the 20 entered. Any number over 40 will be the target rate used. When all information is entered touch the ADD/SAVE control. This saves the information in the database.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 50 ENTERING INSURANCE INFORMATION To enter insurance information into the Rehab Database, Touch DATABASE control at the bottom center of the screen. The Database screen will appear. Place the cursor at the Insurance box. Type in the three letter Insurance code. If the insurance has not been entered three questions will appear. Touch the small control to the right of the insurance box. The Insurance selection screen will appear. If the patients insurance is already listed touch OK. If the list of companies covers the entire page use the UP and DOWN to scroll the list. If the control was touched by mistake touch CANCEL. If the insurance company desired is not listed touch EDIT LIST
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 51 ENTERING INSURANCE INFORMATION The Insurance Input screen will appear. If data needs to be changed touch the name of the insurance company and change the information displayed. To add a new company, touch NEW. Position the cursor over the box to be added and type in new data. When all information is entered touch the CLOSE control. This saves the information in the database.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 52 ENTERING ORDER OF EXERCISE DEVICES To begin monitoring patients on the system, touch ADMISSION control at the bottom of the main screen. The cursor can be moved around the screen with the mouse, keyboard arrows or by touching the box desired. When a patient is entered into the database the order of exercise is entered in the order of the device configuration screen. To change the order desired, place the cursor in the box under the device and on the patient line, that the patient will start the exercise session on. Enter a 1 in the box. Move the cursor along the patient information row and enter the order of exercise until all desired devices are entered. If a device will not be used for this patient leave the column blank. NOTE: If protocol dictates that a patient will use the same device more than once, all columns must be filled to allow the NEXT control to move past FINISHED. NOTE: The exercise devices must be entered in the order of exercise. If you try to enter 4 under the first column the system will change to number 1. This feature is incorporated in case a device is deleted, then the system will automatically realign the order of exercise. NOTE: The devices in the configuration are saved when the patient is entered into the Database. If the device configuration is changed later, the devices will not appear correctly when monitoring. It is important to do the device con figuration before you enter any patients.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 53 ADMITTING PATIENTS TO THE SYSTEM—GROUP ADMIT To begin monitoring patients on the system, touch ADMISSION control at the bottom of the main screen. If the patients were admitted to the database in specific groups and will be monitored in groups touch the GROUP button. This will display Group 1. Continue touching the Group button until the desired group is displayed. The group number is displayed above the screen on the instruction bar. When the desired group is displayed it is now possible to enter the daily weight and resting pressures. Place the cursor in the box under weight for the desired patient. Type in the weight. Use TAB, arrows or mouse to move to SYST. Enter Systolic pressure. Repeat for diastolic pressure. When all patient weight and pressures are entered, assign the transmitters to the patients based on the CHAN #. These are the channels assigned when the patient was admitted to the database. These numbers can be changed. Use caution that numbers are not duplicated since one patient will not be admitted. When all information is correct touch ADMIT. All patients selected should now be displayed on main screen.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 54 ADMITTING PATIENTS TO THE SYSTEM—INDIVIDUAL ADMIT To begin monitoring patients on the system, touch ADMISSION control at the bottom of the main screen. The Admission Screen will be displayed. If the patients were not admitted to the database in specific groups and will be monitored as individuals, touch the SELECT button, then touch the name of the patient desired. The patient name will be inverse to indicate that the patient is selected for monitoring. CHAN# column indicates which channel is assigned when the patient was selected. The channels are assigned on a first come first served basis. The channel number may be changed by touching the patient name, until the desired channel is displayed. When all patients are selected and high lighted it is now possible to enter the daily weight and resting pressures. Place the cursor in the box under weight for the desired patient. The previous entered weight will be displayed in AMBER. Type in the weight. Use TAB, arrows or mouse to move to SYST. Enter Systolic pressure. Repeat for diastolic pressure. CHAN# column indicates which channel is assigned when the patient was selected. The channels are assigned on a first come first served basis. These numbers can be changed by selecting and deselecting the patient until the correct channel is displayed. When all information is correct touch ADMIT. All patients selected should now be displayed on main screen.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 55 MONITORING PATIENTS When the patients are admitted to the system the following MAIN screen will be displayed. The patient name is displayed on the right side of the trace. The timer is displayed to the right of the patient name. The target limits are displayed above the heart rate and the main rate alarms are displayed below the rate. When the start session button is displayed the patient is not monitored. Notice the ALARMS OFF message displayed to left of trace. NOTE: After admission it will take approximately 20 seconds to obtain a valid heart rate. Wait until the rate is stable, this rate is the resting heart rate and all values are determined from this rate. When a stable Heart Rate is displayed touch START SESSION. The following screen will be displayed. When START SESSION is touched the system will automatically save an ECG strip, notice label 1 EVENT to left of trace, this strip will be the pre-test strip. The first scheduled device will be flashing in green under the patient name. The time programmed for this device is displayed between name and heart rate. If the device is not available or the order of exercise is to be changed for this session only touch NXT to bypass the treadmill and select the second device. The T+ AND T- keys are used to adjust the time of exercise by raising or lowering the timer. The center box will indicate the settings for the device selected. To change these settings, with mouse or touch position the cursor over the setting to change, type in the new settings.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 56 MONITORING PATIENTS When all settings are adjusted touch GO in the box in the middle of the screen. The screen will change to the following: The timer has started counting down and will alarm when the session has 30 seconds (or user defined time) left. The control under the timer is the PAUSE control. If the patient has to stop the test or if the workload settings need to be changed, touch the PAUSE control. The CANCEL control will now be displayed. If the patient is able to continue touch the GO under the timer count, this will restart the timer. If the patient is unable to continue touch the CANCEL control. This cancels the test for this device. To change the workload, touch the setting in the center box to change. Type in the new setting. To continue the test, using the elapsed time, touch the GO in the timer box. To reset the timer to the initial setting, touch the GO in the center device box. If the test was cancelled or the device timed out, the system now indicates 2 EVENTS are stored. This event is the Maximum Rate strip for this exercise device. Touch the channel number of the patient monitored. The Rehab log will be displayed.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 57 MONITORING PATIENTS Line 1 indicates all of the pretest information and line two represents the information for the Treadmill. Position the cursor over the box for SYS and type in the systolic pressure. Touch the DIA box and enter diastolic pressure. Continue with RPE and O2 saturation if desired. Repeat the above steps for all remaining devices. To enter data on all of the patients from one screen without having to go back and forth between patients do the following. Touch any patient’s name. Touch REHAB LOG. The above screen permits entry of vital signs data on all of the patients admitted from one screen. Touch the appropriate stage number to select the device the patient is presently on.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 58 CONFIGURING QUICK COMMENTS There is space provided for entering up to 10 comments into the Rehab Log with the use of the F2 key. To enter these comments into the system perform the following: Touch STATUS key. Touch SETTINGS key. Touch RHB COMMENTS. The following screen will be displayed. Click in the Predefined Rehab Comments box to select a line for entry. The line selected will turn blue. Next click inside the Static box. Type in the comment desired. When all entries have been made, click on the Close key.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 59 ENTERING COMMENTS Comments may be placed into the patient log report in the COMMENTS column or on the bottom one third of the cover page. LOG COMMENTS To enter comments into the log report follow the steps below. Place the cursor on the line desired under COMMENTS section. Any information can be typed on this line or quick entries may be used. To use the pre-defined quick entries, hit F2 Function key. The following pull down menu will be displayed. Select the number desired from keypad on keyboard 1, 2, etc. See previous page for instructions for setting up the quick entry comments.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 60 ENTERING ADDITIONAL COMMENTS To enter comments In the additional comments section (bottom third) of the cover page touch the comments button on the rehab log. This will open a section of the screen to allow typing of approximately 800 characters. When all comments are typed touch RETURN.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 61 SETUP PATIENT FOR NON-ECG MONITORING If the patient is not to be monitored for ECG yet the information should be placed in the REHAB LOG following is the procedure to use. Admit the patient in the normal fashion. When the patient is admitted for the first time touch the SETUP control for that patient. The SETUP screen will appear. If the patient is to be monitored without ECG touch the MONITORED control. The control label will change to NON-MONITORED. The ECG will turn off but the patient name and exercise protocol will remain. It will be possible to enter data into the Rehab Log and retain that data for the duration of the exercise sessions.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 62 DISCHARGING PATIENTS When the patient’s heart rate reaches the preset level the following screen will be displayed. Touch the DISCHARGE button to discharge the patient. If the patient rate does not return to resting touch the waveform in the MANUAL STORE area this will store a posttest event and display the DISCHARGE button. If it is necessary to discharge the patient before exercise is completed, touch the patient name. When the setup screen is displayed, touch DISCHARGE. The following screen will be displayed If the patient is to be discharged touch the YES button. If all patients are to be discharged touch DISCHARGE ALL. All patients will be discharged. If discharge was touched by mistake touch NO and the system will return to the main screen,
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 63 EDIT THE LAST SESSION AND PRINT SESSION REPORT After the patient has been discharged and it becomes necessary to edit information, add additional comments or print a second copy of the report do the following. Touch ADMISSION. Use the arrow keys to scroll the patient list to find the desired patient. Click on the CHAN # box of that patient. Click on EDIT LOG. The REHAB LOG will be displayed from the last session attended. Any information can be changed or comments may be added to the report. When the patient is admitted the next time, this record will be locked. Touch the EVENTS control to view the EKG strips for this session. See the EVENTS section of the main manual for operation. Touch RETURN to return to the edit log screen. NOTE. If events are deleted from this screen the corresponding line of the rehab log will also be deleted with all vital sign information. To view the Full Disclosure EKG touch the DISCLOSURE control.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 64 ADJUSTING VOLUME CONTROL To change the volume of the alarms and notifications from the main screen touch STATUS. The STATUS screen will be displayed. Touch SETTINGS. Touch the VOLUME UP or VOLUME DOWN to adjust the volume.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 65 GENERATING REHAB REPORTS To generate the various reports for the rehab system, touch DATABASE. Touch the RHB REPORTS control. The report screen will be displayed. The headers over the patient list, control the sort order for the list. If the LAST name is touched the list will be sorted by last name. If the arrow is pointing up, the patients will be sorted in ascending order. Touch GP to sort by group or INS by Insurance. Select the patients to be printed by INDIVIDUAL, GROUP, INSURANCE or ALL patients. Next select the type of REPORT desired. Sessions selection provides a report of all session activity for the selected patient(s). Trends selection provides a trend report for all parameters selected in configuration screen. Ptn List prints a list of all patients in the database with information checked in the configuration screen. Schedule prints a schedule of groups with information checked in configuration screen.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 66 GENERATING REHAB REPORTS Attendance prints the report of who was present for the specified period. Comments adds the comments to the report. Compliance report prints the attendance reports for patients selected. Select the INTERVAL for the report. Week selects the last completed week information. Month selects the last completed month information. 1st and Last selects data from the first and last sessions for comparison. From To allows selection of data from two specific sessions for comparison. All allows selection of every session the patient has attended. Select the ECG STRIPS desired with the report. 1 MAX HR selects the highest maximum heart rate strip during the selected reports. Pre Test selects only the Pre Test strips from selected sessions. Post Test selects only the Post Test strips from selected sessions. Alarm selects only strips caused by alarm events from selected sessions. Manual selects only strips caused by manually stored strips from selected sessions. All selects all stored strips from selected sessions. Next select the PRINT type of report. Detail prints every entry made in all selected session reports. Summary reports one line from selected session report with min\max entries. By Device prints a report with each selected session sorted by the type exercise device. Touch PRINT to start printing.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 67 Exporting Data from TrensCenter to Outcome Program Touch the STATUS control at the lower right side of the screen. Touch the SETTINGS control. The SETTINGS screen will be displayed. Touch the RHBEXPORT control. Touch RETURN. A file will be created with a list of all active patients demographic data. The name of the file is OUTCOME.TXT. This file will be imported into the Outcomes Program by the following method. From the ODMS Clinic Edition program do the following: Click on FILE. Click on Import and Export.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 68 Click on Import from LSI TrensCenter. Click on Next. For Users of Orion 1.X software, place the cursor in the File to Import Box and type in the file name C:\OUTCOME.TXT and click Next. Click on Finish. The data file will be imported into the Outcomes Program. For Users of Orion 2.X software, place the cursor in the File to Import Box and type in the file name C:\OUTCOME1.TXT and click Next. Click on Finish. The data file will be imported into the Outcomes Program.
TrensCenter Central Station Cardiac Monitor Operator’s Manual Page 69 ARCHIVE PATIENT DATA When a patient has completed all prescribed sessions and the data of these sessions are to be kept, it is possible to Archive this data onto a hard drive or removable disk for later analysis. To Archive patient files touch or click on DATABASE. Select the patient to be archived. Touch the ARCHIVE control. If there is a need to recall that patient information touch the INACTIVE control and select the patient desired. All session reports are now available.

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