Electrocardiograph ECG A. If you have any comments or suggestions on this manual, please contact us at:

Transcription

1 Electrocardiograph ECG-2150 If you have any comments or suggestions on this manual, please contact us at: A

2 In order to use this product safely and fully understand all its functions, make sure to read this manual before using the product. Keep this manual near the instrument or in the reach of the operator and refer to it whenever the operation is unclear. This product stores personal patient information. Manage and operate the information appropriately. Patient names on the screen shots and recording examples in this manual are fictional and any resemblance to any person living or dead is purely coincidental. The contents of this manual are subject to change without notice. Copyright Notice The entire contents of this manual are copyrighted by Shanghai Kohden. All rights are reserved. No part of this document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical, photocopied, recorded, or otherwise) without the prior written permission of Shanghai Kohden. Trademark The mark printed on the SD card that is used in this instrument is a trademark. The company name and model name are trademarks and registered trademarks of each company.

3 ENERAL HANDLING PRECAUTIONS... I WARRANTY POLICY... II EMC RELATED CAUTION... III Conventions Used in this Manual and Device...V General Safety Information...VI Explanations of the Symbols...XIII 1 General Introduction Panel and Parts Descriptions Functions Basic Operation (Function Keys, Panel Keys, Number Keys) Switching Screens AC and Battery Operation Preparation Selecting a Suitable Location Mounting the Electrocardiograph on the Optional Cart Connecting the Power Cord and Grounding the Electrocardiograph Operating on Battery Setting the Recording Paper Turning the Power On or Off Connecting Optional Accessories to the Electrocardiograph Connecting an External Device to the Electrocardiograph Adjusting the Screen Brightness Preparing for Data Management Connecting the Electrocardiograph to a Network Changing Settings Before Measurement System Setup Screen and Main Setup Screen List of Settings Changing the System Setup Settings Changing the Main Setup Settings Saving the System Setup and Main Setup Settings Contents Loading the System Setup and Main Setup Settings Printing the List of System Setup and Main Setup Settings Attaching the Electrodes and Entering Patient Information Attaching the Electrodes Patient Cable Tip Color Coding Lead Connection Error Indication When the Electrode Is Not Attached Firmly Entering the Patient Information Recording Resting ECG Waveforms General Flow of Resting ECG Waveform Recording Notes for Accurate Measurement Resting ECG Recording Screen Automatic Recording Manual Recording Rhythm Recording Recording Examples Periodic ECG Recording General Preparation for Periodic ECG Recording Starting Periodic Recording Recording Examples Data Management General Displaying the Data Management Screen Sending ECG Data Files Printing ECG Waveforms in a Media Editing the ID Printing ECG Waveforms in the Server Deleting ECG Data Files Formatting the Media Printing the File List ECG-2150 Operator s Manual Contents 1

4 Copying Files in the Internal Memory to an SD Card Troubleshooting and Error Messages Recording Clear ECG Waveforms Troubleshooting Error Messages Checking the Software Version Maintenance and System Test Check Items After Turning the Power Off Cleaning and Disinfecting the Electrocardiograph Cleaning and Disinfecting the Patient Cable Cleaning and Disinfecting Electrodes Cleaning and Disinfecting Other Options Regular Check Clock Accuracy Periodic Replacement Repair Parts Availability Policy System Test Screen Reference Specifications General Requirements for Connecting Medical Electrical Systems Standard Accessories Options and Consumables System Connection Diagram Character Code List Contents ECG-2150 Operator s Manual

5 GENERAL HANDLING PRECAUTIONS This device is intended for use only by qualified medical personnel. Use only Shanghai Kohden approved products with this device. Use of non-approved products or in a non-approved manner may affect the performance specifications of the device. This includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode leads, input boxes and AC power. Please read these precautions thoroughly before attempting to operate the instrument. 1. To safely and effectively use the instrument, its operation must be fully understood. 2. When installing or storing the instrument, take the following precautions: (1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive humidity and temperatures, poorly ventilated areas, and dust, saline or sulphuric air. (2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport. (3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage. (4) The power line source to be applied to the instrument must correspond in frequency and voltage to product specifications, and have sufficient current capacity. (5) Choose a room where a proper grounding facility is available. 3. Before Operation (1) Check that the instrument is in perfect operating order. (2) Check that the instrument is grounded properly. (3) Check that all cords are connected properly. (4) Pay extra attention when the instrument is combined with other instruments to avoid misdiagnosis or other problems. (5) All circuitry used for direct patient connection must be doubly checked. (6) Check that battery level is acceptable and battery condition is good when using battery-operated models. 4. During Operation (1) Both the instrument and the patient must receive continual, careful attention. (2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient's safety. (3) Avoid direct contact between the instrument housing and the patient. 5. To Shutdown After Use (1) Turn power off with all controls returned to their original positions. (2) Remove the cords gently; do not use force to remove them. (3) Clean the instrument together with all accessories for their next use. 6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is not functioning properly, it should be clearly marked to avoid operation while it is out of order. 7. The instrument must not be altered or modified in any way. 8. Maintenance and Inspection (1) The instrument and parts must undergo regular maintenance inspection at least every 6 months. (2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect operating condition. ECG-2150 Operator's Manual I

6 (3) Technical information such as parts list, descriptions, calibration instructions or other information is available for qualified user technical personnel upon request from your Nihon Kohden representative. 9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or location of electrodes and/or transducers to avoid possible burn to the patient. 10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage. 11. Contraindications: None. 12. The electrodes cannot be applied directly on the heart WARRANTY POLICY Shanghai Kohden Corparation (SKC) shall warrant its products against all defects in materials and workmanship for one year from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded from the warranty. SKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period, provided these products are used as prescribed by the operating instructions given in the operator's and service manuals. No other party is authorized to make any warranty or assume liability for SKC's products. SKC will not recognize any other warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by someone other than SKC or its authorized agents without prior consent of SKC may be cause for voiding this warranty. Defective products or parts must be returned to SKC or its authorized agents, along with an explanation of the failure. Shipping costs must be pre-paid. This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Shanghai Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation or application, or on which the original identification marks have been removed. II ECG-2150 Operator's Manual

7 EMC RELATED CAUTION This equipment and/or system complies with IEC International Standard for electromagnetic compatibility for medical electrical equipment and/or system. However, an electromagnetic environment that exceeds the limits or levels stipulated in IEC , can cause harmful interference to the equipment and/or system or cause the equipment and/or system to fail to perform its intended function or degrade its intended performance. Therefore, during the operation of the equipment and/or system, if there is any undesired deviation from its intended operational performance, you must avoid, identify and resolve the adverse electromagnetic effect before continuing to use the equipment and/or system. The following describes some common interference sources and remedial actions: 1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station or cellular phone: Install the equipment and/or system at another location. Keep the emitter source such as cellular phone away from the equipment and/or system, or turn off the cellular phone. 2. Radio-frequency interference from other equipment through the AC power supply of the equipment and/or system: Identify the cause of this interference and if possible remove this interference source. If this is not possible, use a different power supply. 3. Effect of direct or indirect electrostatic discharge: Make sure all users and patients in contact with the equipment and/or system are free from direct or indirect electrostatic energy before using it. A humid room can help lessen this problem. 4. Electromagnetic interference with any radio wave receiver such as radio or television: If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or system as far as possible from the radio wave receiver. 5. Interference of lightning: When lightning occurs near the location where the equipment and/or system is installed, it may induce an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord from the equipment and/or system and operate the equipment and/or system by battery power, or use an uninterruptible power supply. 6. Use with other equipment: When the equipment and/or system is adjacent to or stacked with other equipment, the equipment and/or system may affect the other equipment. Before use, check that the equipment and/or system operates normally with the other equipment. 7. Use of unspecified accessory, transducer and/or cable: When an unspecified accessory, transducer and/or cable is connected to this equipment and/or system, it may cause increased electromagnetic emission or decreased electromagnetic immunity. The specified configuration of this equipment and/or system complies with the electromagnetic requirements with the specified configuration. Only use this equipment and/or system with the specified configuration. ECG-2150 Operator's Manual III

8 Caution - continued 8. Use of unspecified configuration: When the equipment and/or system is used with the unspecified system configuration different than the configuration of EMC testing, it may cause increased electromagnetic emission or decreased electromagnetic immunity. Only use this equipment and/or system with the specified configuration. 9. Measurement with excessive sensitivity: The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the surrounding electromagnetic conditions and remove this artifact source. If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden representative for additional suggestions. For EMC compliance, refer to "Specification - Electromagnetic Compatibility" in the Reference section. The CE mark is a protected conformity mark of the European Community. Products with the CE mark comply with the requirements of the Medical Device Directive 93/42/EEC. NOTE about Waste Electrical and Electronic Equipment (WEEE) Directive 2002/96/EC For the member states of the European Union only: The purpose of WEEE directive 2002/96/EC is, as a first priority, the prevention of waste electrical and electronic equipment (WEEE), and in addition, the reuse, recycling and other forms of recovery of such wastes so as to reduce the disposal of waste. Contact your Nihon Kohden representative for disposal. IV ECG-2150 Operator's Manual

9 Warnings, Cautions and Notes Conventions Used in this Manual and Device WARNING: CAUTION: NOTE: A warning alerts the user to possible injury or death associated with the use or misuse of the instrument. A caution alerts the user to possible injury or problems with the instrument associated with its use or misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other property. A note provides specific information, in the form of recommendations, prerequirements, alternative methods or supplemental information. ECG-2150 Operator's Manual V

10 General Safety Information General WARNING Never use the electrocardiograph in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. WARNING Never use the electrocardiograph in a hyperbaric oxygen chamber. Failure to follow this warning may cause explosion or fire. WARNING When the electrocardiograph is used with an electrosurgical unit (ESU), firmly attach the entire area of the ESU return plate. Otherwise, the current from the ESU flows into the electrodes of the electrocardiograph, causing electrical burn where the electrodes are attached. For details, refer to the ESU manual. WARNING When performing MRI test, remove all electrodes and transducers from the patient which are connected to this instrument. Failure to follow this warning may cause skin burn on the patient. For details, refer to the MRI manual. WARNING Before defibrillation, remove everything including electrodes and patches from the patient s chest. If the defibrillator paddle contacts an object on the patient s chest, the discharged energy may be insufficient and cause skin burn. WARNING Before defibrillation, all persons must keep clear of the bed and must not touch the patient or any equipment or cable connected to the patient. Failure to follow this warning may cause electrical shock or injury. WARNING Use only the specified patient cables. Failure to follow this warning may cause skin burn where the electrode is attached and damage the electrocardiograph due to discharge energy when defibrillation is performed. VI ECG-2150 Operator's Manual

11 Installation WARNING Connect only the specified instrument to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or instrument malfunction. WARNING Only use the provided power cord. When the provided power cord cannot be used or when equipotential grounding is doubtful (such as in a facility with poor grounding), operate the electrocardiograph on battery power. Otherwise, the patient and operator may receive electrical shock or injury. WARNING When several medical instruments are used together, ground all instruments to the same one-point ground. Any potential difference between instruments may cause electrical shock to the patient and operator. WARNING Never use a local purchase multiple portable socket outlet. Failure to follow this warning may cause electrical shock to the patient and operator. WARNING Do not put the multiple portable socket outlet on a floor. If the multiple portable socket outlet gets dusty, damaged or contacts liquid, it may cause instrument malfunction and electrical shock to the patient or operator. WARNING Do not use an additional multiple portable socket outlet or extension cord. The impedance of the protective earth increases and the patient and operator may receive electrical shock or injury. WARNING To use non-medical equipment that requires an isolation transformer, only connect it to a specified multiple portable socket outlet that has an isolation transformer. Do not connect the non-medical equipment to a wall AC socket or to a multiple portable socket that does not have an isolation transformer. Do not connect unspecified electrical instruments to a multiple portable socket outlet in the system. Failure to follow this warning may cause leakage current to increase and the patient and operator may receive electrical shock or injury. ECG-2150 Operator's Manual VII

12 Cart CAUTION Only use the KD-105D/105E cart for this electrocardiograph. If another cart is used, it may tip over or the electrocardiograph may fall off. CAUTION Do not move the cart with the casters locked. The cart may tip over. When moving the cart, hold the handle only. CAUTION When moving the cart with patient cable hanger mounted, fold the upper and lower arms together, rotate the arms so that they point toward the handle and do not protrude beyond the edges of the cart. CAUTION To prevent the cart from tipping over or the electrocardiograph falling off the cart: Do not put or hook anything on the handle. Do not ride on the cart. Do not lean on the handle or put your weight on the cart. Periodically check that the casters, handle and frame are firmly attached and not wobbly. Always lock the casters so that the cart does not move accidentally. Accessories and Consumables CAUTION Do not leave accessories and consumables such as electrodes or electrolyte cream (CardioCream) near the patient or in reach of children. If they are swallowed, consult a physician immediately. CAUTION Only use Shanghai Kohden specified parts and accessories to assure maximum performance from your electrocardiograph. Using unspecified recording paper or electrodes may cause incorrect ECG recording and accelerate deterioration of the electrocardiograph. VIII ECG-2150 Operator's Manual

13 Battery Pack WARNING Do not do the following to the battery pack. It may cause leakage, overheating, explosion and fire. Short-circuit the + and terminals on the battery pack. Put the battery pack into fire or heat the battery pack. Disassemble or modify the battery pack. Give strong impact to or deform the battery pack. Use the battery pack on unspecified instruments. Charge the battery pack on unspecified instruments. Install the battery pack with the wrong polarity. Leave the battery pack in the reach of patients. WARNING If the liquid inside the battery contacts the eyes, mouth or skin, do not rub the eyes, mouth or skin. Wash with clean water and see a physician immediately. WARNING The following may cause overheating and leakage of the battery pack. Leaving the battery pack unused for a long period (more than a year). Immersing the battery pack in water or sea water or getting it wet. WARNING Only use the SB-901DC battery pack. CAUTION If the battery operation time is less than 15 minutes, the battery pack may be deteriorated. Do not charge a deteriorated battery pack. Charging a deteriorated battery pack may cause the electrocardiograph to fail to operate in both battery and AC power. CAUTION Do not use or leave the battery pack in direct sunlight or high temperatures such as in a car in hot weather or in front of a stove. It may cause leakage of the battery pack and degrade the performance and lifetime of the battery pack. CAUTION The battery pack must be replaced by qualified service personnel. CAUTION SB-901DC battery pack is NiMH (nickel-metal hydride). Before disposing of the battery pack, check with your local solid waste officials for details in your area for recycling options or proper disposal. The battery is recyclable. At the end of its useful life, under various state and local laws, it may be illegal to dispose of this battery into the municipal waste stream. ECG-2150 Operator's Manual IX

14 Operation WARNING Do not touch the patient while touching any metal part of non-medical electrical equipment or an exposed part when a connector or cover is removed. Failure to follow this warning may cause electrical shock or injury to the patient. WARNING Do not connect the tip of the electrode lead to anything other than an electrode. Connect all the tips to the corresponding electrodes and attach them to the patient. If unconnected tips or electrodes contact an item which is not equipotential grounded, the patient may receive electrical shock. Also, noise may superimpose on the ECG waveforms and measurement data may be incorrect. CAUTION Enter the patient information correctly. Otherwise, the ECG data may be lost or mixed up with another patient's ECG data. When managing examination data that is only in electronic file, make sure to enter the patient information. CAUTION The paper cutter in the recording paper container is sharp. When setting the recording paper, be careful not to cut your finger. Set the recording paper as specified. CAUTION Do not use the output signal from the output connector of the electrocardiograph for a synchronization signal on a defibrillator. There is a time delay between the input signal and output signal. When using the output signal from the electrocardiograph for the synchronization signal on other instrument, always consider this time delay. X ECG-2150 Operator's Manual

15 ECG Recording Judgement CAUTION The automatic ECG interpretation is performed for acquired ECG waveforms only and does not reflect all conditions of the patient. The results of the analysis might not correspond to the judgement of a physician. Overall judgement must be performed by the physician, referring to the analysis result, clinical findings, and other examination results. After the physician s overall judgement, the analysis results should be signed or initialed by the physician. CAUTION Take care when judging the ECG recording because the EMG filter may cause distortion of P-waves and QRS-waves depending on the waveform shape. Maintenance CAUTION Before maintenance, cleaning or disinfection, turn the electrocardiograph power off and disconnect the power cord from the AC socket. Failure to follow this instruction may result in electrical shock and electrocardiograph malfunction. ECG-2150 Operator's Manual XI

16 Network WARNING Connect the electrocardiograph to network as specified. Otherwise the patient and operator may receive electrical shock or injury. To connect the network, contact your Nihon Kohden representative. WARNING Install all network devices, including printer and hubs, outside the patient environment (IEC *). If they are installed inside the patient environment, the patient or operator may receive electrical shock or injury. For installation, contact your Nihon Kohden representative. CAUTION Do not use a damaged network cable. The patient or operator may receive electrical shock when the damaged part is touched. XII ECG-2150 Operator's Manual

17 Explanations of Symbols The following symbols are used with the electrocardiograph. The names and descriptions of each symbol are shown in the table below. On panel Symbol Description Symbol Description Caution Date of manufacture Follow instructions for use Serial number Alternating current Manufacturer Equipotential terminal Type CF applied part The CE mark is a protected conformity mark of the European Community. Products marked with this symbol comply with the requirements of the Medical Device Directive 93/42/EEC and Radio Equipment and Telecommunication Terminal Equipment 1999/5/EC. Input output terminal Eject (Magazine release button) Data input/output SD card slot Battery Symbol Description Symbol Description Electrostatic sensitive devices (To indicate packages containing electrostatic sensitive device, or to identify a device or connector that has not been tested for immunity to electrostatic discharge.) Products marked with this symbol comply with the European WEEE directive 2002/96/EC and require separate waste collection. For Shanghai Kohden products marked with this symbol, contact your Nihon Kohden representative for disposal. Caution Follow instructions for use Recycle mark Manufacturer Environmental protection Date of manufacture The CE mark is a protected conformity mark of the European Community. ECG-2150 Operator's Manual XIII

18 On operation panel Symbol Description Symbol Description On only for a part of equipment Mode Off only for a part of equipment Rhythm Battery charging Paper feed Battery check Mark Alternating current EMG Filter Patient (Male) Copy Patient (Female) START/STOP recording Age Automatic control Manual control On screen Symbol Description Symbol Description QRS sync mark CAL mark On patient cable Symbol Description Symbol Description Caution Defibrillation-proof Type CF applied part XIV ECG-2150 Operator's Manual

19 1 General 1 Introduction Intended Use Features Composition Standard Accessories Options Panel and Parts Descriptions Top View Operation Panel Bottom View Left View Right View Rear View Patient Cable Functions Basic Operation (Function Keys, Panel Keys, Number Keys) Switching Screens AC and Battery Operation Power and Battery Status Indications

20 1. GENERAL Introduction The cardiofax C ECG-2150 has a rechargeable battery pack, 3 channels, multiple recording methods, and LCD electrocardiogram waveform display. It meets the demands of hospitals, scientific research, general wards, rescue and visiting a patient at home. NOTE: Use only Shanghai Kohden parts and accessories to assure maximum performance from your instrument. Intended Use The Shanghai Kohden ECG-2150 electrocardiograph is intended for medical use to process the electrical signals produced by the heart, which are acquired through two or more electrodes, and to display waveforms* and/or prepare a record of these electrical signals. This instrument is a portable ECG acquisition terminal which measures up to 12 leads ECG waveforms. The intended use is just only for diagnosis, not for monitoring of vital physiological parameters. Main functions are recording patient's resting ECG signal and printing the record. Features Compact, lightweight and easy to carry smaller than A4 paper, approx 1.7 kg without battery pack and recording paper Prints up to 3 channels on 63 mm recording paper An LCD screen lets you preview 2.8 seconds of 12 leads ECG waveforms SD memory card available Data transmission through wired LAN to personal computer or another electrocardiograph For ECG analysis, refer to "the ECAPS 12C ECG Interpretation Program User s Guide". Composition Electrocardiograph, ECG-2150 Standard Accessories Recording paper, RQS63-3A 1-2 ECG-2150 Operator s Manual

21 Options Patient cable, BJ-901D / BJ-902D / BJ-903D / BA-901D / BA-903D / BJ-961D / BJ-962D Battery pack, SB-901DC Cart, KD-105D / KD-105E Patient cable hanger, KH-100D SD memory card, QM-001D Cardio cream, Z-101BC Bar code reader Magnetic card reader Medical isolation transformer 1. GENERAL 1 Panel and Parts Descriptions Top View Name Function 1 Operation panel Refer to the Operation Panel section. 2 Paper magazine Contains the recording paper. 3 LCD screen Displays ECG waveforms, patient information, marks and messages. ECG-2150 Operator s Manual 1-3

22 1. GENERAL Operation Panel Name Function 1 POWER key/lamp Turns the electrocardiograph on/off. For details, refer to AC and Battery Operation later in this section. 2 AC power lamp Lit when AC power is supplied. 3 Battery operation lamp During battery operation, indicates the remaining battery power with the color and lighting state. For details, refer to AC and Battery Operation later in this section. 4 Battery charge lamp Indicates the battery charge status. For details, refer to Operating on Battery in Section. NOTE: After charging is complete, the battery charge lamp briefly lights about once every half hour to one hour. This is because a small current is supplied to the battery (supplementary recharging) to prevent self-discharging of the battery. Keep the power cord plugged into the AC socket when the electrocardiograph is not used. 5 MODE key ( 4 number key) Calls up the Main menu screen. On some screens, this key enters the number 4. 6 RHYTHM key/lamp ( 5 number key) Performs rhythm recording in resting ECG examination. The lamp is lit while waveforms are acquired. On some screens, this key enters the number 5. 7 ID key Use to enter patient information. 8 F1, F2, F3, F4 function keys ( 1, 2, 3 number keys) Correspond to the four items at the bottom of the screen. On some screens, these keys enter the number 1, 2 and 3. 9 AGE key ( 6 number key) Selects the patient age range (child or adult). On some screens, this key enters the number GENDER key ( 7 number key) Selects the patient gender. On some screens, this key enters the number FEED/MARK key ( 8 number key) Paper feeding: Feeds the paper while the key is pressed. Event mark: In manual recording mode, adds an event mark to the ECG waveform. On some screens, this key enters the number ECG-2150 Operator s Manual

23 Name 12 FILTER key/lamp ( 9 number key) Function Turns the EMG filter on/off. The lamp lights when the EMG filter is turned on. On some screens, this key enters the number GENERAL 1 13 COPY/CAL key lamp ( 0 number key) Automatic recording mode and rhythm recording mode: Prints copies of the recording results. The lamp lights when copy is available and during printing. Manual recording mode: Records the calibration waveforms. This key does not function for external input signals. On some screens, this key enters the number START/STOP key/lamp Starts or stops recording. The lamp lights during recording. 15 AUTO/MANUAL key/lamp Selects automatic or manual recording. Lamp on: automatic recording Lamp off: manual recording The MODE, RHYTHM, F1, F2, F3, AGE, GENDER, FEED/MARK, FILTER and COPY/CAL keys are used to enter numbers in the System Setup screen and patient information. Refer to Changing the System Setup Settings in Section 3 and Entering the Patient Information in Section 4. Bottom View 1 Name Function 1 Battery compartment Contains the battery pack. CAUTION Always install the battery even when the electrocardiograph operates on AC power. Otherwise sudden power off occurs when an electrode is detached during recording. ECG-2150 Operator s Manual 1-5

24 1. GENERAL Left View 1 2 Name 1 Paper magazine release button Function Press down this button to open the paper magazine and set the recording paper. 2 Patient cable connector Connects the patient cable. Right View WARNING Connect only the specified instrument to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or instrument malfunction. WARNING Install non-medical instruments which are connected to the electrocardiograph outside the patient environment (IEC ). If they are installed inside the patient environment, the patient or operator may receive electrical shock or injury. For installation, contact your Nihon Kohden representative. WARNING Follow IEC for connecting the electrocardiograph to other instruments. WARNING The operator should not touch patient and the input/output interface of the instrument simultaneously. This may cause electric shock 1-6 ECG-2150 Operator s Manual

25 1. GENERAL CAUTION Do not use the output signal from the output connector of the electrocardiograph for a synchronization signal on a defibrillator. There is a time delay between the input signal and output signal. When using the output signal from the electrocardiograph for the synchronization signal on other instrument, always consider this time delay. 1 Name Function 1 SD card slot For an SD memory card (option). 2 LAN port Connects a network cable. 3 AC power cord socket Connects the power cord to supply AC power to the electrocardiograph. Rear View 1 2 WARNING Connect only the specified instrument to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or instrument malfunction. WARNING Install non-medical instruments which are connected to the electrocardiograph outside the patient environment (IEC ). If they are installed inside the patient environment, the patient or operator may receive electrical shock or injury. For installation, contact your Nihon Kohden representative. Name Function 1 Equipotential grounding termial Connect to an external equipotential grounding system by an equipotential grounding conductor. 2 USB connector Connects a USB bar code scanner or a magnetic card reader. ECG-2150 Operator s Manual 1-7

26 1. GENERAL Patient Cable 1 2 Name 1 Electrode leads Connects to chest or limb electrodes. Function 2 Connector Connects the leads to the electrocardiograph. Defibrillation-proof function Patient cable: BJ-961D,BJ-962D, BJ-901D, BJ-902D, BJ-903D, BA-901D, BA-903D are in compliance with IEC standard, waveforms and electrode recovery time are within 5 seconds. NOTE: The APPLIED PART includes the electrodes and those parts of the Patient cable that need to physically contact the PATIENT in NORMAL USE. 1-8 ECG-2150 Operator s Manual

27 1. GENERAL Functions 1 ECG recording (Refer to Section 5) Automatic recording Real time recording Review recording Analysis result recording Rhythm recording One minute of one rhythm lead ECG waveform recording Extended recording Extended arrhythmia rhythm recording Extended sequence recording Extended recording (manual) Copy (manual) ECG data storage (manual) Manual recording ECG manual recording Periodic recording Automatic recording Real time recording Periodic recording ECG data storage Manual recording ECG data management (Refer to Section 7) Send ECG data files Print ECG waveforms Change the ID of the saved file Print server file Delete ECG data files Format a media Print ECG data file list Copy ECG data files in the internal memory to SD card Settings (System setup screen) (Refer to Section 3) Patient information Wave settings Communication settings Recording settings - Auto recording - Report print out - Analysis format and settings ECG-2150 Operator s Manual 1-9

28 1. GENERAL Periodic recording settings System settings Bar code Magnetic card Save/Load/Print system settings To display the System Setup screen 1. Turn the power off. 2. Press the POWER key while pressing the FILTER key. Settings (Main setup screen) (Refer to Section 3) Wave settings Communication settings File processing Recording settings - Recorder - Manual recording - Auto recording - Analysis format and settings - Rhythm recording To display the Main Setup screen Select Setup from the Main Menu screen. Setting (Brightness screen) (Refer to Section 2) Adjusting the screen brightness System test (Refer to Section 9) Demonstration waveform Recorder test Key test Memory test LCD/LED test Electrode input test ECG input circuit test USB Test Initialize system settings Display internal information Display model information To display the System Test screen 1. Turn the power off. 2. Press the POWER key while pressing the FEED/MARK key ECG-2150 Operator s Manual

29 1. GENERAL Basic Operation (Function Keys, Panel Keys, Number Keys) 1 The electrocardiograph has function keys on the screen and dedicated keys on the operation panel. Function Keys Press the function key (F1 - F4) corresponding to the operation or item displayed on the bottom of the screen to perform the desired operation or select the desired item. Number Keys On some screens, you can press the panel key to enter a number (0-9). Panel Keys Press the key on the operation panel to perform the desired operation. Some of the panel keys also function as number keys on some screens. ECG-2150 Operator s Manual 1-11

30 1. GENERAL Switching Screens When the electrocardiograph is turned on, the Resting ECG recording screen appears. To switch to another screen 1 Press the MODE key to display the Main Menu screen. 2 Use the number keys on the operation panel to select the number of the desired item. Press the 1 or 2 key on the Main Menu screen to return to the ECG recording screen ECG-2150 Operator s Manual

31 1. GENERAL AC and Battery Operation 1 Lit AC power lamp on AC power operation: When AC power is supplied, the electrocardiograph operates on AC power and the AC power lamp lights. CAUTION Always install the battery even when the electrocardiograph operates on AC power. Otherwise sudden power off occurs when an electrode is detached during recording. Automatic backlight off In AC power operation, the electrocardiograph automatically turns the backlight off when the Fail Limb message (electrode detachment) is displayed on the screen and there is no key operation for approximately 3 minutes. To turn on the backlight, press any key. The automatic backlight off function can be turned off by setting Backlight auto off to Off on the System Setup screen. Refer to List of Settings in Section 3. Lit Battery power operation: Battery operation lamp on When AC power is not supplied, the electrocardiograph automatically switches to battery power operation and the battery operation lamp lights to indicate the remaining battery power. The electrocardiograph can operate about 120 minutes with a new fully charged battery. NOTE When the battery is almost discharged and the power is turned on, the Charge battery message appears, the battery operation lamp blinks in orange, a notification sounds and the electrocardiograph immediately turns the power off. Automatic power off In battery operation, to prevent unwanted battery consumption, the electrocardiograph automatically turns the power off when the Fail Limb message (electrode detachment) is displayed on the screen and there is no key operation for approximately 3 minutes. In this case, temporarily changed settings are lost. If this happens, turn the power back on to continue using the electrocardiograph. The automatic power off function can be turned off by setting Auto power off to Off on the System Setup screen. Refer to List of Settings in Section 3. ECG-2150 Operator s Manual 1-13

32 1. GENERAL Battery operation time: NOTE: Remaining battery power depends on the surrounding temperature and quality of recording waveform. Battery operation lamp Lights in green Lights in orange Blinks in orange Available recording time At least 15 minutes. 120 minutes or more when the new battery pack be fully charged. 1 minute to 15 minutes Power will be lost within 1 minute. Recharge the battery immediately or operate on AC power. Power and Battery Status Indications Power and battery status are indicated by four lamps on the front panel. A discharged battery is also indicated by a screen message. Lit Lit Lit Lit Lit Lit Lit in green Lit in orange Blink in orange Lit Operating on AC power Power lamp: Lit in blue AC power lamp: Lit in green Battery operation lamp: Off Battery charge lamp: Off Operating on battery power Power lamp: Lit in blue AC power lamp: Off Battery operation lamp: Lit in green Battery charging lamp: Off Operating on battery power and battery operation time is less than 15 minutes Power lamp: Lit in blue AC power lamp: Off Battery operation lamp: Lit in orange Battery charging lamp: Off Operating on battery power and battery needs recharging Power lamp: Lit in blue AC power lamp: Off Battery operation lamp: Blink in orange Battery charging lamp: Off Screen indication: Charge battery message Power off and charging battery Power lamp: Off AC power lamp: Lit in green Battery power lamp: Off Battery charging lamp: Lit in green 1-14 ECG-2150 Operator s Manual

33 2 Preparation 2 Selecting a Suitable Location Mounting the Electrocardiograph on the Optional Cart Mounting the Electrocardiograph on the Cart Connecting the Power Cord and Grounding the Electrocardiograph Connecting the Power Cord Grounding the Electrocardiograph Cutting Off the Power Supply to the Electrocardiograph Operating on Battery Battery Handling Battery Replacement Charging Storage Disposing Inserting the Battery Pack Removing the Battery Pack Charging the Battery Setting the Recording Paper Handling the Recording Paper Recording Paper Storage Usage Replacement Setting the Recording Paper Feeding the Paper Turning the Power On or Off Turning the Power On Check Items Before Turning the Power On Turning the Power On Check Items After Turning the Power On Changing the Date and Time

34 Turning the Power Off Connecting Optional Accessories to the Electrocardiograph Connectable Optional Accessories Connection Remove Connect a Bar Code Reader Connecting an External Device to the Electrocardiograph Adjusting the Screen Brightness Preparing for Data Management About the Media Internal Memory SD Memory Card Using the Internal Memory Using the SD Memory Card About the SD Memory Card Inserting and Removing the SD Memory Card Preparing the SD Memory Card About the External Server Connecting the Electrocardiograph to a Network Using the Wired LAN Setting the IP Address, Subnet Mask and Default Gateway on the Electrocardiograph

35 2. PREPARATION Selecting a Suitable Location Select a suitable examination location according to the following WARNINGS, CAUTIONS and NOTES and refer to GENERAL HANDLING PRECAUTIONS. 2 WARNING Never use the electrocardiograph in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. WARNING Connect only the specified instrument to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or instrument malfunction. WARNING Never use the electrocardiograph in a hyperbaric oxygen chamber. Failure to follow this warning may cause explosion or fire. CAUTION The electrocardiograph should not share the power line with any instrument which consumes a lot of power, such as an X-ray instrument, because it may cause artifact. CAUTION Make sure that there is enough space between the electrocardiograph and the wall for adequate ventilation. Leave more than 5 cm of space between the wall and electrocardiograph so that the operating temperature does not exceed 40 C (104 F). Otherwise the internal temperature of the electrocardiograph rises, which leads to inaccurate operation and shortens the electrocardiograph life. CAUTION Only use the KD-105D/105E cart for this electrocardiograph. If another cart is used, it may tip over or the electrocardiograph may fall off. CAUTION Do not install the electrocardiograph near a power line, dynamo or motor which has electromagnetic induction. Do not install the electrocardiograph near an electrosurgical unit or RF therapeutic equipment. Select a room without excessive noise, vibration, sunlight, high humidity or water splashes. Make sure that there is no interference from a mobile phone. Avoid locations where the electrocardiograph may receive strong electromagnetic interference such as radio or TV stations, mobile phones or mobile two-way radios. Do not install the electrocardiograph where it will be exposed to water or chemical solutions. Avoid direct sprinkling, spray or moist air from a nebulizer or humidifier. These cause malfunction and shorten the life of the electrocardiograph. ECG-2150 Operator s Manual 2-3

36 2. PREPARATION CAUTION When installing the electrocardiograph, take care not to pinch your finger under the electrocardiograph. CAUTION Do not use the electrocardiograph with its side panel down. Failure to follow this instruction may cause the electrocardiograph to fall over or cause battery liquid leakage. NOTE Install the electrocardiograph where the screen can be seen clearly and does not reflect light. Do not place blankets or cloth over the electrocardiograph. Do not install the electrocardiograph in a dusty area. 2-4 ECG-2150 Operator s Manual

37 2. PREPARATION Mounting the Electrocardiograph on the Optional Cart 2 CAUTION Only use the KD-105D/105E cart for this electrocardiograph. If another cart is used, it may tip over or the electrocardiograph may fall off. Mounting the Electrocardiograph on the Cart Use the two set pins and two screws (option, contact your Nihon Kohden representative) to mount the electrocardiograph on the cart. 1 2 Attach the set pins to the holes (KD-105D/105E) on the top cover of the cart. Mount the electrocardiograph by aligning the holes on the rear panel over the set pins. For details, refer to the installation guide of the cart. KH-100D patient cable hanger You can attach the KH-100D patient cable hanger to the cart and put the cables and hook limb leads on the hanger. The hanger prevents the cables from getting tangled or the limb leads from getting in the way. ECG-2150 Operator s Manual 2-5

38 2. PREPARATION Connecting the Power Cord and Grounding the Electrocardiograph Connecting the Power Cord WARNING Only use the provided power cord. When the provided power cord cannot be used or when equipotential grounding is doubtful (such as in a facility with poor grounding), operate the electrocardiograph on battery power. Otherwise, the patient and operator may receive electrical shock or injury. WARNING To avoid the risk of electric shock, this equipment must only be connected to a supply mains with protective earth. NOTE Make sure that there is always a battery pack inside the electrocardiograph in case the power cord is disconnected or there is a power failure. When there is no battery inside the electrocardiograph, there may be noise on the waveform or the electrocardiograph may reset and lose measurement data. The mains plug or appliance coupler is intended to be used as an isolation device from the supply mains. Please always make mains plug or appliance coupler is easy to operate. Connect the provided power cord to the AC power cord socket on the right side panel of the electrocardiograph and plug the cord into a 3-prong AC socket. 2-6 ECG-2150 Operator s Manual

39 2. PREPARATION Grounding the Electrocardiograph 2 WARNING When several medical instruments are used together, ground all instruments to the same one-point ground. Any potential difference between instruments may cause electrical shock to the patient and operator. When more than one electrical instrument is used, there may be electrical potential difference between the instruments. The potential difference between the instruments may cause current to flow to the patient connected to the instruments, resulting in electrical shock (micro shock). Always perform equipotential grounding when required. It is often required in the operating room, ICU room, CCU room, cardiac catheterization room and X-ray room. Consult with a biomedical engineer to determine if it is required. When equipotential grounding is required to ensure patient safety, use the grounding wire of the AC power cord. Cutting Off the Power Supply to the Electrocardiograph To cut off the power supply to the electrocardiograph, disconnect the power cord of the electrocardiograph from the AC socket. When installing the electrocardiograph, position the electrocardiograph so that it is easy to disconnect the power cord from the AC socket. ECG-2150 Operator s Manual 2-7

40 2. PREPARATION Operating on Battery The electrocardiograph can operate on battery power with the optional SB- 901DC battery pack. When a battery is inserted, the electrocardiograph automatically switches to battery power if the power cord is disconnected or there is a sudden power failure. Battery Handling WARNING Do not do the following to the battery pack. It may cause leakage, overheating, explosion and fire. Short-circuit the + and terminals on the battery pack. Put the battery pack into fire or heat the battery pack. Disassemble or modify the battery pack. Give strong impact to or deform the battery pack. Use the battery pack on unspecified instruments. Charge the battery pack on unspecified instruments. Install the battery pack with the wrong polarity. Leave the battery pack in the reach of patients. WARNING Only use the SB-901DC battery pack. WARNING If the liquid inside the battery contacts the eyes, mouth or skin, do not rub the eyes, mouth or skin. Wash with clean water and see a physician immediately WARNING The following may cause overheating and leakage of the battery pack. Leaving the battery pack unused for a long period (more than a year) Immersing the battery pack in water or sea water or getting it wet WARNING Check the direction of the connector when connecting the battery cable. Do not force the battery cable into the battery connector. CAUTION Do not bend or pull the connector of the battery pack cable with strong force. This may damage the battery cable or battery cable connector. CAUTION If the battery operation time is less than 15 minutes, the battery pack may be deteriorated. Do not charge a deteriorated battery pack. Charging a deteriorated battery pack may cause the electrocardiograph to fail to operate in both battery and AC power. NOTE The operation time with the new fully charged battery pack is 120 minutes or more when the surrounding temperature is 25 C (77 F). If the surrounding temperature is more than 25 C (77 F) or depending on waveform quality, the operation time may be less. 2-8 ECG-2150 Operator s Manual

41 2. PREPARATION The lifetime of the battery pack is about one year. When operating the electrocardiograph with the battery pack, check the date when the battery pack was last replaced on the start date label attached to the electrocardiograph. 2 To keep the battery pack fully charged, always keep the power cord connected to the AC socket even when the electrocardiograph is not used. Battery Replacement CAUTION The battery pack must be replaced by qualified service personnel. CAUTION Before connecting or disconnecting instruments, make sure that each instrument is turned off and the power cord is disconnected from the AC socket. Otherwise, the patient or operator may receive electrical shock or injury. Charging CAUTION If the battery operation time is less than 15 minutes, the battery pack may be deteriorated. Do not charge a deteriorated battery pack. Charging a deteriorated battery pack may cause the electrocardiograph to fail to operate in both battery and AC power. CAUTION Charge the battery pack at surrounding temperatures of 5 C to 40 C (41 F to 104 F). If the battery is charged below 5 C or over 40 C, the battery may leak or heat up. This may damage the battery. NOTE Before using a new battery pack, charge it with the ECG-2150 electrocardiograph. The charging time of the battery pack is less than 10 hours when the surface temperature of the battery pack is between 10 C and 35 C (50 F and 95 F). The charging time depends on the surface temperature of the battery pack. When the surface temperature of the battery pack is below 10 C or over 35 C (50 F to 95 F), it may take longer to charge the battery. During charging, the battery pack may heat up. Do not put anything on or cover the electrocardiograph. ECG-2150 Operator s Manual 2-9

42 2. PREPARATION Storage WARNING Do not leave the battery pack unused for more than a year. The battery may leak CAUTION Do not use or leave the battery pack in direct sunlight or high temperatures such as in a car in hot weather or in front of a stove. It may cause leakage of the battery pack and degrade the performance and lifetime of the battery pack. CAUTION Remove the battery pack from the electrocardiograph when it is not used more than six months. The battery may leak and rust. When the battery pack is not used more than 90 days, store the battery pack at temperatures between 20 C to +30 C ( 4 F to +86 F) in a dry place to prevent it from rusting and leakage. If the surrounding temperature is over 30 C (86 F), charge it every three months because it self-discharges quickly. When the battery pack is stored more than one month, charge it before use because the battery pack may have self-discharged. Replace the battery pack with a new one every year to assure maximum performance from the electrocardiograph. When the battery pack is stored for a long time, it may become inactivated and cannot be fully charged. The battery charge may be recovered by discharging and charging the battery several times. Disposing CAUTION SB-901DC battery pack is NiMH (Nickel-Metal Hydride). Before disposing of the battery pack, check with your local solid waste officials for details in your area for recycling options or proper disposal. The battery is recyclable. At the end of its useful life, under various state and local laws, it may be illegal to dispose of this battery into the municipal waste stream. NOTE: When disposing of the electrocardiograph, remove the battery pack and attach tape over the battery cable. Otherwise, the battery may explode at waste disposable services ECG-2150 Operator s Manual

43 2. PREPARATION Inserting the Battery Pack WARNING Do not touch the patient while touching any metal part of non-medical electrical equipment or an exposed part when a connector or cover is removed. Failure to follow this warning may cause electrical shock or injury to the patient. WARNING Only use the SB-901DC battery pack. 2 The electrocardiograph is shipped from the factory with no battery pack installed. Follow the procedure below to insert a battery pack into the electrocardiograph before use. 1 Remove the M3 binding head screw from the battery cover and pull off the battery cover. 2 3 Connect the battery cable to the battery pack connector. Insert the battery pack into the battery compartment. 4 Attach the battery cover and secure it with the screw. ECG-2150 Operator s Manual 2-11

44 2. PREPARATION Removing the Battery Pack Remove the battery pack while pressing the lock under the battery cable. NOTE: Do not pull the cable with strong force. This may damage the connector. Charging the Battery The battery can be charged when AC power is supplied to the electrocardiograph and the power is turned off. You cannot charge the battery when the power is turned on. The battery charge time is at least 10 hours. A new fully charged battery provides at least 120 minutes continuous recording. To charge the battery When the electrocardiograph is not used, connect the electrocardiograph to a wall AC socket to charge the battery. The AC power lamp and battery charge lamp light when the electrocardiograph battery is charging. 1 2 Press the POWER key to turn the power off. Connect the electrocardiograph to a wall AC socket. The AC power lamp and battery charge lamp light. Battery charge lamp Lit: OFF: Charging Fully charged NOTE When you operate the electrocardiograph on battery power, run down the battery as much as possible before recharging. If you frequently charge the battery after it has only been used for a short time, it may shorten the life of the battery. After charging is complete, the battery charge lamp lights about every half hour to one hour. This is because a small current is supplied to the battery (supplementary recharging) to prevent self-discharging of the battery. Keep the power cord plugged into the AC socket when the electrocardiograph is not used. Right after the battery is fully charged, and during battery operation, the battery operation lamp may light in orange when the surrounding temperature is low or when printing ECG waveforms. When operation time is reduced to half, even if the battery pack is fully charged, the battery life may be expired. Replace the battery with a new one. When the battery charge lamp does not light every half hour to one hour, even after a ten-hour recharging, the battery life may be expired. Replace the battery with a new one. For battery operation time, refer to AC and Battery Operation in Section ECG-2150 Operator s Manual

45 2. PREPARATION Setting the Recording Paper 2 Handling the Recording Paper Recording Paper CAUTION Only use the Shanghai Kohden specified 63 mm recording paper. When a narrower recording paper is used and the paper detection circuit cannot detect it, the thermal head may be activated. The thermal head may be damaged where there is no recording paper and the rubber paper feed roller may get burned. If unspecified recording paper is used, it might not print properly or send multiple pages. Model: Type: Length: Paper marks: Grid: Paper location: RQS63-3A Roll 30 m No Yes In the electrocardiograph Storage CAUTION Prolonged storage under conditions such as high temperatures, excessive humidity, direct sunlight, and fluorescent light causes fading of the colored surface. Avoid high temperatures exceeding 50 C (122 F) and excessive humidity. Store the recording paper in a cool, dry and dark place if possible. ECG-2150 Operator s Manual 2-13

46 2. PREPARATION Usage CAUTION Organic solvents and plastics may develop color on the white surface or cause the recording paper to fade. Examples of color-developing materials containing organic solvents: adhesives, paste, felt-tip pens, and semi-dry diazo paper. Examples of color-fading materials made of soft vinyl chloride: document cases, albums, and desk pads including. Examples of color-fading materials containing plastics: erasers, adhesive tapes, and some fluorescent pens. The paper cutter in the recording paper container is sharp. When setting the recording paper, be careful not to cut your finger. Set the recording paper as specified. When pasting the recording paper, use paste with a starch base, PVA base, arabic gum base paste, CMC base synthetic paste, or paper bond. Do not apply high pressure to the recording paper. Rubbing or scratching the surface with a hard object discolors it. Clean the thermal head with the thermal head cleaner after every 100 m printing. A dirty thermal head degrades printing quality. Do not use recording paper which is contaminated with ECG electrolyte cream (CardioCream) or saline solution because the recording paper will fade by the chloride and the contaminated thermal head may cause missing dots. If the thermal head gets contaminated, clean it with the thermal head cleaner pen. Do not touch the thermal head with your fingers. If accidentally touched, clean the thermal head with the thermal head cleaner pen. Follow the procedure to set the recording paper. Otherwise, the recording paper might not feed normally or the feeding motor may stop operation. Replacement CAUTION Do not set the recording paper right after recording because the thermal head is still hot ECG-2150 Operator s Manual

47 2. PREPARATION Setting the Recording Paper 1 Press down the recorder cover release button to open the recorder. 2 Recorder cover release button 2 3 Turn over the recorder cover Set the recording paper in the recorder cover by spreading the paper guides.. Paper guide 4 Pull out the recording paper and align it with the recorder cover. 5 Attach the recorder cover to the recorder while holding the paper. 6 Close the recorder cover by pressing the center of the cover.. NOTE: When recording paper is not aligned with the paper guide, skewing may occur. ECG-2150 Operator s Manual 2-15

48 2. PREPARATION Feeding the Paper You can feed the paper by pressing the FEED/MARK key anytime before or after recording. Turning the Power On or Off WARNING Only use the BJ-901D/BJ-902D/BJ-903D/BJ-961D/BJ-962D or BA-901D/BA-903D patient cables when using with a defibrillator. When the specified patient cable is connected, the electrocardiograph is type CF defibrillation-proof compliance. Failure to follow this warning may cause skin burn where the electrode is attached and damage the electrocardiograph due to discharge energy when defibrillation is performed. Turning the Power On Before turning the power on, check the following items. If there is any damage or the electrocardiograph is suspected to be faulty as a result of checking, attach an Unusable or Repair request label to the electrocardiograph and contact your Nihon Kohden representative. Check Items Before Turning the Power On Overview: Electrocardiograph is not dirty, damaged or in contact with liquid No peeling or tear in the operation panel No key or button is broken Power cord is not damaged Electrodes are clean and not damaged Cable hanger is not damaged Paper recorder is not damaged Battery is installed Connection and setting: Power cord is securely connected Electrocardiograph is securely connected to an external instrument Patient cable is securely connected to the electrocardiograph Recording paper is properly set Battery is fully charged Accessories: Enough electrolyte cream Enough recording paper 2-16 ECG-2150 Operator s Manual

49 2. PREPARATION Enough disinfected or sterilized dry electrodes Patient cable is not frayed or damaged No crack in the rubber of suction electrodes String of fast clip is strong enough New and used electrodes are not used together 2 Turning the Power On Lit Lit When operating on battery power After installing the fully charged battery pack, press the POWER key on the operation panel to turn the power on. The POWER lamp and battery operation lamp light. When operating on AC power After grounding and connecting the power cord to a wall AC socket, press the POWER key on the operation panel to turn the power on. The POWER lamp and AC power lamp light. Check Items After Turning the Power On AC power lamp or battery power lamp lights normally LCD backlight lights No fire, smoke or smell No electrical shock when touching the electrocardiograph Electrocardiograph is not too hot Electrocardiograph does not affect surrounding equipment Screen display is correct (brightness, contrast, no distortion, normal color, etc.) All operation indicators lights All keys on the operation panel operate correctly All settings are correct Calibration waveform is properly displayed and recorded Amplifier of calibration waveform is correct No noise on the calibration waveform No error messages or malfunction during operation Printing is correct (paper feeding without skewing or catching, no jamming, printing darkness, no faded or missing dots, date and time) External instrument operates correctly ECG data files can be saved correctly When the electrocardiograph is used for the first time, set the followings. Refer to Section 3 Changing Settings Before Measurement. Wave settings: System settings: AC filter Date and time, Date display format, Time display format ECG-2150 Operator s Manual 2-17

50 2. PREPARATION Changing the Date and Time The date and time on the printing result is part of important information for the medical record. When the power is turned on, press the MODE key to display the Main Menu screen. Check the Date/ Time on the top of screen is correct. To change the date and time setting, refer to Changing the Date and Time in Section 3. NOTE: If the date and time printed on the recording is not the current date and time, the lithium battery may be burned. Contact your Nihon Kohden representative. Turning the Power Off NOTE: The power cannot be turned off while processing ECG data file. Turn the power off after processing is complete. Press the POWER key on the operation panel for one second to turn the power off. The screen becomes dark and the POWER lamp on the operation panel turns off ECG-2150 Operator s Manual

51 2. PREPARATION Connecting Optional Accessories to the Electrocardiograph 2 WARNING Only connect Shanghai Kohden specified device to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or device malfunction. Install non-medical devices which are connected to the electrocardiograph outside the patient environment (IEC :2012). If they are installed inside the patient environment, the patient or operator may receive electrical shock or injury. Connectable Optional Accessories Bar code reader LS2208 or the equivalent Compatible bar codes WPC (UPC, EAN/ JAN), CODE-39, NW-7, Industrial 2 of 5, Interleaved 2 of 5, CODE-93, CODE-128 Magnetic card reader CRF-200U or the equivalent Connection Use the specified USB device and connect it to the USB connector of electrocardiograph. NOTE: Do not connect USB devices during operation. It may disturb the operation. Remove Hold and pull the connector to remove the cable. NOTE Do not remove USB devices during operation. It may disturb the operation. When you remove the cable, hold and pull the connector. Otherwise, the cable may break. ECG-2150 Operator s Manual 2-19

52 2. PREPARATION Connect a Bar Code Reader Use the specified bar code reader (LS2208), do the procedure correctly as follows and set the setings below. [Connector setting] [Operation mode setting] System setting [Bar code setting] Connection Do the following steps to connect the cable of the bar code reader accessories Connect the USB cable to the LS2208 bar code reader. Confirm that the power is off. Connect the other end of the USB cable to the electrocardiograph USB connector. Turn the power on and confirm the bar code reader sound ECG-2150 Operator s Manual

53 2. PREPARATION Connector setting Set the connector of the bar code reader. NOTE: The settings must to be set when connecting the LS2208 bar code reader for the first time Display the test screen. Read the following bar codes one after the other. Default Enable Codabar Read the bar code successively following the sequence of bar code analyzer reader on-off. Set Codabar Scan Options <DATA><SUFFIX> Enter Read the bar codes until to the Enter location, then save the settings of the bar code reader within 5 seconds. Turn the power off. Resart the electrocardiograph. Set the settings on System setting - Bar code. Confirm that the bar code was read successfully. Failure to read the bar code correctly If the bar code cannot be read correctly, check the connection again and initialize the bar code settings. If you still cannot read the bar code, there may be a bar code reader failure. Contact your Nihon Kohden representative. ECG-2150 Operator s Manual 2-21

54 2. PREPARATION Connecting an External Device to the Electrocardiograph WARNING Only connect Shanghai Kohden specified device to the electrocardiograph and follow the specified procedure. Failure to follow this warning may result in electrical shock or injury to the patient and operator, and cause fire or device malfunction. When several medical devices are used together, ground all devices to the same onepoint ground. Any potential difference between devices may cause electrical shock to the patient and operator. CAUTION Before connecting or disconnecting instruments, make sure that each instrument is turned off and the power cord is disconnected from the AC socket. Otherwise, the patient or operator may receive electrical shock or injury. When more than one electrical device is used, there may be electrical potential difference between the devices. The potential difference between the devices may cause current to flow to the patient connected to the devices, resulting in electrical shock. Always perform equipotential grounding when required. It is often required in the operating room, ICU room, CCU room, cardiac catheterization room and X-ray room. Consult with a biomedical engineer to determine if it is required. Refer to General Requirements for Connecting Medical Electrical Systems in Section ECG-2150 Operator s Manual

55 2. PREPARATION Adjusting the Screen Brightness You can adjust the screen brightness. 1 Press the MODE key. The Main Menu screen is displayed. 2 2 Press 9 to select Screen Brightness. The Brightness screen is displayed Adjust the brightness with the or function key. If the screen is too dim, press the function key. If the screen is too bright, press the function key. Press the OK function key to close the Brightness screen. Press the 1 or 2 key to return to the ECG recording screen. ECG-2150 Operator s Manual 2-23

56 2. PREPARATION Preparing for Data Management About the Media The electrocardiograph can save the acquired ECG waveforms, patient information and analysis result as a file in the internal memory or SD memory card (hereafter referred to as media ). Internal Memory Saves up to 40 files in the memory regardless of the data compression type. SD Memory Card QM-001D SD memory card or equivalents. The QM-001D SD memory card saves up to 780 files (type 1, normal) or 3000 files (type 2, compressed). Refer to Section 7 Data Management. CAUTION Only use a Shanghgai Kohden specified SD memory card. Otherwise, the card might not operate. NOTE: The electrocardiograph can only recognize 64 MB of data on the SD memory card even if the SD memory card is larger than 64 MB. Using the Internal Memory 1 2 Set Media to Internal memory on the File Processing Section of the Main Setup screen. Refer to List of Settings - Main Setup Screen - File Processing in Section 3. Format the internal memory. Refer to Formatting the Media in Section 7. Using the SD Memory Card About the SD Memory Card Refer to the SD memory card manual and the following precautions for operation and cautions. To format an SD memory card, refer to Formatting the Media in Section ECG-2150 Operator s Manual

57 2. PREPARATION CAUTION Only use a Shanghai Kohden specified SD memory card. Otherwise, the card might not operate. CAUTION Do not leave the SD memory card near patients or in reach of children. 2 Recommended SD Memory Card QM-001D Handling CAUTION Never disassemble or modify the SD memory card. Do not bend or give a strong impact to the SD memory card. Do not handle the SD memory card while smoking or eating. Do not get the SD memory card wet. Do not touch any metal part of the SD memory card. Do not peel off the label or sticker on the SD memory card or put other label or sticker on the SD memory card. Only use the SD memory card in the specified instrument. Do not scratch the insertion part of the SD memory card. The electrocardiograph might not operate if dust gets into the insertion part. Put the SD memory card in the case when the SD memory card is removed from the electrocardiograph. Store it where patients cannot accidently swallow the SD memory card. Do not expose the SD memory card to direct sunlight or leave in a high temperature and high humidity. Operating Environment Temperature: 25 C to +85 C ( 13 F to +185 F) Humidity: 25 C to 95% RH (noncondensing) Storage Environment Temperature: 40 C to +85 C ( 40 F to +185 F) Humidity: 25% to 95% RH Do not store the SD memory card in a corrosive gas environment. Operation CAUTION Only format or write data to the SD memory card in the specified instrument. Otherwise, the SD memory card may become unusable. Do not remove the SD memory card or turn the power off while formatting or data is being written to or read from the SD memory card. This may damage the SD memory card or saved data. ECG-2150 Operator s Manual 2-25

58 2. PREPARATION Inserting and Removing the SD Memory Card CAUTION Insert only a Shanghai Kohden specified SD memory card in the SD card slot. Insert or remove the SD memory card straight into or out of the SD card slot. Otherwise, the SD memory card and electrocardiograph may get damaged. Make sure that the electrocardiograph power is turned off, when inserting or removing an SD memory card. Otherwise, the data in SD memory card may get damaged and operation of the electrocardiograph may become unstable. To insert the SD memory card: 1 2 Turn the electrocardiograph power off. Insert the SD memory card straight into the SD card slot with the label side up until it clicks. To remove the SD memory card: Turn the electrocardiograph power off. Press in the edge of SD memory card. Pull the card out straight from the SD card slot. Preparing the SD Memory Card Insert the SD memory card into the SD card slot on the right side panel of the electrocardiograph. Refer to the above Inserting and Removing the SD Memory Card section. Set Media to SD card on the File Processing of the Main Setup screen. Refer to List of Settings - Main Setup Screen - File Processing in Section 3. Format the SD memory card. Refer to Formatting the Media in Section 7. About the External Server The electrocardiograph can send a file to an external server through a network using wired LAN. The electrocardiograph can be connected to a network and sends a file to an external server or receive and print the ECG data saved in the external server ECG-2150 Operator s Manual

59 2. PREPARATION Connecting the Electrocardiograph to a Network The connection method and grounding method depends on the location where the electrocardiograph is installed and the types and installation locations of other instruments. 2 Follow the international safety standards of medical electrical equipment IEC Refer to the General Requirements for Connecting Medical Electrical System in Section 10. Contact an authorized LAN construction company or telephone line company locally. WARNING Connect the electrocardiograph to network as specified. Otherwise the patient and operator may receive electrical shock or injury. To connect the network, contact your Nihon Kohden representative. WARNING Install all network devices, including printer and hubs, outside the patient environment (IEC :2012). If they are installed inside the patient environment, the patient or operator may receive electrical shock or injury. For installation, contact your Nihon Kohden representative. CAUTION The network must be managed by the network administrator. Only the network administrator can change the network settings on the electrocardiograph and connect the electrocardiograph to the network. Incorrect settings or connection may cause failure of the network system and instrument. CAUTION Select an installation location where patient information cannot be seen or accessed by unauthorized personnel. Using the Wired LAN Set the IP address of the electrocardiograph on the Communication Settings in the System Setup screen. Refer to Setting the IP Address, Subnet Mask and Default Gateway on the Electrocardiograph later in this section. Set the external server on the Communication Settings in the System Setup and User Setup screen. Refer to List of Settings - System Setup Screen - Communication Settings and List of Settings - User Setup Screen - Communication Settings in Section 3. Turn the electrocardiograph power off. Connect the network cable to the LAN port on the right side panel of the electrocardiograph. ECG-2150 Operator s Manual 2-27

60 2. PREPARATION Setting the IP Address, Subnet Mask and Default Gateway on the Electrocardiograph Each instrument in the network has a unique IP address for data communication. Duplicate IP addresses must not be present in the same network. The IP address takes the form of four numbers separated by periods, for example: Set the electrocardiograph IP address on the Communication Settings in the System Setup screen. CAUTION The network must be managed by the network administrator. Only the network administrator can change the network settings on the electrocardiograph and connect the electrocardiograph to the network. Incorrect settings or connection may cause failure of the network system and instrument. NOTE: To prevent network problems, do not connect the network cable to the electrocardiograph before the IP address is set Before setting the IP address on the electrocardiograph, check the IP address, subnet mask and default gateway on each instrument in the network. Turn the electrocardiograph power off. Press the POWER key while pressing the FILTER key. The System Setup screen is displayed ECG-2150 Operator s Manual

61 4 2. PREPARATION Press the (F3) function key to select the Communication Settings on the System Setup screen. Press the OK (F4) function key. The Communication Settings screen is displayed. 2 5 Press the OK function key. The Communication Settings screen is displayed. ECG-2150 Operator s Manual 2-29

62 2. PREPARATION 6 Enter the IP address, Subnet mask and Default gateway. i) Press the (F2) or (F3) function key to select Enter of the desired item. ii) Press the Edit (F4) function key. The Enter the IP address message appears. iii) Enter the IP address, Subnet mask or Default gateway with the keyboard on the operation panel. iv) Press the OK (F4) function key. The address is set and the Communication Settings screen is displayed. 7 8 Repeat step 6 to change other settings. When the required settings are changed, turn the power off. Turn the power on again to display the Resting ECG recording screen ECG-2150 Operator s Manual

63 3 Changing Settings Before Measurement 3 System Setup Screen and Main Setup Screen List of Settings Setup Settings Printing the List of System Setup and Main Setup Settings System Setup Screen Patient Information Wave Settings Communication Settings Recording Settings Periodic Recording Settings System Settings Bar Code Magnetic Card Main Setup Screen Wave Settings Communication Settings File Processing Recording Settings Recorder Manual Recording Auto Recording Analysis Format and Settings Rhythm Recording Changing the System Setup Settings Displaying the System Setup Screen and Changing the Settings Changing the Date and Time Entering the Hospital Name Changing the Main Setup Settings Saving the System Setup and Main Setup Settings Loading the System Setup and Main

64 3. CHANGING SETTINGS BEFORE MEASUREMENT System Setup Screen and Main Setup Screen This section explains how to change settings, save settings in an SD memory card, load settings from an SD memory card and print the list of system settings. We recommend saving and printing the settings immediately after installation. There are two setup screens, System Setup screen and Main Setup screen. System Setup screen settings are rarely changed. Main Setup screen settings are frequently changed. You can change settings without turning the power off. In the System Setup screen, you can change the following settings. Patient Information Wave Settings Communication Settings Recording Settings - Auto Recording - Report Print Out - Analysis Format and Settings Periodic Recording Settings System Settings Bar Code Magnet Card Save/Load/Print System Settings In the Main Setup screen, you can change the following settings. Wave Settings Communication Settings - Terminal number File Processing Recording Settings - Recorder - Manual Recording - Auto Recording - Analysis Format and Settings - Rhythm Recording 3-2 ECG-2150 Operator s Manual

65 3. CHANGING SETTINGS BEFORE MEASUREMENT List of Settings System Setup Screen 3 The factory default settings are underlined. Patient Information ID Sex Item Description Settings Select On to enable ID entry when recording starts. NOTE: In default, up to 12 numeric characters can be entered as ID. Contact your Nihoh Kohden representative if up to 20 numeric charaters are needed. Select On to display the sex on the Patient Information screen. Default sex Select the default sex when the power is turned on. M F Blank Age Default age group Data auto delete Select whether to display the age on the Patient Information screen. When displaying age, select whether to display actual age or age group. When Age group is selected, the Patient Information screen cannot be displayed, only sex and age group can be entered for the patient information using the keys on the operation panel. Select the default age group when the power is turned on. This setting is only available when Age or birth date is set to Age group. Select Delete all to clear the previous patient data when the ID is changed. On Off On Off Age Age group Off Delete all Off ECG-2150 Operator s Manual 3-3

66 3. CHANGING SETTINGS BEFORE MEASUREMENT Wave Settings Item Description Settings Baseline drift suppression Baseline drift suppression prevents the baseline from drifting by locking it into one position at the start of recording. Strong Weak Off CAUTION When baseline drift suppression is set to Strong, distortion may occur in the ST segment with a decrease of heart rate when heart rate is less than 50. For bradycardia, set this item to Weak. The Weak setting has characteristics conforming to the AHA recommendations. AC filter Set this to match your AC power line frequency. 50 Hz 60 Hz Off Communication Settings Item Description Settings IP address Set the IP address of the electrocardiograph. xxx.xxx.xxx.xxx ( ) Subnet mask Set the subnet mask address. xxx.xxx.xxx.xxx ( ) Default gateway Set the default gateway address. xxx.xxx.xxx.xxx ( ) DHCP Select On to enable DHCP (Dynamic Host Configuration Protocol). On Off DNS support Select On to enable DNS (Dynamic Host System). On Off DNS server address Set the DNS server address when using DNS. xxx.xxx.xxx.xxx ( ) Connection time-out (ms) Set the time out period for communication. 0 to 9999 (3000) File server address Set the file server address. xxx.xxx.xxx.xxx ( ) File server host name Set the file server host name. Up to 8 alphanumeric characters File server port Set the file server port number. 0 to (30003) FTP port number Set the FTP server port number. (21) File server user name Set the FTP server user name. Up to 128 alphanumeric characters (CEX) File server password Set the FTP server password. Up to 128 alphanumeric characters (CEX) File server send folder File server receive folder Set the folder of the other instruments to send the ECG data files. Set the folder to receive the ECG data files from other instruments. Up to 128 alphanumeric characters (/) Up to 128 alphanumeric characters (/) 3-4 ECG-2150 Operator s Manual

67 3. CHANGING SETTINGS BEFORE MEASUREMENT Recording Settings Auto Recording Item Description Settings Auto start Select On to automatically start recording. On Off 3 Report Print Out Auto mode of resting ECG recording Item Description Settings Select On to print ECG and report in auto mode of the resting ECG recording. Rhythm recording Select On to print ECG in rhythm recording. On Off Periodic recording Select On to print ECG and report in periodic recording. On Off On Off Analysis Format and Settings Item Description Settings Analysis Select the analysis mode. When screening is selected, some ST-T related findings are not obtained. When Advanced is selected, more findings than Standard are obtained. For details, refer to the ECAPS 12C ECG Interpretation Program User s Guide and Upgrade Information. NOTE: The data acquired with Advanced setting might not be used in external systems. Standard Standard (screening) Advanced Advanced (screening) Minnesota Select whether to print the Minnesota code. Minnesota1 Minnesota2 Off Measurement/analysis selection Select whether to print the measurement values and analysis result with the ECG waveforms. Measurement + analysis Measurement only None QTc calculation method Select a method to calculate QTc. ECAPS Bazett ECAPS+Fridericia Bazett+Fridericia QT interval varies according to the heart rate. QTc interval is a corrected value based on a heart rate of 60 bpm. ECAPS: QTc interval (ms) = QT interval (ms) + (1000 R-R interval (ms)) 7 bazett: QTc interval (ms) = QT interval (ms) R-R interval (s) ECG-2150 Operator s Manual 3-5

68 3. CHANGING SETTINGS BEFORE MEASUREMENT Periodic Recording Settings Item Description Settings Starting leads Select the starting lead group. Limb Chest Periodic recording type Select the ECG waveform acquisition interval. Fixed time Interval Off Fixed recording time 30s Fixed recording time 1min Fixed recording time 2min Fixed recording time 3min Fixed recording time 4min Fixed recording time 5min Fixed recording time 6min Fixed recording time 7min Fixed recording time 8min Fixed recording time 9min Fixed recording time 10min Fixed recording time 11min Fixed recording time 12min Fixed recording time 13min Fixed recording time 14min Fixed recording time 15min Interval (min) Select On to acquire the ECG waveform after the specified time when Periodic recording type is set to Fixed time. Select the interval when Periodic recording type is set to Interval. On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off On Off 1 to 60 (3) Interval recording repetitions Select the number of times to acquire ECG waveforms. 1 to 99 (10) Auto gain output Additional slow speed recording Select On to automatically change the waveform amplitude and position during periodic recording. Select On to slow paper speed until the next periodic recording starts. On Off On Off 3-6 ECG-2150 Operator s Manual

69 3. CHANGING SETTINGS BEFORE MEASUREMENT System Settings Item Description Settings Sync sound Select QRS synchronized sound or stylus on paper scratching sound. QRS sync sound Pen sound Off QRS sync sound volume Select the QRS sync sound volume. 1 (min) (max) 3 Notification sound volume Select the notification sound volume. At 0, there is no sound. CAUTION 0 (Off) (max) Chime volume Select the chime volume. 0 (Off) (max) Date and time Set the date and time. Year, Month, Day, Hour and Minute Date display format Select the date display format. yyyy/mm/dd yyyy mmm dd mmm dd yyyy dd mmm yyyy Time display format Select the time display and printing format. 12 hour day 24 hour day Synchronize clock with server Automatically adjust the clock to the time of server. On Off Hospital Language Backlight auto off Auto power off Enter the hospital name. It is printed in the Exam.: column. Select the language for display and recording. NOTE: When you install a local language in the electrocardiograph, check the screen descriptions and printed ECG finding list before use. You can compare the screen descriptions with the text that your Nihon Kohden representative provides. You can compare the ECG finding list with the User s Guide ECAPS 12C ECG Interpretation Program. If there is any missing or incorrect translation, contact your Nihon Kohden representative to correct it. When changing the language to or from Korean, the entered hospital name is deleted. When changing the language to or from Korean, the electrocardiograph must be restarted to enter the hospital name. Select On to automatically turn off the backlight when the electrocardiograph is not operated for 3 minutes. Select On to automatically turn off the electrocardiograph power when it is not operated for 3 minutes in battery operation. Up to 40 alphanumeric characters English Korean Local language On Off On Off ECG-2150 Operator s Manual 3-7

70 3. CHANGING SETTINGS BEFORE MEASUREMENT Bar Code Item Description Settings ID Start address Set the start address. 1 to 99 (1) End address Set the end address. 1 to 99 (12) Sex Start address Set the start address. 1 to 99 (13) End address Set the end address. 1 to 99 (13) Male code Set the male code. Up to 8 alphanumeric characters (1) Female code Set the female code. Up to 8 alphanumeric characters (2) Year Start address Set the start address. 1 to 99 (14) End address Set the end address. 1 to 99 (17) Month Start address Set the start address. 1 to 99 (18) End address Set the end address. 1 to 99 (19) Day Start address Set the start address. 1 to 99 (20) End address Set the end address. 1 to 99 (21) Bar code reader vendor ID* Do not change this. Keep the default setting. Up to 4 alphanumeric characters (05E0) Bar code reader product ID* Up to 4 alphanumeric characters (1200) Magnetic Card Item Description Settings Card reader type Select the card reader type. 1 (track) 3 Track number Select the valid data track number when Card reader type is set to 3 track. ID Start address Set the start address. 1 to 99 (1) End address Set the end address. 1 to 99 (9) Sex Start address Set the start address. 1 to 99 (32) End address Set the end address. 1 to 99 (32) Male code Set the male code. Up to 8 alphanumeric characters (M) Female code Set the female code. Up to 8 alphanumeric characters (F) Year Start address Set the start address. 1 to 99 (0) End address Set the end address. 1 to 99 (0) Month Start address Set the start address. 1 to 99 (0) End address Set the end address. 1 to 99 (0) Day Start address Set the start address. 1 to 99 (0) End address Set the end address. 1 to 99 (0) Magnetic card reader vendor ID* Do not change this. Keep the default setting. Up to 4 alphanumeric characters (0804) Magnetic card reader product ID* Up to 4 alphanumeric characters (0040) ECG-2150 Operator s Manual

71 3. CHANGING SETTINGS BEFORE MEASUREMENT Main Setup Screen Wave Settings Item Description Settings High cut filter Select the high cut filter frequency. 75 Hz 100 Hz 150 Hz 3 EMG suppression frequency Select the EMG filter frequency. 25 Hz 35 Hz Default EMG suppression setting Select On to turn on the EMG filter when the power is on. CAUTION Take care when judging the ECG recording because the EMG filter may cause distortion of P-waves and QRS-waves depending on the waveform shape. On Off Lead mode selection Select the ECG lead recording order. Standard 12 leads Cabrera leads Communication Settings Item Description Settings Terminal number Set the electrocardiograph terminal number. 0 to 9999 (0) File Processing Item Description Settings After analysis result recording Select what to do with ECG data files after analysis result recording. Save Send Save + Send Off Media Select the media to save ECG data files. SD card Internal memory Data compression type File auto delete File Extend Information Select the file format to save ECG data files. Type 1 is normal format and Type 2 is compressed format. Select On to automatically delete the oldest file when the media is full. Type 1 Type 2 On Off On Off ECG-2150 Operator s Manual 3-9

72 3. CHANGING SETTINGS BEFORE MEASUREMENT Recording Settings Recorder High speed printing Item Description Settings Select On to print the analysis results and rythm recording at high speed. Default paper speed Select the initial paper speed when the power is turned on. 25 mm/s 50 mm/s On Off Manual Recording Item Description Settings 12 lead recording channels Select the 12 lead recording channels. 3 ch 1 ch 1 ch + rhythm Auto Recording Item Description Settings Auto gain output Select the auto gain and auto position control function. Auto gain + setting gain Auto gain Setting gain + auto gain Setting gain 12 lead recording channels Select the 12 lead recording channels. 1 ch 3 ch Average + rhythm Time (s) Extended recording Select the total recording time when Change sequence is set to Time. On: rhythm (full page): When an arrhythmia is detected during automatic recording, the rhythm recording starts after automatic recording ends. The format is set in Rhythm Recording in Recording Settings in the User Setup screen. On: sequence (full page): When the fluctuation of 20% of R-R interval is detected during automatic recording, the recording of the lead group is extended. The extend recording time is set in the Mark or Time. 10 to 24 sec (10) On: rhythm (full page) On: sequence (full page) Off Analysis Format and Settings Item Description Settings Result printing format Select analysis result recording printing format. Result only Result + average Include findings criteria Select On to print the criteria for the finding. On Off Pacing detection sensitivity Select the pacing detection sensitivity. If noise is incorrectly detected as a pacing pulse, select Low. High Low 3-10 ECG-2150 Operator s Manual

73 3. CHANGING SETTINGS BEFORE MEASUREMENT Rhythm Recording Item Description Settings Rhythm lead Select the rhythm lead in rhythm lead recording. Standard 12 leads: I, II, III, avr, avl, avf, V1, V2, V3, V4, V5, V6 Cabrera leads: avl, I, avr, II, avf, III, V1, V2, V3, V4, V5, V6 3 Changing the System Setup Settings Displaying the System Setup Screen and Changing the Settings 1 2 Press the POWER key to turn the power off. Press the POWER key while pressing the FILTER key. The System Setup screen is displayed. ECG-2150 Operator s Manual 3-11

74 3. CHANGING SETTINGS BEFORE MEASUREMENT 3 Press the or function key to select the desired item on the Setup screen. 4 Press the OK function key. The Setup screen for that item is displayed. 5 Press the or function key to select the desired item ECG-2150 Operator s Manual

75 3. CHANGING SETTINGS BEFORE MEASUREMENT 6 Press the OK function key. The Setup screen for that item is displayed. Steps 5 and 6 are not necessary for some items. 3 7 Press the or function key to select the desired item. Press the Change function key. The selectable items are toggled. Select the desired setting. To change the date and time, refer to the next Changing the Date and Time section. To enter the hospital name, refer to Entering the Hospital Name in this section. Interval (m) and Interval recording repetitions of Periodic Recording Settings can be changed in steps of 1 by pressing the Change function key or in steps of 10 by pressing the FILTER key. 8 9 Repeat steps 7 to change other settings. Press the Back function key to return to the previous screen. The changed setting is saved. If the screen has more than two pages, press the or function key to scroll the screen. Turn the power off and on again to return to the Resting ECG recording screen. ECG-2150 Operator s Manual 3-13

76 3. CHANGING SETTINGS BEFORE MEASUREMENT Changing the Date and Time 1 2 Display the System Setup screen. Refer to the previous Displaying the System Setup Screen and Changing the Settings section. Press the or function key to select System Settings. 3 Press the OK function key. The System Settings screen is displayed. 4 Select the Date and time with the or function key ECG-2150 Operator s Manual

77 3. CHANGING SETTINGS BEFORE MEASUREMENT 5 Press the Edit function key. The Date and time setting window is displayed Enter the current date and time with the keyboard on the operation panel. The order of the date setting is always yyyy/mm/dd. Press the OK function key. The changed setting is saved. Press the Back function key to return to the previous screen. Entering the Hospital Name 1 2 Display the System Setup screen. Refer to Displaying the System Setup Screen and Changing the Settings in this section. Press the or function key to select System Settings. 3 Press the OK function key. The System Settings screen is displayed. ECG-2150 Operator s Manual 3-15

78 3. CHANGING SETTINGS BEFORE MEASUREMENT 4 Select Hospital with the or function key. 5 6 Press the Edit function key. The Hospital setting window is displayed. Enter the hospital name. When the Language is set to English or Local language Enter the hospital name with the function keys. A-Z: Enters a character. The characters are toggled. Shift: Changes the character type. A - Z a - z Char (symbol) 0-9 : Moves the cursor to the next character. When the Language is set to Korean Enter the hospital name with the character code. Refer to Character Code List in Section Press the START/STOP key. The changed setting is saved and the previous screen appears. The hospital name is printed in the Exam: column on the recording paper ECG-2150 Operator s Manual

79 Changing the Main Setup Settings 3. CHANGING SETTINGS BEFORE MEASUREMENT 1 Press the MODE key to display the Main Menu screen. 3 2 Press 8 to select Main Setup. The Main Setup screen is displayed. 3 Press the or function key to select the desired item on the Main Setup screen. ECG-2150 Operator s Manual 3-17

80 3. CHANGING SETTINGS BEFORE MEASUREMENT 4 Press the OK function key. The Setup screen for that item is displayed. 5 6 Press the or function key to select the desired item. Press the OK function key. The Setup screen for that item is displayed. Steps 6 and 7 are not necessary for some items Press the or function key to select the desired item. Press the Change function key. The selectable items are toggled. Select the desired setting. Repeat steps 7 to change other settings. Press the Back function key to return to the previous screen. The changed setting is saved. If the screen has more than two pages, press the or function key to scroll the screen. Press the 1 or 2 key on the Main Menu screen to return to the ECG recording screen ECG-2150 Operator s Manual

81 3. CHANGING SETTINGS BEFORE MEASUREMENT Saving the System Setup and Main Setup Settings You can save all settings on the System Setup screen and Main Setup screen to an SD memory card Insert the SD memory card into the SD card slot on the right side panel of the electrocardiograph before saving the system settings. Display the System Setup screen. Refer to Displaying the System Setup Screen and Changing the Settings in this section. Press the or function key to select Save/Load/Print System Settings. Save/Load/Print System Settings is on the second page. 3 ECG-2150 Operator s Manual 3-19

82 3. CHANGING SETTINGS BEFORE MEASUREMENT 4 Press the OK function key. The Setup screen is displayed. 5 Select Save System Settings and press the OK function key. The Saving system settings. Do not turn the power off message appears and the system settings are saved. 6 Turn the power off and on again to return to the Resting ECG recording screen ECG-2150 Operator s Manual

83 3. CHANGING SETTINGS BEFORE MEASUREMENT Loading the System Setup and Main Setup Settings You can load previously saved settings on the System Setup screen and Main Setup screen from an SD memory card Insert the SD memory card in the SD card slot on the right side panel of the electrocardiograph before loading the system settings. Display the System Setup screen. Refer to Displaying the System Setup Screen and Changing the Settings in this section. Press the or function key to select Save/Load/Print System Settings. Save/Load/Print System Settings is on the second page. ECG-2150 Operator s Manual 3-21

84 3. CHANGING SETTINGS BEFORE MEASUREMENT 4 Press the OK function key. The Setup screen is displayed. 5 Select Load System Settings and press the OK function key. The Loading system settings. Do not turn the power off message appears. 6 The Apply new system settings? message appears. Press the OK function key. The new system settings are loaded. 7 Press the Cancel function key to cancel. The settings are not changed and the previous screen appears. Turn the power off and on again to return to the Resting ECG recording screen ECG-2150 Operator s Manual

85 3. CHANGING SETTINGS BEFORE MEASUREMENT Printing the List of System Setup and Main Setup Settings 1 2 Display the System Setup screen. Refer to Displaying the System Setup Screen and Changing the Settings in this section. Press the or function key to select Save/Load/Print System Settings. Save/Load/Print System Settings is on the second page. 3 ECG-2150 Operator s Manual 3-23

86 3. CHANGING SETTINGS BEFORE MEASUREMENT 3 Press the OK function key. The Setup screen is displayed. 4 Select Print System Settings and press the OK function key. The Printing system settings. Do not turn the power off message appears and printing starts. 5 To cancel printing, press the Cancel function key. Turn the power off and on again to return to the Resting ECG recording screen ECG-2150 Operator s Manual

87 4 Attaching the Electrodes and Entering Patient Information 4 Attaching the Electrodes Attaching the Limb Electrodes Attaching the Chest Electrodes Patient Cable Tip Color Coding Lead Connection Standard 12 Leads and Cabrera Leads IEC Standard AHA Requirement Error Indication When the Electrode Is Not Attached Firmly Screen Message Indication on the Paper Countermeasure Electrode Detachment Large Polarization Voltage Entering the Patient Information General Entering the Patient Information Directly on the Device Entering the Patient Information Using a Bar Code Reader or Magnetic Card Reader

88 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION WARNING Do not connect the tip of the electrode lead to anything other than an electrode. Connect all the tips to the corresponding electrodes and attach them to the patient. If unconnected tips or electrodes contact an item which is not equipotential grounded, the patient may receive electrical shock. Also, noise may superimpose on the ECG waveforms and measurement data may be incorrect. CAUTION Do not use new and old electrodes together, or re-usable and disposable electrodes together (such as clip electrodes, suction electrodes, and disposable electrodes). If different types are used together, it may cause a high polarization voltage and prevent displaying and recording of the ECG waveforms. Always replace all the electrodes with new ones at the same time. When using an ESU and defibrillator with the electrocardiograph, use silver chloride disposable electrodes. Only use clean and undamaged electrodes with no scratches on the surface. Electrodes with a deteriorated surface may cause high contact impedance and distorted ECG waveforms. Do not touch electrodes, lead tips or electrocardiograph connectors to any other ground or conductive object in the room, such as a metal bedpost. 4-2 ECG-2150 Operator s Manual

89 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Attaching the Electrodes Attaching the Limb Electrodes Attach four limb electrodes to muscular, not bony, areas on the extremities Clean the skin with a cotton moistened with alcohol to remove oil. Apply a thin layer of electrolyte cream (cardiocream) on the cleaned electrode sites. R: Right arm L: Left arm RF: Right leg F: Left leg 3 4 Apply a small amount of electrolyte cream on the contact surface of the electrodes. When limb electrodes are used Attach the limb electrodes to the cleaned skin site. When the ECG clip-on electrodes are used Clip the electrode site with the ECG clip-on electrode. Attaching the Chest Electrodes Clean the skin with a cotton moistened with alcohol to remove oil. Apply a thin layer of electrolyte cream (cardiocream) on the cleaned skin sites. Attach the six electrodes to the cleaned skin site. Do not let the electrodes touch each other. Apply a thin layer of cardiocream on the electrode surface. Put the electrode on the site and squeeze the rubber ball to attach the electrode by suction. Standard 12 Leads ECG/Cabrera Leads ECG C1 (V1): Fourth intercostal space at the right border of the sternum C2 (V2): Fourth intercostal space at the left border of the sternum C3 (V3): Halfway between C2 (V2) and C4 (V4) C4 (V4): Fifth intercostal space on left midclavicular line C5 (V5): Left anterior axial line at the horizontal level of C4 (V4) C6 (V6): Left midaxillary line at the horizontal level of C4 (V4) ECG-2150 Operator s Manual 4-3

90 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Patient Cable Tip Color Coding BJ-901D, BJ-961D (IEC standard, tip: 3 mm diameter) BJ-902D, BJ-962D (IEC/DIN standard, tip: 4 mm diameter) BJ-903D (IEC/DIN standard, clip) Symbol in lead R L F N (RF) C1 C2 C3 C4 C5 C6 Color (tip, clip/lead) Red/Brown Yellow/Brown Green/Brown Black/Brown Red/White Yellow/White Green/White Brown/White Black/White Violet/White BA-901D (AHA requirement, tip: 3 mm diameter) BA-903D (AHA requirement, clip) Symbol in lead RA LA RL LL V1 V2 V3 V4 V5 V6 Color (tip, clip/lead) White/Brown Black/Brown Green/Brown Red/Brown Red/White Yellow/White Green/White Blue/White Orange/White Violet/White 4-4 ECG-2150 Operator s Manual

91 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Lead Connection Standard 12 Leads and Cabrera Leads IEC Standard 4 AHA Requirement ECG-2150 Operator s Manual 4-5

92 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Error Indication When the Electrode Is Not Attached Firmly Screen Message The electrocardiograph continuously checks electrode attachment status. When electrode detachment or large polarization voltage is detected, a message is displayed. Screen message Possible cause Fail R, L, F The indicated limb electrode is detached. Fail Limb Two or more limb electrodes from the R, L or F electrode are detached. The RF electrode is detached. No electrode is attached to the patient. Fail 1, 2, 3, 4, 5 or 6 The indicated chest electrode is detached. Noise Noise or artifact is detected. NOTE If a limb electrode is detached, the chest electrode detachment message is not displayed. Check the chest electrode attachment after removing the cause of the error message. The ECG waveforms can be displayed and recorded if the message due to a large polarization voltage is displayed. If recording starts, the analysis result may be incorrect and the ECG waveforms cannot be saved. Remove the cause of the error message before starting measurement. A flat baseline is recorded for leads with a detached electrode. When using the electrocardiograph with an ESU, artifact from the ESU may be superimposed on the ECG waveforms. Indication on the Paper During recording, the following line is recorded on the paper when an electrode detachment or artifact is detected. Electrode detachment Noise 4-6 ECG-2150 Operator s Manual

93 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Countermeasure Electrode Detachment Large Polarization Voltage Check for detached electrodes corresponding to the message and the electrode lead. Reattach the electrode and connect the electrode lead. 4 If the message is still displayed after reattaching the electrode, it is probably due to a large polarization voltage. A large polarization voltage can have the following causes: New and old electrodes, or re-usable and disposable electrodes are used together (such as clip electrodes, suction electrodes, and disposable electrodes). If different types are used together, it may cause a large polarization voltage and prevent displaying and recording of the ECG waveforms. Improper skin preparation. Use a cotton moistened with alcohol to clean the skin where the electrode is attached and apply the electrolyte cream (cardiocream) on the clean skin site. Reattach the electrode. After defibrillation, the ECG waveforms become unstable. Wait at least 5 seconds until the ECG waveforms are stable before recording the ECG waveforms. When the cause of the message cannot be found, the electrode lead may be faulty. If any abnormality is found, refer to Troubleshooting in Section 8 to take proper action. If there is any damage or the electrocardiograph is suspected to be faulty as a result of checking, attach an Unusable or Repair request label to the electrocardiograph and contact your Nihon Kohden representative. ECG-2150 Operator s Manual 4-7

94 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Entering the Patient Information General You can enter the following patient information on the resting ECG recording screen. The available patient data can be selected in the Patient Information settings. Refer to Section 3 Changing Settings Before Measurement. CAUTION When the patient sex and age is not entered, ECG analysis is performed with the patient as male and 35 years old. NOTE: Add an ID to the patient information to prevent the ECG data from being mistaken for a different patient s ECG data. Available patient data ID: Gender: Age: Up to 20 numeric characters (Default: up to 12 numeric charaters) Male, female Up to 3 numeric characters Age group: 3 to 5, 6 to 9, 10 to 14, 15 to 34, 35+ When Age group is set for Age or birth date on the System Setup When Age group is set for Age or birth date on the System Setup screen, the Patient Information screen cannot be displayed and patient information cannot be entered. Only gender and age group can be entered using the number keys on the operation panel. 4-8 ECG-2150 Operator s Manual

95 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Entering the Patient Information Directly on the Device NOTE: If you change the ID, the Name and Age/Date of birth are deleted and Gender returns to the default setting. 1 Press the ID key. The cursor appears on the ID column. 4 2 Enter the patient ID with the following operation keys and press the START/ STOP (enter) key. The cursor moves to the gender column. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key Select the gender by pressing the GENDER key and press the START/STOP key. The cursor move to the age column. When Age is set to Age in the System setup. Enter the patient age with the operation keys. When Age is set to Age group in the System setup. Select the age group by pressing the AGE key. Press the ID key. The patient information is set and Resting ECG recording screen appears. ECG-2150 Operator s Manual 4-9

96 4. ATTACHING THE ELECTRODES AND ENTERING PATIENT INFORMATION Entering the Patient Information Using a Bar Code Reader or Magnetic Card Reader You can read or enter the patient information from a bar code reader or magnetic card reader. NOTE: Only use a Shanghai Kohden specified SD card reader or bar code reader. Otherwise, the card reader might not operate. Preparation Set the condition to use a bar code or magnetic card reader on Bar code or Magnetic card of the system settings, refer to Connecting Optional Accessories to the Electrocardiograph in Section 2. System settings Set the settings on the System setting System setting-bar code or Magnetic card if you will read or enter the patient information from a bar cord reader or magnetic card reader. Patient information which can be read from a bar code or magnetic card reader Patient information which can be read from a bar code reader: ID, Sub ID, Name, Sex, Birth date Patient information which can be read from a magnetic card reader: ID, Name, Sex, Birth date Entering data using a bar code reader When the information has been read, the pipipi sounds and the data is entered in the electrocardiograph. The information is displayed on the patient information screen. NOTE: Initialize the bar code reader if it cannot read a bar code. After initialization, set the connector and operation mode settings. When reading the bar code, move the bar code reader near the bar code. The bar code cannot be read or is misread in the following conditions. The bar code easily reflects light when it is inside a transparent box. The box transparency, thickness and deformation affect reading of the bar code. Bar code is faint. Bar code is broken or damaged. Bar code is wavy. Bar code length is over 60 mm Entering data using a magnetic card reader When the information has been read, it is entered in the electrocardiograph. The information is displayed on the paitient information screen ECG-2150 Operator s Manual

97 5 Recording Resting ECG Waveforms 5 General Flow of Resting ECG Waveform Recording Notes for Accurate Measurement Before Starting the Recording Detecting QRS Waves Counting the Heart Rate Using the EMG/High-cut Filter ECG Analysis Main Setup Manual Recording Procedure Rhythm Recording General Rhythm Recording Procedure Recording Examples Auto Recording Examples Manual Recording Examples Rhythm Recording Examples Resting ECG Recording Screen Explanation of the Resting ECG Recording Screen Automatic Recording General Real Time Recording Review Recording Auto Gain and Auto Position Preparation for Automatic Recording System Setup Main Setup Automatic Recording Procedure Extended Recording Saving the ECG Data File Printing Another Copy of the Recording Results Manual Recording General Preparation for Manual Recording System Setup

98 5. RECORDING RESTING ECG WAVEFORMS General You can record the resting ECG waveforms automatically or manually. When the power is turned on, automatic recording mode is the default selection. In automatic recording mode, ECG analysis is automatically performed. After ECG waveforms are recorded, the ECG analysis result is automatically printed (unless Report print out setting is set to Off on the System Setting screen). There are two automatic recording modes, real time and review recording mode. In review recording mode, you can verify the ECG waveform displayed on the screen before starting recording. This lets you confirm clear ECG recording and accurate ECG analysis. In real time recording mode, when fluctuation of 20% of R-R interval is detected, the electrocardiograph can automatically extend lead group recording for the preset interval. After recording, you can save the 12 leads ECG (including extended sequence recording) analysis result and patient information as an ECG data file in the media. You can make one or more copies of the recording results before the next recording starts. In manual recording mode, you can manually change the recording settings (paper speed, sensitivity, and EMG filter on/off) during recording. You can also annotate the ECG waveforms with an event mark by pressing the FEED/MARK key. Before or after automatic or manual ECG recording, you can record 1 minute of the rhythm lead. You can set the channel of the lead on the Rhythm Recording of the Recording Settings in the Main Setup screen. For recording settings and other settings, refer to Section 3 Changing Settings Before Measurement. Caution when the ECG waveform has artifact CAUTION During recording, if large artifact appears on the ECG waveform, immediately stop the recording and remove the cause of the artifact. Refer to Troubleshooting in Section 8. Failure to follow this instruction causes overheating and damage to the electrocardiograph If the ECG recording is continued in this condition, the power unit in the electrocardiograph generates high frequency noise which causes the electrocardiograph to heat up. When the electrocardiograph heats up, a notification sound occurs and the START/STOP lamp blinks. The recording cannot be performed until the electrocardiograph cools down. 5-2 ECG-2150 Operator s Manual

99 5. RECORDING RESTING ECG VAVEFORMS Flow of Resting ECG Waveform Recording Following is the basic procedure for recording resting ECG waveforms. Lamp 1 2 Turn the power on. Select automatic or manual recording mode by pressing the AUTO/ MANUAL key. Lamp on: Automatic recording Lamp off: Manual recording 5 Automatic recording: i) Enter the patient information for ECG analysis. ii) Press the START/STOP key or F3 function key (review recording). To print a copy of the recording results, press the COPY/CAL key. When After analysis result recording on File Processing of the Main Setup screen is set to Save, after automatic recording, the analysis result and patient information are automatically saved as an ECG data file in a media. Manual recording: i) Press the START/STOP key. ii) Press the function key to select the next lead group. iii) iv) Repeat step ii) to record all lead groups. Press the START/STOP key to stop recording. Rhythm recording: Press the RHYTHM key. When 1 minute of ECG waveforms are acquired, rhythm lead recording starts automatically. ECG-2150 Operator s Manual 5-3

100 5. RECORDING RESTING ECG WAVEFORMS Notes for Accurate Measurement Before Starting the Recording 1 2 In order to acquire correct heart rate and accurate analysis result, confirm the following before pressing the START/STOP key. Stable heart rate No electrode detachment or noise message The QRS sync mark on the screen blinks in synchronization with the QRS sound or pen sound. To generate the sound, refer to System Settings in Section 3. No artifact in the pen sound. Immediately after electrodes are attached, the ECG waveforms may be unstable because of polarization voltage. Before pressing the START/STOP key wait at least 10 seconds for stable ECG waveforms. Detecting QRS Waves The electrocardiograph detects the QRS wave from leads II, V1 and V5. To assure QRS detection accuracy, take care to minimize superimposed artifact on these leads. Take care that QRS wave detection accuracy is not reduced by artifact superimposed on these leads. Also when the amplitude of these QRS waves is too small (less than 0.5 mv), the electrocardiograph cannot detect the QRS wave. NOTE: If low amplitude QRS wave is displayed on the screen and the QRS sync mark does not blink, the electrocardiograph does not analyze the ECG waveform. The CANNOT ANALYZE ECG message is printed on the ECG analysis result. Counting the Heart Rate The electrocardiograph counts the heart rate by averaging the latest five QRS waves and prints the heart rate together with the ECG waveforms. Using the EMG/High-cut Filter When using the EMG filter, the quality of ECG recording may be reduced. However, the EMG filter and high-cut filter do not affect the ECG analysis. 5-4 ECG-2150 Operator s Manual

101 5. RECORDING RESTING ECG VAVEFORMS ECG Analysis The electrocardiograph acquires 12 leads ECG waveforms simultaneously and analyzes the 10 seconds to 24 seconds of ECG waveforms. The selected leads and interval of the waveforms are printed on the paper. The ECG analysis result is incorrect if artifact is superimposed on the notselected leads or interval. When an electrode detachment line or noise line is printed on the paper, artifact was superimposed on the ECG waveforms during acquisition. When any of these line is printed, record the ECG waveforms again to assure accurate ECG analysis, verifying that all ECG leads are free from artifact. 5 ECG-2150 Operator s Manual 5-5

102 5. RECORDING RESTING ECG WAVEFORMS Resting ECG Recording Screen Displaying the Resting ECG Recording Screen 1 When the power is turned on, the Resting ECG recording screen appears. If another screen is displayed, press the MODE key to display the Main Menu screen. 2 Press 1 to select Resting ECG. The Resting ECG recording screen is displayed. 5-6 ECG-2150 Operator s Manual

103 Explanation of the Resting ECG Recording Screen 5. RECORDING RESTING ECG VAVEFORMS Heart rate Updated every beat. QRS sync mark Blinks in synchronization with the QRS wave. Standard 12 leads Screen Patient information display area For the default settings, refer to Section 3 Changing Settings Before Measurement. When the patient ID, gender and age are entered, they are displayed here. Refer to Entering the Patient Information in Section 4. Examination name 5 Electrode status display area Displays the error message for electrode detachment and noise. CAL mark The height corresponds to 1 mv waveform amplitude. Message and key function display area Displays the functions of the function keys and screen message. Waveform display area Displays 2.8 seconds of the 12-lead ECG waveforms in 2 sequences of 6 channels each. ECG-2150 Operator s Manual 5-7

104 5. RECORDING RESTING ECG WAVEFORMS Heart rate Updated every beat. Cabrera Leads Screen Patient information display area For the default settings, refer to Section 3 Changing Settings Before Measurement. When the patient ID, gender and age are entered, they are displayed here. Refer to Entering the Patient Information in Section 4. QRS sync mark Blinks in synchronization with the QRS wave. Examination name Electrode status display area Displays the error message for electrode detachment and noise. CAL mark The height corresponds to 1 mv waveform amplitude. Message and key function display area Displays the functions of the function keys and screen message. Waveform display area Displays 2.8 seconds of the 12-lead ECG waveforms in 2 sequences of 6 channels each. 5-8 ECG-2150 Operator s Manual

105 5. RECORDING RESTING ECG VAVEFORMS Automatic Recording General The electrocardiograph automatically records the ECG waveforms and calibration waveforms by switching the lead groups in the settings selected in the Setup mode when the START/STOP key is pressed. There are two recording modes: 5 Real Time Recording When you press the START/STOP key, the electrocardiograph starts recording real time ECG waveforms following the Auto Recording settings in the Setup mode. The ECG lead group is periodically switched. When Auto start is set to On on the Auto Recording of the System Setup screen and auto-start conditions are satisfied, real time recording automatically starts. Review Recording When the Resting ECG mode is selected, the electrocardiograph checks for electrode detachment. The electrocardiograph starts acquiring and saving the ECG waveforms when 2 seconds pass with no electrode detachment, so you can check the acquired ECG waveforms before recording starts. When the F3 function key is pressed, the electrocardiograph starts recording the saved waveforms from 10 seconds before the F3 function key is pressed. Auto Gain and Auto Position The recording sensitivity and position are automatically adjusted so that the ECG waveforms of each channel do not overlap. However, waveforms may overlap where there is noise or change of waveform. During recording, if any ECG waveforms exceed the maximum recording width, the waveform amplitude is automatically reduced to 1/2 (up to 1/8) and the waveforms are repositioned so that the entire waveforms can be recorded on the recording paper. The auto gain waveform amplitude is based on the sensitivity setting before recording. ECG-2150 Operator s Manual 5-9

106 5. RECORDING RESTING ECG WAVEFORMS Preparation for Automatic Recording Change the following settings, if necessary. Refer to Section 3 Changing Settings Before Measurement. The factory default settings are underlined. To print out the current settings, refer to Printing the List of System Setup and Main Setup Settings in Section 3. System Setup Wave Settings Baseline drift suppression (Strong, Weak, Off) Baseline drift suppression prevents the baseline from drifting by locking it into one position at the start of recording. CAUTION When baseline drift suppression is set to Strong, distortion may occur in the ST segment with a decrease of heart rate when heart rate is less than 50. For bradycardia, set this item to Weak. The Weak setting has characteristics conforming to the AHA recommendations. Recording Settings Auto Recording Auto start (On, Off) When Auto start is set to On, the real time recording is automatically started according to the format set on 12 lead recording channels when all the following conditions are satisfied: Automatic recording is not started. No electrode detachment is detected for two seconds or more. Five or more QRS waves are detected. Artifact and high frequency noise are not detected. The lead group is periodically switched. NOTE: After recording, this function is available only when the electrodes are reattached to the same patient or attaching the electrodes for the next patient. Main Setup Wave Settings High cut filter (75 Hz, 100 Hz, 150 Hz) This is active only when the EMG filter is turned off. EMG suppression frequency (25 Hz, 35 Hz) EMG filter frequency ECG-2150 Operator s Manual

107 5. RECORDING RESTING ECG VAVEFORMS Lead mode selection (Standard 12 leads, Cabrera leads) Standard 12 leads: I, II, III, avr, avl, avf, V1, V2, V3, V4, V5, V6 Cabrera leads: avl, I, avr, II, avf, III, V1, V2, V3, V4, V5, V6 CAUTION Take care when judging the ECG recording because the EMG filter may cause distortion of P waves and QRS waves depending on the waveform shape. 5 File Processing After analysis result recording (Save, Off) Set whether to save the ECG files after analysis result recording. When you select Save, the ECG files are automatically saved in an SD memory card. Media (SD card, Internal memory) Select the media to save the ECG data files. Recording Settings Recorder High speed printing (On (50 mm/s), Off (25 mm/s)) Applies to analysis result printing. Auto Recording Auto gain control (Auto gain + setting gain, Auto gain, Setting gain + auto gain, Setting gain) Select the auto gain and auto position control function. When Auto gain + setting gain or Setting gain is selected, the sensitivity can be changed by pressing the 10 mm/mv function key. 10 mm/mv 5 mm/mv 20 mm/mv 12 lead recording channels 1 ch: 12-lead ECG waveforms are recorded in the order of lead I, II, III, avr, avl, avf, V1, V2, V3, V4, V5, V6. 3 ch: 12-lead ECG waveforms are recorded as 3 channels in 4 sequences. Average + rhythm: The averaged waveform for each lead and rhythm lead are recorded in 2 channels. The length of each sequence is 10 seconds (fixed). Extended recording On: rhythm (full page): When an arrhythmia is detected during automatic recording, the rhythm recording starts after automatic recording ends. The format is set in Rhythm Recording in Recording Settings in the Main Setup screen. On: sequence (full page): When fluctuation of 20 % of R-R interval is detected during automatic recording, the recording of the lead group is extended. The extend recording time is set in the Time setting. Off: Not recorded. ECG-2150 Operator s Manual 5-11

108 5. RECORDING RESTING ECG WAVEFORMS Analysis Format and Settings Result printing format (Result only, Result + average) Select Result + average when printing the average waveform for each lead with the ECG analysis result. Include findings criteria (On, Off) Prints the criteria for the findings when this item is set to On. Pacing detection sensitivity (High, Low) Select the pacing detection sensitivity. If noise is incorrectly detected as a pacing pulse, select Low. Automatic Recording Procedure CAUTION When Auto start is set to On, select the patient age group and sex before attaching the electrodes to the patient. After the electrodes are attached and the ECG waveform is stable, the recording automatically starts and the default settings of the patient age group and sex are used for ECG analysis. For ECG analysis details, refer to the User s Guide ECAPS 12C ECG Interpretation Program. When the Do not turn the power off message appears during saving the ECG data file, do not turn the power off. Otherwise, the data will be lost. When After analysis result recording on the File Processing of the Main Setup screen is set to Save, check the remaining file capacity and delete unnecessary files before starting recording. CAUTION When the patient sex and age is not entered, ECG analysis is performed with the patient as male and 35 years old. 1 Check the following before starting recording. The patient is relaxed. The electrodes (especially chest electrodes) are not in electrical contact with each other and they are properly attached and there is no artifact. or Check that the AUTO/MANUAL lamp is lit. If it is not lit, press the AUTO/ MANUAL key. Enter the patient information. Refer to Entering the Patient Information in Section 4. If necessary, press the FILTER key to turn the EMG filter on. Select the real time or review recording mode by pressing the START/ STOP key (real time recording) or F3 function key (review recording). The electrocardiograph automatically records the ECG waveforms with switching the lead groups ECG-2150 Operator s Manual

109 5. RECORDING RESTING ECG VAVEFORMS Auto Start When Auto start is set to On and all the following conditions are satisfied, the real time recording is automatically started. Automatic recording is not started No electrode detachment is detected for two seconds or more Five or more QRS waves are detected Artifact and high frequency noise are not detected The lead group is periodically switched You can manually extend a lead group recording by pressing the AUTO/ MANUAL key. This is not available for the review recording. During extended recording, the AUTO/MANUAL lamp blinks. To change to the next lead group, press the AUTO/MANUAL key again. After the lead group which includes lead V6 is recorded, the electrocardiograph automatically stops recording and the ECG analysis result is printed (unless Report print out is set to Off on the System Setting screen). To manually stop recording, press the START/STOP key. When recording the ECG waveforms of another patient without changing the ID, the same ID confirmation message appears. 5 To record the waveforms with the same ID, press the Start function key. To change the ID, press the Edit ID function key. To cancel recording, press the Cancel function key. ECG-2150 Operator s Manual 5-13

110 5. RECORDING RESTING ECG WAVEFORMS Extended Recording The electrocardiograph automatically extends the recording when Extended recording on the Auto Recording of the Main Setup screen is set to On: sequence (full page) or On: rhythm (full page) in automatic recording. Extended rhythm recording: When an arrhythmia is detected, it starts rhythm recording following the format set on the Rhythm Recording of the Recording Settings in the Main Setup screen after automatic recording ends. While acquiring the rhythm lead, the START/ STOP lamp lights. To stop recording, press the START/STOP key once. This stops acquiring waveforms. To stop printing, press the START/STOP key again. Extended sequence recording: Extends the lead group recording when fluctuation of 20% of R-R interval is detected. The extended recording timing is set on the Time setting on the Recording Settings of the Auto Recording in the Main Setup screen. Saving the ECG Data File The 12-lead ECG waveforms (including extended sequence recording and extended rhythm recording), analysis result and patient information are automatically saved as an ECG data file in a media when the After analysis result recording on File Processing of the Main Setup screen is set to Save. When After analysis result recording on the File Processing of the Main Setup screen is set to Off, File is displayed in the message and key function display area. Press the File function key to select the file operation ECG-2150 Operator s Manual

111 5. RECORDING RESTING ECG VAVEFORMS To save and send the ECG data file, press the SaveSend function key. To save the ECG data file, press the Save function key. To send the ECG data file, press the Send function key. To cancel saving, press the Cancel function key. 5 When the selected media (internal memory or SD memory card) becomes full during saving, the Media is full message appears. Select another media and save the files again. When the File auto delete is set to On on the Main Setup screen, the oldest files are automatically deleted and the new files are saved. Printing Another Copy of the Recording Results After automatic and rhythm recording, the COPY/CAL key lamp lights. You can make one or more copies of the recording results by pressing the COPY/CAL key. The automatic and rhythm recording result can be printed. The word COPY is also printed at the top of the recording paper to distinguish it from automatic and rhythm recording results. If the FILTER key setting is changed, the changed setting applies to the printing. When the FILTER lamp lights, EMG filter is applied. When it is off, the high cut filter is applied. When Auto gain output is set to Auto gain + setting gain in the Auto Recording, the auto gain is applied. When it is set to Setting gain + auto gain, the setting gain is applied to the printing. ECG-2150 Operator s Manual 5-15

112 5. RECORDING RESTING ECG WAVEFORMS Manual Recording General You can manually record the ECG waveforms. During recording you can annotate the ECG waveforms when there is a change in patient condition such as chest pain or artifact. In manual recording mode, the baseline is automatically adjusted every time recording is started and the lead group or sensitivity can be changed. ECG analysis is not available in manual recording mode. Preparation for Manual Recording Change the following settings, if necessary. Refer to Section 3 Changing Settings Before Measurement. The factory default settings are underlined. To print the current settings, refer to Printing the List of System Setup and Main Setup Settings in Section 3. System Setup Wave Settings Baseline drift suppression (Strong, Weak, Off) Baseline drift suppression prevents the baseline from drifting by locking it into one position at the start of recording. CAUTION When baseline drift suppression is set to Strong, distortion may occur in the ST segment with a decrease of heart rate when heart rate is less than 50. For bradycardia, set this item to Weak. The Weak setting has characteristics conforming to the AHA recommendations. Main Setup Wave Settings High cut filter (75 Hz, 100 Hz, 150 Hz) This is active only when the EMG filter is turned off. EMG suppression frequency (25 Hz, 35 Hz) EMG filter frequency. CAUTION Take care when judging the ECG recording because the EMG filter may cause distortion of P waves and QRS-waves depending on the waveform shape ECG-2150 Operator s Manual

113 5. RECORDING RESTING ECG VAVEFORMS Recording Settings Manual Recording 12 lead recording channels (3 ch, 1 ch, 1 ch + rhythm) The number of recording channels for the manual recording. Manual Recording Procedure Check the following before starting recording. The patient is relaxed. The electrodes (especially chest electrodes) are not in electrical contact with each other, they are properly attached and there is no artifact. Press the AUTO/MANUAL key to select the manual recording mode. The AUTO/MANUAL lamp is lit when auto recording mode is selected. Select the first lead group. Press the or, function key. Enter the number 4 (<) or 5 (>) with the keyboard on the operation panel. 12-lead / Cabrera leads 1ch, 1ch + rhythm 5 I II III avr avl avf V1 V2 V3 V4 V5 V6 *(avl I -avr II avf III) 12-lead / Cabrera leads 3 ch I, II, III avr, avl, avf *(avl, I, avr) (II, avf, III) V1, V2, V3 V4, V5, V6 * Parentheses indicate Cabrera lead. To change the sensitivity Press the 10 mm/mv function key. or, Press the F1 key. 10 mm/mv 5 mm/mv 20 mm/mv To change the paper speed Press the 25 mm/s function key. or, Press the 25 mm/s or 50 mm/s function key with the keyboard on the operation panel to change the paper speed. 25 mm/s 50 mm/s ECG-2150 Operator s Manual 5-17

114 5. RECORDING RESTING ECG WAVEFORMS To turn on the EMG filter Press the FILTER key. To annotate the ECG waveform with a dotted line Press the FEED/MARK key. A dotted line is continuously printed while this key is pressed. 4 5 Press the START/STOP key to start recording. Select the next lead group. Press the function key. When the lead group is changed, the calibration waveform is automatically recorded. 6 7 Repeat step 5 to record all lead groups. When all lead groups are recorded, press the START/STOP key to stop recording ECG-2150 Operator s Manual

115 5. RECORDING RESTING ECG VAVEFORMS Rhythm Recording General Before or after automatic or manual ECG recording, you can perform rhythm recording. The settings are set on the Rhythm Recording of the Recording Settings in the Main Setup screen. 5 Rhythm Recording Procedure Press the RHYTHM key. The electrocardiograph starts to acquire the ECG waveforms and the elapsed time from the start of ECG waveform acquisition is displayed at the bottom right of the screen. When 1 minute of ECG waveforms are acquired, recording starts. or To stop ECG waveform acquisition, press the RHYTHM key or START/STOP key. After recording, you can make one or more copies of the recording results by pressing the COPY/CAL key. NOTE: To stop rhythm recording, press the Cancel function key. ECG-2150 Operator s Manual 5-19

116 5. RECORDING RESTING ECG WAVEFORMS Recording Examples Auto Recording Examples Standard 12-lead ECG Baseline drift suppression indications D - Strong d - Weak None - Off AC filter indications H50: 50 Hz AC filter H60: 60 Hz AC filter None: Off Patient information High cut filter and EMG filter indications 150 Hz: 150 Hz High cut filter 35 Hz: 35 Hz EMG filter 100 Hz: 100 Hz High cut filter 25 Hz: 25 Hz EMG filter 75 Hz: 75 Hz High cut filter Analysis result Measurement value Cabrera Lead ECG 5-20 ECG-2150 Operator s Manual

117 5. RECORDING RESTING ECG VAVEFORMS 5 Manual Recording Examples Standard 12-lead ECG Cabrera Lead ECG ECG-2150 Operator s Manual 5-21

118 5. RECORDING RESTING ECG WAVEFORMS Rhythm Recording Examples 1 ch, 1 min 5-22 ECG-2150 Operator s Manual

119 6 Periodic ECG Recording 6 General Preparation for Periodic ECG Recording Starting Periodic Recording Recording Examples...6-4

120 6. PERIODIC ECG RECORDING General The electrocardiograph can automatically perform automatic recording at periodic intervals. For automatic recording, refer to Section 5 Recording Resting ECG Waveforms. You can also perform automatic and manual recording during periodic ECG recording. Preparation for Periodic ECG Recording Change the following settings, if necessary. Refer to Section 3 Changing Settings Before Measurement. The factory default settings are underlined. To print the current settings, refer to Printing the List of System Setup and Main Setup Settings in Section 3. System Setup Periodic Recording Settings Starting leads (Limb, Chest) Select the starting lead group. Periodic recording type (Fixed time, Interval, Off) Select the ECG waveform acquisition interval. Fixed recording time (30 s, 1 min to 15 min) Select On to acquire the ECG waveform after the specified time when Periodic recording type is set to Fixed time. Interval (min) (1 to 60 (3)) Select the interval when Periodic recording type is set to Interval. Change function key increments the value by 1 step. FILTER key increments the value by 10 steps. Interval recording repetitions (1 to 999 (10)) Select the number of times to acquire ECG waveform. Change function key increments the value by 1 step. FILTER key increments the value by 10 steps. Auto gain output (On, Off) Select On to automatically change the waveform amplitude and position during periodic recording. Additional slow speed recording (On, Off) Select On to slow paper speed until the next periodic recording starts. Main Setup Recording Settings Manual Recording 12 lead recording channels (3 ch, 1 ch, 1 ch + rhythm) 3 ch: II, avf, V5 1 ch: II 6-2 ECG-2150 Operator s Manual

121 6. PERIODIC ECG RECORDING Starting Periodic Recording 1 Press the MODE key. The Main Menu screen is displayed. 6 2 Press 2 to select Periodic Recording. The Periodic ECG recording screen appears. 3 4 Press the Start function key Periodic recording starts with the preset settings. To perform automatic or manual recording during periodic recording i) Press the START/STOP key. ii) Select automatic or manual recording with the AUTO/MANUAL key. iii) Press the START/STOP key again to start recording. After recording, the periodic recording automatically resumes. To turn off periodic recording, press the MODE key to display the Main Menu screen. ECG-2150 Operator s Manual 6-3

122 6. PERIODIC ECG RECORDING Recording Examples 6-4 ECG-2150 Operator s Manual

123 7 Data Management General Displaying the Data Management Screen Sending ECG Data Files Displaying the Send Screen Sending All ECG Data Files Sending Unsent ECG Data Files Sending an ECG Data File of the Selected ID Sending an ECG Data File of the Selected Date Printing ECG Waveforms in a Media Editing the ID Printing ECG Waveforms in the Server Deleting ECG Data Files Displaying the Delete Screen Deleting All ECG Data Files Deleting Sent ECG Data Files Deleting ECG Data Files of the Selected ID Deleting ECG Data Files of the Selected Date Formatting the Media Printing the File List Copying Files in the Internal Memory to an SD Card

124 7. DATA MANAGEMENT General In automatic recording mode, the ECG waveforms, analysis result and patient information can be saved as an ECG data file in a media. On the Data Management screen, you can do any of the following operations. Send all ECG data files or unsent ECG data files from a media to a personal computer or another electrocardiogragh. You can also send ECG data files of the selected ID or date. Print the ECG waveforms in a media. Change the ID of the selected file. Print the ECG waveforms on the server. Delete ECG data files in a media. Format media. Print the ECG data file list of the selected date in a media. Copy the ECG data files in the internal memory to the SD memory card. To process an ECG data file, select Media in File Processing in the Main Setup screen. The selected media is displayed in the header of the screen. There are two types of data save format, type 1 (normal) and type 2 (compressed). The type can be set in Data compression type in File Processing in the Main Setup screen. When the internal memory is selected, up to 40 ECG data files can be saved regardless of the data compression type. When the SD memory card is selected, up to 780 (type 1) or 3000 (type 2) files can be saved. CAUTION Format the SD memory card before the first use. Format the SD memory card only in an ECG-2150 electrocardiograph. SD memory cards formatted in other ECG models cannot be used in this electrocardiograph. 7-2 ECG-2150 Operator s Manual

125 Displaying the Data Management Screen 7. DATA MANAGEMENT 1 Press the MODE key. The Main Menu screen appears. 7 2 Press 7 to select Data Management. The Data Management screen appears. The number of ECG data files which are saved in the media is displayed at the upper right of the screen. The remaining free space in the media is displayed at the lower right of the screen. Media The number of ECG data files in the media Free space in Media To select the desired item, press the number of the item with the keyboard on the operation panel. The screen of the selected item is displayed. To close the Data Management screen, press the MODE key. The Main Menu screen appears. ECG-2150 Operator s Manual 7-3

126 7. DATA MANAGEMENT Sending ECG Data Files You can send all ECG data files or unsent ECG data files from the media to a personal computer or another electrocardiograph. You can also send ECG data files of the selected ID or date. Displaying the Send Screen 1 2 Display the Data Management screen. Refer to the Displaying the Data Management Screen. Press 1 to select Send. The Data Management - Send screen is displayed. To return to the Data Management screen, press the Back function key. 7-4 ECG-2150 Operator s Manual

127 7. DATA MANAGEMENT Sending All ECG Data Files All ECG data files can be sent from the media to a personal computer or another electrocardiograph. 1 Display the Data Management - Send screen. Refer to the Displaying the Send Screen. 7 2 Press 1 to select All files. The Send all files? message appears. ECG-2150 Operator s Manual 7-5

128 7. DATA MANAGEMENT 3 Press the OK function key. The Sending ECG file. Do not turn the power off message appears. To cancel sending while sending the ECG data files, press the Cancel function key. After the current ECG data file is sent, sending of the remaining files is canceled. The Canceled message and the number of sent files appears. Press the OK function key. The Data management screen is displayed. 4 When all files are sent, the All files sent message appears. Press the OK function key. The Data Management screen is displayed. 7-6 ECG-2150 Operator s Manual

129 7. DATA MANAGEMENT Sending Unsent ECG Data Files Unsent ECG data files can be sent from the media to a personal computer or another electrocardiograph. 1 Display the Data Management - Send screen. Refer to the Displaying the Send Screen. 7 2 Press 2 to select Non sent files. The Send non sent files? message appears. ECG-2150 Operator s Manual 7-7

130 7. DATA MANAGEMENT 3 Press the OK function key. The Sending ECG file. Do not turn the power off message appears. To cancel sending while sending the ECG data files, press the Cancel function key. After the current ECG data file is sent, sending of the remaining files is canceled. The Canceled message and the number of sent files appears. Press the OK function key. The Data management screen is displayed. 7-8 ECG-2150 Operator s Manual

131 7. DATA MANAGEMENT 4 When all files are sent, the All files sent message appears. Press the OK function key. The Data Management screen is displayed. 7 Sending an ECG Data File of the Selected ID You can send an ECG data file of the selected ID to a personal computer or another electrocardiograph. 1 Display the Data Management - Send screen. Refer to Displaying the Send Screen in this section. ECG-2150 Operator s Manual 7-9

132 7. DATA MANAGEMENT 2 Press 3 to select Selected ID. The Enter the ID message appears. 3 Enter the ID and press the Search function key. The files of the selected ID are displayed ECG-2150 Operator s Manual

133 7. DATA MANAGEMENT 4 Select a file and press the Send function key. The Sending ECG file. Do not turn the power off message appears. 7 5 After the selected file is sent, the files of the selected ID is displayed and a C is displayed beside sent ECG data files. ECG-2150 Operator s Manual 7-11

134 7. DATA MANAGEMENT Sending an ECG Data File of the Selected Date 1 You can send an ECG data file of the selected date to a personal computer or another electrocardiograph. Display the Data Management - Send screen. Refer to Displaying the Send Screen in this section. 2 Press 4 to select Selected date. The Enter the date message appears ECG-2150 Operator s Manual

135 7. DATA MANAGEMENT 3 Enter the date and press the Search function key. The files of the selected date are displayed. 7 4 Select a file and press the Send function key. The Sending ECG file. Do not turn the power off message appears. 5 After the selected file is sent, the files of the selected date is displayed and a C is displayed beside sent ECG data files. ECG-2150 Operator s Manual 7-13

136 7. DATA MANAGEMENT Printing ECG Waveforms in a Media Printing ECG Waveforms in a Media You can print the ECG waveforms of the selected ID in a media Select SD card or Internal memory in Media of the Main Settings. Refer to Section 3 Changing Settings Before Measurement. Display the Data Management screen. Refer to the Displaying the Data Management Screen on the previous page. Press 2 to select Print. The Press Enter to enter ID. Press Search to search files for ID message appears. 4 Press the Enter function key. The Enter the ID message appears ECG-2150 Operator s Manual

137 7. DATA MANAGEMENT 5 Enter the ID with the following keys and press the START/STOP (enter) key. The ID is set and the Press Enter to enter ID. Press Search to search files for ID. message appears. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key 7 6 Press the Search function key. The file list of the entered ID appears. 7 Select the file and press the Print function key. The ECG data of the selected file is printed. ECG-2150 Operator s Manual 7-15

138 7. DATA MANAGEMENT Editing the ID You can edit the ID after recording ECG waveforms. 1 2 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 3 to select Edit ID. The Press Enter to enter ID. Press Search to search files for ID message appears. 3 Press the Enter function key. The Enter the ID message appears ECG-2150 Operator s Manual

139 7. DATA MANAGEMENT 4 Enter the ID with the following keys and press the START/STOP (enter) key. The ID is set and the Press Enter to enter ID. Press Search to search files for ID. message appears. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key 7 5 Press the Search function key. The file list of the entered ID appears. 6 Select the file and press the Edit function key. The Change the ID message appears. ECG-2150 Operator s Manual 7-17

140 7. DATA MANAGEMENT 7 Press the Enter function key. The Enter the ID message appears. 8 Enter the new ID with the keys on the operation panel and press the START/ STOP (enter) key. The new ID is set and the Edit complete message appears. 9 Press the OK function key The previous file list without the changed ID data appears ECG-2150 Operator s Manual

141 7. DATA MANAGEMENT Printing ECG Waveforms in the Server You can print the ECG waveforms of the selected ID in the server. 1 2 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 4 to select Print server file. The Enter the ID message appears. 7 3 Enter the ID and press the Search function key. The file list of the entered ID is displayed. 4 Select the file and press the Print function key. The ECG data of the selected file is printed. ECG-2150 Operator s Manual 7-19

142 7. DATA MANAGEMENT Deleting ECG Data Files NOTE: Back up the ECG data files before deleting ECG data files. You can delete all ECG data files, sent ECG data files, ECG data files of the selected date or ECG data files of the selected ID in the media. Displaying the Delete Screen 1 2 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 5 to select Delete. The Data Management - Delete screen appears. To return to the Data Management screen, press the Back function key ECG-2150 Operator s Manual

143 7. DATA MANAGEMENT Deleting All ECG Data Files You can delete all ECG data files from the media. 1 Display the Data Management - Delete screen. Refer to the above Displaying the Delete Screen section. 7 2 Press 1 to select All files. The Delete all files? message appears. ECG-2150 Operator s Manual 7-21

144 7. DATA MANAGEMENT 3 Press the OK function key. The Deleting ECG file. Do not turn the power off message appears. To cancel deleting, while deleting the ECG data files, press the Cancel function key. After the current ECG data file is deleted, the deleting of the remaining files is canceled. The Canceled message and the number of deleted files appears. Press the OK function key. The Data Management screen appears ECG-2150 Operator s Manual

145 7. DATA MANAGEMENT 4 When all files are deleted, the All files deleted message appears. Press the OK function key. The Data Management screen appears. 7 Deleting Sent ECG Data Files 1 You can delete sent ECG data files from the media. Display the Data Management - Delete screen. Refer to Displaying the Delete Screen in this section. ECG-2150 Operator s Manual 7-23

146 7. DATA MANAGEMENT 2 Press 2 to select Sent files. The Delete sent files? message appears. 3 Press the OK function key. Deleting ECG file. Do not turn the power off message appears ECG-2150 Operator s Manual

147 7. DATA MANAGEMENT To cancel deleting, while deleting the ECG data files, press the Cancel function key. After the current ECG data file is deleted, deleting of the remaining files is canceled. The Canceled message and the number of deleted files appears. Press the OK function key. The Data Management screen is displayed. 7 4 When all files are deleted, the All files deleted message appears. Press the OK function key. The Data Management screen is displayed. ECG-2150 Operator s Manual 7-25

148 7. DATA MANAGEMENT Deleting ECG Data Files of the Selected ID You can delete ECG data files of the selected ID from the media. 1 Display the Data Management - Delete screen. Refer to Displaying the Delete Screen in this section. 2 Press 3 to select Selected ID. The Press Enter to enter ID. Press Search to search files for ID message appears ECG-2150 Operator s Manual

149 7. DATA MANAGEMENT 3 Press the Enter function key. The Enter the ID message appears. 7 4 Enter the ID with the following keys and press the START/STOP (enter) key. The ID is set and the Press Enter to enter ID. Press Search to search files for ID. message appears again. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key 5 Press the Search function key. The file list of the selected ID is displayed. ECG-2150 Operator s Manual 7-27

150 7. DATA MANAGEMENT 6 Select the file and press the Delete function key. The Delete the selected data? message appears. 7 8 Press the OK function key to delete the data. When the selected files are deleted, the Files delete message appears. Press the OK function key. The Data management screen appears ECG-2150 Operator s Manual

151 7. DATA MANAGEMENT Deleting ECG Data Files of the Selected Date You can delete ECG data files of the selected date from the media. 1 Display the Data Management - Delete screen. Refer to Displaying the Delete Screen in this section. 7 2 Press 4 to select Selected date. The Press Enter to enter Date. Press Delete to delete files message appears. ECG-2150 Operator s Manual 7-29

152 7. DATA MANAGEMENT 3 Press the Enter function key. The Enter the date. Files will be deleted message appears. 4 Enter the date with the following keys and press the OK function key. The files of the selected date are deleted. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key 5 When the selected files are deleted, the Files deleted message appears. Press the OK function key. The Data management screen appears ECG-2150 Operator s Manual

153 7. DATA MANAGEMENT Formatting the Media You can format a media in the electrocardiograph. CAUTION Only use a Shanghai Kohden specified SD memory card. Otherwise, the card might not operate. CAUTION Format the SD memory card before the first use. Format the SD memory card only in an ECG electrocardiograph. SD memory cards formatted in other ECG models cannot be used in this electrocardiograph. 7 NOTE: Formatting deletes all data in the media. Back up the necessary data before formatting. 1 Insert the SD memory card into SD card slot on the rear panel of the electrocardiograph. To format the internal memory, skip this step. 2 3 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 6 to select Format. The Data Management - Format screen appears. To cancel formatting, press the Cancel function key. The Data Management screen appears. ECG-2150 Operator s Manual 7-31

154 7. DATA MANAGEMENT 4 Press the OK function key. The Formatting. Do not turn the power off message appears. 5 When the formatting is complete, the Formatting complete message appears. Press the OK function key. The Data Management screen appears. NOTE: Do not turn the electrocardiograph power off while displaying the Data Management - Format screen and do not give an impact to the electrocardiograph ECG-2150 Operator s Manual

155 7. DATA MANAGEMENT Printing the File List You can print a list of the ECG data that are saved in the media. The list includes measurement date, ID, gender, age and measurement mode. 1 2 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 7 to select Print file list. The Enter the date message appears. 7 3 Press the Enter function key. The cursor appears on the date. ECG-2150 Operator s Manual 7-33

156 7. DATA MANAGEMENT 4 Enter the date with the following keys and press the OK function key. The date is set. Numeric Key Numeric Key 0 COPY/CAL key 6 AGE key 1 F1 function key 7 GENDER key 2 F2 function key 8 FEED/MARK key 3 F3 function key 9 FILTER key 4 MODE key - F4 function key 5 RHYTHM key Clear AUTO/MANUAL key Enter START/STOP key 5 Press the Print function key. The file list of the selected date is printed ECG-2150 Operator s Manual

157 7. DATA MANAGEMENT Copying Files in the Internal Memory to an SD Card You can copy the ECG data files saved in the internal memory to the SD card. 1 2 Display the Data Management screen. Refer to Displaying the Data Management Screen in this section. Press 8 to select Copy int memory > SD. The Copy internal memory files to the SD card? message appears. 7 3 Press the OK function key. The Copying ECG file. Do not turn the power off message appears. To cancel while copying files, press the Cancel function key. The Canceled message and the number of copied files appears. Press the OK function key. The Data management screen appears. ECG-2150 Operator s Manual 7-35

158 7. DATA MANAGEMENT 4 When all files are copied, the All files copied message appears. Press the OK function key. The Data Management screen appears ECG-2150 Operator s Manual

159 8 Troubleshooting and Error Messages Recording Clear ECG Waveforms AC Interference Muscle Tremor Interference (EMG) Wandering Baseline Abnormal Printout Other Troubleshooting Error Messages Checking the Software Version...8-8

160 8. TROUBLESHOOTING AND ERROR MESSAGES Recording Clear ECG Waveforms AC Interference Appears on the ECG as even-peaked, regular voltages superimposed throughout the tracing. It may appear in conjunction with muscle tremor. Causes: Dirty or corroded lead wire tips or electrodes Loose electrode connection Patient or technician touching an electrode during recording Patient touching any metal part of a bed or examination table Broken lead wire, patient cable or power cord Electrical devices in the immediate area, lighting, concealed wiring in walls or floors Improperly grounded electrical outlet Muscle Tremor Interference (EMG) Appears on the ECG as random, irregular voltages superimposed on the tracing. It may resemble or occur in conjunction with AC interference. Causes: Patient is uncomfortable, tense, nervous or apprehensive Patient is cold and shivering Patient has a neurological or muscular disorder (e.g. Parkinson s Disease) Examination table or bed is too narrow or short to support limbs comfortably 8-2 ECG-2150 Operator s Manual

161 8. TROUBLESHOOTING AND ERROR MESSAGES Wandering Baseline Appears on the ECG as a fluctuation of the tracing up and downward on the grid. Causes: Dirty or corroded electrodes Loose electrodes or electrodes positioned on a bony area Insufficient or dried out cardiocream Oily skin or body lotions and creams Rising and falling of chest during normal or apprehensive respiration 8 When wandering baseline occurs: Clean skin with alcohol or acetone if necessary Reposition electrodes Check the electrode connections Have the patient relax Abnormal Printout During ECG recording, loose or poor electrode contact causes waveform saturation, excessive AC interference, etc. In this case, the electrocardiograph stops printing to protect the thermal head. Check the electrode attachment. ECG-2150 Operator s Manual 8-3