ViTrac TM QP-989P OPERATOR S MANUAL Revision 01-10 January 2017 NKUS LAB, INC. 14 BUNSEN IRVINE CA 92618 2017 NKUS LAB
Table of Contents 1 General... 6 1.1 Introduction... 6 1.2 Connection to Nihon Kohden s Patient Monitoring Network... 6 2 System Requirements... 7 3 Operational Restriction... 8 4 Installing ViTrac... 8 5 Initial Setup... 9 6 Windows in ViTrac... 10 6.1 Settings Window... 10 6.2 About Window... 11 6.3 Bed Selection Window... 12 6.4 All Beds Window... 12 6.5 Wave Display Window... 13 6.6 Trend Data Window... 13 6.7 Graphical Trend Window... 13 6.8 Full Disclosure Window... 14 6.9 Arrhythmia Recall Window... 14 6.10 ST Recall Window... 15 6.11 12 Lead Window... 15 6.12 Hemodynamics Window... 15 7 Viewing Patient Data... 17 7.1 Launching ViTrac... 17 7.2 Selecting a Patient on the ipad... 17 7.3 Selecting a Patient on the iphone... 19 8 All Beds Window... 20 8.1 ipad All Beds Window... 20 8.2 iphone All Beds Window... 22 9 Wave Display Window... 24 9.1 ipad Wave Display Window... 24 9.2 iphone Wave Display Window... 26 10 Trend Data Window... 33 Page 1
10.1 ipad Trend Data Window... 33 10.2 iphone Trend Data Window... 35 11 Graphical Trend Window... 37 11.1 ipad Graphical Trend Window... 37 11.2 iphone Graphical Trend Window... 39 12 Full Disclosure Window... 41 12.1 ipad Full Disclosure Window... 41 12.2 iphone Full Disclosure Window... 43 13 Arrhythmia Recall Window... 47 13.1 ipad Arrhythmia Recall Window... 47 13.2 iphone Arrhythmia Recall Window... 49 14 ST Recall Window... 51 14.1 ipad ST Recall Window... 51 14.2 iphone ST Recall Window... 53 15 12 Lead Window... 55 15.1 ipad 12 Lead Window... 55 15.2 iphone 12 Lead Window... 58 16 Hemodynamics Window... 59 16.1 ipad Hemodynamics Window... 59 16.2 iphone Hemodynamics Window... 61 17 WLAN Transport... 62 18 Troubleshooting... 63 19 Specification... 64 Trademarks Apple, ios, itunes, ipad, ipad mini, iphone, ipod, ipod touch are registered trademarks of Apple Inc. in the United States and other countries. Page 2
General Handling Precautions This software or application is intended for use only by qualified medical personnel. Use only Nihon Kohden approved products. Use of non-approved products or in a non-approved manner may affect the performance specifications of the software or application. CAUTION ViTrac should not be used as the primary method for monitoring patients. WARNING Do not diagnose a patient based only on data displayed on ViTrac. Overall judgment must be performed by a physician who understands the features, limitations and characteristics of ViTrac and by reading the biomedical signals acquired by other instruments. Conventions Used in this Manual and Instrument Warnings, Cautions and Notes Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information. WARNING A warning alerts the user to possible injury or death associated with the use or misuse of the instrument. CAUTION 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. NOTE A note provides specific information, in the form of recommendations, requirements, alternative methods or supplemental information. Page 3
Explanations of the Symbols in this Manual and Instrument Manufacturer The CE mark is a protected conformity mark of the European Community. The products herewith comply with the requirements of the Medical Device Directive 93/42/EEC. European Representative Page 4
Warranty Policy Nihon Kohden NKUS Lab* (NKUS Lab) shall warrant its products against all defects in materials and workmanship for one year from the date of delivery. However, consumable materials such as paper, ink, stylus and battery are excluded from the warranty. NKUS Lab 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 NKUS Lab s products. NKUS Lab 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 NKUS Lab or its authorized agents without prior consent of NKUS Lab may be cause for voiding this warranty. Defective products or parts must be returned to NKUS Lab 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 Nihon Kohden NKUS Lab s 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. In the USA and Canada other warranty policies may apply. CAUTION United States law restricts this device to sale by or on the order of a physician. * NKUS Lab is a subsidiary of Nihon Kohden Corporation. Notes Regarding CE Labelling The CE mark is a protected conformity mark of the European Community. The products herewith comply with the requirements of the Medical Device Directive 93/42/EEC. The CE mark is valid for the ViTrac QP-989P. Page 5
1 GENERAL 1.1 INTRODUCTION ViTrac is designed to provide Doctors, Nurses and other medical personnel with information on multiple patients, any place and any time. The ViTrac application provides a secure method for viewing a wide range of Nihon Kohden generated patient data that can be viewed in near real-time on Apple mobile ios devices within the hospital network or remotely, via a VPN connection. The ios-based mobile application provides a robust and easy-to-use user interface which allows viewing of current waveforms and vital signs and stored full disclosure data, arrhythmia history, ST level history, trend data, hemodynamics data, 12 lead ECG interpretations, and much more. ViTrac uses Nihon Kohden s Unified Gateway technology that is designed with multi-level security controls that restricts access to patient data based on user, user groups and/or mobile client. ViTrac can continuously and simultaneously display data for up to 12 patients on ipad devices and 8 patients on iphone devices, and has various windows for reviewing a wide range of important patient data and status. CAUTION ViTrac should not be used as the primary method for monitoring patients. WARNING Do not diagnose a patient based only on data displayed on ViTrac. Overall judgment must be performed by a physician who understands the features, limitations and characteristics of ViTrac and by reading the biomedical signals acquired by other instruments. 1.2 CONNECTION TO NIHON KOHDEN S PATIENT MONITORING NETWORK Depending on the configuration of the patient network, you have to consider where the most appropriate location to connect the server is. If all Nihon Kohden patient monitoring devices are connected to the same network, you can connect the Unified Gateway server directly to the monitoring network and the hospital network. If the Nihon Kohden patient monitoring devices are sub-networked using routers or layer-3 switches, the Unified Gateway server must be connected to the backbone of the monitoring network and to the hospital network in order to view the patient selection table correctly. Refer to the diagram below for a graphical representation of a typical network configuration. Page 6
ipad iphone Wireless Access Points Wireless Access Points Hospital Network Unified Gateway Patient Monitoring Backbone Central Monitor Switch Monitoring Sub-Network #1 Monitoring Sub-Network #2 Switch Central Monitor Bedside Monitor Bedside Monitor Bedside Monitor Bedside Monitor Bedside Monitor Bedside Monitor 2 SYSTEM REQUIREMENTS ViTrac runs on the following mobile devices: Apple ipad, 2 nd generation or higher, running ios 6.1 to 10.2 Apple ipad mini, 1st generation or higher, running ios 6.1 to 10.2 Apple iphone 4 or higher, running ios 6.1 to 10.2 Apple ipod touch, 4 th generation or higher, running ios 6.1 to 10.2 WARNINGS Check the software version number of the ViTrac and Unified Gateway system before connecting it to the network. Different software versions have different communication methods. More than one communication method in a network may cause communication failure. The network must be managed by the network administrator. Make sure that each device in the network has a different IP address. Otherwise, network data communication cannot be Page 7
performed properly. When adding a device to an already operating network, set the IP address on the device before connecting the device to the network. Patient data displayed on ViTrac may be delayed by several seconds based on network conditions. When the battery level of your mobile device goes below 20%, you should stop using ViTrac and recharge your battery immediately. 3 OPERATIONAL RESTRICTION Category Description General No patient data is stored on the mobile device. Cannot modify any patient data. All Beds Windows ipad: Can display a maximum of 12 patients. iphone/ipod: Can display a maximum of 8 patients. Admit/Discharge Cannot Admit or Discharge patients. CAUTION ViTrac does not perform ECG analysis. Therefore, the QRS sync mark on ViTrac might not synchronize with the patient s actual QRS during pacing or when complicated arrhythmias occur. 4 INSTALLING VITRAC Launch the App Store application and download ViTrac from Apple s App Store. ipad iphone Page 8
5 INITIAL SETUP Press the ViTrac icon to run the application. ipad iphone When running ViTrac for the first time, you are required to accept the terms of the End User License Agreement (EULA). Please read the EULA in detail. If you agree with the terms, press on the Accept button. Otherwise you cannot run the application. ipad iphone Page 9
6 WINDOWS IN VITRAC 6.1 SETTINGS WINDOW The Settings window allows you to configure some basic application settings. ipad Page 10 iphone Unified Gateway o Allows you to select which Unified Gateway ViTrac will use to communicate with Nihon Kohden devices. Only applicable when Demonstration Mode is Off. o You have the option to manually enter the IP address of the Unified Gateway, such as when you are connected to the hospital network remotely via a VPN connection. Turn Manually Enter Gateway Address to On, type the IP address, then press the Set IP Address button. Wait for the indicator to turn green to verify that you have successfully connected to the Unified Gateway. Alarm Notification Sounds o On Alarm notification sounds can be heard. The volume of your device must be set to an audible level and not silenced. o Off Alarm notification sounds will be muted. CAUTION ViTrac should not be used as the primary method for monitoring patients. Patient data displayed on ViTrac may be delayed by several seconds based on network conditions.
Old NIBP Display o Controls how aged NIBP data (as defined by NIBP Old After setting) is displayed. o Dim The NIBP measurement values are displayed in gray instead of their normal color. NIBP measurement date and time are not hidden. o --- The NIBP measurement date and time are hidden, and the NIBP systolic, diastolic and mean values are displayed as dashes. NIBP Old After o Controls how long to wait after a NIBP measurement was taken to dim or hide NIBP values. You can select 10 minutes, 30 minutes, 1 hour, or 24 hours. Demonstration Mode o On You are able to use the application without being connected to the Nihon Kohden patient monitoring network. All data presented is simulated data and does not contain actual patient data. o Off You are able to use the application with actual devices and patients within a Nihon Kohden patient monitoring network. Simulate Alarms o Can be selected only when Demonstration mode is on. o On Randomly generates alarm notifications. o Off No alarm notifications will be generated. Metric Units o Can be selected only when Demonstration mode is on. o On Use Metric units. o Off Use Standard English unit system. 6.2 ABOUT WINDOW The About window shows the part number, version, Device ID, and some other basic information. The Device ID is used to register the ViTrac device as a Mobile Client on the Unified Gateway. NOTE The Device ID changes when you delete the ViTrac app from your mobile device, then later re-download ViTrac from Apple s App Store. Therefore, you will need to re-register the ViTrac device s new Device ID on the Unified Gateway. The Copy button will copy the Device ID to the clipboard. You can then paste the Device ID elsewhere, such as to an email or document. Page 11
ipad iphone 6.3 BED SELECTION WINDOW The Bed Selection window allows you to select which patients data to view. ipad iphone 6.4 ALL BEDS WINDOW The All Beds window displays the near real-time status for all selected devices. Up to 12 patients can be selected on the ipad and up to 8 patients on the iphone/ipod. ipad iphone Page 12
CAUTION There is a small latency associated in displaying numeric vital signs and waveform data on the mobile device. This latency is a factor of network load and the number of beds on the network. The latency will typically not exceed four seconds. 6.5 WAVE DISPLAY WINDOW The Wave Display window displays waveforms and numeric data for a selected bed. ipad iphone 6.6 TREND DATA WINDOW The Trend Data window displays tabular trend of measured parameters. ipad iphone 6.7 GRAPHICAL TREND WINDOW The Graphical Trend window displays trend graphs of measured parameters and arrhythmia events. Page 13
ipad iphone 6.8 FULL DISCLOSURE WINDOW The Full Disclosure window displays full disclosure waveforms. ipad iphone 6.9 ARRHYTHMIA RECALL WINDOW The Arrhythmia Recall window displays the arrhythmia event and waveform of each arrhythmia recall file. ipad iphone Page 14
6.10 ST RECALL WINDOW The ST Recall window displays each ST Recall file s heart rate and the ST waveform and ST value for each lead. ipad iphone 6.11 12 LEAD WINDOW The 12 Lead window displays the results of ECG 12 lead analysis performed at the bedside monitors. ipad iphone 6.12 HEMODYNAMICS WINDOW The Hemodynamics window displays the hemodynamics files. Page 15
ipad iphone Page 16
7 VIEWING PATIENT DATA 7.1 LAUNCHING VITRAC The first time you launch ViTrac, the All Beds window is blank. To start viewing beds, press on the Bed Selection icon. This will bring you to the Bed Selection window. ipad Figure 1 - All Beds Window - First time running iphone 7.2 SELECTING A PATIENT ON THE IPAD ViTrac can select up to 12 patients on the ipad. The Bed Selection window allows you to select which beds to view and which waveforms and vital signs to display. You can easily select a bed from the Available Beds list by touching the desired bed. After selecting the bed, slide the Select Bed control to ON to select the bed. The Waves and Vital Signs list allows you to filter the data and change the display order. Pulling down on the Available Beds list reveals the Search bar and Bed Filter control. Key Features: Search by Patient Name, Patient ID, Physician Name or Bed Name. Filter bed list by: All, Group or Selected. Quickly view selected patient information. Select Waves and Vital Signs you want to view and the order in which they should be displayed. Page 17
Patient Information Bed Filter Control Search Field Selected Status Select Switch Bed, Patient, Physician Name Edit Mode Restore Defaults Rearrange Display Order Display Indicator Figure 2 - Bed Selection Window User Interface Description Bed Filter Control All Shows all beds in alphanumeric order. Group Shows all beds by assigned group. Selected Shows only the beds currently selected for viewing. Search Field Performs partial or full text searching on bed name, patient name, patient ID or physician name. Patient Information Displays currently selected patient s information. Available Beds List Filtered list of available beds. Selected Status If checked, the bed is currently selected for viewing. Select Switch Turn viewing of patient s data on/off. Edit Mode Press the Edit button to change the vital sign/waveform display order. Rearrange Display Order Move the vital sign or waveform row up or down to rearrange the display order. Display Indicator Check to display and un-check to hide a vital sign/waveform. Restore Defaults Press the Default button to select all the vital signs/waveforms. After selecting which beds you want to view, press on the All Beds back button in the upper left. Page 18
7.3 SELECTING A PATIENT ON THE IPHONE ViTrac can select up to 8 patients on the iphone. The Bed Selection window allows you to select which beds to view. Tapping on a bed in the Available Beds list will toggle the bed s selected status between on and off. Pulling down on the Available Beds list reveals the Search bar and Bed Filter control. Key Features: Search by Patient Name, Patient ID, Physician Name or Bed Name. Filter bed list by: All, Group or Selected. Bed Filter Control Search Field Available Beds List Selected Status Bed, Patient, Physician Name User Interface Figure 3 - Bed Selection Window - iphone Description Bed Filter Control All Shows all beds in alphanumeric order. Group Shows all beds by assigned group. Selected Shows only the beds currently selected for viewing. Search Field Performs partial or full text searching on bed name, patient name, patient ID or physician name. Available Beds List Filtered list of available beds. Selected Status If checked, the bed is currently selected for viewing. After selecting which beds you want to view, press on the ViTrac back button in the upper left. Page 19
8 ALL BEDS WINDOW The All Beds window provides a quick overview of the beds currently selected for viewing. User Interface Description The Alarm Notification Sound icon enables or disables playing of alarm notification sounds locally. Note: No information is sent to the bedside to silence the alarm. 8.1 IPAD ALL BEDS WINDOW Bed Selection icon shows the Bed Selection window. Settings icon shows the Settings window and gives you access to the About window. On the ipad, returning back to the All Beds window shows the system trying to establish a connection with the beds. The Bed View will display the Activity Indicator and Connecting message until a successful connection is made. Figure 4 - All Beds Window - Connecting Page 20
After a connection has been established you can view the data for the selected patients. Indicates Demonstration Mode Alarm Notification Sound Icon Bed Selection Icon Settings Icon Vital Sign Scrolling Waveform Scrolling Alarm Message Figure 5 - All Beds Window Key Features: View near real-time waveform and vital sign data. Scroll through vital signs by swiping the vital sign view area up or down. Scroll through waveforms by swiping the waveform view area up or down. Tap on any part of the Bed View region to advance to the Wave Display window. View alarm notice messages with bed border color showing alarm level. Communication Loss is displayed when the bed or mobile device can no longer communicate with the Unified Gateway Server. The channel number is displayed for telemetry beds. Tap on a NIBP vital sign to display the measurement date and time. Page 21
Tap on a blood pressure vital sign to toggle its display setting between Mean and S/D(M). This setting only applies to UV, CVP, RAP, LAP, ICP, ICP2, ICP3, and ICP4. Bed Name Patient Name Telemetry Channel Number Waveform Scrolling Vital Sign Scrolling Border Color Indicates Alarm Level Vital Sign Alarm Alarm Message Figure 6 - Bed View ipad Tap BP to toggle between Mean and S/D(M) Tap NIBP to display measurement date and time Figure 7 -Bed View Vital Sign Scroll Area 8.2 IPHONE ALL BEDS WINDOW Key Features: See near real-time vital sign data. Scroll through vital signs by swiping the vital sign view area left or right. Tap on any part of the Bed View region to advance to the Wave Display window. View alarm notice messages with bed border color showing alarm level. Communication Loss will be displayed when the bed or mobile device can no longer communicate with the Unified Gateway Server. Page 22
Indicates Demonstration Mode Alarm Notification Sound Icon Bed Selection Icon Settings Icon Figure 8 - All Beds Window - iphone Bed Name Telemetry Channel Number Patient Name Border Color Indicates Alarm Level Patient ID Sticky Note Physician Name Alarm Message Vital Sign Scrolling Vital Sign Alarm Figure 9 - Bed View - iphone Page 23
9 WAVE DISPLAY WINDOW The Wave Display window displays near real-time waveforms and numeric data of one bed selected from the Selected Beds List. 9.1 IPad Wave Display Window Selected Beds List Switch Display Modes Waveform Scrolling Freeze/Unfreeze Waveforms Waveform Sensitivity or Scale Setting Waveform s Setting Icon Figure 10 Wave Display Window - Normal View Vital Sign Scrolling User Interface Description Selected Beds List Select a bed by tapping on its Bed View. Switch Display Modes Tap to switch between Normal and Full Screen View. Waveform Scrolling Scroll through waveforms by swiping the waveform view area up or down. Vital Sign Scrolling Scroll through vital signs by swiping the vital sign view area up or down. Page 24
Waveform Sensitivity or Scale Setting Freeze/Unfreeze Waveforms Select a waveform s Setting icon to display this window and modify the waveform s sensitivity or scale value. Freeze and unfreeze the waveform display. Use the Switch Display mode function to show Full Screen view of the Wave Display window. Patient Information Waveform Scrolling Freeze/Unfreeze Waveforms Waveform Sensitivity or Scale Figure 11 - Wave Display Window - Full Screen View Vital Sign Scrolling User Interface Description Patient Information Displays currently selected patient s information. Waveform Scrolling Scroll through waveforms by swiping the waveform view area up or down. Vital Sign Scrolling Scroll through vital signs by swiping the vital sign view area up or down. Page 25
Waveform Sensitivity or Scale Freeze/Unfreeze Waveforms Select a waveform s Setting icon to modify its sensitivity or scale value. Freeze and unfreeze the waveform display. Patient History Tabs View patient history data. 9.2 IPHONE WAVE DISPLAY WINDOW Tapping on a patient s Bed View on the All Beds window displays the Wave Display window. The Wave Display window shows near real-time waveforms and numeric data for the selected bed. Menu Button Settings Button Bed View Vital Sign Scrolling Waveform Scrolling User Interface Figure 12 - Wave Display Window - iphone Description Bed View Tapping on the Bed View displays the Patient Information window. Settings Button Click on Settings Button to select which waveforms and vital signs to display. Vital Sign Scrolling Scroll through vital signs by swiping the vital sign view area left or right. Waveform Scrolling Scroll through waveforms by swiping the waveform view area up or down. Menu Button Reveal menu where you can select patient history data to view, or return to All Beds window. Page 26
Menu Button Figure 13 - Menu - iphone User Interface Description Menu Button Hide menu and return to highlighted window. Home Return to All Beds window. Patient History Menu Item View patient history data. Page 27
Sticky Note Edit Field Patient Information User Interface Description Figure 14 - Patient Information Window Bed View Tapping on the Bed View displays the Patient Information window. Patient Information Displays currently selected patient s information. Sticky Note Edit Field The Sticky Note is an editable text field that is displayed in the patient s Bed View. Note: The Sticky Note is internal to ViTrac, and cannot be viewed from any other Nihon Kohden device. Done Button Click the Done button to return to the previous window. Page 28
Select Waveform Select Setting User Interface Figure 15 Wave Display Waveform Settings - Sensitivity/Scale Description Settings Button Click on Settings Button to display the Waveforms Settings window. Select Waveform Select a waveform to modify its sensitivity or scale setting. Select Setting Select the desired sensitivity or scale setting. Waveforms Back Button Click on the Waveforms Back Button to return to the Waveforms Settings window. Done Button Click the Done button to return to the previous window. Page 29
Display Indicator Rearrange Display Order User Interface Figure 16 Wave Display Waveform Settings - Edit Mode Description Settings Button Click on Settings Button to display the Waveforms Settings window. Edit Mode Press the Edit button to select waveforms. Display Indicator Check to display and un-check to hide a waveform. Rearrange Display Order Move a waveform row up or down to rearrange the display order. Restore Defaults Press the Defaults button to select all the waveforms, arrange them in default order, and reset each waveform s sensitivity or scale setting. Done Button Click the Done button to return to the previous window. Page 30
Display Indicator Rearrange Display Order Vital Signs Settings Button User Interface Figure 17 Wave Display Vital Sign Settings - Edit Mode Description Settings Button Click on Settings Button to display the Waveforms Settings window. Vital Signs Settings Button Click on Vital Signs Button to display the Vital Signs Settings Edit window. Display Indicator Check to display and un-check to hide a vital sign. Rearrange Display Order Move a vital sign row up or down to rearrange the display order. Restore Defaults Press the Defaults button to select all the vital signs, arrange them in default order, and reset each blood pressure s mean setting. Done Button Click the Done button to go to the Vital Signs BP Mean window. Page 31
Select Setting Select BP User Interface Figure 18 Wave Display Vital Signs Settings - BP Mean Description Select BP Select a blood pressure to modify its BP Mean display setting. This setting only applies to UV, CVP, RAP, LAP, ICP, ICP2, ICP3, and ICP4. Select Setting Select the desired display mode. Vital Signs Back Button Click on the Vital Signs Back Button to return to the Vital Signs Settings window. Edit Mode Press the Edit button to select vital signs. Page 32
10 TREND DATA WINDOW The Trend Data window displays tabular trend of measured parameters. Trend data is updated every one minute. Each numerical value is displayed in the parameter color. Blood pressure and temperature are displayed by their labels. Use the Slide Control on the ipad or the Slider on the iphone, or swipe left and right in the main view, to scroll through the tabular trend data by date and time. Swipe up or down in the displayed table to view more vital sign values. 10.1 IPAD TREND DATA WINDOW Slide Control Settings Icon Tabular Trend Data Figure 19 - Trend Data Window - Normal View Press the Settings Icon to change the trend data sampling interval to 1 minute, 5 minutes [default], 10 minutes, 15 minutes, 30 minutes, or 60 minutes. After selecting a new value, the Trend Data window is displayed using the new sampling interval. Page 33
Figure 20 - Trend Data Sampling Interval Popover Use the Switch Display mode function to show Full Screen view of the Trend Data window. Figure 21 - Trend Data Window - Full Screen View Page 34
10.2 IPHONE TREND DATA WINDOW Menu Button Settings Button Tabular Trend Data Slider Figure 22 - Trend Data Window iphone Double tap on the trend table to change the Sampling Interval to the next possible selection - 1 minute, 5 minutes [default], 10 minutes, 15 minutes, 30 minutes, or 60 minutes. Press the Settings Button to select which vital signs are to be displayed on the Trend Data window and in which order. Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Page 35
Display Indicator Rearrange Display Order User Interface Figure 23 - Trend Data Vital Signs Settings Description Settings Button Click on Settings Button to display the Vital Signs Settings window. Display Indicator Check to display and un-check to hide a vital sign. Rearrange Display Order Move a vital sign row up or down to rearrange the display order. Restore Defaults Press the Defaults button to select all the vital signs and arrange them in default order. Done Button Click the Done button to return to the previous window. Page 36
11 GRAPHICAL TREND WINDOW The Graphical Trend window displays trend graphs of measured parameters and arrhythmia events. Each trend graph is displayed in the parameter color. Use the Slide Control on the ipad, or swipe left and right in the trend graph, to scroll through the graphical trend data by date and time. Swipe up or down to view more trend graphs. 11.1 IPAD GRAPHICAL TREND WINDOW Slide Control Settings Icon Graphical Trend Data Cursor Data Cursor Cursor Time Figure 24 - Graphical Trend Window - Normal View A cursor is drawn in the middle of the trend graphs. As data is scrolled, the date, time and numerical values of the graphed trend data beneath the cursor are shown to the left of the graphs. Press the Settings Icon to change the trend graph display to show 60, 12 [default], 6 or 4 samples per hour. After selecting a new value, the Graphical Trend window is displayed using the new samples per hour. Page 37
Figure 25 - Graphical Trend Samples per Hour Popover Use the Switch Display mode function to show Full Screen view of the Graphical Trend window. Figure 26 - Graphical Trend Window - Full Screen View Page 38
11.2 IPHONE GRAPHICAL TREND WINDOW Menu Button Settings Button Graphical Trend Data Cursor Data Cursor Cursor Time Figure 27 - Graphical Trend Window iphone Double tap on the trend graphs to change the Time Span to the next possible selection - 60, 12 [default], 6 or 4 samples per hour. Press the Settings Button to select which vital signs are to be displayed on the Graphical Trend window and in which order. Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Page 39
Display Indicator Rearrange Display Order User Interface Figure 28 - Graphical Trend Vital Signs Settings Description Settings Button Click on Settings Button to display the Vital Signs Settings window. Display Indicator Check to display and un-check to hide a vital sign. Rearrange Display Order Move a vital sign row up or down to rearrange the display order. Restore Defaults Press the Defaults button to select all the vital signs and arrange them in default order. Done Button Click the Done button to return to the previous window. Page 40
12 FULL DISCLOSURE WINDOW The Full Disclosure window displays full disclosure waveforms. The central monitor saves full disclosure waveforms for each bed. Only the waveforms that are stored on the central monitor are available for viewing on ViTrac. Each waveform is displayed in the parameter color. You can select zoom values of 25 mm/second or 6.25 mm/second. Individual waveforms can be reordered and shown or hidden. Use the Slide Control on the ipad or the Slider on the iphone, or swipe in the main view, to scroll through the Full Disclosure data. 12.1 IPAD FULL DISCLOSURE WINDOW Slide Control Settings Icon Full Disclosure Data Waveform Sensitivity or Scale Figure 29 - Full Disclosure Window - Normal View Select a waveform s Waveform Sensitivity or Scale Setting icon to modify its sensitivity or scale value. Press the Settings Icon to change the zoom values and individual waveforms options. After selecting new values, the Full Disclosure window is updated using the new settings. Page 41
Zoom Options Edit Waves mode Display or Hide Wave Figure 30 - Full Disclosure Settings Popover Use the Switch Display mode function to show Full Screen view of the Full Disclosure window. Figure 31 - Full Disclosure Window - Full Screen View Page 42
12.2 IPHONE FULL DISCLOSURE WINDOW Menu Button Settings Button Full Disclosure Data Slider Figure 32 - Full Disclosure Window - iphone - All Waves Mode On the iphone you can toggle the Waveform Display Mode between All Waves and Single Wave by double tapping on the main view. When the Waveform Display Mode is All Waves, all the waves selected in the Waveforms Settings window are displayed on the screen. When the Waveform Display Mode is Single Wave, only the first wave selected to be displayed in the Waveforms Settings window is displayed on the screen. To modify the Zoom Mode on the iphone, pinch out to switch to Zoomed In mode which is equivalent to the ipad s 25 mm/second mode, and pinch in to change to Zoomed Out [default] mode which is equivalent to ipad s 6.25 mm/second mode. Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Page 43
Figure 33 - Full Disclosure Window - iphone - Single Wave Mode Press the Settings Button to select which waveforms are to be displayed on the Full Disclosure window and in which order. Select Setting Select Waveform Figure 34 - Full Disclosure Waveform Settings - Sensitivity/Scale Page 44
User Interface Description Settings Button Click on Settings Button to display the Waveforms Settings window. Select Waveform Select a waveform to modify its sensitivity or scale setting. Select Setting Select the desired sensitivity or scale setting. Waveforms Back Button Click on the Waveforms Back Button to return to the Waveforms Settings window. Done Button Click the Done button to return to the previous window. Display Indicator Rearrange Display Order User Interface Figure 35 - Full Disclosure Waveform Settings - Edit Mode Description Settings Button Click on Settings Button to display the Waveforms Settings window. Edit Mode Press the Edit button to select waveforms. Display Indicator Check to display and un-check to hide a waveform. Rearrange Display Order Move a waveform row up or down to rearrange the display order. Restore Defaults Press the Defaults button to select all the waveforms, arrange them in default order, and reset each waveform s sensitivity or scale setting. Page 45
Done Button Click the Done button to return to the previous window. Page 46
13 ARRHYTHMIA RECALL WINDOW The Arrhythmia Recall window displays the arrhythmia event and waveform of each arrhythmia recall file. The list of arrhythmia recall files can be scrolled and sorted by time or event. Selecting a particular arrhythmia recall file enlarges the waveform and shows arrhythmia annotations. One arrhythmia recall waveform is 8 seconds of ECG waveforms (10 seconds for some bedside monitors). An arrhythmia recall file is created so that the detected arrhythmia is displayed in the center of the recall waveform. 13.1 IPAD ARRHYTHMIA RECALL WINDOW Settings Icon Arrhythmia Recall Files List Tap for more details Expanded Arrhythmia Recall File Figure 36 - Arrhythmia Recall Window - Normal View The Arrhythmia Files List can be scrolled by swiping up or down in the area where the files are displayed. A more detailed view of the Arrhythmia File can be viewed by tapping the preview waveform. The detailed view displays the annotated arrhythmia details. Swiping left or right on the preview or expanded waveform scrolls the waveform. Arrhythmia files can be sorted by Time or Event Priority by clicking the Settings Icon. Highest to lowest priority of arrhythmia events are as follows: Asystole, V. Fib, V. Tachy, Ext. Tachy, Ext. Brady, VPC Run, V Brady, SV Tachy, Pause, Tachycardia, Bradycardia, Couplet, Early VPC, Multiform, V Rhythm, Bigeminy, Trigeminy, VPC, Irregular RR, Prolonged RR, No Pacer Pulse, Pacer Non-Capture. Page 47
Figure 37 - Arrhythmia Recall Sort Mode Popover Use the Switch Display mode function to show Full Screen view of the Arrhythmia Recall window. Figure 38 - Arrhythmia Recall Window - Full Screen View Page 48
13.2 IPHONE ARRHYTHMIA RECALL WINDOW Menu Button Settings Button Expanded Arrhythmia Recall File Arrhythmia Recall Files List Tap for more details Figure 39 - Arrhythmia Recall Window - iphone Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. On the iphone, you can sort the Arrhythmia Recall files by pressing the Time and Event buttons. The current sort mode is indicated as follows. Oldest to newest time is designated by an up arrow in the Time button. Newest to oldest time is designated by a down arrow in the Time button. Highest to lowest event priority is designated by a down arrow in the Event button. Lowest to highest event priority is designated by an up arrow in the Event button. The Arrhythmia Recall Files List is not displayed when the iphone is in landscape mode. Instead, the Arrhythmia Recall window consists only of the currently selected file s expanded waveform, annotations, arrhythmia event, ECG lead and vital sign data. When you tap on the left side of the arrhythmia waveform, the previous file is displayed (this is the arrhythmia recall file that is displayed one line up in the sorted Arrhythmia Recall Files List). When you tap on the right side of the arrhythmia waveform, the next file is displayed. Page 49
Tap to display previous file Tap to display next file Figure 40 - Arrhythmia Recall Window - Landscape Mode Press the Settings Button to filter the arrhythmia recall file list. Selected Indicator User Interface Figure 41 - Arrhythmia Recall Arrhythmias Window Description Settings Button Click on Settings Button to select which particular arrhythmia events to display on the Arrhythmia Recall window. Selected Indicator Check to select and un-check to de-select an arrhythmia event. All Button Click on All button to toggle all the arrhythmia events to be selected or de-selected. Done Button Click the Done button to return to the previous window. Page 50
14 ST RECALL WINDOW The ST Recall window displays ST Recall files. ST recall files are created at a preset interval. The ST Recall window displays date and time of file storage, heart rate, ST waveform and ST value for each lead. Use the Slide Control on the ipad or the Slider on the iphone, or swipe left and right in the main view, to scroll through the ST Recall files by date and time. Swipe up or down to view more leads. 14.1 IPAD ST RECALL WINDOW Slide Control Settings Icon ST Recall File Figure 42 - ST Recall Window - Normal View Press the Settings Icon to change the ST waveforms Sensitivity setting. After selecting a new value, the ST Recall window will be updated with the new sensitivity value. Page 51
Figure 43 - ST Recall Sensitivity Popover Use the Switch Display mode function to show Full Screen view of the ST Recall window. Figure 44 - ST Recall Window - Full Screen View Page 52
14.2 IPHONE ST RECALL WINDOW Menu Button Settings Button ST Recall File Slider Figure 45 - ST Recall Window iphone Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Selected Indicator Figure 46 - ST Recall Sensitivity Settings Window Page 53
User Interface Description Settings Button Click on Settings Button to display the ST waveforms Sensitivity Settings window. Selected Indicator Check to select and un-check to de-select a sensitivity value. Done Button Click the Done button to return to the previous window. Page 54
15 12 LEAD WINDOW The ECG 12 Lead Analysis window displays the results of ECG 12 lead analysis performed at bedside monitors. An analysis report table is available for viewing. Use the Slide Control on the ipad or the Slider on the iphone, or swipe left and right in the 12 Lead file area, to scroll through the ECG 12 Lead data by date and time. 15.1 IPAD 12 LEAD WINDOW Slide Control 12 Lead File Figure 47-12 Lead Window - Normal View Page 55
Use the Switch Display mode function to show Full Screen view of the 12 Lead window. The Analysis Reports information can only be seen in the full screen viewing mode. Analysis Reports displays the analysis results of the file whose report is currently selected (highlighted in gray). Compare Mode Analysis Reports Figure 48-12 Lead Window - Full Screen View (Analysis Reports) Full screen view of the 12 Lead window using the file compare feature. Using the Comparison file feature: Slide through the list of files and select the file that will be the Control file. The Control file will be used as the standard or reference file for the comparison. Press the Compare Mode icon. This will put the system in comparison mode and select the Control file. The Control file will be highlighted in blue. Slide through the list of files and select the file for comparison. This file is highlighted in gray. The Control file can be changed anytime by selecting a new file then pressing on the Control File Selection icon. View the display. Page 56
Compare File Control File Compare Mode Compare File Control File Selection Control File Figure 49-12 Lead Window - Full Screen View (File Compare) Page 57
15.2 IPHONE 12 LEAD WINDOW There is limited space on the iphone to display the 12 Lead file and its corresponding analysis waveforms. Swipe the 12 Lead file area up or down to view more measurement values. Swipe the Waveform Display area in any direction to view different portions of the 12 Lead file contents, including the Analysis Reports. Menu Button 12 Lead File Analysis Reports Waveform Display Slider Figure 50-12 Lead Window - iphone Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Page 58
16 HEMODYNAMICS WINDOW The hemodynamics list created on the bedside monitor can be viewed on the Hemodynamics window. Each numerical value is displayed in the parameter color. Use the Slide Control on the ipad or the Slider on the iphone, or swipe left and right in the main view, to scroll through the hemodynamics data by date and time. Swipe up or down in the displayed table to view more hemodynamics parameters. 16.1 IPAD HEMODYNAMICS WINDOW Slide Control Hemodynamics Data Figure 51 - Hemodynamics Window - Normal View Page 59
Use the Switch Display mode function to show Full Screen view of the Hemodynamics Window. Figure 52 - Hemodynamics Window - Full Screen View Page 60
16.2 IPHONE HEMODYNAMICS WINDOW Menu Button Hemodynamics Data Slider Figure 53 - Hemodynamics Window - iphone Press the Menu Button to reveal the menu where you can select patient history data to view, or return to the All Beds window. Page 61
17 WLAN TRANSPORT The ViTrac app supports the WLAN Transport function. Please reference your Central Monitor and Bedside Monitor Operator s Manuals for details. Both the host monitor and the BSM-1700 transport monitor must be displayed in the Available Beds list on the Bed Selection screen. Select to view the host monitor on ViTrac. When the WLAN Transport function is activated, ViTrac will automatically exchange the Selected host monitor with the transport monitor. Page 62
18 TROUBLESHOOTING Unable to view any beds. Bed not showing up. Numeric and waveform data are not displayed. Waveform data is sometimes interrupted or changed to a triangle waveform. Retrieving information is slow. "Communication Loss" message is displayed with a re-try button. "Communication Loss" message is displayed for all beds. Indicator does not turn green after entering manual IP address for the Unified Gateway. "You are not authorized to access the Nihon Kohden patient monitoring network. message is displayed. Check with your system administration and make sure your mobile device is properly registered. Check with your system administration and make sure your device has access to this bed. Make sure you are properly connected to the network. If the wireless connection is weak or shows low signal strength, communications between the Unified Gateway and the mobile device will take longer. Limited waveform data will be shown. Depending on the traffic of the network and performance of the central monitor, data arrival may be delayed. The bed already has reached the 4 connection limit and cannot be selected at the moment. Make sure you have a stable network connection and re-start the application. Verify that IP address was entered correctly. Verify that Unified Gateway is powered on. Verify that your ViTrac device is registered on the Unified Gateway using the correct Device ID. NOTE: The Device ID changes when you delete the ViTrac app from your mobile device, then later re-download ViTrac from Apple s App Store. Therefore, you will need to re-register the ViTrac device s new Device ID on the Unified Gateway. Page 63
19 SPECIFICATION Display ipad: Select up to 12 beds iphone/ipod: Select up to 8 beds Waveform display method: Moving trace mode Sweep speed: Approximately 25 mm/s Sound Alarm notification sounds played locally Crisis, Warning, Advisory (IEC) Review Data Trend Data Graphical Trend Full Disclosure Arrhythmia Recall ST Recall 12 Lead Hemodynamics Page 64
NKUS Lab R&D and Product Development Center 14 Bunsen Irvine, CA 92618 U.S.A. Telephone: +1 (949) 474-9207 Telefax: +1 (949) 474-8267 E-Mail: support@nklab.com www.nklab.com NIHON KOHDEN EUROPE GmbH Raiffeisenstrasse 10 61191 Rosbach, Germany Telephone: +49 (0) 60 03/8 27-0 Telefax: +49 (0) 60 03/8 27-5 99 E-Mail: info@nke.de www.nihonkohden.de NIHON KOHDEN AMERICA 15353 Barranca Parkway Irvine, CA 92618 U.S.A. Telephone: +1 (949) 580-1555 Telefax: +1 (949) 580-1550 E-Mail: info@nkusa.com www.nkusa.com Page 65