Defibrillators One year warranty. Repairs or replacements of defibrillators will be provided on site if the installation is located within 100 miles of any existing Marquette service person. In other locations, Marquette guarantees 48 hour turn-around service at the factory Ifthe customer requires a loaner forthe return-to-factory service, one will be provided at no charge except for retum shipping charges. Batteries are covered for a period of one year from the date of shipment. Resting ECG analysis One year warranty. Repairs or replacements of defective resting ECG analysis and exercise testing nd exercise testing systems will be made for a period of one year from the date systems shipment. Exceptions Resting ECG product batteries are covered for 90 days from the date of shipment. Repairs or replacements of MAC® PC resting ECG analysis systems will be provided on site ifthe installation is located within 100 miles of any existing Marquette service person. In other locations, Marquette guarantees 48 hour turn- ‘around service at the factory. If the customer requires a loaner for the return-to- factory service, one will be provided at no charge except for return shipping charges. MAC 500 and MAC 1000 have a three year warranty. A refurbished unit will be provided for next working day delivery. Defective unit must be returned to Marquette Medical Systems Service Department in Jupiter, Florida. The remaining warranty period left on original unit applies to exchange unit. Customer may choose return-to-actory 48 hour repair for warranty service in lieu of an exchange unit. Excluded from this warranty are expendable supply items such as, but not limited to, electrodes, magnetic media, leadwires, patient cables, ink, and ribbons. This warranty does not cover repairs or replacement parts, which, in the opinion of Marquette, are required as the result of abuse or misuse of the equipment, failure to ‘maintain the equipment in the manner described in any applicable instructions, use of electrodes, batteries, magnetic media, or other supplies not recommended by Marquette, or faulty devices connected to Marquette equipment. ‘THIS WARRANTY IS GIVEN BY MARQUETTE IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ANY WARRANTY AS TO MERCHANTABILITY OR FITNESS FOR ANY PARTICU- LAR PURPOSE. eee) Date Comment 25 March 1997 Initia release with company name change. 16 July 1997 ‘Added resting ECG product battery information. 16December 1997 | Included Helge resting and stress product information. 25 June 1998 Updated MUSE information, 418913-0010 Marquette Medical Systems, Inc.All rights reserved. 25 June 1998marquette Warranty Medical Systems Cardiology Products Marquette Medical Systems, Inc., hereafter referred to as Marquette, warrants to repair or replace all new Car- diology Products sold by Marquette or its authorized agents when shown to be defective in either materials or ‘workmanship. Ambulatory (Holter Retardes) ™ARS™ MUSE CV™ information system (One year warranty on ambulatory digital analysis and Series 8500 Recorders. Repair or replacement of defective recorders will be made for a period of one year from the date of shipment, provided they are returned to the factory with freight prepaid. ‘Two year warranty on SEER® XT and SEER® MC. ‘One year warranty on analog remote system support from the date of installation. One and a half year warranty on digital remote system support from the date of installation. Software PERFORMANCE WARRANTY: Marquette represents and warrants that licensed software substantially conforms to Marquette’s published specifications, and Performs substantially in accordance with the user manual fora period of ninety C PR CO SOS SC] operator’s manual Software Versions 008A,B,C; 108A,B; 009A; 109A; 010A,B,C; 110A,B,C PN 401003-032 Revision L. ‘APART OFTHE MARQUETTE eee NETWORK c marquette Medical SystemsCONTENTS INTRODUCTION Manwal Information .... Revision History Manual Purpose Chapter Content .. 1 Introduction... 2 Equipment Overview 3 Preparing the Patient 4 Taking a Resting ECG ... 5 Printing a Rhythm Strip 6 Receiving and Transmit Editing ECG Report .. 8 Printing . 9 Creating a Directoy .. 10 Deleting an ECG 11 Using the Pacemaker Option ... 12 Using the Hi-Res Option .. 13 Setup Appendices Related Manuals Conventions Safety Information eee 16 Responsibility of the Manufacturer 16 General . 16 Equipment Symbols 17 Warnings and Cautions saosee 18 ‘Service Information Service Requirements Equipment Identification FCC Requirements .-.seeseen. Type of Service Telephone Company Procedures I Problems Arise Revision L MAC 12/16 resting ECG analysis system i 401003-032EQUIPMENT OVERVIEW ... Equipment Description Overview .. Side View Keyboard Main Menu... Connectors ..... Connector identification ‘AM-4 Acquisition Module ........ Connectors Applying AM-4 Labels Preparing for Use PREPARING THE PATIENT .... Patient Preparation . OVEVIEW nn ‘Skin Preparation .. Using the 10-Wire (12-Lead) Acquisition Module Setup .. Using the 14-Wire (16-Lead) Acquisition Module Setup XYZ Setup .... ‘Auiliry Electrode Placement for XVZ Gonnection Hi-Res Recording Vectorcardiograms VBR, VAR, V7 SetUp on ‘Auiliary Electrode Placement for Pediatric Connection TAKING A RESTING ECG . Entering Patient information Patient ID Number Order Manager Patient Information Software Version 009A and 109A Pediatric ANALYSIS ron Patient Medications ‘Adding Medication MAG 12/15 resting ECG analysis system Revision L -401008-032Recording an ECG scence. Preparation. ECG Status Messages : Lead Error Messages 47 Crating Vector Loops Storing ECGS ... Diskette Error... Using the Vector Function to Record 14-Lead XYZ ECGs ... Using the Pediatric Fu PRINTING A RHYTHM STRIP ..... ‘To Print a Rhythm Strip... RECEIVING AND TRANSMITTING AN ECG .. Introduction Overview ‘Transmitting by Telephone Overview Setup Phone Number. — Setting Up Selection Parameters MUSE System Information Cart information Unconfirmed and Confirmed File Selection... Viewing Patient Data ECG Status Message: ‘Transmitting Locally Overview Setup Setting Up Selection Parameters MUSE System Information .. Cart information .. : Unconfirmed and Confirmed File Selection ECG Status Messages Receiving by Telephone Overview Setup Revision L MAC 12/15 resting ECG analysis system i -401003-032Receiving Locally (from Another Electrocardiograph) .......scsseesesseesns O21 Overview 6-21 Setup 6-21 Receiving from the MAC PC System ........sssv. - 623 Setup 6-23 Receiving from the Marquette Responder 1500 Defibrillator .. Overview + 6-25 6-25 Connecting the External Modem 6-25 Connecting Locally to the Defibrillator 6-26 LolLine Setup .. sn 6°26 MAC 12/15 System Setup .. ee 0G Status Messages 628 EDITING ECG REPORTS ‘Types of Data Reports ..... Overview Pediatric Analysis, Full Edit... Overview Setup : Entering Password... Selecting the ECG File Selecting MUSE System Information Selecting ECGs by Cart Number Viewing the Stored ECG Editing the Selected £CG Entering Reviewer Identification ‘Selecting Functions Using the Insert Function .. Insert Function Examples .. Printing . Patient Data Edit... Overview Setup Selecting the ECG to Edit Selecting MUSE System Inform Selecting ECGs by Cart Number .. Viewing the Stored ECG Editing the Selected ECG Name ID Number Date .. Time .. (MAG 12/16 resting ECG analysis system Revision L -401008-082Physician .. Location Room Number .. Age ... Height Weight Sex Race Medications. ‘Adding Medications Order Number .. Secondary ID Technician 10... Option Number Blood Pressure End of Editing Printing Report... PRINTING ... Printing All ECB. Overview Setup Selecting ECGS... Printing Selected ECGS Selecting ECGs : ‘Selecting MUSE System Information Selecting ECG by Cart Number .. Viewing the Stored ECG CREATING A DIRECTORY .. Create a Directory ........ Chapter Summary Setup... DELETING AN ECG ..... Deleting All Files ‘Setup Entering Password Selecting the ECGs to Delete ing Selected Files Revision L MAG 12/15 resting ECG analysis system v '401003-032Setup Entering Password .. Selecting the ECGs to Delete Setting Up Selecting Parameters ... MUSE System Site Numbers. MUSE System Location Cart Number . Unconfirmed or Confirmed Files Selecting File Format File Status Messages... USING THE PACEMAKER OPTION .. Local Pacemaker Option .. Overview : ‘Two Phase Acquisition .. ‘Sample Final Report .. Recording a Local Pacemaker Evaluation Local Paced Acquisition Acquiring Data .. Pacemaker Pulse Group Override Feature Printing Report ... ‘Storing ECG Data Diskette Error : Transmitting Pacemaker Evaluation... Remote Pacemaker Option . Overview... Sample Final Report .. Recording a Remote Pacemaker Evaluation Remote Pace Acquisition Acquiring Data . Printing Report Storing ECG Data Diskette Error ‘Transmitting Pacemaker Evaluation USING THE HI-RES OPTION .. Introduction .. Overview Taking a Hi-Res ECG ........ STOP Key Use Limb Electrode Placement... MAC 12/15 resting ECG analysis system Revision L 401003-032Chest Electrode Placement . ‘Auxiliary Electrode Placement Patient Information... Saving the Hi-Res ECG to Diskette Printing Hi-Res ECG Report... Selecting UsrTmp! ‘Acquiring Data for Signal Averaging Printing Reports Saving ECG Data To Diskette Diskette Erro Hi-Res Report Re-Analysis .. Selecting All Files to Reanalyze MUSE System Information ..... Cart information nn : : Unconfirmed and Confirmed File Selection... Selecting Discrete Files to Reanalyze Printing Discrete Files SETUP . How to Begin .. Overview Setup Date and Time Setup Phone Setup ....seereeseees esenseensees 195 13-7 Lead Groups Setup .. Rhythm Leads Standard Leads 138 CGR/RMR Leads 189 S1 Leads .. 1310 Setting Acquisition Module Type 1341 Report Format Setup 1312 Description .. BAZ 19-14 Report Format Setup ... 13-16 13417 sesseee 1948 Local Line Setup ...... Revision L MAG 12/15 resting ECG analysis eyster vil 40103-0382Miscellaneous Setup... 13-49 13-28 Defaults Setup ........ Hi-Res Setup .. APPENDIX A ABBREVIATIONS Abbreviations in Manual ..... APPENDIX B MAINTENANCE ... Introduction .. Recommended Maintenance Maintenance/Repait Log Inspection and Cleaning Visual Inspection Precautions .. Cleaning Reusable Electrodes Replacing Paper .. Storing Paper ‘Thermal Paper .... Archivist Thermal Paper ‘Acquisition Modules ANG, Al quisition Modules Replacing Leadwires .. AN-4 Acquistion Module Replacing Leadwires Replacing Leadwire Adapters Diskette Care Maintenance/Repair Log ........ APPENDIX C TROUBLESHOOTING.. Visual Inspection Equipment Problems Modem Setup vil MAC 12/15 resting ECG analysis system Revision 401003-032.Leadwire Problems Lead Error Condition Improving Signal Quality AN-4 Signal Quality. High Resolution Signal Quality . System Error Messages APPENDIX D SAMPLE REPORTS .. {Introduction ....... Overview 81 Report Format 2 Report Format of 2 .. ‘$2 Report Format 2 of ......... Times 1 Complex Report Format (with Tic Marks) Times 2 Complex Report Format (with Tic Marks) One Page 4 x 2.5 Report Format One Page 4 x2.5 with 1 Rhythm Channel Report Format One Page 4 x2.5 with 3 Rhythm Channels Report Format .. ‘Computer Graphic Record (CGR) Report Format ........ Rhythm and Morphology (RMR) Report Format ......... 4x10 Report Format 1 of 4 4x10 Report Format 2 of 4 4x10 Report Format 3 of 4 4x10 Report Format 4 of 4 ‘Automatic Rhythm (1 x 10) Report Format .. Pediatric Report Format . 2x10 Report Format 1 of 2 .... 2x10 Report Format 2 of 2 12 Lead Rhythm Report Format .. Revision L MAC 12/16 resting ECG analysis system ix 401003-0322x8 Report Format .. Vector Loops Report Format .. Pacemaker Evaluation Final Report 1 of 2 .. Pacemaker Evaluation Final Report 2 of 2 .. Hi-Res Template Report Periodic Average Plots .. Hi-Res Final Report (40-250 Hz Filter ... Hit jes Re-Analysis Report (40-250 Hz Filter)... Expanded Report (40-250 Hz Filter)... ‘Mid-ORS Analysis Report (150-250 Hz Fitter) .. APPENDIX E MISCELLANEOUS TASKS ... Inserting and Removing Diskettes ‘Applying Write Protection to a Diskett Formatting a Diskette Using the Order Manager Function What is Order Manager Receiving Orders by Direct Connection Recording ECGs Using the Order Manager How to Delete Orders. Receiving a Holter Transmission ... ‘Sending ECG Data to an Oscilloscope Oscilloscope .. Special Use Functions .. APPENDIX F 12SL ANALYSIS PROGRAM LIBRARY... F-1 ‘12SL Analysis Program Library APPENDIX G GLOSSARY. INDEX .. MAG 12/15 resting ECG analysis system Revision L -401003-032INTRODUCTION Manual Information Revision History. Manual Purpose . Chapter Content... 1 Introduction 2 Equipment Overview 3 Preparing the Patient 4 Taking a Resting ECG 5 Printing @ Rhythm Strip 6 Receiving and Transmitting ECG Editing ECG Reports . 8 Printing 9 Creating a Directory 10 Deleting an ECS. 11 Using the Pacemaker Option .. 12 Using the Hi-Res Option 13 Setup, Appendices. Related Manual Conventions tety Information Responsibility of the Manufacturer Genel ns Equipment Symbols Warnings and Caution Service Information Service Requirements Equipment Identification FCC Requirements... Type of Service .. Telephone Company If Problems Aris. Revision L MAC 12/16 resting ECG analysis system ra 40109-0932INTRODUCTION: Manual information Cc Manual Information Revision History —£chpage of the document has the document part number followed by LSM ORO ened Revision Date Comment a revision letter at the bottom of the page. The latest letter of the alphabet corresponds to the most current revision of the document. The revision history of this document is summarized in the table below. December 26, 1997 January 8, 1992 January 28, 1992 February 13, 1992 May 14, 1998 mooe> F | June 1, 1993, G | June 41, 1993 C H | October 29, 1993, ‘August 7, 1995 K | October 29, 1997 | October 2, 1998 This release updates the MAC 12/15 cardiograph to 008/108 software. This release corrects use of AM-4 acquisition module with MAG 12/15 cardiograph. This release updates the Hi-Res chapter to include the AM-4 acquisition module, This release updates the MAC 12/16/ to 008B and 1088 software. Note was added about grey-based leadwire plug causing incorrect data during pediatric and vector loops ECGs. Also, minor editing changes were made. This release adds receiving 12-lead ECG data from the Marquette Responder 1500 Defibrillator. Correction to document—added the software revision 0O8C to the T-2 page and to revision history. ‘This document changed due to the installation of the new 8-inch CSCAN writer, ‘Therefore, instructions were added for changing the paper. This release adds software versions 009A and 109A. This release adds software versions 010A and 110A to: ‘= Support the year 2000 Define the MUSE location identification numbers in Miscellaneous Setup. 1 Add te abit to enter, csplay and print a4-dgt yar This release also prepares this manual for CD-ROM distribution. This release adds software version 0108, C and 110B, C enhancements. Manual Purpose — Thismanual contains the instructions necessary to operate the equipment safely in accordance with its function and intended use. These instructions include but are not limited to: m= anexplanation of the function of controls and indicators, the sequence of operation, m= connection and disconnection of detachable parts and accessories, and instructions for operator cleaning, preventive inspection and maintenance. Where necessary the manual identifies additional sources of relevant information and/or technical assistance. Revision L MAC 12/15 resting ECG analysis system 13 401003-082INTRODUCTION: Manual Information Chapter Content 1 Introduction 2 Equipment Overview 3 Preparing the Patient 4 Taking a Resting ECG 5 Printing a Rhythm Strip 6 Receiving and Transmitting ECG 7 Editing ECG Reports 8 Printing 9 Creating a Directory 10 Deleting an ECG 11 Using the Pacemaker Option 12 Using the Hi-Res Option 13 Setup Appendices Related Manuals Part Number -402539-001 401003-004 -4001003-033 (000-90160-010 402832-001 TREO ees MAC 12/15 resting ECG analysis system Quick Reference MAG 12/15 resting ECG analysis system Transmitting Guide MAG 12/15 resting ECG analysis system Hi-Res Quick Reference Physicians Guide to Marquette Electronic's Resting ECG Analysis Physicians Guide to MAG 12/15 Options: High Res., Pacemaker Analysis, and Vector Display ‘This manual is organized into the following chapters: Describes the manual contents and provides general information about safety precautions and service requirements. Describes how to connect the system to a power outlet and the acquisition module. Describes how to prepare the skin and locates chest and limb electrode positions. Describes the steps necessary to take a patient's resting ECG and to store the ECG data on a diskette. Describes the steps necessary to print a patient's rhythm strip. Describes how to receive and transmit by telephone, locally or via the RS232 connector. Describes how to change information on a patient's ECG report stored ona diskette. Describes how to print a patient's ECG that has been stored on a diskette. Describes how to review all of the stored ECGs. You can also view a summary of how much memory is available. Describes how to erase one or more patient files from diskette. Describes how to use the Pacemaker option that permits local or remote evaluation of either single or dual chamber pacemakers using standard surface electrodes and a special “Pace” acquisition module. Hi-Res isa system option which analyzes high-frequency low-amplitude (HFLA) ECG information using a special “Hi-Res” acquisition module. Describes various setup options on your system, such as the date and time, types of reports, etc. Includes abbreviations, basic maintenance information, steps for troubleshooting malfunctions, sample report formats, and a glossary. See these documents for additional information. 1-4 MAC 12/16 resting EOG analysis system Revision L 401003-032. -) 45INTRODUCTION: Manual Information Conventions — These are the conventions used in this manual. Safety Messages DANGER safety messages indicate an imminently hazardous situation which, ifnot avoided, WILL result in death or serious injury. WARNING safety messages indicate a potentially hazardous situation which, ifnot avoided, COULD result in death or serious injury. CAUTION safety messages indicate a potentially hazardous situation which, ifnot avoided may result in minor or moderate injury. NOTE messages provide additional user information. Definitions = Items shown in Black text are keys on the keyboard, text to be entered, or hardware items such as buttons or switches on the equipment. m= Items shown in Italicized text are software terms which identify ‘menu items, buttons, or options in various windows. = Toperform an operation which appears with a plus (+)sign between the names of two keys, you press and hold the first key while pressing the second key once. This is called a keystroke combination. For example, “Press Ctrl+Ese” means to press and hold down the Ctrl key while pressing the Ese key. m1 When instructions are given for typing a precise text string with ‘one or more spaces, the point where the spacebar must be pressed is indicated as: . The purpose of the <> brackets is to ensure you press the spacebar when required. = Enter means to press the “Enter” or “Return” key on the keyboard. Do not type “enter.” Revision L MAC 12/15 resting ECG analysis system 15 401003-032INTRODUCTION: Safety Information Safety Information Responsibility of the Manufacturer General Marquette Medical Systems is responsible for the effects of safety, reliability, and performance only if: ‘Assembly operations, extensions, readjustments, modifications, or repairs are carried out by persons authorized by Marquette. = The electrical installation of the relevant room complies with the requirements of the appropriate regulations. = The equipments used in accordance with the instructions for use, ‘When connected to a Marquette acquisition module this equipment is protected against the effects of cardiac defibrillator discharge to ensure Tecovery, as required by test standards. This equipment will not cause abnormal operation of a patient's cardiac pacemaker or other electrical stimulator. This device uses a computerized ECG analysis program which can be used as a tool in ECG tracing interpretation. This computerized interpretation is only significant when used in conjunction with clinical findings. All computer-generated tracings should be overread bya qualified physician. To ensure patient safety, use only parts and accessories manufactured or recommended by Marquette Medical Systems, Inc. Contact Marquette Medical Systems for information before connecting any devices to this equipment that are not mentioned in this manual. ‘The intended uses of this device is to record electrocardiograms, vectorcardiograms and signal-averaged electrocardiograms from surface ECG electrodes, not for positioning (“floating”) temporary pacemaker leadwires, performing pericardiocentesis, or other internal applications. ‘This device is intended for use under the direct supervision of a licensed health care practitioner. 16 MAG 12/15 resting ECG analysis system Revision L -401003-032INTRODUCTION: Safety Information Equipment Symbols 6 ‘quip! yt AC AUX The following symbols appear on the equipment. ACAUTION © To reduce the risk of electric shock, do NOT remove cover (or back). Refer servicing to qualified personnel. ‘Type B equipment. Type B equipment is suitable for intentional external and internal application tothe patient, excluding direct conductive connection tothe patient's heart. ‘Type BF equipment. Type BF equipment is suitable for intentional external and internal application tothe patient, excluding direct conductive connection to the patient's heart. Type BF equipment has an F-type isolated applied part. The paddles indicate that the equipment is defibrillator proof. ‘When this symbol appears on a leadwire, i indicates that the leadwire is resistive, Mains power switch on the Power Module-3 (PM-3). The “I” is the on position and the “O" is the off position ofthis switch. Indicates alternating current. ‘This equipment complies with part 68 FCC rules. The FCC registration number is ‘AM995H-67836-DT-E and the ringer equivalence is 1.38. This symbol means that you must pay attention to the documents delivered with this, equipment. It calls attention to the things to which you must pay special attention during operation and when the equipment is operated in conjunction with other equipment. This is the acquisition module connector. ‘The auxiliary connector. Ths is the auxiliary connector which is used in “local” transmissions. The amount of voltage that can be applied to this connector without damaging the equipment is 0 volts. woen.45.67.48 Revision L MAG 12/16 resting EOG analysis system 17 401003-032INTRODUCTION: Safety Information Warnings and Cautions Do NOT use in the Presence of flammable anesthetics. AWARNING lf, Replace only with the same type and rating of fuse. AAWARNING ~_@ Do NOT contact unit or patient during defibrillation. AAWARNING This device is intended for use under the direct supervision of a licensed health care practitioner. ACAUTION Federal law restricts this device to sale by or on the order of a physician. 8 MAG 12/15 resting ECG analysis system Revision ‘01009-082Cc Service Information INTRODUCTION: Service Information Service Requirements Refer equipment servicing to Marquette Medical Systems’ authorized service personnel only. Any unauthorized attempt to repair equipment ‘under warranty voids that warranty. Itis the user's responsibility to report the need for service to Marquette Medical Systems or to one of their authorized agents. Failure on the part of the responsible individual, hospital, or institution using this equipment to implementa satisfactory maintenance schedule may cause undue equipment failure and possible health hazards. Regular maintenance, irrespective of usage, is essential to ensure that the MAC 12/15 resting ECG analysis system will always be functional when required. ‘Technical specifications describing the equipment can be found in the “MAC 15 resting ECG analysis system field service manual,”PN 401003- 02. Every Marquette Medical Systems device has a unique serial number for identification. The serial number appears on the product label on the base of each unit. Ta ao Dexnesisrxx —j——C (ag eo worse Table 1-3. Equipment Identifications tem Nam Description ‘A [name of device MAC 12/15 resting ECG analysis system B | manufacturer Marquette Medical Systems, Inc. C | serial number Unique identifier D | device characteristics One or two letters that further describe the unit, for example: P = prototype not conforming to marketing specification; R= refurbished equipment; S = special product documented under Specials part numbers; U = upgraded unit | division = Cardiology G=Monitoring J = GW Labs F | product sequence number | Manufacturing number (of total units manufactured) G | product code Two-character product descriptor LO = MAC 12 system, LB = MAC 15 system e 1H | year manufactured 1995, 6 = 1996, (and so on) | | month manufactured ebruary, C = March, D wgust, J = September, K = October, L = November, Revision L MAC 12/15 resting ECG analysis system 138 -401003-032INTRODUCTION: FCC Requirements FCC Requirements Type of Service Telephone Company Procedures If Problems Arise Your system is designed to be used on standard device telephone lines. Connection to telephone company-provided coin service (central office implemented systems) is prohibited. Connection to party lines service is, subject to State tariffs. ‘The goal of the telephone company is to provide you the best service it can. In order to do this, it may occasionally be necessary for them to make changes in their equipment, operations, or procedures. If these changes might affect your service or the operation of your equipment, the telephone company will give you notice, in writing, to allow you to make any changes necessary to maintain uninterrupted service. Ifyou have any questions about your telephone line, such as how many pieces of equipment you can connect to it, the telephone company will, provide this information upon request. In certain circumstances, it may be necessary for the telephone company to request information from you concerning the equipment which you have connected to your telephone line. Upon request of the telephone company, provide the FCC registration number and the ringer equivalence number (REN) of the equipment which is connected to your line; both of these items are listed on the equipment label found at the back of the system. The sum of all of the RENS on your telephone lines should be less than five in order to assure proper service from the telephone company. In some cases, a sum of five may not be usable ona given line. Ifany of your telephone equipment is not operating properly, you should immediately remove it from your telephone line, as it may cause harm to the telephone network. Ifthe telephone company notes a problem, they may temporarily discontinue service. When practical, they will notify you in advance of this disconnection. If advance notice is. not feasible, you will be notified as soon as possible. When you are notified, you will be given the opportunity to correct the problem and informed of your right to file a complaint with the FCC. NOTE This equipment complies with part 68 FCC rules. The FCC registration number is ‘AMQ95H-67836-DT-E and the ringer ‘equivalence is 1.38. 1-10 (MAC 12/15 resting ECG analysis system Rovision L 40103-0322.MAC 12/15 resting ECG analysis system EQUIPMENT OVERVIEW Equipment Description Overview Side View Keyboard Main Menu. Connectors .. Connector Identification .... ‘AM-4 Acquisition Modu Connectors Applying AM-4 Labels Preparing for Use ... 21 -401003-032EQUIPMENT OVERVIEW: Equipment Description Cc Equipment Description Overview This system represents the latest and most sophisticated technology in electrocardiography. This instrument performs rapid, accurate analysis of both morphology and rhythm on a patient's 12-lead ECG. The system also stores and/or transmits these analyses and waveforms to central processors via telephone, cellular telephone, or satellite. ‘The system contains a complete computer system which will rapidly perform the well-accepted 12SL analysis program, developed and continually critiqued by over 20 of the world’s best known electrocardiographers. Updates of the program, as well as additional features, are distributed to each user from time to time via a small software module. ‘The system produces ultra-high fidelity, paper records in many formats to meet your electrocardiography needs. The direct digital writer is capable of transcribing up to 15 simultaneous leads at many paper speeds. The acquisition module acquires, amplifies, and digitizes the patient's signals and is connected to the system with a telephone-type cord. Revision L MAC 12/15 resting ECG analysis system 23 '401003-032.EQUIPMENT OVERVIEW: Equipment Description Side View ttem Description ‘A | storage areas Use for supplies, paper, diskettes. paper release button | Move to release the paper door. | thermal paper Holds thermal paper for printing reports. compartment D_ | keyboards Use keys to enter information, acquire ECGs, startistop printing, etc. (See following page for ‘more information.) E | ciskette drive slot | Insert floppy diskettes her F | brake Apply brake to stabilize drive. ‘= Step on lever to set or release brake. | acquisition module | Connect acquisition module here. ‘connector H_ | AM-4 acquisition | Store the AM-4 acquisition module here. module holder | | power cord holder | Store the mains power cord here. + 24 MAG 12/15 resting ECG analysis system Revision L -401003-032EQUIPMENT OVERVIEW: Equipment Description > Keyboard A |B g ee i. a a Ieee > Af 1 7 HL OG F E sree 38 tion Item Name | Description a | LoD | Displays information, characters typed in, etc. B | function keys | Select a LOD function that is directly above the key. C_ | DELETE key Erases previous character on LOD. em | | ENTER key | Sends information to memory after typing in response to an LCD prompt. € | DOWN/UP ARROWS «= Lightens or darkens LCD contrast when pressed with the SHIFT key. keys | Press the UP ARROW to return the LCD to the previous display, it any. F | SPACE BAR key | Press this key to create a space onthe LCD. G | LEFTIRIGHT ARROW |» Prass the LEFT ARROW key to move the LCD cursor left keys |= Press the RIGHT ARROW key to move the LCD cursor right. H | SHIFT key = Types uppercase (shifted) character. 1 Accesses special functions when pressed with another key. || RECORD ECG key Press this key to acquire an ECG from a patient, Press to print @3-,6-, 12, andlor 15-lead | report. Display the Main Menu before you record an ECG. J | RECORD RHYTHM key | Prints either a 3-,6-, or 12-lead report depending on cart setup. Display the Main Menu before you record a rhythm repor. STOP key Quits the function you are using, stops printing, and returns to the Main Memu. FB and SHIFT key Press both keys at the same to print a rhythm Recall report. This report consists of 10 seconds of -lead ECG rhythm data. Display ether of the Main Menu displays before you | press both keys ~ Rovision L MAC 12/16 resting ECG analysis system 25 401003-032EQUIPMENT OVERVIEW: Equipment Description Main Menu The Main Menuis the starting point for most of the functions of the system and its features are described below. If the Main Menuis not displayed, press the STOP key. 8 Trask viellws Patinfo Rhythm 25mq/s —10nm/mV More eS Fitter PaceGain Bad Lead 100H2 Nort Flatline More . ce Ves Elks J 1 # Deed Description com> Patient information rhythm leads default More writer gain writer speed rhythm leads bad lead pace gain writer fiter Press to enter patient information (patient name, age, etc.) ‘The default or startup Automatic Rhythm leads are shown here. Press to advance to the second display ofthe Main Menu or return tothe first display. Press to change the writer gain - either 2.5, 5, 10, or 20 mn/mY. ‘= Adjusting the gain only affects the output traces. 1 Data for the interpretive option program (12SL) are measured at the 1 Omm/mV setting. 1 Also a “split calibration” of 10/5 mnvm may also be selected which sets the limb leads at 10 mnvmV and the chest and auxiliary leads at § mmvmV. A split calibration, like the following, will appear on writer reports. orm9 Press to change the writer speed - either 1, 5, 25, or 50 mm/s. (1 and 5 mm/s apply only to rhythm reports.) Press to change rhythm leads - either Automatic Rhythm, Group 1, Group 2, Group 3, or Group 4. Press to enable or disable the Bad Lead feature. Selecting FlatLine will resut ina flat line report ian override ofan "XX Disconnected" lead error message occurred during data acquisition. Selecting Use will print a report f raw data and no lead error messages willbe displayed ‘during data acquisition. The ability to print a report of raw data without having to override any lead error message is only possible when an AM-3 or AM-4 is used for data acquisition. Press to enable or disable the PaceGain feature. Selecting Enhance will enable PaceGain. Selecting Normal will disable PaceGain. (When PaceGain is enabled, the pacemaker spike on ECG reports is enhanced, thus making it more obvious. PaceGain will only function when an ‘AN-3 or AM-4 is being used for data acquisition.) Press to change the writer filter (ether 40 Hz or 100 H2).. ime cHEsT 26 MAG 12/15 resting ECG analysis system Revision L 401003-032 a“C Connectors EQUIPMENT OVERVIEW: Connectors Connector Identification AWARNING AAWARNING ~ 2 ~_e Keep leakage current Total system leakage within acceptable limits current must not — ieaecoe 100) auxiliary equipment to microamperes. this device. B «VJ |g a a jfeeia %& — ee coe EL Location | item | Connector Name Description ES ‘A | acquisition module | Connect the acquisition module cable here. ge B | auxiliary Connect the local transfer cable here to transmit data “locally”. C | telephone Connect the telephone cable from a telephone wall outlet here to transmit data via =B ‘modem. The modem is an option. 2E |p | analog output | Useto connec the system to an oscilloscope to monitor waveforms. Ths is an option NOTE ‘The amount of voltage that can be applied to the connector AUX and A/O without damaging the equipment is 0 volts. Rovsion L MAG 12/15 resting ECG analysis systom 27 401003-032.EQUIPMENT OVERVIEW: AM-4 Acquisition Module AM-4 Acquisition Module ‘There are no controls or indicators on the AM-4 acquisition module. ‘You can use this acquisition module with a variety of Marquette Medical Systems’ host equipment. Connectors lead (or 14-wire) capabil AAWARNING To ensure defibrillator protection and protection against high-frequency burns, use only the AM-2, AM-3 or AM-4 with this. ‘equipment. Otherwise, serious injury could result. Even though the AM-2, AM-3, and AM-4 acquisition modules have 16- ies, you can only use the 12-lead (or 10-wire) capabilities on the system for resting ECG analysis. You can use the additional leads for pediatric, vector loops, and late potentials. (See chapter 3, “Preparing the Patient.”) oes ie tem Name Description ‘A | leadwires ‘Attach to electrodes. B__ acquisition module | Connects the acquisition module to the cable electrocardiograph. 28 MAG 12/15 resting ECG analysis system -401003-032 Revision L ~EQUIPMENT OVERVIEW: AM-4 Acquisition Module Applying AM-4 Labels Foryour convenience, 1 of 6 different labels may be placed on the acquisition module. r ~ GEESE OES) (elle eslesiesel el Tu tesieseal ui) = GCC | =z ERon {RC labels rtematonal) ANA bel (Engin engugs) ewe tem Description a 8 c B. c Resting ECG label Hi-Res ECG label Pediatric ECG label Revision L MAC 12/15 resting ECG analysis system 29 -401003-032EQUIPMENT OVERVIEW: Preparing for Use. Preparing for Use 7+ Use this 6 step procedure to prepare the system for use. 1, Make sure that the mains power switch is in the off or “O” position. 210 (MAG 12/15 resting ECG analysis system Revision L 401003-032EQUIPMENT OVERVIEW: Preparing for Use 3. Connect the other end of the power cord to an appropriate, grounded power outlet. AAWARNING ~—! This is Class 1 equipment. The mains plug must be connected to an appropriate power supply. NOTE If the system is not connected to a power outlet for an extended period of time, all setup information be lost. To prevent this, at least once a week connect the system to an appropriate wall outlet, turn the unit on, and leave it on overnight. 4, Tum on the power to the system by pressing the “I” part of the mains power switch. Revision L MAG 12/15 resting ECG analysis system aati -401003-032EQUIPMENT OVERVIEW: Preparing for Use 5, The system does a short self test and displays similar to the following appear. | ‘Software version that the system is using Pon 008K Self Test 12 THEN ‘The “512K” represents the amount of memory available in the unit, 512 kilobytes in this case. ‘After the self test, one of the following two displays will appear. Task ViFliWs Patinfo Rhythm25mn/s10mn/mV More oR fost recent €cG NOT saved on diskette Press Fl to acknowledge ‘The second display will appear after a power loss or in cases ) where the integrity of the ECG data cannot be verified. To continue, press the FI key. 6. Connect the telephone-type connector of the acquisition. module to the connector on the front of the system. ~< a2 (MAG 12/15 resting ECG analysis system Revision L 401003-032PREPARING THE PATIENT Patient Preparation ....... Overview ... ‘Skin Preparation Using the 10-Wire (12-Lead) Acquisition Module Setup Standard 12-Lead Electrode Placement. Using the 14-Wire (16-Lead) Acquisition Module Setup : XYZ Setup ‘Auxiliary Electrode Placement for XYZ Connection Hi-Res Recording Vectorcardiogram: VBR, VAR, V7 Setup .. - ‘Auxiliary Electrode Placement for Pediatric Connection Revision L MAC 12/15 resting ECG analysis system at 401003-032PREPARING THE PATIENT: Patient Preparation Cc Patient Preparation Overview Thedifferences between the 12-lead and 16-lead acquisition modules are shown below. wit v2 vam Patient ‘8VR (or mVR) eave Diskette storage (and transmission) vit wh Taz wh fees C Severn eco a ‘wer pore Patient soate macs =| (ndtranomtosn) woos a. Revision L MAG 12/95 resting ECG analysis eysiem 33 -401008-032PREPARING THE PATIENT: Skin Preparation Skin Preparation Use this 6 step procedure to insure good quality ECG data. a Shave any hair from each electrode site. This improves conductivity, helps hold the electrode to the skin, and makes the removal of the electrode easier. Rub each electrode site thoroughly with alcohol. This removes oil from the skin. Mark each electrode site with a felt tip pen. This provides an ‘easy way to determine when the epidermis has been sufficiently abraded. Use an abrasive pad to remove the epidermal skin layer at each electrode site. The epidermal skin layer has been removed when the mark left from the felt tip pen has been erased. Place an electrode on each prepared site. Ifpossible, use a skin preparation analyzer to test each electrode site, AWARNING Keep the conductive ~ax$, parts of lead electrodes and associated parts away from other conductive parts, including earth. (MAC 12/15 resting ECG analysis system Revision L -401003-032 7PREPARING THE PATIENT: Using the 10-Wire (12-Lead) Acauisition Module C Using the 10-Wire (12-Lead) Acqui in Module Setup When using the 12-Iead acquisition module with the system, follow these steps. AAWARNING Keep the conductive a=, parts of lead electrodes and associated parts away from other conductive parts, including earth. AWARNING ‘To ensure defibrillator protection and protection against high-frequency burns, use only the AM-1, AM-2, AM-3 or AM-4 with this equipment. Otherwise, serious injury could result. @ 1, Set 10 Wirein the AM Type section of the Lead Grps menu. (See “Lead Groups Setup" in chapter 13, “Setup”,) 2, Prepare the limb and precordial electrodes. NOTE To avoid interference with adjoining electrodes, rub chest electrode sites with an up and down motion, rather than from side to side. Revision L MAG 12/15 resting ECG analysis systern 35 '401003-032PREPARING THE PATIENT: Using the 10-Wire (12-Lead) Acquisition Module Standard 12-Lead Electrode Placement Peet cacy Fourth intercostal space atthe right border of the sternum. Fourth intercostal space atthe left border of the sternum. Midway between locations V2 and V4. ‘At the mid-clavicular line inthe fifth intercostal space. ‘At the anterior axillary line on the same horizontal level as V4. ‘Atte mid-axlary line on the same horizontal level as V4 and VS. RAand LA | Traditionally placed anywhere on the arm. Alternate placement to reduce muscle artifact is midway between the elbow and the shoulder. ‘Traditionally placed a few inches above the ankle. Alternate placement to reduce muscle artifact is on the upper leg as close to the torso as possible. NOTE Do not pull or jerk tangled leadwires. To untangle, disconnect leadwires from electrodes. 36 (MAC 12/15 resting ECG analysis system Revision L -401003-032.PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module Cc Using the 14-Wire (16-Lead) Acquisition Module ‘When using the 16-lead acquisition module with the system, follow these steps. Setup 1. Set 14 Wirein the AM Type section of the Lead Grps menu. (See “Lead Groups Setup” in chapter 13, "Setup”.) ‘¢ The system allows you to select additional lead groups defined as Al, A2, A3, and A4. When selected, the lead group is defined as the difference between the electrode site and (RAFAL+LL/3. 2. Prepare the electrodes. NOTE To avoid interference with _adioining electrodes, rub chest electrode sites with an up and down motion, rather than from side to side. 3. Connect the electrodes to the patient. Gc NOTE Do not pull or jerk tangled leadwires. To untangle, disconnect leadwires from electrodes. Revision L (MAG 12/15 resting ECG analysis system 37 -401003-032PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module XYZ Setup Toobtainxvz, set the Al through Ad leads to XYZ. a) 1. Use the AM Type function by returning to the Main Menu. 2. Press the SHIFT key and FI key at the same time to display the System Functions menu. 3. Select Setup. Password: 4, Entera Level 1 password. (The default password is “L1”.) Cart Setup loat/Tim Phone Ld Grps Reports More 5. Select Ld Grps. Lead Groups Rhythm Standrd CGR/RMR_S1_AM Type 6. Select AM Type. (an Type: UO Wire 14 Wire 7. Select 14 Wire. Get Al-A4 leads as: unused AL-Ad XYZ _V3R,V4R,V7 8. Select XYZ. NOTE Do NOT use the auxiliary lead group mode (A1, A2, A3, A4, or V3R, V4R, V7) for XYZ. If you do, the resulting ECG data may be inaccurate and may cause misinterpretation, 9, Inthe final prompt, decide whether or not the XYZ leads will be stored. 38 (MAG 12/15 resting ECG analysis system Revision L -401003-032PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module Auxiliary Electrode — Connect the auxiliary leadwires (A1 through A4) to the patientas shown Placement for XYZ Connection Hi-Res Recording Vectorcardiograms the figures below. eek RL + Fas) euzyveve Anterior Posterior NL moro 20 eee) Leadwire Position va ‘At the mid-clavicular line in the fifth intercostal space. v6 ‘At the left mid-axillary line on the same horizontal level as V4. HIAt) Back of neck, avoid carotid artery and jugular vein. &(A2) ‘Mid-sternum on the same horizontal level as V4 and V6. (a3) At the right mid-axllary line on the same horizontal level as V4 and V6. (Ad) Center of spine on the same horizontal level as V4 and V6, For Hi-Res recording, position the limb leads as follows. Leadwire Posi RAand LA | Right and left arm just below the clavicle. RLand LL | Right and left leg on the lower abdominal quadrant. Table 3-3. Hi-Res Recording Electrode Placement For vectorcardiograms, position the limb leads according to the standard 12-lead placement. Revision L MAC 12/15 resting ECG analysis system 401003-032PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module V3R, V4R, V7 Setup Toobtain VaR, var, and V7, set the Al through A4 leads to VSR, VAR, and wi. > 1. Use the AM Type function by returning to the Main Menu. 2, Press the SHIFT key and F1 key at the same time to display the System Functions menu. 3. Select Setup. Password: 4, Entera Level 1 password. (The default password is “L1”,) Cart Setup lbat/Tim Phone Ld Grps Reports Nore 5. Select Ld Grps. Lead Groups ghythm Standrd CGR/RMR_S1_AM Type 6. Select AM Type. (an Type: U0 Wire 14 Mire + 7. Select 14 Wire. Get Al-A4 leads as: mused _AL-Ad__XYZ_V3R,V4R.V7 8. Select V3R,VAR,V7. NOTE Do NOT use the auxiliary lead group mode (A1, A2, A3, A4, or V3R, VAR, V7) for XYZ. If you do, the resulting ECG data may be inaccurate and may cause misinterpretation. 9. Additional prompts, ask you to decide which leads - V3R, VAR, and/or V7 - will be used, and whether or not these leads will be stored. 310 MAC 12/15 resting ECG analysis system Revision L -401003-032.PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module ili Connect the auxiliary leadwires (Al through A4) to the patient as shown, Aux lary Electrode in the figures below. Place the limb (LA, LL, RA, RL) and chest (V1 Placement for Pediatric through V6) teadwires, according to the standard 12-lead electrode Connection Placement. Anterior Posterior woID90K 0 Table 3-4. Pediatric Electrode Placement Position Halfway between V1 and VAR. ‘At the mid-clavioular line in the fifth right intercostal space. ‘tthe same horizontal level of V4 in the posterior axilary line, Revision L MAG 12/15 resting ECG analysis system ant 401003-032PREPARING THE PATIENT: Using the 14-Wire (16-Lead) Acquisition Module 2 MAG 12/15 resting ECG analysis system -401003-032TAKING A RESTING ECG Entering Patient Informs Patient ID Number... Order Manager Patient Informatio Software Version OO9A and 109A Pediatric Analysis Patient Medications ‘Adding Medications. Recording an ECG ee Preparation EG Status Messages Lead Error Messages ... Printing Vector Loops Storing E0Gs Diskette Eror Using the Vector Function to Record 14-Lead XYZ ECGs .... Using the Pediatric Function ......scssseesseees MAG 12/16 resting ECG analysis system at 401003-032TAKING A RESTING ECG: Entering Patient Information Cc Entering Patient Information Patient ID Number Helpful Hint Before you begin entering patient Information there are a few ‘special keys you should be familiar with. See “Keyboard Description” in chapter 2, “Equipment Overview.” Order Manager Patient Information Itis NOT necessary to enter any of the following information in order to take a resting ECG unless the unit has been set up to require a patient ID before recording a 12-lead ECG. Ifthe patient ID is not required, you can record an ECG at any time ~ if the Main Menuis displayed — by pressing the RECORD ECG key. Ifthe unit does not require the patient's ID number, the patient can be identified by the date and time the ECG was taken. However, if the ECG is transmitted to a MUSE system it will be very difficult to keep track of it without a patient identification number. Instead of entering patient information via the keyboard each time you record an ECG, you can use the order manager to transfer sets of patient information — called “orders” — from the Marquette Order Manager computer to the MAC 12/15 system. (See appendix E, “Using the Order Manager Function.”) You can select a Longor Shortlist of patient information items under Miscin Cart Setup. (See chapter 13, “Setup.”) 1. Ifthe Main Menuis not already displayed, press the STOP key. Task VIFITV5 Patinfo Rhythm 25mm/s 10mm/nv More 2, Select Patinfo, One of the following two prompts will appear. New Patient: Yes No oR Patient Last Name AtoZ, Space, '. -. This is the start of the patient information prompts. You can answer as many as you like, skipping as many as you wish. Software Version 009A and 109A —_The order of the questions asked in the Patinfo menu has been rearranged with software version 009A, 109A. ‘= Togo through the patient information prompts rapidly, press the ENTER key after each prompt appears. ‘= Press the STOP key to skip all the patient information prompts. Revision L (MAG 12/15 resting ECG analysis system 43 '401003-032TAKING A RESTING ECG: Entering Patient Information Pediatric Analysis | When patient's age is entered and the patient is 15 years of age or less, then a pediatric 12SL analysis is performed on the ECG data. ) However, ifno age is entered, then the system will always perform an adult analysis. Patient Medications —Thelastseries of patient information prompts asks you about a patient's ‘medications. The first medication prompt is shown below. A B c Doe Wedicatto None Unknown Clear Add Scroll ree en Description ‘The patient is taking no medications. Use if you do not know what medications the patient is taking. Erases all medications that are currently entered for the patient. Use to add a medication that the patient is taking, Use to review the patient's me time, 1. Press the appropriate key and then press the ENTER key. @ Ifyouselected either None, Unknown, or Clear, then go to step 3. Ifyou selected Add, then go to step 2. Ifyou selected Scroll, the next medication will appear on the display. ‘@ Aiter reviewing all medications, press the ENTER key to continue. Then go to step 3. 2. After selecting Add and pressing the ENTER key, the following display will appear. First Letter of Wedication Wamer A Bc o F-H More as rst Letter of Medication Name: 1-0 ° o-W More on) a4 MAG 12/16 resting ECG analysis system Revision L 401003-032.TAKING A RESTING ECG: Entering Patient Information Adding Medications To adda medication, press the key that matches the first letter of the medication you wish to add. For example, if you want to add Aspirin, then press the FI key to select A. Then press the ENTER key. NOTE ‘The major medical groups are displayed between “<>" symbols. Next, a list of medications will appear for the letter A. coa> Aspir Ifyou want to select Aspirin from the list above, press the FS key. Then press the ENTER key. ‘You can add the following list of medications. Table 4-2. Medications A 10 (Antianginal) Isosorb (Isosorbide) (Antiartythmic) Lidoca (Lidocaine) (Antocoagulants) ‘Nitrate (Nitrates) - (Antinypertensive) Other Aspirin BC P (Beta Blockers) Phenoth (Phenothiazide) CaleBik (Calcium Blockers) Phenytn (Phenytoin) Catopr (Catopri) Procain (Procainamide) Conia (Clonidine) ropran (Propranolol) Coumadn (Coumadin) (Diuretics) Warfar (Warfarin) Dysopyr (Dysopyramide) FH Furosem (Furosemide) Heparin Hydra (Hydralazine) 3. After the medications’ prompt, the option number and blood pressure prompts will appear if they were asked for in the Cart Setup menu. Finally, the Main Menu will reappear. This completes the entry of patient information. Revision L MAG 12/15 resting ECG analysis system 45 401003-032TAKING A RESTING ECG: Recording an ECG Recording an ECG Preparation record an ECG, follow these steps. 1, Prepare the system as described in chapter 2, “Equipment Overview." 2. Prepare the patient as described in chapter 3, “Preparing the Patient.” 3. You do not have to enter patient information in order to record an ECG. However, this step is necessary ifthe unit has been set up to require a patient ID before recording a 12-lead ECG. Ifyou do not provide a patient ID when it is mandated, the system responds similarly in each of the 3 following situations. Ifyou attempt to ignore the request for patient ID while using the Patinfo menu, the unit beeps and freezes on the Patient ID query. Enter the patient ID to continue. ‘Ifyou press the RECORD EOG key immediately after ‘turing on the unit, the unit beeps and the Patient ID query display. Enter the patient ID to continue. ‘Ifyou press the RECORD RHYTHM key immediately after ‘tuming on the unit, a3- or 6-lead strip prints. If you then press the RECORD ECG key, the printing stops, the unit beeps, and the Patient ID query displays. Enter the patient 1D tocontinue. This mandatory ID option has no effect when editing a stored ECG, 4. Ifyou do not want to save the recorded ECGs, remove any diskette that isin the diskette drive, and go to step 7. Otherwise, make sure you have a diskette that can be used to save the ECGs. ‘Also, make sure that this diskette is not write protected (see appendix, "Miscellaneous Tasks.’) 5. Press the eject button to remove a diskette from the diskette drive slot. 6. Insert the diskette - label side up - into the diskette drive slot. 7. Ifthe Main Menuis not displayed, press the STOP key. 46 MAG 12/15 resting ECG analysis system Revision L -401003-032TAKING A RESTING ECG: Recording an ECG Cc ECG Status Messages Lead Error Messages 8, Press the RECORD ECG key. ‘This number increases during the acquisition process, ** Acquiring Data ** Lead error niéssages appear in this area. ‘¢ Ifno error messages appear, go to step 9. . Ifalead error message appears, you have two choices: either correct or override the lead error. Examples of lead error messages are ** VI DISCONNECTED “*, ** H(Al) BASELINE SWAY “*, "* RL LL 60 HZ NOISE *, ** V3R(A2) MUSCLE TREMOR ™. ‘Ifyou correct the lead error, the lead error message disappears, and 10 seconds of data is acquired by the system. Go to step 9, ‘¢ Ifyou override the lead error by pressing the RECORD ECG key, a display similar to the following appears. a1 ** Acquiring Data ** ** LEAD ERROR OVERRIDE ** ‘@ The override message and the error condition appear on all ECG reports printed immediately after acquisition. The override message and the error condition will not be stored to diskette or transmitted. Revision L MAC 12/16 resting ECG analysis system a7 -401003-082TAKING A RESTING ECG: Recording an ECG 9. When the system has acquired the ECG, the following prompt appears. ** ECG Acquisition Complete ** Ifyou answered Yes to the Disable Automatic Gain Check prompt in the Cart Setup menu, go to “Printing.” ‘@ Ifthe Main Menu gain is set to 5 mm/mV and a normal or low amplitude ECG was acquired, the following display appears. 10 mm/mV Limb/Chest Leads: YES NO Limb Only Description Sets all leads to 10 mm/mV. Sets all leads to 5 mmvmV. m **ALL LEADS AT 1/2 ST, ** will appear on all ECS reports except the 1 complexfead report. ‘Sets the limb leads to 10 mmvmV and the chest and auxiliary leads to 5 mmv/mV. w= ** CHEST LEADS AT 1/2 STD ** ill appear on all ECG reports except the 1 complex/ead report. ‘Ifthe Main Menu gain is set to 10 mm/mV and a high amplitude ECG was acquired, the following display appears. mm/nv Limb/Chest. Leads: YES NO Chest Only Ree ea) Description Sots all leads to 5 mmm. = **ALL LEADS AT 1/2 STD. ** will appear on all ECS reports except the 1 complexead report. ‘Sets all leads to 10 mm/mv. ‘Sets the chest and auxiliary leads to 5 mmvmV and the limb leads to 10 mmvmV. = **GHESTLEADSAT 12STD. **wll appear on all ECG reports except the 1 complextead report. 48 MAC 12/15 resting ECG analysis system Revision L 4010-032TAKING A RESTING ECG: Recording an ECG Printing 10. The system processes the ECG and begins printing reports. ¥* Analyzing ECG ** THEN +5 Printing Reports =* Page 1 of 3 These numbers will vary according to how many unconfirmed reports you have selected to print. Ifyou answered No to the Ask for Extra Copies of Plots . prompt in the Cart Setup ment Go to "Vector Loop: . Ifyou asked for the extra copies prompt, the following display appears after all reports have printed. Number of Extra Copies: 0 to 99 11. Type the number of copies you want. 12, Press the ENTER key. 13. The following prompt appears. Change Writer Setting for Reports?” Yes No 14, Press the appropriate key. 15, Press the ENTER key. Ifyou selected No, the system will use the current writer settings (speed, gain, and filter) to print the copies. Go to “Vector Loops.” Ifyou selected Yes, the following appears. Select Settings. Press PRINT to continue PRINT NoPrint 25mm/s — 10mm/mV 100Hz Description Begins printing the report copies. Cancels printing. Changes the writer speed. Changes the writer gain, Changes the writer fier. Revision L MAC 12/15 resting ECG analysis system 40 -401003-032410 TAKING A RESTING ECG: Recording an ECG Vector Loops ——_16: Ifthe acquisition module type is st to 14 Wireand the auxiliary leads are defined as XYZ, the following vector loop report aN prompt appears. Otherwise, goto “Storing ECGs.” Would you Tike to see Vector Loops? Yes No Ifyou selected No, go to “Storing ECGs.” Ifyou selected Yes, then the following appears. ONSET OFFSET GAIN Qon Toff 20nm/mv PRINT EXIT Prem ong err Description ‘Changes the vector loop onset. = For example, Qon (0 onset), Qotf(Qottset, et. Clears any onset increment value. 1 For example, Con, Press the SHIFT key and FA at the same time to add 4 tillseconds to the onset increment value. ‘Changes the vector loop offset. = For example, Potf(P offset), Toff (T offset), ete Clears any offset increment value. = For example, Totfed. Press the SHIFT key and F2 at the same time to add 4 miliseconds to the offset increment value. ‘Changes the vector loop gain. Prints a vector loop plot. 1 Ifthe system "beeps", check the onset and ofset locations for accuracy. Exits this prompt and continues with the next step. MAG 12/15 resting ECG analysis system Revision L -401003-032vision L TAKING A RESTING ECG: Recording an ECG Storing ECGs 17, After all reports have printed, the following displays appears. ** Processing ECG For Storage ** THEN ** Write to Diskette ** NOTE Do NOT press the STOP key when the ** White to Diskette ** message appears on the LCD. Ifa diskette error occurs, go to “Diskette Error.” Ifno diskette error occurs, the following appears. Storage to Diskette Complete Type any key to Continue 18. Press any key to return to the Main Menu. (MAG 12/15 resting ECG analysis system an '401003-032TAKING A RESTING ECG: Recording an ECG Diskette Error 19. Ifa diskette error occurs, a display similar to the following appears. ) ** write To Diskette * DISKETTE NOT IN DRIVE 20. Next, a display similar to one of the following appears. Transmit ** Dialing - 1112345 OR The first display appears only: = Ifyour system is equipped with a modem. In this case the system will try to transmit the recently acquired ECG using the Cart Setup phone number. (See “Phone Setup” in chapter 13, “Setup.”) ‘= Ifno phone number was entered or you wish to cancel the transmission, press the STOP key. When the second display appears: 1 Sclect Ysto try saving the recently acquired ECG todisketteor~) transmitting the ECG over a telephone line. mt Select No, and the recently acquired ECG will be lost. 412 MAG 12/15 resting ECG analysis system Revision L 401009-092TAKING A RESTING ECG: Using the Vector Function to Record 14-Lead XYZ ECGs Using the Vector Function to Record 14-Lead XYZ ECGs ‘The method described in “Recording an ECG” - using the RECORD ECG key - may be used to record a 14-lead XYZ ECG, However, the Vector function is a more efficient and an easier method for recording a 14-lead XYZECG. = XYZ configuration is assumed for the Al through A4 leadwires. Therefore, it is not necessary to use the Cart Setup menu to set ‘XYZ for the Al to Ad leadwires. m XYZleads are automatically stored/transmitted after acquisition. Therefore, itis not necessary to use the Cart Setup meni to set Store for the XYZ leads. Inall other ways, the Vector function operates exactly like the RECORD ECG key method. In both methods, for example, press the RECORD ECG key to override a lead error. To use the Vector function to record a 14-lead XYZ ECG, follow these steps. 1, Follow steps 1 through 7 of the previous “Recording an ECG” section. 2, From the Main Menu, press the SHIFT and FI keys at the same time to display the System Functions menu. 3. Select Vector. 4. Adisplay similar to the following appears. ** Acquiring Data ** ‘The ECG is acquired, report is printed, and the ECGis stored/ transmitted as described in steps 8 through 20 of the previous “Recording an ECG" section. Revision L MAC 12/15 resting ECG analysis system 413 401003-032TAKING A RESTING ECG: Using the Pediatric Function Using the Pediatric Function + ‘The method described in “Recording an ECG" - using the RECORD OG key - may also be used to record a 14-lead ECG in the pediatric format if the Pediatric format has been enabled in Cart Setup and the ‘Al-Ad leads have been set as V3R, VAR, and V7. However, the Pediatric function is a more efficient and easier method for recording a 14-lead VBR, VAR, V7 ECG. = VR, VAR, V7 configuration is assumed for the Al through A4 leadwires. Therefore, itis not necessary to use the Cart Setup ‘menu to set V3R, VAR, and V7 for the Al through A4 leads. = VR, VAR, V7 leads are automatically stored/transmitted after acquisition. Therefore, its not necessary to use the Cart Setup ‘meni to set Store for these leads. Inalll other ways, the Pediatric function operates exactly like the RECORD ECG key method. In both methods, for example, press the RECORD ECG to override a lead error. NOTE Using the Peslatrc function will generate report in the Pediatric format with the A1 -~ through Ad leads set at VOR, VAR, and V7. In order for the 128L to do a Pediatic Analysis, the patients’ age must be 15 years or less. If the age entered is 16 years or more or if no age is entered, the system performs an adult analysis. 1. Follow steps 1 through 7 of the previous “Recording an ECG” section, 2. From the Main Menu, press the SHIFT and Fl keys at the same time to display the System Functions menu. 3. Select Ped. 4, A display similar to the following appears. 4% Acquiring Data ** ‘The ECG is acquired, a report in the Pediatric format is printed, and the ECGis stored/transmitted as described in steps 8 through 20 of the previous “Recording an ECG” section. ana MAC 12/15 resting ECG analysis system Revision L -401003-032.J PRINTING A RHYTHM STRIP Revision L 401003-032PRINTING A RHYTHM STRIP: To Print a Rhythm Strip. G To Print a Rhythm Strip To record a rhythm strip (report), follow these steps. L Prepare the system as described in chapter 2, "Preparing the Equipment”. Prepare the patient as described in chapter 3, “Preparing the Patient”. Ifthe Main Menu is not already displayed, press the STOP key toreturnto it. Trask ViFIIWS Patinfo Rhythm 25nm/s 10nm/mV More Press the RECORD RHYTHM key. The writer starts printing a thythm report, and the Main Menu will change to the following. VTS Rhythm 25mm/s 10mm/nV More Pee a Description Changes the rhythm leads. Changes the writer's speed. Changes the writer's gain. Changes the writer's filter. ¢ Ifnolead error occurs, go to step 5. ‘@ Ifalead error occurs, a lead error message appears on the ‘Main Menu, similar to the following. = V5 DISCONNECTED =™™ Rhythm 25mm/s 10mm/nv More ‘The lead error may be corrected or overridden. Ifyou correct the lead error, the lead error message will, disappear. Goto step 5. Ifyou override the lead error by pressing the RECORD RHYTHM key, the following appears. 75 LEAD ERROR OVERRIDE Rhythm 25mm/s 10mm/nV More Revision L (MAC 12/15 resting ECG analysis system 53 -401003-032PRINTING A RHYTHM STRIP: To Print a Rhythm Strip 5. Tostop printing, press the STOP key. NOTE Normally, when you press the RECORD RHYTHM key, a rhythm report prints until the STOP key is pressed. However, if the printing does not stop, tum the system off and then on again, 54 MAG 12/15 resting ECG analysis system 40108-0382 Revision LRECEIVING AND TRANSMITTING AN ECG ‘Transmitting by Telephon Overview Setup Phone Number .. Setting Up Selection Parameters MUSE System Information ... Cart Information Unconfirmed and Confirmed File Selection... Viewing Patient Data £0G Status Messages 1. ‘Transmitting Locally Overview Setup Setting Up Selection Parameters MUSE System Information... Cart Information Unconfirmed and Confirmed File ECG Status Messages ... AT Receiving by Telephon oo 1B Overview 18 Setup 18 Aaclving Laaly (rom Another Etactrocardiograph) soe Overview 24 Setup 24 Receiving from the MAC PC System soe 8 Setup Receiving from the Marquette Responder 1500 Defibrillator .. Overview : Connecting the External Modem Connecting Locally to the Defiprilator LolLine Setup .. MAC 12/16 System Setup nnarnnennnnsnnsnn ECG Status Messages MAG 12/16 resting ECG analysis system 61 4010-032RECEMING AND TRANSMITTING AN ECG: Introduction c Introduction Overview — This chapters divided into 6 sections. ‘Transmitting by Telephone shows you how to use the system's optional modem to send reports over a telephone line. ‘Transmitting Locally shows you how to send ECGs to another unit using a special cable to connect the system to the other unit, Receiving by Telephone shows you how to use the system's optional modem to receive ECGs over a telephone line. Receiving Locally (from Another Electrocardiograph) shows how to receive ECGs from another unit by using a special cable to connect the system to the other unit. Receiving from the MAC PC system shows you how to receive ECGs from a MAC PC system using a cable to connect the MAC PC system to the MAC 12/15 system. Receiving from the Marquette Responder 1500 Defibrillator shows you how to receive ECGs from a Marquette Responder 1500 Defibrillator using an external modem and cable to connect to the system. Revision L MAG 12/16 resting ECG analysis system 63 401003-032RECEIVING AND TRANSMITTING AN ECG: Transmitting by Telephone Transmitting by Telephone ~ Overview —Onlyasystem equipped with a modem can transmit ECG reports by telephone. Setup 1. Prepare the system as described in chapter 2, “Equipment Overview.” 2. Connect a telephone line from a telephone wall connector to the telephone connector on the back of the system. owe0st 3. When an EOGiis transmitted, the system wil try to delete the“) transmitted ECG. If you do not want the ECGs on diskette deleted, make sure your ECG diskette is write protected (see appendix E, “Miscellaneous Tasks”). 4. Press the eject button to remove a diskette form the diskette drive slot. 5. Insert the diskette - label side up - into the diskette drive slot. 6. Ifthe Main Menuis not displayed, press the STOP key. Trask ViFlIWS PatInfo Rhythm 25nm/s 10mm/mV More 7. Hold down the SHIFT key and then press the FI key to display the System Functions menu. 8. Select Disk. 9. The following display appears. Diskette Functions Xmit Edit Plot Dirctry More 4 MAC 12/16 resting ECG analysis system Revision L -401003-092RECEMING AND TRANSMITTING AN ECG: Transmitting by Telephone 10. Select Xmit (Transmission). Ifyou answered Noto the Will the Local Line be Used prompt in the LclLine section of the Cart Setup menu, go to step 13. . Otherwise, the following display appears. Transmission Device: Phone Local 11, Select Phone. 12, Press the ENTER key. 13. This display appears briefly. ** Batch Transmission ** 14, Next, a phone number prompt appears. Phone Number: No Spaces or Dashes. - Means Pause. Phone Number 15, Ifyou have not entered a phone number, type one in. (See chapter 13, “Setup” for more information.) ‘* Donotuse spaces or dashes (-) in the number. @ The equal (=) sign may be used to insert a pause. For example, in the telephone number 1=2345678, there would bea pause between numbers 1 and 2. 16, After entering the number, press the ENTER key. 17. The next prompt allows you to send either all or some of the ECGs on your diskette. Select Data: All Select Select Ailto transmit all the ECGs of your diskette. Go to “BCG Status Messages.” ¢ Choose Selectto select which ECGs to transmit from your diskette. Continue with the next step. 18. The following display appears. Set up Selection Parameters: Yes No Setting Up Selection Parameters 19. Select Noif you want to skip the following selection prompts and view the first ECG on your diskette. Go to step 33. Revision L MAC 12/15 resting ECG analysis system 65 401003-032RECEMING AND TRANSMITTING AN ECG: Transmitting by Telephone 20. Select Yes and the first selection prompt appears. ~ Select by PID: yes No ‘Ifyou select No, go to “MUSE System Information.” Ifyou select Yes, the following display appears. Patient 1D: Digits 0 To 9 21. Type in the patient's identification number (PID) that will be used to select ECGs. 22, Press the ENTER key. MUSE System Information 23. Aprompt appears that allows you to select those ECGs that have the same MUSE system site number. Select by Site: ves No Ifyou select No, go to step 26. ‘@ Ifyou select Yes, the following display appears. Site Wunber: ) 1 + 255 a“ 24, Type in the MUSE system site number that will be used to select ECGs. 25. Press the ENTER key. 26. Aprompt appears that allows you to select ECGs by their MUSE system location number. Setect by Location: yes No Ifyou select No, go to “Cart Information.” Ifyou select Yes, the following display appears. Location Number: 0-99 27. Type in the MUSE system location number that will be used to select ECGs. 28. Press the ENTER key. 66 (MAG 12/15 resting ECG analysis system Revision L -401003-032RECEIVING AND TRANSMITTING AN ECG: Transmitting by Telephone Cart Information 29. A prompt appears that allows you to select ECGs by their cart number. Select by Cart: Yes No ‘Ifyou select No, go to “Unconfirmed and Confirmed File Selection.” ‘+ Ifyou select Yes, the following display appears. Cart Number: 0+ 255 30. Type in the cart number that will be used to select ECGs. 31. Press the ENTER key. Unconfirmed and Confirmed File 32. The following display appears. Selection Select: Unconf Confrad Both Select Unconfif you want only unconfirmed ECGs to be transmitted. ‘Select Confrmdif you want on confirmed ECGs to be transmitted. ‘@ Select Both if you want unconfirmed and confirmed ECGs to be transmitted. NOTE Selecting Confrmd eliminates the possibilty of selecting any Hi-Res or Pacemaker files since these files can not be confirmed. 33. One of the following two displays, or one very similar, appears. No Data Selected to Transmit Type Any Key to Continue ‘oR EU 123456789 SMITH, JACK Yes NoYes. No... Expand ‘@ Ifthe first display appears, either there are no ECGs on your diskette or there are no ECGs that fit your selection parameters. In either case, press any key and start this procedure again. Ifthe second display appears, this is the first ECG on your diskette or the first ECG that fits your selection parameters. This second display is explained in detail in the next step. Revision L (MAG 12/15 resting ECG analysis system e7 '401003-032RECEMING AND TRANSMITTING AN ECG: Transmitting by Telephone Viewing Patient Data 34, Select which ECGs you wish to transmit, Each ECG on your diskette or each ECG on diskette that fits your selection parameters displays in a manner similar to the following. a 8 oc D E — u 12345671 YES No EXPAND ACR Se CU) Your Action Selects this ECG. Bypasses this ECG. Selects this ECG and al remaining ECGs. Bypasses this ECG and all remaining ECGs. Provides additional patient information such as date and time of ECG. 68 (MAC 12/15 resting ECG analysis eystem Revision L -401003-032 +RECEIVING AND TRANSMITTING AN ECG: Transmitting by Telephone 35. To display additional patient information, select Expand anda ‘message similar to the one below will be displayed. AB c D EU 123456789 SMITH, JACK 04-JaN-89 11:42 C001 LOO] $001 Cont eee ey Description E= ECG or long form, C= CGR (Computer Graphic Record) P= Packer evaluation file L= HiRes file status of data U= unconfirmed ECG. C= confirmed ECG. (See chapter 7, “Editing OG Reports” to change an unconfirmed ECG ‘0-a confirmed ECG.) patiant identification | Unique identifier. number patient name Last name, first name of patient or the date ‘and time when ECG was recorded. Select to return to former display MUSE system site number where ECG was recorded. location Location number where ECG was recorded. cart number Cart number of the unit where ECG was recorded. date and time Day, month, year and time when ECG was recorded. Revision L MAG 12/16 resting ECG analysis system 69 40103-0932.RECEIVING AND TRANSMITTING AN ECG: Transmitting by Telephone ECG Status Messages 36, Next, messages similar to the following appears. ** Batch Transmission ** Reading Diskette Data THEN ** Batch Transmission ** Diating ~ 1112345 37. For each ECG transmitted, displays similar to the following appear. © U 123456789 SMITH, JACK 04-JAN-89 11:42 COO1 LOO1 Soo1 THEN © U 123456789 SMITH, JACK Deleting Diskette Data THEN ‘** Batch Transmission ** Reading Diskette Data THEN ¥* Batch Transmission ** Transmitting Diskette Data NOTE It the following display appears, ** Batch Transmission ** this means that the system could not delete an ECG. This is not an error message. The ‘system will continue transmitting. 38. After all ECGs are transmitted, the following display appears. Transmission Complete Type Any Key to Continue 39, Press any key to return to the following display. Diskette Functions Xnit Edit Plot Dirctry More 40, Press the STOP key to return to the Main Menu. MAG 12/15 resting ECG alysis system -401003-032 Revision LRECEIVING AND TRANSMITTING AN ECG: Transmitting Locally Transmitting Locally SS Overview local connection refers to a direct connection via cable between a transmitting and receiving device. NOTE You can only transmit ECGs locally if you have a serial transmission cable. (Refer to the MAC 12/15 resting ECG analysis system field service manual, PN 401003-002, for detail Setup 1, Prepare the system as described in chapter 2, “Equipment Overview.” 2. Connect the serial transmission cable from the other system (for example, another MAC 12/15 system) to the AUX DATA (RS232) port at the back of you system. 3. When an ECG is transmitted, the system will try to delete the transmitted ECG. If you do not want the ECGs on diskette deleted, make sure your ECG diskette is write protected (see appendix E, “Miscellaneous Tasks"). 4, Press the eject button to remove a diskette from the diskette drive slot. 5. Insert the diskette - label side up - into the diskette drive slot. 6. Select Yes or Will the Local Line be Used prompt in the LclLine section of the Cart Setup menu, 7. Ifthe Main Menu is not displayed, press the STOP key. Trask Vivllev5 Patinfo Rhythm 25mm/s 10nm/nV More vision L MAC 12/16 resting ECG analysis system ett -401003-032RECEIVING AND TRANSMITTING AN ECG: Transmitting Locally 8. Hold down the SHIFT key and then press the FI key to display the System Functions menu, 2) 9. Select Disk. 10. The following display appears. Diskette Functions Xmit_ Edit Plot’ Dirctry More 11, Select Xmit (Transmission). Transmission Device: Phone — Local 12, Select Local 13, Press the ENTER key. 14, Select whether or not the ECG should be sent in a compressed format. Data Format: All Compr . [ECGs sent in the Comprs (compressed) format will be transmitted more rapidly than if Allis used. Only select Comprsif you are sending ECGs to another Marquete product for example, aMAC 12/18 system or) MUSE system), because the compression algorithm is proprietary. ECGs sent using Comprs are stored by the receiving system. . . . ECGs sent using Allare not stored by the receiving system. 15, This display appears briefly. ** Batch Transmission ** 16. The next prompt allows you to send either all or some of the ECGs on your diskette. Select Data: All Select '# Select Allo send all the ECGs on your diskette. Go to “ECG. Status Messages.” ‘* Choose Select to select which ECGs to send from your diskette. Continue with the next step. 17, The following display appears. Set up Selection Parameters: ~ Yes No e12 MAC 12/15 resting ECG analysis system Revision L 401009-032RECEMING AND TRANSMITTING AN ECG: Transmitting Locally Setting Up Selection Parameters 16. Select Noif you want to skip the following selection prompts and view the first ECG on your diskette. Go to step 32. 19, Select Yesand the first selection prompt appears. Select by PID: ves No ‘Ifyou select No, go to “MUSE System Information.” Ifyou select Yes, the following display appears. Patient 10: Digits 0 To 9 20, Type in the patient's identification number (PID) that will be used to select ECGs. 21, Press the ENTER key. MUSE System Information 22. A prompt appears that allows you to select those ECGs that have the same MUSE system site number. Select by Site: Yes No @ Ifyou select No, go to step 25. ‘Ifyou select Yes, the following display appears. Site Number: 1 - 255 23. Type in the MUSE system site number that will be used to select ECGs. 24, Press the ENTER key. 25, A prompt appears that allows you to select ECGs by their MUSE system location number. Select by Location: Yes No ¢ Ifyouselect No, go to “Cart Information.” ‘* Ifyou select Yes, the following display appears. Location Number: 0-99 26. Type in the MUSE system location number that will be used to select ECGs. 27. Press the ENTER key. Revision L MAG 12/16 resting ECG analysis system 613 -401003-032RECEMING AND TRANSMITTING AN ECG: Transmitting Locally Cart Information 28. A prompt appears that allows you to select ECGs by their cart number. “~ Select by Cart: Yes No ‘@ Ifyou select No, go to “Unconfirmed and Confirmed File Selection.” ‘@ Ifyouselect Yes, the following display appears. Cart Number: O- 255 29, Type in the cart number that will be used to select ECGs. 30. Press the ENTER key. Unconfirmed and Confirmed File 31. The following display appears. Selection Select: Unconf Confrmd Both @ Select Unconfif you want only unconfirmed ECGs to be transmitted. ‘@ Select Confrmd if you want on confirmed ECGs to be transmitted. Select Bothifyou want unconfirmed and confirmed ECGsto ~) be transmitted. NOTE Selecting Confimd eliminates the possibilty of selecting any Hi-Res or Pacemaker files since these files can not be confirmed. 82, One of the following two displays, or one very similar, appears. No Data Selected to Transmit Type Any Key to Continue OF EU 123456769 SWITH, JACK Yes NoYes... No... Expand Ifthe first display appears, either there are no ECGs on your diskette or there are no ECGs that fit your selection parameters. In either case, press any key and start this procedure again, ‘¢ Ifthe second display appears, this is the first ECG on your diskette or the first ECG that fits your selection parameters. This second display is explained in detail in the next step. e14 MAC 12/15 resting ECG analysis system Revision L -401003-032RECEIVING AND TRANSMITTING AN ECG: Transmitting Locally 33. Select which ECGs you wish to transmit. Each ECG on your diskette or each ECG on diskette that fits your selection parameters displays in a manner similar to the following. a B oc > E EU 123456789 WITH, JACK YES NOYES... NC EXPAND) recoded) Your Action Selects this ECG, Bypasses this ECG. Selects this ECG and all remaining ECGs. Bypasses this ECG and all remaining ECGs. Provides additional patient information such as date and time of ECG. Revision L MAG 12/16 resting ECG ar -401003-032. 615RECEIMING AND TRANSMITTING AN ECG: Transmitting Locally 34, To display additional patient information, select Expand anda ‘message similar to the one below will be displayed. 2) AB c D € U 123456789 SMITH, JACK 04-JAN-89 11:42 COD] L001 $001 Cont eee ct) Description E=ECG or long form, G= CGR (Computer Graphic Record) P= Packer evaluation file Le HiRes file status of data U= unconfirmed ECG, C= confirmed ECG. (See chapter 7, “Editing ECG Reports" to change an unconfirmed ECG ‘0 a confirmed ECG.) patient identification | Unique identifier. number patient name Last name, first name of patient or the date and time when ECG was recorded. Cont Select to return to former display. site MUSE system site number where ECG was recorded. location Location number where ECG was recorded. cart number Cart number of the unit where ECG was recorded. date and time Day, month, year and time when ECG was recorded. e16 MAG 12/15 resting ECG analysis system Revision L 401003-082Cc ECG Status Messages RECEMING AND TRANSMITTING AN ECG: Transmitting Locally 35. For each ECG transmitted, displays similar to the following appear. 8 NOTE The first display will only appear if the system is waiting forthe receiving system to acknowidge. ** Transmitting Diskette Data ** Waiting for ‘Receiver Ready’ Message ** Batch Transmission ** Reading Diskette Data THEN EU 123456789 SMITH, JACK 04-JAN-89 11:42 C001 L001 S001 i 8 THEN ** Transmitting Diskette Data ** Sending #13 Retry #0 THEN ** Transmitting Diskette Data ** Deleting Diskette Data NOTE Ifthe following display appears, 3 Gatch Transmission == Diskette Error ~ Write Protected this means that the system could not delete an ECG. This is not an error message. The system will continue transmitting. 36. The following two displays appear. >= Batch Transmission ** Ending Transmission THEN Transmission Complete Type Any Key to Continue 37. Press any key to return to the following display. Diskette Functions Xmit Edit Plot Dirctry More 38, Press the STOP key to return to the Main Menu, Revision L (MAG 12/18 resting ECG analysis system 617 -401003-032RECEMING AND TRANSMITTING AN ECG: Receiving by Telephone Receiving by Telephone + Overview Onlyasystem equipped with a modem can receive ECGs by telephone. NOTE When you receive MUSE system data during Reverse Transmission on the MAC 12/15 system, the data will NOT be saved to the system's diskette. The type of report format that is printed on the MAC 12/15 system will depend on the MUSE system settings. Setup 1, Prepare the system as described in chapter 2, “Equipment Overview.” 2. Connect a telephone line from a telephone wall connector to the telephone connector on the back of the system. 3. Ifyoudonot wantto save the ECGs that you will receive, remove any diskette that is in the diskette drive. Go to step 6. Otherwise, make sure you have a diskette that can be used to save the ECGs, Also, make sure that this diskette is not write protected (see appendix E, “Miscellaneous Tasks”). 4. Press the eject button to remove a diskette form the diskette drive slot. 5. Insert the diskette - label side up - into the diskette drive slot. 6. Ifthe Main Menuis not displayed, press the STOP key. Trask VislT5 Patinfo Rhythm 25mm/s 10mm/mV More 7. Hold down the SHIFT key and then press the FI key to display the System Functions menu. oy e18 (MAG 12/15 resting ECG analysis system Revision L -401003-032.RECEMING AND TRANSMITTING AN ECG: Receiving by Telephone 8. Select RevXmit (Reverse Transmission). ‘Ifyou answered Noto the Will the Local Line be Used prompt in the LciLine section of the Cart Setup menu, go to step 11. . Otherwise, the following display appears. Receiving Device Phone Local 9, Select Phone. 10, Press the ENTER key. 11, The system will now check for a diskette in the diskette drive and the following display appears. ** Reverse Transmission ** Check the Diskette 12, If there is no diskette in the diskette drive, then the system will only be able to print the reports you will receive. The following display appears. No Data Storage - Plotter Output Only Type Any Key to Continue. 13. Press any key to continue. NOTE If the following display appears, To Overreadable Report Format Selected Type Any Key to Continue you should cancel receiving reports. Press the STOP key. 14, After checking for a diskette, the system will check the phone line. This display appears. ** Reverse Transmission ** Check the Phone Line Revision L MAG 12/15 resting ECG analysis eystem 619 -401003-032RECEIVING AND TRANSMITTING AN ECG: Receiving by Telephone 15, One of the following two displays appear. ** Reverse Transmission ** Phone Line Not Attached ** Reverse Transmission ** Ready to Receive i ‘Ifthe Phone Line Not Attached message appears, press the ‘STOP key. Check the telephone connection to the system. Restart this procedure. Ifthe Ready to Receive message appears, continue with the next step. 16. The Ready to Receive message will remain on the display until ‘your system receives a telephone call from the unit that will be sending the ECGs. The following display appears. * Reverse Transmission ** Answering the Phone 17, For each ECG received, the following two displays repeat. ** Reverse Transmission ** Receiving Data ** Reverse Transmission ** End of Data Packet Hl 18. When all ECGs are received, the following display appears. *% Printing Reports ** Page 1 of 3 V/ ‘These numbers will vary according to how may ECGs have been received. 19, When the last ECG reportis printed, the following display appears. ** Reverse Transmission ** Ready to Receive 20, Press the STOP key to return to the Main Menu. 620 ‘MAC 12/15 resting ECG analysis system Revision L 401003-032.RECEIMING AND TRANSMITTING AN ECG: Receiving Locally (from Another Electrocardiograph) C Receiving Locally (from Another Electrocardiograph) Overview Setup Alocal connection refers to a direct connection via cable between a ‘transmitting and receiving device. NOTE You can only receive ECGs locally if you have a serial transmission cable. (Refer to the MAC 12/15 resting ECG analysis system field service manual, PN 401003-002, for details). 1, Prepare the system as described in chapter 2, “Equipment Overview.” 2. Connect the serial transmission cable from the other unit (for example, another MAC 12/15 system) to the AUX DATA (RS232) port at the back of you system. 3, Ifyoudo not want to save the ECGs that you will receive, remove any diskette that is in the diskette drive, and go to step 6. Otherwise, make sure you have a diskette that can be used to save the ECGs. Also, make sure that this diskette is not write protected (see appendix E, “Miscellaneous Tasks”). 4, Press the eject button to remove a diskette from the diskette drive slot. 5. Insert the diskette - label side up - into the diskette drive slot. 6. Select Yesfor Will the Local Line be Used prompt in the LelLine section of the Cart Setup menu. Revision L MAG 12/15 resting ECG analysis system 621 401003-0326-22 RECEIVING AND TRANSMITTING AN ECG: Receiving Locally (from Another Electrocardiograph) 7. Ifthe Main Menuis not displayed, press the STOP key. Mask VI+ITWS Patinfo Rhythm 26nm/s 10na/nV Nore 8, Hold down the SHIFT key and then press the FI key to display the System Functions menu. 9. Select RevXmit (Reverse Transmission). 10. The following display appears. Receiving Device: Phone Local LL, Select Local, 12, Press the ENTER key. 13, This display appears briefly. ** Local Reverse Transmission ** 14, For each ECG received, displays similar to the following appear. NOTE ‘The numbers in the displays below are given >) only as examples. Other numbers will appear when you are receiving. %* Local Reverse Transmission #* Waiting #12 Retry #10 THEN ** Local Reverse Transmission ** Revd #2 THEN ¥* Printing Reports ** Page 1 of 3 15. After all ECGs are received, the following display appears. * Local Reverse Transmission ** Waiting #13 Retry #10 16. Press the STOP key to return to the Main Menu. MAC 12/15 resting ECG analyeis system Revision L 401008-032RECEIVING AND TRANSMITTING AN ECG: Receiving from the MAC PC System Cc Receiving from the MAC PC System Setup 1. Prepare the system as described in chapter 2, “Equipment Overview.” 2, Usinga straight cable, plug one end into the auxiliary connector on the side of the MAC PC system and the other end into the acquisition module (AM) connector located on the front of the receiving system. 3. Ifyoudonot want to save the ECGs that you will receive, remove any diskette that isin the diskette drive, and go to step 6. Otherwise, make sure you have a diskette that can be used to save the ECGs. Also, make sure that this diskette is not write protected (see appendix E, “Miscellaneous Tasks”). 4. Press the eject button to remove a diskette from the diskette drive slot. 5. Insert the diskette - label side up - into the diskette drive slot: 6. Ifthe Main Menuis not displayed, press the STOP key. Trask VisTTWS Patinfo Rhythm 25mm/s 10mm/mV More 7. Hold down the SHIFT key and then press the F1 key to display the System Functions menu. 8 Select LocPC (Local PC system). ‘MAG 12/15 resting ECG analysis system 6-23 401003-032.RECEMING AND TRANSMITTING AN ECG: Receiving from the MAC PC System 9. When the following display appears, if you haven’t already done 80, use a straight cable to connect the MAC PC system to the ) ‘MAC 12/15 system as shown in step 2. Disconnect AN & Connect MAC PC Type Any Key to Continue ‘Also, make sure that the MAC PC system has been set up to locally transmit ECGs. (Refer to “Transmitting Locally” in chapter 6, “Receiving and Transmitting an ECG" in the MAC PC. resting ECG analysis system operators manual, PN 403506-001.) 10. Press any key to continue. 11. One of the following two displays appear. No Data Storage - Plotter Output Only Type Any Key to Continue ‘OR Waiting to establish ON LINE Communication with MAC PC ‘© Ifthe first display appears, it means that there is no diskette in the diskette drive slot, and ECGs will only be printed, not saved to diskette. Press any key to continue. Ifthe second display appears, continue with the nextstep. 12, For each ECG received, displays similar to the following appear. 7 Transfer in Progress ae THEN %* Printing Report ** Page 1 of 3 THEN 7 Record Transferred cs THEN Waiting to establish ON LINE communication with MAC PC 13. When the last ECG has been sent, press the STOP key to retum. to the Main Menu, 6-24 MAG 12/15 resting ECG anaiysis system Revision L -401003-032RECEMNG AND TRANSMITTING AN ECG: Receiving from the Marquette Responder 1500 Defibrillator C Receiving from the Marquette Responder 1500 Defibrillator Overview Connecting the External Modem Connect 25-pin connector to the AUX DATA connector ‘on the back panel ofthe system. Only a system equipped with a 1200 baud modem and an AUX DATA connector can receive 12-lead ECG data from a Marquette Responder 1500 Defibrillator equipped with the 12SL analysis program option. ‘Marquette Electronics recommends that you use the Hayes Smart ‘modem 2400 (PN 900436-001) programmed by Marquette Electronics as, the external modem. Connect mains power conned cord here Connect 25-pin telephone ‘connector here. _line here. Q ‘Mains power switch Ol ca ° = \ i wos }! y/ —~ Cable Ep" PN 208/04697000 oc © 25-pin connector oma, 1 ot Revision L MAG 12/15 resting ECG analysis system 6-25 '401003-032RECEMING AND TRANSMITTING AN ECG: Receiving from the Marquette Responder 1500 Defibrillator it Connect the system to the defibrillator directly to receive 12-lead ECG Connecting Locally to ee “ Defibrillator AUX DATA port on the back panel of the LelLing Setup. Vsthistabletoset tne communication parameters forthe AUKDATA Pee ees Step Leo Your Action ) 4 System Functions Select More. Orders Revkmit Disk Vector More 7 System Functions Select Setup. Ped Pace Hi-Res Setup More 3 | Password: ‘Type the password. The default is Lt. 4 Cart Setup Select More. Dat/Time Phone LdGrps Reports More 5 Cart Setup Select Lolline Passwds Moden LclLine Misc More 6 Will the Local Line be Used: Select Yes, Yes No 7 | Local Line Baud Rate: Select More until you can select 1200. 75 110 1346.5 150 More 8 Local Line Number of Stop Bits: ‘Select 1 stop bit. The Main Menu appears. 1 2 626 MAC 12/15 resting ECG analysis system Revision L -40100-082RECEMING AND TRANSMITTING AN ECG: Receiving from the Marquette Responder 1500 Defibrillator Cc MAC 12/15 System Setup Prepare the system as described in chapter 2, “Equipment Overview.” Ifthe Main Menus not displayed, press the STOP key. Task ViFlI+5 Patinfo Rhythm 25mn/s 10mm/mV More Hold down the SHIFT key and then press the FI key to display the System Functions menu. ‘System Functions Orders Revkmit Disk Vector More Select RevXmit. Receiving Device: Phone Local Select Local. The following display appears. ** Local Reverse Transmission #* NOTE When receiving 12-lead ECG data from a Marquette Responder 1500 Defibrillator, you ‘can only print the data, For each ECG received, displays similar to the following appear. NOTE ‘The numbers in the displays below are given only as examples. Other numbers. will appear when you are receiving. io Data Storage - Plotter Output Only Type Any Key to Continue NOTE ‘The previous display appears only it you did not insert a diskette in the diskette drive slot, Revision L MAG 12/15 resting ECG analysis system 627 40103-0382RECEIVING AND TRANSMITTING AN ECG: Receiving from the Marquette Responder 1500 Defibrillator ECG Status Messages 1. The following series of messages will be displayed for each ECG that is received. - %* Local Reverse Transmission ** Waiting #12 Retry #0 THEN ** Local Reverse Transmission ** Revd #2 THEN %* Printing Reports ** Page 1 of 3 2. After all ECGs are received, a display similar to the following appears. ** Local Reverse Transmission ** Waiting #1 Retry #0 3. Press the STOP key to return to the Main Menu. 6-28 MAC 12/15 resting ECG analysis system Revision L 40109-0382EDITING ECG REPORTS ‘Types of Data Reports .. Overview Pediatric Analysis Full Edit . Selecting the ECG File Selecting MUSE System Information . Selecting ECGs by Cart Number ‘Viewing the Stored ECG .. Editing the Selected ECG Entering Reviewer Identification Selecting Functions Using the Insert Function Insert Function Examples Printing Patient Data Overview Setup Selecting the ECG to Selecting MUSE System Information .. Selecting ECGs by Cart Number Viewing the Stored ECG .. Editing the Selected ECG Name 10 Number Date Time . Physic Location Room Number Revision L MAC 12/15 resting ECG analysis system 7A '401003-032‘Adding Medications Order Number Secondary 1D. Technician 1D. Option Number Blood Pressure End of Editing Printing Report MAC 12/15 resting ECG analysis system Revision L -401003-082EDITING ECG REPORTS: Types of Data Reports C Types of Data Reports Overview This chapter is divided into 2 sections. = Full Edit shows you how to change Marquette’s 12SL analysis program statements, measurement data, and patient information that appear on ECG reports. = Patient Data Edit shows you how to change just the patient information that appears on ECG reports. NOTE Editing files may change their order on the diskette directory. Therefore, if files are going to be transmitted to a MUSE system for serial comparison analysis, file editing should be done with the MUSE system after transmission. If editing is done with he MAC 12/15 system before transmission, the MUSE system will perform a serial ‘comparison analysis on the wrong ECG Cc files. The system's 12SL analysis program will perform a pediatric analysis on patients who are 15 years old o less. (The phrase **Pediatric Analysis” will appear on these reports.) Since the 12SL analysis program analyzed ECG data when itis first acquired, a pediatric analysis can not be changed to an adult analysis — or vice versa — using the system's Edit function described in the following pages. For example, assume a 16-year old patient was mistakenly entered as a 15-year old. (The system would do a pediatric analysis.) Then the Edit function was used to correct the patient's age to 16. Even though the age ‘was changed, the patient's ECG reports would still reflect the original pediatric analysis. However, Edit can be used to change the 12SL analysis program statements that appear on reports. Revision L MAG 12/16 resting ECG analysis systom 73 401003-032EDITING ECG REPORTS: Full Eoit Full Edit — rrr nn EEEEEEEEEEEEEEIEI Overview — Yoursystemallows you to edit ECGs stored on diskette. In a full edit you can change the statements, measurements, and/or the patient data. ‘The statements, measurements, and patient data sections are shown on a sample ECG report below. NOTE A tull edit can not be done on Hi-Res and Pacemaker evaluation reports. Patient data 5 neteezea \O eee Measurements 1281 analysis program statements 4 MAC 12/16 resting ECG analysis system Revision L 401003-032Setup Helpful Hint Before you begin editing information, there are a few ‘special keys you should be familar with. See "Keyboard Description” in chapter 2, “Preparing the Equipment’. EDITING ECG REPORTS: Full Edit To perform a full edit, follow these steps. 2 3. 8 9%. 10. ue NOTE Only ECGs stored on a diskette can be edited. Make sure that the diskette containing the ECGs you want to edit is not write protected (see appendix E, “Miscellaneous Tasks"). Press the eject button to remove a diskette from the diskette drive slot Insert the diskette - label side up - into the diskette drive slot, Ifthe Main Menuis not displayed, press the STOP key. Trask ViFlIWVS Patinfo Rhythm 25mm/s 10nm/mV More Hold down the SHIFT key and then press the FI key to display the System Functions menu. Select Disk. ‘The following display appears. Diskette Functions Xmit Edit Plot Dirctry More Select Edit, ‘The following display appears. Edit Functions Full PatData Select Full, Press the ENTER key. Revision L MAG 12/16 resting ECG analysis system 75 -401003-032EDITING ECG REPORTS: Full Edit Entering Password The following display appears. s Password: 2. Enter the Level 1 or Level 2 password. (The default passwords are “LI” and"L2",) 3. Press the ENTER key. 4, The system will check your ECG diskette and the following display appears briefly. ** Editor ** Reading Diskette NOTE It a diskette error message appears, make sure your ECG diskette is not write protected. Selecting the ECG File 1, The next display allows you to edit either all or some of the ECGs on your diskette. -) Select Data: AIL Select . Select Allto edit all the ECGs on your diskette. Go to “Editing the Selected ECG.” Choose Selectto select which ECGs to edit on your diskette, Continue with the next step. . 2. The following display appears. Set up Selection Parameters: Yes No 3. Select Noif you want to skip the following selection prompts and view the first ECG on your diskette. Go to “Selecting MUSE System Information” step 5. 76 MAC 12/15 resting ECG analysis system Revision L -401003-032EDITING ECG REPORTS: Full Edit 4. Select Yesand the first selection prompt appears. Select by PID Yes No . Ifyou select No, go to “Selecting MUSE System Information.” ‘# Ifyou select Yes, the following display appears. Patient 10) Digits 0 To 9 5. Type in the patient's identification number (PID) that will be used to select ECGs. Press the ENTER key. Selecting MUSE System 1. Aprompt appears that allows you to select those ECGs that have the same MUSE system site number. Information Select by Site: Yes No ‘@ Ifyou select No, go to step 4. + Ifyou select Yes, the following display appears. Site Number: 1 = 255 ‘Type in the MUSE system site number that will be used to select ECGs. 3. Press the ENTER key. 4, Aprompt will appear that allows you to select ECGs by their MUSE system location number. Select by Location: Yes No ‘# Ifyou select No, go to “Selecting ECG by Cart Number.” ‘# Ifyou select Yes, the following display appears. Location Number: 0-99 5. Type in the MUSE system location number that will be used to select ECGs. 6. Press the ENTER key. Revision L MAG 12/16 resting ECG analysis system 77 '401003-032EDITING ECG REPORTS: Full Edit Selecting ECGs by Cart Number L ‘A prompt appears that allows you to select ECGs by their cart number. . . Select by Cart: Yes No Ifyou select No, go to step 4. Ifyou select Yes, the following display appears. Cart Number: 0+ 255 ‘Type in the cart number that will be used to select ECGs. Press the ENTER key. ‘The following prompt appears. . oe . Select: Unconf Confrmd Both edited. NOTE Selecting Confrmd eliminates the possibility Of selecting any Hi-Res or Pacemaker files since these files can not be confirmed, No Data Selected to Edit Type Any Key to Continue oR © U 123456789 SWITH, JACK Yes No Yes... No.. Expand Select Unconfif you want only unconfirmed ECGs to be Select Confrmd if you want on confirmed ECGs to be edited. Select Both ifyou want unconfirmed and confirmed ECGs to be edited. One of the following two displays, or one very similar, appears. ‘Ifthe first display appears, either there are no ECGs on your diskette or there are no ECGs that fit your selection parameters. In either case, press any key and start this procedure again. Ifthe second display appears, this is the first ECG on your diskette or the first ECG that fits your selection parameters. This second display is explained in detail in the next step. 78 MAC 12/15 resting ECG analysis system -401003-032 Revision L + ~ ~c FRvision L Viewing the Stored ECG EDITING ECG REPORTS: Full Eait 1. Select which ECGs you wish to edit. Each ECG on your diskette or each ECG on diskette that fits your selection parameters displays in a manner similar to the following. A Bc © u 1234567 YES SMITH YES. Your Action Selects this ECG. Bypasses this ECG. Selects this ECG and all remaining ECGs. Bypasses this ECG and all remaining ECGs. Provides additional patient information such as date and time of ECG. MAG 12/15 resting ECG analysis system 40103-0382 79EDITING ECG REPORTS: Ful Eoit 2, To display additional patient information, select Expand and a ‘message similar to the one below will be displayed. o AB ¢ D € U 123456789 SMITH, JACK 04-JAN-89 11:42 COD1 LOOI S001 Cont Table 7-2. Expanded Patient Data Prompt Description type of data E= ECG or long form, C= CGR (Computer Graphic Record) P= Packer evaluation fle status of data ‘U= unconfirmed ECG C= confirmed EGG. (Use the OK or TOK funtion to change an unconfirmed ECG toa confirmed ECG.) patient identification | Unique identifier. number Patient name Last name, first name of patient or the date and time when ECG was recorded. Cont Select to return to former display. site MUSE system site number where ECG was recorded. location Location number where ECG was recorded. cart number Cart number of the unit where ECG was recorded. date and time Day, month, year and time when ECG was recorded. 70 MAC 12/15 resting ECG analysis system Revision L -401003-032Cc Editing the Selected ECG Entering Reviewer Identification Selecting Functions EDITING ECG REPORTS: Full Edit 1. Displays similar to the following appear. ** Editor *™* Reading Diskette THEN EU 123456789 SMITH, JACK 04-JAN-89 11:42 COO1 L001 $001 Press the ENTER key to edit this ECG. 1. This display appears. Reviewer Number: 1-999 2. Type in your reviewer number. 3. Press the ENTER key. The following display appears. Reviewer Wame: Any 24 Characters. 4, Type in a reviewer name. 5. Press the ENTER key. 1, A display similar to the following appears. SR Insert Delete Expand Measure More 2. Select More. NSR 0K Ki11 Print PatInfo More 3. Select a function: Insert, Delete, Expand, Measure, OK, Kill, Print Patinfo, or More. Revision L MAG 12/15 resting ECG analysis system Tt '401003-032EDITING ECG REPORTS: Full Ecit 4. Foreach ECG report, the following display allows you to change the 12SL analysis program statements (using the Statemts function), measurements (using the Measure function), or patient data (using the PatData function). A B c D E NSR Insert Delete Expand Measure Nore Kil] Print PatInfo More DeSean cuca Description ‘Acronym for 12SL analysis program statement (inthis case, NSR for Normal Sinus Rhythm). ‘Adds either an acronym or free text to the statements section of an ECG report (Insertfunction examples appear on the following pages.) Erases the currently displayed acronym (inthis case, pressing Delete would erase NSR.) Makes the full name of the currently displayed acronym, appear (in this case, pressing Expand would display ‘Normal Sinus Rhythm for NSR.) Changes items in the measurements section of an ECG report. ‘Makes all your changes. This also changes an unconfirmed report to a confirmed report. Undoes all the changes you made. The ECG report will revert to its last saved version, ‘The writer prints the currently edited ECG report. (The words PRELIMINARY COPY will appear on the report.) Edits items in the patient data section of an ECG report. Returns to the prior display. 72 MAG 12/15 resting ECG anaiysis system Revision L -401003-082 +