How To Guide for ECG’s Edan SE-1200 Cardioscan Pty. Ltd. How To Guide for ECG’s Edan SE-1200 Presenter Maree Halliday

Cardioscan Pty. Ltd. Company Information Cardioscan is the largest provider of cardiac reporting offering services to Pathology companies, General Practitioners and Private Hospitals in Australia and has been running since 1984. Backed by a team of dedicated Cardiologists and Technicians. The mission: To deliver superior cardiac reporting services by providing excellent reporting turnaround times, 2 hours for urgent and 4 hours for normal ECG’s, 24 hour turnaround service for Holter and NBP’s. Our aim is for our customers to be able to transfer data electronically and receive these reports back in a timely manner with the ability to produce statistical reports reducing duplication and excessive paperwork.

Overview of Equipment Picture Edan SE-1200 Monitor 12 Lead Set Trace Paper Telstra Wi-Fi Device Netgear Device

TRANSMITTING DEVICES Netgear leads Netgear (modem) Telstra Wi Fi device

ELECTRODES AND ALIGATOR CLIPS Cardioscan Pty. Ltd. ELECTRODES AND ALIGATOR CLIPS 12 Lead set – coloured coded Aligator clips with the correct fitting of electrodes

Initial Set Up Attach the Blue Alligator clips to the 12 lead set and plug cord into the unit Insert the 2 NetGear cables into the right side of the Edan ECG unit Netgear cables 12 lead cable position

ENSURE ALL ANCILLARY DEVICES ARE CONNECTED Netgear Cardioscan Pty. Ltd. ENSURE ALL ANCILLARY DEVICES ARE CONNECTED Netgear Connect blue cable to Net Gear Device then connect to Edan. Connect black power cable to Net Gear Device then to Edan USB Port.

Cardioscan Pty. Ltd. STEP ONE ECG TRACING Check Telstra Wi-Fi device is on, turn on if required by pressing and holding power button. Unit should remain on at all times, do not turn off. Check a number 1 is beside signal tower at top centre of screen. Check signal strength indicated by number of bars in top left corner.

STEP TWO Press and hold power button until “booting” appears on screen

Cardioscan Pty. Ltd. STEP THREE Once the ECG machine is turned on check that the following 3 steps occur. Power Light will be on LAN light will be on WLAN light will be amber and change to green once Telstra device is connected.

STEP FOUR PLACEMENT OF LEADS Lead Placement Limb Leads Apply limb ECG electrodes to the soft tissue of limbs or outer torso LA: black – Left Arm LL: red – Left Leg RA: white – Right Arm RL: green – Right Leg Chest Leads V1: red – 4th Intercostal space, right sternal border. V2: yellow – 4th Intercostal space, left sternal border. V3: blue – Midway between V2 and V4. V4: green – 5th Intercostal space, midclavicular line. V5: orange – Anterior axillary line, horizontal to V4 V6: purple – Mid axillary line, horizontal to V4 and V5.

STEP FIVE PATIENT DATA - PRESS F1 Cardioscan Pty. Ltd. STEP FIVE PATIENT DATA - PRESS F1 TAB ACROSS TO EACH FIELD PATIENT ID. TO commence with “Hospital prefix” Patient Details To enter patient details, Tab across to each field. If you tab past a field, you must continue tabbing through all fields until returning to the missed one. Once all fields have been completed, tab to OK then press enter button. This will return screen to ECG Tracing ADMISSION NUMBER TO BE INSERTED Exam Room = Ward TAB TO OK THEN PRESS “ENTER”

STEP SIX RECORDING ECG Check to ensure Netgear and Cardioscan Pty. Ltd. STEP SIX RECORDING ECG Check to ensure Netgear and Telstra devices are connected To commence recording of ECG – press Start/Stop Button

Cardioscan Pty. Ltd. STEP SEVEN - CHECK At top centre of screen under auto the following will appear; Recording Printing ECG Printout will occur automatically Transmitting The word Trans is visible until transmission is complete. If transmitting NOT successful, ECG is stored, accessed and manually transmitted via F7, Patient Files

An ECG recording will be automatically saved in patient file. Cardioscan Pty. Ltd. On completion of this final step the ECG will be automatically sent to Cardioscan in Melbourne for analysing and reporting An ECG recording will be automatically saved in patient file.

TROUBLE SHOOTING Chest leads poor contact or alligator clip is attached incorrectly to dot Lead indicators are highlighted in yellow if incorrect Correct Incorrect

DOING THE ECG Cardioscan Pty. Ltd. Prior Ensure all equipment on ECG trolley: ECG electrodes, Chlor-Hex swabs, clippers and blades; check paper level in machine Explain ECG procedure to patient Wash hands Patient Prep - Electrodes need good skin contact for good ECG tracing 1 Position patient 2 Expose chest area 3 For males shave chest as required Enter patient data into machine – all fields MUST be filled (ref p2) Important Be aware of any cardiac symptoms at the time of recording, such as chest pain, palpitations or shortness of breath Symptoms must be hand written on the printout and reported to nurse in charge Check Telstra Device connection – can be manually transmitted later Ensure good quality ECG trace before printing/sending. Remove electrodes: re-stick electrodes on plastic film from packet, place patient label on back of film and store in patient folder Cover the patient and return them to a position of comfort Wash Hands Return ECG trolley to storage. Plug In white power cord. Wipe leads with detergent wipes, replace equipment as required and leave trolley clean

TROUBLESHOOTING ANCILLARY DEVICES CONNECTIVITY STEP 1. Firstly check both MODEM and TELSTRA device are turned on and connected. Disconnect black Netgear cable from ECG machine and reconnect. Check: Power light GREEN LAN light GREEN WLAN light amber, changing to GREEN once TELSTRA device is connected. If required: Turn off TELSTRA device Turn on TELSTRA device ( observe the word TELSTRA increase in size) Check signal strength ( visual check symbol of tower 1 next to battery strength indicator)

Troubleshooting http://incenter.medical.philips.com

To Access Patient Files To open and change patient files press F7 button Screen will change to bring up list of patients and show the following functions at bottom of screen Trans All – this allows all listed ECG’s to be transmitted to Cardioscan. Export All – This allows all ECG’s to be exported to different file Del All – This allows all highlighted ECG’s to be deleted Select - This highlights the patient required and changes screen as at C-I below. Search – this allows you to look for a patient by either Name, ID , or Time. Import – This allows data to be imported from external source Return – this allows a return to previous page. If a patient ECG has not transmitted successfully, there will be a blank field under MODE.

Select Patient Use buttons on grey arrow pad at bottom right of keyboard to scroll up or down Once patient has been selected press F4 Button Screen will change to allow the following functions located at the bottom of the screen Edit – This allows you to change the patient information demographics Record – Trans – This allows you to send the ECG for reporting Export – This allows data to sent to external device Delete – This allows selected data to be deleted from recorder Preview – This allows you to view ECG recording and if required print new copy of tracing. Return – this allows you to return to previous screen

Transmit Selected ECG from Patient File Ensure Modem and Telstra device are turned on and connected Push F3 button to transmit ECG to Cardioscan. Once transmitted which can take a short time a pop up box will notify if successfully transmitted. PLEASE NOTE Once ECG has been sent to Melbourne leave Telstra device and ECG Machine on for approximately one minute to ensure full transmission Turn Edan off at power button Plug in white power cord to ensure battery charging of EDAN and Telstra device Please ensure Telstra device remains connected to power as battery life is limited.

Additional Information The small space between the clavicle and the 1st rib is NOT the 1st ICS The center of the active surface of the electrode should be aligned with the relevant anatomical landmark When recording and ECG from female patients, it is convention that V4 – V6 are placed under the breast. If correct anatomical positions are not possible, then position electrode in best practical position. Check for an inverted or negative QRS in lead aVR, as this indicates arm lead reversal Remember: “white is right” There are many rhymes to remember the limb leads – ask your senior nurses Using out of date / old electrodes may degrade the ECG signal quality.