MAGSTIM RAPID2 User manual
Magstim
Rapid
2
®
MAGSTIM
RAPID2
PIN 3576-23-09
OPERATING MANUAL
The
MAGSTIM
Company
LTD
3576-23-09
November
2009
BTL EX2035
Allergan v. BTL
IPR2021-00312
Magstim Rapid2 3576-23-09
TABLE OF CONTENTS
Section
1:
\Varnings and Precautions 1
Section 2: Product Description 3
2.1 Front View
2.2 Indications
2.3 Coils
Section 3: System Setup 6
3.1
Rear
\lie\v
3.2 PSU
3.3 Additional Connectious
3.4
lv1EP
Pod Connection
3.5 Printer
3.6 Set-up
3.7 UI
3.8 Stimulation
Section 4: System Operation Instructions 13
4.1
\Vekome
Screen
4.2 Main Options Menu
4.3 Single Pulse Mode
4.4 Single Pulse Mode MEP
4.5 Repetitive Mode: Setup Standard
4.6 Repetitive Mode: Standard
4.7 Repetitive Mode: Setup Burst
4.8 Repetitive Mode: Burst
4.9 Session J\fode: Setup
4.10 Session Mode
Section 5 System 26
5.1
System Options Menu
5.2 User Configuration
5.3 System Details
5.4 System Configuration
Section 6: Data Reti-ieval 31
6.1
File Maintenance
6.2 Patient Details
6.3
Creating
and
using
Files.
6.4 SD Card
6.5 Print Options
Section 7: System Status Codes 37
7.1
System Status Codes
7.2 Isolated Trigger Port
7.3 SD Card File details
Section 8: Safety Features
42
8.1
Coil Temperature Protection
8.2 Coil Disconnection
Section
9:
Maintenance and Servicing 44
9.1
Voltage Selection Instn1ctions
9.2 User Maintenance
9.3 Technical Maintenance
9.4
Cleaning
and
Disinfecting
9.5
Sen1icing
9.6 Device Lifetime
9.7 Disposal
Section 10: Specifications 48
lll.1 General
10.2 Power
10.3 Ambient Temperature
10.4 Capacitor Life Expectancy
10.5 Output
10.6 Coil Compatibility
10.7 UI Rear P
and
10.8 General
10.9 Handling
Section 11: EMC Emissions and Immunity 56
Section 12: Rapid2 System Packages 59
The MAGSTIM Company LTD November 2009
Magstim Rapid2 3576-23-09
GUARANTEE
Equipment manufactured by the Magstim Company Limited is fully guaranteed covering materials
and
workmanship for a period
of
one year from the date
of
shipment. The capacitor is guaranteed for one
year,
or
1,000,000 discharges, which ever comes first. The Magstim Company Limited reserves the
right to
perfonn
guarantee services in its factory, at
an
authorised repair station,
or
at the customer's
installation.
The Magstim Company's obligations under this guarantee are limited to repairs or, at the company's
option, replacement
of
any defective parts
of
our equipment, except batteries, without charge
if
said
defects occur during normal service.
Claims for damages during shipment must be filed promptly with the transportation company. All
correspondence concerning the equipment must specify both, name and/or number
and
serial number,
as it appears
on
the invoice for said equipment.
Improper use, mishandling, tampering with,
or
operation
of
the equipment without following specific
operating instructions will void this guarantee and release the Magstim Company Limited fi:om any
fu11her
guarantee obligations.
The Magstim Company Limited will only accept responsibility for the effects
on
safety, reliability and
performance
of
the equipment if:
• modifications or repairs are carried out
by
persons authorised
by
The Magstim Company
Limited.
• the electrical installation
of
the relevant room complies with local regulations, and
• the equipment is used in accordance
,:vith
the instructions for use.
The MAGSTIM Company LTD November 2009
Magstim Rapid2 3576-23-09
SECTION:
1.
WARNINGS AND PRECAUTIONS
USA Only
CAUTION: Magne.tic stimulation has not been cleared
by
the
FDA
for cortical stimulation.
Investigational human uses require that the
use.r
complies
\Vith
the.
FDA regulations regarding
It1Yestigational Devices.
Please visit ww,v.fifa.gov/cdrh or ww,v.magstim-us.com fr,r more information.
CAUTION: In the USA, Federal
Lav.-
restricts this device to sale by
or
on
the order
of
a practitioner
licensed
by
the
lav.-
of
the State in
\v-hich
he/ she practices
to
use or order the use
of
the device.
Attention: Consult accompanying documentation before using the Magstim Rapid2.
CAUTION: The Magstim Rapid2 and its stimulating coils must not be used on, or in the
vicinity of, patients
or
subjects with cardiac demand pacemakers, implanted defibrillators, or
other electronic implants.
The Magstim Rapid", its coils and accessories generate high intensity magnetic pulses. The
induced eddy current is
of
sufficient magnitude to stimulate nerves and muscle.
The strong magnetic pulses generated
by
stimulating coils induce eddy currents in any
conductive medium such
as
the human body, nearby metallic objects
or
electronic devices.
l"'B
Pm1icular care must
be
taken
to
ensure that leads connected directly to the patient,
or
other
equipment, are not in a position where the stimulating coil can couple resulting in cmTents
being induced in them.
Caution: for safety reasons, do not leave patient cables attached to the MEP Pod
if
they are
not being nsed.
If
an unused cable is
lefl:
connected, and the patient is connected to the other
channel, there is the possibility that the unused cable may touch an earthed surface which
could allow current to flow through the patient to ground.
Caution: do not allow the coil
or
the coil cable
to
come into close proximity with the MEP
Pod patient cables. During discharge, current may be induced in these cables.
Do not discharge the Magstim with the stimulating coil in the vicinity
of
metallic objects
or
these may
be
projected, moved and/or damaged.
The Magstim Rapid2 must not
be
used in an explosive atmosphere or in the presence
of
flammable anaesthetics.
\Vb.en
the magnetic pulse is delivered, a discharge click
is
produced by the Magstim Rapid2
and its stimulating coil. This discharge click may stm1le.
\1/here possible avoid the use
of
the stimulating coil near the ears. The use
of
ear plugs is
recommended.
High voltages are present within this System. Do not remove covers. Refer servicing to
qualified personnel. Ensure that the System is not subject
to
conditions where water/ liquid
may be tipped on it, including the UI Controller.
To
emure
grounding safety, all mains pov,,er connections should be made directly to wall
power outlet sockets. All
of
the customer's electrical cabling must conform to local electrical
standards. Do not use a terminal block
if
insufficient sockets are available, as this will form a
potential electrical hazard.
The Magstim Rapid2, its stimulating coil and accessories must not be used
ifthere
are
any
signs
of
external damage
or
if
any parts are damp
or
wet.
Cortical magnetic stimulation rnns the risk
of
inducing seizures.
The
l\'IAGSTIM
Company
LTD
November 2009
Magstim Rapid2
Coil
Over
Temperature
~cf.%
__
j
5
3576-23-09
Do
not discharge the Stimulating Coil in the vicinity
of
objects sensitive to magnetic fields.
Examples are credit cards, floppy disks and computer screens.
Protection circuits disable the equipment
if
the temperature
of
the Stimulating Coil exceeds
40°C.
Coils must not be immersed in water,
put
in an ice bucket, or refrigerated, even
if
placed
within a plastic bag, as condensation may be created within the coil. The coils do not have any
specialisedprotection against the ingress
of
liquids; therefore conditions ,vhere ingress
of
liquid,
or
the forming
of
condensation within the coil, can occur must
be
avoided
as
the
electrical insulation will
be
compromised. Cooling must only
be
performed by using a flow
of
cool air from a fan
or
air conditioning unit.
Due to thermal lag, the surface temperature
of
the Stimulating Coil may continue to rise
following the coil over-temp activating and forcing the main unit into a standby condition.
Therefore, the Coil must be removed from the patient as soon as the UI indicates that the coil
is over-temperature.
If
the Rapid system is externally triggered via a signal generator, the coil temperature
algorithm is disabled. Under this condition, at high frequency/high power, it is possible for the
coil temperature to reach levels well in excess
of
the 41°C limit specified in EN60601-L
before the hardware temperature cut-out operates.
If
the system is to be used
m1der
these
conditions, it is essential that the intended protocol be run prior to use on a patient, to ensure
that its temperature remains within the required limit.
There are cun-ently few medical papers available regarding the effects
of
magnetic stimulation
on the unborn child! foetus
or
the expectant mother. As a result
of
this,
we
are unable to verify
the safety
of
the Coil's use on, or by, pregnant vrnmen. We rec01mnend that anyone wishing to
use the Coil
on
a pregnant woman,
or
use it whilst pregnant, should contact the Magstim
Company Ltd. for more information as new medical papers become available.
On no account must the Magstim Rapid2 and its accessories
be
used in
environmental conditions outside those specified in this operating manual.
No pins
of
connectors identified with the ESD warning symbol should be touched. The
connectors involved are those to be found on the rear
of
the User Interface. Connections
should not
be
made to these connectors unless ESD precautionary procedures are used. All
staffresponsible for using the l\fagstim Rapid2 System should receive an explanation
of
the
ESD warning symbol and receive training in ESD precautionary procedures -
Connection should be made only by a person who
is
wearing a conductive wrist strap, which
is connected to a suitable tested earth connection, or following the person grounding
themselves by touching a part
of
the external casing connected
to
protective earth.
The l\'IAGSTIM Company LTD 2 November 2009
Magstim Rapid2
SECTION: 2. PRODUCT DESCRIPTION
2.1 RAPID2
Unit Power Status Indicator
• Flashes when the system
is in STANDBY.
•
On
continuously when
the system
is
ON.
ON/OFF/STANDBY
This switch toggles the
operational state
of
the
Rapi,f.
ARMED Indicatm·
illuminated
v,rhen
the
is
armed and high voltages
are present in the system.
Coil OUTPUT Socket
See below for description
PSU Power Status
•
•
On
continuously when
system
is
ON
ARMED/FAULT Indicator
This LED
is
continuously illuminated when the system is anned and high voltages are present
in the system. This LED turns RED when a fault has been detected in the PSU.
Coil OUTPUT Socket Operation and SYMBOLS
3576-23-09
This socket
is
used to connect the stimulating coil to the Magstim Rapid2. Note that the unit cannot be
anned and triggered unless the stimulating coil
is
connected to this output. Ensure that the locating pin in
the coil plug
is
correctly lined up
\.vith
the coil output socket before inserting the plug. When the coil plug
is
fully engaged in the socket. lock the plug in place by turning the black locking ring clockwise.
To remove the coil, put the Magstim Rapid2 into standby and
tum
the black locking ring anti-clockwise.
HIGH VOLTAGE Symbol
This sign warns that voltages in excess
of
1
SOOV
are present within the instn.unent.
ATTENTION
Symbol-
Consult Operating Manual
See warnings in Section 1regarding the use
of
the Magstim Rapid2.
APPLIED PART Symbol
BF Type Applied Part.
The l\'IAGSTIM Company LTD 3 November 2009
UI
Main
Frame
PSU
Magstim Rapid2 3576-23-09
The applied parts
of
this device, namely the stimulating coil,
i'v1EP
Pod and MEP Pod
patient leads, are electrically isolated from the otherparts
of
the equipment as required
by
the safety standards
ofBSEN60601-l.
2.2 INDICATIONS
The Rapid2 works by inducing electrical currents in tissue using a non-invasive stimulating coil at
frequencies
of
up to 100Hz. The stimulating coil is placed near the intended site
of
stimulation and
trigger pulses initiate
brief
magnetic pulses. The magnetic fields can pass through clothing, tissue and
bone to reach othenvise inaccessible areas. One feature
of
magnetic stimulation is that it
is
less likely to
stimulate pain fibres at the skin surface, reducing the discomfort when compared with conventional
electrical stimulation. Magstim Rapid2 magnetic stimulators combine stimulation frequencies from
lHz
to lO0Hz with a touch screen interface ·which controls every aspect
of
the stimulator's control and
operation.
INDICATIONS
FOR
USE. The Magstim Rapid2 magnetic nerve stimulator systems are intended
for the stimulation
of
peripheral nerves and the human cortex for
diagnostic ,md research purposes.
CONTRAINDICATIONS. Magstim Rapid2 systems and their accessories should not
be
used
on
or
in the vicinity
of
patients
or
users with cardiac demand pacemakers,
implanted defibrillators and/or implanted neurostimulators.
CAUTION. Check the Magstim Rapid2 System and its accessories for any signs
of
damage.
If
the Magstim Rapid2 System
or
any
of
its accessories are
damaged in any
way
they must not
be
used.
The MAGSTIM Company LTD
Federal law restricts this device to sale
by
or
on
the order
of
a
practitioner licensed
by
the law
of
the State in which he/she practices to
use or order the use
of
the device.
To avoid interference problems the Magstim Rapid2, and its
accessories, should not be used in the vicinity
of
any equipment that
does not comply with EMC Standard
EN
60601-1-2, including mobile
phones.
For
reasons
of
safety and reliability,
if
the system is set at
lOO'Y,,
pmver,
the nser must not exceed 250 stimuli per minnte,
or
4000 stimuli
per
hour
or
24,000 stimuli for every 24 hour period. This limitation is in
addition to any other limitation imposed
by
the dedicated controller,
or
heating effects on the stimulating coil and charger circuitry.
The entire Operating Manual should be studied prior to use and users
should be aware, in particular, that high voltages and currents, which
can prove lethal, are present
if
the covers are removed. The Magstim
Rapid2 system's parts are detailed in Sections 3-6.
Each
of
the mains connections for the Rapid2 System must be made
via sepa1·ate, permanent, mains outlets.
On
no account should a
multi-way extension lead
be
used to connect more than one mains
connector to a single mains outlet.
The
Rapid2 System must be used only with the supplied mains
leads fitted with an integrnl filter, as they are requit-ed to maintain
the System's compliance with EN 60601-1-2 regarding Electro-
Magnetic emissions, as is the earth strap fitted between the
stimulator and the power supply unit (PSU).
The MEP
Pod
is designed to
be
fitted to the Magstim Rapid2
UI
only.
Do not attempt to connect it to a computer,
or
any other equipment,
v,rith
a similar connector. To do so could result in electric shock/ burns
to the patient at the site
of
electrode attachment. The MEP Pod
connector has a hole deliberately blocked to prevent incorrect
com1ection.
lOOHz
must
not
be used for cortical stimulation, it is for pel'iphernl
4 November 2009
Magstim Rapid2
2.3 COILS
3576-23-09
use only. For safety guidelines relating to transcranial stimulation,
see Section 9
of
this Operating Manual.
The Stimulating Coil must not
be
discharged in the vicinity
of
the
patient's hem·t.
A variety
of
coils is reconm1ended to stimulate specific neutral patfrways. These coils have their coil
heads labelled with blue arrows,
which
represent the direction
of
the coil discharge current. The virtual
cathode for these coils is approximate to the valley
or
trough formed by the conjunction
of
the hvo
coils, directly opposite the handle towards the leading edge
ofthe
coil.
Double 70mm Coil
2
nd
Generation Double
70mm
Stimulating Coil P/N 3191-00. Also Standard Double
70mm
Stimulating
Coil PfN 9925-00.
Coil Adapter
The Double 70mm coil is capable
of
accurate stimulation
of
co1iical areas and spinal nerve roots.
Applications Include:
• Selective monohemispheric transcranial stimulation
• Excitation
of
spinal roots
• Motor cortex
• Peripheral nerves
Coil P;N 9925-00 must be connected
to
the
stimnlator via the snpplied coil adaptor (P/N
3110-00). This coil ,vill not fi.mction
if
connected directly to the stimulator.
Please note: it is important that the
coil is connected correctly.
If
the
coil appears to be misaligned,
remove and re-connect the coil. Do
not use
if
the coil appears
misaligned.
High Power 90mm Coil (additional item aYailable)
P/N 3193-00
Location
The High Pmver 90mm Coil can be used for central
motor conduction studies. The design
of
the coil
allows between 120 and 160 stimuli
at
the
maximum
power
level before requiring a few
minutes to cool.
The Double 701mn Coil is localised in its area
of
stimulation.
For
reproducible results from cortical
stimulation, the most effective site
of
stimulation should be established and marked using the
Brainsight Frameless Image-Guided TMS stereotactic 3D imaging system.
For
further infornmtion
on
this system please contact The Magstim Company Limited.
For
peripheral sites, the stimulation site
can
be
marked with a suitable pen.
The MAGSTIM Company LTD 5 November 2009
Magstim Rapid2 3576-23-09
For further information regarding coils. see relevant coil operating manuals, or visit the Magstim
website at w,vw.magstim.com.
SECTION: 3. SYSTEM SETUP
UI Cable
Mains Pmver
Switch
Fuse Access
and Voltage
Selector
Power Entry
Module
lOALink
Lead
HVCable
3.2 Power Supply Module (PSU
-3014-00)
LJ ( l
~
.&,&
'"'&
0
Power Supply Module (PSU -3013-00)
(
!
l .&
.&.
I
,..,:,.;.,.
& o
:;;:·~~
The 1\-IAGSTIM Company LTD 6
230VPSU units shown.
115V units are identical in
appearance to the 230V
units, with the exception
of
the voltage/power rating
labels sited on the rear
of
the units.
November 2009
Isolated
Trigger Port
Foot Switch
Pnemnatic
Socket
Cooling Fan
Outlet
HVPower
Entry Socket
Magstim Rapid2 3576-23-09
3.3 ADDITIONAL CONNECTIONS
o Printer
V
SD Card
Insertion Point.
15
WayD
Type
Connector
25
WayD
Type
Connector
Batteries.
26\.VayD
Type
Connector
25 \Vav D Tvpe Connector (situated on rear
of
the UI, 2 rows
of
pins)
This connector is situated on the rear
of
the UI. and has 2 rows
of
pins. The
connector links the UI to the Magstim
Rapid='
as shown on the diagram on the
previous page.
26 Way D Type Connector (situated on
1·ear
ofUI,
3 rnws
of
pins)
This connector is situated on the rear
of
the UI, and has 3 rows
of
pins. It provides
trigger input and output signals (see page 54).
DC Power Jack {situated on rear
of
un
The DC Power Jack
is
situated on the rear
of
the UI. This connector allows an
external 24V. 750mA DC power supply to be attached. A suitable medical grade
supply must be used, conforming
to
IEC 60601-1. This
is
NOT required when the UI
is connected
to
the Magstim Rapid2.
The Printer
is
attached to the User Interface via an Optical/RS232 Interface Cable
which slides into place on the right hand side at the rear
of
the UI.
SD Card Socket (situated on rear
of
the left side panel)
0 This socket is situated on the rear
of
the left hand side panel
of
the UI. This allows
connection
ofan
SD Card. This removable memory storage facility enables transfer
of
data between the
UI
and external devices, such as PCs.
15 Wav D Type Connector (situated on rear
of
UI behind cover)
This connector is situated on the rear
of
the UI behind the removable cover. It
is
designed to accept the Motor Evoked Potential (MEP) pod, available as a separate
item. It has type BF connection.
The l\'IAGSTIM Company LTD 7 November 2009
Magstim Rapid2 3576-23-09
3.4 MEP POD CONNECTION
NOTE. The Rapid2 must be switched
off
before connecting or disconnecting the MEP
Pod.
The Motor Evoked Potential (MEP) Pod
is
an optional component which allows the user to capture
EMG signals and display them on the UI. 2 channels are available. The MEP Pod should be mounted as
close as possible to the subject but should be kept away from sources
of
interference, such as power
cables.
It
is recommended that all EMG cables are screened to minimise interference.
The l\1EP Pod is designed to be used with surface electrodes only.
The MEP Pod is designed to be fitted to the Magstim Rapid2 UI only. Do
not
attempt to colll.lect it to a
computer,
or
any other equipment, with a similar connector. To do so could result in electric shock/
bums to the patient at the site
of
electrode attachment. The MEP Pod com1ector has a hole deliberately
blocked to prevent incmTect connection.
C0:11."NECTION
The MEP Pod is attached to the rear right hand side
of
the
UI
when viewed from the rear. Remove the
plastic cover
to
expose a
15
way D Type socket. Attach the MEP Pod cable, ensuring that the plug is
properly inserted. The plastic coverhas a notch in its lower edge through which the cable must pass.
This cover, when replaced, provides strain relieffor the connector. Do not operate the equipment
without replacing this cover, as damage to the connector and the internal electronics
of
the
UI
is likely.
USE
Attach the
EMG
cable to the
MEP
Pod and snap the free connectors onto surface type electrodes (for
example, Kendall ARBO
Hl24).
Suitable electrodes are available from many medical supply
companies, and no recommendation is made as to a particular type. Electrodes should be chosen which
are suitable
fix
the collection
ofEMG
data, have snap connectors, and which are compliant ,vith local
regulations.
\\'hen
connecting the electrodes, follow the colour code on the MEP Pod.
The EMG connection cable should
be
screened and should be suitable for use ·when in direct contact
with the skin. No latex should be present in the cable.
The electrodes should be positioned on the target muscle which is controlled by the neurons being
stimulated. For example,
if
the area
of
the motor cortex
vv-hich
controls the hand is
to
be stimulated, the
surface electrodes should
be
placed
on
abductor digiti minimi, about
!cm
apart. The ground electrode
should
be
placed on the wrist. Care should
be
exercised when placing surface electrndes.
It
is important
that a consistent approach is observed, as the amplitude
of
the
EMG
signal
is
dependent
on
the position
of
the electrodes. Good practice in relation to skin cleaning should be observed.
CAUTION
For safety reasons, do not leave patient cables attached to the MEP Pod
if
they are not being used.
If
an
unused cable is left connected, and the patient is connected to the other channel, there is the possibility
that the unused cable may touch an earthed surface which could allow cmTent to flow through the
patient to ground.
Do
not allow the coil or the coil cable to come into close proximity ,vith the
MEP
Pod
patient cables.
During discharge, current may
be
induced in these cables.
The MAGSTIM Company LTD 8 November 2009
Magstim Rapid2 3576-23-09
3.5 PRINTER
TO
SET
UP
THE
PRINTER
l.
Inse1i the cable connector straight into the Printers Serial Port to power the printer via the
Mains
Serial Port
2.
Connect the other
end
of
the cable to the
back
of
the UI via an optical RS/232 Interface cable
by sliding the connector into the slot until tight. Connect the printer to its pmver supply and
the
power
supply to the mains.
Op1ical RS/232
Interface cable
--------l~
3. Svvitch the printer
on
via the green button on the left hand side
of
the printer. The
'Power'
LED should
now
be
illuminated green.
TO
LOAD
THE
PAPER
l.
Push the Cover Open buttons
on
the side
of
the printer; this should
open
the Roll Paper Cover.
2. Align the edges
of
the paper roll against the paper holders and push dmvn gently.
3. Pull the paper through and close the cover.
The Printer is
now
ready to be used.
On/Off
Button
Cover Open
Button
The l\'IAGSTIM Company LTD 9
Roll Paper
Cover
Feed
Cover Open
Button
November 2009
Magstim Rapid2
3.6 SET-UP
1.
2.
3.
4.
5.
6.
7.
8.
9.
3576-23-09
Before using the
instnunent
ensure that the
co1Tect
fuses are fitted and that the
voltage selector is set to suit
the
country's
supply voltage (this statement applies to
the Rapict2 Main Frame only). There are 2 fuses, rated at T 1.25A for both l
15V-
±10%, and
230V
-
±10';,·o.
For
infonnation
on
changing the fuses, please see Section
9.
Place the system in a room
near
multiple
power
sockets and ensure easy access to
and around the equipment.
Label the entrances to the
room
to
warn
of
the presence
of
strong magnetic fields
and
to exclude those wearing pacemakers and/or electronic implants.
Connect the power cables provided to the
power
supply socket(s)
on
the rear
of
the
PSU. The
power
reqnirement
of
the Magstim Rapid2 depends
on
the PSU used and
the
parameters set
by
the UI.
The power cables must
be
connected dkectly to wall power outlet sockets,
and
not
via a terminal block. The Rapid2 System must
be
used only with the supplied
mains leads fitted with an integral filter, as they are required to maintain
the
System's
compliance with
EN
60601-1-2 regarding Electro-Magnetic emissions, as is
the earth strap fitted benveen the stimulator and the
power
supply unit (PSU).
Connect the
HV
cable from
the
PSU
to the rear panel
of
the
Main
Frame. Connect
the mains linkbetween the
PSU
Module
and
the
Main
Frame.
Connect the UI Controller to the Magstim Rapid2 via the interface cable supplied.
Connect
the
Stimulating Coil to
the
front panel connector
of
the Magstim Rapid2.
Apply
mains
power
to the Rapid2 System by switching the mains
power
switch
on
the rear panel
of
the Rapid2 Main Frame to the
ON
position.
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November 2009
Magstim Rapid2 3576-23-09
3.7 USER INTERFACE (UI)
ARM Button
0
TRIGGER Button
In\
v;w
ARM
Button
.~++±+++-i:--.;.;.;...;...
SYSTEM STOP
Button
Output Control Knob
The Magstim Rapid2 can be put into the ARMED mode by momentarily pushing the
Green RUN button. This can
only
be achieved
if
the stimulating coil is connected to the
COIL OUTPUT socket.
The Magstim Rapid2 can be triggered, and a magnetic pulse produced,
by
pushing the
Yellow TRIGGER button.
SYSTEM STOP Button
•
0 The Magstim Rapid2
can
be put into the safe inactive default mode by momentarily
pushing the Red STOP button.
In
this mode, the instrument will discharge internally.
OUTPUT CONTROL Knob
This control allows the user to change the screen-selected parameter to the desired value.
It is therefore used to alter screen settings as well as cha11ging the power output
of
the
stimulator.
TOUCH-SENSITIVE SCREEN/ SYSTEM DISPLAY
All selections are made via the touch-screen. To select, touch the centre
of
the button
symbol next to the desired menu option. Do not press hard,
or
use a sharp
or
pointed
object to make the selection, as this
may
damage the touch screen.
In the set-up screens, all selectable items are coloured in pale blue; white items are non-
selectable. The Rotary Control Knob can only
be
used to change parameters already
selected. Details regarding the contents
a11d
operation
of
the UI Screens are given in
Sections 4, 5 and 6
Note:
If
the UI is not used for
30
minutes it will go into a standby condition. In
standby, the screen ,vill appem blank
a11d
the blue LED in the upper right corner
of
the
front bezel will pulse. Touch the screen
to
restore the UI.
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Magstim Rapid2 3576-23-09
3.8 STIMULATION
See Section 4 to select the desired mode, stimulating power, stimulation frequency, train duration and
inter-train delay.
Activate the
AIU\.-1
but1on on the
UI
bezel to arm the unit. The system will charge and the UI will
display READY in the system status
\.Vindow.
NOTE: The system cannot be anned
if
the footswitch is active.
Position the stimulating coil on the desired area
of
tissue. The system can
be
triggered
by
pressing a coil switch button and either pressing the footswitch on the trigger button or on the
UI. A clicking noise
\Yill
emanate from both the stimulating coil and the M.agstim Rapid2 each
time the Magstim Rapid2 is triggered. This indicates that a magnetic pulse is being delivered by
the stimulating coil, which is stimulating the
ne1-ves
beneath it.
\\'hen
necessary, it is possible
to
reposition the stimulating coil and/or to modify the pmver level
on
the
UI
to suit the requirements for the next stimulus. Meanwhile, the system will have recharged and can
be
triggered once again in the nonnal manner.
\Vhen the stimulations have been completed, press the SYSTEM STOP button on the UI.
The system can only be fired when one
of
the follmving
UI
screens is displayed:
• Single Pulse l\fode,
• Repetitive Mode
• Session Mode.
EXTERNAL TRIGGERING
If
an external triggering device is used, the Rapid2 uses the power set to govern the maximum discharge
frequency. Therefore,
if
the external frequency is set higher than the power set will allow, the
stimulator will discharge at the maximum rate the stimulator can achieve for the power set, and not at
the rate from the external trigger source. In these situations, reducing the power will allow the
discharge frequency to increase. However, during external triggering there are no duration limits on the
trains. Therefore, it is probable under high frequency operation that enough energy will be discharged
into the coil to result in its temperature rising rapidly above 40°C following the system going into a coil
over-temp condition and reverting
to
its discharged state.
It is important that
if
this type
of
operation is intended the protocol be
nm
prior to use on a patient and
the surface temperature
of
the coil monitored to ensure that the patient is not exposed to excessive
tempera
t:ures.
NOTE.
If
the external trigger is set to the level triggering option it is possible for auto-triggering to
occur.
IMPORTANT
The temperature
of
the system is internal components becomes elevated during operation. The system
should be left 011, and uncovered, for approximately ten minutes i<)llowing completion
of
stimulation
to
enable the fan to cool the internal system components.
The MAGSTIM Company LTD
12
November 2009
Magstim Rapid2 3576-23-09
SECTION: 4. SYSTEM OPERATION INSTRUCTIONS.
Sv,,-itch
on the system using the ON/OFF/STANDBY button on the front
of
the Rapid2 Main Frame.
4.1 WELCOME SCREEN
The UI will activate automatically. The 'Welcome Screen' will
be
displayed.
The system will fully initialise and the Options Menu will appear after
15
seconds.
Pressing the Continue button before the system has fully initialised gives access
to
the following
options:
Single Pulse Mode
System
File ilfaintenance
The system needs to
be
fully initialised before RepetitiveMode and Session Mode are accessible.
The l\'IAGSTIM Company LTD
13
November 2009
Magstim Rapid2 3576-23-09
4.2 MAIN OPTIONS MENU
All selections are made via the touch-screen. To select, touch the centre
of
the button symbols.
Single Pulse
Repetitive Mode
Session Mode
System
File Maintenance
Selecting this option will call up the Single
Pulse
1vlo,le Screen.
This allows the system to be fired at a maximum rate
of
!Hz, up to I
00%,
power and 0.5
Hz
from
IO
1-110'%. It also allows an
MEP
module to be
configured.
Selecting this option will call up the Repetitive Mode Set-up Screen. (See
section 4.5) This allows the system to
nm
a user defined train
of
pulses from
a single trigger.
Selecting this option will call up the Session Mode Setup Screen. (See
section 4.9) This allows the system to
nm
a series
of
separately defined
trains
of
pulses from a single trigger.
Selecting this option will call up the Systems Options Menn Screen. (See
Section 5J
Selecting this option will call up the File Maintenance Screen. (See section
6)
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November 2009
Magstim Rapid2 3576-23-09
4.3,SINGLE PULSE MODE
The trace window is always active
on
this screen and is intended
to
display
ElVIG
response information
from the MEP Pod.
If
no MEP pod is connected, the screen message will show
'MEP
NOT
INSTALLED.'
To alter the settings, touch the window next to the required setting. A dark blue margin
~Nill
appear
within the selected window. The settings can be quickly altered using the Rotary Control Knob.
POWER PANEL
Trace
Window
L.---1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,1,_1,_1,_l,
__
l,,~,_l,~~,_~,~,,1_l_t<~_t,1_1,_,,1,_1,.1,_,l,l,_l,_l,l,l,l,l,l,l_l,l_l,I_I_I_I_I_I_
:::::::::::::::itll:
__
i!i!i!i!i!i!i!i!i!i!i!i!i!i!i!ill\1i_._i!i::::::::::::::::::::::::::::itl\1Hilililililililililililililililll1i:
·'bl~"~
)?}?i,\MM
:,?,/,/,?,:,:§m~~WMd?J?JJ§bWL,?,/,/,/,?,rntrn
?}?J?Wi.WiMMi@(/
The Power Panel is selected
by
pressing the Power button. \Vhen Power is selected, the button
turns green.
Powe1·
%MT
Enhanced
To adjust the system power level, touch the Stimulator Output window on the
Power Panel. The power level is set to the default value
of
30%. The power can
be increased,
or
decreased, in l
'~t
increments
by
using the Rotary Control Knob.
Each complete 360° rotation changes the output level by approximately
20%,.
The %MT (Motor Threshold) window, displays the percentage
of
stimulator
output which is to be transferred to the Protocol Intensity window. The
'YoMT
cannot be adjusted
to
give more than the l00% in the Protocol Intensity window.
This option enables the pmver level to
be
increased
up
to
110'1/o
power. This
option is only available in Single Pulse Mode.
If
Repetitive Mode
or
Session Mode is accessed via Single Pulse Mode, the Protocol intensity value
will be carried over into these modes.
All other configurable Single Pulse Mode options are available only when the
ivIBP
Pod is connected.
NOTE. The Rapid2 must be switched
off
before connecting or disconnecting the MEP Pod.
The l\'IAGSTIM Company LTD
15
November 2009
Power Panel
%MT Window
Magstim Rapid2 3576-23-09
4.4 SINGLE PULSE
JVIODE
(MEP POD CONNECTED.)
The MEP Pod must
be
connected to access the following options and to view the traces.
NOTE. The Rapid2 must be switched
off
before connecting
m·
disconnecting the MEP Pod.
PARAMETERS PANEL
~:~=-~,1,_1,1,_r,_1,_1_-_l_!_~_:.!_[_:_r_:_:_:~;:~::::~~~~;:~;:::~i~~:~iilililli
__
_
=~~,;a
fffflt::::::::::::::::::::::::::::::::ijfffi
·.·.·-~·-·································-·:·:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:·.·················
P1·ess
the Parameters button (green when selected) to access the
MEP
Configuration panel.
Time Base Selecting the Time Base window allows the user to set the MEP total sample
period. The selectable options are;
20m.s,
50m.s,
l00ms, 200m.s and 500ms and are
selectedusing the Rotary Control Knob. The trace width will show the whole
of
the selected sample period.
Filters Selecting the Filters window allows the user to set the MEP Filter using the
Rotary Control
Knob. Selectable options: 2Hz-10kHz and 20Hz-10kHz.
Volts/Div Trace 1 Selecting the Volts/Div Trace window allows the user to set the scaling factor for
channel
1.
Selectable options: S0µV, IO0µV, 200µV, 500µV, lmV, 2mV, SmV
and l0mV. The default setting is 200~lV.
Volts/ Di\' Trace 2 Selecting the Volts/Div Trace ,:vindow allows the user to set the scaling factor for
channel
2.
Selectable options:
5011.V,
IO0µV, 200µV, 500µV, lmV, 2mV, SmV
and l0mV. The default setting is 200~lV.
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November 2009
Magstim Rapid2 3576-23-09
TIME CURSORS PAi~EL
Press the Time Cursors button (green when selected) to access the Time Cursors panel.
Status
Channel 1
Latencies
Channel 2
Latencies
Select the Status window
to
turn the Latency Cursors
on
and off. The default
setting is OFF.
Select
LI
or L2 to activate a cursor for adjustment. \Vhen the cursors are active,
their current screen time value ,vill be displayed on the trace windmv. The trace
of
the selected cursor can be moved using the Rotary Control Knob, for example
to identify the time
of
an event.
Select
Ll
or
L2 to activate a cursor for adjustment.
\\'hen
the cursors are active,
their current screen time value will be displayed
on
the trace window. The trace
of
the selected cursor can be moved using the Rotary Control Knob. for example to
identify the time
of
an event.
The l\'IAGSTIM Company LTD
17
November 2009
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