Nebula DMS 300-4L User manual

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DMS 300-4L
Holter ECG Recorder
Operator’s Manual

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Table of Contents
Page
Overview of the
Recorder ………………………………………….…….………………….3
Initial Set-
Up…………………………………………..…………………………………………...4
The Start/Setting
Menu ……………………………………………………………………….8
Removing and Loading the
Recorder…………….……………………………….......13

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Overview of the DMS 300-4L Holter Recorder
Front Rear
Side Bottom
HDMI Port
(for ECG Cable) SD Card Slo
t
Battery Compartment
Battery Compartment SD Card (included)
ECG Cable (included)
LCD
Screen
Navigation Buttons

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Initial Set-Up
1. Please insert a compatible SD card into the recorder as indicated in the
picture below.
2. Insert a NEW AAA battery into the recorder. Do not connect any ECG
cable at this point.
3. As soon as the battery is inserted, you will see the DMS logo on the LCD
screen.

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This logo will be quickly followed by a message stating “Initializing SD
Card”. This indicates that the recorder has recognized the card and has
gone through the initial SD card set-up.
(Note: If the 300-4L recorder does not detect the presence of an SD card
once the battery is inserted, the following error message will be
displayed.)
(Note: It is very important that a NEW AAA battery is used for each
individual test in order to minimize the likelihood of missing or incomplete
ECG recording data. To this end, the 300-4L Holter recorder will provide
two different types of warning messages when it detects a low battery.
The first type of warning is for batteries that still have sufficient battery life
for a short Holter recording. You will have the option to continue. The
second warning is for batteries that are detected to be nearly depleted. In
this case, you will not be able to proceed until the battery is replaced with
a new one.)

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4. The recorder will then proceed to display the following message: “Please
Insert Patient Cable”. It should be noted that 4-, 5-, 7-, and 10-electrode
ECG cables (with HDMI connector) are all compatible with the DMS 300-
4L Holter recorder.
5. Upon inserting the ECG cable, the “Start/Setting” screen will be displayed.
If the “Start/Setting” screen is not displayed, please see #6 below.
6. IMPORTANT NOTE: Upon inserting the ECG cable, the LCD screen may
display a message stating “Warning! File isn’t Analyzed”.
The user will not be able to proceed beyond this point. This warning
indicates that the SD card contains an ECG recording which has NOT
been downloaded onto the CardioScan software for analysis. Please
remove the battery and ECG cable, and download the contents of the SD

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card by removing the card and inserting it into an SD card reader
connected to the computer running the CardioScan software.
Please refer to the “Removing the Recorder from the Returning Patient
and Loading from the Recorder to Your Computer” section below for
additional detail.
The act of downloading will NOT delete the ECG recording on the SD
card, but it will place an electronic “marker” on the card which will
communicate to the recorder that an overwrite of the ECG file is allowed.

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The Start/Setting Menu
1. As you can see in the picture below, the current recorder settings (On/Off) for
“ID_Input”, Respiration (“RESP”), and “Pace Maker” are shown in the Start/Setting
screen. These can be changed in the “Setting” menu. The “Lead” input is displayed in
yellow. This cannot be manually changed as it is automatically detected based on the
ECG cable connected (4-, 5-, and 7-electrode result in “3-Lead”; 10-electrode results in
“12-Lead”).
2. A 30-second countdown clock will also be displayed in the lower right-hand portion of
the screen. This gives the user an opportunity to adjust settings, if so desired.
3. The blue Up and Down arrow buttons on the recorder allow the user to navigate
between “Start” (which confirms the settings and prompts the recorder to proceed to the
next display), and “Setting” (which allows the user to adjust the settings before the ECG
recording begins). Press the orange “Enter” button to confirm the selection of “Start” or
“Setting”. For instructions on adjusting settings, please refer to #9 below.

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4. Selecting “Start” in the Start/Setting screen will prompt a 10-second countdown “Start
Recording” confirmation message. Select “OK” if you are ready to proceed. (Please
note that not making any selection in the Start/Setting screen, and allowing the 30-
second countdown clock to expire, will have the same effect as selecting “Start”.)
5. A message will now appear for 5-10 seconds stating “Erasing ECG File”. This function
automatically deletes any existing ECG data present in the SD card.
6. The recorder has now begun to record patient ECG data. As the illustration below
shows, the LCD screen displays: the date in the upper left, the current time immediately
below it, the number of leads in the upper right, the time elapsed in blue, a green battery
life icon in the lower right, and a picture at the bottom indicating that pressing the
orange key on the recorder will display the various ECG leads in real-time. No action
on the part of the operator is needed beyond this point until the recorder is ready to be
removed from the patient for ECG data download.

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7. Please note that the LCD screen dims after approximately 30 seconds in order to
conserve battery life.
8. Pressing the orange “Enter” key at any point will display the patient’s real-time ECG by
channel, as well as the patient’s heart rate. The Up and Down arrows can be used to
navigate between channels.
9. As highlighted above in Step #3, selecting “Setting” will allow the user to adjust the
settings before the ECG recording begins.
10.Upon selecting “Setting” in the Start/Setting screen, a 4-digit password prompt will
appear. Please input the appropriate password to enter the settings menu.

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11.As pictured below, the recorder will now display various settings selections: “System
Setting”, “Time Setting”, “Load Default”, “Version Help”, and “Exit”. Please use the blue
Up and Down arrow buttons and orange Enter key to navigate the settings menu.
12.System Setting: This allows the user to set “Patient ID”, “PaceMaker”, and “Respiration
Test” to either “On” or “Off”. If “Patient ID” is switched to “On”, the user will be prompted
to assign the patient an identification code. This information will be transferred, along
with the patient’s ECG data, when the SD card is downloaded onto the computer
running the CardioScan software

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13.Time Setting: This allows the user to set the appropriate date and time. The 300-4L
Holter recorder has an internal time-keeping function regardless of whether a battery is
inserted or not. Thus, the user will not have to set the date and time for every patient. It
is also important to note that the date and time can be updated automatically using the
CardioScan software if the operator chooses to pre-enroll the patient.
14.Load Default: This quickly allows the user to restore the 300-4L recorder to its default
factory settings.
15.Version Help: This displays the recorder model number, the serial number, and the
firmware version.
16.Exit: Once the user is finished with the settings menu, press exit to return to the main
“Start/Setting” screen.

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Removing the Recorder from the Returning Patient and Loading from the
Recorder to Your Computer
1. Upon returning to your office, remove the battery cover from the back of the Holter
recorder, and remove the battery.
2. Make sure to discard the battery, since the recorder is designed for one new battery per
each recording.
3. Warning: If you do re-use the battery, you will likely cause the recorder to stop
operating in the middle of recording your next patient.
4. Un-snap the Lead Wires from the electrodes, and disconnect the ECG cable from the
recorder.
5. On your computer desktop screen, double-click the CardioScan Icon
6. ECG data can be downloaded from the Holter recorder in two different ways: 1) remove
the SD card from the recorder and insert it into the SD card reader connected to your
PC or 2) plug the recorder into the HDMI-to-USB download cable connected to your
computer. The SD card can be accessed through the battery compartment. Push it in
to release it.
7. In the upper left of the Holter program main menu display, click on the “New Patient”
button which will bring up the “Patient Data” display. [WARNING: MAKE SURE YOU
CLICK ON “NEW PATIENT”. DO NOT CLICK ON “ENROLL”, AS YOU RISK
ERASING ALL ECG DATA FROM THE SD CARD YOU ARE TRYING TO
DOWNLOAD].
8. If you pre-enrolled your patient, you should see the information that you have already
entered for the patient. If not, please enter the required information such as the
supervising physician, the referring physician, the patient name, the patient’s age, etc.
Please note that data fields such as date, time, and whether the patient has a
pacemaker will be automatically downloaded from the SD card based on the initial
settings selection.
9. After entering all of the patient information, click on the “Next” button. If you have filled
out something incorrectly, the computer will prompt you to fill in the applicable
information.
10.If you have not connected the SD card reader or your download cable correctly, you will
be prompted to insert the patient’s SD card. Please simply make sure that the SD card

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reader or cable is connected to the PC. Now click on the “OK” button to load the Holter
ECG data.
11.The patient’s data will now be loaded onto the CardioScan program and the software
will analyze your data.
12.When the analyzing has finished, you will be prompted, “You may take out the SD card
now or disconnect the Holter recorder now”. Click on the “OK” button.
13.You are now finished and ready to use the Holter for another patient.
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