SOMNOmedics DOMINO User manual

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DOMINO
VERSION 3.0.0.0
SOMNOmedics GmbH –Am Sonnenstuhl 63 –D-97236 Randersacker
Tel. +49 (0) 931 / 35 90 94-0 –Fax +49 (0) 931 / 35 90 94-49
E-Mail [e-mail] –Internet www.somnomedics.eu
Manual

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Please be aware that this manual contains only the main functions of the DOMINO software for the
respective software version. The functions needed to conduct, score and evaluate measurements as
well as report output are explained in this manual. More detailed information concerning analysis
settings and additional special features can be found in the ‘Additional Information DOMINO’ file on your
DOMINO software CD.
SOMNOscreenTM, SOMNO HDTM and
SOMNOtouchTM is copyright protected by
SOMNOmedics.
Rev. 1
29.10.2019

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Contents
1Recording a new case.................................................................................................................... 5
1.1 Preparing a new case (necessary for SOMNOtouchTM RESP only)......................................... 5
1.2 Starting a new case online........................................................................................................ 7
1.3 Continuous impedance measurement.................................................................................... 12
1.4 Bio-calibration ......................................................................................................................... 13
1.5Blood pressure calibration ...................................................................................................... 14
1.5.1 Blood pressure calibration on SOMNOscreenTM .............................................................15
1.5.2 Blood pressure calibration on SOMNO HDTM..................................................................15
1.5.3 Blood pressure calibration on SOMNOtouchTM RESP ....................................................16
1.6 Dual time base ........................................................................................................................ 18
1.7 Transfer a recording from memory card to computer ............................................................. 19
1.7.1 Transfer SOMNOscreenTM recordings from flash card to a computer.............................19
1.7.2 Transfer SOMNO HDTM or SOMNOtouchTM RESP recordings from device to
a computer.......................................................................................................................21
2Analysing a new case.................................................................................................................. 22
2.1 Auto processing ...................................................................................................................... 22
2.2 Screen layout .......................................................................................................................... 24
2.2.1 Analysis and raw data......................................................................................................24
2.2.2 Raw data profile...............................................................................................................24
2.2.3 Analysis profile.................................................................................................................26
2.2.4 Display profile ..................................................................................................................29
3Editing events............................................................................................................................... 29
3.1 Edit Mode................................................................................................................................ 30
3.2 Select Edit mode..................................................................................................................... 32
3.3 Quick Edit mode...................................................................................................................... 32
3.4 Editing video............................................................................................................................ 33
4Reporting ...................................................................................................................................... 34
4.1 Report templates..................................................................................................................... 34
4.1.1 Report generating............................................................................................................34
4.1.2 Report adjustments..........................................................................................................35
4.2 Form letters............................................................................................................................. 37
5Troubleshooting........................................................................................................................... 39
6Contact.......................................................................................................................................... 45

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1 Recording a new case
1.1 Preparing a new case (necessary for SOMNOtouchTM RESP only)
Connect the SOMNOtouchTM RESP device to the docking station which need to be connected by
USB-cable to the computer and have a plugged-in power supply.
Click on the ‘Initialisation symbol of the DOMINO panel (no. 1).
Fig. 1-1 Initialisation icon in DOMINO panel
The ‘Preparing new recording’ window will appear in which you can enter the patient data (see Fig. 1-6
Online Mode: ‘Patient’ tab, page 7).
Click on ‘Next’ or the ‘Date’ tab after entering the patient data.
Fig. 1-2 ‘Preparing new recording’ window: ‘Date’ tab
Activate the ‘Manual Start’ checkbox, enter the intended recording duration and select ‘Next’ or the
‘Montage’ tab.

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Fig. 1-3 ‘Preparing new recording’ window: ‘Montage’ tab
Select a montage for the SOMNOtouchTM RESP and make sure the ‘Online Mode ON’ checkbox is
activated.
Chose the ‘Initialise Flash Card’ button and remove the SOMNOtouchTM RESP from the docking station.
Start the recording on the SOMNOtouchTM RESP as displayed in the screens below.
Fig. 1-4 Recording Start on SOMNOtouchTM RESP

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See Chapter 1.5.3 Blood pressure calibration on SOMNOtouchTM RESP, page 16, if a blood pressure
calibration is to be performed.
1.2 Starting a new case online
Click on the ‘Online’symbol of the DOMINO panel (no. 4).
Fig. 1-5 Online icon in DOMINO panel
The ‘New Recording’window will appear in which you can enter the patient data.
Existing patient data can be imported by clicking on the ‘DB’button and searching for the corresponding
patient.
Fig. 1-6 Online Mode: ‘Patient’ tab

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Click on ‘Next’or the ‘Montage’tab after entering the patient data.
Select a montage.
(For SOMNOtouchTM RESP the same montage as during the device initialisation has to be selected,
see chapter 1.1)
Fig. 1-7 Online Mode: ‘Montage’ tab
1
Lists the available montages
2
Shows the type of device for which the selected montage was prepared
(Please note: The device type of the montage and that of your hardware must be the same.)
3
Lists any previously created analysis templates or analysis- / raw data profiles linked to the
selected montage
4
Shows the sensor application on a virtual patient
5
Activates ‘Online Mode On’ for recordings up to 14 hours
6
Activates ‘Signal display’ for recordings longer than 14 hours
(Please note: There is no verification that the battery capacity is sufficient for the intended
recording duration. Eventually you may need an external battery to achieve the intended
recording duration.)
1
2
3
4
5
6
8
9
7

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7
Continuous Impedance measurement (see 1.2 Continuous impedance measurement, page
12)
8
With ‘ADC’ and ‘TxLink’ additional channels from external boxes can be selected for the
recording.
9
Configures the channels of the external box (see 8)
Now turn on the SOMNOscreenTM or SOMNO HDTM device and click on ‘Next’ or the ‘Recording’ tab.
(The recording on the SOMNOtouchTM RESP device has to be started already, see chapter 1.1)
Fig. 1-8 Online Mode: ‘Recording’ tab
1
Set the recording duration
2
Shows the maximum online recording time depending on the capacity of the hard disk
3
Program an online recording with ‘Auto Start’ if desired and/or the optional ‘Signal Check’
(Please note: an online connection will need to be established to activate this feature,
see 10)
4
Comments can be entered if necessary
5*
Activate the video recording
1
2
3
4
5
6
7
8
9
10
11
11

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6*
Enter IP address of the camera as well as user name and password
7*
Choose the video format according to the camera type in use.
(Please note: sound is neither recorded nor can the clips be cut in MJPG)
8*
Enter the IP address, COM port or USB port of the data receiver
9*
The system needs to be paired if you are using a Bluetooth system
(Select ‘Search SOMNOscreen BT’, choose your device and ‘Set as default SOMNOscreen
BT’ to pair your system)
10
If a connection is established, the current capacity of the rechargeable battery will be
displayed and the checkbox ‘Initialize Flash Card’ can now be selected.
(For the SOMNOtouchTM RESP ‘Recording … - Montage ID: …’ is displayed)
11*
Auto processing can be activated and configured (see 2.1 Auto processing, page 22)
* After the recording starts the setting will be automatically saved for the next measurement.
Press ‘OK’and the selected configuration will be sent to the main device.
Now the signal view will open and will show the defined settings for the recording.
Please note: The device has started recording, but the data is not yet being saved on the computer.
Start the online recording by pressing the ‘Start Recording’ button.
For the SOMNOtouchTM RESP the following window appears in which ‘Connect to running record’
need to be selected.
Fig. 1-9 Start online recording for SOMNOtouchTM RESP

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Fig. 1-10 Signal view before starting online recording
If the video option has been activated, the video recording will start automatically when the online
recording starts (see Fig. 1-11 Video window during online recording, page 12).

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Fig. 1-11 Video window during online recording
1
Digital zoom
The zoomed view will be saved only. This is why the software will swap back to the not
zoomed view automatically after a few seconds.
2
Stop video recording
Stops recording the video on the hard disk drive. You can still watch the patient on the
monitor. The video recording can be started again manually at any time.
3
Pan tilt zoom function and optical zoom
This option is available for camera VID34 only.
4
Intercom
This is an optional function which allows the medical staff in the recording room to give
instructions to the patient in his room via an integrated speaker in the camera. The
‘Intercom’ button has to be pressed down continuously when speaking. The sound on the
video recording will be disabled when the intercom is being used to avoid acoustic
feedback.
5
Mute function
This option switches off the sound.
1.3 Continuous impedance measurement
For patients with cardiac pacemakers or other implanted stimulators the active continual
impedance measurement must to be deactivated (see Fig. 1-7 Online Mode: ‘Montage’ tab, no. 7,
page 8)!
You can check the impedances of the EOG- and EEG-channels both before and during the online
recording.
1
2
3
4
5

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Start the impedance measurement from the toolbar of the online display by selecting ‘Check EEG/EOG
channels’ or by using the same option in the ‘Tools’ menu .
Fig. 1-12 Impedance check
The colours displayed represent the electrical
contact between the electrodes and the skin.
Green indicator = good contact (R ≤5 kΩ)
Yellow indicator = sufficient contact
Red indicator = insufficient contact (R > 10 kΩ),
Reapplication necessary
Press ‘Save’ to document the impedance
measurement in the report. This is only possible
during an ongoing recording and a maximum of 5
times.
If the continuous impedance measurement is activated in the montage (see Fig. 1-8 Online Mode:
‘Montage’ tab, no. 7), you will be able to view the ‘Impedance’ channel for the headbox. During an online
recording the impedances of all EOG and EEG channels are displayed consecutively in the channel
‘Impedance’.
With the SOMNO HDTM you will also be able to see the impedance measurement for the EMG channels.
Fig. 1-13 Impedance channel
Additionally the impedances are shown in the individual EOG-/EEG-channels and each referenced
channel as a coloured bar corresponding to the quality of the impedance.
Fig. 1-14 Impedance bar
In an open recording the ‘Impedance’ channel can also be used to display a single channel’s impedance.
Right click on the channel name ‘Impedance’ and select ‘Impedance Display’.
1.4 Bio-calibration
In online mode you can select ‘Set Marker’ from the ‘Tools’ menu or the toolbar . Alternatively you
can choose ‘Set Marker’ when you right click on the signals.

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Ask the patient to perform the action required for the marker and double click the respective marker at
the same time. The marker will appear immediately in the raw data. You can save individualized marker
names and set the markers with . If ‘Add marker to list’ is activated, the marker will be added to the
list automatically.
Fig. 1-15 Bio-calibration with markers (horizontal and vertical eye movement) and marker list
Please note: Only one marker per second is permitted.
1.5 Blood pressure calibration
Blood pressure values are calculated using a PTT (Pulse Transit Time) based method. The PTT is
calculated using the ECG signal and the Plethysmographic waveform from the pulse oximeter. The
blood pressure function is an optional extra and may be subject to an additional charge.
Prerequisite: A one-time blood pressure calibration is required. The blood pressure of the patient must
be measured with an external device at the beginning of a recording. Please ensure that the blood
pressure cuff is applied on the arm opposite the SpO2 sensor.
Fig. 1-16 Applying the device for measuring blood pressure
with 1-channel ECG sensor
with ECG over headbox

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Please proceed as follows when measuring the blood pressure with an external device:
The patient should sit still in an upright position and not speak. Place the cuff on the patient’s arm at
heart level. Always use the opposite arm to where the SpO2 sensor is applied, i.e. if the SpO2 sensor
is attached to the right hand, place the blood pressure cuff on the left arm.
1.5.1 Blood pressure calibration on SOMNOscreenTM
Please follow the instructions in section 1.5 Blood pressure calibration. Press the patient marker
button on the SOMNOscreenTM while you are taking the blood pressure reading and write down the
measured blood pressure values.
In the online recording, position the cursor on the patient marker you just set and select the point ‘BP
calibration’ by making a right click in the raw data window. Enter the measured blood pressure values
on into the window and confirm with .
Fig. 1-17 Enter blood pressure calibration values
The blood pressure curves will be calculated and displayed in the numeric display as well as signal
curve in the analysis window.
1.5.2 Blood pressure calibration on SOMNO HDTM
Please follow the instructions in section 1.5 Blood pressure calibration. Tap on the calibration symbol
on the device’s touch screen.
Fig. 1-18 Blood pressure calibration symbol on SOMNO HDTM display
The device automatically checks the signal quality of the ECG and SpO2 plethysmogram waveform.
Measure the blood pressure with a blood pressure cuff gauge (digital or by auscultation). Enter the
indicated blood pressure on the display.
Alternatively, you can click on the marker symbol and set a patient marker while you are taking the blood
pressure reading and write down the measured blood pressure values.

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Fig. 1-19 Marker on the SOMNO HDTM display
In the online recording, position the cursor on the patient marker you just set and select the point ‘BP
calibration’ by making a right click in the raw data window. Enter the measured blood pressure values
on into the window and confirm with .
Fig. 1-20 Enter blood pressure calibration values
The blood pressure will be calculated and displayed in the numeric display and as signal curve in the
analysis window.
1.5.3 Blood pressure calibration on SOMNOtouchTM RESP
Please follow the instructions in section 1.5 Blood pressure calibration. During the measurement start
on the device, you are asked whether you want to perform the blood pressure calibration. After
confirmation to perform the calibration, the instructions on the display must be followed.

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1-21 Blood pressure calibration on SOMNOtouchTM RESP display
After starting the recording, the display will show only PTT values instead of blood pressure values if
the blood pressure calibration is aborted or skipped.

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1.6 Dual time base
In dual time base, respiratory and sleep- raw data can be displayed synchronously with different time
bases. To select this view choose ‘Dual Time Base’ from the ‘View’ menu.
Fig. 1-22 Dual Time Base selection
Two raw data windows will be displayed. Note that the upper window limits the maximum time interval
of the lower window. The ‘Swap Window’ function in the ‘View’ menu needs to be activated if the lower
window should display a longer time interval than the upper window.
Fig. 1-23 Dual Time Base
Respiratory
Neurologically

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1.7 Transfer a recording from memory card to computer
During each online recording the measurement data is also saved on the memory card in the device.
This back up can be used if the online recording is incomplete due to external disturbances (e.g. power
failure or network issues).
Please note: This backup will be overwritten with the next recording, so if the backup is needed, it must
be transferred before starting a new recording.
Never remove memory card or battery from the device when the recording is running!
1.7.1 Transfer SOMNOscreenTM recordings from flash card to a
computer
The measurement must be finished before transferring data from a flash card. An ongoing recording
would need to be stopped manually. To do this press all three buttons , and on the
SOMNOscreenTM simultaneously for at least 1 second. Select ‘Cancel’ in the following menu and ‘Sure’
afterwards. Wait till the device turns off.
Follow the subsequent steps to transfer the recording from memory card to the computer:
1. Take the flash card out of the SOMNOscreenTM device.
2. Open the DOMINO Panel.
3. Insert the flash card into the card reader which need to be connected to the computer via USB
cable.
4. The DOMINO software will recognize if there is a recording on the flash card and will
automatically open the ‘Download Data from Device’ window. Alternatively the ‘Download Data’
button can be selected in the panel (no. 2).
Fig. 1-24 Download Data icon in DOMINO panel
Remark: See section 5 Troubleshooting on page 42 if no recording appears in the
‘Download Data’ window.
5. Adjust the patient data if necessary and press ‘Download’
(see Fig. 1-24 Download Data from Device window, page 21).

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Remark: The recording will be opened automatically if the ‘Auto processing’ checkbox is
activated and the ‘Analyse’ option has been selected.