Welch Allyn CARDIOPERFECT User manual

CardioPerfect
Pocket ECG User - Manual
DIR 80012822 Ver. C
European Regulatory Manager
Welch Allyn Ltd.
Navan Business Park
Dublin Road
Navan, County Meath,
Republic of Ireland
Tel.: [phone]
Fax: [phone]
Welch Allyn
4341 State Street Road
Skaneateles Falls, NY
13153-0220 USA
www.welchallyn.com
0297

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Caution US Federal law restricts this device to sale by or on the
order of a physician.
Instructions for use
The information contained in this manual is subject to change without notice.
All changes will be in compliance with regulations governing manufacture of medical
equipment.
© Copyright Welch Allyn 2010.
No part of this publication may be reproduced, transmitted, transcribed, stored in a retrieval
system or translated into any human or computer language in any form by any means without
the consent of the copyright holder.
Unauthorized copying of this publication may not only infringe copyright but also reduce the
ability of Welch Allyn to provide accurate and up-to-date information to users and operators
alike.
User responsibility
This product is designed to perform in conformity with the description thereof contained in this
operation manual and accompanying labels and inserts, when assembled, operated,
maintained and repaired in accordance with the instructions provided. A defective product
should not be used. Parts that are broken, plainly worn, missing or incomplete, distorted or
contaminated should be replaced immediately. Should any repair or replacement become
necessary, we recommend that service be performed at the nearest factory approved service
center. The user of the product shall have the sole responsibility for any malfunction, which
results from improper use, faulty maintenance, improper repair, damage or alteration by anyone
other than Welch Allyn or their authorized service personnel.

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Warranty, Service, and Spare Parts
Warranty
All repairs on products under warranty must be performed or approved by Welch Allyn.
Unauthorized repairs will void the warranty. In addition, whether or not covered under warranty,
any product repair shall exclusively be performed by Welch Allyn certified service personnel.
Assistance and Parts
If the product fails to function properly or if assistance, service, or spare parts are required,
contact the nearest Welch Allyn Technical Support Center.
USA 1-800-535-6663 Canada 1-800-561-8797
Latin America ([phone] South Africa ([phone]
European Call Center ([phone] Australia ([phone]
United Kingdom ([phone] Singapore ([phone]
France ([phone] Japan ([phone]
Germany ([phone] China ([phone]
Before contacting Welch Allyn it is helpful to attempt to duplicate the problem and to check all
accessories to ensure that they are not the cause of the problem.
When calling, please be prepared to provide:
Product name and model number and complete description of the problem
The serial number of your product (if applicable)
The complete name, address and phone number of your facility
For out-of-warranty repairs or spare parts orders, a purchase order (or credit card) number
For parts order, the required spare or replacement part number(s)
Repairs
If your product requires warranty, extended warranty, or non-warranty repair service, please
call first the nearest Welch Allyn Technical Support Center. A representative will assist you
troubleshooting the problem and will make every effort to solve it over the phone, avoiding
potential unnecessary return.
In case the return cannot be avoided, the representative will record all necessary information
and will provide a Return Material Authorization (RMA) number, as well as the appropriate
return address. A Return Material Authorization (RMA) number must be obtained prior to any
return.
Packing Instructions
If you have to return goods for service, follow these recommended packing instructions:
Remove all hoses, cables, sensors, power cords, and ancillary products (as appropriate)
before packing, unless you suspect they are associated with the problem.
Wherever possible use the original shipping carton and packing materials.
Include a packing list and the Welch Allyn Return Material Authorization (RMA) number.
It is recommended that all returned goods be insured. Claims for loss or damage to the product
must be initiated by the sender.

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Table of Contents
1. GETTING STARTED ...................................................................................9
1.1 The Pocket ECG window.....................................................................................9
2. RECORDING ECGS..................................................................................12
2.1 Record an ECG..................................................................................................12
2.2 Place electrodes on the patient..........................................................................13
2.3 Patient card........................................................................................................14
2.4 Select how you want to view leads....................................................................15
2.5 Apply a notch filter .............................................................................................15
2.6 Cancel a recording.............................................................................................16
3. VIEWING ECGS ........................................................................................17
3.1 Views .................................................................................................................18
3.2 Viewing ECGs....................................................................................................19
3.3 Zoom in and out on an ECG..............................................................................19
3.4 Set chart speed and sensitivity..........................................................................19
3.5 Lead selector .....................................................................................................20
3.6 Apply a notch filter .............................................................................................20
3.7 Make measurements .........................................................................................21
3.8 Set Colors..........................................................................................................21
3.9 Other settings.....................................................................................................21
4. INTERPRETING ECGS .............................................................................22
4.1 Edit and confirm an interpretation......................................................................22
4.2 Add comments...................................................................................................23
4.3 View interpretation history..................................................................................23
4.4 Work with voice comments................................................................................24
5. TRANSFER OF ECGS...............................................................................26
5.1 Send and Receive ECGs...................................................................................26
6. WORKSTATION........................................................................................28
6.1 The Welch Allyn CardioPerfect Pocket ECG window ........................................28

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6.2 Tools tab............................................................................................................30
6.3 Import tab...........................................................................................................30
6.4 Export tab...........................................................................................................30
6.5 Settings tab........................................................................................................30
7. MAINTAINING THE RECORDER..............................................................31
7.1 Clean the cables................................................................................................31
7.2 Replace or charge the battery of the recorder...................................................31
8. INSTALLATION AND SETUP ...................................................................33
8.1 Requirements.....................................................................................................33
8.2 Installing Pocket ECG........................................................................................33
8.3 Setup your Pocket PC........................................................................................33
8.4 Customizing Pocket ECG ..................................................................................34
8.5 Installing the plug-in for Welch Allyn CardioPerfect...........................................36
8.6 Configure Welch Allyn CardioPerfect.................................................................36
9. SHORT DESCRIPTION.............................................................................37
10. TROUBLESHOOTING...............................................................................40

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Welcome
Welcome to CardioPerfect Pocket ECG, a Pocket PC-based Resting ECG recording system, a
mobile extension of the Welch Allyn CardioPerfect Workstation software.
With the CardioPerfect Pocket ECG, you can record, view and interpret Resting ECGs with
your Pocket PC. You can also use it to send and receive ECGs through the Welch Allyn
CardioPerfect Workstation Telemedicine functionality.
This manual contains specific information about the Welch Allyn CardioPerfect Pocket ECG.
The ECGs recorded with your Pocket ECG can be imported into the Workstation Software with
the Pocket ECG plug-in for Welch Allyn CardioPerfect Workstation as described in this manual.
For other information about the Workstation software please refer to the appropriate
Workstation manuals.
Intended use
The device is specifically intended for the recording of standard 12-lead electrocardiograms.
Please note that the word “device” is used to indicate the Welch Allyn CardioPerfect recording
hardware in combination with the Pocket ECG software.
Indications
Because of the widespread availability and application of the generic kind of device, the user is
assumed knowledgeable enough to determine if use of the device is indicated.
Contraindications
There are no known contraindications for the recording of a resting ECG.
Precautions
Due to summation of leakage currents, it is possibly hazardous to connect several devices to
the patient simultaneously.

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Notations used in the manual
In this manual the following notations are used:
Dialog boxes:
The names of dialog boxes, windows and tabs are displayed in bold.
When referring to check boxes in dialogs, the term “selected” means that a check is
displayed in the check box, and therefore that the option is active.
When referring to a certain button, setting or menu option the text in this control is
displayed in bold.
Stylus:
Tap means to press the stylus to the screen and quickly release.
Tap and hold means point to an item and then press and hold the stylus to the screen.
Drag means to point, press and then hold down while moving the stylus.
Entering data:
Data can be entered via the keypad or handwritten with the stylus
Keypad:
The keypad is located on the right in the status bar. You can operate the keypad by
briefly touching it with the stylus.
Handwriting recognition:
Touch the arrow button next to the keypad icon in the status bar and select the desired
writing mode in the pop-up menu.

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1.Getting started1.Getting started
1.1 The Pocket ECG window1.1 The Pocket ECG window
This section will guide you around the various parts of Pocket ECG. By tapping on the Pocket
ECG icon
This section will guide you around the various parts of Pocket ECG. By tapping on the Pocket
ECG icon either in the start menu or in the command bar at the bottom of the screen you
can start the Pocket ECG program.
Navigation bar
Command ba
r
Folder toolbar
File List area
Navigation bar The top bar is called the navigation bar. In the navigation bar you can read
which program is currently active. In addition, the time is also displayed here.
To the left of the time you will find the loudspeaker icon. To the right of it,
depending on the application, you will see an icon closing the application or
confirming entries.
Command bar This bar is located at the bottom of the display. Each menu in the command
bar contains a number of tasks that you can perform with Pocket ECG.
File list area The file list area lets you easily retrieve patients and tests. In this area, you
can see all your recorded ECG files and Patient cards, select a file and open
it for review or delete it.
Folder list area In the folder list area the document tree is shown. The ECG and patient files
are shown per default in the My Documents folder.

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Basic principles of Pocket ECG.
In Pocket ECG you are working in one of three main modes, each having different window
layout and control button functionality:
-MONITOR mode
-REVIEW mode
-FILE LIST mode
Monitor mode
Monitor window Monitor during ECG recording
Monitor mode is used to evaluate the quality of traces see average pulse rate and start ECG
Recording. In some cases it can be used for long term monitoring. You may also enter
Patient data or change Settings before Recording in this mode.
Review mode

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Review mode allows you to evaluate recorded ECGs, scroll through all recorded segments,
provide measurements, enter or edit Patient data and Texts, listen or add voice comments
or change Settings.
File list mode
File list mode allows you to see all your recorded ECG files and patient files. Select an ECG
file, open it for Review or delete or select a patient file and open it. From here you may
create new files for recording.
The files from the selected folder in the Folder list area are shown in the file list area. In
the picture above the files in the My Documents folder are shown. If Pocket ECG is started
by default the My Documents folder will be opened and any new recordings will be stored in
this folder. To add, rename or delete a file or folder select a folder in the Folder list area
then tap Folder in the Folder toolbar. You can now select New, Rename or Delete.
To enlarge or decrease the size of the File list area you can either tap on the
corresponding arrow symbol  in the Folder toolbar, or you can drag the toolbar with
your stylus.

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2.Recording ECGs
2.1 Record an ECG
Pocket ECG records ECGs fast, easily and reliably. The only thing you have to do is make sure
the electrodes are placed correctly and switch on the recorder. Pocket ECG takes care of
recording and saving the recording.
To record an ECG, you need to follow these global steps. Each step is explained in more
detail on the following pages.
1. Place electrodes on the patient (see § 2.2 ).
2. In Pocket ECG, create a NewECG test.
If there are no recordings for this patient on your Pocket PC start with To create a new test.
If a previous test is available for the patient for whom you want to record an ECG or if a Patient
card is available for this patient, select the (latest) test or the patient card, indicated with , in
the File list area then continue with To create a new test.
To create a new test:
In the Command bar, tap on the ECG menu and tap New.
If you have selected a patient/file in the File list area, Pocket ECG will ask if you want
to copy the Patient data from the selected file to the new ECG.
If you select Yes the Patient data will be copied into the Patient card for the new test. If
you select No or if no file was selected the Patient card will be empty and has to be
filled in later.

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3. The Real-time monitor is displayed. Pocket ECG asks you to switch on the recorder. Switch
on the recorder.
4. The Real-time monitor displays the ECG traces and average pulse rate.
5. Select which leads should be displayed and adjust your view on the ECG traces in the ECG
menu (see § 2.4 ).
6. Create or adjust a Patient Card (see § 2.3 ).
7. If necessary, apply a Notch filter to remove possible noise due to AC mains interference
(see § 2.5 ).
8. In the Real-time monitor, wait until the signal is stabilized and, tap the Record button
to start recording. The progress of the recording is shown in the gauge at the bottom of the
window.
9. When the recording is finished, Pocket ECG will ask you to switch of the recorder. Switch of
the recorder. Pocket ECG automatically saves the ECG and the recorded ECG is
automatically displayed in the Review window.
10. If you are satisfied with the recording disconnect the patient.
11. You can add interpretations, comments and voice comments. Save the recording by
tapping the OK button. If not previously filled in the Pocket ECG will now ask for a User
name and e-mail address to sign the ECG file.
2.2 Place electrodes on the patient
Important: Because Pocket ECG is a 12 lead electrocardiograph all electrodes must be
connected! Proper skin preparation (abrasion if necessary) and proper electrodes are very
important for a good signal quality.
Important: When you connect the electrodes to the patient, make sure that the electrodes and
their connectors (also the RL/N electrode) do not contact other conducting parts (including
earth).
Extremity electrodes
When you record a Resting-ECG, the extremity electrodes should be connected to the ankles
and wrists.

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Precordial electrodes
Connect the precordial electrodes in the following positions:
V1 : Fourth intercostal space, at the right sternal margin.
V2 : Fourth intercostal space, at the left sternal margin.
V3 : Fifth rib, between leads V2 and V4.
V4 : Fifth intercostal space, on the left midclavicular line.
V5 : Left anterior axillary line, at the horizontal level of V4.
V6 : Left midaxillary line, at the horizontal level of V4.
2.3 Patient card
It is advisable to fill in the patient card or check if the patient data are still accurate before
recording an ECG. After opening an existing ECG or creating a new ECG you can enter or edit
the patient data in the Patient card in Monitor mode or Review mode.
To fill in a new patient card or edit an existing one:
1. In Monitor or Review mode select Patient card in the ECG menu. A patient card will
be displayed.
2. In the General tab of the patient card, enter the patient's number, name, insurance
number, gender, birth date, weight and height. The patient number is mandatory.
3. In the Address tab, enter the patient's address information.
4. In the History tab, you can enter some information on the patient's history, for instance
whether the patient is a smoker, and the amount of exercise a patient gets. You can
start typing straight under the previous comment.
5. Tap on the button to save the patient information.
6. Tap on the OK button in the command bar to save the recording.

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2.4 Select how you want to view leads
Once you have created a new ECG, the Real time monitor displays the ECG traces. Before you
start the actual recording, you can select how you want to view the traces. Pocket ECG offers
these views: 2x4, 3, 6+1 and 2. In addition, you can set different chart speeds and different
sensitivities. To adjust these settings go to the ECG menu, select Display and Settings.
To select a different view:
In the Real-time monitor, select a view from the list in the Lead drop-down menu and
select OK. The new view is immediately displayed.
With the option Constant you can adjust the following leads:
2x4 Leads: the leads shown in the upper left (P1) and upper right (P2) window
6+1 Leads: the lead shown in the bottom (C) window.
3 Leads: L1, L2,L3
2 Leads: P1, P2
To select a different chart speed or sensitivity for the view:
In
the Real-time monitor, select a chart speed or sensitivity from the list. The speed
and sensitivity are immediately displayed.
2.5 Apply a notch filter
ECG traces can contain noise due to AC mains interference. This makes the traces harder to
read. You can filter out noise by applying a notch filter. When you apply a filter, the original
ECG signal is not permanently changed. You only change the way it is displayed on the
monitor. You can always restore the original signal.
To apply a notch filter:
In
the ECG menu select Display and Settings. Select the appropriate Notch filter and
Strength.

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2.6 Cancel a recording
You can cancel a recording at any time in the recording process.
To cancel a recording:
Click the Cancel button in the Real-time monitor. The recording is cancelled. If you
leave Monitor mode you are asked to switch off the recorder. The test is not saved.

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3.Viewing ECGs
Pocket ECG offers a wealth of viewing possibilities. You can view an ECG in a number of
formats, also called views, and perform a number of actions, such as zooming in and out on a
complex and making measurements between two points.
To view an ECG:
1. Select an ECG from the list. ECGs are indicated with a sign.
Patient
ECG
2. From the ECG menu select Open. Pocket ECG automatically starts the Review mode,
the test is displayed in the workspace.
Heart rate
View
Scroll between leads
Zoom in or out

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3.1 Views
Pocket ECG offers various views on an ECG. You can have a look at all twelve leads in three
different formats (6+1, 2 or 3 lead view). The fourth format, the 2x4 format, shows eight leads.
2x4 lead view
The leads are shown in a 2x4 configuration.
V1-V6 are shown by default. The leads in the
upper left and right window are adjustable
(P1&P2 in the Settings menu).
3 lead view
The 3 lead view displays 3 leads, you can
switch between the displayed leads with the
arrows in the command bar. In sequence the
following leads are shown:
I, II, III
aVR, aVL, aVF
V1-V3
V4-V6
L1-L3 (adjustable in the settings menu)
6+1 lead view
The 6+1 lead view displays 7 leads. The lead
at the bottom can be used as a kind of rhythm
strip. You can switch between the displayed
leads in the 6 smaller windows with the arrows
in the command bar. In sequence the following
leads are shown:
V1-V6 →I, II, III, aVR, aVL, aVF
In the bottom window lead C is shown, which
is adjustable in the settings menu.
2 lead view
The 2 lead view displays 2 leads, you can
switch between the displayed leads with the
arrows in the command bar. In sequence the
following leads are shown:
I, II →III, aVR →aVL, aVF →V1, V2 →V3,
V4 →V5, V6 →P1, P2
P1 & P2 are adjustable in the settings menu.

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3.2 Viewing ECGs
There are a number of things you can do while viewing ECGs in Monitor mode or Review
mode. They fall apart in the following groups of actions:
Action Function Mode
Adjusting scales and
magnitude of the view Zoom in and out Monitor and Review
Set chart speed Monitor and Review
Set sensitivity Monitor and Review
Switch between
displayed leads Lead selector Monitor and Review
Not available in the 2x4
configuration
Improving signal quality Apply notch filter Monitor and Review
Studying the ECG Make measurements Review
On the next pages, each action is described in detail.
3.3 Zoom in and out on an ECG
If you want to get a closer look at the traces, you can adjust the size of the leads by zooming in
and out of the ECG in Monitor or Review mode.
To see leads in more detail:
Tap on the zoom in icon
To see a larger part of the ECG:
Tap on the zoom out icon
To switch to single lead view:
Tap on the requested lead in the View area.
To switch back to multi-lead view:
Tap and hold the stylus in the View area.
3.4 Set chart speed and sensitivity
Pocket ECG offers a wide range of speed and sensitivity. You can adjust the scale of the ECG
by adjusting the chart speed and the sensitivity.

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Chart speed
Sensitivity
To set the chart speed or sensitivity:
In the ECG menu, select Display and Settings. Tap on the drop down box and select
a value.
3.5 Lead selector
Except for the 2x4 configuration you can scroll between leads with the blue arrows in
the command bar. For the order in which the leads are shown see paragraph 3.1 .
3.6 Apply a notch filter
ECG traces can contain noise that is due to AC mains interference. This makes the traces
harder to read. You can filter out noise by applying a notch filter. When you apply a filter, the
original ECG signal is not permanently changed. You only change the way it is displayed on the
monitor. You can always restore the original signal.
To apply a notch filter while you view an ECG:
In the ECG menu, select Display and Settings. And select a Notch filter and
Strength. The Notch filter can be set on 50Hz (Europe), 60Hz (USA) or Off. If no
extensive AC mains interference exists we recommend setting the Notch filter Off.
In case of interference, first try to eliminate that interference as much as possible. If
eliminating is not possible try using a notch filter set to normal strength or in case of
very strong interference set it to strong or aggressive.
Caution
Extensive filtering may affect the shape of the ECG trace