Cardiograph

PageWriter XLi
M1700A

INSTRUCTIONS FOR USE

Notice All rights are reserved. inconsistent with the physician’s
Reproduction in whole or in part interpretation.
About This Edition is prohibited without the prior
Edition 9 written consent of the copyright Philips assumes no liability for
Printed in the USA holder. failures resulting from RF
WARNING interference between Philips
Publication number
medical electronics and any
M1700-92909 As with electronic equipment, radio frequency generating
The information in this guide Radio Frequency (RF) equipment at levels exceeding
applies to the PageWriter XLi interference between the those established by applicable
cardiograph. This information is cardiograph and any existing RF standards.
subject to change without transmitting or receiving
equipment at the installation CAUTION
notice. Philips shall not be
liable for errors contained site, including electrosurgical Use of accessories other than
herein or for incidental or equipment, should be evaluated those recommended by Philips
consequential damages in carefully and any limitations may compromise product
connection with the furnishing, noted before the equipment is performance.
performance, or use of this placed in service.
material. THIS PRODUCT IS NOT
Radio frequency generation INTENDED FOR HOME USE.
Edition History
from electrosurgical equipment IN THE U.S., FEDERAL LAW
Edition 1 May 1990 and close proximity transmitters RESTRICTS THIS DEVICE
Edition 2 July 1991 may seriously degrade TO SALE ON OR BY THE
Edition 3 January 1992 performance. ORDER OF A PHYSICIAN.
Edition 4 April 1993
Medical Device Directive
Edition 5 July 1993 Like all electronic devices, this
Edition 6 June 1994 cardiograph is susceptible to The PageWriter XLi
Edition 7 January 1995 electrostatic discharge (ESD). Cardiograph complies with the
Edition 8 April 2000 Electrostatic discharge typically requirements of the Medical
Edition 9 February 2002 occurs when electrostatic Device Directive 93/42/EEC
energy is transferred to the and carries the 0123 mark
Copyright
patient, the electrodes, or the accordingly.
Copyright ©2001 Philips
cardiograph. ESD may result in Authorized EU-representative:
Electronics North America
ECG artifact that may appear as Philips Deutschland GmbH
Corporation Philips Medical Herrenbergerstrasse 130
narrow spikes on the
Systems
cardiograph display or on the D-71034 Boeblingen
3000 Minuteman Road Germany
printed report. When ESD
Andover, MA 01810-1099
occurs, the cardiograph’s ECG Fax: +49-7031-14-2346
USA
interpretation may be
(978) 687-1501

ii
Safety Summary
Safety Symbols Marked on the Cardiograph

The following symbols are used on the cardiograph.

Caution - See operating instructions

Type CF, defibrillation protected

Alternating current

Equipotential (this is on the ground lug)

The following symbols appear on the cardiograph packaging.

Keep dry

Temperature and relative humidity

ranges

Fragile

iii
 Conventions Used in This Manual

WARNING Warning statements describe conditions or actions that can result in personal injury
or loss of life.

CAUTION Caution statements describe conditions or actions that can result in damage to
the equipment or software.

NOTE Notes contain additional information on cardiograph usage.

Softkey represents the temporary key labels that appear on the keyboard
display.

Key represents keys on the front panel.

iv
Documentation Map

Documentation Map

If you want to: Use this manual:

Verify that all equipment is included Packing List

Record ECGs Operating Guide

Enter patient ID

Make copies of ECGs

Store ECGs
Transmit or receive ECGs

Troubleshoot problems

Maintain the cardiograph

Set up the cardiograph

Install the battery

Install the software

Load paper

Change applications

Install or use Preview Plus

Configure the cardiograph Instructions for Use

Prepare the patient

Maintain the cardiograph

Install and use the modem

Configure and use Special Applications Instructions for Use

v
 Documentation Map

If you want to: Use this manual:

Order supplies

Use filters

Understand analysis Physician’s Guide

vi
 Contents

Safety Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Safety Symbols Marked on the Cardiograph . . . . . . . . . iii
Conventions Used in This Manual . . . . . . . . . . . . . . . . . iii
Documentation Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

1 Introduction

About This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

2 Acquiring an ECG

ECG Technique. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

Relaxing the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Preparing the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Preparing the Skin at the Electrode Positions . . . . . . . . 2-3
Securing the Electrodes . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Monitoring ECG Quality . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Quality Messages on the Cardiograph’s Display . . . . . 2-7

3 Understanding the PageWriter XLi Special Applications

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Understanding TPI Variables . . . . . . . . . . . . . . . . . . . . 3-2
Understanding ACI TIPI Variables . . . . . . . . . . . . . . . 3-3
Using the TPI and ACI-TIPI Applications . . . . . . . . . 3-3
Analyzing an ECG with the Predictive Instruments . . 3-4
Generating Reports with the Special Applications Off 3-5
Generating Reports with the Special Applications On 3-6
Auto Analysis and the Default Choice . . . . . . . . . . . . 3-7
Generating a STAT ECG Report . . . . . . . . . . . . . . . . . 3-8

Contents-1
4 Choosing Report Features

ECG Formats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

The Auto Report . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Auto Report Information . . . . . . . . . . . . . . . . . 4-1
Manual Formats . . . . . . . . . . . . . . . . . . . . . . . . 4-6
The Manual Lead Sets . . . . . . . . . . . . . . . . . . . 4-6

5 ECG Storage

Advantages of Disk Storage . . . . . . . . . . . . . . . . . . 5-1

Storing Reports with the Special
Applications Off . . . . . . . . . . . . . . . . . . . . . . . 5-2
Storing Reports Using Auto Analysis and
the Default Choice . . . . . . . . . . . . . . . . . . . . . . 5-2
Automatically Storing Reports Using
Forced Auto-Store . . . . . . . . . . . . . . . . . . . . . . 5-2
Disk Handling and Maintenance Instruction . . . . . 5-3
Using the ECG-Log and Store-Log . . . . . . . . . . . . 5-4
Printing ECG Logs . . . . . . . . . . . . . . . . . . . . . . . . . 5-7

6 Configuring Your Cardiograph

Using Configuration Menus . . . . . . . . . . . . . . . . . . 6-1

Selecting Configuration Parameters . . . . . . . . . . . 6-3
Understanding Global Configuration . . . . . . . . . . . 6-4
Interpretation Parameters. . . . . . . . . . . . . . . . 6-10
Line Frequency . . . . . . . . . . . . . . . . . . . . . . . 6-11
Selecting Custom Lead Groups . . . . . . . . . . . 6-11
Selecting AutoCopy . . . . . . . . . . . . . . . . . . . . 6-11
Selecting ECG Management Parameters . . . . 6-12
Selecting Battery Timeout Periods . . . . . . . . 6-12
Setting a Password . . . . . . . . . . . . . . . . . . . . . 6-13
Turning Off Unused ID Fields . . . . . . . . . . . . . . . 6-13
Storing the Configuration Information . . . . . . 6-14
Using a Stored Configuration . . . . . . . . . . . . . 6-15

Contents-2
 Printing the Configuration . . . . . . . . . . . . . . . 6-16

7 Setting Up Your Cardiograph for Transmitting

ECGs

Transmitting ECGs Directly . . . . . . . . . . . . . . . . . . 7-3

Configuring the Cardiograph to Transmit
ECGs Directly . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Transmitting ECGs by Telephone to Another Site . 7-5
Installing the Modem
(For United States use only) . . . . . . . . . . . . . . . 7-5
Connecting a Telephone to the Same Line
as the Modem . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7
Configuring the Cardiograph for Modem Usage7-7
Entering the Phone Number . . . . . . . . . . . . . . . 7-9
Configuring the Cardiograph for AutoDial . . . 7-9
Installing the Modem on the Cart . . . . . . . . . 7-10
Transmitting ECGs by FAX to Another Site . . . . 7-11
Installing the FAX/Modem . . . . . . . . . . . . . . 7-12
Connecting a Telephone to the Same Line
as the FAX/Modem . . . . . . . . . . . . . . . . . . . . 7-14
Configuring the Cardiograph for FAX Usage 7-14
Entering the Phone Number . . . . . . . . . . . . . . 7-15
Transmitting an ECG via FAX . . . . . . . . . . . 7-16
Printing an ECG on an HP LaserJet Printer . . . . . 7-17
Setting up the LaserJet Printer7-18
Configuring the Cardiograph to Print ECGs
on the HP LaserJet . . . . . . . . . . . . . . . . . . . . . 7-18
Receiving ECGs . . . . . . . . . . . . . . . . . . . . . . . . . . 7-20
Configuring the Cardiograph to
Receive ECGs Directly . . . . . . . . . . . . . . . . . 7-20
Configuring the Cardiograph to Receive
ECGs via Modem . . . . . . . . . . . . . . . . . . . . . . 7-21
Receiving an ECG via FAX . . . . . . . . . . . . . . 7-21
Configuring the Cardiograph to Receive
via FAX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-22

Contents-3
 Receiving ECG Reports from a 5600C
ECG Management System . . . . . . . . . . . . . 7-22
Receiving ECGs from Philips M1730A/
M3700A TraceMaster ECG Management
System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-23

8 Troubleshooting

Troubleshooting Leads Off . . . . . . . . . . . . . . . . . . 8-1

Troubleshooting ECG Noise . . . . . . . . . . . . . . . . . 8-1
Understanding Error Messages. . . . . . . . . . . . . . . . 8-3
Calling for Assistance. . . . . . . . . . . . . . . . . . . . . . . 8-3
Solving Equipment Problems . . . . . . . . . . . . . . . . . 8-4

9 Supplies

Availability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

A Lead Systems

Frank Leads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

Special Lead Configurations. . . . . . . . . . . . . . . . . . A-2
V3R, V4R, V7 and V8 . . . . . . . . . . . . . . . . . . . A-2
VX1, VX2, VX3 and VX4 . . . . . . . . . . . . . . . . A-2

Glossary

Contents-4
1 Introduction
1
2
About This Manual
This guide contains reference information and configuration instructions for
experienced PageWriter XLi cardiograph users. For additional help on using
your cardiograph refer to the Philips PageWriter XLi Operating Guide.

1-1
 2 Acquiring an ECG

One of the most important aspects of recording a clear ECG is good

ECG technique. This chapter includes a review of recommended ECG
2
technique as well as information about using the patient module.

NOTE Computerized ECG analysis should always be reviewed by a

qualified physician.

ECG Technique
ECG technique is very important, both to avoid difficulty when taking
the ECG and to achieve the best quality result. There are three key
aspects of good ECG technique:

l helping the patient to relax

l preparing the patient for electrode connection

l using the patient module to check lead connections

For best results, perform the following steps in the order given. More
details on good technique follow this list.

l Check that the patient is comfortable and relaxed. Reassure

the patient that the procedure is painless.

l If possible, place the patient away from electrical fixtures and

their power cords, and away from the cardiograph’s power
cord if AC power is on.

l Expose the patient’s forearms, lower legs, and chest.

l Beginning with the right leg position, apply electrolyte and

attach electrodes.

2-1
Acquiring an ECG

NOTE Disposable electrodes, when used properly, may be used for

acceptable ECGs. For best results, prepare the skin and carefully
follow manufacturer’s usage instructions.

Relaxing the Patient

The more the patient relaxes, the less the ECG will be affected by
noise. Your good technique helps the patient relax. You can help the
patient to relax by the following:

l Make sure the patient is lying down and comfortable. The

patient’s arms and hands must be relaxed. If the table is too
narrow, place the patient’s hands under the buttocks to
prevent muscle tension in the arms.

l When possible, take the ECG in a quiet room or area where

others can’t see the patient. Privacy is important to relaxation.
Draw the curtains around the bed area when taking the ECG
in a room with other people.

l Gain the patient’s confidence by explaining the test and that it

won’t hurt.

l Your calm, relaxed attitude will help put the patient at ease.

l Don’t let the patient move unnecessarily. It’s also best to

avoid all conversation during the actual ECG recording to
keep the patient as still as possible.

Preparing the Patient

Selecting the Electrode Positions, Table 2-1, shows the proper

electrode positions for taking an ECG. Put the electrodes in the correct
anatomical locations according to information in Figure 2-1.
Additional information concerning other lead systems may be found
in Appendix A.

2-2
 Acquiring an ECG

The tip of each lead wire is lettered and color coded for easy lead
identification. For example, make sure that the RA lead wire and
electrode connect to the right arm and the RL lead wire and electrode
connect to the right leg.

Table 2-1 Standard 12-Lead Electrode Positions

2
Lead Position

RL On the right leg (inside calf, midway between knee and ankle)

LL On the left leg (inside calf, midway between knee and ankle)

RA On the right arm (on the inside)

LA On the left arm (on the inside)

V1 Fourth intercostal space, at right sternal margin

V2 Fourth intercostal space, at left sternal margin

V3 Midway between V2 and V4

V4 Fifth intercostal space at left midclavicular line

V5 Same transverse level as V4, on anterior auxiliary line

V6 Same transverse level as V4, at left midaxillary line

Figure 2-1 Standard 12-Lead Electrode Positions

2-3
Acquiring an ECG

Preparing the Skin at the Electrode Positions

Since dry skin is a relatively poor electrical conductor, you must

prepare the skin to ensure good contact between the skin and the
electrode. Before securing the electrodes, you must lower the skin
resistance at the electrode site by:

l Making sure that all electrodes are clean and bright. (Dirty or
corroded electrodes prevent a good electrical connection.)

l Avoiding bony areas. Select flat, fleshy sites. You don’t have
to shave hair from the skin unless the hair is very thick.

l Rubbing the skin briskly with the edge of the electrode or a

gauze pad until the skin is slightly red, but not bruised.

l Applying electrolyte to the prepared areas on the skin. Rub

some electrolyte into the skin, but leave a slightly moist
residue. Do not spread electrolyte on the chest area
between electrodes. This will cause distorted waveforms on
the ECG.

NOTE Do not use alcohol or acetone pads in place of the electrolyte

because they impair the electrode contact with the skin.

Securing the Electrodes

Two types of electrodes are included in the accessory box:

l Metal plate limb electrodes, held in place on the patient by

rubber straps.

l Welsh cup chest electrodes, held in place by suction.

Securing the electrodes is a key part of good ECG technique and

obtaining a good ECG trace. To avoid jittery waveforms, make sure
that the electrodes are secure. Do not overtighten limb plate

2-4
 Acquiring an ECG

electrodes, since this might cause discomfort which results in muscle

artifact on the waveforms.

Fasten the electrodes to the chest positions by squeezing the rubber

bulb of the suction cup. See Figure 2-2. The bulb should be partially
deflated when the electrode is firmly attached to the chest.

A good test for firm electrode contact is to grasp the electrode and try
2
to move it. If it moves easily, the electrode connection is too loose. If
it digs into the flesh, the electrode is too tight. Do not allow the chest
electrodes to move in any way. Check the patient module display for
indications that the connections are good. Ideally, the noise bar should
remain in the green zone.

Do not leave suction electrodes connected to the chest for prolonged

periods. The suction can cause intradermal hemorrhaging.

Figure 2-2 Connect Leadwires to Electrodes

2-5
Acquiring an ECG

Figure 2-3 Fasten Electrodes

Monitoring ECG Quality

There are three ways that the PageWriter XLi helps you monitor the
quality of your ECG recordings.

l using the patient module display

l using the preview screen

l observing quality messages on the cardiograph’s display

2-6
 Acquiring an ECG

You can stop the recording before or during printing if you see artifact
or other ECG waveform problems on the screen. Modify lead
placement or improve patient preparation and resume recording the
ECG.

For further instructions on using the patient module display and the
preview screen, refer to the PageWriter XLi Operating Guide. 2
Quality Messages on the Cardiograph’s Display

After you start an Auto ECG recording, the cardiograph’s display will
show messages which indicate the quality of the recording. If there is
minimal noise and all electrodes are securely attached, the message
ECG ok will appear.

Some messages indicate problems with the leads. They list the
condition and the action to take. There are four conditions which
affect the ECG:

l Leads off

l AC noise

l Artifact

l Baseline wander

If any of these conditions are severe, the message directs you to retry
the recording. Correct the problem and then resume recording the
ECG.

2-7
3 Understanding the PageWriter XLi Special
Applications

Overview
The ACI TIPI (Acute Cardiac Ischemia - Time Insensitive Predictive
Instrument) and the TPI (Thrombolytic Predictive Instrument) are
software products that enhance the computer-assisted ECG analysis 3
capabilities of the PageWriter XLi Cardiograph. These "Predictive
Instruments" generate 0-100% Predicted Probability scores of ACI
(Acute Cardiac Ischemia) and patient outcome with and without
thrombolytic therapy for acute myocardial infarction (AMI). These
predicted probabilities are based on ECG features, patient age,
gender, blood pressure, chest pain status and time since ischemic
symptom onset. The cardiograph can be configured to automatically
print these probabilities on the Auto ECG report.

Indications for Use

The ACI-TIPI is intended for use as an aid to clinicians in the

diagnosis and triaging decision process of patients with ACI, which
includes unstable angina pectoris and acute myocardial infarction
(AMI).

The TPI is intended for use as an aid to clinicians identifying which

patients with AMI are appropriate candidates for thrombolytic
therapy. TPI is intended for adult patients, aged 35-75, diagnosed with
symptoms of acute myocardial infarction.

These programs can be used in real-time and retrospective settings

since they rely on information that is readily available in the
emergency department (ED), or by retrospective review of the
patient’s medical record. The emergency physician’s real-time
decision making process is aided by having the predictive instruments
incorporated into the electrocardiograph. The predictive scores, once

3-1
Understanding the PageWriter XLi Special Applications

acquired, can then be used along with actual patient outcome to help
improve patient management practices retrospectively.

The predictive instruments provide the physician with tools to:

l aid diagnosis and triage of some patients with symptoms

suggestive of ACI

l identify those patients most likely to benefit from

thrombolytic therapy

l facilitate the earliest possible administration of thrombolytic

therapy

NOTE For intended use and contraindication information, consult the

Predictive Instrument Physician’s Guide for important information.

Understanding TPI Variables

There are nine predictors of thrombolytic-related benefits and risks

which include six clinical factors and detailed information on three
ECG features.

The six clinical factors are:

l time since ischemic onset

l patient age

l patient gender

l patient blood pressure (systolic and diastolic)

l patient’s history of diabetes

l patient’s history of hypertension

3-2
 Understanding the PageWriter XLi Special Applications

NOTE For each of the clinical factors listed above, patient data must be
entered in order to produce a TPI report.

The three ECG features are:

l the presence or absence of pathological or significant Q

waves

l the presence and degree of ST segment elevation or

depression 3
l the presence and degree of T wave elevation or inversion

Understanding ACI TIPI Variables

Seven variables are used to predict Acute Cardiac Ischemia. These

variables include four clinical factors and detailed information on
three ECG features.

The four clinical factors are:

l the presence or absence of chest pain or pressure, or left arm

pain

l if chest pain or pressure, or left arm pain is the patient’s most

important presenting symptom

l patient age

l patient gender

NOTE For each of the clinical factors listed above, patient data must be
entered in order to produce the ACI-TIPI report.

3-3
Understanding the PageWriter XLi Special Applications

The three ECG features are:

l the presence or absence of pathological or significant Q

waves

l the presence and degree of ST segment elevation or

depression

l the presence and degree of T wave elevation or inversion

The exclusionary cases for both the TPI and ACI-TIPI applications
are listed in the Predictive Instrument Physician’s Guide. Please refer
to this document for information.

Using the TPI and ACI-TIPI Applications

To use the TPI and ACI-TIPI applications, you must configure the
cardiograph and enable the applications. There are several types of
reports that are produced by the cardiograph. These reports are
summarized in Table 3-1.

3-4
 Understanding the PageWriter XLi Special Applications

Table 3-1 PageWriter XLi Reports

Report Type Contents of Report Notes

Standard 09 (Std 09) l ECG waveforms,

measurements
l ECL 09 Adult
Interpretation

Standard P4 (Std P4) l ECG waveforms,

measurements
3
l ECL P4 Pediatric
Interpretation

ACI-TIPI (T0) l ECG waveforms

l TIPI Analysis
l No Risk Management
Report

Risk Management l Risk Management l Only available

Report: when T0 is enabled
- 1 page summarizing
l The ACI-TIPI
clinical information
Report will also be
and may be used by
printed
the Clinician to docu-
ment clinical deci-
sions

TPI (H0) l ECG waveforms

l TPI Analysis

Analyzing an ECG with the Predictive Instruments

The flexibility of the PageWriter XLi allows you to configure the

Predictive Instruments based on the type of patients presenting in
your clinical setting. Using the Configuration Menu, you can set up
your cardiograph to provide the desired analysis.

3-5
Understanding the PageWriter XLi Special Applications

When first turned on the PageWriter XLi cardiograph will have the
Special Applications turned off. The Special Application choices are
part of the Global Configuration Menu and enable access to the
following settings.

Table 3-1 Special Applications Settings

Default value when

Parameter Choices
Special Apps = off

Research Leads Off/VX1-VX4/V4R-V8 Off

Default Adult Criteria 09/P4 09

Default Pediatric Criteria 09/P4 P4

Patient ID Criteria On/Off Off

ACI-TIPI On/Off Off

Risk Mgmt. On/Off Off

Risk Range 0%-100% -

TPI On/Off Off

Screening On/Off Off

Leads Normal/Cabrera Normal

Storage Mode Standard/Special Normal

VCG Off/vcg1/vcg2/vcg3/vcg4 Off

Default Storage Criteria Def Adult/Ped, TIPI, TPI Def Adult/Ped

It is important to understand that it is possible to set the Default Adult

Criteria and the Default Pediatric Criteria to be either 09 or P4. This
flexibility is designed for unusual clinical settings, and you should
always be aware of just how your cardiograph is set up.

3-6
 Understanding the PageWriter XLi Special Applications

Generating Reports with the Special Applications Off

This method of working enables any kind of report to be generated,

however it does not allow for generation of multiple simultaneous
reports. Through the top level Auto Analysis menu, you can specify
the kind of report to be made. There are five choices available: Adult,
Pediatric, TIPI, or TPI, or Default.

For each of these report options, here are the resulting reports given
when Special Applications are Off and the Auto button has been
pressed:
3
l Adult: the XLi will do an 09 report (regardless of patient age)

l Pediatric: the XLi will do a P4 report (regardless of patient

age)

l TIPI: the XLi will do a TIPI report. A Risk Management

report will not be generated.

l TPI: the XLi will do a TPI report. TPI screening will not
occur.

l Default: the XLi will do an 09 report if the age is unspecified

or above 15 years. The XLi will do a P4 report if the age is 15
years or less.

1. From the main display, press the F1 key until Auto Analysis
appears.

2. Press the F3 key to select the desired report format.

3-7
Understanding the PageWriter XLi Special Applications

Generating Reports with the Special Applications On

It is possible to configure the PageWriter XLi to produce multiple

reports. When the setting for Special Applications is turned to On,
and the Auto button is pressed, there are five choices of reports
available: Adult, Pediatric, ACI-TIPI, TPI or Default. The first four
choices and their resulting outcomes are described below.

l Adult: the XLi will do the Default Adult Criteria Report

(regardless of the patient’s age)

l Pediatric: the XLi will do the Default Pediatric Criteria

Report (regardless of the patient’s age)

l ACI-TIPI: the XLI will do a TIPI report. Also, if the Risk

Management Report is set to On in the Special Applications
menu and the ACI-TIPI Report risk factor falls within the
limits set up, a Risk Management Report will be produced.

l TPI: the XLi will do a TPI report. TPI Screening will not
occur.

Auto Analysis and the Default Choice

If Default is selected from the Auto Analysis menu, multiple reports

may be produced when the Auto button is pressed. This is also
dependent upon what is enabled in Special Applications in the
Global Configuration menu.

l TPI

l TPI is on and TPI Screening is off, a TPI report will be

generated.
l TPI and TPI Screening are on and the TPI Analysis Crite-
ria are met, a TPI report will be generated.
l TPI and TPI Screening are on, but the TPI Analysis Cri-
teria are not met, a TPI report will not be generated.

3-8
 Understanding the PageWriter XLi Special Applications

l ACI-TIPI

l ACI-TIPI is on, this will be the next report produced. If

the Risk Management Report is on and the ACI-TIPI cal-
culated risk is between the low and high risk limits as set
up in the Special Applications, then a Risk Management
report will be produced.

l Standard ECG

l Patient ID Criteria Off: the XLi will do the Default Adult

Report if the patient’s age is specified as over 15. If the
3
patient’s age is 15 years or under, the Default Pediatric
Report will be produced.

l Patient ID Criteria On and Patient ID Criteria Loaded:

this custom interpretation report will be generated.

l Patient ID Criteria On but Patient ID Criteria Not

Loaded: a Null report will be produced.

l Patient ID Criteria On but Patient ID Criteria Not

Entered: the XLi will do the Default Adult Report if the
patient’s age is specified as over 15. If the patient’s age
15 years or under, the Default Pediatric Report will be
produced.

l Vectorcardiography

l If VCG is on and at least one of the X, Y or Z leads is

included as a rhythm lead in the report type, with
Research leads off, then the XLi will produce a VCG
report.

3-9
Understanding the PageWriter XLi Special Applications

Generating a STAT ECG Report

If your cardiograph has been configured with Special Applications

on, and with TPI and/or TIPI interpretations enabled, you may omit
these interpretations by running a STAT ECG. A STAT ECG is
guaranteed to generate a single standard report (typically 09 Adult
Criteria or P4 Pediatric Criteria) without the need for Patient ID
information. A STAT ECG is initiated by pressing the Auto key twice
in succession. A STAT report is produced even if Print Auto = OFF
in the Global Configuration menu.

3-10
4 Choosing Report Features

This chapter describes the various ECG reports and how to print the
Extended Measurements report.

ECG Formats
The Auto Report

Twelve-lead Auto reports display a ten second ECG in the following

formats: 4
l Auto 3 x 4
The Auto 3 x 4 format displays consecutive 2.5 second
segments of 12 leads, three leads at a time. One or three leads
can be displayed as rhythm strips at the bottom of Auto 3 x 4
report. The rhythm strips show the same 10 second segments
as in the Auto 3 x 4 section of the report.

l Auto 3 x 5
The Auto 3 x 5 format displays consecutive 2 second
segments of 12 leads. The 5th lead column shows the
extended pediatric leads: V3R, V4R, and V7. One or three
leads can be displayed as rhythm strips at the bottom of the
Auto 3 x 5 report. The rhythm strips show the same 10 second
segments as in the Auto 3 x 5 section of the report.

l Auto 4 x 4
The Auto 4 x 4 format displays consecutive 2.5 second
segments of 12 leads. The 4th row consists of the extended
research leads: VX1-VX4 or V3R, V4R, V7, and V8. The
Auto 4 x 4 report can show 1 rhythm strip.

4-1
Choosing Report Features

l Auto 6 x 2
The Auto 6 x 2 format displays consecutive 5 second
segments of 12 leads, six leads at a time.

Auto Report Information

The Auto report may be printed with patient ID information only or

with various types of analysis information. You can select which
information appears on the printed report. See Chapter 6,
Configuring Your Cardiograph, for information on choosing which
features will be printed on the report.

Basic Measurements Report. The Basic Measurements report

includes patient ID information and basic measurements for the ECG.
These measurements, including heart rate, interval, and axis
measurements, are shown in the table below with their associated
symbols as they appear on the report.

Table 3-1 Basic Measurements

Symbol Description Units

Rate Heart rate beats per minute

PR PR interval milliseconds

QRSD QRS duration milliseconds

QT QT interval milliseconds

QTc QT interval corrected for rate milliseconds

P Frontal P axis degrees

QRS Frontal mean QRS axis degrees

T Frontal T axis degrees

4-2
 Choosing Report Features

Severity Report. This report shows a summary statement of the

severity derived from the ECG interpretation. There are five ECG
severities:

l Normal

l Otherwise Normal

l Borderline

l Abnormal

l Defective Data

Interpretive Report. The Interpretive report includes basic

measurement information as well as statements from the analysis of 4
the extended measurements derived from medical and technical
criteria. This report also shows a summary statement of the severity
of the ECG interpretation.

Reasons Report. The Reasons report includes all of the features

included on the Interpretive report as well as summarized reasons for
each interpretative statement. The reason for each statement provides
a summary of the criteria which were met in order to print the
interpretive statement.

Extended Measurements Report. The Extended Measurements

report lists the measurements which determine a suggested
interpretation. This two page report summarizes the morphology and
rhythm characteristics for the individual lead waveforms and rhythm
groups in the ECG.

To print the Extended Measurements report for a stored ECG:

1. Insert the disk that contains the ECG.

2. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

4-3
Choosing Report Features

3. Press Files . The display becomes:

Delete Log Edit Print Files

4. Press Print . The display becomes:

123456 9-23-01 11:25:51 AM

Select Print Next Previous More

5. Press Next or Previous until the correct patient ID number

appears. Press Select .

l If you know the ID number of the ECG you want to print,

press More , then Find .

l Or, type the patient ID number and press Enter . The most
recent ECG with that patient ID number appears. If you want
a different ECG for that patient, scroll through the list by
pressing Previous . Then press Select .

6. Press Select and then Print . If your cardiograph has been

configured to print Choice, the following display appears.
Choose desired analysis for print.
None Measure Interp. Reasons More

Press More and the following display appears.

Choose desired analysis for print.
Extended Sev. only More

See Chapter 6, Configuring Your Cardiograph for information on

configuring your cardiograph to print the Extended Measurements
report.
7. Press Extended .

4-4
 Choosing Report Features

8. The message Printing 1 of 1 ECG(s) will appear and the two-

page Extended Measurements report will be printed on the car-
diograph.

You can also configure the cardiograph for Choice to print this report
when copying an ECG.

Manual Formats

Manual ECGs print continuously after you press Manual until you
press Stop . Manual ECGs are printed as the ECG waveform occurs.

The Manual Lead Sets

Manual mode is used for monitoring rhythm over an extended period.

Besides standard lead combinations, you can configure your own lead
4
combinations for Custom Manual 3 or 6 leads. See Chapter 6,
Configuring Your Cardiograph, for information on selecting lead
combinations in Manual mode.

Besides the conventional 12 leads, you may use one of the following
sets of supplemental leads:

Pediatric leads V4R, V3R, V7

Frank leads X, Y, Z

Generic research leads VX1, VX2, VX3, VX4

Right chest/Posterior research V4R, V3R, V7, V8

leads

The following tables show lead selection choices.

4-5
Choosing Report Features

Table 3-2 Manual Standard Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 I, II, III I, aVF, V2

aVR, aVL, aVF
V1, V2, V3
V4, V5, V6

6 I, II, III, aVR, aVL, aVF II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6

12 I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6

Table 3-3 Manual Standard plus Pediatric Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 I, II, III I, aVF, V2

aVR, aVL, aVF
V1, V2, V3
V4, V5, V6
V3R, V4R, V7

6 I, II, III, aVR, aVL, aVF II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V2, V3R, V4R, V7

12 |I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
I, II, aVF, V4R, V3R, V1, V2, V3, V4, V5, V6, V7

4-6
 Choosing Report Features

Table 3-4 Manual Standard plus Frank Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 I, II, III I, aVF, V2

aVR, aVL, aVF
V1, V2, V3
V4, V5, V6
X, Y, Z

6 I, II, III, aVR, aVL, aVF II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V2, X, Y, Z

12 I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
I, II, aVF, V1, V2, V3, V4, V5, V6, X, Y, Z 4
Table 3-5 Manual Standard plus Generic Research Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 I, II, III I, aVF, V2

aVR, aVL, aVF
V1, V2, V3
V4, V5, V6
VX1, VX2, VX3

6 I, II, III, aVR, aVL, aVF II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, VX1, VX2, VX3, VX4
12 I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
I, II, V1, V2, V3, V4, V5, V6, VX1, VX2, VX3, VX4

4-7
Choosing Report Features

Table 3-6 Manual Standard plus Right Chest/Posterior Research Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 I, II, III I, aVF, V2

aVR, aVL, aVF
V1, V2, V3
V4, V5, V6
V4R, V3R, V1
V6, V7, V8

6 I, II, III, aVR, aVL, aVF II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V4R, V3R, V7, V8
I, aVF, V2, V6, V7, V8

12 I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
I, II, V4R, V3R, V1, V2, V3, V4, V5, V6, V7, V8

Table 3-7 Manual Cabrera Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 aVL, I, -aVR I, aVF, V2

II, aVF, III
V1, V2, V3
V4, V5, V6

6 aVL, I, -aVR, II, aVF, III II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6

12 aVL, I, -aVR, II, aVF, III, V1, V2, V3, V4, V5, V6

4-8
 Choosing Report Features

Table 3-8 Manual Cabrera plus Pediatric Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 aVL, I, -aVR I, aVF, V2

II, aVF, III
V1, V2, V3
V4, V5, V6
V3R, V4R, V7

6 aVL, I, -aVR, II, aVF, III II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V2, V3R, V4R, V7

12 aVL, I, -aVR, II, aVF, III, V1, V2, V3, V4, V5, V6
I, II, aVF, V4R, V3R, V1, V2, V3, V4, V5, V6, V7 4
Table 3-9 Manual Cabrera plus Frank Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 aVL, I, -aVR I, aVF, V2

II, aVF, III
V1, V2, V3
V4, V5, V6
X, Y, Z

6 aVL, I, -aVR, II, aVF, III II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V2, X, Y, Z
12 aVL, I, -aVR, II, aVF, III, V1, V2, V3, V4, V5, V6
I, II, aVF, V1, V2, V3, V4, V5, V6, X, Y, Z

4-9
Choosing Report Features

Table 3-10 Manual Cabrera plus Generic Research Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 aVL, I, -aVR I, aVF, V2

II, aVF, III
V1, V2, V3
V4, V5, V6
VX1, VX2, VX3

6 aVL, I, -aVR, II, aVF, III II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, VX1, VX2, VX3, VX4

12 aVL, I, -aVR, II, aVF, III, V1, V2, V3, V4, V5, V6
I, II, V1, V2, V3, V4, V5, V6, VX1, VX2, VX3, VX4

Table 3-11 Manual Cabrera plus Right Chest/Posterior Research Leads

Number of Default Custom

Lead Choices
Leads Lead Choices

3 aVL, 1, -aVR I, aVF, V2

II, aVF, III
V1, V2, V3
V4, V5, V6
V4R, V3R, V1
V6, V7, V8

6 aVL, I, -aVR, II, aVF, III II, aVF, V1, V2,

V1, V2, V3, V4, V5, V6 V4, V6
I, aVF, V4R, V3R, V7, V8
I, aVF, V2, V6, V7, V8
12 aVL, I, _aVR, II, AVF, III, V1, V2, V3, V4, V5, V6
I, II, V4R, V3R, V1, V2, V3, V4, V5, V6, V7, V8

4-10
5 ECG Storage

This chapter contains information about storing ECGs on a flexible

disk. Information about using and printing the ECG-Log and the
Store-Log is also included.

Advantages of Disk Storage

Storing ECGs on disk allows you to recall the ECGs later as needed.
Individual ECGs can be recalled for editing patient information, re-
analyzing, or printing. Groups of ECGs can be recalled from disk for
reanalyzing or for printing.

ECGs are stored in two ways:

Standard mode 5
l stored at 250 samples per second
l contain only the waveform segments printed on the Auto
report
l more than 100 ECGs can be stored on disk in Standard mode

Special mode
l stored at 500 samples per second
l contain a full ten seconds of information for all leads
l approximately 35 ECGs can be stored on a disk in Special
mode
l only ECGs stored in Special mode can be re-analyzed or re-
formatted

5-1
ECG Storage

Refer to the Global Configuration Fields Table in Chapter 6,

Configuring Your Cardiograph, for information about how to
configure the storage mode on your cardiograph.

NOTE ECGs stored to disk on a PageWriter XLs cardiograph in Special

mode, can be analyzed on a PageWriter XLi. To analyze the ECG
from the disk, press Files from the main menu, then press Analyze .
You may then select the ECGs to analyze.

Storing Reports with the Special Applications Off

Press Store to archive the last ECG report generated. The archived
report will be the last one generated.

This will not change the global cardiograph configuration. The

cardiograph will revert to the last saved storage/transmission
configuration option if the cardiograph is powered off.

Storing Reports with the Special Applications On

For the report choices of: Adult, Pediatric, TIPI, and TPI, pressing
Store will archive the last report generated. Risk Management
Reports are never stored.

Storing Reports Using Auto Analysis and the Default

Choice

Pressing Store when Auto Analysis is set as the default setting will
generate the Default Store report type previously defined in the
Global Menu settings.

A Standard ECG report is archived when a TPI report is not generated

and Default Store report type is set to TPI.

5-2
 ECG Storage

Automatically Storing Reports Using Forced Auto-Store

The PageWriter XLi may be configured (in the Global

Configuration menu) to store an ECG if patient ID information is not
entered. Answer the Global Configuration dialog AutoStore? [Yes |
No | Force] with Force, to store an ECG with an Unknown patient
ID.

Disk Handling and Maintenance

Instructions
The following instructions will prevent ECG disk damage and data
loss.

l Never manually open the silver shutter on the disk.

l Do not expose the disk to direct sunlight, extremes of

temperature or humidity, magnetic fields, or dust.
5
l Place the disk in a protective cover when the disk is not inside
the drive.

l Store disks in a clean, dry place.

l Do not eject the disk, move the cardiograph or turn off the
cardiograph when the disk is active in the drive. The disk is
active when the drive access light is on.

l Clean the disk drive with a wet-dry cleaning kit regularly.

Wet-dry cleaning kits are available from local computer
stores.

l Clean the disk drive every six months unless the working
environment is particularly dusty or dirty. Clean the drive
more often in dusty or dirty environments.

5-3
ECG Storage

TraceMaster ECG Management System users:

l If you transfer ECGs to the TraceMaster System by disk,

clean the TraceMaster drive every six months unless the
working environment is particularly dusty or dirty. Clean the
drive more often in dusty or dirty environments.

l Replace the disks regularly. The recommended interval is

every three months. If the disks are used for more than 50
ECGs per day, replace the disks more frequently.

l For best results, use only Philips recommended disks.

(Philips part number M1700-89004)

l For more information, contact your Philips service

representative.

Using the ECG-Log and Store-Log

The cardiograph automatically maintains two ECG logs. The ECG-
Log is a list of the last 60 Manual and Auto ECGs recorded on the
cardiograph. The latest ECG has the highest number. When more than
60 ECGs fill the list, the earliest ECGs disappear from the list.

The Store-Log lists all Auto ECGs stored on the flexible disk which
is in the cardiograph’s disk drive. The Store-Log is updated
automatically when you store an ECG and when you delete a stored
ECG from the flexible disk.

5-4
 ECG Storage

A B C

D E F G H I J K

Figure 5-1 The ECG-Log

Table 5-1 The ECG-Log

5
Description

A The last 60 ECGs recorded

B Location number including institution, department and cardiograph codes

C Date and time of the report

D Numerical order in which the ECG was recorded

E Date and time when the ECG was recorded

F Patient name and identification number

G ECG format and mode

H Initials of the person who recorded the ECG

I Department in which the ECG was recorded

J Institution, department and cardiograph identification number

K ECG storage indication

5-5
ECG Storage

A B C D
E F G H I J K LMNO

Figure 5-2 The Store-Log

Table 5-1 The Store Log

Description
A Information about ECGs stored on the flexible disk in the cardiograph
B Number of ECGs stored on the flexible disk
C Percentage of space available on the disk
D Date and time of the report
E Numerical order in which the ECG was stored
F Date and time when the ECG was recorded
G Patient name and identification number
H ECG format
I Initials of the person who recorded the ECG
J Department in which the ECG was recorded
K Institution, department and cardiograph identification number
L S-ECG storage mode (Standard is 250, Special is 500; 3x5 and 4x4 Reports are 500; SAECG is
SAE)
M T - Indication that ECG was transmitted. For 3x5 and 4x4 Reports a (-) will appear
N E - Patient ID information edited, Yes or No
O A - Criteria used to interpret the ECG

5-6
 ECG Storage

Printing ECG Logs

To print an ECG-Log or Store-Log.

1. Press Manual until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Files . The following display appears.

Delete Log Edit Print Files

3. Press Log . The following display appears.

Log to Print
ECG LogStore LogExit
l di i il
4. Press ECG-Log to print a list of recorded ECGs. Press 5
Store-Log to print a list of stored ECGs.

5-7
 6 Configuring Your Cardiograph

Your cardiograph may be configured to meet the specific

requirements of your institution. Typically the cardiograph is
configured only during initial installation.

This chapter describes:

l global configuration
l patient ID entry configuration
l printing and saving configuration information

NOTE Print the current configuration settings of your cardiograph before

changing the configuration. For more information, refer to
Instructions on Printing Configuration at the end of this chapter.

Using Configuration Menus

6
This section describes how to configure the cardiograph’s operating
features. Each configuration menu choice is described briefly in a list,
then in more detail in the section that follows the list.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The main configuration menu appears.

Configuration File Jobs
GlobalID Transmit Files Exit

6-1
Configuring Your Cardiograph

NOTE If this is not the initial configuration, you may need to type the
configured password before you can make any changes.

Here are the basic descriptions for each softkey in this menu:

Global l Sets the operating parameters for the car-

diograph.
l Global configuration affects all cardio-
graph operations.

ID l Selects which patient identification

entries are requested before recording an
ECG.

Transmit l Set the communication parameters

required for transmitting and receiving
ECGs.

Files l Stores a copy of the cardiograph configu-

ration and software to flexible disk, or
prints the configuration settings.

Exit l Returns you to the main menu.

NOTE When you make changes to the system configuration, it is

recommended that you save the configuration on a flexible disk. If
you must reload the configuration, restoring a custom configuration is
much quicker and easier from a flexible disk than by re-entering the
changes manually. Refer to Storing the Configuration Information
later in this chapter for more information.

Two cases where you would need to use the configuration

information from the disk are if you lose battery power or if different
configurations are regularly used in your institution.

6-2
 Configuring Your Cardiograph

Selecting Configuration Parameters

This section describes how to select and change Global, Transmit or
ID configuration parameters.

The initial display is similar to the first parameter in the Global list.

Initial Interpretation? Reasons

Enter Choose Previous Exit

The message line on top displays the parameter with its current
setting. The softkey labels are displayed on the bottom line.

Enter l Accepts current setting, and advances to the next

parameter.
l Returns to the menu if pressed when the last param-
eter is displayed.

Choose l Advances through the list of choices for the speci-

fied parameter.

Tab l Appears only for the custom lead group parameters

in the Global list.
l Use to select leads for custom format.
6
Leads l Use to select rhythm leads in Default Auto? param-
eter in Global configuration.

Previous l Returns to the previous display (does not appear on

the first display).

Exit l Returns to the main menu.

6-3
Configuring Your Cardiograph

Understanding Global Configuration

This section describes how to change configuration settings.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The Main Configuration menu appears.

Configuration
GlobalID Transmit Files Exit

3. Press GlobalID and the following display appears.

Initial Interpretation? Reasons

Enter Choose Previous Exit

Table 6-1 lists each Global parameter. Factory default settings are
shown in boldface type. Additional information on parameter settings
can be found after Table 6-1.

Table 6-1 Global Configuration Settings

Setting Choices
Parameter Comments
(default in bold)

Initial Interpretation? Reasons See Interpretation

None Parameters section
Measure following table.
Interpret
Severity only

6-4
 Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

Copy Interpretation? Reasons l See Interpretation

Extend Measure Parameters section fol-
None lowing table.
Severity only
Choice
Measure
Interpret

AutoStore? Yes l Determines whether an

No Auto ECG is automati-
Force cally stored without
operator intervention.

Patient ID required? Yes l Appears only if

No AutoStore is No
l Determines whether the
cardiograph will require
patient ID information
before recording an Auto
ECG. If AutoStore is
Yes, this parameter is
Yes. 6
Auto Frequency .15-150 Hz l W = Baseline Wander
Response? .05-150 Hz filter
.5-150 Hz W
l See Philips Interpretive
.15-40 Hz
Cardiograph Physi-
.5-40 Hz W
cian’s Guide for more
.05-100 Hz
information.
.15-100 Hz
.5-100 Hz W

Manual Frequency .5-40 Hz W l W = Baseline Wander

Response? .05-40 Hz filter
.5-100 Hz W
l See Philips Interpretive
.05-100 Hz
Cardiograph Physi-
.5-150 Hz W
cian’s Guide for more
.05-150 Hz
information

6-5
Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

Line Power Filter? Off l A software filter that

On removes power line
(AC) interference.

Line Power Frequency? 60 Hz l No default

50 Hz
l Selected during soft-
ware installation for use
by line power filter

Filter Key? Baseline Wander & Artifact l Determines which filter

Baseline Wander combinations are active
Artifact when Filter key is On.

Auto print speed? 25 mm/sec l Default Auto ECG print

50 mm/sec speed, can be overrid-
den from the front key
panel.

Default Auto? 3x4 Default format for Auto

3 x 4,1R (I) ECGs.
3 x 4,3R (I, II, III)
6x2
3x5
3 x 5,1R (I)
3 x 5, 3R(I, II, III) H Plug Shorted
4x4
4 x 4,1R (I)
Special Apps. = Yes,
Research Set

Default Manual? 3 l Default format for Man-

6 ual ECGs.
12

Leads? AHA l Selects between two lead

IEC naming conventions.
l Affects lead labels on
reports.

6-6
 Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

Custom 3 lead group? I aVF V2 l You can set any combi-

nation of the available
leads for routine usage.
See explanations follow-
ing table.

Custom Manual 6? II aVF V1 V2 V4 V6 l You can set any combi-

nation of the available
leads for routine usage.
See explanations follow-
ing table.

Units of Measure? English (lb/in) l Used for height and

Metric (kg/cm) weight entry

Print Interpretation? Reasons l See Interpretation

Extend Measure Parameters section fol-
None lowing table.
Severity only
Choice
Measure
Interpret

Time format? AM/PM

6
24 Hr

Time separator? HH:MM:SS

HH.MM.SS

Date format? MM/DD/YYYY

DD/MM/YYYY
YYYY/MM/DD

Date separator? MM/DD/YYYY

MM.DD.YYYY
MM-DD-YYYY
MM DD YYYY

Decimal format? XXX,XXX.XX

XXX.XXX,XX

6-7
Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

Paper size? A (8.5 x 11 in)

A4 (210 x 297 mm)

Auto Print? Yes l Allows or suppresses the

No printing of an Auto ECG.
l If Auto Store is No, the
Auto Print Choice of No
is invalid.

AutoCopy? Yes l See explanation follow-

No ing table.

Copies? (1-5) Type number between 1 and 5 l If AutoCopy is Yes,

selects number of auto-
matic copies after origi-
nal recording.

Location code? Type a 5-letter l See explanations follow-

alphanumeric code. ing table.

Cart ID? Type a 4-digit code. l See explanations follow-

ing table.

Institution Name? Type name, l See explanations follow-

40 characters maximum ing table.

Confirmation? PRELIMINARY -
MD MUST REVIEW.
Type a label,
30 characters maximum

User A label? Type a label, l See explanations follow-

8 characters maximum ing table.

User B label? Type a label, l See explanations follow-

8 characters maximum ing table.
Battery timeout? Type minutes between 3 l See explanation follow-
and 999. ing table.

6-8
 Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

Set keyboard? lower case

UPPER CASE

Special applications? No l Allows configuration of

Yes research leads, ECG
storage mode, and lead
system.

Research leads? No (= Frank Leads) l Used for four additional

Yes (= Research Leads) leads.
l This parameter appears
when Special Applica-
tions is set to Yes.

Default Adult Criteria? 09 l This parameter appears

P4 when Special Applica-
tions is set to Yes.

Default Pediatric P4 l This parameter appears

Criteria? 09 when Special Applica-
tions is set to Yes.
6
ID criteria version entry? No l This parameter appears
Yes when Special Applica-
tions is set to Yes.

Default ID criteria Type version, l 09, P4, T0, H0 or cus-

version? 2 character maximum tom.
l This parameter appears
when Special Applica-
tions is set to Yes.

6-9
Configuring Your Cardiograph

Setting Choices
Parameter Comments
(default in bold)

ECG storage mode? Standard l Special allows ECGs to

(250 samples/second) be re-analyzed on a
Special PageWriter XLi.
(500 samples/second)
l This parameter appears
when Special Applica-
tions is set to Yes.

Lead system? Standard l If available.

Cabrera
l This parameter appears
when Special Applica-
tions is set to Yes.

VCG? Off | VCG1 | VCG2 | VCG3 |

VCG4

ACI-TIPI? Off | On

Risk Mgmt Report? Off | On

Low Limit for Risk 0-100 | 10

Mgmt?
High Limit for Risk 0-100 | 90
Mgmt?

TPI? On | Off

Auto-TPI Candidate On | Off

Screen?

Store Analysis Type? Std Adult/Ped | ACI-TIPI |

TPI

Power on application? XLi l Allows your cardio-

Preview + graph to start up in the
SAECG selected application.

Password? Type a password, 8 characters l See explanation follow-

maximum; no spaces ing table.

6-10
 Configuring Your Cardiograph

Interpretation Parameters

These parameters determine which analysis information is included in

an ECG report.

l Initial Interpretation controls the information that appears

on the ECG when it is first taken.

l Copy Interpretation controls the information that appears

on ECG copies. A copy may be made automatically or when
the Copy button is pressed.

l Print Interpretation controls the information that appears on

a printout of a stored ECG.

Table 6-2 Interpretation Parameters

None Prints waveform and patient ID.

Severity only Prints waveform and ID, severity.

Measure Prints waveform and ID, basic measurements

summary.

Interpret Prints waveform and ID, basic measurements

summary, ECG computer-generated
6
interpretation.

Reasons Prints waveform and ID, basic measurements

summary, computer-generated ECG
interpretation with interpretation reason
statements.

Extend Measure Prints a tabular summary of all measurements

performed on ECG data.

Choice Allows the user to select the level of information

included when the copy is made without having
to change the overall instrument configuration.

6-11
Configuring Your Cardiograph

Line Frequency

This parameter selects the frequency of the filter enabled by the line
power filter. The user usually selects the frequency during initial
installation in response to a prompt. However, the user will not be
prompted when a custom configuration is installed. Including this
parameter in Global Configuration allows the user to change the
frequency selection after initial software installation.

Selecting Custom Lead Groups

Besides the pre-defined lead groups, you can configure one group of
three leads and one group of six leads that may be selected for Auto 3
x 4, 3R, Manual 3 or Manual 6 reports. These lead groups will appear
and be recorded when you select Custom 3-lead group and Custom
Manual 6-lead group reports from the main display.
1. Configure custom lead groups from Global Configuration when
the following display appears.

Custom 3 lead group I aVF V2

Enter Choose Tab Previous Exit

2. Press Choose to change leads.

3. Use Tab to move to the next lead field. In this case, the next lead
field is aVF.

4. Press Enter to save the selections.

Selecting AutoCopy

When AutoCopy is set to Yes, the cardiograph automatically prints

one or more copies of the Auto ECG after the original is recorded.
You may choose interpretation features for the copies in the Copy
Interpretation parameter. When AutoCopy is set to No, the user
must press Copy to receive each additional printed copy.

6-12
 Configuring Your Cardiograph

Selecting ECG Management Parameters

These parameters trigger processing protocols on either the ECG

Management System and ECG workstation, or provide information
for ECG tracking.

Table 6-3 ECG Management Parameters

Location code A 5-digit code. The first three digits

represent the institution and the last two
digits represent the department.

Cart ID A 4-digit code identifying which

cardiograph recorded the ECG.
Institution Name Identifies the institution, such as City
General Hospital. Limited to 40 characters.

User A label Label such as Smoker? or Temp? that

appears in ID entry process. Limited to
eight characters.

User B label Label such as Smoker? or Temp? that

appears in ID entry process. Limited to
eight characters. 6
Selecting Battery Timeout Periods

To conserve battery power, the cardiograph turns off after the period
of time specified by this parameter. The time is measured from the
completion of the last operation, the last key press, or disconnection
of all patient leads. The timeout function is disabled when the
cardiograph is plugged into AC power and the AC switch is on. If the
cardiograph turns off, current ID information and Copy memory are
lost.

6-13
Configuring Your Cardiograph

Setting a Password

To protect your configuration settings from casual changes, you can

require password entry to access the configuration. This password is
set in Global Configuration.

CAUTION If the password is set and forgotten, you will be unable to change the
cardiograph configuration without re-installing the supplied software.

Turning Off Unused ID Fields

Patient ID fields that are not used may be turned off.

To turn off ID fields:

1. Press Config from the main display. The following display
appears.

Configuration
GlobalID Transmit Files Exit

2. Press the ID softkey and the following display appears.

Allow NAME entry? Yes

Enter Choose Exit

The following lists each configuration option. Select either Yes or No

to exclude that item from the patient ID information printed on the
ECG. Yes is the default setting for each option indicated with an
asterisk.

l Allow NAME entry*?

l Allow AGE entry*?

l Allow SEX entry*?

6-14
 Configuring Your Cardiograph

l Allow CHEST PAIN entry*?

l Allow HX DIABETES entry*?

l Allow HX HYPERTENSION entry*?

l Allow AC ISCHEMIC Sx TIME entry*?

l Allow BP entry*?

l Allow WEIGHT entry*?

l Allow HEIGHT entry*?

l Allow RACE entry*?

l Allow DX entry*?

l Allow RX entry*?

l Allow OPERATOR entry*?

l Allow DEPARTMENT entry*?

6
l Allow ROOM entry*?

l Allow REQUESTED BY entry*?

l Allow USER A entry? (USER A is replaced by the label

defined in global configuration.)

l Allow USER B entry? (USER B is replaced by the label

defined in global configuration.)

l Allow ECG Mgr Priority entry? ECG Management System

processes this ECG first.

6-15
Configuring Your Cardiograph

Storing the Configuration Information

Press Files from the Main Configuration menu. The following

menu appears.
Configuration File Jobs
Store Print Exit

Store Stores the cardiograph configuration on

flexible disk.

Print Prints a copy of the cardiograph

configuration.

Exit Returns to the main configuration

menu.

NOTE Store the cardiograph configuration each time it is changed. If the

cardiograph’s configuration is lost due to loss of battery power, you
will be able to easily restore the cardiograph to its latest
configuration.

Storing the configuration on a flexible disk allows you to load known

configuration settings into the cardiograph.

To store the configuration:

1. Insert a blank formatted disk into the disk drive.

2. Press Store . The prompt Enter Disk Label appears.

This optional label can be up to 16 characters long and is dis-
played while the operating system is installed. Examples of labels
are 11/01 Config or Dr. Jones Disk.

3. Type the label and press . The cardiograph displays

Storing cardiograph configuration until storing is complete.

6-16
 Configuring Your Cardiograph

NOTE If an unformatted flexible disk is inserted into the disk drive, press
Yes to format the disk. Formatting a disk takes about 90 seconds.
You may also insert a formatted flexible disk at this time.

Using a Stored Configuration

To use a stored configuration on another PageWriter XLi cardiograph

or to reload a configuration:
1. Turn off the cardiograph.
2. Insert the configuration disk.
3. Turn on the cardiograph. A display with a disk label similar to the
following will appear. The disk label may vary.

Load Configuration? 11/901 Config

Yes No

4. Press Yes if the label displayed matches the configuration you

wish to load.
Press No and the cardiograph configuration will not be altered.
Find the configuration disk to load and follow the instructions
from step 1 again.
6
5. Remove the configuration disk.

The cardiograph will now operate with the configuration parameters

from the disk.

Printing the Configuration

1. Press Config from the main display. The following display
appears.
Configuration File Jobs
Store Print Exit

6-17
Configuring Your Cardiograph

2. Press Files . The following display appears.

Configuration File Jobs

Store Print Exit

3. Press Print . The message Printing Cardiograph Configura-

tion appears on the display until the two page printout is com-
plete.

You then return to the Configuration Files menu.

6-18
 7 Setting Up Your Cardiograph for Transmitting
ECGs

This chapter describes how to set up your PageWriter XLi

cardiograph for transmitting and receiving ECGs.

NOTE Transmission of 3 x 5 and 4 x 4 ECG Reports to a Philips TraceMaster

ECG Management System is not possible. FAX transmission and
LaserJet printing of 3 x 5 and 4 x 4 formats is allowed. The LaserJet
printer must have a serial port.

For instructions on how to transmit an ECG, refer to the PageWriter

XLi Operating Guide.

PageWriter XLi cardiographs can send ECGs to the following Philips

products:

l another PageWriter XLi cardiograph

l Philips M1730A and M3700A TraceMaster ECG

Management Systems

l class III FAX Machines

l all PCL5 printers 7

The PageWriter XLi cardiograph can receive text reports from the
Philips M1730A and M3700A TraceMaster ECG Management
Systems.

NOTE You will only be able to select from transmittable ECGs when you
press Transmit . You cannot transmit Manual ECGs, ECGs recorded
with research leads, or ECGs interpreted with a different criteria
program version than on the transmitting cardiograph. The criteria
program is the software used to interpret the ECG. The receiving

7-1
Setting Up Your Cardiograph for Transmitting ECGs

instrument must have the same criteria version installed as the

sending PageWriter XLi cardiograph.

Up to four sites may be configured on your cardiograph to transmit or

receive ECGs.

Examples of transmitting situations are:

l An ECG can be transmitted from the bedside to an Philips

ECG Management System for printing, analyzing, and
storing.

l ECGs can be recorded on rounds and then transmitted to

another area of the institution to a PageWriter XLi
cardiograph or an Philips TraceMaster ECG Management
System.

l ECGs can be sent by modem to another institution for

overreading or further analysis.

l ECGs can be sent by FAX/modem to a FAX machine for

overreading or further analysis.

7-2
 Setting Up Your Cardiograph for Transmitting ECGs

Transmitting ECGs Directly

You may transmit ECGs directly by cable to a Philips TraceMaster
ECG Management System. Figure 7-1 shows how to connect the
necessary cables.

Figure 7-1 Connecting the Cables for Direct Transmission

a. PageWriter XLi Cardiograph

b. Transmission Cable
c. Philips ECG Management System Connection
7

7-3
Setting Up Your Cardiograph for Transmitting ECGs

Configuring the Cardiograph to Transmit ECGs Directly

After connecting the cables, configure the cardiograph for direct

transmission.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The Main Configuration menu appears.

Configuration
GlobalID Transmit Files Exit

3. Press Transmit . The Transmit Configuration menu appears.

Configuration
Transmit Receive AutoDial Exit

4. Press Transmit to configure any of four transmission sites. The

Configure Site menu appears.

Configuration Site
#1 #2 #3 #4 Exit

5. Select a site number and the following display appears.

Connection? None
Global Choose Exit

6. Press Choose until you see the choice Direct Connection, then
press Enter . The next display will allow you to select the baud
rate. When you choose direct connection, the default baud rate
will be 9600.

7-4
 Setting Up Your Cardiograph for Transmitting ECGs

Transmitting ECGs by Telephone to

Another Site
Use a modem to transmit ECGs by telephone to another PageWriter
XLi cardiograph or to a Philips Tracemaster ECG Management
System.

Installing the Modem (United States only)

Before using the M1706B modem you must connect the cables.
Figure 7-2 shows how to connect the cables for transmitting ECGs by
modem.

Figure 7-2 Connecting the Modem Cables

7-5
Setting Up Your Cardiograph for Transmitting ECGs

a. PageWriter XLi Cardiograph

b. Modem Power Cord
c. Modem
d. Phone Line Connector
e. Modem Data Cable

Refer to Figure 7-2 and perform the following steps to install the
modem.
1. Turn the cardiograph to Standby.
2. Turn the modem power switch off.

WARNING Equipment connected to the cardiograph’s RS-232 connector may cause

ground leakage current exceeding the maximum specified in UL544/IEC601-
1 safety standards. Do not connect any equipment to the RS-232 connector
during cardiograph operation when the patient cable is connected to a
patient.

NOTE Make sure that the battery level is sufficient to prevent loss of
configuration settings and software in the cardiograph when AC
power is removed. Check the Battery Level indicator lights on the
cardiograph’s key panel to ensure that they are all on.

3. Turn the cardiograph AC switch off.

4. Insert the larger connector end of the modem cable (24252M) into
the RS-232C plug on the back of the modem. Tighten the retain-
ing screws.
5. Insert the smaller end of the modem cable into the plug on the
back of the cardiograph marked Data Comm. Tighten the retain-
ing screws.

7-6
 Setting Up Your Cardiograph for Transmitting ECGs

NOTE Connect the modem to the cardiograph and to the telephone line in the
following order. This will avoid the possible electrical hazards from
the outlet and telephone line.

6. Plug the modem power cable into the plug on the modem marked
9.0V ~AC.
7. Plug the other end of the modem power cable into the cardio-
graph.
8. Insert either end of the telephone cable into the connector on the
back panel of the modem marked To Line.
9. Insert the free end of the telephone cable into the telephone wall
jack.
10. Plug the cardiograph power cable into the cardiograph and an AC
outlet if they are not already plugged in.
11. Turn on the cardiograph’s AC power switch.
12. Turn on the modem.
13. Turn on the cardiograph.

Connecting a Telephone to the Same Line as the Modem

To connect a telephone to the same line as the modem:

1. Connect one end of the telephone cable to the telephone.
7
2. Plug the free end of the cable into the modem connector marked
To Phone.

The modem is now installed and ready for use. You must configure
the cardiograph for modem usage before transmitting ECGs.

7-7
Setting Up Your Cardiograph for Transmitting ECGs

Configuring the Cardiograph for Modem Usage

To transmit ECGs by telephone from the cardiograph, you must

configure the cardiograph in the following way:

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The main configuration menu appears.

Configuration
Global ID Transmit Files Exit

3. Press Transmit and the Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

4. Press Transmit to configure any of four transmission sites. The

Configure Site menu appears.

Configuration Site
#1 #2 #3 #4 Exit

5. When you select a site number, the following display appears.

Connection? None
Enter Choose Exit

7-8
 Setting Up Your Cardiograph for Transmitting ECGs

Table 7-1 Modem Settings

Parameter Selection

Baud Rate? 9600

Connection? Programmable Modem

Phone #? Type phone number, 36 characters

maximum
Dial Type? Tone (default setting)
Pulse

Pause Length? 2, 4, 6, 8, 10 (seconds)

Entering the Phone Number

Table 7-2 Special Dialing Characters

Parameter What it does

Pause l Inserts a pause in the number

dialing sequence to avoid dial-
ing errors if the number is sent
,
too rapidly.
l For example: 1,234,567,8900

Tone l Instructs the modem to wait for

a dial tone before completing 7
the dialing sequence.
w
l This is used to ensure an out-
side line is engaged before dial-
ing the number.
l For example: 9w567,8900
l The modem dials 9, then waits
for a dial tone.

7-9
Setting Up Your Cardiograph for Transmitting ECGs

Parameter What it does

X l Instructs the modem not to wait

for a dial tone.
l This might be required when
you dial through a PBX system
or with some non-U.S.
modems.
l For example: X567,8900

Configuring the Cardiograph for AutoDial

AutoDial is for users who always transmit to the same site. To

configure the cardiograph for AutoDial:
1. Select AutoDial from the Transmit Configuration menu. The
following menu appears.

AutoDial Site? None

Enter Choose Exit

2. Press Choose to select the site (#1, #2, #3, or #4) to which the
cardiograph will automatically transmit when the operator presses
Transmit .

3. Press Enter and the selected site will be set. The display will
return to the Transmission Configuration menu. If you have not
configured the transmission site, you can configure it from this
menu.

7-10
 Setting Up Your Cardiograph for Transmitting ECGs

Installing the Modem on the Cart

After the M1706B modem is configured, you can install it on the

cardiograph cart as shown in Figure 7-3.

Figure 7-3 Attaching the Modem to the Cart

To attach the modem to the cart:

1. Thread the knobscrew into the threaded hole on the underside of
the crossbar on the cart but do not tighten it.
2. From the back of the cart, set the modem on top of the crossbar
with the front of the modem (the display end) to your left. Make
sure that it fits between the two guides molded into the paper tray 7
on the cart.
3. Install the modem bracket and tighten the knobscrew.

Transmitting ECGs by FAX to Another

Site
You can use the M1706B FAX/modem to transmit ECGs by
telephone to another PageWriter XLi cardiograph or to any Class III

7-11
Setting Up Your Cardiograph for Transmitting ECGs

FAX machine. The FAX/modem can be used for transmitting as a

normal modem as well.

WARNING Some Group III fax machines distort the received fax transmission by com-
pressing the image to fit the viewing or printing device. This distortion can
affect the amplitude and time scale of an ECG transmitted by fax.

For example, PC based fax/modems and fax cards will normally compress
the received image when displaying the fax transmitted ECG on the PC
monitor and can compress the image when the fax is printed.

To determine whether a fax machine distorts the received ECG fax, you will
need to measure the ECG report’s grid spacing or the calibration pulse and
check these measurements against the printed scale factors shown at the
bottom of a printed ECG report. The grid is nominally printed at 1 mm inter-
vals in both the time and amplitude directions. The width of the calibration
pulse is 200 msec and its height represents 1 mV. Therefore an ECG report
with a 10 mm/mV amplitude scale and 25 mm/sec time scale should have a
calibration pulse that is 10 mm tall and 5 mm wide.

7-12
 Setting Up Your Cardiograph for Transmitting ECGs

Installing the FAX/Modem

Before using the FAX/modem you must connect the cables as shown
in Figure 7-4.

Figure 7-4 Connecting the Modem Cables

7
a. PageWriter XLi Cardiograph
b. Modem Power Cord
c. Modem
d. Phone Line Connector
e. Modem Data Cable

Refer to Figure 7-4 and perform the following steps to install the
modem.

7-13
Setting Up Your Cardiograph for Transmitting ECGs

1. Turn the cardiograph to Standby.

2. Turn the modem power switch off.

NOTE Make sure that the battery level is sufficient to prevent any loss of
configuration settings and software in the cardiograph when AC
power is removed. Check the Battery Level indicator lights on the
cardiograph’s key panel to ensure that they are all on.

3. Turn the cardiograph AC switch off.

4. Insert the larger connector end of the modem cable (24252M) into
the RS-232C plug on the back of the modem. Tighten the retain-
ing screws.
5. Insert the smaller end of the modem cable into the plug on the
back of the cardiograph marked Data Comm. Tighten the retain-
ing screws.

CAUTION Connect the modem to the cardiograph and to the telephone line in the
following order. This will avoid the possible electrical hazards from
the outlet and telephone line.

6. Plug the modem power cable into the plug on the modem marked
9.0 V ~ AC.
7. Plug the other end of the modem power cable into the cardio-
graph.
8. Insert either end of the telephone cable into the connector on the
back panel of the modem marked To Line.
9. Insert the free end of the telephone cable into the telephone wall
jack.
10. Plug the cardiograph power cable into the cardiograph and an AC
outlet if they are not already plugged in.
11. Turn on the cardiograph’s AC power switch.
12. Turn on the modem.

7-14
 Setting Up Your Cardiograph for Transmitting ECGs

13. Turn on the cardiograph.

Connecting a Telephone to the Same Line as the FAX/

Modem

To connect a telephone to the same line as the FAX/modem:

1. Connect one end of the telephone cable to the telephone.
2. Plug the free end of the cable into the unused modem connector.

The FAX/modem is now installed and ready for use. You must
configure the cardiograph for FAX/modem usage transmitting ECGs
by FAX.

Configuring the Cardiograph for FAX Usage

To FAX ECGs by telephone from the cardiograph.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The main configuration menu appears.

Configuration
Global ID Transmit Files Exit

7
3. Press Transmit . The Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

4. Press Transmit to configure any of four transmission sites. The

Configure Site menu appears.

Configuration Site
#1 #2 #3 #4 Exit

7-15
Setting Up Your Cardiograph for Transmitting ECGs

5. When you select a site number, the following display appears.

Connection? None
Enter Choose Exit

l If you wish to step through setting choices, press Choose .

l If you wish to select the displayed choice and move to the

next field, press Enter .

l If you wish to finish configuring and select the displayed

choice, press Exit .

Table 7-3 Modem Settings

Selection
Parameter
(default setting in bold)

Baud Rate? 9600

Connection? Programmable Modem

Phone #? Type phone number, 36 characters

maximum

Dial Type? Tone (default setting)

Pulse

Pause Length? 2, 4, 6, 8, 10 (seconds)

7-16
 Setting Up Your Cardiograph for Transmitting ECGs

Table 7-4 Special Dialing Characters

Parameter What it does

Pause l Inserts a pause in the number

dialing sequence to avoid dial-
ing errors if the number is sent
,
too rapidly.
l For example: 1,234,567,8900

Tone l Instructs the modem to wait for

a dial tone before completing
the dialing sequence.
w
l This is used to ensure an out-
side line is engaged before dial-
ing the number.
l For example: 9w567,8900
l The modem dials 9, then waits
for a dial tone.

X l Instructs the modem not to wait

for a dial tone.
l This might be required when
you dial through a PBX system
or with some non-U.S.
modems.
l For example: X567,8900
7
Transmitting an ECG via FAX

After a site has been configured on the cardiograph for FAX

transmission, you can FAX an ECG to the site. The FAX/modem must
also be installed to FAX to a FAX site. See Chapter 5 in the
PageWriter XLi Operating Guide for the steps to FAX an ECG to the
configured FAX site.

7-17
Setting Up Your Cardiograph for Transmitting ECGs

Printing an ECG on an HP LaserJet

Printer
You can print stored ECGs on an HP PCL5 LaserJet printer. Figure 7-
5 shows how to connect the cables between the cardiograph and the
printer.

Figure 7-5 Connecting the Printer Cable

a. PageWriter XLi Cardiograph

b. HP LaserJet Printer

7-18
 Setting Up Your Cardiograph for Transmitting ECGs

c. HP LaserJet Printer Serial Interface Port

d. LaserJet Cable (HP 24542G)

WARNING The PageWriter XLi A.05.00 software allows you to print ECGs on a Laser-
Jet. The LaserJet printer is NOT isolated to UL544/IEC-601-1 leakage cur-
rent specifications. Be sure to disconnect the LaserJet from the
cardiograph when you want to record ECGs.

Setting up the LaserJet Printer

You must set up the LaserJet printer for serial printing before using it
to print stored ECGs from the cardiograph. To configure the printer
for serial printing, perform the following steps.

1. With the printer on, press the Online key until the light turns
off.

2. Press the Menu key to step through the settings until

I/ O=PARALLEL* appears.

If I/O=SERIAL* appears, the printer is already set for serial

printing.
3. Press the + key until I/O=SERIAL appears.

4. Press the Enter key. An asterisk will appear:

I/O=SERIAL*.
7
5. Press Menu . The BAUDRATE setting will appear.
6. Press the + key until BAUDRATE=19200 appears.

7. Press the Enter key. An asterisk will appear:

BAUDRATE=19200*.

7-19
Setting Up Your Cardiograph for Transmitting ECGs

8. Press the Online key.

The printer is ready to use with your cardiograph.

Configuring the Cardiograph to Print ECGs on the HP

LaserJet

After connecting the cables, you must configure the cardiograph for
printing on the HP LaserJet.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The Main Configuration menu appears.

Configuration
Global ID Transmit Files Exit

3. Press Transmit . The Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

4. Press Transmit to configure any of four transmission sites.

Configuration Site
#1 #2 #3 #4 Exit

5. Select a site number and the following display appears.

Connection? None
Enter Choose Exit

6. Press Choose until you see the choice LaserJet. Press Enter .
The baud rate display appears.

7-20
 Setting Up Your Cardiograph for Transmitting ECGs

7. Press Choose until you see the baud rate 19200. Press Enter .
8. Select whether to print a grid. If you have unlined paper in the
printer, this selection will print the grid with the ECG.

Your cardiograph is now set up to print to an HP LaserJet when you

select the configured site from the Transmit menu. See the
PageWriter XLi Operating Guide for information about transmitting
ECGs.

Receiving ECGs
When configured and connected for receiving, the cardiograph may
receive ECGs whenever it is turned on. ECG reports are printed
immediately when they are received. These reports cannot be copied
or stored on the flexible disk.

Configuring the Cardiograph to Receive ECGs Directly

After connecting the cables, you must configure the receiving

cardiograph for direct reception.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The Main Configuration menu appears. 7

Configuration
Global ID Transmit Files Exit

3. Press Transmit . The Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

7-21
Setting Up Your Cardiograph for Transmitting ECGs

4. When you press Receive the following display appears.

Connection? None
Enter Choose Exit

5. Choose Direct Connection, then press Transmit to proceed to

baud rate selection. When you choose direct connection, the
default baud rate will be 9600.

Configuring the Cardiograph to Receive ECGs via

Modem

To configure the cardiograph for receiving ECGs by telephone:

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The main configuration menu appears.

Configuration
Global ID Transmit Files Exit

3. Press Transmit . The Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

4. When you press Receive the following display appears.

Connection? None
Enter Choose Exit

Choose the programmable modem selection for connection type. The

default baud rate for the programmable modem is 2400.

7-22
 Setting Up Your Cardiograph for Transmitting ECGs

Receiving an ECG via FAX

The cardiograph may receive ECGs via the FAX/modem any time the
cardiograph is configured for FAX/modem usage and is idle.

Configuring the Cardiograph to Receive via FAX

To configure the cardiograph to receive via FAX.

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Config . The Main Configuration menu appears.

Configuration
Global ID Transmit Files Exit

3. Press Transmit . The Transmit Configuration menu appears.

Configuration Site
Transmit Receive AutoDial Exit

4. Press Receive . The following display appears.

Connection? None
Enter Choose Exit
7
Choose the FAX programmable modem selection for connection type.
The default baud rate for the FAX programmable modem is 2400.

Receiving ECG Reports from a 5600C ECG Management

System

After you have configured a site number for the 5600C ECG
Management System with the appropriate connection parameters, you
can receive reports from that system.

7-23
Setting Up Your Cardiograph for Transmitting ECGs

To receive reports from that system:

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Transmit . The following display appears.

Selected All NewGroup Query Files

3. Press Query . You may then select the site number which is
assigned to the 5600C ECG Management System.
4. After you press the site number, the cardiograph will call the sys-
tem, ECGs will be transmitted from the ECG Management Sys-
tem to the cardiograph, and the cardiograph will print the reports
as they are received.

Receiving ECGs from a Philips M1730A or M3700A

TraceMaster ECG Management System

PageWriter cardiograph users can receive ECGs from the M1730A

and M3700A on request by using the Query function. The M1730A
and M3700A will send the ECGs in batch or individually depending
on how the cardiograph user responds to system questions on the
cardiograph as shown in the instructions below.

There are two types of Query, Standard query and Interactive query.

In Standard query, reports must be queued at the system for output to

the cardiograph. Only diagnostic and extended measurements reports
can be sent in standard query.

In interactive query, the cardiograph user selects the ECG to receive.

A full ECG (report and waveform) can be received this way.

7-24
 Setting Up Your Cardiograph for Transmitting ECGs

NOTE Query will timeout after an idle period. The length of this period is
determined by how the ECG Management system is configured.

From the cardiograph:

1. Press Menu until the following display appears.

Transmit Store Config CheckDisk Files

2. Press Transmit . The following display appears.

Selected All NewGroup Query Files

3. Press Query . If Interactive query is configured on the system, the

following display appears on the cardiograph. If Interactive query
is not configured on the system, consult the system administrator
for the ECG Management system for assistance.
Select an online report?
Yes No

NOTE Press No to start a batch query. All reports queued for your location
will now be printed.
7
4. Press Yes to select Interactive query. You will be asked for your
ID number. Your ID number is the same as your password. See
your system administrator if you do not know your ID number.

5. Type a valid ID number and press Enter . You will be asked for
an institution number:

l Type a three digit number for the desired institution or type

All (may result in an extended search if you do not specify a
patient ID).

7-25
Setting Up Your Cardiograph for Transmitting ECGs

6. Press .
7. After you enter a valid institution number, you will be asked for
patient ID. Type either a patient ID or a patient name no more
than 16 characters long.

8. Press . The message Searching database, please wait ...

appears. The duration of the search depends on how many ECGs
are stored on the database and how specific your search criteria
are.
9. If the search is unsuccessful, the following display appears and
you can start a new search.
No ECGs for this patient
New Inst New ID

l Transmit returns you to step 5.

l New ID retains the institution you entered earlier, and

returns you to step 6.

10. If the search is successful, a display similar to the following

appears.
2 ECGs found for:PATIENT IDNUMBER
Newest Oldest NewInst New ID

l Newest shows the most recent stored ECG in the list.

l Oldest shows the oldest stored ECG in the list.

11. Press Newest or Oldest and a display similar to the following

appears.
III PATIENTID 01/26/01 06:21:52
Next Previous Select More

7-26
 Setting Up Your Cardiograph for Transmitting ECGs

From this display you can scroll through a list of selected ECGs.
The top line contains:

l Institution number (III)

l Patient ID number or the first 16 characters of the patient

name

l Date and time that this ECG was recorded

12. Press Select to receive and print the displayed ECG.

l Press Next or Previous to view other ECGs.

13. Press More and the softkey selections will change as shown
below.
III PATIENTID 01/26/01 06:21:52
Name NewInst New ID More

l If you wish to change the displayed ECGs from patient ID

numbers to names, press Name . The display returns to the
set of keys shown in step 8.

l If names are already displayed, you will see ID instead of

Name . If you wish to change the displayed ECGs from 7
patient names to ID numbers, press ID .

l If you wish to start a new search through another institution,

press NewInst .

l If you wish to start a new search for other patient ID

numbers, press New ID .

l If you wish to return to the set of keys shown in step 8, press

More .

7-27
Setting Up Your Cardiograph for Transmitting ECGs

You may end the interactive query session any time by pressing the
Stop key on the cardiograph. The transmission link will end
immediately.

Consult your system administrator for more information about

interactive query and how your system operates.

7-28
8 Troubleshooting

This chapter describes ways to improve ECG quality by correcting

electrode contact problems as well as equipment problems. The tables
in this chapter list possible actions to take for difficulties encountered
when recording ECGs.

Troubleshooting Leads Off

You can identify which electrode is off by using the patient module as
well as the preview screen. Poor electrode contact or a disconnected
wire is shown on the patient module display by an X, on the preview
screen by a flat dotted line, and on the printed report by a flat line.

Table 8-1 Leads Off Indications

Preview Patient Printed

Lead
Screen Module Report

RL Dotted line on all leads X on all leads Flat line on all leads

RA, Dotted line on all leads X on lead which is off and Flat line on all leads
LA, X on chest leads
and/or
LL

Chest Dotted line on lead(s) X on lead(s) which is off Flat line on lead(s) which
lead(s) which is off is off

8
Troubleshooting ECG Noise
Use the electrode status indicators (noise bars) on the patient module
to check the quality of the ECG signal. The preview screen is another
way to check the ECG signal quality before recording the ECG. Noise
on the ECG recording is often due to poor electrode contact or to

8-1
 Troubleshooting

environmental interference. Try improving the conditions

surrounding the recording before using filters. As a last resort when
you cannot eliminate or reduce noise at its source, use one or more of
the configurable filters on your cardiograph.

There is some compromise between fidelity and clarity on the ECG

trace when using any of the filters besides the line power (AC)
filter.The more filters applied to the signal, the greater the possibility
of removing details of the ECG signal besides removing noise. This is
why filters should only be used as a last resort after attempting to
improve the ECG technique.

Table 8-2 PageWriter XLi Cardiograph Filters

Configurable Settings
Filter Type Interference Sources In the Filter Box
(default in bold)

Auto low 0.15 Hz Electrode movement, patient .15 , .5

frequency 0.05 Hz movement or respiration or .05
response 0.5 Hz W

Auto high 150 Hz Movement of skeletal muscles 150,

frequency 100 Hz 100, or
response 40 Hz 40

Manual low 0.5 Hz W Electrode movement, patient .5 or .05

frequency 0.05 Hz movement or respiration
response

Manual high 40 Hz Movement of skeletal muscles 40, 100,

frequency 100 Hz or 150
response 150 Hz

Line Power (AC) 50 Hz AC power lines, equipment operating

60 Hz near the patient

Baseline Wander BaselineWander setting Electrode movement or poor contact W

and press Filter and skin preparation

Artifact Artifact setting and press Muscle tremor F

Filter

8-2
 Troubleshooting

Understanding Error Messages

The error messages that appear on the display will instruct you as to
what action to take. If it is something that you can correct, the
message will instruct you what to do.

If an error number appears, note the number and then perform the
following steps.

1. Cycle the power. Set the On-Standby button to Standby and

then back to On.
2. If the error reappears, re-install the System disk. See Setting Up
Your Cardiograph for the First Time in the PageWriter XLi
Cardiograph Operating Guide.
3. If the error continues, try another System disk.
4. If the error recurs, call your Philips service representative.

Calling for Assistance

For telephone assistance, call the Response Center nearest to you, or

visit our website at:

www.medical.philips.com/cms and follow the link for services.

United States of America

Medical Response Center Tel: (800) 548-8833

Latin America
8
Tel: 305-269-7500

8-3
Troubleshooting

Canada

Eastern Region Central and Western Regions

Tel: (800) 361-9790 Tel: (800) 268-1221

Other International Areas

Australia France

Tel: 131147 Tel: 0803 35 34 33

Germany Italy

Tel: 018 05 32 62 77 Tel: 800-825087

Netherlands United Kingdom

Tel: (0) 20-547-2555 Tel: 44-344-36633

Belgium Finland

Tel: 02 404 9102 Tel: 09 6158 0400

Spain

Tel: 34 91 631 31 00

Solving Equipment Problems

The following tables list symptoms of equipment problems grouped
by functions with suggested solutions. Many of the suggestions
recommend that you try a sequence of actions until the problem is
resolved. If the first action solves the problem, you do not need to try
further actions.

8-4
 Troubleshooting

Table 8-3 Battery Problems

Symptom What to Do

Message: No battery. Install the battery, then try turning on the cardiograph.
Load battery. Cardiograph won’t turn
on.

AC indicator not lit 1. Plug in power cord.

2. Turn on AC switch.
3. Call your Philips service representative.
Cardiograph doesn’t run on AC, but Call your Philips service representative.
runs on battery

Cardiograph doesn’t run on battery, but 1. Charge battery for 24 hours.

runs on AC. 2. Replace battery.
3. Call your Philips service representative.

Cardiograph won’t power up on AC or Call your Philips service representative.

battery

Battery charge level indicator never 1. With the cardiograph connected to AC power, turn on the
indicates full capacity. cardiograph. If only a single battery level indicator is lit
(other than the Battery Low Warning), reload the
operating system, insuring the paper compartment door
is closed. If the operating system is loaded with this door
open, only a single indicator will light.
2. If after completing the step above, all battery level
Battery charge level indicator always indicators are not lit, the battery requires further
indicates full capacity on AC power charging. When checking the battery level, always turn
with battery. the cardiograph on while connected to AC power.
3. Replace battery.
4. Call your Philips service representative.
8

8-5
Troubleshooting

NOTE When dealing with noise problems, remember that most noise is the
result of technique or poor electrode contact. If noise persists after
checking the electrode placement and other elements of technique, the
noise may be the result of faulty electrode wires. Only when you
eliminate technique and electrode wires as the causes of the noise
should you consider calling your Philips service representative.

Table 8-4 Patient Module and Connecting Cable Problems

Symptom What to Do

No display on patient module l Adjust contrast.

display.
l Call your Philips service representative.

Leads off displayed on preview l Call your Philips service representative.

screen, but patient module
appears blank or displays
asterisk, blanks, and boxes.

Leads off not indicated when l Remove electrode wire from patient module.
wire is off.
l Ensure the contacts on the patient module are
clean and dry.
l If Leads off is not indicated, call your
Philips service representative.

Leads off indicated when wire is l Remove electrode wire and install shorting plug.
not off. If Leads off is indicated, call your Philips service
representative.
l If Leads off is not indicated, replace electrode
wire.

8-6
 Troubleshooting

Table 8-4 Patient Module and Connecting Cable Problems

Symptom What to Do

No response to start button. l Verify that the cardiograph is not in Configura-

tion mode or busy.
l Try pushing the button harder.
l Suspect patient module if cardiograph starts from
front panel but not from patient module button.
l Call your Philips service representative.

Bad ECG: l See Table 6-1 in the PageWriter XLi Cardiograph

Good calibration pulse in lead(s) Operating Guide.
where trace(s) is (are) not good.
l Isolate defective wires and replace.
A lead is missing on Auto l Call your Philips service representative.
reports: Electrode off on bottom
of report.
On Manual reports: Leads off
on trace.

Electrode off on ECG when no l Be sure STAT ECG is not taken within 15 sec-
electrode is off. onds of cardiograph power-up.

Noisy lead(s): AC (regular l See Table 6-1 in the PageWriter XLi Cardiograph
pattern) Operating Guide.
For 60 Hz, 12 peaks/5 mm
l Reposition patient module cable away from AC
at 25 mm/ sec; for 50 Hz, 10
power.
peaks/5 mm
l Try plugging cardiograph into AC outlet.

Noisy lead(s): Muscle artifact. l See Table 6-1 in the PageWriter XLi Cardiograph
Operating Guide.
l Replace disposable electrodes or lead adapters. 8
l Call your Philips service representative.

Noisy lead(s): I, III, aVL l Replace LA leadwire.

Noisy lead(s): II, III, aVF l Replace LL leadwire.

Noisy lead(s): I, II, aVR l Replace RA leadwire.

8-7
Troubleshooting

Table 8-4 Patient Module and Connecting Cable Problems

Symptom What to Do

Noise in only one V lead. Noise l See Table 6-1 in the PageWriter XLi Cardiograph
in general. Operating Guide.
l Isolate defective wires and replace.

Table 8-5 Printer Errors

Symptom What to Do

Paper doesn’t move; printer error message l Replace paper or clear paper jam.
displayed after checking paper supply.
l Call your Philips service
representative.

Paper moves then stops and displays an l Make sure cardiograph is loaded properly with
error message. Check paper supply. approved thermal paper.
l Clean paper sensor lens. See PageWriter Cardio-
graph XLi Operating Guide for instructions.
l Call your Philips service representative.

Printer error message displayed; transient l Charge battery.

low battery status indication during
l Replace battery.
printing (battery too low for good
printing) l Call your Philips service representative.

Message: Printer door open. l Close door.

l Call your Philips service representative.

Paper moves but nothing prints. l Make sure cardiograph is loaded with approved
Paper moves but printing is faint. thermal paper.
l Call your Philips service representative.

8-8
 Troubleshooting

Table 8-5 Printer Errors

Symptom What to Do

Paper stops in the wrong place after l Make sure cardiograph is loaded with approved
pressing Page Advance or Auto . No thermal paper.
error message. l Clean sensor lens.
l Call your Philips service representative.

Printed data is garbled. l Call your Philips service representative.

Poor print quality or some dots not l Clean printhead. See the PageWriter XLi Cardio-
printing. graph Operating Guide for instructions.
l Call your Philips service representative.

Some dots always on. l Call your Philips service representative.

Printing is dark on one side of page but l Call your Philips service representative.
faint on the other side.

Table 8-6 Disk Drive Errors

Symptom What to Do

Disk drive inoperative. l Call your Philips service representative.

Error message Try new disk appears. l Try known good disk.
l Call your Philips service representative.

Error message Unrecognized file l Corrupt file, try known good file.
type appears.
8

8-9
Troubleshooting

Table 8-7 Preview Screen Problems

Symptom What to Do

Washed out display. l Adjust brightness and contrast controls for best dis-
play appearance.

All white screen. l Adjust contrast or brightness or both.

All black screen.
l Call your Philips service representative.

No brightness adjust. l Call your Philips service representative.

No contrast adjust.
All blue screen.
Garbled data on display.

Backlight flickers. Half screen lit. No l Adjust brightness.

backlight but characters present.
l Call your Philips service representative.

8-10
 Troubleshooting

Table 8-8 Keyboard and Keyboard Display Problems

Symptom What to Do

Display stays blank. l Adjust contrast or brightness.

l Call your Philips service representative.

Keys won’t work. Unable to enter l Call your Philips service representative.
data or operate controls.

Table 8-9 Transmission Errors

Symptom What to Do

1540, 1541 l Call your Philips service representative.

Message ERROR 153X: Remote site l This is a message from the remote site informing
failure. the user that the communication link has been ter-
minated.

Unable to transmit or receive. l Check to see that modem is turned on and plugged
in, if using a modem.
l Call your Philips service representative.

Message No answer at site. Retry? l Type an X before typing the phone number. The
when there is a dial tone. The modem will not wait for a dial tone.
cardiograph will not be able to start the
transmission because the modem doesn’t
recognize the dial tone.

3 x 5, 4 x 4 untransmittable, FAX only l This is a message to indicate that the user has
attempted to transmit reports that are unrecognized
by the remote site.
8

8-11
 9 Supplies

Availability
Pricing and availability of the following and other supplies are
available from Philips Medical Supplies Centers.

l U.S.: 1-800-225-0230

l Outside the USA, contact your local Philips Sales Office,

your authorized Philips Dealer or Distributor, or visit our
Medical Supplies website at: www.medical.philips.com/cms

Paper

M1707A Paper, 8.5" x 11", 1600 sheets, Header

M1708A Paper, 8.5" x 11", 1600 sheets, No Header

M1709A Paper, Metric, 1600 sheets, Header

M1710A Paper, Metric, 1600 sheets, No Header

M2206A Paper, 8.5" x 11", anti-fade, 1600 sheets, Header

M2207A Paper, Metric, anti-fade, 1600 sheets, Header

Battery

M1721A Battery assembly - lead acid type

9

9-1
Supplies

Electrodes

40418A Welsh electrode; 15mm base 5cc bulb; screw connect; 6/box

40421A Welsh electrode; 15mm base 5cc bulb; push-in connect; 6/box
(AHA Leads)

40490E Welsh electrode; 4mm conn.(banana); 15mm cup; 2cc bulb (IEC
Leads)
9301-0119 Large welsh electrode; 30mm dia cup; screw connect; 1/box

40420A Disposable diagnostic pre-gelled electrode; 1000/case

13943B Disposable diagnostic solid gel electrode; 1000/case, Tab Style

13944B Disposable diagnostic wet gel electrode; 300/case, Snap Style

40423A Reusable infant limb plate electrode; pk/4 (AHA Leads)

40424A Reusable limb plate electrode; push-in connect; pk/4

40425A Reusable limb plate electrode; screw connect; pk/4

40491E Limb plate electrode; 4mm conn.(banana); 4 ea. (IEC Leads)

40494E Limb clamp electrode; screw connect; 4/box

40493E ECG adult foam electrode (Europe only); 300/case

40419A Replacement bulb; 5cc for all 15mm dia. cups; 12/pk

40422A Small replacement bulb; 2cc for all 15mm dia. cups; 12/pk

Lead Adapters

14282A Lead adapter; converts post to spring clip

40475A Lead adapter; from post to snap-on;10/pk. (AHA Leads)

40498E Adapter; from banana plug to pincher;10/pk. (IEC Leads)

13946B Tab electrode adapter; 10/pk.

9-2
 Supplies

Lead Adapters

40431B Lead adapter from 1/8" post to alligator clip; 10/pk. (AHA Leads)

40432B Lead adapter from 4mm post to alligator clip; 10/pk. (IEC Leads)

Patient Cables

M1719A Data cable, 2.5M

M1720A Data cable, 9M

9-3
Supplies

Replacement Leads

M1711A AHA Limb Lead Replacement Kit; qty 2

M1712B AHA Chest Lead Replacement Kit; 24", qty 3

M1712C AHA Chest Lead Replacement Kit; 15", qty 3

M1713B AHA Complete Lead Set; Chest leads, 24", limb leads 39"

M1714A IEC Limb Lead Replacement Kit; qty 2

M1715B IEC Chest Lead Replacement Kit; 60cm; qty 3

M1715C IEC Chest Lead Replacement Kit, 38cm; qty 3

M1716B IEC Complete Lead Set; chest leads 60 cm; limb leads 100 cm

M1717B Extra Leads Set, AHA or IEC (Pediatric, Frank, & Research); 24"/60 cm
(qty 4)

M1718A Lead Support Kit; 4 shorting plugs, 10 banana adapters, 2 lead separators

Other

14030A Rubber limb strap, 15 in.; 4/pk

14030B Rubber limb strap, 30 in.; 4/pk, w/button

14030C Rubber limb strap, 60 in.; 4/pk, w/button

9301-0119 Large Welsh electrode; 30 mm dia cup; screw connector; 1/box

9301-0120 Replaceable bulb for 30 mm dia cup Welsh electrode; 1/box

M1700-89004 Box of 10 High Density Disks (available from your Philips service
office)

9-4
 A Lead Systems
A

Frank Leads
Table A-1 Frank Lead Electrode Positions

Lead Color Code Position

I Orange/Red At the right midaxillary line

E Orange/Yellow At the front midline

C (V4) Orange/Green Between front midline and left midaxillary line at 45
angle

A (V6) Orange/Brown At the midaxillary

M Orange/Black At the back midline

H Orange/Violet On the back of the neck or on the forehead

F Red On the left leg

Figure A-1 Frank Lead Electrode Positions.

A-1
Lead Systems

Special Lead Configurations

The PageWriter XLi provides flexibility in the configuration and
recording of ECG leads beyond the standard twelve by providing four
additional leads. Please note that use of the additional leads does not
affect the cardiograph’s computerized ECG analysis. The analysis
program uses only the standard 12 leads.

V3R, V4R, V7 and V8

Additional leads can be placed into the patient module. When the
power to the cardiograph is turned on, the additional leads will be
recognized by the cardiograph. The cardiograph will identify the
additional leads as V3R, V4R, V7 and V8. The V8 lead position on
the module is labeled H.

These additional lead locations are positioned to investigate the right

and posterior walls of the heart for both children and adults.

Children have a proportionately larger right heart mass than adults

(hypertrophy of the left ventricle has not yet advanced). Therefore
use of leads V3R, V4R, V7 and V8 provides desirable information
about the electrical conduction on the right side of the heart that might
not be seen in the standard 12 leads.

Leads V3R, V4R, V7 and V8 are also useful in evaluating adult

patients suspected of having an inferior infarct involving the right or
posterior wall of the heart. These additional leads may reveal changes
indicative of injury that may be difficult to distinguish in the standard
12 leads.

VX1, VX2, VX3 and VX4

Researchers have the opportunity to label the four additional leads as

VX1, VX2, VX3 and VX4. This selection is found in the Special
Applications section of the cardiograph Global Configuration. The
lead locations are determined entirely by the researcher. They will all
be unipolar leads using the same Wilson pole as reference as used by
the standard chest leads V1 through V6.

A-2
 Lead Systems

Table A-2 Lead Configuration Choices A

Auto
Patient Module /
Global Configuration Lead Type Lead Set Report
Shorting Plug
Format

Pediatric 12 Leads + 3 x 4, 6 x 2,
V4R, V3R, V7 3x5

Standard 12 Leads 3 x 4, 6 x 2

Research Leads = Off Frank 12 Leads + 3 x 4, 6 x 2

X, Y, Z

Special Applications = On Generic 12 Leads + 3 x 4, 6 x 2

Research Leads = VX1, Research VX1, VX2, 4x4
VX2, VX3, VX4 VX3, VX4

A-3
Lead Systems

Table A-2 Lead Configuration Choices

Auto
Patient Module /
Global Configuration Lead Type Lead Set Report
Shorting Plug
Format

Special Applications = On Right Chest/ 12 Leads + 3 x 4, 6 x 2

Research Leads = V3R, Posterior V4R, V3R, V7, 4x4
V4R, V7, V8 Research V8

A-4
B Glossary

B
AC filter

The configurable filter which screens out ECG artifact caused by power
line interference.

adult criteria

Interpretive rules used when analyzing ECGs if person’s age is above 15

years. (See ECG analysis, analysis criteria, and pediatric criteria)

AHA leads

ECG lead names and identifying colors recommended by the American

Heart Association. Limb leads are labelled RA, LA, LL, RL. Chest leads
are labelled V1-V6. (See IEC leads)

alphanumeric

Composed of both letters and numbers. PageWriter XLi has an

alphanumeric keyboard.

alternating current (AC)

Electrical current provided by wall outlets. AC may be either 60 or 50 Hz

depending on country.

analysis criteria

Rules used to interpret ECGs. (See adult criteria, pediatric criteria, and
ECG analysis)

Glossary-1
 applications

Software used for a specific task. The PageWriter XLi contains the
SAECG application and the Preview Plus application.

artifact

ECG waveform distortion that may diminish ECG quality. ECG artifact
(or noise) may be caused by electrical interference, poor electrode
connections, or patient movement.

artifact filter

Philips term for filter which screens out noise on the ECG caused by
muscle tremor. Operators turn on the artifact filter by pressing the Filter
key on the key panel.

Auto ECG

Twelve-lead ECG recorded and analyzed over a ten second period and
printed in a preselected format.

AutoCopy

Philips term for user-configurable option which programs the cardiograph

to automatically copy any Auto ECG recorded.

AutoDial

Philips term for user-configurable option which programs the cardiograph

to transmit an ECG to a particular site when the operator presses
Transmit .

AutoStore

Philips term for user-configurable option which programs the cardiograph

to automatically store any Auto ECG recorded.

Glossary-2
baseline wander

A slow upward or downward motion on the baseline of any ECG

waveform.

baseline wander filter

The configurable filter which reduces baseline wander.

B
battery timeout

Philips term for the process cardiograph uses to turn off automatically
after a preset time period to conserve power. The number of minutes
before battery timeout can be set in configuration mode.

baud rate

The speed at which data (ECGs) can be transmitted from one instrument
to another.

Cabrera

An alternative limb lead order in which aVR is inverted and shown as

aVR. Lead order is aVL, I, -aVR, II, aVF, III, V1 - V6. (See standard
leads. Also see Questions and Answers in the PageWriter XLi Physician’s
Guide.)

calibration pulse

A 200 ms, 1 mV square wave pulse which appears on the printed record.
Calibration pulse shows the sensitivity at which the ECG was recorded
and may show the effect of the filters.

CheckDisk

Philips term for softkey function which checks the percentage of flexible
disk storage available for storing Auto ECGs.

Glossary-3
 configuration

The manner in which the cardiograph is programmed to function. When

the software is installed, the cardiograph defaults to a preset configuration
which may be changed at any time.

continuous preview

The Preview Plus application that allows you to view the ECG waveform
on the preview screen without pauses when you print an ECG report.

cycle power

To press the On-Standby button to Standby and then back to On.

Data Commport

The cardiograph connector into which the modem data cable or direct
connection cable is inserted for ECG transmission.

delayed Manual

The Preview Plus application that allows you to capture and print ECG
information that you see on the preview screen. Ordinarily the ECG
information you see printed is what occurred after you pressed Manual .

ECG analysis

Computerized process for measuring and interpreting an Auto ECG.

ECG report

Paper copy produced by PageWriter XLi cardiographs when the operator

presses one of the Auto start keys. This report includes a graphic
representation of the heart’s electrical activity (ECG waveforms) and
identifying information and may also include interpretive information
produced by the computerized analysis software. ECG reports must be
overread by qualified physicians.

Glossary-4
ECG-Log

Philips term for the softkey function which accesses the list of the last 60
ECGs recorded on a cardiograph.

FAX

An image transmitted electronically.

B
FAX/modem

A device that allows the cardiograph to send and receive ECGs and
FAXes (Group III only).

file

Data such as an Auto ECG stored on a flexible disk.

flexible disk

A disk which can be inserted in the disk drive to store data such as Auto
ECGs or the system configuration. Flexible disks can also be used to load
software.

format

The manner in which ECG waveforms are presented on the printed ECG
report. ECG format is selected by the operator.

Frank leads

Lead system which obtains three dimensional ECG waveform

information. This information is presented using the three orthogonal
leads X, Y, and Z.

frequency response

The range of frequencies in which the cardiograph records ECG data.

front panel

Cardiograph area that includes the front panel display and the keyboard.

Glossary-5
 global configuration

Philips term for general cardiograph function settings. (See configuration)

Hertz (Hz)

A unit of electrical frequency (cycles per second).

ID fields

Philips term for the areas where variable patient information can be
entered. Using the ID fields, the operator can key in information such as
patient identification number, name, and age.

IEC leads

Lead names and identifying colors recommended by the International

Electrotechnical Commission standard. IEC limb leads are labelled R, L,
F, and N. Chest leads are labelled C1-C6. (See AHA leads)

jittery waveform

Irregular up and down movement on the baseline of the ECG often caused
by patient movement or muscle tremor.

Manual ECG

ECG report format which runs continuously until the operator stops the
recording. The ECG may show three, six, or twelve lead waveforms.
Many institutions and physicians may identify this format as a rhythm
strip.

measurements

The amplitudes, durations, areas, and intervals which characterize the

ECG waveform.

Glossary-6
Menu key

Cardiograph key that changes the menu selections displayed on the

cardiograph’s front panel display.

modem

Device used to transmit data (ECGs) over phone lines.

B
morphology

Related to the shape of the ECG waveform.

operator

The person who records the ECG.

overread

To review an ECG report. This review must be completed by a qualified

physician.

password

Private code word that limits access to the cardiograph’s configuration

software to those persons knowing the code word. Passwords prevent
accidental or unauthorized changes to cardiograph configuration.

patient module

Philips term for the remote unit that contains all of the cardiograph’s ECG
data acquisition electronics, the display where electrode status appears,
and a remote start/stop key. The patient module connects to the patient
data cable and to the leads attached to the patient.

PCL printer language

Philips page description language for printers. Used for defining a page,
selecting fonts, and other formatting elements.

Glossary-7
 pediatric criteria

The interpretive rules used when analyzing ECGs if person’s age is 15

years or less. (See adult criteria, ECG analysis, and analysis criteria)

preliminary report

An ECG report that has not been reviewed by a qualified physician. (See
overread)

Preview Plus

The PageWriter XLi application that provides enhanced information on

the preview screen. Preview Plus also allows you to reformat ECG
reports, record timed Auto ECGs, record delayed Manual ECGs, and
view a continuous ECG.

preview screen

Philips term for the optional screen which, when installed on the
cardiograph, shows the ECG traces as they will appear on the printed
ECG report.

power on application

The configured setting that allows your cardiograph to start up in a

particular application.

query

An operation mode that allows the cardiograph to call an Philips ECG

Management system and receive an ECG or reports for printing.

reformatted report

A printed report that is printed with a different lead presentation than the
original ECG report. For example, you can reformat a 3 x 4 ECG and
print it as a 6 x 2 ECG.

Glossary-8
research lead set

Optional leads that can be positioned wherever needed in addition to

standard, 12 lead set. Research leads are unipolar.

rhythm strip

Philips term for ten second recording of a particular lead that is printed at
B
the bottom of an Auto ECG report. (See Manual and Auto ECG)

shorting plug

Small spacer plug inserted in patient module lead slot when lead is not in
use.

softkeys

Function keys labelled in the lower portion of the cardiograph’s front

panel display and physically positioned underneath the display. These
keys change functions when they are pressed. The matching display label
also changes.

standard leads

The conventional twelve lead order is I, II, III, aVR, aVL, aVF, V1 - V6.
(See Cabrera)

Store-Log

Philips term for function which accesses a list of all ECGS stored on the
flexible disk.

timed Auto ECG

The configured cardiograph setting that allows Auto ECGs to be recorded

(and printed or stored on the selected option) at selected regular intervals.

Glossary-9
 transmission site

Philips term for the four preset, configurable transmission selections.

Operators may select connection type, baud rate (if appropriate), phone
number (if appropriate), dialing type (if appropriate), and pausing length
(if appropriate).

Welsh cups

Reusable electrodes held in place with suction cups.

Glossary-10
 Index

Numerics analysis information is AutoStore B-2

1540 8-10 included in an ECG axis measurements 4-2
report 6-10
2 ECGs found for
analyze 5-2
B
PATIENT ID baseline wander B-3
NUMBER 7-25 applications B-2
baseline wander filter B-3
250 5-1 artifact 2-4, B-2
battery 8-7, 9-1
500 6-9 muscle 2-4
conserving power
attach the modem to the
A cart 7-10
6-12
Abnormal 4-3 power 7-13
Auto 3 x 4 4-1
AC problems 8-5
Auto 6 x 2 4-1
filter 8-2, B-1 timeout 6-12, B-3
Auto Frequency Response
indicator 8-4 battery level 7-6
6-5
noise 2-7 indicator lights 7-13
Auto Frequency
outlet 7-7, 7-13 battery power, losing 6-2
Response? 6-5
power 6-12, 7-6, 7-13 Battery timeout? 6-8
Auto high frequency
power lines 8-2 baud rate 7-4, 7-15, 7-19,
response 8-2
switch 6-12, 7-6, 7-7, 7-21, 7-22, B-3
Auto low frequency
7-13, 8-4 Baud Rate? 7-8
response 8-2
accessory box 2-4 Borderline 4-3
Auto print speed 6-6
adult criteria B-1 brightness
Auto print speed? 6-6
AHA leads B-1 adjusting 8-9
Auto Print? 6-8
Allow NAME entry? 6-13 Auto Report 4-1
alphanumeric B-1 AutoCopy
alternating current B-1 configuring 6-11
analysis 4-1 interpretation 6-12
computerized 2-1 AutoCopy? 6-8
analysis criteria B-1 AutoDial 7-9, B-2
AutoDial Site? 7-9

i
Index

C configuration Special applications

cable modem 7-6, 7-13 Institution Name 6-12 6-8
printer 7-17 Interpretation storage mode 6-8
problems 8-6 Parameters 6-10 Time format 6-7
transmission 7-3 keyboard case 6-8 Time separator 6-7
cables LaserJet printing 7-18 to Receive ECGs
FAX/modem 7-12 lead system 6-8 Directly 7-20
Cabrera B-3 Line Frequency 6-11 to Receive ECGs via
calibration pulse B-3 Line Power Filter 6-6 Modem 7-21
cardiograph query Line Power Frequency to Receive via FAX
7-23 6-6 7-22
cart Location code 6-12 to transmit ECGs by
Installing the Modem Manual Frequency telephone 7-5
7-10 Response 6-6 Units of Measure 6-7
Cart ID 6-12 number of copies 6-8 User A label 6-8
Cart ID? 6-8 operating features 6-1 User B label 6-8
changing parameters 6-3 Paper size 6-7 connect the cables for
Check paper supply 8-7 Password 6-10 FAX/modem 7-12
CheckDisk B-3 password 6-13 connecting
chest electrode 2-4 patient ID entry 6-13 telephone to modem
Choose desired analysis Print Interpretation line 7-7
for print 4-5 6-7 cables 7-18
computerized analysis 2-1 printing 6-1, 6-8 cables for printing
configuration 6-1, 6-3, printing settings 6-15 7-18
7-4, 7-21, B-4 protecting 6-13 cables for
global parameters 6-4 storing 6-15 transmission 7-4
default settings 6-4 using stored 6-15 Modem Cables 7-5
global 6-11, 6-14, B-6 Receiving ECG connection type 7-21
initial 6-1 Reports from a Connection? 7-8, 7-15
Initial Interpretation 5600C ECG 7-22
6-10 research leads 6-8

ii
 Index

Connection? None 7-4, Date separator? 6-7 display

7-8, 7-15, 7-19, 7-20, Decimal format? 6-7 main 6-16
7-21, 7-22 Default Adult Criteria? problems 8-9
connector, phone line 7-6 6-9
continuous preview B-4 Default Auto? 6-3, 6-6
E
ECG
contrast Default ID criteria
analysis B-4
adjusting 6-5, 8-9 version? 6-9
copies 6-10
Copies? 6-8 Default Manual? 6-6
criteria 7-1
Copy Interpretation 6-10 Default Pediatric Criteria?
logs 5-4, 5-7
Copy Interpretation? 6-5 6-9
manual 4-6, B-6
Copy memory 6-12 default settings 6-4
measurements 4-4
criteria 4-3 Defective Data 4-3
physician review of
adult B-1 delayed Manual B-4
2-1
analysis B-1 Destination? 7-15
printout information
criteria summary 4-3 dial tone 7-9
6-10
criteria version 7-1 Dial Type? 7-8, 7-15
quality 2-1
custom dialing 7-9
quality improvement
3-lead group, Direct Connection 7-4,
8-1
configuring 6-11 7-21
re-analyzing 5-1
lead groups, direct transmission
report B-4
configuring 6-11 connecting cables 7-4
reports 4-1
Manual 6-lead, disconnected wire 8-1
storage mode 5-6, 6-8
configuring 6-11 disk
storing 5-1
Custom Manual 6? 6-7 flexible B-5
timed Auto B-9
cycle power B-4 stored configuration
tracking 6-12
6-15
D storing ECGs 5-1
transmittable 7-1
Data Comm 7-6, 7-13 troubleshooting noise
disk drive 5-3
Data Commport B-4 8-1
errors 8-8
database ECG ok 2-7
disks 9-4
search 7-25 ECG storage mode? 6-9
Date format? 6-7 ECG technique 2-1, 2-4

iii
Index

ECG-Log 5-4, 5-5, B-5 F G

printing 5-7 FAX 7-21 Global 6-2
edited patient ID 5-6 FAX Programmable global configuration 6-13,
electrode 2-4 Modem 7-15 6-14, B-6
disposable 2-2 FAX/modem 7-15 Global parameters 6-4
metal plate limb 2-4 files 4-4, 5-2, 5-7, 6-1
positions 2-4 Filter 8-2
H
suction 2-4 heart rate, on the report
filter
Welsh cup chest 2-4 4-2
baseline wander B-3
Welsh large 9-2 Hertz B-6
line power 6-11
electrode connection 2-1 Filter Key? 6-6 I
electrode contact, poor filters 8-2 ID 6-3, 7-26
8-5 artifact 8-2 ID fields
electrodes 9-2 Auto high frequency turning off 6-13
Welsh cups B-10 response 8-2 ID numbers 7-26
electrolyte 2-4 Auto low frequency ID parameters 6-3
Enter 6-3 response 8-2 IEC leads B-6
Enter Disk Label 6-15 baseline wander 8-2 indicator
entering line power (AC) 8-2 AC 8-4
phone number for a Manual high indicator lights, Battery
site 7-15 frequency Level 7-13
ERROR 153X response 8-2 Initial Interpretation 6-10
Remote site failure Manual low frequency Initial Interpretation? 6-5
8-10 response 8-2 Reasons 6-3, 6-4
error messages, flexible disk B-5 installing
understanding 8-3 format B-5 modem 7-5, 7-10
Exit 6-1, 6-4 Frank Lead Electrode Institution Name? 6-8
Extended 4-5 Position A-1 institution number 7-24
Extended Measurements Frank Leads 4-7, B-5 interactive query 7-24
report 4-1, 4-5 frequency response B-5 ending 7-26
printing 4-4 front panel B-5 Interference Sources 8-2

iv
 Index

Interp 4-5 Manual Cabrera + N

Research Leads 4-10
L Manual Cabrera Leads
Name 7-26
Lead system? 6-9 New ID 7-25, 7-26
4-9 New Inst 7-25, 7-26
Leads off 2-7
Manual ECG 4-6, B-6 Newest 7-25
Leads Off Indications 8-1
Manual Frequency No answer at site. Retry?
limb electrodes 2-4
Response? 6-6 8-10
limb strap 9-4
Manual high frequency No battery. Load battery.
line Frequency,
response 8-2 8-4
configuring 6-11
Manual leads No ECGs for this patient
line power (AC) filter 8-2
selection choices 4-6 7-25
Line Power Filter 6-6
Manual low frequency noise
line power filter 6-11
response 8-2 bars 2-4, 8-1
Line Power Frequency?
Manual Standard + eliminating 8-2
6-6
Research Leads 4-8 troubleshooting 8-1
LL 2-3
Measure 4-5 None 4-5
Load configuration? 6-16
measurements B-6 Normal 4-3
Location code? 6-8
ECG 4-4
Log 5-7
Measurements Report 4-2 O
Log to Print 5-7 Oldest 7-25
Menu 4-4
M Menu key B-7 online report 7-24
main configuration menu messages operating parameters 6-2
7-4, 7-7, 7-14, 7-19, quality 2-7 operating system 6-15
7-20, 7-21, 7-22 modem 7-5, B-7 operator B-7
main display 6-11 cable 7-5 Otherwise Normal 4-3
main menu 6-2, 6-3 connector 7-7 outside line 7-9
Manual 4-6 data cable 7-6 overread B-7
Manual Cabrera + Frank power cord 7-6 P
Leads 4-10 morphology 4-4, B-7 Paper 9-1
Manual Cabrera + muscle artifact 2-4 paper size? 6-7
Pediatric Leads 4-9

v
Index

parameters Phone Line Connector Printing 1 of 1 ECG(s)

changing 6-1 7-6, 7-12 4-5
global 6-2 phone number 7-8 Printing cardiograph
ID 6-2 power 8-4 configuration 6-16
selecting 6-3 power on application B-8 printing copies
transmit 6-3 Power on application? 6-9 automatically 6-11
password 6-1, 7-24, B-7 preliminary report B-8 Printing ECG Logs 5-7
setting 6-13 Preparing 2-2 Printing-Store-Log 5-7
Password? 6-10 skin 2-3 programmable FAX
patient Preview Plus B-8 modem 7-8, 7-22
preparing 2-1 preview screen 2-6, 8-5, Pulse 7-8, 7-15
Patient Cables 9-3 B-8
patient ID Problems 8-9
Q
quality
edited 5-6 Previous 6-3
messages 2-6
entries 6-13 Print 4-4
query 7-23, B-8
entry configuration Print Interpretation 6-10
interactive 7-26
6-1 Print Interpretation? 6-7
standard 7-23
Patient ID required? 6-5 printed report 4-1
timeout 7-23
patient module 2-1, 2-4, printer cable 7-17
queuing reports 7-24
B-7 Printer door open 8-7
problems 8-5 printing R
patient module display configuration 6-1, RA 2-2
2-4, 8-5 6-16 re-analyzing stored ECG
Pause 7-9, 7-16 connecting cables 5-1
pause length parameter 7-18 Reasons 4-5
7-16 printing Reasons report 4-3
Pause Length? 7-8, 7-15 ECG-Log 5-7 Receive 7-20
pediatric criteria B-8 Extended
pediatric leads 4-6 Measurements
Phone # 7-8, 7-15 report 4-4

vi
 Index

receiving 7-21 report severity

baud rate 7-21 Measurements 4-2 Abnormal 4-3
connection type 7-21 preliminary B-8 Borderline 4-3
FAX programmable printed 4-1 Defective Data 4-3
modem 7-22 Reasons 4-3 Normal 4-3
from the 5600C 7-1 reformatted B-8 of the ECG
programmable Severity 4-3 interpretation 4-3
modem 7-21 research lead set 4-6, B-9 Otherwise Normal 4-3
setting up cardiograph Research leads? 6-8 Severity Report 4-3
7-1 rhythm shorting plug B-9
receiving ECGs characteristics 4-4 signal quality 2-6, 2-7
batch 7-23 groups 4-4 site 7-8
individually 7-23 rhythm strip B-9, 4-1 site number 7-4, 7-15,
reformatted report B-8 right leg electrode 2-2 7-19, 7-22, 7-23
re-installing software RL 2-3 for the 5600C 7-22
6-13 RS-232C 7-6 softkeys B-9
relaxing the patient 2-2 Special applications? 6-8
report
S Special mode
SAE 5-6
analysis information storing 5-1
search for ECGs
6-10 standard leads B-9
unsuccessful 7-25
Auto 4-1 Standard mode
Searching database,
ECG B-4 storing 5-1
please wait ... 7-25
Extended Stop 4-6, 7-26
Select an online report?
Measurements storage mode 5-1, 5-6
7-24
4-1, 4-3 setting 6-15
selecting parameters 6-4
Interpretive 4-3 Store-Log 5-4, 5-6, 5-7,
sending ECGs
B-9
batch 7-23
printing 5-7
individually 7-23
Set keyboard? 6-8
setting a password 6-13

vii
Index

storing Transmit 6-2, 7-4, 7-14 V4 2-3

configuration 6-2, Configuration menu V5 2-3
6-15 7-8, 7-14, 7-19, V6 2-3
Special mode 5-1 7-20
Standard mode 5-1 transmit parameters 6-2
W
waveform
Storing cardiograph transmittable ECGs 7-1
jittery 2-4, B-6
configuration 6-15 transmitted ECG 5-6
Welsh cup chest
storing ECGs 5-1 transmitting
electrodes 2-4
suction electrodes 2-5 by Telephone 7-5
Welsh cups B-10
supplies 9-1 FAX/modem 7-11
wires
setting up cardiograph
T 7-1
defective 8-6
Tab 6-3
via FAX 7-16
telephone
transmitting ECGs
cable 7-13
directly 7-3
wall jack 7-7
troubleshooting 8-1
Time format? 6-7
troubleshooting ECG
Time separator? 6-7
Noise 8-1
timed Auto ECG B-9
Try new disk 8-8
timeout
battery 6-8, B-3 U
query 7-23 Units of Measure? 6-7
To Phone 7-7 User A label? 6-8
tone 7-9, 7-15, 7-16 User B label? 6-8
transmission using
errors 8-10 stored configuration
transmission cable 7-3 6-15
transmission
configuration menu
V
V1 2-3
7-10
V2 2-3
transmission site 7-10,
V3 2-3
B-10

viii
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