GE Healthcare MAC® 5500/MAC® 5500 HD Resting ECG Analysis System Operator's Manual Software Version 10 2046275-016 Revision A MAC® 5500/MAC® 5500 HD Resting ECG Analysis System English 2010 General Electric Company. All Rights Reserved.
Publication Information The information in this manual only applies to MAC® 5500 and MAC® 5500 HD system software version 10. It does not apply to earlier software versions. Due to continuing product innovation, specifications in this manual are subject to change without notice. MAC, MULTI-LINK, MUSE, MACTRODE, Ultra-Archivist, MobileLink, and 12SL are trademarks owned by GE Medical Systems Information Technologies, Inc., a General Electric Company going to market as GE Healthcare.
Contents 1 Introduction Product Information.................................................................................... 9 Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Prescription Device Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Modem Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Connecting the MobileLink Wireless Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Connecting External Exercise Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Test End Phase .......................................................................................... 81 7 Editing Protocols Protocol Overview..................................................................................... 83 Editing or Creating Protocols .................................................................... 85 8 Printing ECG Reports Printing Another Report ............................................................................ 89 Printing Stored ECGs .......................
Locking and Unlocking the SD Card. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Inserting and Ejecting the SD Card. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Formatting the SD Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hi-Res...................................................................................................... 155 Setting Up a Card Reader........................................................................ 156 Automatic Configuration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Manual Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercise Final Reports ............................................................................. 184 Exercise Report Codes............................................................................. 185 D Master's Step Data Master's Step Table ................................................................................. 187 ST-T Changes ..........................................................................................
1 Introduction This chapter provides information required for the proper use of the product and manual. Familiarize yourself with this information before using the product. Product Information This section provides a general overview of the product. A detailed description of the product can be found in Chapter 2, System Overview.
Introduction If polarizing electrodes are used, we recommend disconnecting the leadwires from the patient before delivering the shock. Electrode defibrillation recovery is the ability of the electrode to allow the ECG trace to return after defibrillation. We recommend using non-polarizing disposable electrodes with defibrillation recovery ratings as specified in AAMI EC12 4.2.2.4. (Refer to “Parts and Accessories” on page 10 for a list of approved electrodes.
Introduction Electrodes The following non-polarizing electrodes have been approved for use with this device.
Introduction Leadwires (cont'd.
Introduction Leadwires (cont'd.
Introduction ECG Adapters and Connectors (cont'd.
Introduction KISS Aspiration System Accessories (cont'd.
Introduction Papers The following thermal papers have been approved for use with this device. Papers Part Number Description 9402-020 Premium Thermal-Sensitive Chart Paper, Full Page Red Grid, 8.5 in x 11 in. (216mm x 280mm) Sheet, Z-fold, Queue Hole, 300 sheets/pack, 8 packs/case, 2400 sheets/case 9402-021 Premium Thermal-Sensitive Chart Paper, Full Page Red Grid, A-4 Modified, 8.
Introduction Equipment Symbols The following symbols may appear on the product or its packaging. Symbol Description Type BF equipment. The acquisition module is protected from defibrillation shocks. Alternating Current Equipotential Charge the battery. The flashing amber LED next to this symbol indicates you must connect the system to AC power to recharge the battery. Waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately.
Introduction Symbol Description USA Only: For use only on or by order of a physician. CE Mark — Symbolizes conformity with applicable EU (European Union) directives.
Introduction Product and Packaging Labeling This section identifies the product labels and their locations on the product and packaging.
Introduction Refer to the previous illustrations for the locations of the labels identified in the following table. No. Label 20 Description 1 Located on the bottom of the device, this label indicates the device contains mercury and must be disposed of in accordance with state and local laws. 2 Located on the cover of the device, this label identifies the product's model number. 3 Located on the back of the device, this label contains the Disposal and GOST labels.
Introduction No. Label Description 10 Located to the right of the display, this label instructs the user on where to place leads.
Introduction Equipment Identification Every GE Healthcare device has a product label that identifies the product name, part number, manufacturing information, and unique serial number. This information is required when contacting GE Healthcare for support. Product Label The product label is laid out in the following format. Depending on the product, the label may vary slightly in format, but it contains the same information.
Introduction Serial Number Format Item Name Description 1 Product Code Three-letter code that uniquely identifies the product line. Refer to “Product Codes” on page 23 for more information. 2 Year Manufactured Two-digit code identifying the year the device was manufactured. Values range from 00 to 99 For example: 00 = 2000, 04 = 2004, 05 = 2005 (and so on). 3 Fiscal Week Manufactured Two-digit code identifying the week the device was manufactured. Values range from 01 to 52.
Introduction Regulatory and Safety Information This section provides information about the safe use and regulatory compliance of this device. Familiarize yourself with this information and read and understand all instructions before attempting to use this device. The system software is considered medical software. As such, it was designed and manufactured to the appropriate medical regulations and controls. Any exceptions are noted in the Compliance Information - Exceptions section.
Introduction WARNING: CONNECTION TO MAINS — This is class I equipment. The mains plug must be connected to an appropriate power supply. WARNING: DEFIBRILLATOR PRECAUTIONS — Do not come into contact with patients during defibrillation. Otherwise, serious injury or death could result. Patient signal inputs labeled with the CF and BF symbols with paddles are protected against damage resulting from defibrillation voltages.
Introduction WARNING: SHOCK HAZARD — Improper use of this device presents a shock hazard. Strictly observe the following guidelines. Failure to do so may endanger the lives of the patient, user, and bystanders. When disconnecting the device from the power line, remove the plug from the wall outlet before disconnecting the cable from the device; otherwise, there is a risk of coming into contact with line voltage by inadvertently introducing metal parts in the sockets of the power cord.
Introduction CAUTION: BATTERY POWER — If a device equipped with an optional battery pack will not be used or connected to the power line for a period of over six months, remove the battery. CAUTION: BEFORE INSTALLATION — Compatibility is critical to safe and effective use of this device. Please contact your local sales or service representative prior to installation to verify equipment compatibility. CAUTION: DISPOSABLES — Disposable devices are intended for single use only.
Introduction Classification This device is classified as follows, in accordance with IEC 60601–1: Category Classification Type of protection against electric shock Class I internally powered equipment. Degree of protection against electric shock Type BF defibrillation-proof applied part. Degree of protection against harmful ingress of water Ordinary equipment (enclosed equipment without protection against ingress of water).
Introduction Legal Notice Our equipment contains several fields that can be filled in before performing an ECG. Some of these fields must be filled in before performing an exam; some are optional and therefore left to the user to assess whether they are needed to perform the exam. A field Race is one of these optional fields. Race has been acknowledged by the medical profession as useful to analyze some pathologies.
Introduction Manual Information This section provides information for the correct use of this manual. Manual Purpose This manual provides information necessary for the configuration and safe operation of this equipment in accordance with its function and intended use. It is not intended as a replacement for, but a supplement to, thorough product training. Keep it with the equipment at all times. Additional manuals may be ordered by contacting GE Healthcare.
Introduction Convention Description Enter Indicates that you must press the Enter or Return key on the keyboard. Do not type Enter. > The greater than symbol, or right angle bracket, is a concise method to indicate a sequence of menu selections. For example, the statement “From the main menu, select System > Setup > Options to open the Option Activation window” replaces the following: 1. From the main menu, select System to open the System menu. 2.
Introduction To see available training, go to the GE Healthcare training website (http://www.gehealthcare.com/usen/education/index.html) and select Diagnostic Cardiology under the Technical Service Education section. For more self-paced course offerings, tools, and reference guides you may find useful, please visit the GE Healthcare Education Store at www.gehealthcare.com/educationstore.
2 System Overview This chapter describes the device's hardware components, software screen components, report layout, and basic navigation and data entry. Familiarize yourself with this information before using the device. Hardware Description This section identifies the key components of the MAC system hardware. Familiarize yourself with these components, their location, and their use before attempting to use the equipment.
System Overview 3 Name Description LAN Port Connect to a LAN cable. LEDs provide information about connection status. • The green LED indicates a good Ethernet link. • The amber LED flashes to indicate network traffic. 4 Keyboard Controls the system and enters data. Name Description 1 Back panel connectors Connect to peripherals. 2 Secure data card slot Insert a secured data (SD) card for external storage. 3 Green AC Power Indicates the system is connected to AC power.
System Overview Name Description 1 Battery Supplies power when unit is not connected to AC power. Recharge the battery when the battery icon flashes on-screen. 2 Writer door Provides access to the writer, paper tray, and battery. 3 Acquisition module connector Connects the unit to an acquisition module. 4 Paper tray Contains the paper used to print ECGs. 5 Paper size selector Adjusts the paper tray for STD (US Letter) or A4 paper sizes.
System Overview 6 Name Description IR Exchanges ECG data with a MAC system or MUSE CV system via infrared transmission. NOTE: Depending on the age of your system, infrared transmission may not be supported. 7 Card slot Houses a system card for external data storage or to update software. 8 Ground lug Connects to non-grounded peripheral devices to ensure equipotential. 9 Main AC Power Connects the system to an AC power supply via power cable.
System Overview Name Description 6 Rhythm key Prints continuous ECG data, which cannot be stored or transmitted. 7 Stop key Stops the writer from printing. 8 Arrow pad Moves the cursor left, right, up, or down. Pressing the center button selects the highlighted menu or screen item. 9 Return key Enters information into the system. 10 Information key Provides additional user information. 11 Spacebar Adds a space between typed characters or highlights screen items.
System Overview Name Description 3 Recovery Advances the exercise test to the recovery phase or to the next stage within the current recovery phase. 4 Test end Ends the test and starts the test end phase. 5 Speed W Adjusts the belt speed on treadmills or load on ergometers. Press Speed W — to decrease the speed or load. Press Speed W + to increase the speed or load. 6 Grade Adjusts the grade of the treadmill. Press Grade á to increase the grade. press Grade â to decrease the grade.
System Overview Name Description 1 Leadwires Attaches to the patient electrodes. The acquisition module uses either 10 or 14 leadwires. 2 Rhythm button Initiates the printing of a rhythm strip. 3 Stop writer button Cancels the current print job. 4 Acquisition module cable Connects the acquisition module to the MAC system. 5 ECG Button Initiates the recording of an ECG. NOTE: If you enable the Preview before analysis function, press (5) to view the data.
System Overview 10 Leadwire AHA 10 Leadwire IEC 13 Leadwire AHA Pediatric 13 Leadwire IEC Pediatric 14 Leadwire AHA 14 Leadwire IEC 14 Leadwire AHA Aux 14 Leadwire IEC Aux Leadwire Adapters MULTI-LINK leadwires require one of the following adapters to connect to electrodes.
System Overview Connecting the LAN Option See the LAN Option for MAC™ Resting ECG Systems Installation and Troubleshooting Guide for information about connecting the LAN option. Connecting the Modem Option See the Field Service Manual for information about mounting and connecting the modem option. Connecting the MobileLink Wireless Option See the MobileLink Installation and Troubleshooting Guide for information about mounting, configuring, and connecting the wireless option.
System Overview 1. Connect one end of the acquisition module cable to the MAC system and the other end to the acquisition module. 2. Connect the leadwires to the acquisition module. Refer to “Acquisition Equipment” on page 38 for more information. Verifying Correct Operation To verify the correct operation of the MAC system, press the power button to turn on the system. • If the system starts up without displaying error messages, the system is operational.
System Overview Resting ECG Screen The following illustration is the standard test screen. Name Description 1 Software Version Displays the system's software version during the first few seconds of power up. 2 User Prompts Provides additional information for the user. 3 Hookup Advisor Displays the quality of the patient hookup. Can be turned on or off. 4 Function Icon Indicates the Main Menu function currently being used. In this example, the Resting ECG function is being used.
System Overview Exercise Test Screen The following illustration is the exercise test screen. 44 Name Description 1 System Messages Provides error or other information. 2 Current Heart Rate Bar Graph Provides a graphical representation of the patient's latest heart rate. The top horizontal line is the maximum predicted heart rate (220 - age). The line below that is the target heart rate (a percentage of 220 - age). At the start of Exercise phase, a third line displays the resting heart rate.
System Overview Name Description 9 Current Heart Rate Displays the patient's heart rate. Determined using the three leads displayed on your screen during the pre-test phase. These leads can be changed during the test by selecting the Measurements function. 10 Function Icon Indicates the Main Menu function currently being used. In this example, the Exercise12 function is being used. 11 Battery Status Icon Indicates the status of the battery charge.
System Overview Function Description Creates new or edits existing exercise test protocols. Also, a protocol can be saved, printed, or erased. EditProtocol Conducts the 12-lead exercise test and allows you to print reports. This is a purchased option. Exercise 12 Conducts the 15-lead (12 standard, 3 user-defined leads) exercise test and allows you to print reports. This is a purchased option. Exercise 15 Runs the Master’s Step exercise protocol. (Japan only.
System Overview Function Description Requests, displays, and prints confirmed ECGs retrieved from a MUSE CV system. This is a purchased option. Remote Query Acquires, prints, and stores ECG orders received from a MUSE system with a Hospital Information System (HIS) interface. Ord Mgr Int. Returns to the previous screen. Return Selecting a Menu Function You have two methods for selecting functions from the Main Menu: • Function Keys • Arrow Pad Using Function Keys 2046275-016A 1.
System Overview Using the Arrow Pad 1. Press the arrow keys on the Arrow Pad until the desired menu item is highlighted. 2. Press the middle button on the Arrow Pad to select the highlighted menu item. Report Layout The following illustration and table describe the basic report layout. For more information about reports, refer to “ECG Reports” on page 135.
System Overview 2046275-016A Name Description 1 Patient Demographics Displays information about the patient, including patient name, birth date, gender, race, height, weight, room, and location. 2 Vital Signs Displays information about the patient's vital signs, including heart rate, PR interval, QRS duration, QT/QTc, P-R-T axes, and blood pressure. 3 ECG Header Displays information about the ECG, including patient ID, ECG date and time, and hospital name.
System Overview Entering Data You have two methods for entering data into the MAC system: • Typing data into a highlighted field • Selecting data from a drop-down list Typing Data into a Highlighted Field 1. Using the Arrow Pad, press the arrow keys to highlight the desired field. 2. Type the relevant data into the field. 3. Press either the middle button of the Arrow Pad or the Return key to enter the data into the field. The cursor moves to the next data field.
System Overview Selecting Data from a Drop-down List 1. Using the Arrow Pad, press the arrow keys to highlight the desired field. 2. Press the middle button of the Arrow Pad. A list of available values drops down. 3. Using the Arrow Pad, press the arrow keys to highlight the desired value. 4. Press the middle button of the Arrow Pad to select the desired value. The value is entered into the field and the cursor moves to the next data field.
System Overview 52 MAC® 5500/MAC® 5500 HD 2046275-016A
Preparing the Patient 3 This chapter provides the procedures for preparing the patient's skin and properly placing electrodes. Some of the procedures for placing electrodes may not apply in all cases, depending on the system and options purchased. NOTE: These instructions do not cover the application of electrodes for the KISS Electrode Application System (not available in the United States). To use the KISS system, see the KISS operator’s manual for instructions.
Preparing the Patient Preparing the Patient's Skin Careful skin preparation is the key to an interference-free ECG. Signal quality is indicated on the device via the Hookup Advisor indicator. 1. Select the electrode placement sites for ECG monitoring or diagnosis per the protocol specified by the hospital or physician. Refer to “Electrode Placement” on page 55 for diagrams and descriptions of electrode placement for various protocols. 2. Ensure that each site is dry, clean, and free of excessive hair.
Preparing the Patient Electrode Placement This section describes various methods for placing electrodes for both resting and exercise ECGs. CAUTION: PROPER LEADWIRE CONNECTION — Improper connection will cause inaccuracies in the ECG. Trace each individual leadwire from its acquisition module label to the colored connector and then to the proper electrode to ensure that it is matched to the correct label location. Resting ECG Placement The following methods are applicable for resting ECGs.
Preparing the Patient Standard 15 Lead Placement 56 AHA Label IEC Label Description 1 V1 red C1 red Fourth intercostal space at the right sternal border. 2 V2 yellow C2 yellow Fourth intercostal space at the left sternal border. 3 V3 green C3 green Midway between location 2 and 4. 4 V4 blue C4 brown Mid-clavicular line in the fifth intercostal space. 5 V5 orange C5 black Anterior axillary line on the same horizontal level as 4.
Preparing the Patient Frank X, Y, Z Placement 2046275-016A AHA Label IEC Label Description 1 LA black L yellow Just below the clavicle of the left arm. 2 E orange E light blue Mid-sternum on the same horizontal level as 3 and 4. 3 V4 blue C4 brown Mid-clavicular line in the fifth intercostal space. 4 V6 purple C6 purple Mid-axillary line on the same horizontal level as 3. 5 LL red F green Left leg, lower abdominal quadrant. 6 RL green N black Right leg, lower abdominal quadrant.
Preparing the Patient NEHB Placement 58 AHA Label IEC Label Description 1 A1 orange Nst white Attachment point of the second rib to the right sternal edge. 2 A2 orange Nax white Fifth intercostal space on the left posterior axillary line. (Same position as V8 or C8.) 3 V4 blue Nap white Mid-clavicular line in the fifth intercostal space. (Same position as C4.
Preparing the Patient Pediatric Placement 2046275-016A AHA Label IEC Label Description 1 V1 red C1 red Fourth intercostal space at the right sternal border. 2 V2 yellow C2 yellow Fourth intercostal space at the left sternal border. 3 V3 green C3 green Midway between location 2 and 4. 4 V4 blue C4 brown Mid-clavicular line in the fifth intercostal space. 5 V5 orange C5 black Anterior axillary line on the same horizontal level as 4.
Preparing the Patient Exercise ECG Placement The following methods are applicable only if the Exercise option has been enabled. In addition to the standard electrodes, apply one electrode on the sternum (A1) and one in location V5R/C5R (A2). It is recommended that arm electrodes be placed on the patient’s torso, just under the clavicles.
Preparing the Patient CM5, CC5, CH Lead Placement 2046275-016A Electrode Description 1 A1 Mid-sternum at the second intercostal space. 2 A2 In the fifth intercostal space in the right anterior axillary line (V5R/C5R). 3 A3 On either side of the neck or anywhere above the shoulders.
Preparing the Patient 62 MAC® 5500/MAC® 5500 HD 2046275-016A
Entering Patient Information 4 The first step in conducting any ECG test (resting, pediatric, 15-lead, vector loops, or exercise) is to identify the patient. Patients can be identified by manually entering the data, by bar code scanner or magnetic card reader, or by retrieving it from a MUSE CV system.
Entering Patient Information Manually Entering Patient Information You can manually enter patient data on all MAC systems. 1. For each new patient, select Patient Data. The Patient Data entry window opens. 2. Using the arrow pad, navigate from field to field and enter data as appropriate. For more information on how to manually enter data in the MAC system, refer to “Entering Data” on page 50. NOTE: Our equipment contains several fields that can be filled in before performing an ECG.
Entering Patient Information Connecting the Card Reader Before you can use the card reader, it must be connected to the MAC system and the system must be configured to correctly use the peripheral. Typically, this is done only once and the card reader remains attached and ready for use. 1. Connect the magnetic card reader to port A on the back panel of the system. For information on the system ports, refer to “Back Panel” on page 35. 2. Configure the card reader.
Entering Patient Information Do one of the following: • Select the correct order to load it. You can then modify the order information or begin the test. • Select Cancel to load the patient information directly from the card. You can then use or modify the patient information as needed. For information on configuring your system, refer to Appendix E, “Creating Bar Codes and Magnetic Cards”.
Entering Patient Information Accept or modify the data as needed. • If the system locates only one ADT record, it loads that record and displays it in the Patient Data window. Accept or modify the data as needed. • If the system locates multiple matching ADT records, it displays a list of those records. Do one of the following: • Select the correct record to load its ADT information. You can then use or modify the patient information as needed.
Entering Patient Information The MUSE system’s infrared device must be pointed directly at the MAC system’s IR port with no obstruction, as shown in the following illustration. • Wireless This method works with MobileLink and MobileLink UHS wireless systems. For instructions on mounting, configuring, and connecting the client bridge to the system, refer to the MobileLink Installation and Troubleshooting Guide.
Entering Patient Information Manually Entering Orders If you do not have a MUSE CV system, or cannot connect to the MUSE CV system for some reason, you can manually create the order directly on the MAC system using the following procedure. NOTE: The option to add orders locally must be in System Setup. Refer to “Order Manager Interface” on page 129. 1. Select Ord Mgr Int. The Order Manager Interface opens. 2. Select More > Create Order. The Create Order window opens. 3.
Entering Patient Information 70 MAC® 5500/MAC® 5500 HD 2046275-016A
Recording an ECG 5 The method for recording an ECG varies depending on the type of ECG to be recorded. This chapter describes how to record the following ECG types: • Standard ECGs • Signal Averaged ECGs • Master's Step ECGs Some methods may not be available on your system, depending on which options have been purchased and enabled. To assist you in recording an interference-free ECG, the MAC system provides a Hookup Advisor to alert you to troubles with the electrode connection.
Recording an ECG • Red indicates a lead-fail condition or extreme baseline shifts. The red indicator is always the left-most circle of the of the indicator and flashes when lit. • Yellow indicates muscle artifact, power line interference, baseline wander, or electrode noise. The yellow indicator is always the middle circle of the of the indicator. • Green indicates generally acceptable signal quality. The green indicator is always the right-most circle of the of the indicator.
Recording an ECG Prompt level in the system setup. If a message and prompt is displayed, the lead quality indicator will reflect the overall 10-second lead quality. • If Preview before analysis is enabled, the system setup Prompt level is disregarded and the system immediately displays the Preview screen. Any lead quality messages will be displayed in this screen along with the overall 10-second lead quality indicator.
Recording an ECG This opens a list of available gains. Options include 2.5 mm/mV, 5 mm/mV, 10 mm/mV, 20 mm/mV, and 10/5. The selected value appears on the function key on the screen. • To adjust the filter of the printed ECG, press 150 Hz. This opens a list of available filters. Options include 20 Hz, 40 Hz, 100 Hz, and 150 Hz. This affects only the printout; the screen filter is always set to 40 Hz. The selected value is displayed on the function key.
Recording an ECG Continue to close the message and continue. See “Critical Values Setup” on page 143 for more information on configuring Critical Values. • The ECG report prints. This occurs only if the report has been configured to print automatically. See Chapter 14, “System Setup”, for more information. • The Saving ECG window flashes on the screen. This occurs only if a report has been set to save automatically. See Chapter 14, “System Setup”, for more information.
Recording an ECG 5. Select Store to store the ECG data. 6. You are now ready to transmit the ECG data to a MUSE system. Refer to Chapter 9, “Transmitting ECGs” for details. Master's Step ECGs This is an optional test method that is available only in Japan. For information on enabling the Master's Step Exercise option, refer to “Option Activation” on page 126. For information on configuring the Master's Step Exercise, refer to “Setting Up Master's Step Test” on page 159. 1. Select Master's Step. 2.
Exercise Stress Testing 6 Exercise Stress Tests are optional features that allow you to conduct ECG tests while the patient exercises on a treadmill or ergometer. For information on enabling the 12–Lead Exercise and 15–Lead Exercise options, refer to “Option Activation” on page 126. Stress tests are controlled by test protocols. Protocols consist of several phases intended to allow the patient to warm up prior to the exercise and to cool down afterward.
Exercise Stress Testing The Rhythm Leads window opens. This window allows you select the lead groups to use in the test, check lead connections, and check lead placement. Highlight the appropriate option and press Return. 5. After the settings have been adjusted, select Select Proto. A list of available stress test protocols opens. 6. Select the desired protocol. The selected test begins. Refer to the following sections for instructions on how to proceed during each phase of the test.
Exercise Stress Testing • Press the emergency stop button (usually mounted on the treadmill) to stop the treadmill IMMEDIATELY. • Press the Speed W +, Speed W –, and Grade keys to manually control the test. However, once you press these keys, the pre-programmed protocol becomes inactive: you must manually control the speed and grade during the remainder of the exercise and recovery phases.
Exercise Stress Testing The exercise test advances automatically through the exercise stages unless the operator manually overrides the test. NOTE: When the stages in the treadmill protocol have durations other than infinite, the exercise test advances from stage to stage automatically. However, you can press Exercise (on the treadmill controller keyboard) at any time to manually advance to the next exercise stage. 3. Manually adjust the treadmill's speed and grade, or the ergometer's load, as necessary.
Exercise Stress Testing Recovery Phase In recovery, the treadmill speed and grade or the ergometer load decreases based on the protocol configuration. 1. Press the Recovery button to advance to the recovery phase. The clock begins timing the recovery phase. A maximum 12-lead measurement is taken (if that is part of the selected protocol). 2. If necessary, adjust the equipment's speed, grade, or load manually. You can adjust the speed, grade, or load in the following ways.
Exercise Stress Testing 3. Select Continue to return to the Test-End menu. • A final report prints automatically if you selected this option in the Edit Protocol function (select System Setup > Exercise Test > Final Report). • To change the type of reports that print automatically, see “Final Report” on page 151. 4. To edit Patient Data, Reason for termination, or Comments, select Edit. You can edit this information until you select New Patient or Main Menu. 5.
Editing Protocols 7 Protocols are scripts used to run exercise stress tests. The Exercise Stress Test option comes with several predefined protocols. The Edit Protocol function allows you to edit the predefined protocols or create new ones. This chapter describes the protocol fields that can be modified and explains how to modify them. For information on conducting stress tests, refer to Chapter 6, “Exercise Stress Testing”.
Editing Protocols Protocol Parameters (cont'd.) Parameter Description Ramp Protocol Determines how frequently the intensity of the exercise should change. • Select Yes if you want the ergometer workload or treadmill speed and grade to change every 6 seconds. • Select No if you want the ergometer workload or treadmill speed and grade to change with each stage change. Name of PRETEST phase Determines the name of the pretest phase as it will appear on your reports.
Editing Protocols Parameter Description Treadmill Sets the treadmill speed in MPH or Km/h and grade in percentages. • MPH can range from 0.0 to 25.0 in 0.1 MPH increments. • Km/h can range from 0.0 to 40.0 Km/h in 0.1 Km/h increments • Grade can range from 0.0% to 40.0% in 0.1% increments. Report Sets the reports that will print and the points during the stage in which they print.
Editing Protocols The current stage information is displayed. b. Edit the information. c. When you are done, press Return. • To change the duration: a. Use the arrow pad to select the Duration field. b. Enter the desired duration. c. To enter an infinite duration, delete the value in the field. d. When you are done, press Return. • To change the exercise intensity: a. Use the arrow pad to select the ergometer workload, treadmill speed, or treadmill grade, as appropriate. b.
Editing Protocols 6. When you are done editing the stages of the Pretest phase, press Phase > Exercise. This opens the Exercise phase window. 7. Press the Stages/Manual function key to toggle between the Stages and Manual modes of the phase as appropriate. 8. With the Stages mode selected, repeat step 5 to edit the stages of the Exercise phase. 9. When you are done editing the stages of the Exercise phase, press Phase > Recovery. This opens the Recovery phase window. 10.
Editing Protocols 88 MAC® 5500/MAC® 5500 HD 2046275-016A
Printing ECG Reports 8 The MAC system can be configured to print a report automatically during an ECG test. In addition, you can choose to reprint an ECG report in a different format during the test. Finally, you can print ECG reports that are stored on the system. This chapter explains how to print another report during the ECG test, how to print a stored ECG report, and how to store the printouts after they print.
Printing ECG Reports Storing Printouts When imaged and stored properly, ECG tracings will resist fading for several years. The expected lifespan depends on the paper. For example, GE Healthcare's Premium Thermal Recording Papers resist fading for 5–7 years. By contrast, GE Healthcare's Ultra-Archivst® Thermal Recording Papers are guaranteed to resist fading for 100 years. Refer to the documentation that accompanies your paper for its expected lifespan.
Transmitting ECGs 9 The MAC system can transmit ECGs to other MAC systems, a MUSE CV system, or a PC using any of the following methods, depending on which options have been purchased: • Modem • Manual Line • Serial Line • MUSE Network • Ethernet Line • Wireless Most methods transmit ECGs in GE Healthcare's Hilltop format, but you can also choose to transmit ECGs in XML format. The MAC system can be configured to transmit ECGs during an ECG test.
Transmitting ECGs Internal Modem 1. External Modem Select File Manager. A list of ECGs opens. 2. Select Location. A list of devices to which the ECG report can be transmitted opens. 3. Do one of the following • If the receiving device is shown, select it and continue to step 4. • If the receiving device is not shown, manually enter the device: a. Select Location. b. Select Manual Dial. c. Enter the telephone number of the receiving device. d. Press Return. e. Select the modem type. f.
Transmitting ECGs This identifies the connection method and includes the following: • Manual Dial • Serial Line • MUSE Network • Ethernet Line • Phone Number For predefined modem locations, this column will contain the location's phone number. For Manual Dial locations, this column will contain a question mark (?) and a phone number must be entered if the location is selected. For Serial Line, MUSE Network, and Ethernet Line, this column will be blank.
Transmitting ECGs Transmitting ECGs in XML Format Most methods transmit ECGs in GE Healthcare's proprietary Hilltop format. You can, however, use the following procedure to transmit ECGs in XML to a PC; the data can then be extracted for analysis. 1. Connect the serial port of the MAC system to the serial port of a PC running a terminal emulation program. 2. On the MAC system, press File Manager. A list of ECGs opens. 3. Press Location. A list of available locations opens. 4.
Receiving ECGs 10 This chapter explains how to receive ECGs from other MAC systems and from a MUSE CV system. Receiving ECGs from Another MAC System Chapter 9, “Transmitting ECGs”, explains how to manually transmit ECGs from one MAC system to another. However, in order to receive those ECGs on the other MAC system, the receiving system must be set up to receive them. The following sections explain how to set up the MAC system to receive ECGs from other MAC systems via modem or locally.
Receiving ECGs 3. After all the ECGs have been received, select Cancel to take the system out of receiving mode. 4. Select Main Menu. Receiving ECGs Locally Use the following procedure to prepare the MAC system to receive ECGs locally, that is, from within the facility. This method receives ECGs via infrared or direct connection between the two systems.
Receiving ECGs This is a purchased option. Before receiving ECGs via modem, connect your modems as described in “Receiving ECGs via Modem” on page 95. • MobileLink wireless This is a purchased option. Before receiving ECGs via MobileLink, connect and configure the MobileLink wireless system as described in the MobileLink Installation and Troubleshooting Guide.
Receiving ECGs • Rhythm displays rhythm information for the current ECG. • Next displays the next selected ECG. • Return closes the display and returns to the list of ECGs. • To print the selected ECG(s), press Print. The system retrieves and prints the test(s). The report format set up in System Setup is used. Refer to Chapter 14, “System Setup”, for more information.
11 Editing ECGs While it usually not necessary to modify an ECG, the MAC system allows you to edit an ECG's demographic information, ECG measurements, and interpretive statements. After you have edited the ECG, you are prompted to save the updated file. NOTE: If you plan to store ECGs in XML format (see “Transmitting ECGs in XML Format” on page 94), DO NOT edit the ECGs on the MAC system. Edits made to ECGs WILL NOT BE SAVED in the XML file.
Editing ECGs Select Store to save the edited file. This will replace the original file. Select Cancel or press ‘Esc’ to discard the changes made to the current file. 9. Select Store to save the edited file. Editing ECG Measurements Only overreaders can modify ECG measurements. You must enter an overreader's password and reviewer information before you can edit the measurements. This prevents unqualified persons from adjusting the ECG reading. 1. Press File Manager. A list of ECG reports opens. 2.
Editing ECGs Editing Interpretive Statements The MAC system automatically adds interpretive statements to ECG reports. The system allows you to edit these statements as you deem necessary. You can add, modify, join, and delete statements. You must enter an overreader's password and reviewer information before you can edit the statements. This prevents unqualified persons from adjusting the statements. 1. Press File Manager. A list of ECG reports opens. 2. Press Select.
Editing ECGs The new statement will be inserted AFTER the current statement. Select statement type… b. Select the type of statement to insert. The options are: • Acronym • Freetext • Newline c. Enter a 12SL library acronym or free form text and press Return. 10. To join the selected statement with another statement, select the second statement and press Join. 11. To delete the selected statement, press Delete. 12. Continue to edit statements as necessary. 13.
Deleting ECGs and Orders 12 To free up storage space, the MAC system allows you to delete ECGs and uncompleted orders. This chapter describes those procedures. Deleting ECGs To delete ECGs, you must enter a System or Overread password, if the passwords are defined. You should only delete ECGs that have been transmitted to another ECG, a MUSE CV system, or a PC for storage. 1. Press File Manager. A list of ECG reports opens. 2. Press Select. The cursor is displayed on the screen. 3.
Deleting ECGs and Orders Deleting Orders Use the following procedure to delete orders stored locally on the device. 1. From the Main Menu, select Ord Mgr Int. NOTE: Depending on the options enabled on your system, you may need to select More to toggle through the menu until Ord Mgr Int is available. The Order Manager Interface window opens with a list of local orders displayed. 2. Select Delete Orders. The available options on the menu change. 3. To cancel without deleting any orders, select Cancel.
Deleting ECGs and Orders The orders are not deleted and you return to the opening set of menu options. 6. To delete all the completed orders, select Del Completed. The message Are you sure you want to delete all completed orders? opens. Do one of the following: • To delete all the completed orders, select Yes. The orders are deleted and you return to the opening set of menu options. • To cancel the deletion, select No. The orders are not deleted and you return to the opening set of menu options.
Deleting ECGs and Orders 106 MAC® 5500/MAC® 5500 HD 2046275-016A
13 Using an SD Card The MAC system allows you to extend the device's storage capacity by using an external Secure Digital (SD) card. The SD Card is also used to distribute and apply software updates. The following table compares the differences between internal storage and SD card storage. Be aware of these differences when selecting your storage option. Internal Storage vs SD Card Storage Internal Storage SD Card No Yes 70%..90%..
Using an SD Card Preparing the SD Card Before using the SD card, you must know how to lock, unlock, insert, eject, and format the card. Locking and Unlocking the SD Card You can lock an SD card to secure the data. Before using the SD card, unlock it by moving the lock tab into the unlocked position (1). This allows you to store data on or delete data from the card. To prevent accidental deletion of data, protect the SD card by moving the lock tab into the locked position (2).
Using an SD Card Select Yes to format the card. Managing Files on the SD Card To use the SD card for external storage, use the File Manager to copy files to the card, restore files from the card, and save files in XML format to the card. Displaying Stored ECGs 1. Power on the unit. 2. Select File Manager. A list of stored ECGs is displayed. 3. Choose Select. The cursor moves to the screen. 4. Highlight the ECG(s) to display. 5. Select Display.
Using an SD Card Restoring Files from the SD Card After files have been copied to an SD card, you can use the Restore All function to copy files from the SD card to internal storage. NOTE: If CT Data Guard is enabled and its Prevent deleting of untransmitted records field is set to Yes, you will receive the following warning if any of the records in internal storage have not been transmitted: The operation deletes existing records.
Using an SD Card Updating Software from the SD Card When a software update is made available for the MAC system, it is provided on an SD card. Use the following procedure to apply the update. NOTE: Connect the system to AC power before you begin the software update. Keep the system connected to AC power during the software update and do not power off the system during the software update. 1. Press Power to turn on the system. 2. From the Main Menu, select System Setup. 3. Enter the system password.
Using an SD Card 112 8. Press Power to turn on the system. 9. Verify the software version has been updated.
14 System Setup This chapter describes how to use System Setup to configure your system. It provides an overview of the setup process and details on how to set up: • Automatic tasks • System basics • ECGs • Signal Averaged ECGs • Exercise Stress Tests • Master's Step Tests • Card Readers • Bar Code Readers In addition, the chapter provides an overview of the System Setup hierarchy and instructions on how to print, save, and restore the system settings.
System Setup • Order Manager Interface • Input Method Select • ECG • • • • • ECG Acquisition ECG Analysis Patient Questions Writer Setup Resting ECG Reports • Report Leads • Confirmed Reports • Unconfirmed Reports • Pediatric ECG Reports • Report Leads • Confirmed Reports • Unconfirmed Reports • 15 Lead Reports • • • • Extra Leads Report Leads Confirmed Reports Unconfirmed Reports • Vector Loops • • • • Vector Loops Report Leads Confirmed Reports Unconfirmed Reports • Analog Outputs • CD Data Guard S
System Setup • 15 Lead Exercise • Extra Leads • Report Leads • Exercise Reports • Final Report • Screen • Inputs/Outputs • Hi-Res • Master's Step • Print Setup • Save Setup • To System • To SD Card • Do not save setup • Restore Setup • To Original Factory Settings • From SD Card • Do Not Restore Setup Process Overview The following procedure describes the basic flow and steps for using the System Setup function. Use this process when configuring specific settings. 1. Select System Setup.
System Setup Use this option if you want to use the settings to quickly configure other MAC systems. Be sure that an SD card is inserted into the system's card slot. • To cancel, select Do not save setup. 7. Select Main Menu to exit System Setup.
System Setup Setting Up Resting ECG Report Printing This option allows you to select the report format that will print for different resting ECGs. 1. Log into the System Setup function. Refer to “Process Overview” on page 115. 2. Select ECG. 3. Select the type of ECG reports to configure. You have the following options: • Resting ECG Reports • Pediatric ECG Reports • 15-Lead Reports • Vector Loops Reports 4. Select Unconfirmed Reports. A list of available report formats is displayed. 5.
System Setup Setting Up Automatic ECG Transmission Use the following procedure to set up the system to automatically transmit ECGs. NOTE: Before setting up automatic transmission, you must define the receiving device, its default location, and its transmission paramters. Refer to “Transmission” on page 124. 1. Log into the System Setup function. Refer to “Process Overview” on page 115. 2. Select ECG > ECG Analysis > Auto ECG Transmission. A list of options opens.
System Setup Setting Up System Basics This section describes the following basic system settings: • Miscellaneous Setup • Patient Questions • Screen Colors • Transmission • Network Setup • Option Activation • Date and Time • Language • Order Manager Interface • Input Method Select Miscellaneous Setup To configure the system's basic settings, log on to the System Setup screen, select Basic System > Miscellaneous Setup, and complete the fields described in the following table.
System Setup Miscellaneous Setup (cont'd.) Field Description Site number Identifies the site where the unit is located. This corresponds with a site number used by the MUSE CV system with which this unit communicates. Valid values range from 1–254, inclusive. Location number Identifies the location where the unit is located. This corresponds with the locations on the MUSE CV system with which this unit communicates. Valid values range from 0–9999, inclusive.
System Setup Miscellaneous Setup (cont'd.) Field Description Overread password Prevents unauthorized persons from editing or deleting ECG measurements. The password must be entered to access these functions. Enter a 6–character password. The default password is OVREAD. Keep track of all assigned passwords. Device password Prevents unauthorized persons from accessing the system. The password must be entered to use the system. Enter a 6–character password. By default, the password is blank.
System Setup Patient Questions (cont'd.) Field Description Age Determines the method the system uses to enter the patient's age. Select one of the following values: • Date of birth Select this option to enter the patient's birth date in day-month-year format. The system will calculate the patient's age. • Age in years Select this option to enter the patient's age in years, months, weeks, days, or hours.
System Setup Patient Questions (cont'd.) Field Description Referred by number Determines whether the system will prompt you to enter the ID number of the referring physician. Select Yes to prompt for this information. When entering the referring physician's number, enter numbers that are compatible with the MUSE CV system to which the MAC system communicates. Test Indication Determines whether the system will prompt for the test reason. Select Yes to prompt for the reason.
System Setup Screen Colors To configure the system's screen colors, log on to the System Setup screen, select Basic System > Screen Colors, and complete the field described in the following table. Screen Colors Field Description Screen Colors Defines the system colors. Select the desired color scheme: • Monochrome Select this option to display white elements. • Option 1 Select this option to view white, green, yellow, and red elements.
System Setup Transmission Settings (cont'd.) Field Description , - Two second pause Indicates you can create a two-second pause by entering a comma in a telephone number. This will force the modem to wait for a dial tone before dialing. This is useful when accessing an outside line; the pause allows time to connect to the outside line before dialing the telephone number.
System Setup Network Settings To configure the system's local area network settings, log on to the System Setup screen, select Basic System > Network Setup, and complete the fields described in the following table. Network Settings Field Description IP Address Identifies the network's IP address. Subnet Mask Identifies the network's subnet mask. Gateway Identifies the network's gateway. Port Number Identifies the network's port number.
System Setup A list of the following options is displayed. 2046275-016A Option Code Description 12 Lead Exercise ST12 Enables 12–lead stress tests. 15 Lead Exercise ST15 Enables 15–lead stress tests. Hi-Res HRES Enables QRS signal averaging. PHi-Res PRES Enables P-wave signal averaging, which enhances measurement accuracy by maximizing signal fidelity. AT Modem MODM Enables transmission and receipt of data over an external AT modem.
System Setup 3. Option Code Description Critical Values CRIT Enables the critical value function, which allows you to define custom alerts based on key ECG values. If the Critical Values function is enabled, you must configure the alerts. Refer to “Critical Values Setup” on page 143 for more information. Acute Coronary Syndrome ACSM Enables the acute coronary syndrome (ACS) function. This function performs an ACS analysis on resting ECGs, vector loops ECGs, and 15-lead ECGs.
System Setup Power Up Options To configure the system's power up application, log on to the System Setup screen, select Basic System > Power Up Options, and complete the fields described in the following table. NOTE: For detailed instructions, refer to “Setting Up Power Up Function” on page 116. Power Up Options Field Description Power Up Application Select the application that opens automatically when you start the system.
System Setup Order Manager Interface (cont'd.) Field Description Auto order delete Determines whether the system will automatically delete orders under the following conditions: • the orders have been successfully transmitted to a receiving device, and • the associated ECGs have been transmitted and deleted. This field is NOT dependent on the Delete after transmit field on the Miscellaneous Setup window. Both fields operate independently.
System Setup Setting Up ECGs This section describes the following ECG settings: • ECG Acquisition • ECG Analysis • Patient Questions • Writer Setup • ECG Reports • Analog Outputs • CT Data Guard • Critical Values Setup ECG Acquisition To configure ECG acquisition, log on to the System Setup screen, select ECG > ECG Acquisition, and complete the fields described in the following table. ECG Acquisition Field Description Baseline roll filter Removes baseline sway.
System Setup ECG Acquisition (cont'd.) Field Description AC noise level warning Enables the system to check for powerline interference when recording ECGs. Hookup Advisor Enables the Hookup Advisor option, which monitors the quality of ECG signals for resting, 15-lead, pediatric, vector loops, and Master's Step measurements. When enabled, the system overrides the settings for Baseline wander warning, Muscle tremor warning, and AC noise level warning.
System Setup ECG Analysis To configure the analysis of ECGs, log on to the System Setup screen, select ECG > ECG Analysis, and complete the fields described in the following table. ECG Analysis Field Description Preview before analysis Determines whether the system will display the ECG data before it analyzes it. Applies for resting, pediatric, 15–lead, and vector loops only. Select Yes to enable preview. Screening criteria Prevents specific 12SL statements from appearing on ECG reports.
System Setup ECG Analysis (cont'd.) Field Description Auto ECG storage Determines which ECGs are stored automatically: • All ECGS All ECGs are stored upon completion. • No ECGS No ECGs are stored automatically. • Only ABNORMAL ECGs Only ECGs that the 12SL interpretation mark as abnormal are stored automatically. Auto ECG transmission Determines which ECGs are transmitted automatically: • All ECGS All ECGs are transmitted upon completion. • No ECGS No ECGs are transmitted automatically.
System Setup Writer Setup To configure the writer's behavior, log on to the System Setup screen, select ECG > Writer Setup, and complete the fields described in the following table. Writer Setup Field Description Speed Determines the writer's default speed in millimeters per second. Gain Determines the writer's default gain setting in millimeters per millivolts. For example, the setting 10/5 displays limb leads at 10 mm/mV and precordial leads at 5 mm/mV.
System Setup System Setup > ECG> Vector Loops ECG Reports > Report Leads Report Leads Field Description Standard leads Defines which leads will print for each channel. When you change a channel's lead, the new lead prints on all ECG reports including the channel. You can define the lead for channels 1 through 15, except for the Resting ECG Report, which includes only channels 1 through 12.
System Setup Extra Leads In addition to the report leads, the 15-Lead ECG Report also allows you to define the leads used by three additional electrodes. To configure the extra leads, log on to the System Setup > ECG> 15 Lead Reports > Extra Leads, Extra Leads Field Description Lead Set Determines the three additional leads used for 15–lead reports. You can: • Select a predefined set of leads.
System Setup System Setup > ECG> Resting ECG Reports > Confirmed Reports • Pediatric ECG Report System Setup > ECG > Pediatric ECG Reports > Confirmed Reports • 15 Lead ECG Report System Setup > ECG> 15 Lead Reports > Confirmed Reports • Vector Loops ECG Report System Setup > ECG> Vector Loops ECG Reports > Confirmed Reports The following table identifies the available report settings for confirmed ECGs.
System Setup Confirmed Reports Formats (cont'd.) Formats Resting 4 by 2.5s Y 4 by 2.5s + 1 rhythm ld Y 4 by 2.5s + 3 rhythm lds Y Pediatric 15 Lead Vector Loops Y Y Y 5 by 2s Y Y Y 5 by 2s + 1 rhythm ld Y Y Y 5 by 2s + 3 rhythm lds Y Y Y 5 by 10s Y Y Y Y Y Y Y Y Y 12 Rhythm leads Y Autorhythm Y CGR Y Expanded Median Y Pharma 4 by 2.
System Setup The following table identifies the available report settings for unconfirmed ECGs. Unconfirmed Reports Settings Field Description Interpretation with Available for each report format, this field determines how many copies of the report with 12SL interpretation will print. You can enter any value from 0 to 10. If you enter 0, the report will not print.
System Setup Unconfirmed Reports Formats (cont'd.) Formats Pediatric 15 Lead Vector Loops 5 by 2s Y Y Y 5 by 2s + 1 rhythm ld Y Y Y 5 by 2s + 3 rhythm lds Y Y Y 5 by 10s 1 Y Y Y Y Y Y Y Y Y Resting 12 Rhythm leads Y Autorhythm 1 Y CGR Y Expanded Median 1 Y Pharma 4 by 2.
System Setup Analog Outputs (cont'd.) Field Description Delay Defines the delay in milliseconds for the TTL Output QRS detector signal. Enter a value from 0 to 100. QRS Beep Determines whether the system beeps for each QRS complex. Select On to enable the beep. CT Data Guard To configure the Clinical Trial Data Guard, log on to the System Setup screen, select ECG > CT Data Guard Setup, and complete the fields described in the following tables.
System Setup CT Data Guard — Clinical Trial Setup (cont'd.) Field Description Dose Type Determines whether the dose type is required on each test. Select Yes to require the dose type. If you require dose type, you can edit the list of dose types. You can have up to 20 types. Each type can be up to 32 characters long. Additional Questions Determines whether the response to additional patient questions are required on each test. Select Yes to require additional questions.
System Setup Notifications Setup To configure the critical value notifications, log on to the System Setup screen, select ECG > Critical Values Setup, and complete the fields described in the following tables. Critical Values Notification Setup Field Description Enabled notifications Enables or disables the critical value notifications. Select Yes to enable the critical value notifications. Critical values password Defines the password required to edit the critical values notifications.
System Setup Critical Values Notification Setup (cont'd.) Field Description Ischemia detection Ischemia detection enables the notification for ECGs in which ischemia is detected. Select Yes to enable ischemia notifications. AV Block detection AV Block detection enables the notification for ECGs in which an AV block is detected. Select Yes to enable AV Block notifications. Arrhythmia detection Arrhythmia detection enables the notification for ECGs in which an arrhythmia is detected.
System Setup Setting Up Signal Averaged ECGs To configure how the system calculates signal averages ECGs, log on to the System Setup screen, select Hi-Res, and complete the fields described in the following table. NOTE: These settings are available only if you have purchased the optional HI-Res or PHi-Res functions. Signal Averaged ECGs Field Description Analysis filter Defines the analysis filter the Hi-Res and PHi-Res options use. GE Healthcare recommends using the 40–25Hz filter.
System Setup Miscellaneous Setup To configure the exercise tests' basic settings, log on to the System Setup screen, select Exercise Test > Miscellaneous Setup, and complete the fields described in the following table. Miscellaneous Setup Field Description Timeout Interval Determines how long it takes for a menu or prompt to close if it is not being used. Enter a value from 15 to 600 seconds. Cubic Spline Enables baseline control.
System Setup Writer Setup To configure the writer settings for exercise tests, log on to the System Setup screen, select Exercise Test > Writer Setup, and complete the fields described in the following table. Writer Setup Field Description Speed Determine the writer's default speed in millimeters per second. Gain Determines the writer's default gain setting in millimeters per millivolts. For example, the setting 10/5 displays limb leads at 10 mm/mV and precordial leads at 5 mm/mV.
System Setup Use the following instructions to select the correct Report Leads for each report type: • 12 Lead Exercise Report System Setup > Exercise Test > 12 Lead Exercise > Report Leads • 15 Lead Exercise Report System Setup > Exercise Test > 15 Lead Exercise > Report Leads Report Leads Field Description Standard leads Defines which leads will print for each channel. When you change a channel's lead, the new lead will print on all exercise reports that include the channel.
System Setup Report Leads (cont'd.) Field Description Swedish format rhythm leads Sets the rhythm lead(s) to print in the Swedish Format reports. When you change a rhythm lead, the new lead will print on all reports that include the lead. For example, if you select V5 for the Swedish format rhythm lead 1, then the V5 waveform will print on all reports that include Swedish format rhythm lead 1. When printing or storing 3-lead median or trend reports, the first three Swedish format rhythm leads are used.
System Setup The following table identifies the available report settings for exercise reports. Exercise Reports Settings Field Description Exercise Reports Determines which format will be used for each exercise report. Refer to the following table for a list of the available formats. Median Report Determines which format will be used for each median report.
System Setup To configure the final report, select System Setup > Exercise Test > Final Report and complete the fields in the following table. Final Report Field Description Storage Option Selects the method for storing the final report. Options are: • Store Strips and Final Report • Store Final Report Only • No storage of test data Final Report Preview Selects the format of the final report preview.
System Setup Screen To configure how your exercise tests are displayed on the screen, log on to the System Setup screen, select Exercise Test > Screen, and complete the fields described in the following table. Screen Field Description Display Rhythm Medians Determines whether the median complex is displayed in front of the Rhythm Lead 1, 2, and 3. Screen Filter Determines the filter to use for displaying the exercise test.
System Setup Inputs/Outputs Field Description Slow Analog Output Determines the slow analog output for controlling external exercise equipment. Options include: • Not Used • DC Heart Rate • Workload • Speed (x1) • Speed (x3) • Grade If using exercise protocols for an ergometer or an analog treadmill (see Chapter 7, “Editing Protocols”) you must configure the slow and fast analog output properly to control the workload device.
System Setup Inputs/Outputs (cont'd.) Field Description TTL Output Determines how the TTL output will be used. Options are: • Not Used • QRS Detect • BP Prompt NOTE: If selecting any of the external blood pressure devices, the TTL output must be configured to provide a QRS Trigger that meets the specifications of the blood pressure device. (See the blood pressure device operators manual for TTL trigger specifications.) Polarity Determines the polarity of the TTL Output.
System Setup Hi-Res Settings (cont'd.) Field Description Correlation Threshold Determines the correlation threshold. Options are: • Medium • High • Very High • Ultra High Template Format Determines how many copies of this report print for the Hi-Res function. Enter a value from 0 to 10. If you enter 0, the report will not print. Standard Format Determines how many copies of this report print for the Hi-Res function. Enter a value from 0 to 10. If you enter 0, the report will not print.
System Setup Automatic Configuration Use the following procedure to automatically configure your magnetic card reader. 1. Obtain a configuration card. For information on creating magnetic patient ID cards, refer to Appendix E, “Creating Bar Codes and Magnetic Cards”. 2. With the card reader properly mounted, connect to port A on the back of the system. 3. From the Main Menu, select System Setup > Basic System > Input Method Select > Patient Data Input Device > Card Reader > Return. 4.
System Setup Setting Up a Bar Code Reader This section describes two methods for configuring the bar code reader: • Automatic Configuration • Manual Configuration NOTE: When configured for a bar code reader, the system will prompt you to scan the patient ID bar code when you select Patient Information. If no bar code is available, press esc to enter the patient information manually.
System Setup 3. Enter the bar code configuration information. For information on creating bar codes, refer to Appendix E, “Creating Bar Codes and Magnetic Cards”. 4. Press esc twice. 5. Select Save Setup > To System. Setting Up Master's Step Test To configure the Master's Step Test, log on to the System Setup screen, select Master's Step, and complete the fields described in the following table. NOTE: This option is available only Japan.
System Setup Master's Step Setup (cont'd.) Field Description Continuous Recording Determines whether the rhythm is printed continuously between post exercise ECGs. Post Exercise ECG Time Defines the time, in minutes, after the first post exercise ECG when an additional ECG should be taken. You can take up to nine ECGs. Set any undesired tests to 0.
System Setup An SD card with the system settings must be inserted into the device's card slot. • To cancel the restore, select Do Not Restore Setup.
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A Maintenance Regular maintenance, irrespective of usage, is essential to ensure that the equipment will be functional when required. For the MAC system, regular maintenance includes the following: • • • • Equipment Inspection and Cleaning Paper Maintenance Battery Maintenance Leadwire Adapter Replacement For the maintenance procedures for your peripheral equipment, refer to the documentation provided with that equipment.
Maintenance • Verify that all cords and connectors are securely seated. • Inspect keys and controls for proper operation: • Toggle keys should not stick in one position. • Knobs should rotate fully in both directions. Cleaning and Disinfecting Exterior Surfaces Clean and disinfect the exterior surfaces of all equipment and peripheral devices monthly, or more frequently if needed. Cleaning and Disinfecting the Surfaces Proper cleaning and disinfecting prolongs the life of the product.
Maintenance Cautions • Follow the cleaning instructions exactly. • Wring excess disinfectant from wipe before using. • Never immerse the device, cables, or leadwires in any liquid, as this may corrode metal contacts and affect signal quality. • Do not allow fluid to pool around connection pins. If this happens, blot dry with a soft, lint-free cloth. • Never use conductive solutions or solutions that contain chlorides, wax, or wax compounds to clean the device, cables, or leadwires.
Maintenance • Unit malfunction • Voided warranty Use the following procedure to clean and disinfect the cables and leadwires. 1. Remove cables and leadwires from the device or system before cleaning. 2. Use care in cleaning leadwires to prevent pulling the long wires from the connector ends. Metal connections can be pulled away from the connectors. 3. To clean, wipe with a lightly moistened cloth. Use a mild soap and water solution to moisten the cloth.
Maintenance • Never immerse the device, cables, or leadwires in any liquid, as this may corrode metal contacts and affect signal quality. • Do not allow fluid to pool around connection pins. If this happens, blot dry with a soft, lint-free cloth. • Never use conductive solutions or solutions that contain chlorides, wax, or wax compounds to clean the device, cables, or leadwires.
Maintenance Use the following procedure to clean and disinfect the cables and leadwires. 1. Remove cables, leadwires, and batteries from the device before cleaning. Make sure to firmly close the battery door after removing the batteries. 2. To clean, wipe with a lightly moistened cloth. Use a mild soap and water solution to moisten the cloth.
Maintenance • Never use solutions or products that contain any type of Ammonium Chloride such as, but not limited to: • Dimethyl Benzyl Ammonium Chloride • Quaternary Ammonium Chloride solutions • Abrasive cleaners or solvents of any kind • Acetone • Ketone • Betadine • Alcohol-based cleaning agents • Sodium salts • Never autoclave or steam clean the device, cables, or leadwires. • Do not use until thoroughly dry.
Maintenance 3. Use a cloth lightly moistened with distilled water to rinse away the cleaning solution. Make certain that moisture does not enter the electronics area below the battery compartment floor. 4. Dry thoroughly with a lint-free cloth and allow the battery compartment to air dry completely prior to closing the compartment door. Paper Maintenance Proper paper maintenance ensures optimum ECG printouts.
Maintenance 3. To set the tray for standard (US Letter) paper, slide the guide toward the front of the device. 4. You are now ready to load your paper. Loading the Paper Use the following instructions to load paper into the MAC system. Refer to the following illustration. 2046275-016A 1. Open the writer drawer. 2. Place the pad of paper with the holes on the left.
Maintenance 3. Advance the first sheet of paper. 4. Close the writer drawer securely. Battery Maintenance Proper battery maintenance prolongs the battery life and ensures that the MAC system will operate when needed. Proper maintenance consists of the following: • Charging the battery • Conditioning the battery • Replacing the battery Charging the Battery A fully charged battery ensures that the MAC system will operate without being connected to an AC outlet.
Maintenance Use the following procedure to charge the battery: 1. 2. Power off the system. Connect the system to an AC wall outlet. To indicate the battery is charging, the amber battery light glows (1) and the charging battery icon is displayed on the screen (2). 3. Charge the system for 4–5 hours or until the battery gauge icon indicates a full charge. NOTE: If the battery is fully charged or exceeds safe charging temperature, the system will not charge the battery.
Maintenance WARNING: BATTERY PACK DISPOSAL — Do NOT dispose of the battery pack by fire or burning. Follow local environmental guidelines concerning disposal and recycling. WARNING: CHEMICAL BURN — If battery fluid contacts your skin, eyes, or clothing, immediately wash the area with clean water and see a doctor.
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Troubleshooting B The following sections identify some of the more common problems with the MAC system and list their potential causes and solutions. If this information cannot resolve your issue, contact GE Healthcare Technical Support.
Troubleshooting • • • • Slipped or misplaced electrodes can result in faulty readings. Refer to “Preparing the Patient's Skin” on page 54. Verify proper electrode application. Perspiration, excessive hair, lotions, and dead skin cells must be removed from the electrode site. Refer to “Electrode Placement” on page 55. Check for defective or expired electrodes. Verify the electrodes have not exceeded their shelf life. Check for defective, broken, or disconnected leadwires.
Troubleshooting • Check the Emergency Stop switch on the device. Verify it is not depressed. • Check the device settings. Verify that it does not retain settings from the previous patient. System Errors The following errors may occur while you are operating this system. You may be required to perform some action. If you perform the recommended actions and the condition still remains, contact authorized service personnel.
Troubleshooting Problem Cause Solution Cannot use the system because Device Password does not work. Device Password has been changed or has not been adequately communicated to the staff. Contact your administrator for the Device Password. You are prompted to format to recover the file system. The internal storage has been corrupted. Format the internal storage to restore the file system.
Report Formats C The MAC system provides several report formats to provide the information you need to analyze and evaluate the patient's ECG. The following sections describe the available formats so you can choose the correct report for your needs. Numeric Reports Several reports use numeric titles that describe the way in which the data is presented. For example, the report 4 by 2.5s + 1 rhythm ld presents the following information: 1 Four columns of data containing 3 leads with 2.
Report Formats • 2 by 10s • 3 by 5 @ 50mm/s • 3 by 10s • 4 by 2.5s • 4 by 2.5s + 1 rhythm lead • 4 by 2.5s + 3 rhythm leads • 4 by 10s • 5 by 2s • 5 by 2s + 1 rhythm lead • 5 by 2s + 3 rhythm leads • 5 by 10s Additional Reports The following additional report formats are available. 182 Report Description 12 Rhythm Leads 10 seconds of 12-lead rhythm. Autorhythm 10 seconds of 3, 6, or 12 leads of rhythm. CGR One median complex for each of the 12 leads combined with 10 seconds of 3-lead rhythm.
Report Formats Report Description ACI-TIPI The analysis of the acquired ECG data appears at the top of the report. Hi-Res or PHi-Res Signal Overlapped X,Y,Z data at two different amplitudes. RMR One median complex for each of the 12 leads combined with 10 seconds of 3-lead rhythm. Swedish Format 1 One median complex for each of the 12 leads at writer speed of 50mm/s combined with 5 seconds of 6-lead rhythm at half writer speed. Text is on the bottom of the page.
Report Formats Report Description 12 or 15-Lead Report Based on Exercise report setups, a variety of 12 or 15 Lead report formats will print without ECG analysis when the 12 ld key is pressed or when 12/15 lead reports are configured in the protocol. 5 Second Rhythm Report This report can be chosen from the Edit Protocol application to print at certain points during the test. Rhythm Report A continuous, real-time recording of raw data - 3, 6, 12 leads.
Report Formats Exercise Report Codes The following report codes are printed in the lower left corner of the exercise reports. 2046275-016A Code Description A+ Auto Arrhythmia Reporting is ON. A- Auto Arrhythmia Reporting is OFF. H+ Stag Hold is ON. H- Stag Hold is OFF. S+ Cubic Spline is ON. S- Cubic Spline is OFF. 50 50Hz AC filter is ON. 60 60Hz AC filter is ON. HR Binary encoded format for heart rate leads.
Report Formats 186 MAC® 5500/MAC® 5500 HD 2046275-016A
Master's Step Data D The following sections provide the information you need to run a Master's Step stress test. NOTE: The Master's Step is an option and is available only in Japan. Master's Step Table The following table identifies the number of steps to set according to the patient's age, sex, and weight.
Weight (kg) 18–22 22–26 27–31 32–35 MAC® 5500/MAC® 5500 HD 36–40 41–44 45–49 50–53 54–58 59–63 64–67 2046275-016A 68–72 Sex Age (Years) 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 Male 35 36 Female 35 35 33 Male 33 35 32 Female 33 33 32 Male 31 33 31 Female 31 32 30 Male 28 32 30 Female 28 30 29 Male 26 30 29 29 29 28 27 27 26 25 25 24 23 23 22 Female 26 28 28 28 28 27 26 24 23 22 21 21
2046275-016A Weight (kg) 73–76 77–81 82–85 86–90 MAC® 5500/MAC® 5500 HD 91–93 94–99 100–104 Sex Age (Years) 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 Male 18 21 23 24 23 22 22 21 20 19 18 18 17 17 Female 15 16 20 19 19 18 18 17 16 16 15 14 13 12 20 22 23 23 22 21 20 19 18 18 17 17 16 14 19 18 18 17 17 16 16 15 14 13 13 12 Male 19 21 23 22 21 20 19 19 18 17 16 16 15 Female 13 18 1
Master's Step Data ST-T Changes The existence of any ST-T change is assessed by classifying ST-T into three assessment levels: • Positive One of the following criteria must be met on 2 or more leads: • ST Depression ≥ 0.1mV • ST Elevation≥ 0.2mV • T wave change ≥ 1.0mV • Borderline One of the following criteria must be met on any lead: • ST Depression ≥ 0.05mV • ST Elevation ≥ 0.1mV • T wave change ≥ 0.5mV • Negative This is assessed if neither the Positive nor Borderline criteria are met.
Creating Bar Codes and Magnetic Cards E The following sections provide the information you need to configure bar codes and magnetic patient ID cards. The bar code reader can read Code 39, 39EX, 128, PDF-417 (2-D), Interleaved Code 2 of 5, and Data Matrix bar codes. The card reader can read magnetic cards that adhere to ISO 7810 and 7811. NOTE: All data resides in fixed-width fields.
Creating Bar Codes and Magnetic Cards Bar Code Reader and Magnetic Card Reader Configuration Fields Field Byte Length Total number of bytes Enter the total number of bytes contained in the magnetic patient card or patient bar code. This is typically, but not necessarily, the sum of the bytes listed in the following fields. Patient ID The patient's identification number. Enter the field's Offset and Length.
Creating Bar Codes and Magnetic Cards Bar Code Reader and Magnetic Card Reader Configuration Fields (cont'd.) Field Byte Length Enable data retrieval Determines whether the system will issue a query for matching orders or patient information when scanning the bard code or magnetic card. To enable data retrieval, select Yes. The following fields determine what information is used to conduct the query, what information is retrieved, and where the information is retrieved from.
Creating Bar Codes and Magnetic Cards Automatic Configuration Settings 194 Field Character used to reserve byte space Patient ID 9 First name 5 Last Name 6 Year of birth 3 Month of birth 1 Day of birth 2 Gender F Visit Number 8 MAC® 5500/MAC® 5500 HD 2046275-016A
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