User's Manual

Ultraview Care Network
9-14
Arrhythmia Problem Solving
Refer to ECG on page 8-3 for additional monitoring tips.
False Alarms
Careful attention to good monitoring techniques, especially during setup, will
reduce false alarms. When false alarms occur, check the following:
• Multiple classes with atrial fibrillation or flutter waveforms. Either 1) merge
these classes with the dominant or another abnormal class, 2) deactivate the
alarms for these classes, or 3) consider deactivating the Abnormals per
Minute alarm.
• Repetitive artifact mimicking QRS complexes. Review the morphology of
abnormal classes that are triggering alarms. Either merge these abnormal
classes together or deactivate the alarm for these classes.
• In some cases VFIB may resemble previously classified abnormal beats
which may cause VFIB to be detected as a RUN. If this occurs, use the
waveform display as the primary indication of condition.
• Some beats may not be recognized as morphologically different from the
learned, dominant beat. You may be able to improve performance by
changing electrode positions or switching to a lead setting that provides
better differentiation between the dominant and abnormal beats.
Abnormal Beats Mis-classified
There are a number of possible situations that might cause beats to be improperly
classified (either too many or too few).
• If the message NOISY SIGNAL is displayed, too much noise is present on
either one, or both, ECG channels.
• If the message ECG VOLTAGE TOO LOW is displayed, the signal level is
below the threshold for QRS detection.
• Some beats are not recognized as being different from the learned dominant
beat.
You may be able to improve performance in these cases by changing electrode
positions or by switching to a lead setting that provides a better signal or allows
abnormal beats to be more clearly differentiated from dominant beats.
No Couplet or Run Alarms
If alarms do not occur as expected, check the following:
• Abnormal in a Row alarm limit may be set too high to generate alarm for
couplets. When you wish to be alerted for couplets, set Abnormal in a Row
alarm limit to 2.
• Abnormal beat(s) may not meet the classification criteria of 15% prematurity
(for the second beat in a couplet or subsequent beats — at 90 BPM — in a
run) and R-R intervals of less than or equal to 666 msec. No action is
indicated. An Abnormal in a Row alarm (COUPLET or RUN) will not be
generated unless both criteria are met.
• Processing may have been suspended or the signal quality may be poor.
Resume processing or check electrodes for other causes of a poor signal.