1、HLT0073 Cardiac Diagnostics Instrumentation Class 8,Instructor: Joanne Lambley, MSc (Kin),Agenda,Discuss: Electrocardiograph Holter monitor Treadmill Exercise Testing SystemIn terms of: Maintenance Troubleshooting Calibration,ECG - Maintenance,Contact an authorized technician if: Equipment falls fro
2、m cart Liquid is spilled on equipment Equipment not functioning properly Parts on the enclosure are cracked or deteriorating Any cord or connector shows signs of deterioration,ECG - Maintenance,Cleaning: Clean housing with clean, damp cloth using a mild household detergent To disinfect, spray housin
3、g with INCIDIN or similar product Never immerse cables in fluid. Do not use bleach, acetone or other harsh chemicals Rub cables with a clean cloth moistened with a formaldehyde solution such as CIDEX,ECG - Maintenance,Computerized units perform a self-test every time they are powered up No calibrati
4、on is necessary Visually inspect patient cable for cracks and broken or bent pins Test with a simulator Check the signal transmission through the cable by flexing the cable and electrode lead wires and observing the ECG rhythm for irregular tracings,ECG Troubleshooting,Unit will not turn on Unit not
5、 connected to AC line voltage Battery has no charge Faulty power cord or AC outlet Unit has frozen will not respond to key strokes and display does not change Press on/standby key (shuts down after a possible delay of up to 5 seconds Press on/standby again to restart Waveforms are flat for all leads
6、 on tracing Electrodes not applied properly ECG acquired too quickly (wait for sensors OK) Patient cable not attached properly to unit or is faulty,ECG - Troubleshooting,Baseline drift for one or more leads Poor patient prep Use of dissimilar electrodes or electrodes not recommended for ECG unit use
7、d Electrodes need to sit longer on skin Poor electrode contact with skin Tracing is noisy or fuzzy AC interference from lighting, cables, or equipment near patient Try operating ECG on battery Occasional noise or artifact in one or more leads Patient movement Muscle tremor noise Poor electrode conta
8、ct with skin If problem persists, try changing filter setting to 40 Hz manufacturer warns that this may affect the ECG output,ECG Troubleshooting,Incorrect HR printed or displayed: Bigeminal rhythm Poor data quality (artifact) QRS amplitude and T wave amplitude almost the same Incorrect or missing m
9、easurement on printout Poor data quality (artifact) Rapid, large and erratic deflections Broken lead wire,Holter - Maintenance,Cleaning: Dampen a soft cloth with mild detergent and water Clean recorder, lead wires, and belt clip Do not leave batteries in the recorder when it is not in use Damage fro
10、m corrosion could result,Holter Monitor Troubleshooting,No display Ensure patient cable is connected Ensure battery is inserted with correct polarity Install a new alkaline battery Low battery Inspect battery compartment, clean contacts if necessary Install a new alkaline battery Battery does not la
11、st 24 or 48 hours Ensure a new alkaline battery is being used Noise artifacts on ECG signal Ensure all electrodes are securely attached to the patient Replace the patient cable If problems persist, contact facility biomedical department or manufacturers technical support,Holter - Calibration,No cali
12、bration is required for the monitor or the analysis system Holter monitor places calibration signals at the start of each recording automatically,Treadmill - Operation,Guidelines for Safe Operation Keep treadmill area clear (maintain open space at each side of at least 0.5 m and 2 m at the back) Do
13、not start treadmill with someone standing on the belt Do not leave patient unattended on the treadmill Secure loose clothing (check shoelaces) before starting treadmill Keep speed and grade at minimum settings when patient gets on the treadmill Patient should hold the handrail as the treadmill slows
14、 down. Technologist must be in a position to support and assist the patient when the belt stops Use the emergency stop button only for emergencies The button will cut power to the belt drive motor The button will lock into place Turn counter-clockwise to unlock it,Treadmill - Maintenance,Inspect tre
15、admill belt for wear Check position of belt Should not rub against the frame Should be centered Cleaning: Turn off treadmill and unplug Clean exterior and belt with damp sponge Do not use detergents or cleaning agents on deck Do not let liquids enter the interior of the treadmill Once per week, elev
16、ate treadmill to maximum grade and clean floor underneath (excess dust may interfere with operation) Belt tension may need adjustment (biomed dept) Leakage current checked (biomed dept) Unplug treadmill when moving it (do not place hands beneath the treadmill when it is plugged in,Treadmill - Troubl
17、eshooting,If the belt does not run, check the monitoring system for an error code Consult treadmill manuals troubleshooting guide or Record code and consult authorized technician If no error code is present: Shut down monitoring system and restart Check cables for proper connection,Treadmill - Troub
18、leshooting,Possible reasons treadmill not working: Treadmill not plugged in Interface cable with monitoring system disconnected Circuit breaker switch on treadmill off No power at outlet Emergency stop button unplugged from treadmill Emergency stop button activated,Treadmill - Calibration,Treadmill
19、Auto Calibration Will operate the treadmill automatically for approx. 5 minutes during the calibration process Manual Calibration User can activate the treadmill controls from this screen. Will compare the speeds and grades selected by the user to what is being returned by the treadmill,Exercise Tes
20、ting System - Maintenance,Turn system off and unplug Clean external surfaces with a damp cloth moistened with a mild soap solution; wipe dry Disinfect components using gauze moistened with: Cidex (2% glutaraldehyde solution) Isopropyl alcohol Chlorine bleach (1:10 dilution with water) Hexachlorophen
21、e (pHisoHex) Disinfectant supplied by your facility Disinfect truck cable and patient lead wires Do not immerse in water or the cleaning solution Inspect cables for frayed insulation, excessive bends or crimps, or other signs of wear After cleaning, verify that cables are reconnected properly,Exerci
22、se Testing System - Troubleshooting,Error message: Electrode disconnected Reattach or replace electrode Artifact during test Try to determine faulty lead Possible to quickly prep new site and attach electrode while patient is exercising If this does not help, and test quality is compromised, stop test,
