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Electrocardiograph: Operator'S Manual
Electrocardiograph: Operator'S Manual
Electrocardiograph ECG-1150
Electrocardiograph
ECG-1150
0614-901906D
Printed: 2012/09/24
Electrocardiograph
ECG-1150
Keep this manual near the instrument or in the reach of the operator and refer to it whenever the operation is unclear.
This product stores personal patient information. Manage and operate the information appropriately.
Patient names on the screen shots and recording examples in this manual are fictional and any resemblance to any
person living or dead is purely coincidental.
Copyright Notice
The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No part of this document
may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical, photocopied, recorded,
or otherwise) without the prior written permission of Nihon Kohden.
Trademark
The mark printed on the SD card that is used in this instrument is a trademark. The company name and model name are
trademarks and registered trademarks of each company.
Contents 1
2
GENERAL HANDLING PRECAUTIONS.............................................................................. i
WARRANTY POLICY.......................................................................................................... ii 3
EMC RELATED CAUTION...................................................................................................iii
Conventions Used in this Manual and Instrument............................................................... v 4
Warnings, Cautions and Notes.................................................................................. v
Explanations of the Symbols in this Manual and Instrument.................................... vi 5
On Panel......................................................................................................... vi
On Operation Panel........................................................................................vii
6
On Screen......................................................................................................vii
7
On Patient Cable............................................................................................vii
6
Section 4 Attaching the Electrodes and Entering Patient 7
Information............................................................................. 4.1
Attaching the Electrodes................................................................................................... 4.3 8
Attaching the Limb Electrodes................................................................................ 4.3
Attaching the Chest Electrodes.............................................................................. 4.3 9
Patient Cable Tip Color Coding......................................................................................... 4.4
Lead Connection............................................................................................................... 4.5 10
Standard 12 Leads and Cabrera Leads................................................................. 4.5
IEC Standard................................................................................................ 4.5
AHA Requirement........................................................................................ 4.5
Error Indication When the Electrode Is Not Attached Firmly............................................. 4.6
Screen Message..................................................................................................... 4.6
Indication on the Paper........................................................................................... 4.7
Countermeasure..................................................................................................... 4.7
Electrode Detachment.................................................................................. 4.7
Large Polarization Voltage............................................................................ 4.7
Entering the Patient Information....................................................................................... 4.8
General................................................................................................................... 4.8
Entering the Patient Information ............................................................................ 4.9
4
Section 9 Maintenance and System Test.............................................. 9.1
5
Check Items After Turning the Power Off.......................................................................... 9.2
Cleaning and Disinfecting the Electrocardiograph............................................................ 9.3
6
Cleaning the Surface of the Electrocardiograph..................................................... 9.3
Cleaning the Display of the Electrocardiograph...................................................... 9.3
7
Disinfecting the Surface of the Electrocardiograph................................................. 9.4
Cleaning the Thermal Head.................................................................................... 9.4 8
Cleaning the Paper Roller....................................................................................... 9.5
Cleaning the Sensor............................................................................................... 9.5 9
Cleaning the Wheel Gear....................................................................................... 9.5
Cleaning and Disinfecting the Patient Cable..................................................................... 9.6 10
Cleaning................................................................................................................. 9.6
Disinfecting............................................................................................................. 9.6
Cleaning and Disinfecting Electrodes............................................................................... 9.7
Cleaning................................................................................................................. 9.7
Disinfecting............................................................................................................. 9.7
Cleaning and Disinfecting Other Options.......................................................................... 9.7
Regular Check.................................................................................................................. 9.8
Clock Accuracy................................................................................................................. 9.9
Periodic Replacement..................................................................................................... 9.10
Repair Parts Availability Policy........................................................................................ 9.11
System Test Screen........................................................................................................ 9.12
System Test Items................................................................................................ 9.12
Displaying the System Test Screen...................................................................... 9.13
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
3. Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is combined with other instruments to avoid misdiagnosis or other
problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety.
(3) Avoid direct contact between the instrument housing and the patient.
6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is
not functioning properly, it should be clearly marked to avoid operation while it is out of order.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or
location of electrodes and/or transducers to avoid possible burn to the patient.
10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator
discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.
WARRANTY POLICY
Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year
from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded
from the warranty.
NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period,
provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals.
No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any
other warranty, either implied or in writing. In addition, service, technical modification or any other product change
performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding
this warranty.
Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure.
Shipping costs must be pre-paid.
This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon
Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism,
water or other casualty, improper installation or application, or on which the original identification marks have been
removed.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station
or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source such as cellular phone
away from the equipment and/or system, or turn off the cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of the equipment
and/or system:
Identify the cause of this interference and if possible remove this interference source. If this is not
possible, use a different power supply.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or
system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is installed, it may induce
an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord
from the equipment and/or system and operate the equipment and/or system by battery power, or use
an uninterruptible power supply.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden
representative for additional suggestions.
For EMC compliance, refer to “Specifications - Electromagnetic Compatibility” in the Reference section.
The CE mark is a protected conformity mark of the European Community. Products with the CE mark comply
with the requirements of the Medical Device Directive 93/42/EEC.
NOTE about Waste Electrical and Electronic Equipment (WEEE) Directive 2002/96/EC
For the member states of the European Union only:
The purpose of WEEE directive 2002/96/EC is, as a first priority, the prevention of waste electrical and
electronic equipment (WEEE), and in addition, the reuse, recycling and other forms of recovery of such
wastes so as to reduce the disposal of waste.
Contact your Nihon Kohden representative for disposal.
WARNING
A warning alerts the user to possible injury or death associated with the use or misuse of the instrument.
CAUTION
A caution alerts the user to possible injury or problems with the instrument associated with its use or
misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other
property.
NOTE
A note provides specific information, in the form of recommendations, prerequirements, alternative methods or
supplemental information.
On Panel
Gain Rhythm
Paper speed
On Screen
On Patient Cable
Introduction........................................................................................................................................................... 1.2
Intended Use.............................................................................................................................................. 1.2
Features..................................................................................................................................................... 1.2
Composition............................................................................................................................................... 1.2
General Safety Information................................................................................................................................... 1.3
General....................................................................................................................................................... 1.3
Installation.................................................................................................................................................. 1.3
Battery Pack............................................................................................................................................... 1.5
Operation.................................................................................................................................................... 1.6
Maintenance............................................................................................................................................... 1.7
Panel and Parts Descriptions............................................................................................................................... 1.8
Front Panel................................................................................................................................................. 1.8
Left Side Panel........................................................................................................................................... 1.8
Operation Panel......................................................................................................................................... 1.9
Right Side Panel....................................................................................................................................... 1.10
Rear Panel............................................................................................................................................... 1.11
Patient Cable............................................................................................................................................ 1.11
Functions............................................................................................................................................................ 1.12
Basic Operation (Function Keys, Panel Keys, Number Keys)............................................................................. 1.14
Switching Screens.............................................................................................................................................. 1.15
AC and Battery Operation.................................................................................................................................. 1.16
Power and Battery Status Indications...................................................................................................... 1.17
Introduction
NOTE
Use only Nihon Kohden parts and accessories to assure maximum
performance from your instrument.
Intended Use
The Nihon Kohden ECG-1150 electrocardiograph is intended for medical use to
process the electrical signals produced by the heart, which are acquired through
two or more electrodes, and to display waveforms* and/or prepare a record of
these electrical signals. This instrument is a portable ECG acquisition terminal
which measures up to 12 lead ECG waveforms.
* Essential performance in EMC standard.
Features
• Compact, lightweight and easy to carry — smaller than A4 paper, 2 kg without
battery or recording paper
• Prints up to 3 channels on 63 mm recording paper
• An LCD screen lets you preview 2.8 seconds of 12 lead ECG waveforms
• SD memory card available
For ECG analysis, refer to “ECAPS 12C ECG Interpretation Program User’s
Guide”.
Composition
• Electrocardiograph, ECG-1150
Standard Accessories
• Thermal head cleaner
• Recording paper, RQS63-3
• Input check jig
Options
• Accessory kit, YD-100D/YD-101D/YD-102D/YD-103D
• Patient cable, BJ-901D/BJ-902D/BJ-903D/BA-901D/BA-903D/BJ-961D
• Battery pack, SB-901D
• Cart, KD-104E/KD-105D/KD-105E
• Storage rack, DI-010D
• Patient cable hanger, KH-100D
• SD memory card, QM-064DE (for Europe), QM-001D/064D (for other
countries)
• Cardio cream, Z-101BC
• Medical isolation transformer
1.2 Operator’s Manual ECG-1150
1. GENERAL
1
General Safety Information
General
WARNING WARNING
Never use the electrocardiograph in the presence Never use the electrocardiograph in a hyperbaric
of any flammable anesthetic gas or high oxygen chamber. Failure to follow this warning
concentration oxygen atmosphere. Failure to may cause explosion or fire.
follow this warning may cause explosion or fire.
WARNING WARNING
When the electrocardiograph is used with an When performing MRI test, remove all electrodes
electrosurgical unit (ESU), firmly attach the entire and transducers from the patient which are
area of the ESU return plate. Otherwise, the connected to this instrument. Failure to follow this
current from the ESU flows into the electrodes of warning may cause skin burn on the patient. For
the electrocardiograph, causing electrical burn details, refer to the MRI manual.
where the electrodes are attached. For details,
refer to the ESU manual.
WARNING WARNING
Before defibrillation, remove everything including Before defibrillation, all persons must keep clear
electrodes and patches from the patient’s chest. If of the bed and must not touch the patient or any
the defibrillator paddle contacts an object on the equipment or cable connected to the patient.
patient’s chest, the discharged energy may be Failure to follow this warning may cause electrical
insufficient and cause skin burn. shock or injury.
WARNING
Use only the specified patient cables. Failure to
follow this warning may cause skin burn where
the electrode is attached and damage the
electrocardiograph due to discharge energy when
defibrillation is performed.
Installation
WARNING WARNING
Connect only the specified instrument to the Only use the provided power cord. When the
electrocardiograph and follow the specified provided power cord cannot be used or when
procedure. Failure to follow this warning may equipotential grounding is doubtful (such as in a
result in electrical shock or injury to the patient facility with poor grounding), operate the
and operator, and cause fire or instrument electrocardiograph on battery power. Otherwise,
malfunction. the patient and operator may receive electrical
shock or injury.
WARNING WARNING
When several medical instruments are used Never use a local purchase multiple portable
together, ground all instruments to the same one- socket outlet. Failure to follow this warning may
point ground. Any potential difference between cause electrical shock to the patient and operator.
instruments may cause electrical shock to the
patient and operator.
WARNING WARNING
Do not put the multiple portable socket outlet on To use non-medical equipment that requires an
a floor. If the multiple portable socket outlet gets isolation transformer, only connect it to a
dusty, damaged or contacts liquid, it may cause specified multiple portable socket outlet that has
instrument malfunction and electrical shock to the an isolation transformer. Do not connect the non-
patient or operator. medical equipment to a wall AC socket or to a
multiple portable socket that does not have an
isolation transformer. Do not connect unspecified
WARNING
electrical instruments to a multiple portable
Do not use an additional multiple portable socket
socket outlet in the system. Failure to follow this
outlet or extension cord. The impedance of the
warning may cause leakage current to increase
protective earth increases and the patient and
and the patient and operator may receive
operator may receive electrical shock or injury.
electrical shock or injury.
Cart
CAUTION CAUTION
Only use the KD-104E/105D/105E cart for this • Do not move the cart with the casters locked.
electrocardiograph. If another cart is used, it may The cart may tip over.
tip over or the electrocardiograph may fall off. • When moving the cart, hold the handle only.
CAUTION CAUTION
When moving the cart with patient cable hanger To prevent the cart from tipping over or the
mounted, fold the upper and lower arms together, electrocardiograph falling off the cart:
rotate the arms so that they point toward the • Do not put or hook anything on the handle.
handle and do not protrude beyond the edges of • Do not ride on the cart. Do not lean on the
the cart. handle or put your weight on the cart.
• Periodically check that the casters, handle and
frame are firmly attached and not wobbly.
• Always lock the casters so that the cart does
not move accidentally.
CAUTION CAUTION
Do not leave accessories and consumables such Only use Nihon Kohden specified parts and
as electrodes or electrolyte cream (CardioCream) accessories to assure maximum performance
near the patient or in reach of children. If they are from your electrocardiograph. Using unspecified
swallowed, consult a physician immediately. recording paper or electrodes may cause
incorrect ECG recording and accelerate
deterioration of the electrocardiograph.
Battery Pack
WARNING WARNING
Do not do the following to the battery pack. It may If the liquid inside the battery contacts the eyes,
cause leakage, overheating, explosion and fire. mouth or skin, do not rub the eyes, mouth or skin.
• Short-circuit the + and – terminals on the Wash with clean water and see a physician
battery pack. immediately.
• Put the battery pack into fire or heat the battery
pack.
WARNING
• Disassemble or modify the battery pack.
The following may cause overheating and
• Give strong impact to or deform the battery
leakage of the battery pack.
pack.
• Leaving the battery pack unused for a long
• Use the battery pack on unspecified
period (more than a year)
instruments.
• Immersing the battery pack in water or sea
• Charge the battery pack on unspecified
water or getting it wet
instruments.
• Install the battery pack with the wrong polarity.
• Leave the battery pack in the reach of patients. WARNING
Only use the SB-901D battery pack.
CAUTION CAUTION
If the battery operation time is less than 15 Do not use or leave the battery pack in direct
minutes, the battery pack may be deteriorated. sunlight or high temperatures such as in a car in
Do not charge a deteriorated battery pack. hot weather or in front of a stove. It may cause
Charging a deteriorated battery pack may cause leakage of the battery pack and degrade the
the electrocardiograph to fail to operate in both performance and lifetime of the battery pack.
battery and AC power.
CAUTION CAUTION
The battery pack must be replaced by qualified SB-901D battery pack is NiMH (Nickel-Metal
service personnel. Hydride). Before disposing of the battery pack,
check with your local solid waste officials for
details in your area for recycling options or proper
disposal. The battery is recyclable. At the end of
its useful life, under various state and local laws,
it may be illegal to dispose of this battery into the
municipal waste stream.
Operation
WARNING WARNING
Do not touch the patient while touching any metal Do not connect the tip of the electrode lead to
part of non-medical electrical equipment or an anything other than an electrode. Connect all the
exposed part when a connector or cover is tips to the corresponding electrodes and attach
removed. Failure to follow this warning may cause them to the patient. If unconnected tips or
electrical shock or injury to the patient. electrodes contact an item which is not
equipotential grounded, the patient may receive
electrical shock. Also, noise may superimpose on
the ECG waveforms and measurement data may
be incorrect.
CAUTION CAUTION
Enter the patient information correctly. Otherwise, Do not use the output signal from the output
the ECG data may be lost or mixed up with connector of the electrocardiograph for a
another patient’s ECG data. When managing synchronization signal on a defibrillator. There is
examination data that is only in electronic file, a time delay between the input signal and output
make sure to enter the patient information. signal. When using the output signal from the
electrocardiograph for the synchronization signal
on other instrument, always consider this time
CAUTION
delay.
The paper cutter in the recording paper container
is sharp. When setting the recording paper, be
careful not to cut your finger. Set the recording
paper as specified.
CAUTION CAUTION
• The automatic ECG interpretation is performed Take care when judging the ECG recording
for acquired ECG waveforms only and does not because the EMG filter may cause distortion of
reflect all conditions of the patient. The results P-waves and QRS-waves depending on the
of the analysis might not correspond to the waveform shape.
judgement of a physician.
• Overall judgement must be performed by the
physician, referring to the analysis result,
clinical findings, and other examination results.
After the physician’s overall judgement, the
analysis results should be signed or initialed by
the physician.
Maintenance
CAUTION
Before maintenance, cleaning or disinfection, turn
the electrocardiograph power off and disconnect
the power cord from the AC socket. Failure to
follow this instruction may result in electrical
shock and electrocardiograph malfunction.
Front Panel
Name Function
1 Operation panel Refer to next page.
3 LCD screen Displays ECG waveforms, patient information, marks and message.
Name Function
1 Recorder door release button Press this button to open the recorder door.
Operation Panel 1
7
8
4 2 3
9
10
1
5 6
11 12 13 14 15
Name Function
1 AC power lamp Lit when AC power is supplied.
2 Battery operation lamp During battery operation, indicates the remaining battery power with the color and
lighting state. For details, refer to “AC and Battery Operation” later in this section.
3 Battery charge lamp Indicates the battery charge status. For details, refer to “Operating on Battery” in
Section 2.
NOTE
After charging is complete, the battery charge lamp lights about every half
hour to one hour. This is because a small current is supplied to the battery
(supplementary recharging) to prevent self-discharging of the battery. Keep
the power cord plugged into the AC socket when the electrocardiograph is not
used.
4 POWER key/lamp Turns the electrocardiograph on/off. For details, refer to “AC and Battery Operation”
later in this section.
5 MODE key (“4” number key) Calls up the Main menu screen. On some screens, this key enters the number “4”.
6 RHYTHM key/lamp (“5” Performs rhythm recording in resting ECG examination. The lamp is lit while
number key) waveforms are acquired. On some screens, this key enters the number “5”.
7 F1, F2, F3, F4 function keys Correspond to the four items at the bottom of the screen. On some screens, these keys
(“1”, “2”, “3” number keys) enter the number “1”, “2” and “3”.
9 AGE key (“6” number key) Selects the patient age range (child or adult). On some screens, this key enters the
number “6”.
10 GENDER key (“7” number Selects the patient gender. On some screens, this key enters the number “7”.
key)
Name Function
11 FEED/MARK key (“8” Paper feeding:
number key) Feeds the paper while the key is pressed.
Event mark:
In manual recording mode, adds an event mark to the ECG waveform.
On some screens, this key enters the number “8”.
12 FILTER key/lamp (“9” Turns the EMG filter on/off. The lamp lights when the EMG filter is turned on. On
number key) some screens, this key enters the number “9”.
13 COPY/CAL key lamp (“0” Automatic recording mode and rhythm recording mode:
number key) Prints copies of the recording results. The lamp lights when copy is available and
during printing.
Manual recording mode:
Records the calibration waveforms. This key does not function for external input
signals.
On some screens, this key enters the number “0”.
14 START/STOP key/lamp Starts or stops recording. The lamp lights during recording.
The MODE, RHYTHM, F1, F2, F3, AGE, GENDER, FEED/MARK, FILTER and COPY/CAL keys are used to enter
numbers in the System Setup screen and patient information. Refer to “Changing the System Setup Settings” in Section 3
and “Entering the Patient Information” in Section 4.
Name Function
1 SD card slot For an SD memory card (option).
2 AC power cord socket Connects the power cord to supply AC power to the electrocardiograph.
3 Equipotential grounding For a grounding lead. When equipotential grounding is required, always perform
terminal equipotential grounding by using the optional grounding lead.
NOTE
• The equipotential grounding terminal can be removed. Be careful not to lose
the terminal.
• Only use Nihon Kohden specified equipotential grounding terminal.
Rear Panel 1
Name Function
1 Battery compartment Contains the battery pack.
CAUTION
Always install the battery even when the electrocardiograph operates on
AC power. Otherwise sudden power off occurs when an electrode is
detached during recording.
Patient Cable
1
Name Function
1 Electrode leads Connects to chest or limb electrodes.
Functions
The electrocardiograph has function keys on the screen and dedicated keys on
the operation panel.
Function Keys
Press the function key (F1 - F4)
corresponding to the operation or
item displayed on the bottom of
the screen to perform the desired
operation or select the desired item.
Panel Keys
Press the key on the operation panel to perform the desired operation.
Some of the panel keys also function as number keys on some screens.
Number Keys
On some screens, you can press the panel key to enter a number (0 - 9).
1
Switching Screens
When the electrocardiograph is turned on, the Resting ECG recording screen
appears.
2. Use the number keys on the operation panel to select the number of the
desired item.
Press the “1” or “2” key on the Main Menu screen to return to the ECG recording
screen.
AC power operation:
When AC power is supplied, the electrocardiograph operates on AC power and
the AC power lamp is lit.
Lit
The automatic backlight off function can be turned off by setting “Backlight auto
off” to “Off” on the System Setup screen. Refer to “List of Settings” in Section
3.
The automatic power off function can be turned off by setting “Auto
power off” to “Off” on the System Setup screen. Refer to “List of
Settings” in Section 3.
Lit • Operating on battery power and battery operation time is less than 15 minutes
Power lamp: Lit
AC power lamp: Off
Battery operation lamp: Lit in orange
Lit in orange Battery charging lamp: Off
WARNING WARNING
Never use the electrocardiograph in the presence Never use the electrocardiograph in a hyperbaric
of any flammable anesthetic gas or high oxygen chamber. Failure to follow this warning
concentration oxygen atmosphere. Failure to may cause explosion or fire.
follow this warning may cause explosion or fire.
WARNING
Connect only the specified instrument to the
electrocardiograph and follow the specified
procedure. Failure to follow this warning may
result in electrical shock or injury to the patient
and operator, and cause fire or instrument
malfunction.
CAUTION CAUTION
The electrocardiograph should not share the • Do not install the electrocardiograph near
power line with any instrument which consumes a a power line, dynamo or motor which has
lot of power, such as an X-ray instrument, electromagnetic induction.
because it may cause artifact. • Do not install the electrocardiograph near
an electrosurgical unit or RF therapeutic
equipment.
CAUTION
• Select a room without excessive noise,
Make sure that there is enough space between
vibration, sunlight, high humidity or water
the electrocardiograph and the wall for adequate
splashes.
ventilation. Leave more than 5 cm of space
• Make sure that there is no interference from a
between the wall and electrocardiograph so that
mobile phone.
the operating temperature does not exceed 40°C
• Avoid locations where the electrocardiograph
(104°F). Otherwise the internal temperature of
may receive strong electromagnetic
the electrocardiograph rises, which leads to
interference such as radio or TV stations,
inaccurate operation and shortens the
mobile phones or mobile two-way radios.
electrocardiograph life.
• Do not install the electrocardiograph where
it will be exposed to water or chemical
CAUTION solutions. Avoid direct sprinkling, spray or
Only use the KD-104E/105D/105E cart for this moist air from a nebulizer or humidifier. These
electrocardiograph. If another cart is used, it may cause malfunction and shorten the life of the
tip over or the electrocardiograph may fall off. electrocardiograph.
CAUTION CAUTION
When installing the electrocardiograph, take care Do not use the electrocardiograph with its side 2
not to pinch your finger under the panel down. Failure to follow this instruction may
electrocardiograph. cause the electrocardiograph to fall over or cause
battery liquid leakage.
NOTE
• Install the electrocardiograph where the screen can be seen clearly and
does not reflect light.
• Do not place blankets or cloth over the electrocardiograph.
• Do not install the electrocardiograph in a dusty area
CAUTION
Only use the KD-104E/105D/105E cart for this electrocardiograph. If
another cart is used, it may tip over or the electrocardiograph may
fall off.
holder together on the KD-105D/105E cart, but the card reader holder
interferes with putting items in and taking items out of the drawer.
WARNING
Only use the provided power cord. When the provided power cord
cannot be used or when equipotential grounding is doubtful (such as
in a facility with poor grounding), operate the electrocardiograph on
battery power. Otherwise, the patient and operator may receive
electrical shock or injury.
NOTE
• Make sure that there is always a battery pack inside the
electrocardiograph in case the power cord is disconnected or there is a
power failure.
• When there is no battery inside the electrocardiograph, there may be
noise on the waveform or the electrocardiograph may reset and lose
measurement data.
Connect the provided power cord to the AC power cord socket on the right side
panel of the electrocardiograph and plug the cord into a 3-prong AC socket.
WARNING
When several medical instruments are used together, ground all
instruments to the same one-point ground. Any potential difference
between instruments may cause electrical shock to the patient and
operator.
When more than one electrical instrument is used, there may be electrical
potential difference between the instruments. The potential difference between
the instruments may cause current to flow to the patient connected to the
instruments, resulting in electrical shock (micro shock).
Operating on Battery
2
The electrocardiograph can operate on battery power with the optional SB-901D
battery pack. When a battery is inserted, the electrocardiograph automatically
switches to battery power if the power cord is disconnected or there is a sudden
power failure.
Battery Handling
WARNING WARNING
Do not do the following to the battery pack. It may If the liquid inside the battery contacts the eyes,
cause leakage, overheating, explosion and fire. mouth or skin, do not rub the eyes, mouth or skin.
• Short-circuit the + and – terminals on the Wash with clean water and see a physician
battery pack. immediately.
• Put the battery pack into fire or heat the battery
pack.
WARNING
• Disassemble or modify the battery pack.
The following may cause overheating and
• Give strong impact to or deform the battery
leakage of the battery pack.
pack.
• Leaving the battery pack unused for a long
• Use the battery pack on unspecified
period (more than a year)
instruments.
• Immersing the battery pack in water or sea
• Charge the battery pack on unspecified
water or getting it wet
instruments.
• Install the battery pack with the wrong polarity.
• Leave the battery pack in the reach of patients. WARNING
Check the direction of the connector when
connecting the battery cable. Do not force the
WARNING
battery cable into the battery connector.
Only use the SB-901D battery pack.
CAUTION CAUTION
Do not bend or pull the connector of the battery If the battery operation time is less than 15
pack cable with strong force. This may damage minutes, the battery pack may be deteriorated.
the battery cable or battery cable connector. Do not charge a deteriorated battery pack.
Charging a deteriorated battery pack may cause
the electrocardiograph to fail to operate in both
battery and AC power.
NOTE
• The operation time with the fully charged battery pack is 90 minutes
or more when the surrounding temperature is 25°C (77°F). If the
surrounding temperature is more than 25°C (77°F) or depending on
waveform quality, the operation time may be less.
• The lifetime of the battery pack is about one year. When operating the
electrocardiograph with the battery pack, check the date when the
battery pack was last replaced on the start date label attached to the
electrocardiograph.
• To keep the battery pack fully charged, always keep the power cord
connected to the AC socket even when the electrocardiograph is not
used.
Battery Replacement
CAUTION CAUTION
The battery pack must be replaced by qualified Before connecting or disconnecting instruments,
service personnel. make sure that each instrument is turned off and
the power cord is disconnected from the AC
socket. Otherwise, the patient or operator may
receive electrical shock or injury.
Charging
CAUTION CAUTION
If the battery operation time is less than 15 Charge the battery pack at surrounding
minutes, the battery pack may be deteriorated. temperatures of 5 to 40°C (41 to 104°F). If the
Do not charge a deteriorated battery pack. battery is charged below 5°C or over 40°C, the
Charging a deteriorated battery pack may cause battery may leak or heat up. This may damage
the electrocardiograph to fail to operate in both the battery.
battery and AC power.
NOTE
• Before using a new battery pack, charge it with the ECG-1150
electrocardiograph.
• The charging time of the battery pack is less than 10 hours when the
surface temperature of the battery pack is between 10 and 35°C (50
and 95°F). The charging time depends on the surface temperature of
the battery pack. When the surface temperature of the battery pack is
below 10 or over 35°C (50 to 95°F), it may take longer to charge the
battery.
• During charging, the battery pack may heat up. Do not put anything on
or cover the electrocardiograph.
Storage
WARNING 2
Do not leave the battery pack unused for more than a year. The
battery may leak.
CAUTION
Do not use or leave the battery pack in direct sunlight or high
temperatures such as in a car in hot weather or in front of a stove. It
may cause leakage of the battery pack and degrade the
performance and lifetime of the battery pack.
CAUTION
• Remove the battery pack from the electrocardiograph when it is
not used more than six months. The battery may leak out and rust.
• When the battery pack is not used more than 90 days, store the
battery pack at temperatures between –20 to +30°C (–4 to +86°F)
in a dry place to prevent it from rusting and leakage.
• If the surrounding temperature is over 30°C (86°F), charge it every
three months because it self-discharges quickly.
• When the battery pack is stored more than one month, charge it
before use because the battery pack may have self-discharged.
• Replace the battery pack with a new one every year to assure
maximum performance from the electrocardiograph.
When the battery pack is stored for a long time, it may become inactivated and
cannot be fully charged. The battery charge may be recovered by discharging and
charging the battery several times.
Disposing
CAUTION
SB-901D battery pack is NiMH (Nickel-Metal Hydride). Before
disposing of the battery pack, check with your local solid waste
officials for details in your area for recycling options or proper
disposal. The battery is recyclable. At the end of its useful life, under
various state and local laws, it may be illegal to dispose of this
battery into the municipal waste stream.
NOTE
When disposing of the electrocardiograph, remove the battery pack and
attach tape over the battery cable. Otherwise, the battery may explode at
waste disposable services.
WARNING WARNING
Do not touch the patient while touching any metal Only use the SB-901D battery pack.
part of non-medical electrical equipment or an
exposed part when a connector or cover is
removed. Failure to follow this warning may cause
electrical shock or injury to the patient.
The electrocardiograph is shipped from the factory with no battery pack installed.
Follow the procedure below to insert a battery pack into the electrocardiograph
before use.
1. Remove the M3 binding head screw from the battery cover and pull off the
battery cover.
NOTE
• When you operate the electrocardiograph on battery power, run down
the battery as much as possible before recharging. If you frequently
charge the battery after it has only been used for a short time, it may
shorten the life of the battery.
• After charging is complete, the battery charge lamp lights about every
half hour to one hour. This is because a small current is supplied to
the battery (supplementary recharging) to prevent self-discharging of
the battery. Keep the power cord plugged into the AC socket when the
electrocardiograph is not used.
• Right after the battery is fully charged, and during battery operation,
the battery operation lamp may light in orange when the surrounding
temperature is low or when printing ECG waveforms.
• When operation time is reduced to half, even if the battery pack is fully
charged, the battery life may be expired. Replace the battery with a new
one.
• When the battery charge lamp does not light every half hour to one
hour, even after a ten-hour recharging, the battery life may be expired.
Replace the battery with a new one.
For battery operation time, refer to “AC and Battery Operation” in Section 1.
CAUTION
• Only use the Nihon Kohden specified 63 mm recording paper.
When a narrower recording paper is used and the paper detection
circuit cannot detect it, the thermal head may be activated. The
thermal head may be damaged where there is no recording paper
and the rubber paper feed roller may get burned.
• If unspecified recording paper is used, it might not print properly or
send multiple pages.
Model: RQS63-3
Type: Roll
Length: 30 m
Paper marks: No
Grid: No
Paper location: In the electrocardiograph
Storage
CAUTION
Prolonged storage under conditions such as high temperatures,
excessive humidity, direct sunlight, and fluorescent light causes
fading of the colored surface. Avoid high temperatures exceeding
50°C (122°F) and excessive humidity. Store the recording paper in a
cool, dry and dark place if possible.
Usage
CAUTION 2
• Organic solvents and plastics may develop color on the white
surface or cause the recording paper to fade.
Examples of color-developing materials containing organic
solvents:
Adhesives, paste, felt-tip pens, and semi-dry diazo paper.
Examples of color-fading materials made of soft vinyl chloride:
Document cases, albums, and desk pads including.
Examples of color-fading materials containing plastics:
Erasers, adhesive tapes, and some fluorescent pens.
• The paper cutter in the recording paper container is sharp. When
setting the recording paper, be careful not to cut your finger. Set
the recording paper as specified.
• When pasting the recording paper, use paste with a starch base,
PVA base, arabic gum base paste, CMC base synthetic paste, or
paper bond.
• Do not apply high pressure to the recording paper. Rubbing or
scratching the surface with a hard object discolors it.
• Clean the thermal head with the thermal head cleaner after every
100 m printing. A dirty thermal head degrades printing quality.
• Do not use recording paper which is contaminated with ECG
electrolyte cream (cardioCream) or saline solution because the
recording paper will fade by the chloride and the contaminated
thermal head may cause missing dots. If the thermal head gets
contaminated, clean it with the thermal head cleaner pen.
• Do not touch the thermal head with your fingers. If accidentally
touched, clean the thermal head with the thermal head cleaner
pen.
• Follow the procedure to set the recording paper. Otherwise, the
recording paper might not feed normally or the feeding motor may
stop operation.
Replacement
CAUTION
Do not set the recording paper right after recording because the
thermal head is still hot.
Paper guide
4. Pull out the recording paper and align it with the recorder cover.
5. Attach the recorder cover to the recorder while holding the paper.
2
NOTE
When recording paper is not aligned with the paper guide, skewing
may occur.
WARNING
Only use the BJ-901D/BJ-902D/BJ-903D/BJ-961D or BA-901D/BA-
903D patient cables when using with a defibrillator. When the
specified patient cable is connected, the electrocardiograph is type
CF defibrillation-proof compliance. Failure to follow this warning may
cause skin burn where the electrode is attached and damage the
electrocardiograph due to discharge energy when defibrillation is
performed.
1. Connect the patient cable to the patient cable connector on the right side
panel of the electrocardiograph.
NOTE
Do not lift the electrocardiograph while holding the patient cable and
do not bend or pull the patient cable strongly. This may break the
cable.
WARNING
Only use the provided power cord. When the provided power cord
cannot be used or when equipotential grounding is doubtful (such as
in a facility with poor grounding), operate the electrocardiograph on
battery power. Otherwise, the patient and operator may receive
electrical shock or injury.
Accessories:
• Enough electrolyte cream
• Enough recording paper
• Enough disinfected or sterilized dry electrodes
• Patient cable is not frayed or damaged
• No crack in the rubber of suction electrodes
• String of fast clip is strong enough
• New and used electrodes are not used together
Lit
After turning the power on, check the following items.
When the electrocardiograph is used for the first time, set the followings. Refer
to Section 3 “Changing Settings Before Measurement”.
Wave settings: AC filter
System settings: Date and time, Date display format, Time display format
To change the date and time setting, refer to “Changing the Date and Time” in
Section 3.
NOTE
If the date and time printed on the recording is not the current date and
time, the lithium battery may be burned. Contact your Nihon Kohden
representative.
Press the POWER key on the operation panel for one second to turn the power
off. The screen becomes dark and the POWER lamp on the operation panel turns
off.
If the screen is too dim, press the function key. If the screen is too bright,
press the function key.
5. Press the “1” or “2” key to return to the ECG recording screen.
Internal Memory
Saves up to 40 files in the memory regardless of the data compression type.
SD Memory Card
QM-001D/064D/064DE SD memory card or equivalents.
The QM-001D/064D/064DE SD memory card saves up to 780 files (type
1, normal) or 3000 files (type 2, compressed). Refer to Section 7 “Data
Management”.
CAUTION
Only use a Nihon Kohden specified SD memory card. Otherwise, the
card might not operate.
NOTE
The electrocardiograph can only recognize 64 MB of data on the SD
memory card even if the SD memory card is larger than 64 MB.
CAUTION
Only use a Nihon Kohden specified SD memory card. Otherwise, the
card might not operate.
CAUTION
Do not leave the SD memory card near patients or in reach of
children.
Handling
CAUTION
• Never disassemble or modify the SD memory card.
• Do not bend or give a strong impact to the SD memory card.
• Do not handle the SD memory card while smoking or eating. Do
not get the SD memory card wet.
• Do not touch any metal part of the SD memory card.
• Do not peel off the label or sticker on the SD memory card or put
other label or sticker on the SD memory card.
• Only use the SD memory card in the specified instrument.
• Do not scratch the insertion part of the SD memory card. The
electrocardiograph might not operate when the dust gets into the
insertion part.
• Put the SD memory card in the case when the SD memory card
is removed from the electrocardiograph. Store it where patients
cannot accidently swallow the SD memory card.
• Do not expose the SD memory card to direct sunlight or leave in a
high temperature and high humidity.
Operating Environment
Temperature: –25 to +85°C (–13 to +185°F)
Example:
QM-064D SD memory card Humidity: 25 to 95% RH (noncondensing)
Storage Environment
Temperature: –40°C to +85°C (–40 to +185°F)
Humidity: 25 to 95% RH
• Do not store the SD memory card in a corrosive gas environment.
Operation
CAUTION
• Only format or write data to the SD memory card in the specified
instrument. Otherwise, the SD memory card may become
unusable.
• Do not remove the SD memory card or turn the power off while
formatting or data is being written to or read from the SD memory
card. This may damage the SD memory card or saved data.
CAUTION 2
• Insert only a Nihon Kohden specified SD memory card in the SD
card slot.
• Insert or remove the SD memory card straight into or out of the SD
card slot. Otherwise, the SD memory card and electrocardiograph
may get damaged.
• Make sure that the electrocardiograph power is turned off, when
inserting or removing an SD memory card. Otherwise, the data
in SD memory card may get damaged and operation of the
electrocardiograph may become unstable.
2. Insert the SD memory card straight into the SD card slot with the label side
up until it clicks.
2. Set “Media” to “SD card” on the File Processing of the Main Setup screen.
Refer to “List of Settings - Main Setup Screen - File Processing” in Section
3.
There are two setup screens, System Setup screen and Main Setup screen.
System Setup screen settings are rarely changed. Main Setup screen settings are
frequently changed. You can change settings without turning the power off.
In the System Setup screen, you can change the following settings.
• Patient information
• Wave settings
• Recording settings
- Auto recording
- Report print out
- Analysis format and settings
• Periodic recording settings
• System settings
• Save/Load/Print system settings
In the Main Setup screen, you can change the following settings.
• Wave settings
• File processing
• Recording settings
- Recorder
- Manual recording
- Auto recording
- Analysis format and settings
- Rhythm recording
List of Settings
Patient Information
Wave Settings
CAUTION
When baseline drift suppression is set to
“Strong”, distortion may occur in the ST
segment with a decrease of heart rate when
heart rate is less than 50. For bradycardia,
set this item to “Weak”. The “Weak” setting
has characteristics conforming to the AHA
recommendations.
Recording Settings
Auto Recording
QT interval varies according to the heart rate. QTc interval is a corrected value
based on a heart rate of 60 bpm.
ECAPS:
(1000 − R-R interval (ms))
QTc interval (ms) = QT interval (ms) +
7
bazett:
QT interval (ms)
QTc interval (ms) =
R-R interval (s)
System Settings
CAUTION
Take care when judging the ECG recording
because the EMG filter may cause distortion
of P-waves and QRS-waves depending on
the waveform shape.
Lead mode selection Select the ECG lead recording order. Standard 12 leads
Cabrera leads
File Processing
Recording Settings
Recorder
Manual Recording
Auto Recording
Rhythm Recording
2. Press the POWER key while pressing the FILTER key. The System Setup
screen is displayed.
3. Press the or function key to select the desired item on the Setup
screen.
4. Press the OK function key. The Setup screen for that item is displayed.
6. Press the OK function key. The Setup screen for that item is displayed. Steps
5 and 6 are not necessary for some items.
8. Press the Change function key. The selectable items are toggled. Select the
desired setting.
For changing the date and time, refer to the next “Changing the Date and
Time” section.
For entering the hospital name, refer to “Entering the Hospital Name” in this
section.
10. Press the Back function key to return to the previous screen. The changed
setting is saved.
3.10 Operator’s Manual ECG-1150
3. CHANGING SETTINGS BEFORE MEASUREMENT
If the screen has more than two pages, press the or function key to scroll
the screen.
Turn the power off and on again to return to the Resting ECG recording screen. 3
5. Press the Edit function key. The Date and time setting window is displayed.
6. Enter the current date and time with the keyboard on the operation panel.
The order of the date setting is always yyyy/mm/dd.
5. Press the Edit function key. The Hospital setting window is displayed.
7. Press the START/STOP key. The changed setting is saved and the previous
screen appears.
2. Press “8” to select “Main Setup”. The Main Setup screen is displayed.
3. Press the or function key to select the desired item on the Main Setup
screen.
4. Press the OK function key. The Setup screen for that item is displayed.
6. Press the OK function key. The Setup screen for that item is displayed. Steps
6 and 7 are not necessary for some items.
8. Press the Change function key. The selectable items are toggled. Select the
desired setting.
10. Press the Back function key to return to the previous screen. The changed
setting is saved.
If the screen has more than two pages, press the or function key to scroll
the screen.
Press the “1” or “2” key on the Main Menu screen to return to the ECG recording
screen.
You can save all settings on the System Setup screen and Main Setup screen to
an SD memory card.
1. Insert the SD memory card into the SD card slot on the right side panel of
the electrocardiograph before saving the system settings.
2. Display the System Setup screen. Refer to “Displaying the System Setup
Screen and Changing the Settings” in this section.
5. Select Save System Settings and press the OK function key. The “Saving
system settings. Do not turn the power off” message appears and the system
settings are saved.
6. Turn the power off and on again to return to the Resting ECG recording
screen.
You can load previously saved settings on the System Setup screen and Main
Setup screen from an SD memory card.
1. Insert the SD memory card in the SD card slot on the right side panel of the
electrocardiograph before loading the system settings.
2. Display the System Setup screen. Refer to “Displaying the System Setup
Screen and Changing the Settings” in this section.
5. Select Load System Settings and press the OK function key. The “Loading
system settings. Do not turn the power off” message appears.
6. The “Apply new system settings?” message appears. Press the OK function
key. The new system settings are loaded.
Press the Cancel function key to cancel. The settings are not changed and
previous screen appears.
7. Turn the power off and on again to return to the Resting ECG recording
screen.
1. Display the System Setup screen. Refer to “Displaying the System Setup
Screen and Changing the Settings” in this section.
4. Select Print System Settings and press the OK function key. The “Printing
system settings. Do not turn the power off” message appears and printing
starts.
5. Turn the power off and on again to return to the Resting ECG recording
screen.
WARNING
Do not connect the tip of the electrode lead to anything other than an
electrode. Connect all the tips to the corresponding electrodes and
attach them to the patient. If unconnected tips or electrodes contact
an item which is not equipotential grounded, the patient may receive
electrical shock. Also, noise may superimpose on the ECG
waveforms and measurement data may be incorrect.
CAUTION
• Do not use new and old electrodes together, or re-usable and
disposable electrodes together (such as clip electrodes, suction
electrodes, and disposable electrodes). If different types are used
together, it may cause a high polarization voltage and prevent
displaying and recording of the ECG waveforms.
• Always replace all the electrodes with new ones at the same time.
• When using an ESU and defibrillator with the electrocardiograph,
use silver chloride disposable electrodes.
• Only use clean and undamaged electrodes with no scratches on
the surface. Electrodes with a deteriorated surface may cause high
contact impedance and distorted ECG waveforms.
• Do not touch electrodes, lead tips or electrocardiograph
connectors to any other ground or conductive object in the room,
such as a metal bedpost.
3. Attach the six electrodes to the cleaned skin site. Do not let the electrodes
touch each other.
5. Put the electrode on the site and squeeze the rubber ball to attach the
electrode by suction.
Lead Connection
AHA Requirement
Screen Message
The electrocardiograph continuously checks electrode attachment status. When
electrode detachment or large polarization voltage is detected, a message is
displayed.
NOTE
• If a limb electrode is detached, the chest electrode detachment
message is not displayed. Check the chest electrode attachment after
removing the cause of the error message.
• The ECG waveforms can be displayed and recorded if the message
due to a large polarization voltage is displayed. If recording starts,
the analysis result may be incorrect and the ECG waveforms cannot
be saved. Remove the cause of the error message before starting
measurement.
• A flat baseline is recorded for leads with a detached electrode.
• When using the electrocardiograph with an ESU, artifact from the ESU
may be superimposed on the ECG waveforms.
4
Electrode detachment Noise
Countermeasure
Electrode Detachment
Check for detached electrodes corresponding to the message and the electrode
lead. Reattach the electrode and connect the electrode lead.
If the message is still displayed after reattaching the electrode, it is probably due
to a large polarization voltage.
When the cause of the message cannot be found, the electrode lead may be
faulty. If any abnormality is found, refer to “Troubleshooting” in Section 8 to
take proper action. If there is any damage or the electrocardiograph is suspected
to be faulty as a result of checking, attach an “Unusable” or “Repair request”
label to the electrocardiograph and contact your Nihon Kohden representative.
General
You can enter the following patient information on the resting ECG recording
screen. The available patient data can be selected in the Patient Information
settings. Refer to Section 3 “Changing Settings Before Measurement”.
CAUTION
When the patient sex and age is not entered, ECG analysis is
performed with the patient as male and 35 years old.
NOTE
Add an ID to the patient information to prevent the ECG data from being
mistaken for a different patient’s ECG data.
When “Age group” is set for “Age or birth date” on the System Setup
When “Age group” is set for “Age or birth date” on the System Setup screen, the
Patient Information screen cannot be displayed and patient information cannot be
entered. Only gender and age group can be entered using the number keys on the
operation panel.
2. Enter the patient ID with the following operation keys and press the START/
STOP (enter) key. The cursor moves to the gender column.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
3. Select the gender by pressing the GENDER key and press the START/STOP
key. The cursor move to the age column.
5. Press the ID key. The patient information is set and Resting ECG recording
screen appears.
Operator’s Manual ECG-1150 4.9
Section 5 Recording Resting ECG
Waveforms
General................................................................................................................................................................. 5.2
Flow of Resting ECG Waveform Recording.......................................................................................................... 5.3 5
Notes for Accurate Measurement......................................................................................................................... 5.4
Before Starting the Recording.................................................................................................................... 5.4
Detecting QRS Waves................................................................................................................................ 5.4
Counting the Heart Rate............................................................................................................................ 5.4
Using the EMG/High-cut Filter.................................................................................................................... 5.4
ECG Analysis............................................................................................................................................. 5.5
Resting ECG Recording Screen........................................................................................................................... 5.6
Displaying the Resting ECG Recording Screen......................................................................................... 5.6
Explanation of the Resting ECG Recording Screen................................................................................... 5.7
Automatic Recording............................................................................................................................................ 5.9
General....................................................................................................................................................... 5.9
Real Time Recording........................................................................................................................ 5.9
Review Recording............................................................................................................................ 5.9
Auto Gain and Auto Position............................................................................................................ 5.9
Preparation for Automatic Recording......................................................................................................... 5.9
System Setup................................................................................................................................. 5.10
Main Setup..................................................................................................................................... 5.10
Automatic Recording Procedure.............................................................................................................. 5.12
Extended Recording....................................................................................................................... 5.14
Saving the ECG Data File.............................................................................................................. 5.14
Printing Another Copy of the Recording Results...................................................................................... 5.15
Manual Recording.............................................................................................................................................. 5.16
General..................................................................................................................................................... 5.16
Preparation for Manual Recording............................................................................................................ 5.16
System Setup................................................................................................................................. 5.16
Main Setup..................................................................................................................................... 5.16
Manual Recording Procedure................................................................................................................... 5.17
Rhythm Recording.............................................................................................................................................. 5.19
General..................................................................................................................................................... 5.19
Rhythm Recording Procedure.................................................................................................................. 5.19
Recording Examples.......................................................................................................................................... 5.20
Auto Recording Examples........................................................................................................................ 5.20
Manual Recording Examples................................................................................................................... 5.21
Rhythm Recording Examples................................................................................................................... 5.21
General
You can record the resting ECG waveforms automatically or manually. When the
power is turned on, automatic recording mode is the default selection.
After recording, you can save the 12 lead ECG (including extended sequence
recording) analysis result and patient information as an ECG data file in the
media. You can make one or more copies of the recording results before the next
recording starts.
In manual recording mode, you can manually change the recording settings
(paper speed, sensitivity, and EMG filter on/off) during recording. You can also
annotate the ECG waveforms with an event mark by pressing the FEED/MARK
key.
Before or after automatic or manual ECG recording, you can record one minute
of the rhythm lead. You can set the channel of the lead on the Rhythm Recording
of the Recording Settings in the Main Setup screen.
For recording settings and other settings, refer to Section 3 “Changing Settings
Before Measurement”.
CAUTION
During recording, if large artifact appears on the ECG waveform,
immediately stop the recording and remove the cause of the artifact.
Refer to “Troubleshooting” in Section 8. Failure to follow this
instruction causes overheating and damage to the
electrocardiograph.
Automatic recording:
i) Enter the patient information for ECG analysis.
ii) Press the START/STOP key or F3 function key (review recording).
When “After analysis result recording” on File Processing of the Main Setup
screen is set to “Save”, after automatic recording, the analysis result and
patient information are automatically saved as an ECG data file in a media.
Manual recording:
i) Press the START/STOP key.
ii) Press the function key to select the next lead group.
iii) Repeat step ii) to record all lead groups.
iv) Press the START/STOP key to stop recording.
Rhythm recording:
Press the RHYTHM key. When one minute of ECG waveforms are acquired,
rhythm lead recording starts automatically.
NOTE
If low amplitude QRS wave is displayed on the screen and the QRS sync
mark does not blink, the electrocardiograph does not analyze the ECG
waveform. The “CANNOT ANALYZE ECG” message is printed on the
ECG analysis result.
ECG Analysis
The electrocardiograph acquires 12 lead ECG waveforms simultaneously and
analyzes the 10 to 24 seconds of ECG waveforms. The selected leads and
interval of the waveforms are printed on the paper.
2. Press “1” to select “Resting ECG”. The Resting ECG recording screen is
displayed.
Electrode status
display area
Displays the error
message for electrode
detachment and
noise.
CAL mark
The height corresponds
to 1 mV waveform
amplitude.
Electrode status
display area
Displays the error
message for electrode
detachment and
noise.
CAL mark
The height corresponds
to 1 mV waveform
amplitude.
Automatic Recording
General
The electrocardiograph automatically records the ECG waveforms and
calibration waveforms by switching the lead groups in the settings selected in the
Setup mode when the START/STOP key is pressed.
5
There are two recording modes:
When “Auto start” is set to “On” on the Auto Recording of the System Setup
screen and auto-start conditions are satisfied, real time recording automatically
starts.
Review Recording
When the Resting ECG mode is selected, the electrocardiograph checks for
electrode detachment. When 2 seconds pass with no electrode detachment, the
electrocardiograph starts acquiring and saving the ECG waveforms. So you
can check the acquired ECG waveforms before recording starts. When the
F3 function key is pressed, the electrocardiograph starts recording the saved
waveforms from 10 seconds before the F3 function key is pressed.
During recording, if any ECG waveforms exceed the maximum recording width,
the waveform amplitude is automatically reduced to 1/2 (up to 1/8) and the
waveforms are repositioned so that the entire waveforms can be recorded on the
recording paper. The auto gain waveform amplitude is based on the sensitivity
setting before recording.
To print out the current settings, refer to “Printing the List of System Setup and
Main Setup Settings” in Section 3.
System Setup
Wave Settings
Baseline drift suppression (Strong, Weak, Off)
Baseline drift suppression prevents the baseline from drifting by locking it into
one position at the start of recording.
CAUTION
When baseline drift suppression is set to “Strong”, distortion may
occur in the ST segment with a decrease of heart rate when heart
rate is less than 50. For bradycardia, set this item to “Weak”. The
“Weak” setting has characteristics conforming to the AHA
recommendations.
Recording Settings
Auto Recording
Auto start (On, Off)
When “Auto start” is set to “On”, the real time recording is automatically
started according to the format set on “12 lead recording channels” when all the
following conditions are satisfied:
• Automatic recording is not started.
• No electrode detachment is detected for two seconds or more.
• Five or more QRS waves are detected.
• Artifact and high frequency noise are not detected.
• The lead group is periodically switched.
NOTE
After recording, this function is available only when the electrodes are
reattached to the same patient or attaching the electrodes for the next
patient.
Main Setup
Wave Settings
• High cut filter (75 Hz, 100 Hz, 150 Hz)
This is active only when the EMG filter is turned off.
• EMG suppression frequency (25 Hz, 35 Hz)
EMG filter frequency.
• Lead mode selection (Standard 12 leads, Cabrera leads)
Standard 12 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
Cabrera leads: aVL, I, –aVR, II, aVF, III, V1, V2, V3, V4, V5, V6
CAUTION
Take care when judging the ECG recording because the EMG filter
may cause distortion of P-waves and QRS-waves depending on the
waveform shape.
File Processing
• After analysis result recording (Save, Off)
Set whether to save the ECG files after analysis result recording. When you
select “Save”, the ECG files are automatically saved in an SD memory card.
• Media (SD card, Internal memory)
Select the media to save the ECG data files.
Recording Settings
Recorder 5
High speed printing (On (50 mm/s), Off (25 mm/s))
Applies to analysis result printing.
Auto Recording
• Auto gain output
(Auto gain + setting gain, Auto gain, Setting gain + auto gain, Setting gain)
Select the auto gain and auto position control function. When “Auto gain +
setting gain” or “Setting gain” is selected, the sensitivity can be changed by
pressing the 10 mm/mV function key.
10 mm/mV 5 mm/mV 20 mm/mV
• Extended recording
On: rhythm (full page): When an arrhythmia is detected during automatic
recording, the rhythm recording starts after
automatic recording ends. The format is set in
“Rhythm Recording” in “Recording Settings” in the
Main Setup screen.
On: sequence (full page): When fluctuation of 20% of R-R interval is detected
during automatic recording, the recording of the lead
group is extended. The extend recording time is set
in the “Time” setting.
Off: Not recorded.
CAUTION
• When “Auto start” is set to “On”, select the patient age group
and sex before attaching the electrodes to the patient. After the
electrodes are attached and the ECG waveform is stable, the
recording automatically starts and the default settings of the
patient age group and sex are used for ECG analysis. For ECG
analysis details, refer to the User’s Guide “ECAPS 12C ECG
Interpretation Program”.
• When the “Do not turn the power off” message appears during
saving the ECG data file, do not turn the power off. Otherwise, the
data will be lost.
• When “After analysis result recording” on the File Processing of
the Main Setup screen is set to “Save”, check the remaining file
capacity and delete unnecessary files before starting recording.
CAUTION
When the patient sex and age is not entered, ECG analysis is
performed with the patient as male and 35 years old.
2. Check that the AUTO/MANUAL lamp is lit. If it is not lit, press the AUTO/
MANUAL key.
4. If necessary, press the FILTER key to turn the EMG filter on.
5. Select the real time or review recording mode by pressing the START/
or STOP key (real time recording) or F3 function key (review recording).
The electrocardiograph automatically records the ECG waveforms with
switching the lead groups.
Auto Start
When “Auto start” is set to “On” and all the following conditions are
satisfied, the real time recording is automatically started.
• Automatic recording is not started
• No electrode detachment is detected for two seconds or more
• Five or more QRS waves are detected
• Artifact and high frequency noise are not detected
• The lead group is periodically switched
5
You can manually extend a lead group recording by pressing the AUTO/
MANUAL key. This is not available for the review recording. During
extended recording, the AUTO/MANUAL lamp blinks. To change to the
next lead group, press the AUTO/MANUAL key again. After the lead group
which includes lead V6 is recorded, the electrocardiograph automatically
stops recording and the ECG analysis result is printed (unless “Report print
out” is set to Off on the System Setting screen).
When recording the ECG waveforms of another patient without changing the ID,
the same ID confirmation message appears.
To record the waveforms with the same ID, press the Start function key.
Extended Recording
The electrocardiograph automatically extends the recording when “Extended
recording” on the Auto Recording of the Main Setup screen is set to “On:
sequence (full page)” or “On: rhythm (full page)” in automatic recording.
When “After analysis result recording” on the File Processing of the Main
Setup screen is set to “Off”, “File” is displayed in the message and key function
display area. Press the File function key to select the file operation.
To save the ECG data file, press the Save function key.
When the selected media (internal memory or SD memory card) becomes full
during saving, the “Media is full” message appears. Select another media and
save the files again. When the “File auto delete” is set to “On” on the Main Setup
screen, the oldest files are automatically deleted and the new files are saved.
The automatic and rhythm recording result can be printed. The word “COPY” is
also printed at the top of the recording paper to distinguish it from automatic and
rhythm recording results.
If the FILTER key setting is changed, the changed setting applies to the printing.
When the FILTER lamp lights, EMG filter is applied. When it is off, the high cut
filter is applied.
When “Auto gain output” is set to “Auto gain + setting gain” in the Auto
Recording, the auto gain is applied. When it is set to “Setting gain + auto gain”,
the setting gain is applied to the printing.
Manual Recording
General
You can manually record the ECG waveforms. During recording you can
annotate the ECG waveforms when there is a change in patient condition such
as chest pain or artifact. In manual recording mode, the baseline is automatically
adjusted every time recording is started and the lead group or sensitivity can be
changed. ECG analysis is not available in manual recording mode.
To print the current settings, refer to “Printing the List of System Setup and Main
Setup Settings” in Section 3.
System Setup
Wave Settings
Baseline drift suppression (Strong, Weak, Off)
Baseline drift suppression prevents the baseline from drifting by locking it into
one position at the start of recording.
CAUTION
When baseline drift suppression is set to “Strong”, distortion may
occur in the ST segment with a decrease of heart rate when heart
rate is less than 50. For bradycardia, set this item to “Weak”. The
“Weak” setting has characteristics conforming to the AHA
recommendations.
Main Setup
Wave Settings
• High cut filter (75 Hz, 100 Hz, 150 Hz)
This is active only when the EMG filter is turned off.
• EMG suppression frequency (25 Hz, 35 Hz)
EMG filter frequency.
CAUTION
Take care when judging the ECG recording because the EMG filter
may cause distortion of P-waves and QRS-waves depending on the
waveform shape.
Recording Settings
Manual Recording
• 12 lead recording channels (3 ch, 1 ch, 1 ch + rhythm)
The number of recording channels for the manual recording.
2. Press the AUTO/MANUAL key to select the manual recording mode. The
AUTO/MANUAL lamp is lit when auto recording mode is selected.
or,
Enter the number “4 (<)” or “5 (>)” with the keyboard on the operation
panel.
12 lead/Cabrera lead 3 ch
or,
or,
Press the “25 mm/s” or “50 mm/s” function key with the keyboard on the
operation panel to change the paper speed.
25 mm/s 50 mm/s
7. When all lead groups are recorded, press the START/STOP key to stop
recording.
Rhythm Recording
General
Before or after automatic or manual ECG recording, you can perform rhythm
recording. The settings are set on the Rhythm Recording of the Recording
Settings in the Main Setup screen.
5
After recording, you can make one or more copies of the recording results by
pressing the COPY/CAL key.
NOTE
To stop rhythm recording, press the Cancel function key.
Recording Examples
Measurement value
General................................................................................................................................................................. 6.2
Preparation for Periodic ECG Recording.............................................................................................................. 6.3
Starting Periodic Recording.................................................................................................................................. 6.4
Recording Examples............................................................................................................................................ 6.5 6
General
To print the current settings, refer to “Printing the List of System Setup and Main
Setup Settings” in Section 3.
System Setup 6
Periodic Recording Settings
• Starting leads (Limb, Chest)
Select the starting lead group.
Main Setup
Recording Settings
Manual Recording
12 lead recording channels (3 ch, 1 ch, 1 ch + rhythm)
3 ch: II, aVF, V5
1 ch: II
4. To turn off periodic recording, press the MODE key to display the Main
Menu screen.
Recording Examples
General................................................................................................................................................................. 7.2
Displaying the Data Management Screen............................................................................................................ 7.3
Printing ECG Waveforms in a Media.................................................................................................................... 7.4
Editing ID.............................................................................................................................................................. 7.6
Deleting ECG Data Files...................................................................................................................................... 7.9
Displaying the Delete Screen..................................................................................................................... 7.9 7
Deleting All ECG Data Files....................................................................................................................... 7.9
Deleting ECG Data Files of the Selected ID............................................................................................. 7.11
Deleting ECG Data Files of the Selected Date......................................................................................... 7.13
Formatting the Media.......................................................................................................................................... 7.16
Printing File List.................................................................................................................................................. 7.18
Copying Files in the Internal Memory to an SD Card......................................................................................... 7.20
General
In automatic recording mode, the ECG waveforms, analysis result and patient
information can be saved as an ECG data file in a media.
On the Data Management screen, you can do any of the following operations.
• Print the ECG waveforms in a media
• Change the ID of the selected file
• Delete ECG data files in a media
• Format media
• Print the ECG data file list of the selected date in a media
• Copy the ECG data files in the internal memory to the SD memory card
To process an ECG data file, select “Media” in “File Processing” in the Main
Setup screen. The selected media is displayed in the header of the screen.
There are two types of data save format, type 1 (normal) and type 2
(compressed). The type can be set in “Data compression type” in “File
Processing” in the User Setup screen.
• When the internal memory is selected, up to 40 ECG data files can be saved
regardless of the data compression type.
• When the SD memory card is selected, up to 780 (type 1) or 3000 (type 2) files
can be saved.
CAUTION
• Format the SD memory card before the first use.
• Format the SD memory card only in an ECG-1150
electrocardiograph. SD memory cards formatted in other ECG
models cannot be used in this electrocardiograph.
The number of ECG data files which are saved in the media is displayed
at the upper right of the screen. The remaining free space in the media is
displayed at the lower right of the screen.
The number of ECG data
files in the media
Media
To select the desired item, press the number of the item with the keyboard on
the operation panel. The screen of the selected item is displayed.
To close the Data Management screen, press the MODE key. The Main
Menu screen appears.
2. Display the Data Management screen. Refer to the “Displaying the Data
Management Screen”on the previous page.
3. Press “1” to select “Print”. The “Press Enter to enter ID. Press Search to
search files for ID” message appears.
4. Press the Enter function key. The “Enter the ID” message appears.
5. Enter the ID with the following keys and press the START/STOP (enter) key.
The ID is set and the “Press Enter to enter ID. Press Search to search files for
ID.” message appears.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
6. Press the Search function key. The file list of the entered ID appears.
7. Select the file and press the Print function key. The ECG data of the selected
file is printed.
Editing ID
2. Press “2” to select “Edit ID”. The “Press Enter to enter ID. Press Search to
search files for ID” message appears.
3. Press the Enter function key. The “Enter the ID” message appears.
4. Enter the ID with the following keys and press the START/STOP (enter) key.
The ID is set and the “Press Enter to enter ID. Press Search to search files for
ID.” message appears.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
5. Press the Search function key. The file list of the entered ID appears.
6. Select the file and press the Edit function key. The “Change the ID” message
appears.
7. Press the Enter function key. The “Enter the ID” message appears.
8. Enter the new ID with the keys on the operation panel and press the START/
STOP (enter) key. The new ID is set and the “Edit complete” message
appears.
9. Press the OK function key The previous file list without the changed ID data
appears.
NOTE
Back up the ECG data files before deleting the ECG data files.
You can delete all ECG data files, ECG data files of the selected date or ECG
data files of the selected ID in the media.
2. Press “3” to select “Delete”. The Data Management - Delete screen appears.
To return to the Data Management screen, press the Back function key.
2. Press “1” to select “All files”. The “Delete all files?” message appears.
3. Press the OK function key. The “Deleting ECG file. Do not turn the power
off” message appears.
To cancel deleting, while deleting the ECG data files, press the Cancel
function key. After the current ECG data file is deleted, the deleting of the
remaining files is canceled. The “Canceled” message and the number of
deleted files appears. Press the OK function key. The Data Management
screen appears.
4. When all files are deleted, the “All files deleted” message appears. Press the
OK function key. The Data Management screen appears.
2. Press “2” to select “Selected ID”. The “Press Enter to enter ID. Press Search
to search files for ID” message appears.
3. Press Enter function key. The “Enter the ID” message appears.
4. Enter the ID with the following keys and press the START/STOP (enter) key.
The ID is set and the “Press Enter to enter ID. Press Search to search files for
ID.” message appears again.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
5. Press Search function key. The file list of the selected ID is displayed.
6. Select the file and press the Delete function key. The “Delete the selected
data?” message appears.
8. When the selected files are deleted, the “Files delete” message appears. Press
the OK function key. The Data management screen appears.
2. Press “3” to select “Selected date”. The “Press Enter to enter Date. Press
Delete to delete files” message appears.
3. Press the Enter function key. The “Enter the date. Files will be deleted”
message appears.
4. Enter the ID with the following keys and press the OK function key. The
files of the selected date are deleted.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
5. When the selected files are deleted, the “Files deleted” message appears.
Press the OK function key. The Data management screen appears.
CAUTION CAUTION
Only use a Nihon Kohden specified SD memory • Format the SD memory card before the first
card. Otherwise, the card might not operate. use.
• Format the SD memory card only in an ECG-
1150 electrocardiograph. SD memory cards
formatted in other ECG models cannot be used
in this electrocardiograph.
NOTE
Formatting deletes all data in the media. Back up the necessary data
before formatting.
1. Insert the SD memory card into SD card slot on the rear panel of the
electrocardiograph.
To cancel formatting, press the Cancel function key. The Data Management
screen appears.
4. Press the OK function key. The “Formatting. Do not turn the power off”
message appears.
NOTE
Do not turn the electrocardiograph power off while displaying the
Data Management - Format screen and do not give an impact to the
electrocardiograph.
You can print a list of the ECG data that are saved in the media. The list includes
measurement date, ID, gender, age and measurement mode.
2. Press “5” to select “Print file list”. The “Enter the date” message appears.
3. Press the Enter function key. The cursor appears on the date.
4. Enter the date with the following keys and press the OK function key. The
date is set.
FEED/MARK
2 F2 function key 8
key
5 RHYTHM key
AUTO/ START/STOP
Clear Enter
MANUAL key key
5. Press the Print function key. The file list of the selected date is printed.
You can copy the ECG data files saved in the internal memory to the SD card.
2. Press “6” to select “Copy int memory > SD”. The “Copy internal memory
files to the SD card?” message appears.
3. Press the OK function key. The “Copying ECG file. Do not turn the power
off” message appears.
To cancel while copying files, press the Cancel function key. The “Canceled”
message and the number of copied files appears. Press the OK function key.
The Data management screen appears.
4. When all files are copied, the “All files copied” message appears. Press the
OK function key. The Data Management screen appears.
AC Interference
Appears on the ECG as even-peaked, regular voltages superimposed throughout
the tracing. It may appear in conjunction with muscle tremor.
Causes:
• Dirty or corroded lead wire tips or electrodes
• Loose electrode connection
• Patient or technician touching an electrode during recording
• Patient touching any metal part of a bed or examination table
• Broken lead wire, patient cable or power cord
• Electrical devices in the immediate area, lighting, concealed wiring in walls or
floors
• Improperly grounded electrical outlet
Causes:
• Patient is uncomfortable, tense, nervous or apprehensive
• Patient is cold and shivering
• Patient has a neurological or muscular disorder (e.g. Parkinson’s Disease)
• Examination table or bed is too narrow or short to support limbs comfortably
Wandering Baseline
Appears on the ECG as a fluctuation of the tracing up and downward on the grid.
Causes:
• Dirty or corroded electrodes
• Loose electrodes or electrodes positioned on a bony area
• Insufficient or dried out cardioCream
8
• Oily skin or body lotions and creams
• Rising and falling of chest during normal or apprehensive respiration
Abnormal Printout
During ECG recording, loose or poor electrode contact causes waveform
saturation, excessive AC interference, etc. In this case, the electrocardiograph
stops printing to protect the thermal head.
Other
When an electrosurgical unit (ESU) is used with the electrocardiograph, noise
generated by an ESU is superimposed on the ECG waveforms.
Equipment in the same room as the electrocardiograph may generate noise on the
ECG waveforms.
• Noise from an electrosurgical unit
• Noise from the AC power line
• Spike noise caused by electrostatic energy as shown below. The ECG may
interpret the noise spike as a QRS or pacemaker spike.
NOTE
The baseline becomes flat for a while after defibrillation to protect the
electrocardiograph.
Troubleshooting
When trouble occurs, take quick action referring to the table below. If there is
any damage or the electrocardiograph is suspected to be faulty as a result of
checking, turn the power off, attach an “Unusable” or “Repair request” label to
the electrocardiograph and contact your Nihon Kohden representative.
Trouble Action
When the POWER key is pressed, the Check that the power cord is firmly connected to the
electrocardiograph does not operate on AC electrocardiograph and AC socket.
power (the POWER lamp is not lit).
When the POWER key is pressed, the 1. Check that the battery is inserted in the electrocardiograph correctly.
electrocardiograph does not operate on 2. Check the battery. If it is almost discharged, operate the
battery power (the POWER lamp and electrocardiograph on AC power or recharge the battery. If the 8
battery operation lamp are not lit). remaining battery operation time is less than 15 minutes, replace it
with a new one.
Nothing can be printed. 1. Check that the recording paper is set correctly. If the “Check paper
and recorder” message appears and notification sounds, there is no
recording paper. Correctly set the recording paper.
2. Check that the recorder cover is firmly closed.
3. If the START/STOP lamp is not lit, press and hold down the
START/STOP key until the lamp is lit.
4. If “Report print out” is set to Off in the system settings, set it to On.
Refer to “Recording Settings” in Section 3.
During battery operation, the power is 1. Check the battery. If it is almost discharged, operate the
turned off during recording. electrocardiograph on AC power or recharge the battery. If the
remaining battery operation time is less than 15 minutes, replace it
with a new one.
2. Check that the battery is inserted in the electrocardiograph correctly.
3. If the battery has been used more than one year, replace it with a
new one.
The power is turned off during recording Check the internal memory with “Memory Test” in the System Test. If
on either AC or battery operation. the memory is faulty, contact your Nihon Kohden representative. If the
memory is not faulty, power loss might be caused by static electricity.
Keep the electrocardiograph away from materials which generate
electrostatic discharge such as curtains.
The screen turns black when operating on When “Backlight auto off” is set to On in the system settings, the LCD
AC power. screen automatically turns off to save power. Press any key to turn the
screen on again.
The power is turned off when operating on The power is automatically turned off when the “Fail” message
battery power. (electrode detachment) is displayed on the screen and there is no key
operation for approximately three minutes to save the battery power.
Press the POWER key to resume operation. Refer to “Automatic power
off” in “AC and Battery Operation” of Section 1.
Trouble Action
No ECG waveform can be recorded even 1. Check the continuity of the patient cable with “Electrode Input Test”
when the electrodes are attached to the in the System Test.
patient correctly. 2. Check that the electrodes are clean. If an electrode is contaminated
with electrolyte cream (cardioCream), the ECG waveform cannot
be recorded due to high skin-electrode contact impedance. Wash the
electrode to remove dirt or contamination.
3. If a new and old electrode, or a reusable and disposable electrode
are used together, the ECG waveform cannot be recorded due to
high polarization voltage. Do not use different types or ages of
electrodes together.
4. Check if the skin is cleaned and apply electrolyte cream
(cardioCream) before attaching the electrodes.
5. If a disposable electrode is used more than once, the ECG waveform
cannot be recorded due to polarization voltage. Only use new
electrodes.
Cannot record all electrodes. Select the first lead group by pressing the function key.
Analysis result recording cannot be 1. If the recording time is less than 10 seconds, the electrocardiograph
performed. does not analyze the acquired ECG waveform. Record the ECG
waveform at least 10 seconds.
2. When the printed heart rate is “***”, the electrocardiograph did not
detect the QRS waves because the amplitude of lead II, V1 and V5
are too small. Always check that the heart rate correctly appears on
the screen before pressing the START/STOP key.
Recording result is partially missing or When the thermal head is touched with a dirty hand, or comes in
faint. contact with cardioCream or physiological saline solution, this causes
missing dots on the recording or reduces recording intensity. Clean the
thermal head with the thermal head cleaner. Take care not to touch the
thermal head with a dirty hand when setting the recording paper.
The electrocardiograph does not print Excessive noise during printing causes the electrocardiograph does not
anything or recording result is faint. print anything or faint printing to protect the thermal head. Check that
noise is not superimposed on the waveform on the screen and restart
printing.
Paper skews as it feeds. 1. Check if the specified recording paper is used.
2. Set the recording paper straight by aligning it with the paper guide.
3. When the thermal head is dirty, the recording paper may skew.
Clean the thermal head with the thermal head cleaner.
Paper gets jammed in the recorder. Set the recording paper as specified in “Setting the Recording Paper” in
Section 2.
The screen is not bright and the waveform Adjust the screen brightness. Refer to “Adjusting the Screen
cannot be read. Brightness” in Section 2.
The date and time is not correct. 1. Set the correct time in the system settings. Refer to “Changing the
Date and Time” in Section 3.
2. Replace the built-in lithium battery. The lifetime of the battery is
about 6 years.
Keys on the operation panel do not work. 1. Press the POWER key for more than 7 seconds to shut down the
electrocardiograph. If the cause of the trouble is freezing of the
software by static electricity, the electrocardiograph turns off.
2. Press the POWER key for one second to turn the power on. If error
information prints out, contact your Nihon Kohden representative.
The power is not turned off by pressing the Press the POWER key for more than 7 seconds to shut down the
POWER key. electrocardiograph. If the cause of the trouble is freezing of the
software by static electricity, the electrocardiograph turns off. If you
cannot restart the electrocardiograph, attach an “Unusable” or “Repair
request” label to the electrocardiograph and contact your Nihon
Kohden representative.
Press the POWER key for one second to turn the power off. If
the electrocardiograph is not turned off, there is a failure in the
electrocardiograph. Attach an “Unusable” or “Repair request” label to
the electrocardiograph and contact your Nihon Kohden representative.
Error Messages
When an error message is displayed on the screen, take quick action referring to
the table below.
The software version is printed at the bottom of the paper in automatic or manual
ECG recording.
8
Model System software ECG analysis
After use, check the following items for the next use.
Overview:
• Electrocardiograph is not dirty, damaged or in contact with liquid
• No peeling or tear in the operation panel
• No key or button is broken
• Electrodes are clean and not damaged
• Power cord is not damaged
• Cable hanger is not damaged
• Recorder is not damaged
Accessories:
• Enough electrolyte cream
• Enough recording paper
• Enough disinfected or sterilized dry electrodes
• Patient cable is not frayed or damaged
• Electrode lead is not damaged
• No crack in the rubber of suction electrodes
Storage:
• Electrodes are washed
• The battery is fully recharged
• The thermal head is clean
• The sensor is clean
• The power is turned off
• No chemicals or water are near the electrocardiograph
• Acceptable storage temperature and humidity
CAUTION
Do not use volatile liquids such as thinner or benzine, because these
will cause the materials to melt or crack.
CAUTION
Before maintenance, cleaning or disinfection, turn the
electrocardiograph power off and disconnect the power cord from the
AC socket. Failure to follow this instruction may result in electrical
shock and electrocardiograph malfunction.
9
CAUTION
• After cleaning, make sure that the electrocardiograph is completely
dried.
• Never sterilize the electrocardiograph because the materials may
deform, crack or discolor.
• The “CAUTION LABEL” contains important information for
operating the electrocardiograph. Clean the label if it is dirty. If the
label is damaged or difficult to read, contact your Nihon Kohden
representative to replace it with a new one.
Use a dry cloth when you wipe the connector of the electrocardiograph, input
box or operation panel. Otherwise, water gets inside the electrocardiograph and
causes malfunction.
CAUTION
• Do not use a rough cloth.
• Do not use acidic, alkaline detergents or alcohol other than ethanol
or isopropyl.
Clean the display using a dry soft cloth or a cloth which is moistened with
neutral soap and wrung out.
CAUTION
• Wipe the electrocardiograph thoroughly after disinfecting it with
spray.
• Do not sterilize or disinfect the electrocardiograph with ultraviolet
light or ozone.
• Do not use hypochlorous acid for disinfecting.
CAUTION
• Do not clean the thermal head right after recording because the
head is still hot.
• Only clean the head with the provided thermal head cleaner pen.
Otherwise the thermal head may be damaged.
To protect the thermal head from abrasion or damage and assure optimum
performance and long service life, clean the surface of the head with the
provided thermal head cleaning pen after every 10 sets of recording paper.
2. Push the paper magazine release button and open the paper magazine.
3. Clean the gray colored part of the thermal head with the thermal head
cleaner pen.
Cleaning
CAUTION
Do not immerse the connector in liquid.
CAUTION
Do not use volatile liquids such as thinner or benzine, because these
will cause the materials to melt or crack.
Clean the patient cable using a soft cloth or a cloth moistened with neutral soap
or water and wipe with a dry cloth. Make sure that the patient cable is completely
dried after cleaning.
If you leave electrolyte cream (cardioCream) on the patient cable surface and
leave the tip wet, it may cause inaccurate ECG recording due to high skin
electrode contact impedance.
Disinfecting
CAUTION
• Do not use hypochlorous acid for disinfecting.
• Wipe the patient cable thoroughly after disinfecting it with spray.
To disinfect the electrode, wipe it with a soft cloth moistened with any of the
disinfectants listed below. Use the recommended concentration.
Cleaning
CAUTION
Do not use volatile liquids such as thinner or benzine, because these
will cause the materials to melt or crack.
Wipe the electrode using a gauze moistened with below 35°C (95°F) warm water
and neutral soap or invert soap or, cotton moistened with alcohol. Make sure that
the electrode is completely dried after cleaning.
Disinfecting
CAUTION
Do not sterilize electrodes by boiling. It may damage the electrode.
To disinfect the electrode, wipe it with a soft cloth moistened with any of the
disinfectants listed below. Use the recommended concentration.
Regular Check
Overview:
• Electrocardiograph is not dirty, damaged or rusty
• Electrocardiograph and cart are not broken or rattling
• Recorder cover release button is not broken
Input circuit:
• Electrode lead is not cut or broken
• Sensitivity and time constant are correct
• AC filter and high-cut filter operate correctly
• Patient cable is not dirty or damaged
• Patient cable is not broken
Screen:
• Contrast and backlight brightness are correct
• Battery charge lamp operates correctly
• Waveform display and other screen display are correct
Recorder:
• Specified recording paper is used
• Paper feed properly
• No missing dots on printing
• Paper empty sensor operates correctly
Power:
• Power cord is not broken
• Supplied voltage is correct
Operation:
• Electrocardiograph passes all check items in the System Test screen
• QRS synchronization sound and notification sound are correct
• System settings are correct and are saved correctly
• Date and time are correct
Safety:
• No current leakage
Clock Accuracy
Periodically check that the date and time on the printing result is correct.
To change the time setting, refer to “Changing the Date and Time” in Section 3.
Periodic Replacement
For inspection and replacement of the above parts, consult your Nihon Kohden
representative.
Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to
maintain the performance of the instrument) for a period of 8 years from the
date of delivery. In that period NKC or its authorized agents will repair the
instrument. This period may be shorter than 8 years if the board or part necessary
for the faulty section is not available.
This section provides brief explanations of each test or function and explains
how to display the System Test screen. For details, refer to the Service Manual.
• Electrode Input Test: This is used to check if the input analog signal
processing circuit detects the lead off condition
correctly using the input check jig. If a lead is
not connected, the “Error” message is displayed
on the screen.
• ECG Input Circuit Test: In this test, the input analog signal processing
circuit generates 1 mV rectangular waveforms
that are printed.
• Initialize System Settings: This resets all system settings to the factory
default settings.
• Display Internal Information: This displays the internal temperature and power
voltage of the electrocardiograph.
• Display Model Information: This displays the model name, software version
and analysis version of the electrocardiograph.
2. Press the POWER key while pressing the FEED/MARK key. The System
Test screen is displayed.
4. Press the Test function key or START/STOP key to execute the item.
5. Press the Cancel function key or START/STOP key to finish the item.
Specifications..................................................................................................................................................... 10.2
ECG Input...................................................................................................................................... 10.2
Waveform Data Processor............................................................................................................. 10.2
Recorder........................................................................................................................................ 10.2
Power Requirement........................................................................................................................ 10.2
Color LCD (with backlight)............................................................................................................. 10.3
Environment................................................................................................................................... 10.3
Performance................................................................................................................................... 10.3
Dimensions and Weight................................................................................................................. 10.3
Safety Standard............................................................................................................................. 10.3
Electromagnetic Compatibility........................................................................................................ 10.4
10
Electromagnetic Emissions............................................................................................................ 10.4
Electromagnetic Immunity.............................................................................................................. 10.5
Recommended Separation Distances between Portable and Mobile RF Communications
Equipment...................................................................................................................................... 10.7
System Composition for EMC Test................................................................................................. 10.7
General Requirements for Connecting Medical Electrical Systems................................................................... 10.8
Standard Accessories...................................................................................................................................... 10.10
Options and Consumables............................................................................................................................... 10.11
Optional Accessory Kit........................................................................................................................... 10.11
Options for the Electrocardiograph......................................................................................................... 10.12
Character Code List.......................................................................................................................................... 10.13
How to Read the Character Code List.................................................................................................... 10.13
Specifications
ECG Input
Input impedance: ≥ 50 MΩ
Electrode offset tolerance: ≥ ±550 mV
Defibrillation-proof: Isolated and defibrillator protected only when the following specified patient
cable is connected
Patient cable: BJ-901D, BJ-902D, BJ-903D, BA-901D, BA-903D, BJ-961D
Recovery time: ≤ 10 s (IEC 60601-2-25: 1993 51.102 compatible)
Common mode rejection ratio: ≤ –110 dB
Patient leakage current: ≤ 5 × 10-8 A
Standard sensitivity: 10 mm/mV ±5%
Internal noise: ≤ 20 µVp-v
Interference between channels: ≤ –40 dB
Frequency response: 150 Hz (≥ 71%, high-cut filter: 150 Hz)
Sample rate: 8000 sample/s
Recorder
Recording speed accuracy: ≤ ±5%
Printing density: 200 dpi (8 dots/mm), 320 dots/mm2 (25 mm/s)
Scanning line density: 1 ms
Number of recording channels: 1, 2, 3
Paper speed: 10, 25, 50 mm/s
Recording paper: 63 mm width, 30 m roll paper
Mechanical noise: ≤ 48 dB at paper speed 25 mm/s
Printed data: Program type, version, date and time, paper speed, sensitivity, lead name, filter,
Patient information (ID number, sex, age), event mark, electrode detachment, noise
Power Requirement
Line voltage: 100 to 240 V AC ±10%
Line frequency: 50, 60 Hz
Power input: 45 VA
Environment
Operating environment
Temperature: 5 to 40°C (41 to 104°F)
Humidity: 25 to 95% RH (noncondensing)
25 to 80% RH (recording paper)
Atmospheric pressure: 700 to 1060 hPa
Storage environment
Temperature: –20 to +65°C (–4 to +149°F) 10
–20 to +50°C (–4 to +122°F) (recording paper)
Humidity: 10 to 95% RH
10 to 90% RH (recording paper)
Atmospheric pressure: 700 to 1060 hPa
Other: Indoor portable
Performance
Performance standard: IEC 60601-2-51: 2003
Safety Standard
Safety standard: IEC 60601-1: 1988
IEC 60601-1 Amendment 1: 1991
IEC 60601-1 Amendment 2: 1995
IEC 60601-2-25: 1993
IEC 60601-2-25 Amendment 1: 1999
IEC 60601-1-2: 2001
Type of protection against electrical shock:
CLASS I EQUIPMENT (AC Powered)
Internally Powered EQUIPMENT (BATTERY Powered)
Degree of protection against electrical shock:
Defibrillator-proof type CF applied part when patient cable BJ-901D, BJ-902D,
BJ-903D, BA-901D, BA-903D or BJ-961D is used
Degree of protection against harmful ingress of water:
IPX0 (non-protected)
Degree of safety of application in the presence of FLAMMABLE ANAESTHETIC MIXTURE WITH AIR, OR WITH
OXYGEN OR NITROUS OXIDE: Equipment not suitable for use in the presence of FLAMMABLE
ANAESTHETIC MIXTURE WITH AIR, OR WITH OXYGEN OR NITROUS
OXIDE
Mode of operation: CONTINUOUS OPERATION
Electromagnetic Compatibility
IEC 60601-1-2: 2001
IEC 60601-1-2 Amendment 1: 2004
Electromagnetic Emissions
This Model ECG-1150 is intended for use in the electromagnetic environment specified below.
The customer or the user of the ECG-1150 should assure that it is used in such an environment.
Electromagnetic Immunity
This Model ECG-1150 is intended for use in the electromagnetic environment specified below.
The customer or the user of the ECG-1150 should assure that it is used in such an environment.
Electromagnetic environment
Immunity test IEC 60601 test level Compliance level
- guidance
Electrostatic discharge ±6 kV contact ±6 kV contact Floors should be wood, concrete or
(ESD) ±8 kV air ±8 kV air ceramic tile. If floors are covered with
IEC 61000-4-2 synthetic material, the relative humidity
should be at least 30%.*
Electrical fast ±2 kV for power supply ±2 kV for power supply Mains power quality should be that
transient/burst lines lines of a typical commercial or hospital
IEC 61000-4-4 ±1 kV for input/output ±1 kV for input/output environment.*
lines lines
Surge ±1 kV differential mode ±1 kV differential mode Mains power quality should be that
IEC 61000-4-5 ±2 kV common mode ±2 kV common mode of a typical commercial or hospital
environment.
Voltage dips, short <5% UT (>95% dip in UT) <5% UT (>95% dip in UT) Mains power quality should be that
interruptions and for 0.5 cycle for 0.5 cycle of a typical commercial or hospital
voltage variations on environment.
power supply input 40% UT (60% dip in UT) 40% UT (60% dip in UT) If the user of the ECG-1150 requires 10
lines for 5 cycles for 5 cycles continued operation during power
IEC 61000-4-11 mains interruptions, it is recommended
70% UT (30% dip in UT) 70% UT (30% dip in UT) that the ECG-1150 be powered from
for 25 cycles for 25 cycles an uninterruptible power supply or a
battery.
<5% UT (>95% dip in UT) <5% UT (>95% dip in UT)
for 5 s for 5 s
Power frequency 3 A/m 3 A/m Power frequency magnetic fields should
(50/60 Hz) be at levels characteristic of a typical
magnetic field location in a typical commercial or
IEC 61000-4-8 hospital environment.
NOTE 1: UT is the AC mains voltage prior to application of the test level.
NOTE 2: Electrostatic energy may generate spike noise which is superimposed on the ECG waveforms.
NOTE 3: Noise from AC power line may generate noise which is superimposed on the ECG waveforms.
* This electrocardiograph may show temporary degradation during exposure of ESD, fast transients and bursts. Within 10 s
the electrocardiograph shall resume normal operation in the previous operating mode, without loss of any system settings
or stored data, and shall continue to perform its intended function as described in this manual.
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.
* Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
1
radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy.
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be
considered. If the measured field strength in the location in which the ECG-1150 is used exceeds the applicable RF
compliance level above, the ECG-1150 should be observed to verify normal operation. If abnormal performance is
observed, additional measures may be necessary, such as re-orienting or relocating the ECG-1150.
*2 Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and 10
reflection from structures, objects and people.
When more than one electrical instrument is used, there may be electrical
potential difference between the instruments. Potential difference between
instruments may cause current to flow to the patient connected to the
instruments, resulting in electrical shock (micro shock). Therefore, electrical
instruments must be appropriately installed as specified in IEC 60601-1-1: 2000
Second edition.
KEY TO TABLE
• Additional protective earth: If necessary, provide additional protective
earthing, which is permanently connected (see also 58.201).
NOTE: Equipment modification may be required.
• Separating transformer: If necessary, limit the ENCLOSURE LEAKAGE
CURRENT, by using an additional separating transformer according to annex
EEE.
NOTE 1: No equipment modification is required.
NOTE 2: A separating transformer is a transformer with one or more input
winding(s) separated from the output winding(s) by at least basic insulation
[IEC 60989].
• SEPARATION DEVICE: If necessary, apply SEPARATION DEVICE.
• IEC 60601: MEDICAL ELECTRICAL EQUIPMENT in compliance with IEC
60601.
• IEC XXXXX: Non-medical equipment in compliance with relevant IEC safety
standards.
10
Standard Accessories
NOTE
• Only use Nihon Kohden specified parts and accessories to assure
maximum performance from your instrument.
• When ordering the following accessories/consumables, specify the
supply code. When the supply code is not provided with the accessory,
specify the model or code number.
1 2
Power cord
Type H 1 L935
Type N 1 L936
Enter the character code to enter the “Hospital” name on the System Settings of
the System Setup.
Search for the character in the list on the next two pages. Replace the * in the left
side number with the number (0 to 9) at the top of the column.
If you enter a character code for a blank area which does not have a character, an
unexpected character may be entered.
10