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PageWriter TC20 Cardiograph
INSTRUCTIONS FOR USE

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  • Page 1 PageWriter TC20 Cardiograph INSTRUCTIONS FOR USE...
  • Page 3 PageWriter TC20 Cardiographs NSTRUCTIONS FOR Edition 1 July 2011...
  • Page 4 Department. This document must law. Use of this product for be returned to Philips when the user purposes other than the express is no longer licensed and in any intended purpose provided by the event upon Philips’...
  • Page 5 .............xx PageWriter TC20 Cardiograph Instructions for Use...
  • Page 6: Table Of Contents

    ..........1-28 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 7 ..........2-1 Configuration with a Philips TraceMaster ECG Management System .
  • Page 8 ........... . 4-26 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 9 ..........A-11 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 10 ..............C-4 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 11 ........... C-8 PageWriter TC20 Cardiograph Class I (Internally Powered) .
  • Page 12 Table of Contents viii PageWriter TC20 Cardiograph Instructions for Use...
  • Page 13 Cardiograph About the Instructions for Use This PageWriter TC20 Cardiograph Instructions for Use is intended to assist users in the safe and effective use of the product. Before attempting to operate this product, read this Instructions for Use, and note and strictly observe all Warning and Cautions as described in this document.
  • Page 14: Safety Summary

    Safety Summary Symbols Marked on the Cardiograph Symbol Name Description Attention; read the Instructions See the PageWriter TC20 Cardiograph Instructions for Use for Use. Type CF ECG physio isolation is type CF, defibrillator proof. Defibrillator Proof Suitable for all patient applications including direct cardiac application.
  • Page 15 Interference may occur in the vicinity of equipment radiation marked with this symbol. Equipotential Grounding Post Equipotential grounding post used for establishing common ground between instruments. Fuse The PageWriter TC20 cardiograph contains a 1.6 amp (250V) time-delay fuse. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 16 This product consists of devices that may contain mercury, which must be recycled or disposed of in accordance with local, state, or federal laws. (Within this system, the backlight lamps in the monitor display contain mercury.) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 17 Optional Patient Cable Do not transport the cart with the patient cable arm positioned to the side. Only transport the cart with the patient cable arm positioned to the front of the cart. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 18 It is the responsibility of the operator to comply with IEC 60601-1-1 and test the medical system according to the requirements. For additional information contact Philips Medical Systems.
  • Page 19 Only use Philips Medical Systems replacement parts and supplies with the cardiograph. The use of non- CAUTION approved replacement parts and supplies with the cardiograph is strictly prohibited. Cardiograph safety and performance are not guaranteed when non-approved replacement parts and supplies are used with the cardiograph.
  • Page 20  insulation. Ensure that no exposed wires are visible on the AC power cord. Only use the Philips Medical Systems AC power cord supplied with the cardiograph. Use  of any other power supply has not been verified and may lead to operator or patient harm, including electrical shock.
  • Page 21  the Manufacturer's Disclosure Statement. ECG Interpretation Always enter accurate patient information (including age and gender) if using the Philips DXL ECG CAUTION Algorithm or Philips 12-Lead Algorithm for ECG interpretation. Before acquiring an ECG, ensure that the cardiograph screen does not show the DEMO MODE...
  • Page 22 Any combination of instruments should be evaluated by local safety personnel before being put into service. IEC 60601-2-51 For information on the standard IEC 60601-2-51, please go to the Philips InCenter web site ). For information on using the Philips InCenter site, see page 1-4. incenter.medical.philips.com...
  • Page 23 Periodically inspect the patient cable for any cracks or breaks in the cable insulation. If the  integrity of the patient cable is not assured, replace the patient cable. Contact Philips Medical Systems or your certified dealer for further assistance.
  • Page 24 Do not open any covers on the cardiograph. There are no internal cardiograph components that are serviced by the operator. The Philips Medical Systems warranty is applicable only if you use Philips Medical  Systems approved accessories and replacement parts. See “Supplies, Options, and Ordering Information”...
  • Page 25: Usb Memory Stick

    Do not use the USB memory stick to import ECGs onto the cardiograph that have been WARNING used with other cardiographs, or other non-Philips devices. Only use the USB memory stick that is available for purchase as an optional accessory from Philips CAUTIONS ...
  • Page 26 12-lead reports may include or exclude ECG measurements, reasons, or analysis statements. Intended Use The intended use of the Philips ECG Algorithm is to analyze multi-channel ECG signals from adult and pediatric patients with algorithms that provide measurements, data presentations, graphical presentations, and interpretations for review by the user.
  • Page 27: Getting Started

    Learning Kit describe all aspects of setting up, using, and maintaining your cardiograph. N O T E Read and complete the materials included in the PageWriter TC20 Cardiograph Learning Kit before using the cardiograph. Pay close attention to all warnings and cautions.
  • Page 28: Pagewriter Tc Cardiograph Learning Kit

    PageWriter TC Cardiograph Learning Kit PageWriter TC Cardiograph Learning Kit Philips provides detailed instructional and reference materials in the PageWriter Cardiograph Learning Kit. The PageWriter Cardiograph Learning Kit contains the Quick Help Guide, User Skills Checklists, and the PageWriter TC User Documentation DVD.
  • Page 29 Updates to this training program will be available on a periodic basis, and may be downloaded from the Philips InCenter site. For more information on accessing and using the Philips InCenter site, see “Using the Philips InCenter Site” on page 1-4.
  • Page 30: Philips Ecg Xml Information

    For more information on configuring your cardiograph for use with an external ECG management system, see the PageWriter TC Cardiograph Network Configuration Guide included on the PageWriter TC User Documentation DVD, or download the file from the Philips InCenter site.
  • Page 31: About Adobe Acrobat Versions

    InCenter site. PageWriter TC20 Cardiograph Components The following sections include a description of all of the components of the PageWriter TC20 cardiograph, including the connection ports on the cardiograph, the patient cable, and optional accessories available with the cardiograph.
  • Page 32: Tc20 Cardiograph

    PageWriter TC20 Cardiograph Components TC20 Cardiograph The following figures illustrate the front and back of the cardiograph. Figure 1-3 PageWriter TC20 Cardiograph (right front view) A Touch screen F Keyboard B Audio speakers G AC power on indicator light C Battery compartment...
  • Page 33 Hospital Only or Hospital Grade. Never adapt a grounded plug to fit an ungrounded outlet by removing the ground prong. Use the equipotential post when redundant earth ground is necessary according to IEC 60601-1-1. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 34: About The Patient Cable

    The patient cable is attached to the cardiograph through the patient data connector on the rear of the cardiograph. WARNING The Philips patient cable (supplied with cardiograph) is an integral part of the cardiograph safety features. Use of any other patient cable may lead to the distortion or corruption of patient ECG data, may compromise defibrillation protection and degrade cardiograph performance, and overall cardiograph safety may be seriously degraded.
  • Page 35 ) located on the rear panel of the cardiograph. Drape the patient cable over the top of the rear handle on the cart to help ensure that the patient cable does not drag on the ground. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 36: Working With The Battery

    Before plugging the cardiograph into AC power, insert the battery into the cardiograph. CAUTION Installing the Battery N O T E The TC20 cardiograph operates with a single battery, part number 989803170371. To install the battery: Open the battery door. 1-10 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 37 Insert the battery with the external connector facing the bottom rear of the compartment. Push in the battery and ensure that the battery is fully inserted into the slot. The gold pull tab will insert along with the battery. Reinstall the battery door. PageWriter TC20 Cardiograph Instructions for Use 1-11...
  • Page 38: Charging The Battery

    If battery calibration is necessary, the message appears on the Battery Status Recommend Calibration Information window. For more information on battery calibration, see “Battery Calibration” on page 5-10. 1-12 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 39: Battery Power Indicator

    The cardiograph beeps and an error message appears until  the unit is plugged into AC power (audio feature may be disabled). Double-tap the icon to see how many minutes are left of  operating battery power. No or Dead Battery PageWriter TC20 Cardiograph Instructions for Use 1-13...
  • Page 40: Using The Wireless Connection

    PageWriter TC Cardiograph Network Configuration Guide available on the PageWriter TC User Documentation DVD, or the file can be downloaded from the Philips InCenter site. Only use appropriate wireless LAN devices with the cardiograph that have been purchased from CAUTION Philips.
  • Page 41: Using The Usb Memory Stick

    The PageWriter TC cardiograph only supports the USB memory stick that is available for purchase as CAUTION an optional accessory from Philips. Philips does not guarantee that other USB memory sticks are compatible with the PageWriter TC cardiograph. Figure 1-8...
  • Page 42: Using The Barcode Reader

    Using the Cardiograph Touch Screen The touch screen provides access to all of the cardiograph features. Simply touch the buttons on the screen to open the different screens and to perform different functions. 1-16 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 43: Touch Screen Overview

    The Exam Type selected for the current patient Selected Exam Type  session. The available Exam Types are:  Resting 12-Lead Timed ECG Touch the button to change the selected Exam  Type. PageWriter TC20 Cardiograph Instructions for Use 1-17...
  • Page 44 The settings underneath this button include the Exam Layout  selected ECG report layout settings, and the level of interpretation generated by the Philips interpretive algorithm that are being applied to the selected Exam Type. Any of the settings on this screen may be ...
  • Page 45 Disclose  the number of Events currently stored in Disclose for the current patient session. , and buttons are used in 1-2-3 Operation sequence to acquire and print a standard 12-lead Features ECG. PageWriter TC20 Cardiograph Instructions for Use 1-19...
  • Page 46: Changing The Lead Format On The Main Ecg Screen

    3 total rows with 4 leads in each row. In this view, the limb and augmented leads are on the  left, and the precordial leads are on the right. See Figure 1-11 on page 1-21.  1-20 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 47 Changing the Lead Format on the Main ECG Screen Figure 1-10 Default 6x2 Lead Format on Main Screen A Limb Leads B Precordial Leads Figure 1-11 3x4 Lead Format on Main Screen PageWriter TC20 Cardiograph Instructions for Use 1-21...
  • Page 48: The Status Bar

     edited for the current patient session. The current selected filters (Artifact, Baseline Operating Settings  Wander), pacing detection setting, and report scaling settings. pacing setting is recommended Unknown  for most ECGs. 1-22 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 49 Gray bars indicate that the wireless adapter is  unable to associate to an access point. Displays the available battery power. For more Battery Power Indicator  information, see “Battery Power Indicator” on page 1-13. PageWriter TC20 Cardiograph Instructions for Use 1-23...
  • Page 50 Accuracy of this measurement beyond 240 bpm has not been verified.  Displays the date of birth, patient name, and Patient Date of Birth, patient ID number for the current patient session. Name, and ID Number 1-24 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 51: Working With Simulated Data

     restart, the cardiograph is in real-data acquisition mode. To return to simulation mode, you must re-enable it in the settings. For configuration details, see “Enabling and Disabling Simulation Mode” on page 2-7. PageWriter TC20 Cardiograph Instructions for Use 1-25...
  • Page 52: Supplies, Options, And Ordering Information

    “Using the Philips InCenter Site” on page 1-4. All supplies may be ordered on the web at: http://shop.medical.philips.com For additional assistance, contact your Philips Sales Representative or your local distributor. Ordering Options and Upgrades For more information on ordering any of the following cardiograph upgrades or options, contact your Philips Sales Representative or your local distributor.
  • Page 53: Accessories

    Pediatric Lead Extenders Welsh Bulbs Double-sided Tab Clips, compatible with both tab and snap electrodes Warranty Option Number Description 3 year return to Philips Bench 5 year parts and support by certified dealer PageWriter TC20 Cardiograph Instructions for Use 1-27...
  • Page 54: Product Troubleshooting

    For information on product troubleshooting, see the PageWriter TC Cardiograph Service Manual included on the PageWriter TC User Documentation DVD, or the file may be downloaded from the Philips InCenter site. For details, see “Using the Philips InCenter Site” on page 1-4.
  • Page 55 0180 5 47 5000 Greece 31 40 2781619 Hungary 31 40 2781619 Italy 0800 232100 Netherlands 31 40 27 211 27 Norway 47 800 84 080 Poland 31 40 2781619 Rumania 31 40 2781619 PageWriter TC20 Cardiograph Instructions for Use 1-29...
  • Page 56 81 (0)120 095 205 Korea 82 (0)2 3445 9010 Malaysia 1800 886 188 New Zealand 0800 251 400 Philippines 63 2 8162617 ext. 875 Singapore 1800 Philips Taiwan 0800 005 616 Thailand 66 (0)2 614 3569 1-30 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 57 Ordering Options and Upgrades Africa and Middle East Centers Country Telephone Number All countries 31 40 2781619 PageWriter TC20 Cardiograph Instructions for Use 1-31...
  • Page 58 Contacting a Philips Response Center 1-32 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 59: Chapter 2. Configuring Default Clinical Settings

    For information on configuring the wireless LAN option, see the PageWriter TC Wireless LAN Installation Instructions provided with the wireless adapter, or download the file from the Philips InCenter web site ( ). For information on using the Philips incenter.medical.philips.com InCenter web site, see page 1-4.
  • Page 60: Configuration With A Philips Tracemaster Ecg Management System

    ECG management system, see the PageWriter TC Cardiograph Network Configuration Guide (only available in English) included on the User Documentation and Training DVD, or download the file from the Philips InCenter web site ). For information on the Philips InCenter site, see page 1-4.
  • Page 61: Opening The Setup Screens

    Touch to configure password and power  save features. Includes Maintenance Tests that can be  used to troubleshoot or to optimize cardiograph performance. For more information, see Chapter 5, “Cardiograph Care and Maintenance.” PageWriter TC20 Cardiograph Instructions for Use...
  • Page 62 Cardiograph Service Manual (only available in English). Touch to access software updates and to Upgrade Kit Installation  add options. and Software Updates See the PageWriter TC Cardiograph  Service Manual (only available in English PageWriter TC20 Cardiograph Instructions for Use...
  • Page 63: Using Setup Help

    Information box on the screen (see Figure 2-2 on page 2-5). Touch the button when done. Close Figure 2-2 Help displayed on a Setup screen A Setup Help window PageWriter TC20 Cardiograph Instructions for Use...
  • Page 64: Configuring 12-lead Exam Settings

    (bottom right of screen) to continue. AAMI Next On the following screen, select a report format to specify for this Exam. Select the Rhythm leads for the selected report format (if necessary). Touch the button to continue. Next PageWriter TC20 Cardiograph Instructions for Use...
  • Page 65: Enabling And Disabling Simulation Mode

    ECG data shown on the report is captured simultaneously, or time sequentially. On the right side of the screen, select an interpretation level for the Philips 12-lead or DXL ECG algorithm. Touch the button to continue.
  • Page 66 Enabling and Disabling Simulation Mode To disable Simulation mode Restart the cardiograph.  The cardiograph automatically restarts in real-time acquisition mode after a restart (after initially enabling the option). PageWriter TC20 Cardiograph Instructions for Use...
  • Page 67: Chapter 3. The Patient Session

    A patient session begins by entering accurate patient information. Patient information is then linked with all waveform data acquired during the patient session. Entering accurate patient information (age, gender) is highly recommended if using the Philips 12- CAUTION ...
  • Page 68 “Checking Signal Quality” on page 3-16. cardiograph, color-coded ECG waveforms appear on the Main screen. Check the signal quality. Touch the Map button on the cardiograph to “Leads Map” on page 3-18. verify electrode and lead connections. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 69 “Using the Last ECG Feature on the  patient using the optional feature Preview Screen” on page 3-27. Last ECG (requires an active TraceMaster connection) “Critical Values on Preview Screen” on  page 3-29. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 70: Patient Preparation

    Make sure the patient is lying down and is comfortable. The patient’s arms and hands must  be relaxed. If the table is too narrow, place the patient’s hands under the buttocks to prevent muscle tension in the arms. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 71: Preparing The Skin

    Do not use alcohol to clean the skin because it dries the skin. If there is no time to follow the procedure above, rub the site with gauze to remove dead, dry skin and to increase capillary flow. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 72: Electrode Placement

    Left side of the sternum in the 4th intercostal space Midway between V2/C2 and V4/C4 Left midclavicular line in the 5th intercostal space Anterior axillary line at the same level as V4/C4 Left midaxillary line at the same level as V4/C4 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 73 Electrode Placement Figure 3-1 Male Standard 12-Lead Electrode Placement (AAMI/IEC) V2/C2 V3/C3 V1/C1 V4/C4 V5/C5 V6/C6 RA/R LA/L RL/N LL/F PageWriter TC20 Cardiograph Instructions for Use...
  • Page 74 Patient Preparation Figure 3-2 Female Standard 12-Lead Electrode Placement (AAMI/IEC) V2/C2 V3/C3 V1/C1 V4/C4 V5/C5 V6/C6 RA/R LA/L LL/F RL/N PageWriter TC20 Cardiograph Instructions for Use...
  • Page 75: Attaching Disposable Electrodes

    Special care is necessary when using Welsh Bulb electrodes. Pay special attention to all warning associated with these electrodes. For information on cleaning the reusable Welsh Bulb electrodes, see “Reusable Electrode Cleaning” on page 5-5. Philips recommends the use of disposable electrodes at all times with the PageWriter TC cardiograph.
  • Page 76 This electrode is used on the chest. The limb clamp electrodes are used on the arms and legs. Philips recommends the application of highly conductive multipurpose electrolyte gel to the electrode site whenever Welsh Bulb and limb clamp electrodes are used.
  • Page 77: Attaching The Patient Cable

    Electrode Cleaning” on page 5-5, to clean reusable electrodes after each use. Attaching the Patient Cable Each lead wire tip is labeled and color-coded for easy identification. To attach the patient cable: Attach each lead wire to the corresponding electrode.  PageWriter TC20 Cardiograph Instructions for Use 3-11...
  • Page 78: Using The On/standby Button

    (prior to entering Standby) appears. N O T E If the Disclose or Rhythm screens are viewed prior to entering Standby, the Main screen will appear when the cardiograph is returned to active use. 3-12 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 79: Entering Patient Information

    Patient information is entered under this tab. Fields in blue are required (if configured) and must be completed. N O T E A message appears if the ID screen is exited before completing the required patient information fields. PageWriter TC20 Cardiograph Instructions for Use 3-13...
  • Page 80: Selecting A Record From The Worklist

    (lower right corner of screen) to select the highlighted record for Select the current patient session. The Main screen appears with the patient information for the selected order appearing on the Status Bar (top of screen). 3-14 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 81: Searching For Orders/adt Updates

    Touch a record to select it. The selected record appears highlighted in blue. To select the highlighted record for the current patient session, touch the button (bottom of Select screen). N O T E Touch the Cancel button to exit the screen without saving the record. PageWriter TC20 Cardiograph Instructions for Use 3-15...
  • Page 82: Editing Id Information

    ( Finally, when using the Philips DXL ECG Algorithm, the cardiograph also detects the one of 20 lead reversals. After you press the ECG button, if detected, an alert message appears on the...
  • Page 83: Color-coded Waveforms

    Patient tremors, shivering  One or more limb leads are patient, inadequate  disconnected (chest leads preparation display in orange) Very poor electrode  contact, dry electrodes PageWriter TC20 Cardiograph Instructions for Use 3-17...
  • Page 84: Leads Map

    All 12 leads show discontinuities or RL or N (right leg) electrode or cable wire dashed lines All leads except I show LL or F (left leg) electrode or cable wire discontinuities or dashed lines 3-18 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 85: Identifying Ecg Problems

    Patient cable is too close to Move cardiograph away from the the cardiograph or other patient. Unplug the cardiograph and power cords. operate on battery only. Move other electrical equipment away from patient. Unplug electric bed. PageWriter TC20 Cardiograph Instructions for Use 3-19...
  • Page 86 Clean the electrode site. Reapply electrodes. electrodes. Check expiration date on disposable electrodes. Faulty patient cable. Replace faulty patient cable. Poor print quality (uneven Dirty printhead. Clean the printhead. contrast or blank streaks) Use recommended paper. 3-20 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 87: Urgent (stat) Ecgs

    In the split screen display, the limb and augmented leads  on the left, and the precordial leads are on the right See Figure 3-9 on page 3-22  PageWriter TC20 Cardiograph Instructions for Use 3-21...
  • Page 88 See Figure 3-10 on page 3-22  Figure 3-9 Default 6x2 Lead Format on Main Screen A Limb Leads B Precordial Leads Figure 3-10 3x4 Lead Format on Main Screen 3-22 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 89: Taking An Auto Ecg

    When the ECG button illuminates, it means that the ECG is ready to be taken. To take an Auto ECG: When the button is lit, press it to take an Auto ECG.  PageWriter TC20 Cardiograph Instructions for Use 3-23...
  • Page 90: Using The Preview Screen

    (cannot be selected), depending on how your cardiograph is configured. If the buttons are grayed out, your cardiograph is configured to automatically perform these functions. If the buttons do not appear, your cardiograph is not configured to support these functions. 3-24 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 91 Change the rhythm lead  Change the amount of interpretation that appears on the ECG  report The new settings are immediately applied. PageWriter TC20 Cardiograph Instructions for Use 3-25...
  • Page 92 ECG preview. Touch the button to print out the ECG report with the new Print interpretation applied. Page forward Touch to view additional pages of the displayed ECG report and page back button 3-26 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 93: Using The Last Ecg Feature On The Preview Screen

    When a previous patient ECG is printed at the cardiograph using the feature, a note Last ECG appears on the ECG report specifying that this is a previously recorded ECG. Figure 3-12 Previous ECG Watermark on ECG Report PageWriter TC20 Cardiograph Instructions for Use 3-27...
  • Page 94: Viewing Event Markers On The Preview Screen

    For information on capturing Events on the Main or Rhythm screens, see “Capturing Events from the Main or Rhythm Screens” on page 3-33. Figure 3-13 Event Marker Symbol on Preview Screen A Event Marker Symbol on ECG Report 3-28 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 95: Critical Values On Preview Screen

    The messages are triggered by a defined set of interpretive statements that are listed in Appendix B, “Critical Value Statements.” These warning statements include ACUTE MI VERY , and for the Philips DXL ECG Algorithm HIGH HEART RATE COMPLETE HEART BLOCK version PH100B, the statement is supported.
  • Page 96: Rhythm Ecg Acquisition

    The Unknown setting is recommended for most ECGs. Touch the button to close the window and to apply the settings. Touch the Cancel button to close the window and to discard the settings. 3-30 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 97: Special Note About Artifact Filter

    P waves, and the entire QRS-T complex. Only use the Artifact filter for ECGs that otherwise would be unreadable due to significant levels of muscle artifact. Figure 3-15 The Rhythm Screen with rhythm report printing Figure 3-16 Rhythm Toolbar with no report actively printing PageWriter TC20 Cardiograph Instructions for Use 3-31...
  • Page 98 This button only appears when no rhythm report is printing.  Rhythm Button Touch this button to resume printing a rhythm report.  This button only appears when no rhythm report is printing.  3-32 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 99: Disclose Ecg Acquisition

    Even though an Event scrolls off of the screen, it is saved for future review and processing. Wait 15 seconds after capturing an Event, and then touch the button to view Events. Disclose PageWriter TC20 Cardiograph Instructions for Use 3-33...
  • Page 100: Reviewing Events On The Disclose Screen

    ECG report The 12-lead ECG report is derived from the 10-seconds of data  that is captured inside the orange Focus box The new settings are immediately applied. 3-34 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 101 Tap anywhere on the timeline to move the orange shaded area  and to display different ECG waveform data on the screen. White upright lines in the timeline are saved Events.  PageWriter TC20 Cardiograph Instructions for Use 3-35...
  • Page 102: Using Timed Ecg

    A progress bar on the bottom of the screen provides a status update on the number of ECGs remaining, and the number of seconds remaining until the next ECG is taken. Touch button (bottom of screen) at any time to stop the Timed ECG protocol. Stop 3-36 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 103: Chapter 4. Reading The Printed Ecg Report

    With software version A.05.00, the appearance and location of fields on the ECG reports is changing as part of standardizing report formats across Philips devices. Note, however, that most of the fields and their definitions remain the same, with the addition of a few new fields (see “Report Information”...
  • Page 104 ECG report if more than four fields are configured. Figure 4-2 A 12-Lead 3x4, 1R Report (page two) Q Additional Patient Clinical Information Fields (page 4-8) Additional Configurable Clinical Information (page 4-11) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 105: Interpretive, Reason, And Severity Statements

    Interpretive, Reason, and Severity Statements This area of the report contains the interpretive, reason, and severity statements generated by the Philips 12-Lead, or Philips DXL ECG Algorithm. Figure 4-3 Interpretive, Reason, and Severity Statements on the ECG Report Interpretive Reason...
  • Page 106: Severity Statement

    Critical Values appear on the ECG report if specific interpretive statements are generated by the Philips DXL ECG Algorithm. These statements are intended to alert caregivers of an ongoing or imminent cardiac event, such as a silent MI, that require immediate clinical treatment.
  • Page 107 Acute Myocardial Infarction Statement on ECG Report Figure 4-5 Extreme Tachycardia Statement on ECG Report Extreme Tachycardia Statement on ECG Report Figure 4-6 Complete Heart Block Statement on ECG Report Complete Heart Block Statement on ECG Report PageWriter TC20 Cardiograph Instructions for Use...
  • Page 108: Basic Measurements

    For certain clinical situations, the Fridericia corrected QT interval may be preferable over Bazett’s, and this additional measurement may be configured to appear in the measurements section of the printed ECG report. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 109 PR interval milliseconds QRSD QRS duration milliseconds QT interval milliseconds QTcB Bazett’s Rate-Corrected QT interval milliseconds QTcF Fridericia Rate-Corrected QT interval milliseconds Frontal P axis degrees Frontal QRS axis degrees Frontal T axis degrees PageWriter TC20 Cardiograph Instructions for Use...
  • Page 110: Patient Id Clinical Information

    If more than two Patient ID Clinical Information fields are entered, the third and subsequent fields appear at the top of a second page of the report. Figure 4-10 Patient ID Clinical Information on the ECG Report (page two) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 111: Patient Id Information

    Patient name 70 Years Patient age (may be configured to display date of birth) Male Patient gender Race Patient ethnicity 247 lbs, 70 in. Patient weight and height BP: 133/90 Patient blood pressure (mm/Hg) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 112: Institution Information

    Room: 228 Room number of patient or room number where ECG was acquired Oper: Williams Operator identification Fac: West Campus (5) Name and ID number of facility or other unit within an institution 4-10 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 113: Configurable Clinical Information

    ECG report. The examples below are for informational purposes only. Figure 4-13 Configurable Clinical Information on the ECG Report (page one) Figure 4-14 Configurable Clinical Information on the ECG Report (page two) PageWriter TC20 Cardiograph Instructions for Use 4-11...
  • Page 114: Ecg Order Information

    Institution-defined order number, part of order management system. Enc: E-123 Institution-defined encounter number, part of order management system. Reason: Annual Physical The reason for acquiring the ECG, may be part of an order management system. 4-12 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 115: Physician Information

    NPI (National Provider Identifier) number in parenthesis. The NPI is only applicable to providers inside the United States. Figure 4-16 Physician Information on the ECG report PageWriter TC20 Cardiograph Instructions for Use 4-13...
  • Page 116: Report Information

    The ECG report is designated as STAT. Non-standard lead gains The limb leads or precordial leads were recorded at a gain  other than the standard 10mm/mV. See “Calibration Information” on page 4-15.  4-14 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 117: Calibration Information

    If the calibration pulse is stepped the precordial leads were recorded at half the scale  of the limb leads. Table 4-6 Calibration Pulse Shapes Calibration Pulse Shape Limb Precordial (mm/mV) (mm/mV) PageWriter TC20 Cardiograph Instructions for Use 4-15...
  • Page 118 For ECG recordings where the precordial leads or limb leads were recorded at a gain other than 10mm/mV, the statement Non-standard lead gains appears in the Report Information section on the printed report. Figure 4-19 Calibration information on the ECG report 4-16 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 119: Time Separator

    For example, on a 3x4 grid all signals start at 0 in the first column, 2.5 seconds in the second column, 5.0 seconds in the third column, and 7.5 seconds in the fourth column. PageWriter TC20 Cardiograph Instructions for Use 4-17...
  • Page 120: Pacing Detection Settings

    ECG report if Use this setting if there are false pacemaker  the Non-paced pulse detections from noise, or if incorrect setting is selected. interpretive statements or inappropriate paced ECG complexes appear on the report. 4-18 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 121 ECG ACQUIRED WITH  is printed on the ECG MAGNET IN PLACE report. This statement notifies the overreader that a magnet or programmer was used and would explain the fixed rate behavior of the pacer. PageWriter TC20 Cardiograph Instructions for Use 4-19...
  • Page 122: Algorithm Version Number

    Options are: No setting. Borderline suppression was disabled.  Shown as Exclude low certainty statements.  Shown as Exclude all borderline statements.  See Appendix A, “Suppressed Borderline Interpretive Statements.” 4-20 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 123: Filter Settings

    N O T E While all filters affect displayed and printed ECGs, the interpretive algorithms always receive, store, and analyze data at 0.05 to 150 Hz. Figure 4-24 Filter Information Box on the Printed ECG Report PageWriter TC20 Cardiograph Instructions for Use 4-21...
  • Page 124: Artifact Filter

    When the AC filter is used, the AC filter symbol is included in the filter information box at the lower right corner of the printed ECG report. Figure 4-26 AC Filter Symbol on Printed ECG Report 4-22 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 125: Frequency Response Filters

    0.05 Hz (recommended for normal use) eliminates baseline wander from most ECGs, additional suppression may be required. Enabling the baseline wander filter suppresses all frequencies below 0.5. Bailey JJ, Berson AS, Garson A, Horan LG, Macfarlane PW, Mortara DW, Zywietz C. “Recommendations for  Standardization and Specifications in Automated Electrocardiography: Bandwidth and Digital Signal  Processing.” Circulation 81:730‐739 (1990). PageWriter TC20 Cardiograph Instructions for Use 4-23...
  • Page 126: Speed And Sensitivity Settings

    The speed at which the ECG was printed  Available settings:  – 25mm/sec – 50 mm/sec Limb The limb lead sensitivity setting  Available settings:  – 5, 10, or 20 mm/mV 4-24 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 127: Device Identification Number

    Device Identification Number This identification number may be entered at the acquisition device. This number is used to identify the individual device that acquired the ECG. Figure 4-30 Device ID on the ECG Report PageWriter TC20 Cardiograph Instructions for Use 4-25...
  • Page 128: 12-lead Ecg Report Examples

    With software version A.05.00, the appearance and location of fields on the ECG reports is changing as part of standardizing report formats across Philips devices. Note, however, that most of the fields and their definitions remain the same, with the addition of a few new fields (see “Report Information”...
  • Page 129 Baseline Wander Filter Figure 4-31 3x4, 1R Report with Standard Leads PageWriter TC20 Cardiograph Instructions for Use 4-27...
  • Page 130 12-Lead ECG Report Examples Figure 4-32 3x4, 1R Report with Cabrera Leads and Simultaneous Acquisition 4-28 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 131 Baseline Wander Filter Figure 4-33 6x2 Report with Cabrera Leads PageWriter TC20 Cardiograph Instructions for Use 4-29...
  • Page 132 12-Lead ECG Report Examples Figure 4-34 12x1 Report with Cabrera Leads (page one) 4-30 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 133 Baseline Wander Filter Figure 4-35 12x1 Report with Cabrera Leads (page two) PageWriter TC20 Cardiograph Instructions for Use 4-31...
  • Page 134 12-Lead ECG Report Examples Figure 4-36 Panoramic (Pan-12) Report N O T E Leads are displayed in Cabrera sequence on the Panoramic (Pan-12) Report regardless of the selected lead standard on the acquisition device. 4-32 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 135: St Map Reports

    For the 3x4 1R 8ST report, if the ST value of a lead exceeds +/-.30mV, the value displayed for leads in the ST Map will not exceed +/-.30mV, regardless of their actual value. PageWriter TC20 Cardiograph Instructions for Use 4-33...
  • Page 136 ST Map Reports Figure 4-37 3x4 1R 8ST Report 4-34 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 137 12-Lead ST Map Reports Figure 4-38 3x4 1R 10ST Report PageWriter TC20 Cardiograph Instructions for Use 4-35...
  • Page 138: Rhythm Report

    Rhythm reports are not analyzed, so they do not provide measurement information or interpretive statements, and they are not saved to the Archive. The calibration pulse appears at the beginning of each ECG trace. 4-36 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 139 12-Lead ST Map Reports Figure 4-39 Rhythm Report with 6 Leads PageWriter TC20 Cardiograph Instructions for Use 4-37...
  • Page 140 Rhythm Report Figure 4-40 Rhythm Report with 12 Leads 4-38 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 141: 1-minute Disclose Report

    Disclose lead. Disclose reports are not analyzed, so they do not provide measurement information or interpretive statements, and they are not saved to the Archive. Each 10-second waveform segment on the report is labeled next to the lead name. Figure 4-41 1-Minute Disclose Report PageWriter TC20 Cardiograph Instructions for Use 4-39...
  • Page 142: Extended Measurements Report

    Extended Measurements Report The Extended Measurements Report summarizes the output of the Philips 12-Lead Algorithm version PH090A, or of the Philips DXL ECG Algorithm version PH100B. The report includes the morphology characteristics for the individual leads, and the rhythm characteristics for the rhythm groups.
  • Page 143: Cardiograph

    The following chapter contains information about basic cardiograph care, and periodic cardiograph maintenance that may be required. If further technical assistance is required, contact the nearest Philips Response Center or your certified dealer. Table 5-1 Recommended Frequency of Maintenance Tasks...
  • Page 144: Cardiograph Cleaning

    Ensure that the AC power indicator light (next to power button) is not lit. Wipe the external surfaces of the cardiograph with a soft cloth dampened in any of the approved cleaning solutions listed below. When cleaning, avoid the lead wire connectors and patient cable connectors. CAUTION PageWriter TC20 Cardiograph Instructions for Use...
  • Page 145: Approved Cleaning Solutions

    If the integrity of the patient cable is not assured, replace the patient cable. Contact Philips or your certified dealer for further assistance. WARNING Always clean and disinfect the patient cable after patient use, if the cable comes into direct contact with the patient’s skin.
  • Page 146: Approved Cleaning Solutions

    “Approved Cleaning Solutions” on page 5-4. Wring excess moisture from the cloth before cleaning. Do not: CAUTION Autoclave the patient cable or use ultrasonic cleaners  Immerse  Use abrasive materials  Wet the connectors  PageWriter TC20 Cardiograph Instructions for Use...
  • Page 147: Reusable Electrode Cleaning

    Cidex Ortho Phthaladehyde  Cetylcide  Vesphene 2 Aqueous Phenolic Germicidal Agent  Do not: CAUTION Use isopropyl alcohol  Autoclave the reusable electrodes or use ultrasonic cleaners  Use abrasive materials  PageWriter TC20 Cardiograph Instructions for Use...
  • Page 148: Cleaning The Print Head

    Cleaning the Print Head A Print head To clean the print head: Open the paper drawer. Wipe the print head lightly with a foam swab dipped in 90% alcohol. Allow the print head to dry. PageWriter TC20 Cardiograph Instructions for Use...
  • Page 149: Printer Paper

    Printer Paper Replace the printer paper when a red stripe appears on the printed ECG report. Only use Philips replacement printer paper. For part ordering information, see “Supplies, Options, and Ordering Information” on page 1-26. To change the printer paper: Open the paper drawer and remove any remaining sheets.
  • Page 150: Battery Maintenance And Care

    A Paper hold down bar Close the paper drawer. Battery Maintenance and Care The PageWriter TC20 cardiograph uses a removable lithium ion battery that supplies power to the cardiograph during mobile use, and powers the cardiograph printer while it is plugged into AC power.
  • Page 151: Replacing The Battery In The Tc20 Cardiograph

    Properly dispose of or recycle depleted batteries according to local regulations. Do not WARNING disassemble, puncture, or incinerate the disposed batteries. Carefully follow the instructions for replacing the battery. Only use batteries with Philips WARNING part number 989803170371. Before removing and replacing batteries from the cardiograph, press down and hold the On/ ...
  • Page 152: Battery Calibration

    N O T E Accessing the Service Utility may require entering a password. If a password is lost and cannot be retrieved, contact the Philips Response Center or your certified dealer for assistance. From the Service Utility screen, ensure that the...
  • Page 153: Ping Test

    The Configuration Setup and Service Setup Utilities menu appears. Touch . On the Default Cardiograph Settings Configure Cardiograph Default Settings screen, touch the button (upper right side of screen). Maintenance Test PageWriter TC20 Cardiograph Instructions for Use 5-11...
  • Page 154: Lead Wire Performance Test

    When the cardiograph has reached the end of its product life, dispose of it according to local ordinances. When any of the cardiograph accessories reach the end of their product life, dispose of these items in accordance with manufacturer instructions and local ordinances. 5-12 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 155: Maintaining The Touch Screen

    Wring excess moisture from the cloth. Wipe the touch screen area clean. Allow the touch screen to dry completely before use. Perform the Touch Screen Calibration test (see page 5-13) to optimize performance. PageWriter TC20 Cardiograph Instructions for Use 5-13...
  • Page 156: Changing The Date And Time

    N O T E Opening the Setup screens may require entering a password. If a password is lost and cannot be retrieved, call the Philips Response Center or your certified dealer for further assistance. To set the date and time: On the Archive or Setup screen, touch the date or time setting at the top of the display.
  • Page 157: Replacing The Cardiograph Fuse

    AC power on indicator light on cardiograph A AC power on indicator light Only use replacement AC fuses with Philips part number 453564131221, or use a 1.6 amp (250V) time-delay fuse the same size and configuration as the original fuse.
  • Page 158 Push on both ends of the fuse and pull out the fuse from the fuse holder slot. Insert the new fuse using the same orientation. Push the fuse all the way into the fuse holder slot. The fuse snaps into place. 5-16 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 159: Appendix A. Suppressed Borderline Interpretive Statements

    These statements often include the terms “minimal,” “consider,” or “borderline.” For more information on the Philips 12-lead Algorithm version PH090A, see the Philips 12- Lead Algorithm Physician’s Guide. For more information on the Philips DXL Algorithm version PH100B, see the Philips DXL ECG Algorithm Physician’s Guide.
  • Page 160: Philips 12-lead Algorithm Version Ph090a Exclude Low Certainty Suppressed Statements

    Philips 12-Lead Algorithm Version PH090A Exclude Low Certainty Suppressed Statements Philips 12-Lead Algorithm Version PH090A Exclude Low Certainty Suppressed Statements The following interpretive statements listed in Table A-1 are suppressed when the Exclude setting is selected under the button on the Setup, Default...
  • Page 161 SEALP ANT-LAT....ST >0.15 mV, I aVL V2-V6 ST ELEV, PROBABLY NORMAL VARIATION, ANT SEANP LEADS..ST>0.15mV, V2-V5 ST ELEVATION, PROBABLY NORMAL VARIATION, SEINP INF....ST>0.15mV, II III aVF BORDERLINE SHORT PR INTERVAL....PR int <** mS SPRB PageWriter TC20 Cardiograph Instructions for Use...
  • Page 162 Philips 12-Lead Algorithm Version PH090A Exclude Low Certainty Suppressed Statements Table A-1 Philips 12-Lead Algorithm Version PH090A Exclude Low Certainty - Suppressed Statements (continued) Statement Code Interpretive Statement BORDERLINE T WAVE ABNORMALITIES....T axis not TAXAB between (-10,100) BORDERLINE T WAVE ABNORMALITIES.....QRS-T axis...
  • Page 163: Philips 12-lead Algorithm Version Ph090a Exclude All Suppressed Statements

    Philips 12-Lead Algorithm Version PH090A Exclude All Suppressed Statements The interpretive statements listed in Table A-1, “Philips 12-Lead Algorithm Version PH090A Exclude Low Certainty - Suppressed Statements,” on page A-2, and the interpretive statements listed in Table A-2, “Philips 12-Lead Algorithm Version PH090A Exclude All Setting - Suppressed Statements,”...
  • Page 164 Philips 12-Lead Algorithm Version PH090A Exclude All Suppressed Statements Table A-2 Philips 12-Lead Algorithm Version PH090A Exclude All Setting - Suppressed Statements (continued) Statement Code Interpretive Statement IRBBB, THE RSR' PATTERN MAY ALSO REFLECT IRBBRV RVH..IRBBB, R or R' >0.5mV in V1-V3 BORDERLINE LATERAL Q WAVES..Q >35mS, I aVL V5 V6...
  • Page 165 HYPERTROPHY......S < ** mV in V5 CONSIDER RIGHT VENTRICULAR RVHS6 HYPERTROPHY......S < ** mV in V6 MINIMAL ST DEPRESSION, ANTEROLATERAL SD0AL LEADS....ST <-0.03mV, I aVL V2-V6 MINIMAL ST DEPRESSION, ANTERIOR SD0AN LEADS......ST <-0.03mV, V2-V4 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 166 Philips 12-Lead Algorithm Version PH090A Exclude All Suppressed Statements Table A-2 Philips 12-Lead Algorithm Version PH090A Exclude All Setting - Suppressed Statements (continued) Statement Code Interpretive Statement MINIMAL ST DEPRESSION, INFERIOR SD0IN LEADS....ST <-0.03mV, II III aVF MINIMAL ST DEPRESSION, LATERAL SD0LA LEADS....ST <-0.03mV, I aVL V5 V6...
  • Page 167: Philips Dxl Ecg Algorithm Version Ph100b Exclude Low Certainty Suppressed Statements

    No further rhythm analysis attempted due to paced rhythm NFRA Artifact in lead(s) ** and baseline wander in lead(s) ** QMAB Artifact in lead(s) ** QMART Baseline wander in lead(s) ** QMBW Borderline repolarization abnormality..ST dep & abnormal T REPB PageWriter TC20 Cardiograph Instructions for Use...
  • Page 168 Philips DXL ECG Algorithm Version PH100B Exclude Low Certainty Suppressed Statements Table A-3 Philips DXL ECG Algorithm Version PH100B Exclude Low Certainty - Suppressed Statements (continued) Statement Code Interpretive Statement RSR' in V1 or V2, probably normal variant..small R' only RSR1 RSR' in V1, normal variation..term-vector post-rightward...
  • Page 169: Philips Dxl Ecg Algorithm Version Ph100b Exclude All Suppressed Statements

    The interpretive statements listed in Table A-3, “Philips DXL ECG Algorithm Version PH100B Exclude Low Certainty - Suppressed Statements,” on page A-9, and the interpretive statements listed in Table A-4, “Philips DXL ECG Algorithm Version PH100B Exclude All Setting - Suppressed Statements,” on page A-11, are suppressed when the...
  • Page 170 Philips DXL ECG Algorithm Version PH100B Exclude All Suppressed Statements Table A-4 Philips DXL ECG Algorithm Version PH100B Exclude All Setting - Suppressed Statements (continued) Statement Code Interpretive Statement LVH by voltage......R >*.***mV in V5 or V6 LVHR56 LVH by voltage........R >*.***mV in V6 LVHR6 Consider left ventricular hypertrophy..RV6+SV1 >*.***mV...
  • Page 171 II III aVF Borderline T abnormalities, lateral leads.....T flat/neg, T0LA I aVL V5 V6 Borderline T wave abnormalities..T/QRS ratio < 1/20 or flat T T0NS Tall T waves, probably normal variant..T >1.2mV, age 16-30 TTW30 PageWriter TC20 Cardiograph Instructions for Use A-13...
  • Page 172 Philips DXL ECG Algorithm Version PH100B Exclude All Suppressed Statements A-14 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 173: Appendix B. Critical Value Statements

    Appendix A Introduction This Appendix includes a listing of all interpretive statements generated by the Philips 12- Lead Algorithm version PH090A, and by the Philips DXL ECG Algorithm version PH100B, that will result in a Critical Value statement appearing on the ECG report. Use of the Critical Values feature makes it simple to align with the Joint Commission’s National Patient Safety...
  • Page 174: Philips 12-lead Algorithm Version Ph090a Acute Myocardial Infarction Critical Value Statements

    Philips 12-Lead Algorithm Version PH090A Acute Myocardial Infarction Critical Value Statements Philips 12-Lead Algorithm Version PH090A Acute Myocardial Infarction Critical Value Statements If any of the interpretive statements listed in Table B-1 result from the measurements generated by an ECG, the Critical Value statement will appear on the ECG report.
  • Page 175 ST ELEVATION, PROBABLE ANTEROLATERAL INJURY PINJAL ST >0.15 mV, I aVL V2-V6 ST ELEVATION, PROBABLE INFERIOR INJURY PINJI inf ST>0.1 mV, lat ST<-0.05 mV ST ELEVATION, PROBABLE LATERAL INJURY PINJL ST >0.08 mV, I aVL V5 V6 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 176 Philips 12-Lead Algorithm Version PH090A Acute Myocardial Infarction Critical Value Statements Table B-1 Philips 12-Lead Algorithm Version PH090A Acute Myocardial Infarct Warning Statements (continued) Statement Code Interpretive Statement POSTERIOR INFARCT, ACUTE PMIA prominent R T, ST <-.05 V1-V4 PROBABLE POSTERIOR INFARCT, ACUTE PPMIA prominent R T, ST <-.05 V1-V3...
  • Page 177: Philips 12-lead Algorithm Version Ph090a Tachycardia Critical Value Statements

    Philips 12-Lead Algorithm Version PH090A Tachycardia Interpretive Statements Statement Code Interpretive Statement EXTREME TACHYCARDIA ETACH V-rate >(220-age) WIDE COMPLEX TACHYCARDIA TACHW V-rate>***, QRSd>*** EXTREME TACHYCARDIA WITH WIDE COMPLEX, NO VTACH FURTHER RHYTHM ANALYSIS ATTEMPTED PageWriter TC20 Cardiograph Instructions for Use...
  • Page 178: Philips 12-lead Algorithm Version Ph090a Complete Heart Block Critical Value Statements

    Philips 12-Lead Algorithm Version PH090A Complete Heart Block Critical Value Statements Philips 12-Lead Algorithm Version PH090A Complete Heart Block Critical Value Statements If any of the interpretive statements listed in Table B-3 result from the measurements generated by an ECG, the Critical Value statement...
  • Page 179: Philips Dxl Ecg Algorithm Version Ph100b Acute Myocardial Infarction Critical Value Statements

    Inferoposterior infarct, acute (LCx)..ST>.1 inf, <-.1 V1-3 or >.05 V7-9 IPMIAX Probable lateral infarct, acute....Q >28mS, ST>0.10mV, V5 V6 I aVL LMIAP Lateral infarct, possibly acute....Q >28mS, ST >0.10mV, V5 V6 I aVL LMIPA PageWriter TC20 Cardiograph Instructions for Use...
  • Page 180 Philips DXL ECG Algorithm Version PH100B Acute Myocardial Infarction Critical Value Statements Table B-4 Philips DXL ECG Algorithm Version PH100B Acute Myocardial Infarct Critical Value Statements (continued) Statement Interpretive Statement Code Lateral infarct, acute.........ST >.10mV, V5 V6 I aVL LMIA Lateral infarct, acute (LAD)......ST >.10mV, V5 V6 I aVL...
  • Page 181: Philips Dxl Ecg Algorithm Version Ph100b Tachycardia Critical Value Statements

    Philips DXL ECG Algorithm Version PH100B Tachycardia Critical Value Statements Statement Code Interpretive Statement Extreme tachycardia.........V-rate >(220-age) ETACH Wide-QRS tachycardia V-rate>***, QRSd>*** TACHW Extreme tachycardia with wide complex, no further rhythm VTACH analysis attempted PageWriter TC20 Cardiograph Instructions for Use...
  • Page 182: Philips Dxl Ecg Algorithm Version Ph100b Complete Heart Block Critical Value Statements

    Philips DXL ECG Algorithm Version PH100B Complete Heart Block Critical Value Statements Philips DXL ECG Algorithm Version PH100B Complete Heart Block Critical Value Statements If any of the interpretive statements listed in Table B-3 result from the measurements generated by an ECG, the Critical Value statement...
  • Page 183: Philips Dxl Ecg Algorithm Version Ph100b Acute Ischemia Critical Value Statements

    ECG report. Acute Ischemia Table B-7 Philips DXL ECG Algorithm Version PH100B Acute Ischemia Critical Value Statements Statement Code Interpretive Statement Repol abnrm, severe global ischemia (LM/3VD) LMMVD STe aVR, STd & Tneg, ant/lat/inf PageWriter TC20 Cardiograph Instructions for Use B-11...
  • Page 184 Philips DXL ECG Algorithm Version PH100B Acute Ischemia Critical Value Statements B-12 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 185: Specifications

    Specifications Appendix A Technical Specifications ECG Functions Simultaneous Lead Acquisition (up to 12 leads)  Rhythm Strips (up to 12 selected leads)  Event Marking: 6 independent events can be marked for later review and analysis  Full Disclosure: Five-minute history of up to 12 leads. Complete ECG of any 10 seconds. ...
  • Page 186: Signal Processing/acquisition

    The QRS wave must be a minimum of 100µV peak to peak or greater for the lead’s complex to be CAUTION measured. The operation of the cardiograph below this value may cause incorrect ECG analysis. Filters AC noise (50 or 60 Hz)  Baseline Wander  Artifact  PageWriter TC20 Cardiograph Instructions for Use...
  • Page 187: Printer

     STEMI Diagnostic Aids Polar ST Maps with frontal and transverse planes available on two ECG report formats  STEMI-CA criteria  Critical Values  Rhythm Report Formats Rhythm (up to 12 selected leads) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 188: Battery Operation

    Charge Current (mA)  Low battery audio and visual alerts  Recharge Four hours to >90% capacity, with the cardiograph turned off  Ethernet LAN Network Connection 10/100 Base-TX IEEE 802.3 Ethernet via on-board RJ45 connector PageWriter TC20 Cardiograph Instructions for Use...
  • Page 189: Barcode Reader (optional

    Orders: Up to 200 pending orders can be stored on the cardiograph  ADT: Full patient demographic information can be automatically retrieved  ECG File Formats XML (Schema 1.03 and 1.04, 1.04.01, 1.04.02)   PageWriter TC20 Cardiograph Instructions for Use...
  • Page 190: Power And Environment

    10% to 90% relative humidity (non-condensing)  Up to 4,550 m (15,000 ft.) altitude, 572 hPA  Cardiograph Dimensions 31 x 40.5 x 20.5 cm (12 x 16 x 8 inches) Cardiograph Weight <8.5 kg (19 lb) PageWriter TC20 Cardiograph Instructions for Use...
  • Page 191: Safety And Performance

    (Includes national differences for standards CAN/CSA-C22.2 No. 60601-2-51: 2004, EN 60601-2-51: 2003) IEC/EN 60601-1-2 2001: 2nd ed Electromagnetic compatibility- Requirements and tests  AAMI EC11: 1991 (R: 2001) Diagnostic Electrocardiographic Devices  PageWriter TC20 Cardiograph Instructions for Use...
  • Page 192: Classification (iec 60601-1

    It is the responsibility of the operator to comply with IEC 60601-1-1 and test the medical system according to the requirements. For additional information contact Philips. Electromagnetic Compatibility (EMC) Electronic devices can either generate or receive electromagnetic interference.
  • Page 193: Reducing Electromagnetic Interference

    TC20 cardiograph service and user documentation can result in increased emissions or decreased immunity of the system. The PageWriter TC20 cardiograph should not be used next to or stacked on top of other WARNING equipment. If you must stack the product, you must check that normal operation is possible in the necessary configuration before the product is used.
  • Page 194 Guidance and Manufacturer’s Declaration: Electromagnetic Immunity The PageWriter TC20 cardiograph is intended for use in the electromagnetic environment specified below. The customer or the user of the PageWriter TC20 cardiograph should assure that it is used in such an environment.
  • Page 195 Guidance and Manufacturer’s Declaration: Electromagnetic Immunity (continued) The PageWriter TC20 cardiograph is intended for use in the electromagnetic environment specified below. The customer or the user of the PageWriter TC20 cardiograph should assure that it is used in such an environment. Immunity Test...
  • Page 196 Guidance and Manufacturer’s Declaration: Electromagentic Immunity (continued) The PageWriter TC20 cardiograph is intended for use in the electromagnetic environment specified below. The customer or the user of the PageWriter TC20 cardiograph should assure that it is used in such an environment.
  • Page 197 Guidance and Manufacturer’s Declaration: Electromagentic Immunity (continued) The PageWriter TC20 cardiograph is intended for use in the electromagnetic environment specified below. The customer or the user of the PageWriter TC20 cardiograph should assure that it is used in such an environment.
  • Page 198: Wireless Lan Option Specifications

    The PageWriter TC20 cardiograph is intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the PageWriter TC20 cardiograph can help to prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the PageWriter TC20 cardiograph as recommended below, according to the maximum output power of the communications equipment.
  • Page 199 16-leads, attaching color clips to configurable clinical information 4-11 charging 1-12 leads 1-10 configuration installing 1-10 3x4, 1R report 4-1 with a Philips TraceMasterVue ECG Bazett’s formula rate-corrected QT cabrera leads and simultaneous Management System 2-2 interval 4-6 acquisition 4-28 configuration, with a Philips...
  • Page 200 OrderVue physician information 4-13 searching for orders on Patient ID report information 4-14 screen 3-15 speed and sensitivity settings 4-24 selecting order on cardiograph 3-14 STAT label 4-14 overreading 4-14 time separator 4-17 Index-2 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 201 A-1, B-1 R/T ECG, taking an Auto ECG 3-23 suppressed borderline interpretive reason statements 4-3 statements listing A-1 red dotted lines 3-17 version number on printed report 4-20 warning statements listed B-1 PageWriter TC20 Cardiograph Instructions for Use Index-3...
  • Page 202 CD 1-2 very high heart rate statement 4-4 waveform dotted red line 3-17 green 3-17 orange 3-17 yellow 3-17 waveform size and sensitivity settings on printed report 4-24 wireless LAN card specifications C-14 Index-4 PageWriter TC20 Cardiograph Instructions for Use...
  • Page 204 Philips Medical Systems 3000 Minuteman Road Andover, MA 01810 USA Printed in USA PageWriter TC20 Cardiograph Instructions For Use 453564267371 Edition 1 *453564267371* *Edition 1*...

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