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After the patient has been "prepped" and the electrodes attached to the appropriate locations on the patient's body, start the CardioCard™ Software Suite by double clicking the "Heart" Icon on your desktop. Start the "Resting EKG" by clicking the "red heart" at the top toolbar. Once you see a good ECG and a good heart rate on the screen, you may save the ECG in one of two ways. You can depress the F3 key, which will store the next 12 second strip. You can also click the "12 second save Icon" at the top of the screen after 15 seconds or so. This will store the last 12 second strip. Either method will save a 12 second strip of the selected leads. If the ECG heart rate is significantly lower or higher than you expected, based on the ECG displayed, it is usually caused by an amplitude problem. If too low, the amplitude of the "Real time Analysis Lead" is likely too low. The remedy is to either increase the gain or select a different analysis lead by clicking "Options" then "Real-time Analysis Lead". If too high, the T-wave of the Analysis Lead is likely too high. The remedy is to lower the gain or increase the "R amplitude minimum" under the "options" menu. (the R amplitude minimum rejects any wave part smaller than the percentage set of the last known good R wave) The rule of thumb for good R wave detection is for the R wave amplitude to be positive and greater than 1.5 divisions (which is 1.5 large squares or 0.75 mV). Examples of normal ECGs, noise, baseline "wander", PVCs, Holter "Marks", etc. (Figure 13) Before you can successfully save the strip into the patient database, a record must be established for the patient either before the strip is saved or after the strip is saved. If you did not establish a patient record initially, you will be prompted when you hit the F3 or "12 second save Icon". In order to create a record, you need to put in the patient name (last, first), identification number or SS number (nine numeric digits), the patient's age (two numeric digits) and the patient's gender. Note 1: the CardioSuite™ has been installed using default values. By going into the "System Setup" screen (Figure 3) in the Appendix you are able to change the defaults to suit your needs: Demographics (first vs last), limits, print options, display options, leads displayed on screen, etc Note 2: after storing a strip, the system will ask you if you want to print Note 3: the "storing process" automatically puts you (the operator) in the database screen Note 4: during monitoring you can print (in real-time) by clicking the green and white printer icon Note 5: if System Setup does not have "full interpretations" selected, interpretation abbreviation definitions can be obtained (Figure 4)
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