Multix Fusion Analog Turnover Workbook

SIEMENS SIEMENS Multix Fusion Multix Fusion Analog Turnover Workbook www.usa.siemens.com/healthcare Answers for life. Table of Contents Day One: System Overview . . . . . . . . . . . . . . . 4 Day Two: Performing Patient Exams . . . . . . . 18 Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . 19 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Contact Information Summary . . . . . . . . . . . 27 Introduction Purpose Learning Objectives The purpose of this training session is to provide After completing this training session, you will be able to: you with the skills and knowledge to operate • Correctly perform startup and shutdown procedures your system. • Identify the key hardware features of the Multix Fusion system Learning Materials • Describe the key features of the IT Touch generator • Make changes to default organ programs and create The following instructional materials are new organ programs referenced throughout this training session: • List the steps needed to perform a patient study System Owner Manual: Provides the necessary knowledge and expertise to accurately and safely operate the system. Training Workbook: Supports the Systems Owner Manual through “big picture concepts,” examples, stories, interactive exercises, and references to online documentation. This book is yours to keep so you can write in the book. Step-by-Steps: These documents provide quick reference tips to aid customers in “just-in-time” learning opportunities. 2 SIEMENS SIEMENS ........ [ ............. L 3 Day One Day One: System Overview Notes After this session, you will be able to: • Correctly perform start-up and shutdown procedures • Identify the key hardware features on the Multix Fusion system • Describe the four steps of the workflow • Program the IT Touch generator Switching On/Start-up • The Multix Fusion is turned on from the switched-off mode • The X-ray room and generator are switched on and off by the same switch Starting the system from the powered-down state • If the Multix Fusion has been switched off at the main circuit breaker, simply switch the main circuit breaker on, and then switch the power on at the control console. There is no X-ray tube warm-up required. Day One: Hardware Features Overview This section will discuss the key hardware features of the Multix Fusion. Tableside Controls Emergency Stop 0 • All system drives are shut down and movements are stopped immediately. Movements can only be resumed when Emergency Stop is cancelled. Emergency Stop Reset • Turn the Emergency Stop button clockwise and pull. System movements are now enabled. Multix Fusion 4 Day One Bucky Tray Notes • The bucky tray has a brake handle for positioning of the bucky tray for table exposures. • When inserting cassettes into the bucky tray, the laser light localizer must hit the axis mark of the cassette. This action will trigger automatic collimation. 0 PAY Ceiling-Mounted X-ray Tube Tube Movement Control Elements – Left Side Com Tube rotation about the vertical axis Tube vertical movement up and down – manual Tube movement up – motorized - Tube movement down – motorized - 5 Day One Tube Movement Control Elements – Right Side Notes Tube movement transverse – detents to table and wallstand (green LED) Tube movement longitudinal – SID detents to wallstand (green LED) Tube angulation – cranial and caudal to table and wallstand (CO) Tube movement transverse, longitudinal, and vertical. This function is also found as a rocker switch at the end of the tube handles on both sides. *Note: All tube movements, manual or motorized, are deadman functions. Releasing the button will stop the movement of the tube. Touch User Interface (TUI) (3) (1) 4 -135º 117 +2.0 H 102cm 8 KV H/U/D (2) + - T 1. Information field with icons 2. Control field with selectable buttons 3. Message field for system messages and “OK” status Information Field • System Mode – table, wallstand, or free exposure • Tube angulation – table, wallstand, or free exposure • SID – table and wallstand. System must be in grid and SID detent (wallstand) for value to be displayed. Red icon indicates conditions are not met so value cannot be calculated. 6 Day One • Wallstand Tracking – conditions for wallstand tracking: Notes Tube in grid and SID detent – Wall mode selected – Wallstand at 0º tilt – Cassette or detector inserted in wallstand – Tube angulation (none). Horizontal to wallstand – *Note: Tracking button on wallstand must be pressed and all conditions met for tracking to be active. A red tracking icon on the TUI means not all conditions for tracking are met or tube is “lost.” Control Field Control element disable function. If enabled, all tube, table, and wallstand controls (movements) are disabled. Top Alignment. When collimating top to bottom, the tube will move up to place the center of the X-ray beam higher on the cassette or detector. Very useful on smaller-chest patients. Conditions for top alignment • Wallstand tilt at 0º • Tube in grid and SID detents • No tube angulation – horizontal to wallstand • Image receptor size of 14 x 17, portrait only • 14 x 17 landscape is center alignment only Increase Value. Applies to kV, mAs, ms (exposure time), and density correction (for AEC exposures). + Function must first be selected before Increase Value is active. Decrease Value. Applies to kV, mAs, ms (exposure time), and density correction (for AEC exposures). - Function must first be selected before Decrease Value is active. Selection of small and large focal spots. 0/0 7 Day One Selection of dose (sensitivity) level. For AEC U Notes exposures only. It is recommended to use the “U” setting for standard dose exposures. H/U/D Density correction (for AEC only). Values range from -4 to +4, in 0.5 increments. +3 will double +2.0 density; -3 will reduce density by half. kV selector. Values range from 40 to 150 and are based on the Siemens exposure 117 point system. KV SID Tracking. Can be used on table or wallstand. Must be on detent to table or wallstand grid and have at least 85 cm SID to activate. HO SID Tracking. Can be used on table or wallstand. Must be on detent to table or wallstand grid and have at least 85 cm SID to activate. Message Field System will display a green check mark to indicate ready for exposure, or any system or error message. V STOP Generator Operating Elements One-Point Technique – for use with AEC only. 8 117 2.0 H 115cm KV H/U/D + 8 Day One Notes Two-Point Technique – Manual kV and mAs. V 117 23.7 115cm 8 KV MAS + - Three-Point Technique – Manual kV, mAs, and exposure time. Maximum exposure time is 5.0 seconds. V - HO 117 23.7 110 KV MAS ms glDo . A + - Message Field Bucky tray open. X-ray will be prevented. Cassette exposed (for table and wall bucky). X-ray will be prevented. Emergency Stop activated. All system movements are blocked. X-ray is possible. STOP SID on wall bucky undefined. X-ray is prevented. 1 ....... DO Undefined receptor (for table and wall bucky). Make sure cassette is centered in bucky tray. X-ray is prevented. 9 Day One Call Service. X-ray is possible. Notes Generator not ready. X-ray is prevented. Collimator Control Elements 0 (8) (7) (6) (5) M (9) (3) (4) F # 7+ (2) (10) (1) (11) 1. Rails for inserting collimator accessories 2. Collimator light localizer 3-4. Manual setting of height and width of collimator light field 5. Motorized selection of copper filtration 6. Display field. Copper filtration selection is shown here. 7. Memory button. Sets the last exposed collimated field. 8. Lever for rotating collimator. Limits are ± 45º. 9. Buttons for entering SID for free exposures 10. Tape measure for SID using free exposures Wallstand Cassettes can be inserted in portrait or landscape orientation. Utilize the cassette stop to support (D) all cassettes in the wallstand bucky (not needed with 14 x 17 portrait). Wallstand grids are color coded and the responsibility of selecting (E) and inserting the correct grid lies 40 with the radiographer. • Blue – 115 cm (45") • Pink – 150 cm (60") • Orange – 180 cm (72") 10 Day One Generator Console Notes The IT Touch generator console operates in 2 modes: Program and Manual. Program mode allows you to select an organ program based on body region. These organ programs are for the average-sized patient. Manual mode allows you to change the organ program settings for your current patient. The generator console touch screen is separated into 2 sections: the display field and control panel. Thorax lat 200123 DO 61 ( 1 ) HGy.m2 % HU 125 100 KV % DO Thorax pa Thorax lat 8 (2) - + Program Manual (1) Display field (2) Control panel The display field will show: • The organ program name • Exposure factors (kV, mA/mAs, exposure time) • Focal spot • Tube utilization (80% or 100%) 80 % • Dose area product (if configured) 12345 uGy.m2 • Exposure ready display 8 • Heat units display 61 %HU 11 Day One • Copper filtration utilized 2 0.3 Notes Cu • Acquisition mode DO • Door to the exam room is open • AEC selections (in AEC mode) • AEC density correction 0.5 The display field will show: • kV, mAs, and ms (exposure time) • Generator output (80% and 100%) • Focal spot (small and large) Cu • Film/screen combination (H, U, D) – configurable • AEC chamber selection • Copper filtration selection • Selection of 3-point technique mA (breathing technique) mAs • Creating or editing an organ program • Selection of acquisition mode DO 12 Day One Program Mode Notes Thorax lat 200123 61 %HU 125 100 KV % ILDO Thorax pa Do Thorax lat + Program Manual Program Mode allows the user to select an organ program from a particular body region. Selecting a body region will display the organ programs for that region. Selecting an organ program will display the technical factors for that organ program. These technical factors are for the average-sized patient. There are several pages of organ programs for each body region. Use the program page icon to view these additional pages. 1 Changing Technical Parameters If you wish to change the technical factors for an organ program in Program mode, simply select the organ program you wish to use, then select Manual mode. You can then change kV, mAs, switch from AEC to manual techniques, etc. You are only changing the technical factors for the current patient; you are not changing the default factors. To return to the original default factors, select Program mode and re-select the organ program you wish to use. Editing/Creating Organ Programs You can edit existing organ programs or create new ones. This is done from the Program mode. • From the Program mode, select the organ program you wish to edit • Press the pencil icon • This brings up the Program Editor Set Data page. Set the desired technical factors: kV – mAs (if using a manual technique) – focal spot size – AEC chambers (if using an AEC technique) – film/screen combination (if using an AEC technique) – density correction (if using an AEC technique) – acquisition mode – 13 Day One Once you have the desired factors set, press the Notes check mark to save, V or the X to discard and cancel. X If you press the check mark button, you are now directed to the Edit Program Name screen. Program Editor Edit Program Name X V Type in the organ program name. Use these keys for assistance: • Shift for upper/lower case of one character • Shift for upper/lower case of several characters • Return to start a new line • Backspace to delete a character • Move the cursor to the desired location Once the organ program name is completed, press the check 70 20 0.4 100 mark to store or the X to discard 8 Thorax ap Thorax lat and cancel. If you store, you are now directed to the Set Program Position screen Program Editor Set Program Position x 14 Day One Press the location where you want the organ Notes program to go (current location or a new one). To cancel and discard, press the X button. To store, press the memory button. You will now be directed back to the main Program page. Deleting an organ program To delete an organ program: • Select Program mode • Select the organ program you wish to delete • Press Delete. The Program Delete window appears • Confirm by again selecting Delete Cleaning and Disinfecting the Table and Wallstand • For cleaning, use water or a lukewarm diluted household cleaning agent • For disinfecting, use common surface disinfectants (aldehyde and/or amphotenic based) Cleaning and Disinfecting the Touch User Interface • Do not spray the Touch User Interface directly; wipe only with a soft cloth dampened with water 15 Day One Technical Data Sheet Notes Patient Table • Max. patient weight 300 kg • Table moving grid, 10:1, 115 cm focus Wallstand • Tiltable from -20º to +90º (tilting function is optional) • Wallstand moving grid, 10:1, 115 cm focus, 150 cm focus, 180 cm focus X-ray Generator • Output is 55 kw, 65 kw (optional), or 80 kw (optional) • kV range is 40 kV to 150 kV • mAs range is 0.5 mAs to 800 mAs • Exposure time range is 1 ms to 5000 ms X-ray Tube • Focal spots are 0.6 mm (small) and 1.0 mm (large) • Copper filtration – 0.1 mm, 0.2 mm, and 0.3 mm, motorized • Heat units – 783,000 HU capacity • Collimator rotation ± 45º IT Touch Generator • Organ programs selected by body region (7 body regions) • 12 organ programs per page • Maximum 15 pages per body region Accessories • Table handgrip (standard) • Wallstand overhead handgrip (standard) • Compression belt (optional) • Lateral cassette holder (optional) • Cassette holder without retainer (optional) • Grid holder (optional) • Compensation filters (optional) • BABIX holder (optional) • Table footswitch (optional) 16 Day One Day One Exercises Notes Day One Complete the following exercises: 1. Turn the system on/off 2. Perform table movements 3. Attach any accessories to the table or wallstand 4. Manually move the tube into transverse and longitudinal detents 5. On the Touch User Interface, change the kV and AEC and add 0.2 mm copper 6. On the wallstand, change out the grid 7. Adjust the vertical movements of the wallstand 8. On the IT Touch generator, select a thorax organ program and change the kV 9. Modify an organ program name and store the change 10. Create a new organ program and correctly store name, technical factors, and position 11. Delete an organ program and confirm the deletion 12. End session 17 Day Two Day Two: Performing Patient Exams Notes Objectives After this session, you will be able to: 1. Correctly select and manipulate organ programs 2. Perform patient exams 18 Troubleshooting System Movements and Functions Notes It is possible to disable system movements and functions by using the Disable function . Some points to remember are: • When not activated, the icon will have a blue diagonal line through it All system movements . should be possible . • When active, the icon will be backlit and have a reddish diagonal line through it All buttons on . the tube, wall bucky, and table are disabled and no system movement is possible . Top Alignment Top Alignment is designed to allow for the re-centering of the X-ray beam when you collimate top to bottom An example would be a smaller adult . or a child chest X-ray. When you collimate top to bottom, the X-ray beam automatically centers higher to place the center of the beam in the center of the thorax, not over the abdomen The more closely you . collimate top to bottom, the higher the beam center becomes. When this icon is active, it will be backlit. There are some conditions that must be met for Top Alignment to be active These are: . • The wall bucky is tilted to 0º (there is no tilt) • You must be on detent to the wall bucky and to the correct SID • The X-ray tube is angled at 90º (horizontal) • The image receptor size is 14x17" 14x17 portrait – OK - 14x17 landscape – receptor must be inserted - at the top of the bucky tray 14x17 landscape – if receptor is inserted in - the center of the bucky tray, Top Alignment is not possible • All other image receptor sizes – 10x12, 11x14, etc. can only be center aligned Top Alignment is . not possible . • If the Top Alignment icon appears grayed-out, then some of the conditions have not been fulfilled . 19 Troubleshooting SID Tracking Notes SID Tracking, or Source to Image Distance Tracking, allows the user to change the height of the bucky tray and have the tube follow to maintain the SID. This can be done at PH DO the table or wall bucky. When SID Tracking is active, the icon will be backlit. There are some conditions that must be met for SID Tracking to function: Wall Bucky • The wall bucky is tiltable and is tilted to 90º (horizontal) • X-ray tube must be detented in X and Y planes above tilted wall bucky • X-ray tube angulation must be 0º, ± 3º • SID must be greater than 33" • A cassette must be inserted into the wall bucky tray Table Bucky • The X-ray tube is in detent to the table bucky grid • X-ray tube angulation is 0º, ± 3º • SID must be greater than 33” • A cassette must be inserted into the wall table bucky tray If these conditions cannot be or have not been fulfilled when the SID Tracking button is pressed, then the icon will appear dark pink. This indicates that SID Tracking is lost. The function is active, but not all of the requirements for tracking have been met. Here are some things to look for when SID Tracking is lost: 1. If at the wall bucky, make sure the bucky is horizontal and not tilted 2. Make sure the X-ray tube is not angled more than 3º 3. If at the table bucky, make sure the table height is not too high or low, meaning the tube cannot maintain an SID greater than 33" When it comes to Top Alignment and SID Tracking, the optimal workflow is to fulfill all of the requirements for that function first, then activate the function with the icon. 20 Troubleshooting ACSS Notes ACSS is an acronym that stands for “Automatic Collimator Size Selection”. Simply put, this is automatic collimation. This means that, when active, you cannot collimate larger than your cassette size, but you can collimate smaller. ACSS has a condition that must be met for it to be active, and that condition is: • The cassette must be centered in the bucky tray (table or wall) Look for the mark on your cassette that shows where the center is along that edge, and make sure that mark lines up with the small indent on the spring mechanism in the bucky tray that secures the cassette in the tray. Then push the bucky tray all the way in. 1. When the cassette is properly inserted, ACSS will be displayed on the LCD display of the tube. This indicates that ACSS is active. 2. If you see “Manual” on the tube after pushing the bucky tray in, then ACSS is not active. This is usually a result of not having the cassette centered properly. *Note: You cannot make an exposure in the table or wall bucky if ACSS is not active. Re-centering the cassette should activate ACSS. Remember, ACSS only applies to exposures in the table and wall bucky. It does not apply to tabletop exposures. The Message Field The Message Field is the area of the Touch User Interface next to where the system green “Ready” field is displayed with the check mark, indicating an exposure can be made. HO 117 2.0 H 115cm H/U/D + - 21 Troubleshooting This is also the area where system error messages are displayed Notes STOP xxxº HBO 8 :17 +2.0 H xxxcm HJW/D + The various messages that may be displayed are as follows: 1. The bucky tray is open (table or wall). No exposure 2. The cassette has been exposed. No exposure 3. The Emergency Stop button has been activated STOF 4. The SID on the wall bucky is not defined (not in detent). No exposure 5. Undefined image receptor (cassette not centered). No exposure 6. Call Service 7. Generator not ready. No exposure Key Points 1. If there are more than 3 messages, only one will be displayed. 2. If there are 3 or fewer messages, all will be displayed. 22 Notes 23 Notes 24 Notes 25 Notes 26 Contact Information Summary Welcome to Siemens Healthcare Discover. Try. Buy. on webShop Siemens Healthcare is dedicated to helping you get Do you want to “Discover. Try. Buy.” options, accessories, the most out of your investment throughout the entire and clinical education to make the most of your product life cycle and beyond. Our goal is to enable imaging equipment? Discover images, case studies, you to take technology further, profitability higher and video demonstrations with the latest clinical and patient care to the next level. Find the information, applications. Try advanced applications utilizing resources and tools you need to get the most out free software trials. Buy applications, coils, clinical of your recent investment and stay up-to-date. education, and accessories, conveniently at any time. Visit www.usa.siemens.com/Welcome2Healthcare. Visit www.usa.siemens.com/webShop today! Clinical Training and Continuing Education UPTIME Clinical Application Support: Call 1-800-888-7436 • Troubleshooting assistance • Immediate assistance for software applications and workflow issues Please provide the Functional Location Number when calling for assistance. Clinical Education Offerings: Call 1-888-221-8010 (follow the prompts) • Classroom Training (Offerings, Registration & Scheduling) • Educational Symposia • Onsite Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Clinical Training and Continuing Education portfolio. Siemens Training Centers Siemens Clinical Education Training Center – TDC2 110 Mac Alyson Court Cary, NC 27511 Siemens Healthcare Training Center at the University of Utah 421 Wakara Way Suite 140 Salt Lake City, UT 84108 27 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications Local Contact Information and options as well as standard and optional Siemens Medical Solutions USA, Inc. features which do not always have to be 51 Valley Stream Parkway present in individual cases. Malvern, PA 19355-1406 Siemens reserves the right to modify the USA design, packaging, specifications and options Telephone: +1-888-826-9702 described herein without prior notice. Please www.usa.siemens.com/healthcare contact your local Siemens sales representative for the most current information. Global Business Unit Note: Any technical data contained in this Siemens AG document may vary within defined tolerances. Medical Solutions Original images always lose a certain amount Imaging & Therapy Systems of detail when reproduced. Angiography & Interventional X-ray Systems Siemensstr. 1 DE-91301 Forchheim Order No. A914CX-CS-122243-P1-4A00 Germany Printed in USA 09-2012 | All rights reserved Telephone: +49 9191 18-0 © 2012 Siemens Medical Solutions USA, Inc. www.siemens.com/healthcare Global Siemens Headquarters Global Siemens Healthcare Legal Manufacturer Siemens AG Headquarters Siemens AG Wittelsbacherplatz 2 Siemens AG Wittelsbacherplatz 2 80333 Muenchen Healthcare Sector DE-80333 Muenchen Germany Henkestrasse 127 Germany 91052 Erlangen Germany Telephone: +49 9131 84-0 www.siemens.com/healthcare www.siemens.com/healthcare