Nexaris Angio-CT Artis System Operation Online Training

Welcome to the Artis System Basics Operation Online Training! This course serves as an introduction to basic operation of the ceiling-mounted Artis systems. The course includes information about the different controls modules, movements of the C-arm, and Programmed positions.   Upon successful completion of this course, you will be able to: Explain basic system operation procedures Identify the three main system control modules Describe the function of the multifunctional joystick, foot switches, and the hand switch Recognize the movements of the system C-arm Summarize how to store and move to Programmed Positions 1. Filter Joysticks - Pressing down on filter joysticks will clear all filters from the field of view 2. Collimation Joystick - Pressing down on the collimation joystick will clear only the collimation 3. Filter Selection - The Wedge/Finger filter button allows for the choice between wedge filters or finger filters 4. Home Filters & Collimation - Clears all filters and collimation 5. Zoom Stage Control - Allows for choice of zoom formats 7. Collimator Rotation - Manual Image rotation; Used to rotate collimator to adjust image on screen 1 2 3 4 5 6 6. Switch Over - Switches between the wedge and finger filter with Angio collimator only 7       Foot Switches The foot pedal is designed to make it easy to step from Fluoro to acquisition.  The functions of some of the pedals can be configured in the service mode. Also, depending on system type and room construction, even light switches can be configured into the pedal.     (1) Fluoro: This pedal is always used for Fluoro (2) Acquisition: This pedal is always used for acquisitions   (3) & (4) Options: This pedal may be configured for room lights, table brake, or other options depending on the system 2 1 3 4   Hand Switch: The hand switch is a standard feature for the angio systems.   Multi-Function Button: This button can control the Variable Frame Rate, manual PERIVISION, and manual Dyna CT/InSpace3D depending on the system and the mode of operation.   C-arm angulation RAO/LAO Angle of stand swivel Vertical axis SID (Source to image distance) Angle of table swivel vertical access Transverse table position Table tilt direction and degree Longitudinal table position Isocenter - tabletop distance C-arm angulation Cranial/Caudal Zoom format To reposition the C-arm, press the system position button on the Stand Control Module. Select the desired position by deflecting the joystick and pressing one or both of the function buttons. The C-arm can be driven to the desired position by pressing the dead man's switch and deflecting the joystick to the 12 o'clock position until the end position is reached.     Move the unit to the required position   Set the primary collimator and the filter diaphragms   Press the Store key The Programmed Positions menu appears on the Assist screen   Select the required memory position (number) by deflecting the stand/C-arm joystick away from you or towards you repeatedly   Press one or both buttons on the side of the stand/C-arm joystick   Select the target position Press the required position key The corresponding menu appears on the Assist screen   Select the required target position by deflecting the stand/C-arm joystick away from you or towards you repeatedly Confirm the target positions by pressing one (or both) side buttons   Moving to the target position Press the stand/C-arm joystick down and deflect it away from you (12 o'clock position) until the target position has been reached Or if hands free movement is configured: Press the configured hands free pedal on the footswitch   Storing System Positions with Shortcut (Direct I, II, III) Move the unit to the required position Press the store key The LED on the key lights up Press the required position key Moving to Direct Positions: Press the desired direct position Deflect the joystick to 12 o'clock until the end position is reached Select the required reference image Press the System Positions key The LED on the program key lights up The corresponding menu appears on the Assist screen Select Automap by deflecting the stand/C-arm joystick away from you or towards you repeatedly   Confirm the position by pressing one or both buttons on the side of the stand/C-arm joystick   Continue by using the standard procedure for moving to the target position   Press this icon on the touchscreen to display the reference image for the current system position The matching reference image is displayed If there is no reference image matching the current system position, a message will appear (1) (2) (3) (4) 1. Table - Table Control Module (TCM) 2. Stand/C-arm - Stand Control Module (SCM) 3. Collimator & Filter - Collimation Control (CCM) 4. Imaging system - Touchscreen Control (TSC)   No Movement: The currently set numeric values of the system positions are displayed below the symbols if necessary   Movement: If movement is in progress, only the values that are changing are displayed to facilitate operation   Collision: If a collision has occurred, a "navigation aid" is displayed instead of the current value If this icon appears , then a movement in the + direction will elimination the collision If this icon appears , then a movement in the - direction will eliminate the collision If this icon appears , then movement is not possible Disclaimer: Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. Please contact your local Siemens sales representative for the most current information. Functionalities described in the material or parts of this functionality may not yet be released for customers and not yet be commercially available in every country. Due to regulatory requirements, the future availability of said functionalities or parts thereof in any specific country is not guaranteed. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2018 Congratulations! You have completed the Artis System Operation Online Training course. Take some time to review the material covered in this course before proceeding to the final quiz. Explain basic system operation procedures Switching the System On – press the Power-On push button for more than 0.5 sec and then release the button. This button turns on the entire Artis system, which takes approximately 4-5 minutes Switching the System Off – select Options > End Session > Shut Down Do NOT switch off the main power, only use the Shut Down Option within the system software Resetting the Image System – press the small Reset button beside the Power-On switch to reset only the imaging system without rebooting the entire system Resetting the Stand – hold down the Direct Position Buttons I and II at the same time and push the STOP button to reset the stand and in-room components via the Stand Control Module Identify the three main system control modules Table Control Module (TCM) – used to adjust the tabletop position by pressing down the joystick and deflecting it to one side Collimator Control Module (CCM) – provides access to imaging parameters (including zoom, collimation, filtration, and image rotation) needed for Fluoroscopy and acquisition Stand Control Module (SCM) – used to store and recall System-, Programmed-, and Direct-Positions as well as change the orientation of the stand controls. Describe the function of the multifunctional joystick, foot switches and the hand switch Multifunctional Joystick – used to drive the C-arm, select and drive Pre-Programmed and System positions, and adjust the height of the FD lift (SID) Foot Switches – designed to easily switch between Fluoro and acquisition. Some of the pedals can be configured in the service mode Hand Switch – top button is used to release acquisition and back button has multiple functions depending on the system and mode of operation  Recognize the movements of the system C-arm Stand Longitudinal Movement Stand Swivel/Rotation C-arm Rotation C-arm Orbital Movement FD Lift Summarize how to store system positions Storing Programmed Positions – Move the unit to required position Set primary collimator and filter diaphragms Press the Store key Select required memory position number by deflecting the joystick Press one or both buttons on the side of the joystick Moving to Programmed Positions – Press the required Position Key Select required target position by deflecting the joystick away from and towards you repeatedly Confirm the target position by pressing one or both side buttons Press the joystick down and deflect it away from you (12 o’clock) until target position has been reached Storing Direct Positions – Move the unit to the required position Press the Store key Press the required Position Key Moving to Direct Positions – Press the desired Direct Position Key Deflect the joystick to 12 o’clock until the end position is reached Select the link to view/print the review material before proceeding to the final quiz. (1) Flat detector (FD) (2) Membrane keys (3) FD slide (4) C-arm (5) Telescopic C-arm slide (6) X-ray tube assembly with primary collimator (7) Ceiling rails   Movements of the Ceiling C-arm (1) Stand longitudinal movement (on ceiling rails) (2) Stand swivel/rotation (3) C-arm rotation (can/caud angulations) (4) C-arm orbital movement (RAO/LAO angulations) (5) FD lift All movements are motor-driven. (1) (2) (3) (4) (5) (6) (7) (1) (2) (5) (3) (4) With the Stand Control Module you can store and recall System-, Programmed-, and Direct-Positions as well as change the orientation of the stand controls.  Depending on the system type and purchased options, there are different system positions available with Artis. Stand Control Module Positions Learn about the Stand Control Module positions. Slide NumberText BlocksCalloutsAudio ScriptImage File1Stand/C-arm Control Joystick To get C-arm movement, first press down on the top of the joystick, and then deflect the joystick in the direction you want the C-arm to move.The joystick on the SCM controls the C-arm movement. To get C-arm movement, first press down on the top of the joystick (the dead man's switch) and then deflect the joystick in the direction that you want the C-arm to move. 2Programmed Positions Up to 50 Programmed Positions can be recalled using this button. To Recall a Programmed Position: Press the Programmed Position button Using the joystick, select the Programmed position from the Assist Screen and then press one or both of the Select buttons on the side of the joystick Press the Dead Man Switch and then deflect the joystick upwards/towards the 12 o'clock position until the position is reached Next, if you activate the Programmed position button again, the next programmed position in the list on the data display is highlighted automatically Up to 50 Programmed Positions can be recalled using this button. To Recall a Programmed Position... First, press the Programmed Position button. Then, using the joystick, select the Programmed position from the Assist Screen and then press one or both of the Select buttons on the side of the joystick. Next, press the Dead Man Switch and then deflect the joystick upwards or towards the 12 o'clock position until the position is reached. If you activate the Programmed position button again, the next programmed position in the list on the data display is highlighted automatically 3Store Control Storing positions makes it easy to recall an exact position at a later time. When setting up protocols for a particular type of exam, Programmed Positions can be a more efficient option. If you need different views during an intervention for example, the direct positions are more helpful. The system can store the following options: C-arm position Flat Detector position (SID) Zoom format Wedge/Finger Filter Placement Collimation Table height Storing positions makes it easy to recall an exact position at a later time. When setting up protocols for a particular type of exam, Programmed Positions can be a more efficient option. If you need different views during an intervention for example, the direct positions are more helpful. The system can store the following options: C-arm position, Flat Detector position, Zoom format, Wedge or Finger Filter Placement, Collimation, and Table height 4Orientation Button for Control Modules: The orientation key causes movements to be made in the same direction as the joystick of the respective control console is deflected. The orientation of the control console can be changed by pressing the key for more than 3 seconds. The LED light for the orientation of the controls should be on the side of the patient graphic where the controls are currently.The orientation key for control modules causes movements to be made in the same direction as the joystick of the respective control console is deflected. The orientation of the control console can be changed by pressing the key for more than 3 seconds. The LED light for the orientation of the controls should be on the side of the patient graphic where the controls are currently. For example, if the controls are mounted on the foot end of the table, the LED should be lit at the foot end of the patient graphic. This is important because it changes the direction of the C-arm and table joystick or servo movements.5Zero Stop: Pressing the Zero-Stop button allows the C-arm to stop whenever a 0 and a 90 degree position is reached.  For example when moving the C-arm from LAO to RAO, the C-arm would stop at 0 and 90 degrees. To move past 0 and 90 degree positions, the joystick must be released and re-engaged. If the button is not active, the C-arm will not stop on the 0 and 90 degree position.  Pressing the Zero-Stop button will allow the C-arm to stop whenever a 0 and a 90 degree position is reached. For example when moving the C-arm from LAO to RAO, the C-arm would stop at the 0 and 90 degree position. To move past 0 and 90 degree positions, the joystick must be released and re-engaged. If the button is not active, the C-arm will not stop on the 0 and 90 degree position.6Direct Position I, II, III Direct positions are a quick way to recall a previously stored position. To recall: Press the desired direct position Deflect the joystick to 12 o'clock position until the end position is reached Please note: By pressing the Direct I and Direct II Positions simultaneously, all collision protection devices are ignored. This will allow the system to be freed from a collision.Direct positions are a quick way to recall a previously stored position. To recall, Press the desired direct position. Then, deflect the joystick to the 12 o'clock position until the end position is reached. Please note: By pressing the Direct I and Direct II Positions simultaneously, all collision protection devices are ignored. This will allow the system to be freed from a collision. Multifunctional Joystick Learn about the multifunctional joystick. Element HTML   Dead Man's Switch The dead man's switch must be depressed in order to get C-arm movement   Function buttons Used to select a programmed or system position When making a selection, either one or both of the buttons can be pressed   Rocker Button For lifting and lowering the FD (setting the SID) Front (visible to the user)Back Sound File Audio ScriptThe multifunctional joystick is used to drive the C-arm. The joystick can select and drive the C-arm to pre-programmed and system positions, as well as to adjust the height of the FD lift (SID). You can achieve shortcuts to some of the system positions by using the function buttons while deflecting the joystick.  Please note that these shortcuts vary by system.     The system console consists of the following components: Monitors - LCD, Optional Cockpit Keyboard Mouse On box - within the On Box are USB ports and an integrated DVD RW The system console is used for patient administration, post processing and archiving. It is also used to switch the system on and off.   System On Learn about switching the system on. Element HTMLCentral Power On button for the entire Artis system Boot up time is approximately 4-5 minutes. Note:  Workplaces such as Sensis or syngo Workplace must be turned on separately. With the nexaris Angio-CT, the CT must be turned on separately as well. Power On LED Sound File Audio ScriptWhen switching the system on, make sure the on-site main switch is switched on and the emergency SHUTDOWN button is inactive. Then, press the power-on pushbutton on the system console for more than 0.5 seconds before releasing the button. The central Power On button will bring the entire Artis system up. Boot up time is approximately 4-5 minutes. Note: Workplaces such as Sensis or syngo Workplace must be turned on separately. With the nexaris Angio-CT, the CT must be switched on separately as well. System Off Learn about switching the system off. Element HTML The Log Off button will stop and restart syngo and the application.  Use this option if the mouse pointer stops reacting to movement.  This does not reset the imaging system.     The Shutdown process will take approximately 2-3 minutes. A normal shutdown process will begin after all the background jobs have finished. A forced shut down process will cancel the background jobs and shut the system off immediately. Never use the main Power Off switch to shut down the system.   Sound File Audio ScriptWhen turning the system off, it is important to always use the proper sequence of steps.  In the drop down menu at the top, select Options, then End Session and Shut Down. Note:  With all the Artis systems, do not switch off the main power.  Only use the shut down option within the system software.  If the main power is switched off, the Flat Panel Detector (FD) will cool down.  This might require a 2 hour wait time before turning on the system again.  Image quality is only guaranteed with a "warm" detector. System Reset Learn about resetting the image system. Element HTML The Image System Reset keeps the system power on.  Bypass Fluoro is still possible. Sound File Audio ScriptIf the imaging system is inoperable, you can reset the imaging system without rebooting the entire system by pressing the small Reset button beside the Power On switch. However, once the current case is completed, it is recommended to do a full system reboot. With an image system reset, the system power stays on and "BYPASS" Fluoro is still possible. Observe message at the Assist screen. Stand Reset Learn about resetting the stand. Element HTML Imaging is still possible during a Stand Reset.   Fluoro and acquisition are still possible. Sound File Audio ScriptYou can reset just the stand and in-room components via the Stand Control Module. While holding down direct position buttons 1 and 2 together, press the Emergency Stop button on the front of the SCM.  Once it has been pressed, wait a few seconds and then pull the Emergency Stop button out again. After just another few seconds, the stand will be available again. With a stand reset the imaging system stays completely on (Fluoro and acquisition is possible). The Artis Cockpit consolidates the system controls in one workplace in the control room. The Artis Cockpit displays and controls up to nine systems such as Artis, syngo X Workplace or Sensis with only one keyboard and one mouse on one medical grade display.   Cockpit Screen Layout Learn about the Cockpit screen layout. Element HTML Sound File Audio ScriptFour layouts can be configured and individually manipulated within the Cockpit screen. Additionally, multiple screens can be connected and moved in the Cockpit screen. The maximum number of visible screens is six and there are nine screens available for selection.   C-arm rotation (cran/caud angulations) Laser positioner light on/off C-arm Orbital Movement (RAO/LAO Angulations) FD rotation (setting portrait/landscape) Longitudinal Tabletop Movement with Stepping Table Longitudinal C-arm movement with Artis zee multi-purpose/Artis zee ceiling FD lifting and lowering - setting the SID The Table Control Module (TCM) has a joystick/panning that allows you to adjust the tabletop position by pressing down the joystick and deflecting it to one side. There are two different types of TCMs.   Table Control Modules (TCM) Learn about functions of the table control modules. Slide NumberText BlocksCalloutsAudio ScriptImage File1Raising and Lowering the Table Press the key for the required movement and keep it pressed until the required table height is reached The table height is changed immediately To raise and lower the table, press the key for the required movement and keep it pressed until the required table height is reached. The table height is changed immediately. 2Stopping in the isocenter Set the table height for the isocenter Press the Isocenter key The LED lights up The current table height is saved as isocenter height The table stops every time this position is reached If the table does not stop, press the Isocenter key again The ISO function is automatically deactivated when a new patient is registered To stop in the isocenter, set the table height for the isocenter and then press the Isocenter key. The LED lights up and the current table height is saved as isocenter height. The table stops every time this position is reached. If the table does not stop, press the Isocenter key again. The ISO function is automatically deactivated when a new patient is registered. 3Moving the Tabletop If continuous holding has been configured Press and hold the panning knob down Move the tabletop (floating movement) If continuous holding has been configured, press and hold the panning knob down. Then you are able to move the tabletop (using floating movement). 4Moving the tabletop longitudinally only Press the key for disabling lateral movement of the tabletop The LED lights up The tabletop can only be moved longitudinally when the brakes are released To enable tabletop movement in any direction once again: Press the key again  To move the tabletop longitudinally only, press the key for disabling lateral movement of the tabletop. The LED lights up. The tabletop can only be moved longitudinally when the brakes are released. To enable tabletop movement in any direction once again, press the key again. 5Table with Tilt Longitudinal Tilt (transverse axis) Tabletop can be tilted by +/- 15 degrees to the head-up position or head-down position Lateral Tilt (longitudinal axis) Tabletop can be tilted sideways by another +/- 15 degrees Press this key to activate lateral tilt The LED lights up Tilting the Table Press the key for the required movement and keep it pressed until the required table tilt is reached The table tilts in Trendelenburg or reverse Trendelenburg direction The tabletop tilts sideways if lateral tilt is activated Press both buttons simultaneously to return the table position back to zero   Now let's take a look at tables with tilt. If a tilting patient table is installed, the tabletop with the patient can be tilted longitudinally or along the transverse axis by ±15° to the head-up position which is the reverse Trendelenburg or head-down position which is the Trendelenburg. If the table with lateral tilt is installed, the tabletop with the patient can be tilted sideways by another ± 15° along the longitudinal axis. Press this key to activate lateral tilt. The LED lights up. To tilt the table, press the key for the required movement and keep it pressed until the required table tilt is reached◦The table tilts in the Trendelenburg or reverse Trendelenburg direction. The tabletop tilts sideways if lateral tilt is activated. If both buttons are pressed simultaneously, the table position returns back to zero. Different Table Control Modules Learn about the difference between the table control modules. TCM-M/S   TCM-J               Knob with Floating Tabletop Comes with or without Servo Assistance   Joystick on an additional control console